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Biomedical subjects

B Luboinski

Publications and source records attributed to B Luboinski.

At least 109 records · Page 6Linked to original sources
PubMed1989

Multiple synchronous and metachronous cancers of the upper aerodigestive tract: a nine-year study.

This retrospective study was based on 9,089 patients and includes 855 cases (9.4%) of multiple primary cancers treated between 1975 and 1983. Three hundred fifty (42.1%) of these multiple cancers were considered synchronous, while 480 (57.9%) were classified as metachronous. Fifty percent of the metachronous cancers occurred within 31 months after the first primary; the mean time between the first primary and the second primary was 45 months. Approximately 22% of second primaries were found more than 5 years after the initial tumor. Five-year survival rates were higher in metachronous cancers (55%) than in synchronous cancers (18%). Survival rates varied according to the treatment. In 49.4% of synchronous tumors the treatment had to be modified because of the presence of two cancers. In these patients, 5-year survival rates were as low as 8%. In synchronous cancers that required no modification of the treatment, the prognosis was better and the survival rate was 28%. The preferential anatomical location of the second synchronous and metachronous cancers is discussed for first primaries situated in the oral cavity (103 cases), the oropharynx (120 cases), the hypopharynx (92 cases), and the larynx (87 cases). Second primaries in the esophagus were mostly synchronous cancers while, in the lung, second cancers were more frequently metachronous tumors.

Age Factors↗
PubMed1989

[Clinical, anatomo-pathologic aspects and therapeutic results in 63 malignant ORL non-Hodgkin's lymphomas in children].

Sixty-three children with non Hodgkin's lymphoma involving the ENT zone (Waldeyer's ring) were treated between 1975 and 1985 at the Institut Gustave-Roussy. The tumors were localized in the cavum (32 cases), tonsils (16 cases), mandibles (9 cases) whereas 6 patients had more than one of these sites involved. At the time of diagnosis, 16 (25%) had neuro-meningeal involvement. Distribution, according to stages and histology was as follows: 4 stages I, 27 stages II, 12 stages III, 17 stages IV and 3 were unclassifiable. A Burkitt type of lymphoma was diagnosed in 37 (58%), a convoluted lymphoblastic type in 6 (10%) and 20 (32%) fell in a broad category of "other lymphoblastic variety" (32%). With regard to therapy, two consecutive time periods could be identified: from 1975 to 1980 all patients were given the same treatment and neuro-meningeal prophylaxis consisted of irradiation of the skull and intrathecal injections of methotrexate. Since 1981, the therapeutic regimen is designed according to the histo-immunological classification of the tumors and neuro-meningeal prophylaxis is carried out with the use of high dose methotrexate. With this new approach the survival rate has increased from 45 to 80% and the incidence of neuromeningeal relapses has decreased.

Adolescent↗
PubMed1989

[Secondary reconstruction of the mouth floor using a complete and prepared skin graft after non-interrupted pelvi-mandibulectomy].

A technique of secondary reconstruction of the buccal floor after non interruptive pelvimandibulectomy by thin-split graft enables insertion of a dental prosthesis to assist functional recovery. Results of 46 grafts of this type performed at the Institut Gustave Roussy, Villejuif, France, including 21 cases previously analysed in the Annales d'oto-laryngologie, Paris 1985.

Adult↗
PubMed1989

[ORL cancer in the child. Histologic and topographic distribution. Therapeutic indications (apropos of 380 IGR cases 1975-1987)].

Three-hundred and eighty cases of head and neck cancers in children, observed in the Pediatric Department of the Institut Gustave Roussy over a 12-year period are reported. The authors study the clinical presentation of these cancers (primary site and histological distribution) and consider the major prognostic factors. A brief reminder is then given of the therapeutic indications for the main tumors observed.

Child↗
PubMed1989

[Radiotherapy of cancer limited to the vocal cords].

