Prognostische Bedeutung einer Diabeteserkrankung beim Endometriumkarzinom

Objective: The purposes of this study were to analyze the relationship between clinical and pathological risk factors in endometrial cancer and additional diabetes mellitus and to clarify the correlation between additional diabetes mellitus and survival of patients with this disease. - Material and methods: This analyze included 181 patients with endometrial carcinoma who were treated between 1985 and 1995 at the University hospital Mainz. Patients with sarcoma were excluded. For statistical analysis a Χ 2 -test was performed for univariat analysis. A Kaplan-Meier procedure was performed for over all survival and disease free interval and COX-Regression for multivariate analysis of independ…

Evaluation of c-erbB-2-oncogene expression as a prognostic factor in ovarian cancer

Release of non-neuronal acetylcholine from the human placenta: difference to neuronal acetylcholine

The synthesis and release of non-neuronal acetylcholine, a widely expressed signaling molecule, were investigated in the human placenta. This tissue is free of cholinergic neurons, i.e. a contamination of neuronal acetylcholine can be excluded. The villus showed a choline acetyltransferase (ChAT) activity of 0.65 nmol/mg protein per h and contained 500 nmol acetylcholine/g dry weight. In the absence of cholinesterase inhibitors the release of acetylcholine from isolated villus pieces amounted to 1.3 nmol/g wet weight per 10 min corresponding to a fractional release rate of 0.13% per min. The following substances did not significantly modify the release of acetylcholine: oxotremorine (1 micr…

Complexity of expression of intermediate filament proteins, including glial filament protein, in endometrial and ovarian adenocarcinomas

The expression patterns of intermediate filament proteins of primary and metastatic endometrial (n = 18) and ovarian (n = 24) adenocarcinomas were analyzed by immunocytochemistry using a panel of specific antibodies and by gel electrophoresis of cytoskeletal preparations, followed by immunoblotting. All cells of all endometrial adenocarcinomas studied contained the "simple epithelial"-type cytokeratins (CKs) 8, 18, and (mostly) 19, with variable numbers of cells also positive for CK 7 and vimentin. In addition, most of these tumors contained individual cells or groups of cells that were positive for the stratification-related CKs 4, 5, 6, 13, 14, and 17. The latter CKs were often associated…

Reconstructive surgery following resection of primary vulvar cancers.

Objective. This study describes the surgical treatment and follow-up of 213 patients with primary vulvar cancer; particular attention is given to reconstructive surgical procedures. Methods. The clinical and pathological parameters of the patients were recorded according to standardized procedures, and the data concerning type of operation, surgical reconstruction and postoperative course of disease (recurrence-free and overall survival) were analyzed. Results. In about one-third of the cases, plastic surgery reconstruction involving skin-flaps was performed. In the present group of patients, plastic surgery procedures led to an elevated degree of operability as well as to more satisfactory…

mdm2 mRNA expression is associated with survival in ovarian cancer

Expression of mdm-2 mRNA was measured in 90 ovarian-cancer tissue specimens using the S1 nuclease assay, to investigate a possible association between MDM2 expression and prognosis. mdm-2 mRNA expression was an independent prognostic factor for patients with primary ovarian cancer, FIGO (International Federation of Gynecology and Obstetrics) stages III and IV (n = 57), who all received chemotherapy with carboplatin or cisplatin and cyclophosphamide. Median survival time for patients (FIGO stages III and IV) with no detectable expression of mdm-2 mRNA (n = 14) was 171 days, as compared with 839 days for patients (n = 43) with detectable mdm-2 mRNA (p = 0.0194; log-rank test). However, no ass…

Prognostic significance of c-erB-2 mRNA in ovarian carcinoma.

