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Biomedical subjects

C C Abbou

Publications and source records attributed to C C Abbou.

At least 145 records · Page 8Linked to original sources
PubMed1993

Orchiectomy and nilutamide or placebo as treatment of metastatic prostatic cancer in a multinational double-blind randomized trial.

The efficacy and tolerance of the nonsteroidal antiandrogen nilutamide in the treatment of prostatic cancer were studied in a large double-blind clinical trial initiated in 1986. Patients with metastatic prostatic cancer without prior endocrine manipulation underwent orchiectomy and were randomized to 1 of 2 groups receiving nilutamide (225 patients) or placebo (232). Nilutamide and placebo were evaluated for efficacy in 207 and 216 patients, respectively. Progression-free survival was significantly longer in the nilutamide group (median time to progression 20.8 months on nilutamide and 14.9 months on placebo, p = 0.005). Median time to death from prostatic cancer was 30.0 months in the placebo group and 37 months in the nilutamide group. Objective regressions were higher in the nilutamide group (41%) than in the placebo group (24%). Significant differences in favor of the nilutamide group were found at several intervals for bone pain, prostatic acid phosphatase, prostate specific antigen, alkaline phosphatase and bone scan isotope uptake. Nilutamide and orchiectomy constitute a more effective treatment for metastatic prostatic cancer than orchiectomy alone, and the adverse effects of nilutamide, usually minor, are outweighed by the significant improvements in most disease measures and progression-free survival.

Acid Phosphatase↗
PubMed1993

[Pelvic lymphatic excision using laparoscopy. Its value in the staging of tumors of the bladder].

Laparoscopic surgical procedures are being evaluated in urologic diseases including bladder cancer. Patients with apparently localized tumors may have lymph node involvement indicating disseminated disease for which locoregional treatments are inadequate. Laparoscopic lymphadenectomy may be useful for staging, since neither noninvasive procedures nor intraoperative examination of lymph nodes removed during cystectomy are completely reliable. The technique is described in detail. Benefits in bladder cancer patients remain to be determined.

Humans↗
PubMed1993

[Natural history and prognostic factors of superficial tumors of the bladder].

Forty-five patients with superficial bladder cancer managed by transurethral resection alone were studied longitudinally to identify factors associated with progression. Tumor grade, multiple tumor foci, and time to first recurrence were closely correlated with progression. Findings from this study are compared with previous reports. These data are useful to identify patients requiring more aggressive therapy, including intravesical anticancer drugs and BCG, and monitoring with closer-spaced cystoscopies.

Female↗
PubMed1993

[Radical cystectomy for cancer. Technic].

Radical cystectomy is the treatment of choice for invasive bladder cancer. Morbidity and mortality associated with this procedure have been reduced substantially as a result of advances in surgical techniques and instruments. The cystectomy technique described herein offers satisfactory exposure and hemostasis, thus providing optimal conditions for achieving high-quality urinary diversion.

Cystectomy↗
PubMed1993

[Results of the treatment of bladder tumors infiltrating the muscle].

Recent studies have shown improvements in survival in patients with invasive bladder cancer, perhaps as a result of stage selection and reduced perioperative morbidity rather than of increased effectiveness of treatments. The main ongoing therapeutic trials (combined use of chemotherapy with either surgery or radiation therapy) aim at controlling occult metastases which may be present in up to 50% of apparently localized bladder cancers. Identification of risk factors for metastatic disease is therefore crucial. In this study, factors potentially associated with response to treatment were analyzed on the basis of a review of outcomes reported with current treatments.

Combined Modality Therapy↗
PubMed1993

[The use of monoclonal antibodies in the evaluation of the aggressiveness of tumors of the bladder].

Monoclonal antibodies produced using hybridoma technology have enabled identification of new tumor markers. Targets include tumor-associated antigens, growth factors and their receptors, blood group antigens, cell proliferation antigens, oncogene or tumor suppressor gene products, and markers for drug resistance. Immunohistochemical or flow cytometry studies performed with monoclonal antibodies can be used to determine the immunophenotype of normal and tumoral urothelium; specificity may be primarily for superficial or deep tumors, or for different tumor grades. A number of monoclonal antibodies have been found of prognostic value independently from conventional prognostic criteria. Others have shown diagnostic value. The most promising monoclonal antibodies are reviewed herein.

Antibodies, Monoclonal↗
PubMed1993

[Surgical anatomy of the lymphatic drainage of the bladder].

Descriptive anatomy teaches us that the lymphatic drainage of the bladder converges directly on to the middle and internal chains of the external iliac nodes, but never on to the external chain, sometimes on a sacral common iliac node and widely on internal iliac nodes. Surgical observations confirm this: no lymph node metastasis in the external chain of external iliac nodes is noticed, nor common iliac adenopathy without upstream invasion. On the basis of these descriptions, lymphadenectomy was performed from inguinal ligament to iliac bifurcation. Anatomical data largely explain pelvic recurrences due to the existence of unremoved common iliac nodes or unrecognized hypogastric nodes because of difficult access without sacrificing efferent branches of internal iliac artery.

