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Biomedical subjects

C Solassol

Publications and source records attributed to C Solassol.

At least 37 records · Page 2Linked to original sources
PubMed1986

Aggressive regional surgery for advanced ovarian carcinoma.

Between January 1975 and December 1983 in the Cancer Institute, Montpellier, France, regional surgery (RS) was performed on 18 Stage III and 3 Stage IV patients (International Federation of Gynecology and Obstetrics [FIGO]) with histologically proven cystadenocarcinoma of the ovary. All patients were placed into one of three nonrandomized groups: Group A (9 patients), RS at first-look surgery; Group B (7 patients), RS at second-look surgery; and Group C (5 patients), RS at third-look surgery. Group A was given adjuvant chemotherapy, whereas Group B and C patients underwent nonregional surgery at first- or second-look operation, and received chemotherapy supplemented in some Group C cases by radiotherapy before RS. The adjuvant chemotherapy consisted of: cyclophosphamide plus Alkeran (mephalan) plus 5-fluorouracil (the first 7 patients) and Adriamycin (doxorubicin) plus cisplatin plus hexamethylmelamine (14 additional patients). RS consisted of basic procedures--abdominal hysterectomy; bilateral salpingo-oophorectomy; omentectomy--and specific procedures--abdominal and pelvic peritonectomy; either total or partial colectomy; jejunoilectomy, leaving at least 150 cm of the jejunum; and retroperitoneal lymph node dissection aimed at maximal cytoreduction of tumor mass. There was no operative mortality. The overall postoperative morbidity was 33.3% (seven patients) due to wound sepsis. The survival from the beginning of treatment (absolute survival [AS]) and survival after RS (RSS) were compared. In Group A (AS = RSS) the probability of survival at 112 months (6/9 patients are still alive) was 0.52. In Groups B and C the median survival times (AS and RSS) were 37 and 17 months and 18 and 1 month, respectively. The difference in AS among the three groups of patients was not statistically significant (log-rank test), whereas the RSS was statistically significant between Group A versus Groups B, C, and Groups B and C combined (P less than 0.05).

Adult↗
PubMed1986

[Long-term intrathecal isobaric morphine therapy].

In order to evaluate long-term intrathecal morphine therapy for cancer pain, whatever its location, 121 patients (80% were ambulatory patients) treated between April 1979 and April 1985 at the Cancer Institute of Montpellier (Centre Paul-Lamarque) were assessed. Morphine was stored in a presternal insulin syringe, protected by a sterile and waterproof dressing. A bolus administration of morphine via a subcutaneous lombo-epigastric subarachnoid catheter was scheduled every 12 h. This "closed" device was opened for refilling in an operating room only. The mean follow-up was 68 days (maximum: 13 months). More than 15,000 intrathecal injections were made. The mean daily amount of morphine required was 2.3 mg (extremes: 0.75 and 21 mg). All patients developed tolerance, requiring an adjustment of morphine dosages every 30 to 45 days. With the isobaric morphine solution, good or very good analgesia was achieved in 82% of patients, even in those suffering from thoracic or otolaryngologic pain. Mechanical complications (catheter coming out of the subarachnoid space in 7.67% of cases, leakage of CSF along the catheter in 9.16% of cases) were related to the exteriorization of the proximal catheter tip. With the exception of errors in manipulation, neither infection nor clinical respiratory depression were noticed. Nausea and vomiting were frequent but resolved spontaneously within a few days. Urine retention (33%) occurred mainly in men over 65 years, after pelvic surgery or radiotherapy. Because of the absence of a defined zone of analgesia, the small volumes required and the "ready for use" preparation, intrathecal isobaric morphine therapy will lead to easy self-administration via an implanted pump in the future.(ABSTRACT TRUNCATED AT 250 WORDS)

Catheters, Indwelling↗
PubMed1986

[Muscular tumors of the esophagus. Apropos of 9 cases and review of the literature].

Between 1970 and 1983, nine cases of tumors of esophageal muscle and connective tissue were treated at the Centre Paul Lamarque. Leiomyoma (LM) (6 cases in this series) represented 0.8% of esophageal tumors reported from among 1,200 patients, while leiomyosarcoma (LMS) (3 cases in this series) were observed in 0.25%. LM is usually detected fortuitously and is asymptomatic, LMS provoking dysphagia of the "foreign body" type contrasting with the "monstrosity" of the radiologic image. Endoscopy and biopsy is justified only when LMS in suspected, since it could interfere with enucleation. Treatment is surgical, by enucleation without mucosal effraction for LM and esophageal resection for LMS. Adjuvant therapy has failed to provide evidence of efficacy.

Adult↗
PubMed1985

[Hepatic metastases. Medicosurgical treatment or priority to surgery?].