The oncogene specific mRNA of c-erbB-2 was detected by the S1 nuclease protection assay in 95 ovarian cancer specimens. In 79 primary carcinomas, we found 16 (20%) with strong expression, 13 (17%) with weak expression, 4 (5%) with very weak expression, and 46 (58%) with no expression. In 3 of 16 recurrencies (19%) a strong expression of c-erbB-2 mRNA was detected, in 2 (12%) weak expression was detected, and in 11 (69%) no expression of c-erbB-2 mRNA was detected. Kaplan-Meier analysis revealed no significant association between strong expression of c-erbB-2 mRNA and survival of the 79 patients with primary cancer. However, in the subgroup of patients with FIGO (International Federation of …

345 Comparison of cisplatin and mitomycin/5-FU as radiosensitizers in the treatment of vulvar cancer – results of a single institutional cohort study

Introduction/Background* Treatment of vulvar cancer contains surgery if applicable and often primary or neo-/adjuvant chemoradiation. Cisplatin and Mitomycin/5-FU are widely used radiosensitizers in vulvar cancer, although evidence is limited. We retrospectively investigated both radiosensitizers for outcome and toxicity. Methodology We screened the archive for patients treated with chemoradiation for pathologically-confirmed squamous cell cancer of the vulva between 01/2010 – 02/2021 at our institution. The impact of both radiosensitizers on prognosis was compared using Kaplan-Meier method and Cox-Regression analysis. Result(s)* 127 patients with vulvar cancer were screened. 24 patients re…

Tumor Vascularity, Hypoxia, and Malignant Progression in Solid Neoplasms

Malignant progression designates the biologic process which transforms a phenotypically normal cell fixed and cooperating within a tissue into a disseminated therapy-resistant lethal disease. In clinical terms this process consists of three major steps (Fig. 1): () the transition from regulated to deregulated cell proliferation, () the emerging ability of the neoplastic cell collectives to induce angiogenesis and to invade other tissues, () the development of metastases and of resistance towards anti-tumor therapies.

Surgical therapy of recurrent vulvar cancer.

Objective The success of various surgical interventions in 201 cases with recurrent vulvar carcinoma was examined in the light of patients' pretreatment, surgical therapy, plastic reconstruction, and postoperative disease course. Study design A databank of standardized clinical data was analyzed using statistical procedures. Results Therapy was selected on an individual basis according to tumor status. Recurrence at a site distant from the primary tumor, particularly in the inguinal region, indicated a markedly unfavorable prognosis. In contrast, tumors recurring locally did not exhibit any significant differences. Plastic surgery reconstruction led to improvements with respect to operabili…

Wertigkeit der Abradathistologie von Endometriumkarzinomen

Objective: We compared immunohistological examination of endometrium biopsy specimen with the results of the immunohistological examination of tumor specimen to analyse the valence of this preoperative examination according to the clinico-pathological findings and overall-survival. Material and Method: Between 1985 and 1995 193 women were treated of an endometrial carcinoma at the University hospital Mainz. In this group we evaluated 41 patients with enough preoperative endometrial biopsy material for a retrospective immunohistochemical analysis and complete follow-up data. The materials from diagnostic curettage were stained and analysed for oestrogen and progesterone receptor status and f…

Aspekte der Rehabilitation

Ist die spezifische Antitumorbehandlung beendet, so schliesen sich fur die meisten Patientinnen Rehabilitationsmasnahmen an. Unter dem Uberbegriff Rehabilitation werden medizinische Leistungen, Wiedereingliederungsmasnahmen in den Beruf und soziale Rehabilitation zusammengefasst. Ziel ist es, dass die Betroffenen mit so wenigen Einschrankungen wie moglich in ihr gewohntes Leben zuruckkehren, zum Beispiel die eigene Wohnung benutzen und den Alltag ohne fremde Hilfe bewaltigen konnen. Der Bedarf an Masnahmen ist individuell sehr unterschiedlich und abhangig von multiplen Faktoren wie Allgemeinzustand pratherapeutisch, Alter, Grunderkrankungen und bereits bestehenden tumorbedingten Einschranku…

