George Baumgartner

Combination radical surgery and multiple sequential chemotherapy for the treatment of advanced carcinoma of the testis (stage III).

Nineteen patients with advanced testicular carcinomas (Stage III) were treated by a combination of multisequential chemotherapy with vinblastine, bleomycin, platinum, adriamycin, cytoxan, actinomycin D, and reductive surgery. Of the sixteen patients who were operated on 10 patients are alive and free of disease from 5 to 15 months. Two patients are alive with residual disease and four patients died. (Three were free of malignant tumor and one had residual malignant disease.) Three patients are still receiving preoperative chemotherapy. Pathology reported benign tumors in 8 out of 16 patients operated on. All these patients were previously treated with multiple chemotherapy. Several facts emerge from this study: (1) the great effectiveness of the combination of multisequential chemotherapy and reductive surgery to produce complete clinical remission in advanced testicular carcinomas (63.6%, 13 out of 19 patients); (2) the possibility of benign transformation of these tumors (50%, 8 out of 16); (3) the importance of the second‐look surgery in testicular tumors.

Chemotherapy of Advanced Carcinoma of the Prostate with 5-Fluorouracil, Cyclophosphamide and Adriamycin

There were 33 patients with clinically relapsing advanced prostatic carcinoma (stages C and D) treated by 2 different combinations of chemotherapy. The 13 patients in group 1 received 5-fluorouracil and cyclophosphamide and 20 patients in group 2 received adriamycin and cyclophosphamide. The over-all response was 69.3 per cent in group 1 and 65 per cent in group 2. Our preliminary results should encourage further evaluation of these drug combinations by other investigators under carefully controlled conditions.

Chemotherapy of Bladder Carcinoma with Cyclophosphamide and Adriamycin

We assigned 49 patients with transitional cell carcinoma of the bladder to 1 of 3 groups: 21 patients (group 1) received cyclophosphamide alone, 10 patients (group 2) received adriamycin alone and 18 patients (group 3) received cyclophosphamide and adriamycin. The objective responses were 52.3 per cent in group 1, 10 per cent in group 2 and 50 per cent in group 3. These results suggest a significant activity of the drugs (especially in groups 1 and 3) tested in bladder cancer.

Evaluation of Lymphangiography for Clinical Staging of Bladder Tumors

Preoperative lymphangiography was done on 18 patients with bladder cancer and the results were correlated with the surgicopathological findings at the time of radical cystectomy and pelvic lymph node dissection. Correlation between radiological and pathological findings showed no falsely negative results. One patient had a falsely positive interpretation of lymphangiography. The accuracy of the study was 94 per cent. Accurate interpretation of lymphography is related to the experience of the reader. Routine use of lymphangiography in clinical staging of bladder cancer is recommended.

Transitional cell carcinoma of ileal loop following cystectomy

This is the second case reported in the literature involving transitional cell carcinoma in an ileal loop. The case is described and the literature reviewed.

Nonhormonal chemotherapy for disseminated renal cell carcinoma

Twenty-five patients with disseminated renal cell carcinoma have been followed for eleven months. These patients have been treated with CCNU, bleomycin, methotrexate, and platinum in various combinations. The results have been discussed in light of other studies using chemotherapeutic agents against this disease process.

Neuroblastoma presenting as renal cell carcinoma in an adult.

A rare case of a fifty-six-year-old female with neuroblastoma is presented. Possible implications as to etiology are discussed, and the radiographic similarities between renal cell carcinoma and neuroblastoma are presented.

Preliminary reticulum cell sarcoma of prostate gland

A case of primary reticulum cell sarcoma of the prostate gland is presented. This is the seventh well-documented case we have found in the literature. No evidence of extraprostatic extension has been found two and a half years after diagnosis was made, despite no chemotherapy nor radiotherapy.

The value of palliative spinal surgery in metastatic urogenital tumors.

There were 22 patients with vertebral metastases and impending neurologic damage from prostatic, vesical and renal cell carcinoma treated by decompressive laminectomy combined with local radiotherapy and chemotherapy. The neurological recovery was complete in the prostatic carcinoma patients (10 of 10), partial in the vesical carcinoma patients (2 of 5) and unsatisfactory in the renal cell carcinoma patients (1 of 7).