The Experts below are selected from a list of 15 Experts worldwide ranked by ideXlab platform

Fiona C. Burkhard - One of the best experts on this subject based on the ideXlab platform.

  • IS THERE A CHANCE OF CURE FOR WOMEN WITH LOCALLY RECURRENT GYNECOLOGICAL MALIGNANCY AFTER EXENTERATIVE SURGERY AND URINARY DIVERSION
    The Journal of Urology, 2009
    Co-Authors: Martin Spahn, Christel Weiss, Pia Bader, Detlef Frohneberg, Urs E. Studer, Fiona C. Burkhard
    Abstract:

    INTRODUCTION AND OBJECTIVE: Locally recurrent gynecological malignancys generally have a poor prognosis and therapeutic optins are limited. We evaluated a series of women undergoing exenterative surgery and urinary diversion for gynecological malignancy. METHODS: All patients who underwent pelvic Exenteration for recurrent gynecological malignancy between 1989 and 2001 at Bern University Hospital or Karlsruhe Medical Center were evaluated. Variables assessed included time to recurrence, type of Exenteration and urinary diversion, pathological stage, postoperative complications and survival. Cox proportional hazard analysis and Kaplan-Meier survival method and subgroup analysis were performed. RESULTS: Initial therapy prior to recurrence in the 43 evaluated patients was surgery only in 19/43 (44%), in 16/43 (37%) patients surgery was combined with either radiation therapy (23%), chemotherapy (5%) or radio-chemotherapy (9%). Of the remaining 8 patients 5/43 (12%) underwent radiation therapy only and 3/43 (7%) underwent combined radio-chemotherapy. Anterior Exenteration was performed in 37 (86%) patients and total Exenteration in 6 (14%). Half of the women underwent additional procedures. A continent urinary diversion was constructed in 16 (4 ileal orthotopic bladder substitutes, 2 continent ileal reservoirs, 10 continent ileocecal reservoirs (Mainz-pouch I) and an ileal conduit in 27 patients. The majority of the early postoperative complications were minor and only 2 patients required additional surgical intervention. Four intestinal fistulas were succesfully treated conservatively. Late complications were mainly tumor related. Complication rates related to the urinary diversion were low and there was no difference in complications between continent and incontinent diversion. Overall disease specific 5 year survival rate after Exenteration was 33.9 %. This correlated significantly with surgical margin status. CONCLUSIONS: In patients with completely resectable (R0) recurrent cervical cancer of the Pelvis, Exenteration is a viable option with 5 year survival rates of approx. 43%. Continent urinary diversion did not show higher complication rates than an ileal conduit and should be considered an option even in irradiated patients. This may be of greater significance in younger patients where an intact body image may play an important role on quality of life.

Hongqian Guo - One of the best experts on this subject based on the ideXlab platform.

  • Advanced prostatic ductal carcinoma in a patient with a long survival time following a total Pelvis Exenteration: A case report
    Oncology Letters, 2016
    Co-Authors: Ming Zhou, Weidong Gan, Jinyu Zheng, Xiang Yan, Hongqian Guo
    Abstract:

    Ductal adenocarcinoma of the prostate (DAP) is a rare variant of prostate cancer, and has poorly-identified clinical characteristics. Few cases have been previously reported in Chinese males and DAP is more commonly reported in Caucasian males over 70-years of age. In the present study, a 55-year-old Chinese male patient that demonstrated typical lower urinary tract symptoms and normal prostatic-specific antigen levels underwent a transurethral resection of the prostate. The patient was subsequently diagnosed with DAP. A total Pelvis Exenteration was then conducted successfully. During the 40-month follow-up, the patient remained progression-free. A review of the literature was conducted in order to assess the clinical course, diagnosis, prognosis and optimal management for DAP. The review indicated that DAP is more likely to demonstrate an aggressive clinical course and an unfavorable prognosis; therefore, once the diagnosis has been confirmed, an aggressive management strategy is recommended for the patient, even in the case of metastatic disease.

Martin Spahn - One of the best experts on this subject based on the ideXlab platform.

  • IS THERE A CHANCE OF CURE FOR WOMEN WITH LOCALLY RECURRENT GYNECOLOGICAL MALIGNANCY AFTER EXENTERATIVE SURGERY AND URINARY DIVERSION
    The Journal of Urology, 2009
    Co-Authors: Martin Spahn, Christel Weiss, Pia Bader, Detlef Frohneberg, Urs E. Studer, Fiona C. Burkhard
    Abstract:

