Search PubMed⌕ Search

Biomedical subjects

E Leblanc

Publications and source records attributed to E Leblanc.

67 records · Page 4Linked to original sources
PubMedDate not supplied

Surgical staging of early invasive epithelial ovarian tumors.

Early stage epithelial ovarian carcinoma is defined pathologically as a tumor strictly limited to one or both ovaries without any extra-ovarian disease (i.e., Stage IA or B of the International Federation of Gynecology and Obstetrics (FIGO) classification). This diagnosis can be obtained only after an exhaustive surgical staging procedure, performed as soon as the diagnosis of epithelial invasive ovarian carcinoma is established. This staging surgery currently encompasses a peritoneal cytology, the thorough inspection of all the visceral and parietal peritoneal surfaces with biopsy of any abnormality, total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH + BSO), random peritoneal biopsies, omentectomy, appendectomy and bilateral pelvic and para-aortic lymphadenectomies, up to the left renal vein. The results of this staging procedure and its indications are discussed. In all of the cases, the radical removal of the pathologic adnexa is indicated, along with the complete peritoneal and retroperitoneal staging. While fertility-sparing surgery (avoiding hysterectomy and contralateral adnexectomy, if possible) seems to be safe for young women, a TAH + BSO is the rule for the others. Adjuvant chemotherapy can be omitted in well-differentiated tumors with a negative staging operation, but currently it remains indicated in all other cases. Indeed, the ultimate goal in early stage ovarian carcinoma is to not impair by inadequate management the high chance of a cure.

Carcinoma↗
PubMedDate not supplied

High-energy resolution X-ray, gamma and electron spectroscopy with cryogenic detectors.

Cryogenic detectors offer remarkably better energy resolutions than those achievable with conventional semiconductor or scintillation detectors. With the additional asset of a detection efficiency close to unity for low-energy X-ray photons and electrons, these detectors have the potential to perform X-ray, gamma and electron spectroscopy of a hitherto unknown quality, in particular at low energies. Two types of cryogenic detectors are described and the results of prototype detectors are presented.

Calorimetry↗
PubMedDate not supplied

A new absolute method for the standardization of radionuclides emitting low-energy radiation.

Microcalorimeters (or bolometers) operated at temperatures below 100 mK allow individual counting of photons and electrons with a very low energy detection threshold. The physics is based on the pulse temperature increase of the target (or absorber) of the detector due to the complete absorption of both electrons and photons. Since this target can be constructed with a perfect 4-pi geometry, a bolometer offers potentially a new method for absolute activity measurements of radionuclides emitting low-energy radiation. In this paper we present our first results of a feasibility study of activity standardization of a 55Fe solution with a prototype 4-pi bolometer.

Journal Article↗
PubMedDate not supplied

[Role of laparoscopy in the management of uterine cervix cancer].

At the turn of this century, the evidence of the benefits of a concurrent chemo-radiotherapy in locally advanced tumors and the development of mini-invasive surgery (laparoscopic and radical vaginal surgery) are the two main advances in the management of cervical carcinomas. From a personal experience of 304 cervical carcinomas, the different techniques of laparoscopy used in cervical carcinomas are addressed and discussed. Their long-term results when involved in the management protocols of cervical carcinomas at different stages are reported. From this series, some conclusions are drawn: 1) laparoscopy can spare a laparotomy in early-stage node-negative patients with low tumoral volume; 2) it can spare a systematic extended-field radiation therapy in high-risk patients with node-negative para-aortic exploration; 3) it can spare surgery in patients with a centro-pelvic advanced stage or recurrence, possibly candidates for an exenterative procedure, if occult spread is found in the intra- or retroperitoneal areas. The more and more frequent combination of the mini-invasive surgery for staging and treatment and radiotherapy or chemotherapy explains the need for new protocols of a more and more complex and specialized management.

Adenocarcinoma↗
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↗