Panniculectomy in conjunction with radical cystectomy in the obese patient.

Obesity in the abdominal area causes difficulty not only with the placement of an ileal conduit stoma and conduit length but also with surgical exposure during radical surgery to the pelvis. Such problems may be ameliorated by using a horizontal abdominal dermolipectomy in conjunction with a midline fascial and peritoneal incision and the Turnbull ileal stoma in selected obese patients. The advantages of this technique far outweigh the limited complications which may be encountered.

VAB-6 combination chemotherapy in resected stage II-B testis cancer.

Twenty-four patients with resected Stage II-B nonseminomatous germ cell tumors of the testis received adjuvant chemotherapy with the modified VAB-6 regimen for one year. Eighteen patients had nodal category N2B and six nodal category N3 (extranodal extension of tumor). Adjuvant VAB-6 started with two four day inductions at approximately four week intervals.

Adjuvant vinblastine, actinomycin D, bleomycin, cyclophosphamide and cis-platinum chemotherapy regimen with and without maintenance in patients with resected stage IIB testis cancer.

A total of 42 patients with stage IIB nonseminomatous germ cell tumors of the testis after orchiectomy and retroperitoneal lymph node dissection received adjuvant chemotherapy with the modified vinblastine, actinomycin D, bleomycin, cyclophosphamide and cis-platinum regimen. Of the patients 29 had N2B and 13 had N3 nodal categories. Adjuvant vinblastine, actinomycin D, bleomycin, cyclophosphamide and cis-platinum chemotherapy was given with maintenance in the first 24 patients and without maintenance (2 months of chemotherapy) in the subsequent 18.

An evaluation of automated flow cytometry (FCM) in detection of carcinoma in situ of the urinary bladder.

Among a series of more than 500 urologic patients studied by automated flow cytometry (FCM), there were 123 who proved to have carcinoma in situ of the urinary bladder. Eighty had flat carcinoma in situ and 43 had papilloma with foci of carcinoma in situ or diffuse noninvasive papillary carcinoma. Of those with papillary carcinomas and papilloma with carcinoma in situ, 88% were positive by FCM, as were 98% of the cases of flat carcinoma in situ.

Flow cytometry followup of patients with low stage bladder tumors.

A total of 98 urologic outpatients with a history of conservatively treated low stage bladder tumors underwent 325 examinations during a 2-year interval, each comprising conventional cytology, cystoscopy and automated flow cytometry. The flow cytometry results agreed with cystoscopic findings and conventional cytology in 80 per cent of the examinations, while cystoscopy and cytology agreed in 75 per cent. Assuming cystoscopic findings were entirely accurate, the false negative rate for flow cytometry was 8.

HLA antigens in patients with germ cell cancers of the testis.

The expression of HLA-A, -B, -C, and -DR antigens has been analyzed in 145 unrelated Caucasian patients with germ cell tumors of the testis. Eighteen of these patients had pure seminoma, while the remaining patients had nonseminomatous tumors with embryonal carcinoma, teratocarcinoma, choriocarcinoma, and/or yolk sac components, with or without seminoma. Increases were noted in the frequencies of Aw33, B5, DR5, and DRw6 among the patients with pure seminoma, A3 and B7 among the patients with embryonal carcinoma with or without seminoma, and Aw32 among the patients with yolk sac tumor components.

Flow cytometry of normal and nonneoplastic diseases of the bladder: an estimate of the false positive rate.

From July 1980 through February 1981, 100 patients with normal or nonneoplastic disease of the bladder were studied by flow cytometry. These patients had a variety of medical problems, including carcinoma of the prostate, benign prostatic hypertrophy, acute and chronic cystitis and carcinoma of other sites. The results showed that inflammation and cystitis affected flow cytometry analysis and could lead to false positive diagnoses under some circumstances.

Cyclophosphamide, methotrexate and 5-fluorouracil combination chemotherapy versus chloroethyl-cyclohexy-nitrosourea in the treatment of metastatic prostatic cancer.

In a prospective, randomized study the effect of cyclophosphamide, methotrexate and 5-fluorouracil combination chemotherapy was compared to the single agent, chloroethyl-cyclohexy-nitrosourea, in the treatment of hormonally refractive metastatic prostatic carcinoma. All patients could be evaluated and were followed for at least 2 years or until death. Responses were defined by the National Prostatic Cancer Project criteria.

Preoperative irradiation and cystectomy for bladder cancer.

Between 1971 and 1974, 101 patients at Memorial Sloan-Kettering Cancer Center underwent planned integrated treatment for bladder cancer with 2000 rads by megavoltage delivered to the whole pelvis over five consecutive days followed by radical cystectomy within a week. The overall five-year survival rate was 39%; the hospital mortality rate was 2%. In the pelvis alone tumor recurred in 9% of the patients.