Plastische Rekonstruktion der Vulva

Die Therapie des Vulvakarzinoms erfolgt in der Regel durch eine operative Entfernung des Tumors und der Lymphknoten in der Inguinalregion. Je nach Lage, Grose und Ausdehnung des Tumors wird dieser durch eine lokale Resektion in sano, eine partielle oder komplette Vulvektomie reseziert. Ist der Wundverschluss nicht spannungsfrei moglich, ist eine Lappenplastik zum Wundverschluss erforderlich. Auch zur Verbesserung des funktionellen und/oder asthetischen Outcomes ist vor allem bei jungen Frauen haufig eine lokale Lappenplastik indiziert. In der Rezidivsituation oder bei extrem ausgedehnten Tumoren sind distante Lappen (z. B. vom Oberschenkel oder der Bauchdecke) notwendig, um diese grosen Def…

Perineal Excision of a Large Angiomyxoma in a Young Woman Following Magnetic Resonance and Angiographic Imaging

Abstract Background. Aggressive angiomyxomas are rare, arise from connective tissue of the perineum or the lower pelvis, and affect predominantly young women. Case. We describe an unusual case of aggressive angiomyxoma in which the perineal approach was possible owing to MRI scanning and selective angiography indications. Conclusion. In cases of large aggressive angiomyxomas these diagnostic procedures should make it possible to decide which operative route might be best for the patient.

Immunohistochemical Detection of Hormone Receptors in Breast Carcinomas (ER-ICA, PgR-ICA): Prognostic Usefulness and Comparison with the Biochemical Radioactive-Ligand-Binding Assay (DCC)

In a prospective study conducted since 1983, the hormone-receptor status of primary breast carcinomas was investigated using immunohistochemical (ER-ICA, PgR-ICA) and biochemical (DCC) methods. The degree of immunohistochemical staining was evaluated according to the immunoreactive score (IRS) devised by Remmele and Stegner [Frauenarzt 28, 41-43 (1987)]. The findings obtained using the biochemical radioactive-ligand-binding assay (cutoff level, 20 fmol/mg) and those obtained using qualitative immunohistochemical methods were in agreement in 72.5% (ER-ICA) and 72.2% (PgR-ICA) of cases. For the 789 cases of primary breast carcinoma examined, postoperative data were available for a mean follow…

Angiogenesis of cancer of the cervix. Contrast-enhanced dynamic MRT, histological quantification of capillary density and lymph system infiltration

Purpose: It was the aim of this project to examine (i) the relationships between contrast-enhanced dynamic MR imaging derived characteristics and histologic microvessel density counts – a recognized surrogate of tumor angiogenesis – from tumors in patients with primary or recurrent cancer of the uterine cervix, and (ii) to correlate these parameters with lymphatic involvement (i. e. lymphatic channels) to assess tumorbiological aggressiveness in terms of lymphatic spread. Materials and methods: Pharmacokinetic MR imaging parameters (amplitude A, exchange rate constant k 21) were derived from contrast-enhanced dynamic MR imaging in thirty-three patients with biopsy proven cancer of the uteri…

Usefulness of immunohistochemical staining for p53 in the prognosis of breast carcinomas: correlations with established prognosis parameters and with the proliferation marker, MIB-1.

Mutations of the p53 gene often result in the overexpression of p53 protein. Previous studies have suggested that the function of p53 and its mutant protein forms may be linked with the disease course of patients with a breast carcinoma. In the present study, we tested 462 primary breast carcinomas for the presence of p53 antigen using immunohistochemical methods employing antibodies against the clone, DO-1. These tumors were also immunohistochemically stained using the monoclonal antibody, MIB-1, in order to demonstrate the presence of Ki67. Comparison of the presence of p53 with other prognostic parameters revealed highly significant negative correlations with estrogen- and progesterone-r…

Tumor Vascularity—A Novel Prognostic Factor in Advanced Cervical Carcinoma

Objective: In the search for the optimal treatment of advanced cervical cancer, the identification of valid prognostic factors obtainable without histopathologic investigation of the entire tumor and the locoregional lymph nodes is of paramount interest. Tumor microvessel density has recently been demonstrated to correlate strongly with disease aggressiveness in breast cancer and other malignancies. Methods: We established a computerized image analysis system to quantify tumor microvascularity by using the closest-individual method, which determines the distribution of distances from random points within the tumor to the closest microvessel (DTCMV). Tumor microvascularity was assessed in pa…

