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Biomedical subjects

A Fabre

Publications and source records attributed to A Fabre.

At least 37 records · Page 2Linked to original sources
PubMed1988

[Inoperable cancers of the upper respiratory and digestive tracts. Value of chemotherapy: 185 cases].

A series of 185 squamous cell carcinomas of the head and neck was retrospectively analyzed. Induction chemotherapy was systematically administered. The overall tumour response rate was 38 per cent, and 39 tumours (22.4 per cent) became resectable after chemotherapy. The survival of complete responders was statistically higher than that of non or partial responders. Complete responders treated either by radiation therapy or surgery had similar survivals. Surgery improved the prognosis and reduced the rate of local and regional failures in non responders, including poor responders (less than 50 per cent).

Carcinoma, Squamous Cell↗
PubMed1988

[Chemotherapy and partial surgery in epithelioma of the pharyngo-larynx].

On the basis of a series of 185 patients, the authors evaluate the results of the therapeutic sequence chemotherapy-partial surgery in carcinomas of the pharyngolarynx. The action of chemotherapy is confirmed (80% clinical responses greater than 50%, 55% residual tumours or in complete histological regression). The therapeutic sequence chemotherapy-surgery gave 25% local failures and 1% lymph node failures. The development of the therapeutic strategy in carcinomas of the pharyngolarynx is considered in relation to the action of current modalities of chemotherapy.

Actuarial Analysis↗
PubMed1988

[Tumor and lymph node response to chemotherapy. Prognosis in cancer of the pyriform sinus and the lateral laryngeal margin].

The prognostic value of the tumoural and lymph node response to chemotherapy was studied in cancers of the piriform sinus and the lateral laryngeal margin. 102 operable patients were selected and were operated after chemotherapy. The incidence of loco-regional failures and visceral metastases was significantly higher in the absence of any lymph node response.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

[Pharyngo-esophageal diverticula. Treatment and results].

27 patients were seen in the ENT department of Hopital Laennec for pharyngo-oesophageal diverticulum between 1970 and 1987. 25 patients were operated: diverticulectomy in 14 cases, diverticulopexy in 10 cases. Cricopharyngeal myotomy was performed in every case. In one case, myotomy was the only treatment. The postoperative course and the functional results were analysed in the 3 groups. The operative indications are discussed. The functional results were excellent regardless of the technique used (95.8% in the present series).

Aged↗
PubMed1988

[Continuous ambulatory chemotherapy in cancer of the upper respiratory and digestive tract].

Chemotherapy of the upper respiratory and gastrointestinal tracts is currently based on Cis-platinum-5 FU administered by continuous infusions which, up until 1985, were performed in hospital during a 4 days admission. These infusions can now be administered on an outpatient basis over a period of 6 days. More than 600 patients have been treated in this way. The improvement in the results observed on a population of 86 operable patients confirms the value of prolonged continuous infusions. The clinical and psychological acceptability of this method, which allows the patient to maintain his autonomy and sometimes his occupation, is an important advance which could promote extension of this approach, particularly in view of its economic advantages.

Ambulatory Care↗
PubMed1988

[Hemipharyngolaryngectomies. Functional and carcinologic results].

A retrospective study of 260 hemilaryngopharyngectomies performed between 1964 and 1986 defines the functional and oncological results of these operations and the improvement in the oncological results and survival when neoadjuvant chemotherapy is used.

Actuarial Analysis↗
PubMed1988

[Vocal rehabilitation after total laryngectomy by musculomucous tracheo-esophageal fistula. Results apropos of 27 cases].

Twenty seven cases of Myomucosal Tracheoesophageal shunt following total laryngectomy performed at Laennec Hospital are presented. The surgical technique which was initially reported by M. Strome is summarized. The advantages of this procedure as compared to other tracheoesophageal fistulas are discussed. The first sixteen cases of this series failed: 12 stenoses occurred and 4 flaps necrosed. The eleven last Myomucosal shunts of this series are functioning. Aspiration was only problematic in one case. Six of the eleven functioning shunts have excellent voicing; three other patients are able to voice before completion of speech therapy and one patient has a too short follow-up for voice evaluation. The authors emphasize the contra-indications for the procedure. Medical conditions that can potentially lead to flap necrosis include: arteritis, diabetes mellitus, and gastrointestinal reflux.