197 patients, with an early glottic cancer, were heated with radiotherapy at the Institute Gustave Roussy, between 1970 and 1983. Radiation was delivered up to a dose of 65 Gy over 6 1/2 weeks on a small area centered on the glottic region. All patients had previously undergone direct laryngoscopy and showed T1 stage tumours (175 T1a and 22 T1b) although in 32 cases there was a suspicion of very limited involvement of the ventricle or sub-glottis. 5 year survival for the overall population was 77.5%. 38 local recurrences were observed, 1/4 of these occurring after 3 years. For the overall population, local control at 5 years was 85.7%. Suspicion of supra or sub-glottic involvement and the presence of impaired mobility of the larynx were shown to be important prognostic factors. Local control at 5 years was 90% for "true T1" cases. Few complications were observed and the functional results of irradiation were judged to be excellent.

Adult↗
PubMed1987

Combined treatment of cancer of the posterior oral cavity and oropharynx.

Ninety composite resections were carried out as primary treatment for a squamous carcinoma of the tonsillar region between 1970 and 1978. All patients have been followed-up for at least 3 years, except for 5 who have been lost to follow-up. All patients received postoperative radiotherapy (between 50 Gy and 65 Gy depending on the tumour resection status). Sixty-one patients received preoperative chemotherapy and 42% had clinical reduction of tumour size. The overall survival was 45.5% at 3 years and 43% at 5 years. Local recurrences were the most frequent oncological failure (25%). Tumours classed T3, insufficient tumour resection and lymph node invasion had poor prognostic value. We emphasize the necessity for primary surgery with preoperative chemotherapy and postoperative radiotherapy for squamous carcinoma of the posterior oral cavity and oropharynx.

Adult↗
PubMed1987

[Functional surgery in cancer of the laryngeal vestibule. Apropos of 149 cases treated at the Institut Gustave-Roussy].

Functional surgery for treatment of 149 cases of cancer of vestibule of larynx admitted to the Institut Gustave-Roussy, Paris, included 92 supraglottic horizontal laryngectomies and 57 reconstructive subtotal laryngectomies with crico-hyoidopexy. General selection criteria for performing subtotal laryngectomy were very strict: local criteria included tumor of vestibule with possible extension to ventricle, to an arytenoid cartilage or to the HTE space, and regional criteria, more particularly, required absence of any palpable gland or mobile gland of less than 2.5 cm. This rigorous selection explains excellent carcinologic results: 90.8% survival after 5 years following subtotal laryngectomy as against 37.9% after supraglottic horizontal laryngectomy, equivalent to a survival rate for all cases of cancer of vestibule of larynx treated by functional surgery of 65% at 3 years and 58% at 5 years.

Adult↗
PubMed1986

Synovial sarcoma of the head and neck: an account of four cases and review of the literature.

Four cases of Malignant Synovioma of the head and neck are reported. It is a rare tumour with only 76 published cases in the world literature. Study of these 76 cases allows identification of the clinical features of this tumour and also highlights the problems of histological diagnosis. The study shows that the most effective treatment is radical primary surgery in association with post-operative radiotherapy and chemotherapy.

Adolescent↗
PubMed1985

[Secondary reconstruction of the buccal floor by total skin graft after noninterruptive pelvimandibulectomy].

A technique of secondary reconstruction of the buccal floor after non-interruptive pelvimandibulectomy by thin-split skin graft enables insertion of a dental prosthesis to assist functional recovery. Results of 21 grafts of this type performed at the Institut Gustave Roussy, Villejuif, France are analyzed, this operative procedure enabling 14 of these patients to start taking solid food again.

Humans↗
PubMed1984

[Myocutaneous flaps in cervicofacial oncology. Results apropos of 87 patients].

Results are reported of the use of 93 musculocutaneous flaps, distinction being drawn between those used for secondary reconstruction and those employed during surgical excision. Secondary flaps were used to close 19 pharyngostomies, 10 orostomies, and 2 necrotic skin lesions, and for reconstruction of a circular pharyngectomy. Large radiation doses had been given in 29 of these 32 patients. Treatment was a total failure in 3 cases, and was partially ineffective in 5 patients, with the need for alternative surgery. Flaps obtained during initial surgery (57 cases) included 33 patients treated by radiation. Partial healing was obtained in 5 cases but the treatment was unsuccessful in 4 cases: all on previously radiated tissue. Unfavourable factors are mainly previous radiation and the hypopharyngeal site of loss of substance. Indications for the different types of flap are discussed.