Myoperitoneale Composite Flaps: Ein neues operatives Prinzip zur Vaginalrekonstruktion

In spite of the development of various techniques for the formation of a neovagina, the longterm results are often disappointing, especially if the simpler methods (dilation, ectopic pouch formation, epithelium transfer) have been applied. The more complex surgical techniques such as musculo/fasciocutaneous and colon flaps are associated with a significant risk of severe complications. For certain operative situations necessitating vaginal reconstruction, adequate procedures are still missing. Based on surgico-anatomic investigation of the vascular territories of the myoperitoneal anterior abdominal wall, we introduce the use of myoperitoneal composite flaps from the deep inferior epigastri…

Einfluß der Proliferationsrate auf den Krankheitsverlauf von nodalnegativen Mammakarzinomen

In 250 patients with node-negative breast cancer and no systemic adjuvant therapy the impact on the prognosis of the variables age, histological tumour type, tumour size, histological grade, receptor status and localisation of the tumour within the breast, was studied. Patients were followed over a mean period of 60 (range 7-164) months. In a subset of 124 cases additional examination of the growth fraction rate, detected by immunohistochemical determination of antibody Ki-67 and semiquantitative measurement of the stained tumour cell nuclei was performed. In 43 cases, measurement of S-phase fraction by flow cytometry was also performed. By univariate analysis, the histological tumour type …

Characterization of a Human Carcinosarcoma Cell Line of the Ovary Established after in Vivo Change of Histologic Differentiation

Abstract Objectives. Cell lines are valuable in vitro models for clinical and basic research. Most ovarian cancer cell lines described are serous cystadenocarcinomas or poorly differentiated adenocarcinomas. The establishment of ovarian cancer cell lines with rare histologic differentiation is especially of interest. We describe the establishment of a carcinosarcoma cell line of the ovary after in vivo selection. Methods. The cell line OV-MZ-22 was established from a solid tumor mass in the upper abdomen. At the time of establishment, the patient underwent secondary debulking and was pretreated with six cycles of cis -platinum/epirubicin/cyclophosphamide. Features of the cell line studied i…

Capacity of Gentamicin-Treated Pseudomonas aeruginosa to Induce Granulocyte Locomotion

In protection against an invading parasite the host’s granulocytes play an essential role. To exert their defense the phagocytes have to be attracted to the site of parasite invasion. We have shown that Pseudomonas aeruginosa ATCC 27853 and other clinical isolates of this species can induce granulocyte migration, either directly or via generation of chemotactic activity in serum [1].

Assessment of myometrial infiltration and preoperative staging by transvaginal ultrasound in patients with endometrial carcinoma

In recent years, the incidence of carcinoma of the endometrium has shown an upward trend, such that it is currently the most frequently encountered malignant tumor of the female genital tract. An accurate preoperative diagnosis of the extent and spread of such carcinomas is of crucial importance for the selection of a therapeutic approach appropriate to the stage and infiltration of each particular tumor. In a prospective study of 80 patients with a carcinoma of the endometrium, performed at the Department of Obstetrics and Gynecology of the University of Mainz, we compared the preoperative findings of transvaginal sonography with the postoperative histological results with respect to the f…

Reconstructive plastic surgery in the treatment of vulvar carcinomas

Abstract Objective The results obtained using plastic surgery reconstruction in 207 patients with a primary or recurrent vulvar carcinoma were analyzed with regard to the surgical procedures applied, pre-treatment and post-operative findings, along with the long-term oncological disease course. Study design Standardized data concerning the surgical procedures applied and clinical factors were collected in a databank and statistically analyzed. Results The flaps employed were termed either ‘local' (cutaneous or fasciocutaneous; n =84) or ‘regional' (myocutaneous, n =123). For local flaps, the rate of secondary healing was 31%, dropping to 20% for regional flaps. Such healing disturbances oft…