Female↗
PubMed1988

[Partial surgery of epithelioma of the glottic area].

Technical aspects are described for partial vertical surgery used in 286 patients with epithelioma of vocal cords. Results and limitations are discussed and the place of partial vertical or partial supracricoid horizontal surgery with cricohyoidoepiglottopexy defined. Progress in therapeutic strategy is outlined and the value of induction chemotherapy emphasized.

Carcinoma↗
PubMed1988

[Esophagectomy and pharyngectomy in cancers of the upper respiratory and digestive tracts and the esophagus. Results apropos of 16 cases].

A series of 16 squamous cell carcinomas of the pharynx with an extension to the cervical esophagus, or multiple primaries of the pharynx and esophagus is presented. The surgical procedure consisted of an oesophagectomy associated with either total pharyngolaryngectomy, or partial pharyngectomy, or transmandibular resection. 13 patients received neo-adjuvant chemotherapy: CDDP-5-FU. Postoperative complications occurred in less than 20% without any postoperative death. One-year and five-year actuarial survival rates were respectively 20% and 13.3%. The mean survival was 9.5 +/- 3.7 months. 75% of the deaths were due to local or cervical lymph node recurrences. Neo-adjuvant chemotherapy could improve the prognosis of these pharyngo-oesophageal carcinomas.

Adult↗
PubMed1988

[Partial supracricoid laryngectomies: techniques, indications and results].

The authors present results of a retrospective study on 99 patients who underwent a partial supracricoid laryngectomy. Indications included carcinomas developed on the laryngeal vestibule, in the ventricle or at the glottic level. This represents an alternative to total laryngectomy. Surgical techniques and functional results are discussed. Ninety-eight percent of patients could be decanulated and a regular diet was possible in 94%. The survival rates are 76% after three years and 68% after five years. Local recurrences occurred in 3% of cases and cervical metastases were not controlled in 13%. The authors comment on indications for surgery according to the site of involvement. Contra-indications are massive invasion of the pre-epiglottic space, extension away from the superior aspect of the cricoid and arytenoid fixation.

Cricoid Cartilage↗
PubMed1987

[Ethmoidal adenocarcinoma surgically treated in one stage by transfacial and subfrontal approach after inductive chemotherapy. Preliminary results of a new therapeutic approach].

The authors present a new therapeutic protocol for ethmo++idal adenocarcinomas. It includes a pre-operative chemotherapy based on a four days continued infusion of cis-platinum and 5 F.U. (three cures with 3 weeks-intervals); it is followed by a carcinologic removal realized through a combined transfacial and intra-cranial approach. They discuss the interest of combined surgery which should allow a limitation of intra-cranial recurrencies. The intra-cranial extension must not be a limit to the removal even in case of dural, or even sub-dural extension. The reconstruction of the anterior basis of the skull has been simplified as much as possible: it has been performed either with a bone graft removed from the frontal flap inner table, or with a precut madreporic coral graft. In all cases, the dura has been doubled with a large shred of galea. They emphasize the efficiency of pre-operative chemotherapy. Eleven patients underwent such a protocol; two were operated in a recurrence, 9 in first hand. The preliminary results seem to be promising: the one year and two years actuarial survival rates are 84%.

Adenocarcinoma↗
PubMed1987

[Partial supracricoid laryngectomy. Technics, indications and results].

A series of one hundred and thirteen cases of supracricoid partial laryngectomy (SPCL) is presented with the description of the surgical technic. All the patients, previously untreated, were decanulated. The deglutition was eventually normal in 97.2% of those treated by SCPL with circo-hyoido-epiglottopexy (CHEP) and in 95.5% after SCPL with crico-hyoido-pexy (CHP). The carcinologic results are presented. The actuarial survival rate at 3 years was 86.5%, after SPCL with CHEP and 71.4% after SCPL with CHP. At 5 years the actuarial survival was 66.3% after SCPL with CHP. The surgical indications are discussed according to the tumor site: vestibular carcinomas should be treated by SCPL with CHP and glottic carcinomas by SCPL with CHEP. A tumor extension beyond the superior border of the cricoid cartilage precludes these surgical procedures.