Humans↗
PubMed1992

[Double liver-kidney transplantation in the presence of a positive T cross-match].

Kidney transplantation, when performed across a positive T lymphocyte cross-match, is always followed by the occurrence of a hyperacute rejection. On the other hand, successful hepatic allografts have been reported under these same conditions. Furthermore, clinically and experimentally hepatic allograft has been reported to induce tolerance of other organs from the same donor. Thus, combined liver-kidney transplantation constitutes an ideal application of these immunological events. We report here the case of a sequential liver-kidney transplantation in which liver transplantation performed prior to kidney transplantation with an organ from the same donor induced kidney tolerance despite an initial positive T lymphocyte cross-match.

Adult↗
PubMed1992

Immunohistochemical detection of acidic fibroblast growth factor in bladder transitional cell carcinoma.

Acidic fibroblast growth factor (aFGF) is a regulatory peptide which, on account of its structural homologies with the products of oncogenes, is involved in cell proliferation, differentiation, and motility. We previously reported the presence of aFGF in the urine of patients with transitional cell carcinoma (TCC). aFGF can also induce the motility of a rat-derived bladder carcinoma cell line (NBTII). This immunohistochemical study used polyclonal rabbit antibodies against acidic and basic FGF and peroxidase detection. Native NBTII nude mice xenografts and aFGF transfected NBTII (NFS14) nude mice xenografts were used as tissue controls for antibody specificity. The samples included 4 normal urothelia and 12 TCC. In addition, cytospins of 4 different tumoral cell lines of human bladder and normal bladder cells were stained. The results showed strong immunostaining in all tumoral urothelium samples using anti-aFGF and a very low amount of staining or none at all in healthy tissues. A primary analysis suggested that the strongest reaction was obtained in high-grade tumors (3 + vs + for lower-grade tumors). Using bFGF antibody, strong immunohistochemical staining was detected on basal membranes and stromal vessels and none in urothelium. These data confirm aFGF expression in the epithelial cell compartment of bladder cancer and the likely involvement of this regulatory peptide in the biology of TCC.

Animals↗
PubMed1990

Immunohistochemical markers defined by monoclonal antibodies and response to bacillus Calmette-Guérin endovesical immunotherapy for superficial bladder tumors.

As bacillus Calmette-Guérin (BCG) immunotherapy is highly effective for most but not all superficial bladder tumors, there is a need to define predictors of response to this mode of treatment. We have investigated a panel of markers defined by monoclonal antibodies, directed against tumor-associated transitional cell carcinoma antigen (G4 and E7), epidermal growth factor receptor, cytokeratin (CK) 18 and blood group antigens A, B and H, using an indirect immunoperoxidase staining on paraffin sections. Twenty superficial bladder tumors (T1) treated with intravesical BCG therapy (10 responders and 10 nonresponders) were tested with this panel. Among the responders, expression of CK18 antigen was positive in 7 and negative in 3, whereas in the nonresponder group it was positive in 2 and negative in 8. The difference was statistically significant (p less than 0.05). Loss of expression of CK18 antigenicity was associated with recurrence or progression of superficial bladder tumors following BCG therapy, indicating that changes in CK patterns should be investigated as potential predictive markers for response to BCG.

Administration, Intravesical↗
PubMed1990

[Results of treatment of superficial vesical tumors by transurethral resection alone and transurethral resection followed by an intravesical instillation of Calmette-Guerin bacillus].

Superficial bladder tumors treated at the Henri Mondor Hospital from 1984 through 1988 were analyzed for recurrence and progression using the following prognostic parameters: stage (TNM classification, 1978), grade (G1, G2, G3), size, number of tumors, and tumor malignancy index as defined by the Besançon group. Forty-five patients were treated with transurethral resection alone (TUR group) whereas 30 had TUR followed by the prophylactic instillation of fresh Calmette-Guérin bacillus in the bladder (BCG group). In TUR patients, parameters predictive of progression included grade G3, multiple tumors, stage T1, recurrence within 6 months of TUR, and a tumor malignancy index above 455. None of these criteria were predictive of a response to BCG. Results obtained in the BCG group were comparable to those reported in the literature and confirmed the efficacy of BCG instillations to prevent recurrence and progression of superficial carcinomas of the bladder.

Administration, Intravesical↗
PubMed1990

[Cystic cancer of the kidney].

Four cases of cystic renal adenocarcinoma in adults free of renal dysfunction are reported. The authors propose a diagnostic approach for atypical cysts that takes the new imaging techniques into account (ultrasonography and CT scan initially, MRI subsequently). A practical therapeutic strategy is also described: because intraoperative histologic diagnosis is difficult partial nephrectomy to allow an intraoperative study of the entire cyst is advocated; extensive nephrectomy, which is the only procedure that ensures total exeresis of the carcinoma, is performed either immediately if the intraoperative study of the cyst or of its aseptic necrotic and hemorrhagic content is positive, or later if subsequent histologic studies reveal a malignancy.