Not all patients with liver metastases should be referred to the surgeon. Selection is necessary, based on the patient's general and hepatic condition, on the nature of the primary cancer and on the intra-hepatic spread of the metastases. At the moment, less than 1% of patients with metastatic liver are operated upon. In the absence of clinical or biochemical evidence of hepatic dysfunction, surgical specialists may consider operating patients under 75 with synchronous or metachronous metastases from colorectal cancer or endocrine tumours. If clinical and laboratory evaluation is favourable, the decision to operate and the type of partial hepatic resection selected depend on pre-operative investigations which are, successively: ultrasonography, computerized tomography, radioisotope scanning and possibly arteriography for endocrine tumours (not all these examinations are necessarily required). Other possible referrals are patients with liver metastases from non-colorectal or non-endocrine primary tumours of low evolutive potential, as evaluated by changes in levels of biological markers and by monthly morphological studies of metastatic tissue over 3 to 6 months. The major limiting factor in these patients is previous heavy chemotherapy which makes this type of surgery extremely hazardous. Recently published data justify primary surgical reduction of the tumour followed by systemic or regional chemotherapy at the end of the liver tissue regeneration period. In marker-dependent subjects the susceptibility to chemotherapy of the remaining malignant tissue can be evaluated by changes in marker levels if these were still above normal values after partial hepatectomy.

Adenocarcinoma↗
PubMed1985

[Cancer of the endometrium: analysis of the comparative results and causes of failure in radiosurgical treatment and physical agents alone. 215 cases treated between 1968 and 1978].

Two groups of patients (215 cases) with endometrial cancer were treated between 1968 and 1978 either by a combination of radiotherapy and surgery or by radiotherapy alone. In the first group (99 cases) with a mean age of 59 years, results were very favorable for stage T1 and T2 (49/60, 82%) which confirm other results in the literature. The combination of radiotherapy and surgery comprising external irradiation and intracavitary irradiation prior to total hysterectomy did not appear to increase the number of complications to the urinary or digestive tracts. The second group (116 cases) comprised patients treated exclusively by radiotherapy due to the presence of metastatic disease (74 cases) or excessive local-regional extension (37 cases). The cure rate at 5 years appeared satisfactory for stage T1 (35/54, 65%). The differing results between combined radiotherapy and surgery with methods using radiotherapy alone should be partially corrected to take into account the older average age of the second group (69 years). Failures due to the appearance of metastases were approximately similar in both groups (near 6%); on the other hand, local-regional recurrences were more frequent when radiotherapy alone was used, which accounts for the differing results between the two groups. In the second period (1972 to 1978), the group treated exclusively with radiotherapy benefited from a technique used with cervical cancer: external irradiation followed by intracavitary irradiation with a Fletcher-Suit applicator with results similar to those treated in the first period with intracavitary irradiation.(ABSTRACT TRUNCATED AT 250 WORDS)

Endometrium↗
PubMed1985

[Epithelial tumors of the ovary. Therapeutic results apropos of 165 cases of stage II and III tumors].

A report on the treatment of 165 epithelial tumours of the ovary (60 of which were stage II and 105 were stage III) by medical means after surgery. The results are far better in stage II cases for the length of survival without disease and the 5 year survival rate when surgical excision was complete (40 months and 43%) as compared with the disease-free interval and survival when surgical excision was incomplete (14 months and 27%) (p less than 0.05). There was a significant difference (p less than 0.05) in favour of pelvic and total abdominal irradiation as compared with other added therapeutic measures: 41 months as a median of disease-free interval and 60% survival at 5 years for patients who had pelvic and total abdominal irradiation combined with chemotherapy as against 26 months and 38% survival for patients who had only pelvic irradiation with chemotherapy. In the 105 stage III cases the median interval of disease-free survival and the survival at 5 years are quite different (p less than 0.01) for the 57 cases who had complete surgical excision (30 months and 17.5%) as compared with those who only had incomplete surgical treatment (1.4 months and 2%). There was no significant difference in the disease-free interval and the 5 year survival rate according to the different post-surgical therapeutic measures, whether these were chemotherapy alone or pelvic irradiation or pelvic and abdominal irradiation. These results are compared with those of other treatments following surgery of tumours of the ovary (a historical comparison and random trials).

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

[Regional pancreatectomy in the treatment of pancreatic adenocarcinoma. Apropos of 41 cases].

Out of 88 carcinomas of the pancreas observed from 1973 through 1981, 41 regional total (19 patients) or subtotal (22 patients) pancreatectomies were performed. Routine histological examination of 12 lymph nodes areas and pancreatic peritoneal involvement were used to determine three stages: 1) stage I without metastatic lymph nodes involvement (18 patients), 2) stage II with peripancreatic metastatic lymph node involvement (14 patients), 3) stage III with pedicular and/or retroperitoneal metastatic lymph node and/or peritoneal involvement. Six patients died in the postoperative period (14.6 p. 100). Complications were infections (11 patients), pancreatic anastomotic leakage after subtotal pancreatectomy (11 patients), digestive bleeding (8 patients). No patients need insulin two months after subtotal pancreatectomy. After total pancreatectomy diabetes mellitus was controlled by 0.30 UI/kg/day of insulin (mean). The three years survival was 38 p. 100 (Kaplan-Meier). In the author's experience, regional pancreatectomy seems to be the best surgical procedure in patients with carcinoma of the pancreas except in patients with poor general condition, age over 75, and stage III.

Adenocarcinoma↗
PubMed1983

[Transparietal biliary drainage. 27 cases].

During a 2-year period, 27 patients with obstructive jaundice (due to cancer in 27) underwent transhepatic biliary drainage with an 85% success rate. Most of the failures occurred in early attempts and were due to lack of experience. In neoplastic obstructive jaundice, endoprosthesis proved superior to external drainage: jaundice regressed more frequently and more completely, the patients' comfort was improved, survival was significantly prolonged and complications were less frequent. Per-operative biliary drainage, used in a controlled trial, proved useless, as patients developed cholangitis.

Adult↗