Invasives Karzinom der Vagina

Vaginalkarzinome gehoren zu den seltenen Tumoren (etwa 500 Falle pro Jahr in Deutschland). Risikofaktoren sind die HPV-Infektion, Immundepression, Nikotinabusus und HPV-assoziierte Vorerkrankungen der Cervix uteri und der Vulva. Als teilweise Primarpravention kann die HPV-Impfung gelten. Eine systematische Fruherkennung existiert angesichts der Seltenheit der Erkrankung nicht. Auffallige zytologische Befunde bei fehlender oder unauffalliger Zervix sollten zu einer intensivierten Untersuchung mit Inspektion und Kolposkopie veranlassen. Es handelt sich uberwiegend um Plattenepithelkarzinome. Die definitive Diagnostik erfolgt durch histologische Sicherung. Zum Staging werden erst in fortgeschr…

Cytokeratin and Vimentin Expression in Primary and Recurrent Carcinoma of the Vulva

Radical vulvectomy for the treatment of a vulvar carcinoma inevitably entails severe psychosexual consequences for the patients. Thus, for such tumors, reliable histological prognostic parameters are needed to allow; when appropriate, the use of less radical operative measures. One possible approach to this problem might be to examine tumors immunohistochemically for the presence of cytoskeletal components. To assess the utility of this method, we applied a panel of antibodies directed against cytokeratins (CKs) and vimentin to a groups of vulvar carcinomas (62 primary and 35 recurrent tumors) and examined the results for possible correlations with the course of disease and various clinical…

Prognostic Effect of Epithelial Cell Adhesion Molecule Overexpression in Untreated Node-Negative Breast Cancer

Abstract Purpose: Epithelial cell adhesion molecule (Ep-CAM) recently received increased attention not only as a prognostic factor in breast cancer but also as a potential target for immunotherapy. We examined Ep-CAM expression in 402 consecutive node-negative breast cancer patients with long-term follow-up not treated in the adjuvant setting. Experimental Design: Ep-CAM expression was evaluated by immunostaining. Its prognostic effect was estimated relative to overexpression/amplification of HER-2, histologic grade, tumor size, age, and hormone receptor expression. Results: Ep-CAM status was positive in 106 (26.4%) patients. In multivariate analysis, Ep-CAM status was associated with disea…

Immunohistochemical evaluation of growth fractions in human breast cancers using monoclonal antibody Ki-67.

We performed immunohistochemical analyses of 568 breast/cancer specimens using Ki-67, a monoclonal antibody specific for a nuclear antigen present in proliferating cells. The specimens were divided into three groups (I-III) according to the proportion of Ki-positive cells detected. These findings were compared with features of tumor extension as well as with certain prognostic variables. There was no detectable correlation between Ki-67 reactivity and either tumor size or node involvement. In contrast, a statistically significant correlation was found between Ki-67 reactivity and tumor grading, in that G-I tumors had small growth fractions, while a high proportion of G-III tumors exhibited …

Scientific Proceedings Second International Symposium on Cytostatic Drug Resistance

Glutathione, GlutathioneS-Transferase α and π, and Aldehyde Dehydrogenase Content in Relationship to Drug Resistance in Ovarian Cancer

Glutathione, glutathione S-transferases alpha and pi, and aldehyde dehydrogenase are associated with resistance to carboplatin and/or cyclophosphamide in cell lines. Therefore, we examined whether the expression of these factors in ovarian cancer tissue specimens is associated with resistance of the patients to combination chemotherapy with cyclophosphamide/carboplatin. Ovarian cancer tissue specimens were taken intraoperatively from 139 patients and frozen in liquid nitrogen, and the contents of glutathione S-transferases alpha and pi, total glutathione, and aldehyde dehydrogenase activity were determined. No association between the levels of glutathione S-transferases alpha and pi or alde…