Adenocarcinoma↗
PubMed1989

Conservative treatment of renal allograft rupture with polyglactin 910 mesh and gelatin resorcin formaldehyde glue.

Renal-sparing treatment of spontaneous renal allograft rupture remains a surgical challenge, since profuse hemorrhage may result from these friable kidneys during surgical repair. A technique is proposed to achieve control of local bleeding with a synthetic glue (gelatin, resorcin and formaldehyde) and external compression with a polyglactin 910 absorbable mesh. We report 4 cases of spontaneous allograft rupture associated with rejection and bleeding was controlled in all 4. Three grafts were preserved with more than 1 year of followup. The other graft had to be removed for uncontrolled vascular rejection despite satisfactory control of renal fractures. Renal wrapping with external compression is proposed to improve results of conservative management of renal allograft rupture.

Adult↗
PubMed1989

Use of vena cava to obtain additional length for the right renal vein during transplantation of cadaveric kidneys.

During cadaveric organ harvesting removal of the right renal vein and a segment of the vena cava may facilitate venous anastomosis of the right kidney. The technique to obtain adequate length of the right renal vein using the vena cava is simple, physiological and effective. A segment of the inferior vena cava should be harvested with the right but not necessarily with the left kidney. The use of a long segment of vena cava makes the renal transplantation much easier and does not interfere with multiorgan procurement. The method is most useful when the right renal vein is extremely short or when the recipient has a large abdomen and a deep pelvis.

Anastomosis, Surgical↗
PubMed1988

Conservative treatment of bladder carcinoma by partial cystectomy and interstitial iridium 192.

From 1971 to 1984, 85 patients with bladder carcinoma were treated conservatively at the Henri Mondor Hospital by a combination of short course of pre-operative external pelvic irradiation, iliac node dissection, partial cystectomy, and iridium 192 implantation. There were 79 transitional cell carcinomas (G1: 12, G2: 25, G3: 36, Gx: 6) and 6 squamous cell carcinomas. By clinical stage, based on endoscopic resection, there were 43 T1, 30 T2, 5 T3, and 7 Tx. After partial cystectomy the pathologic stage distribution was: 41 pT1, 31 pT2, and 13 pT3. Crude disease-free survival at 5 years is 72% for T1 tumors and 55% for T2, but overall only 16% of patients died of bladder carcinoma. Local failures were seen in 11.5% of T1 and 0% of T2 tumors, and second bladder tumors developed at a distance from the treated site in 11.5% of T1 and 7% of T2. There is a non significant trend for intravesical recurrences (both local failures and second tumors) to occur more frequently for G1 tumors (25%) than for G2 (16%) or G3 (7%). At 5 years 95% of disease-free survivors have a functioning bladder. Regional or distant metastases occurred in 54% of patients with pT3 tumors and 10% of those with pT1 or pT2; within each stage there was no apparent influence of grade on metastatic risk. The four patients with histologically positive iliac nodes received additional post-operative external pelvic irradiation; three died of metastases and one is disease free at 10 years. No abdominal scar recurrences were seen. Late complications occurred in 6% of the population. For T1 tumors we suggest modification of the described protocol, eliminating the pre-operative irradiation and the lymph node dissection. If there is no doubt as to the pathologic stage after complete endoscopic resection, iridium 192 implantation delivering a dose of 60 Gy, without partial cystectomy, may be sufficient management. By contrast, for T2 tumors, all elements of the protocol seem important to obtain optimal results.

Adult↗
PubMed1988

[The value of the serum level of the prostate-specific antigen in prostatic pathology].

Development of serum assays for prostate-specific antigen (PSA) has provided physicians with a new marker for carcinoma of the prostate. PSA was compared to prostate acid phosphatases (PAP), the reference serum marker, in 162 patients including 54 patients with carcinoma of the prostate (CP), 84 patients with benign hypertrophy of the prostate (BHP), and 24 controls free of prostate disorders. PSA appeared more sensitive but less specific than PAP. Results showed that PSA is not suitable for routine screening in the population at large where BHP is common. In BPH, the rise in PSA concentrations parallels the size of the hypertrophy. However, in patients with CP, PSA seems more sensitive than PAP for evaluating tumor spread and response to treatment. The prognostic bearing of increased levels in patients with apparently localized carcinomas remains to be elucidated.

Acid Phosphatase↗
PubMed1988

[Use of the vena cava in renal transplantation. Extension of the right renal vein].

Vena cava is a providential material for the transplant surgeon. Prolongation of the right renal vein using vena cava is a simple and effective procedure. Consequently the inferior vena cava must be harvested with the right and not the left kidney for which it is unnecessary. The use of a long segment of vena cava makes the renal transplantation and easy, well-defined procedure without interfering with the requirements of multiorgan donation.

Humans↗