melphalan and Mesonephroma

Poor survival rates of ovarian carcinoma have continued to be a cause of grave concern over decades and led to growing attention and alert in recent years. Promising results have already been recorded. More knowledge of important factors with relevance to prognosis has been helpful in unitising large-scale therapeutic studies for better comparability, a desire which had been unfulfilled in the past. Close interdisciplinary cooperation between gynaecologists, radiotherapists, and chemotherapists proved to be essential to optimum programmes of therapy. Persistent basic research for better understanding of biological behaviours of ovarian carcinomas and of so far unknown factors of prognosis and persistent efforts for earlier diagnosis of ovarian carcinoma are just as important. This is the only way to more effective control of the disease which still is, diagnostically and therapeutically, one of the major problems in gynaecology.

Topics: Carcinoma; Chlorambucil; Cyclophosphamide; Cystadenocarcinoma; Female; Humans; Melphalan; Mesonephroma; Neoplasm Staging; Ovarian Neoplasms; Prognosis; Thiotepa

In 1970, a prospective multidisciplinary protocol was initiated for Stages I through III obviously malignant ovarian epithelial carcinomas. The planned sequential therapy included 1) surgery, 2) radiotherapy (2000 rads to whole abdomen, 3000 rad boost to pelvis), 3) chemotherapy (ten cycles of Alkeran), and 4) a "second-look" surgical procedure. Ninety-six patients were enrolled in this program through 1976. Median follow-up of the survivors was greater than 44 months. Adjusted disease-free survival was 90 percent for Stage I, 64 percent for Stages IIB--IIC, and 16 percent for Stage III. Stage III patients with no palpable tumor at time of initiation of radiation therapy had a survival of 37 percent. No Stage III patient with palpable tumor at time of initiation of radiation therapy was cured. Eight percent of patients developed small bowel obstruction requiring surgical intervention. Three percent of all patients died of hematologic causes; of the 30-month-plus survivors, 5 percent (2 of 37) developed acute myelogenous leukemia. Cure and toxicity will be examined in detail and compared with the literature.

Topics: Adenocarcinoma; Adenocarcinoma, Mucinous; Female; Humans; Intestinal Obstruction; Melphalan; Mesonephroma; Neoplasm Recurrence, Local; Neoplasm Staging; Ovarian Neoplasms; Pilot Projects; Prospective Studies; Radiotherapy; Time Factors

We report the serum levels of carcinoembryonic antigen (CEA) in 109 patients with ovarian cancer. Histology, degree of differentiation, and clinical stage influenced the incidence of positive CEA. Although CEA was significantly raised in patients with a variety of tumours, the highest incidence (77 per cent) was found in those with serious cystadenocarcinoma. Nearly all (94 per cent) of the poorly differentiated tumours were associated with a positive CEA result. Serial CEA levels provided a useful guide to management during cytotoxic chemotherapy, rapidly falling levels indicating a favourable tumour response which was reflected clinically. However, only two-thirds of tumours were associated with detectable CEA levels in serum, day-to-day variations in individual serum levels occurred, and CEA levels tended to fall paradoxically during terminal illness. The significance of persistently low levels in the apparent absence of disease was uncertain.

Topics: Adenocarcinoma; Carcinoembryonic Antigen; Cystadenocarcinoma; Cystadenoma; Dysgerminoma; Endometriosis; Female; Follow-Up Studies; Granulosa Cell Tumor; Humans; Melphalan; Mesonephroma; Ovarian Neoplasms; Pregnancy

Topics: Antibody Formation; Antineoplastic Agents; Body Weight; Cyclophosphamide; Cystadenocarcinoma; Endometriosis; Erythrocyte Count; Female; Humans; Leukocyte Count; Melphalan; Mesonephroma; Middle Aged; Ovarian Neoplasms; Time Factors