    INTRODUCTION AND OBJECTIVE: Locally recurrent gynecological malignancys generally have a poor prognosis and therapeutic optins are limited. We evaluated a series of women undergoing exenterative surgery and urinary diversion for gynecological malignancy. METHODS: All patients who underwent pelvic Exenteration for recurrent gynecological malignancy between 1989 and 2001 at Bern University Hospital or Karlsruhe Medical Center were evaluated. Variables assessed included time to recurrence, type of Exenteration and urinary diversion, pathological stage, postoperative complications and survival. Cox proportional hazard analysis and Kaplan-Meier survival method and subgroup analysis were performed. RESULTS: Initial therapy prior to recurrence in the 43 evaluated patients was surgery only in 19/43 (44%), in 16/43 (37%) patients surgery was combined with either radiation therapy (23%), chemotherapy (5%) or radio-chemotherapy (9%). Of the remaining 8 patients 5/43 (12%) underwent radiation therapy only and 3/43 (7%) underwent combined radio-chemotherapy. Anterior Exenteration was performed in 37 (86%) patients and total Exenteration in 6 (14%). Half of the women underwent additional procedures. A continent urinary diversion was constructed in 16 (4 ileal orthotopic bladder substitutes, 2 continent ileal reservoirs, 10 continent ileocecal reservoirs (Mainz-pouch I) and an ileal conduit in 27 patients. The majority of the early postoperative complications were minor and only 2 patients required additional surgical intervention. Four intestinal fistulas were succesfully treated conservatively. Late complications were mainly tumor related. Complication rates related to the urinary diversion were low and there was no difference in complications between continent and incontinent diversion. Overall disease specific 5 year survival rate after Exenteration was 33.9 %. This correlated significantly with surgical margin status. CONCLUSIONS: In patients with completely resectable (R0) recurrent cervical cancer of the Pelvis, Exenteration is a viable option with 5 year survival rates of approx. 43%. Continent urinary diversion did not show higher complication rates than an ileal conduit and should be considered an option even in irradiated patients. This may be of greater significance in younger patients where an intact body image may play an important role on quality of life.

Massimo Freschi - One of the best experts on this subject based on the ideXlab platform.

  • 18 IMPACT OF STAGE MIGRATION ON THE PREVALENCE OF PELVIC LYMPH NODE METASTASES IN PATIENTS UNDERGOING EXTENDED PELVIC LYMPH NODE DISSECTION FOR PROSTATE CANCER: A 23-YEAR SINGLE INSTITUTION EXPERIENCE
    European Urology Supplements, 2009
    Co-Authors: A. Briganti, N. Suardi, Andrea Gallina, Andrea Salonia, G. Zanni, Marco Bianchi, Niccolo Passoni, U. Capitanio, L. Da Pozzo, Massimo Freschi
    Abstract:

    INTRODUCTION AND OBJECTIVE: Locally recurrent gynecological malignancys generally have a poor prognosis and therapeutic optins are limited. We evaluated a series of women undergoing exenterative surgery and urinary diversion for gynecological malignancy. METHODS: All patients who underwent pelvic Exenteration for recurrent gynecological malignancy between 1989 and 2001 at Bern University Hospital or Karlsruhe Medical Center were evaluated. Variables assessed included time to recurrence, type of Exenteration and urinary diversion, pathological stage, postoperative complications and survival. Cox proportional hazard analysis and Kaplan-Meier survival method and subgroup analysis were performed. RESULTS: Initial therapy prior to recurrence in the 43 evaluated patients was surgery only in 19/43 (44%), in 16/43 (37%) patients surgery was combined with either radiation therapy (23%), chemotherapy (5%) or radio-chemotherapy (9%). Of the remaining 8 patients 5/43 (12%) underwent radiation therapy only and 3/43 (7%) underwent combined radio-chemotherapy. Anterior Exenteration was performed in 37 (86%) patients and total Exenteration in 6 (14%). Half of the women underwent additional procedures. A continent urinary diversion was constructed in 16 (4 ileal orthotopic bladder substitutes, 2 continent ileal reservoirs, 10 continent ileocecal reservoirs (Mainz-pouch I) and an ileal conduit in 27 patients. The majority of the early postoperative complications were minor and only 2 patients required additional surgical intervention. Four intestinal fistulas were succesfully treated conservatively. Late complications were mainly tumor related. Complication rates related to the urinary diversion were low and there was no difference in complications between continent and incontinent diversion. Overall disease specific 5 year survival rate after Exenteration was 33.9 %. This correlated significantly with surgical margin status. CONCLUSIONS: In patients with completely resectable (R0) recurrent cervical cancer of the Pelvis, Exenteration is a viable option with 5 year survival rates of approx. 43%. Continent urinary diversion did not show higher complication rates than an ileal conduit and should be considered an option even in irradiated patients. This may be of greater significance in younger patients where an intact body image may play an important role on quality of life.

Ming Zhou - One of the best experts on this subject based on the ideXlab platform.

  • Advanced prostatic ductal carcinoma in a patient with a long survival time following a total Pelvis Exenteration: A case report
    Oncology Letters, 2016
    Co-Authors: Ming Zhou, Weidong Gan, Jinyu Zheng, Xiang Yan, Hongqian Guo
    Abstract:

    Ductal adenocarcinoma of the prostate (DAP) is a rare variant of prostate cancer, and has poorly-identified clinical characteristics. Few cases have been previously reported in Chinese males and DAP is more commonly reported in Caucasian males over 70-years of age. In the present study, a 55-year-old Chinese male patient that demonstrated typical lower urinary tract symptoms and normal prostatic-specific antigen levels underwent a transurethral resection of the prostate. The patient was subsequently diagnosed with DAP. A total Pelvis Exenteration was then conducted successfully. During the 40-month follow-up, the patient remained progression-free. A review of the literature was conducted in order to assess the clinical course, diagnosis, prognosis and optimal management for DAP. The review indicated that DAP is more likely to demonstrate an aggressive clinical course and an unfavorable prognosis; therefore, once the diagnosis has been confirmed, an aggressive management strategy is recommended for the patient, even in the case of metastatic disease.