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C Bognel

Publications and source records attributed to C Bognel.

At least 55 records · Page 3Linked to original sources

[Anatomo-pathologic study of hepatic toxicity in intra-arterial hepatic chemotherapy].

Intra-arterial hepatic chemotherapy is effective in the treatment of colorectal or endocrine carcinomas liver metastasis. However it is potentially toxic for the healthy liver. To check this, we studied non tumoral liver specimens in 14 patients treated by intra-arterial chemotherapy with 5 fluorouracil, 5 fluoro-2 deoxyuridine and an association of 5 fluorouracil and streptozotocin. The main hepatic lesions observed were: sclerosing cholangitis, central vein (dilatation and fibrosis) and moderate hepatocellular necrosis or cholestasis in the centrolobular area. Thus intra-arterial hepatic chemotherapy has important toxic effects on healthy liver, even if clinical and biological liver disturbances are minimal in most cases. Caution must be exercised in using this method.

Adult↗

[Gastric adenocarcinoma surgically treated. A multivariate analysis of prognostic factors].

One hundred and twelve curatively resected gastric adenocarcinomas were studied retrospectively to appreciate the survival factors. Twenty different criteria (clinic, histologic and therapeutic parameters) were assessed using univariate and then multivariate analysis (semi parametric regression (COX's) model). Only three criteria were very important according to the multivariate analysis: 1) invasion of neighboring organs (p less than 0.006) with a relative risk score (RRS) of 4.26; 2) intravascular or intralymphatic tumor embols outside the tumor (p less than 0.004; RRS = 2.11); 3) invaded distal nodes (located at the origin of the vessels (p less than 0.04; RRS = 1.88). A prognosis index was described according to these results. A repartition of the patients in three prognostic groups according to these 3 criteria was proposed. Future, trials should consider these three different prognostic groups.

Adenocarcinoma↗

Squamous cell carcinoma of the anal canal: treatment by external beam irradiation.

External beam radiation therapy alone or in combination with curietherapy is the recommended treatment for anal canal carcinoma in some countries. In others, surgery is the sole accepted treatment. The results for 64 patients treated by external radiotherapy alone show excellent survival for stage T1T2 tumors but results are poor for large tumors (stage T4). The overall 5 year crude survival rate is 46%. The 5-year results are better for stage T1T2 (72%) than for stage T3T4 (35%). The presence of inguinal node involvement at first examination is a very poor prognostic sign. Local recurrences and metastases are infrequent for stage T1T2, but are more common for stage T3 and T4. Complications follow radiotherapy more frequently in those with stage T3 and T4 tumors. The analysis of local recurrences, complications and survival shows that radiation therapy may be sufficient treatment for stage T1 and T2 and for some stage T3 tumors. The importance of anal sphincter involvement and the poor quality of life for patients who are cured but develop complications, shows the need for combined treatment with surgery and perhaps with chemotherapy. For small tumors the results obtained by external radiotherapy alone are comparable with those obtained by external radiotherapy and curietherapy in terms of survival and complications.

Adult↗

[Surgical treatment of severe radiation injuries of the small intestine and colon-rectum. Apropos of 85 patients surgically-treated at the Gustave-Roussy Institute].

Radiation lesions of the small intestine, colon and rectum were treated surgically in 85 patients between 1970 and 1983. These were serious complications in all cases involving the short-term vital prognosis in patients lacking signs of recurrence of cancer for which they had received radiotherapy. Immediate operative mortality was 26%. Anastomotic digestive fistulae complicated 31% of resection-anastomosis and 29% of internal bypass operations. During the next 2 years the progression of the chronic radiation lesions themselves required repeat operations due to further complications in 19% of patients, with an operative mortality of 33%. Rather than comparing efficacy of resection-anastomosis with that of internal bypass procedures they should be considered as complementary, since they have different indications. Based on the analysis of results and acquired experience, a surgical strategy is proposed for treating complicated radiation lesions of the intestines.

