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Biomedical subjects

B Castelain

Publications and source records attributed to B Castelain.

41 records · Page 3Linked to original sources
PubMedDate not supplied

[Endometrial cancer: what's new?].

OBJECTIVES: New and much debated data of the endometrial cancer concerning the preoperative assessment of myometrial invasion, the surgical staging, and the adjuvant treatment. PATIENTS AND METHODS: Medline (1998-2002): searching for "endometrial carcinoma". RESULTS: The pap smears are useful when it is difficult to have a transvaginal ultrasonography or an MRI. We can perform the pap smears and the endometrial biopsy in the clinic. If a patient has pap smears with malignant cells or elevated preoperative CA 125, it probably is a cancer with poor prognostic factors. Surgical staging with abdominal and node evaluation is necessary. The MRI seems to be the best preoperative imaging because we have information about adnexal and abdominal metastases, pelvic or aortic nodes and the invasion of the myometrium. So it gives us information on the surgical route, and provides indication for a lymphadenectomy. The surgical staging is a part of the treatment of the endometrial cancer: an exploration of the peritoneal cavity, a pelvic lymphadenectomy, a para-aortic lymphadenectomy if the pelvic nodes are positive or if there are factors of bad prognosis (deep stage IC, grade 3, adnexal or abdominal involvement, serous carcinoma of the endometrium). It can be performed if technical conditions are correct. The adjuvant teletherapy in the documented stage IpN0 (surgical staging with pelvic lymphadenectomy) does not seem to be necessary. But we can perform an adjuvant brachytherapy (high-dose rate if it is possible) in patients with a high local recurrence (stage IC, stage I with grade 3, stage IB grade 2). CONCLUSION: The preoperative MRI is useful choosing the surgical approach, and the depth of the myometrial invasion, which can be an indication for a pelvic lymphadenectomy. The surgical staging must be a part of the treatment of the endometrial cancer. So the adjuvant teletherapy in patients with stage IpN0 documented should not be used.

Adenocarcinoma↗
PubMedDate not supplied

[Treatment of pelvic lymph node involvement in early stage cervical cancer].

OBJECTIVES: Results of a retrospective paired study comparing the outcome of patients irradiated for lymph node involvement according to the method of node assessment: laparotomy or laparoscopy. MATERIAL AND METHODS: Twenty-six patients with cervical cancer managed by postoperative radiation therapy for pelvic node involvement during the Wertheim-Meigs operation (historical group) were compared to 26 patients in whom lymph node involvement was discovered at the time of laparoscopy and managed by definitive radiation therapy without hysterectomy (laparoscopy group). The patients were matched according to age, stage, tumor histology and tumoral volume. RESULTS: No difference was observed in the five-year survivals. Although it was not significant there were more grade 3-4 radio-induced complications in the historical group. CONCLUSIONS: The introduction of laparoscopy and the absence of hysterectomy did not impair the outcome of our patients. Laparoscopic lymphadenectomy reduces the risk of radio-induced adverse effects.

Adult↗
PubMedDate not supplied

[Celioscopic pelvic and para-aortic lymphadenectomy].

Because small volume lymph node metastases are difficult to recognize despite modern imaging techniques and since staging laparoscopy is costly and leads to important patient discomfort, pelvic then para-aortic lymph node endoscopic dissection has been introduced for staging gynaecological cancers. Since 1988, we have performed 110 pelvic and 17 para-aortic lymph node dissections using this technique. Pava-aortic endoscopic biopsy is indicated for advanced cancer of the cervix and subrenal biopsy for cancer of the ovary. Pelvic node dissection alone is useful in early stage cancers of the uterus and in cancers of the endometrium as well as in urological indications.

Adult↗