Adult↗
PubMed1987

[Combined ORL and neurosurgical approach in adenocarcinoma of the ethmoid. Preliminary results apropos of 15 cases].

Fifteen cases of adenocarcinoma of the ethmoid sinus treated by a combined subfrontal and transfacial approach after induction chemotherapy are reported. The surgical technique is described precisely including a paralateronasal approach combined with a bifrontocoronal incision, a bilateral ethmoidectomy and reconstruction of the anterior base of the skull by one sheets taken-out from the inner surface of the frontal flap or more recently madreporic coralline grafts; the dura is hermetically sealed and it is lined with a large galea flap. Results were as following: one post-operative death, no clinical rhinorrhea, no recurrence from the anterior cerebral fossa, one orbital and one sphenoidal recurrences. Surgical indications are discussed according to the different extensions of the tumor and a frontal lobe extension is not a contraindication. This surgical procedure should be employed for the adenocarcinomas of the ethmoid invading the superior cells even in the absence of lysis of the cribriform plate in order to avoid the endocranial recurrences.

Adenocarcinoma↗
PubMed1986

[Induction chemotherapy in cancers of the respiratory and digestive tracts by continuous infusions combining cisplatinum (C), fluorouracil (F), bleomycin (B) or C and F].

A series of 344 patients with squamous cell carcinoma (oropharynx, larynx, hypopharynx, or buccal cavity) were treated between November 1982 and January 1985 by chemotherapy. This involved either cisplatinum (C) on day 1 followed by continuous infusion of 5-fluorouracil (F) and bleomycin (B) from day 1 to day 4 or C combined with F as continuous infusion from day 1 to day 4. Tumoral response was 61% and nodal response 61%. Among the 234 patients operated upon, 31 (13%) were free from tumoral cells in the specimen and 25 (48%) with residual tumor. Toxicity of cancer chemotherapy was markedly minimized with the second regimen involving continuous administration of Cisplatin over 24 hours for a period of 4 days. Tolerance was improved mainly in the digestive and renal spheres: cardiovascular complications related to essential hyperhydration during administration of single-dose Cisplatin on day 1 were non-existent with this new continuous mode of administration. This new procedure should optimize results and improve the comfort of patients.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

[Survival in cancers of the piriform sinus after induction chemotherapy].

285 cases of primary squamous cell carcinoma of pyriform sinus were treated by initial surgery completed by radiation. 242 patients received neo-adjuvant chemotherapy: Bleomycin as single agent (n = 95), Vincristine-Methotrexate-Bleomycin or Endoxan: 3 courses (n = 98), CDDP-Bleomycin, 5 FU or Methotrexate: 3 courses (n = 40). Chemotherapy was not administrated to 43 patients. Actuarial survival at 3 years without chemotherapy was 30%, after Bleomycin: 31%, VMB-VME: 47%, CMB-CFB: 61%. The 5-year survival without chemotherapy was 17%, with Bleomycin: 28%, with VMB-VME: 32%. Actuarial survival at 5-year including only deaths due to cancer was 13% without chemotherapy, 29% with Bleomycin and 39% with VMB-VME. This increasing of survival was directly related to improvement of locoregional prognosis.

Adult↗
PubMed1986

[Cancers of the soft palate. Apropos of 135 cases].

Results of treatment of 135 cases of squamous cell carcinoma of soft palate treated between 1962 and 1983 in the ORL department of Hôpital Laennec, Paris, showed prognosis to be related to 3 main factors. Firstly, the frequency of syndromes and metasynchronous multiple primary cancers. Secondly, the presence of local recurrences. Their frequency should be reduced by performing first intention excision of the tumoral site with wide extension to the anterior and particularly the posterior pillars, and by the routine use of induction chemotherapy. Thirdly, nodal recurrences that can be prevented by routine prophylactic treatment of bilateral cervical lymph chains.

Adult↗