Adult↗
PubMed1983

[Cancer of the cervical esophagus. 64 cases treated by radiotherapy. Evaluation and considerations].

Radiotherapy was applied in 64 of 88 cases of cervical esophagus cancer during the period 1968 to 1980. The lesions treated were 49 epitheliomas of the esophageal opening, excluding hypopharyngeal tumors extending into the esophagus, and 15 epitheliomas of the remaining cervical segment of the esophagus. Survival did not exceed 2 years in any patient, and the reasons for these poor results are investigated. These included the particular selection of patients, the choice of radiotherapy as basic treatment, and the dosage administered. A new therapeutic approach is proposed based on pathologic findings and the various therapeutic measures available. Preoperative chemotherapy is followed by a total laryngopharyngectomy, with a total esophagectomy without opening the thorax and under certain well defined conditions. Continuity is re-established by a gastropharyngostomy, and postoperative radiotherapy is given routinely. This very heavy therapeutic approach, is appropriate for selected patients only, other cases having, unfortunately, to make do with an association of radio and chemotherapy.

Carcinoma, Squamous Cell↗
PubMed1980

[The treatment by radiotherapy only of carcinomas of the margin of the larynx. Experience of the Institut Gustave-Roussy. 161 cases (author's transl)].

From 1955 to 1970, 161 squamous cell carcinomas of the épilarynx were treated at Institut Gustave-Roussy by radiation therapy alone. Most part of the patients were referred to radiotherapy for local extensions (21 cases), or medically poor conditions (73) forbiding surgery. Only 50 cases were really suitable to radiation therapy. Results are poor. 30% at 3 years, 15% at 5 years. Analysis of different groups (indications, size, of the tumor, nodes, mobility), gives a better appreciation of the possibility of radiation therapy. The results are in agreement with literature. Application of combination of surgery and radiotherapy permitted by improvement of anesthesia is probably better in same cases, but many of the patients with epilarynx are in so poor conditions, that besides patient suitable to radiation therapy (bulky tumors, type of epiglottis with normal mobility) many of the patients are in too poor conditions to receive surgery.

Aged↗
PubMed1979

Lymphoepitheliomas of the larynx (undifferentiated carcinomas of nasopharyngeal type).

Three cases of lymphoepitheliomas of the larynx are reported. This type of carcinoma--which occurs almost exclusively in nasopharynx--is very unfrequent in the larynx (0.2%). In the 3 cases, the tumors arose in a ventricular diverticulum which presented the same lymphoepithelial structure as the tonsils. Under such conditions, these lymphoepitheliomas, which have to be called 'undifferentiated carcinomas of nasopharyngeal type' are believed to develop from the lymphoepithelial tissue of the laryngocele.

Adult↗
PubMed1978

Relationship between laryngoceles and laryngeal carcinomas.

Because X-ray evaluation of the larynx is an unreliable method of detecting laryngoceles, a study based on the systematic measurement of the ventricular depth in surgical specimens was carried out to determine the frequency of laryngoceles and their relationship to laryngeal carcinomas. The frequency of laryngoceles was found to be about 2% in the normal larynx. The frequency in laryngeal cancer specimens was about 18%. This difference demonstrated the role of cancer in the genesis of laryngoceles. A close relationship between the ventricular diverticuli and the tumors was observed on microscopic examination in half of the laryngeal carcinomas associated with laryngoceles. These carcinomas can be considered to have developed on the laryngoceles. Depending upon the degree of tumor spread and the number of laryngoceles involved, different types of carcinoma developing in laryngoceles can be recognized. This particular form of tumor can be misinterpreted as an ulcerated vestibular tumor, in which case inappropriate treatment may be tried.

Carcinoma, Squamous Cell↗