Characterization of bladder papilloma by two-parameter DNA-RNA flow cytometry.

Two-parameter flow cytometry (FCM) studies of 0.9% NaCl solution bladder irrigation specimens were performed on 48 patients with histologically orderly or atypical papilloma of the urinary bladder in order to assess the value of RNA as a possible second parameter, along with DNA, in the detection of bladder tumors. DNA, RNA, and nuclear diameter measurements were obtained for each of 5000 cells/sample, and analyses were based on the distributions of those values.

Significance of prostatic biopsies after radiation therapy for carcinoma of the prostate.

The significance of a prostatic biopsy after radiation therapy for prostatic cancer is at present uncertain. Criteria for interpreting residual tumor cells as viable and, more important, determining whether such cells are biologically capable of local growth and/or subsequent dissemination, by histological evaluation, require further clinical correlation and studies designed to better characterize biological behavior and growth potential of neoplastic cells in general and how this may or may not be altered by irradiation. A positive biopsy after radiation therapy must be regarded, however, as ominous simply because its potential significance is yet to be determined.

Effects of estrogen administration on serum testosterone in Copenhagen rats.

In order to develop a standard experimental method of exogenous therapy in the Copenhagen rat, several treatment regimens were evaluated to determine their effect on the serum testosterone. Diethylstilbestrol diphosphate (DES-P) was administered either continuously in the drinking water or as a single intraperitoneal injection. Oral low-dose estrogen (0.

Effect of estrogen on the mixed lymphocyte reaction in normal individuals and prostatic cancer patients.

Lack of initial response or relapse to hormones in advanced prostatic cancer may be due to an adverse effect of estrogen on host immune function. This study investigated the effect of diethylstilbestrol diphosphate (DES-P) on the normal mixed lymphocyte reaction (MLR) and on the MLR in prostatic cancer patients before and during treatment with DES-P. These data showed that the normal MLR was suppressed by high concentrations of estrogen in vitro, but physiologic levels of DES-P were not suppressive.

Radiation-induced sarcoma following radiotherapy for testicular tumor.

We report 4 cases of soft tissue sarcoma following radiation therapy for testicular tumor. The tumors included leiomyosarcoma, fibroxanthosarcoma, reticulum cell sarcoma and spindle cell sarcoma. Each malignancy arose within the irradiated area after a long latent period (mean 12 years) and each was histologically proved.

Adherent suppressor cells in the blood of patients with bladder cancer.

Patients with advanced bladder cancer frequently show a low mixed lymphocyte reaction. Depressed mixed lymphocyte reactions may be augmented by removing adherent cells, which appear to be monocytes. Since cancer patients often have a larger proportion of monocytes than normal individuals they may have suppression simply because of an increase in the number of these cells.

VAB-6 combination chemotherapy in disseminated cancer of the testis.

Twenty-nine men with stage III or unresectable stage II malignant germ cell tumors and no previous chemotherapy received treatments with the VAB-6 protocol. The VAB-6 regimen is a 1-year program beginning with three successive inductions at 3-to-4-week intervals: day 1--cyclophosphamide, 600 mg/m of body surface area intravenously, bleomycin, 30 mg intravenously, dactinomycin, 1 mg/m2 intravenously, and vinblastine, 4 mg/m2 intravenously; days 1 through 3--bleomycin, 20 mg/m2 . d by continuous infusion; and day 4--cisplatin, 120 mg/m2 intravenously.

Combined chemotherapy and surgery in treatment of advanced germ-cell tumors.

Forty-eight selected patients with GCT who were suspected of having residual disease after two or three chemotherapy inductions underwent an attempt at resection of this residual tumor. In 37 patients all gross disease was resected: 11 had malignant tissue, eight adult teratoma, and 18 no residual neoplasm, and 9, 7 and 17, respectively, remain free of disease. Patients in whom complete resection was not possible generally did poorly.

Automated flow cytometry to monitor intravesical BCG therapy of superficial bladder cancer.

The automated flow cytometry system (FCM) at Memorial Sloan-Kettering Cancer Center has been used to monitor the effect of intravesical BCG in the therapy of superficial bladder cancer. Analysis of saline bladder washings prior to therapy, weekly during the six weeks of therapy, and at follow-up examination in 2 patients, 1 responder and 1 nonresponder, provides the basis for some projections regarding the potential value of this technique.

Androgen stimulated chemotherapy in the Dunning R-3327 prostatic adenocarcinoma.

This study was undertaken to determine whether hormonal stimulation followed by chemotherapy with a cell-cycle specific agent would improve the effectiveness of the chemotherapy in a prostatic adenocarcinoma model. One hundred Copenhagen rats were randomised into 5 equal groups and injected subcutaneously with 2 x 10(7) cells of Dunning G strain prostatic adenocarcinoma. The groups were treated in the following fashion: 1.