Adolescent↗

[Cancers of the rectum: predictive factors in locoregional recurrence. Multifactorial study].

Local recurrences (LR) after curative surgery have been analyzed in series of 173 rectal adenocarcinomas treated between 1973 and 1983. LR predictive factors were analyzed by univariate and multivariate (Cox model) studies. Five factors had no predictive value on LR: age, sex, tumor differentiation, tumor size, and number of metastatic nodes. Five factors had a predictive value on LR: severe clinical symptoms (fixation, obstruction and perforation) (p = 0.03), tumors localized within five cm of the anal verge (p less than 0.001), intramural infiltration (p = 0.09), localization of positive nodes (p = 0.02), and tumor emboli inside the vessels (p less than 0.01). The multivariate study underlined the two main predictive factors: the tumor site within 5 cm of the anal verge (p less than 0.001) and involvement of the serosa (p = 0.05). An equation of LR risk is presented and four subgroups of different LR risk patients are defined. This study might provide guidelines for indications and evaluation of major adjuvant treatments in the highest LR risk patients.

Adenocarcinoma↗

Malacoplakia of the gallbladder.

A case of malacoplakia of the gallbladder is described. The cytoplasm of histiocytes in the gallbladder wall was filled with granules positive for periodic acid-Schiff, von Kossa's, and Perls' stains, which is highly suggestive of malacoplakia. Both local inflammation and recent neoplasia could have played a role in the histogenesis of the malacoplakia.

Cholecystectomy↗

[Meningeal carcinomatosis in adults (author's transl)].

Twenty cases of carcinomatous meningitis in adults, treated in the Gustave Roussy Institute between 1970 and 1980, are reviewed. In fourteen cases meningitis was secondary to breast cancer. Initial inflammation was present in 90% of the mammary tumors. Clinical features as well as biochemical and cytological findings in cerebrospinal fluid are described. The various therapeutic regimens using radiotherapy and intrathecal chemotherapy are analyzed in terms of survival and compared with other published studies. The most significant point is the necessity for early diagnosis which improves survival. However, prognosis for this metastatic disease is always very poor.

Adenocarcinoma↗

Gastric carcinoma with argyrophilic cells: light microscopic, electron microscopic, and immunochemical study.

An immunochemical study of a gastric adenocarcinoma with argyrophilic cells showed two areas of tumor that react differently with the usual histochemical reagents as well as with immune sera against gastrin and mucoprotein associated with antigens. Ninety per cent of the tumor cells were PAS positive and contained M2 antigen, and some also contained M1 antigen. About 30 per cent of the M2-positive cells stained strongly with an antigastrin serum as well as with the argyrophilic reagents. The remaining 10 per cent of tumor cells were signet-ring cells located in several clumps in the tumor. These cells were positive for both PAS and alcian blue and contained intestinal M3 antigen. Forty-five per cent of them also contained M1 gastric antigens. Carcinoembryonic antigen (CEA) was found in the cytoplasm of each tumor cell. The presence of CEA and M1 antigen together indicates a fetal pattern, suggesting that the cells originate from very immature gastrointestinal stem cells.

Adenocarcinoma↗

[Post-radiation injury of the ileal small bowel: clinical and pathological report of 12 cases (author's transl)].

At the Institut Gustave-Roussy we have collected a series of 12 cases studied both on clinical and patological grounds. These patients underwent ileal resection for acute abdominal symptoms occuring after radiation therapy for genital cancer. Ileal lesions after radiation of gynecological cancer are rare: one per cent at the Institut Gustave-Roussy. These complications occur when certain technical types of radiation therapy are employed, and especially when dose exceeds 50 Gy or when a particular clinical condition is present. Gross examination of the bowel segment shows a stiffness of the digestive wall with frequent stenosis, sometimes in association with perforation or fistula. Histological lesions of radiated bowel are essentially located in the submucosa. They are nonspecific, mainly represented by obliterative angiopathy and fibrosis of the ileal wall.

Adult↗