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H Pujol

Publications and source records attributed to H Pujol.

At least 91 records · Page 5Linked to original sources
PubMed1989

Multivariate analysis of prognostic factors for curative resectable rectal cancer.

Several reports have shown that prognostic factors of rectal cancer are pathological parameters such as lymph node metastases, tumour infiltration, perineural and venous infiltration, and clinical parameters such as tumour level, mobility of the tumour and number of quadrants involved. From 1979 to 1983, 208 patients were treated curatively for rectal cancer in Montpellier Cancer Institute. A multivariate analysis was done to evaluate prognostic factors of our population. Prognosis was influenced by lymph node metastases, preoperative radiotherapy, tumour infiltration and histological type. The role of preoperative radiotherapy in local control and in survival appeared highly significant. Our results confirm the importance of external beam irradiation in local recurrence and in survival as shown randomly in the EORTC prospective trial. The growing trend in sphincter-saving surgery should be associated with preoperative radiotherapy.

Adult↗
PubMed1989

Inaugural intra-atrial neoplastic thrombosis in stage II Hodgkin's disease.

We report the first case of intra-atrial neoplastic thrombosis discovered in the initial stage of Hodgkin's disease. Considering the course of the case and the recurrence after 18 months we emphasize the necessity of screening cardiac cavities by CT Scan with a bolus, and of treating such a case as an initial stage IV Hodgkin's disease.

Adult↗
PubMed1989

A new technique of total three-stage esophagectomy for carcinoma with a combined right cervical and thoracic approach.

Total esophagectomy with a combined right cervicothoracic approach can be considered to be an extension of the classic right abdominothoracic method. The inclusion of a wide operating field composed of the neck and thorax, as well as the upper right limb, makes the method applicable to both provisional and obligatory operations. The nonobligatory cervical phase constitutes a useful safety approach when frozen section biopsy of the residual esophagus yields positive specimens, if a conventional Lewis-Santy right abdominothoracic procedure has been chosen.

Anastomosis, Surgical↗
PubMed1989

[Colorectal cancers in young adults: the reasons for poor prognosis].

Over an 18-year period, 2,600 patients were treated for colorectal carcinoma in the Montpellier Cancer Institute. Of the 93 patients younger than 40 years of age (3.6%), 78 records were retrospectively studied. The overall 5-year survival rate was 30%. Their survival was not significantly affected by the site of the primary tumor, the degree of tumor differentiation, or sex. The only significant parameter was Dukes staging at presentation (p less than 0.0001). An analysis of sites of recurrence revealed the frequency of liver metastases, ovarian metastasis in women, and local recurrence of rectal cancer. Although the high failure rate in these areas clearly justifies aggressive combined therapy, the high frequency of inaugural Stade D patients (27%) and their short mean survival time (5 months), underline the crucial importance of early detection. However, it is unfortunate that colorectal cancer screening in young patients is difficult because of the low rates of precancerous states (4%).

Adult↗
PubMed1988

Colorectal carcinoma in patients younger than 40 years of age. Montpellier Cancer Institute experience with 78 patients.

During an 18-year period, 2600 patients were treated for colorectal carcinoma in the Montpellier Cancer Institute. Of the 93 patients younger than 40 years of age (3.6%), 78 records were retrospectively studied. The overall 5-year survival rate was 30%. Their survival was not significantly affected by the site of the primary tumor, the degree of tumor differentiation, or sex. The only significant parameter was Dukes' staging at presentation (P less than 0.0001). An analysis of sites of recurrence revealed the frequency of liver metastasis, ovarian metastasis in women, and local recurrence of rectal cancer. Although the high failure rate in these areas clearly justifies aggressive combined therapy, the high frequency of inaugural Stage D patients (27%) and their short mean survival time (5 months), underline the crucial importance of early detection. However, it is unfortunate that colorectal cancer screening in young patients is difficult because of the low rates of precancerous states (4%).

Adenocarcinoma↗
PubMed1988

Immunoenzymatic assay of Mr 52,000 cathepsin D in 182 breast cancer cytosols: low correlation with other prognostic parameters.

The Mr 52,000 cathepsin-D-like protease induced by estrogens in MCF7 human breast cells was assayed in 182 primary breast cancer cytosols prepared for receptor assays from pre- and post-menopausal patients. Using two solid-phase sandwich immunoenzymatic assays, we quantified the total Mr 52,000 cathepsin D (52K-cath-D) (the Mr 52,000 precursor protein and its Mr 48,000 and 34,000 processed forms) and the Mr 52,000 precursor alone. The value of total 52K-cath-D varied between 3 and 165 pmol/mg protein and the proportion of the precursor varied from 0 to 28% of total 52K-cath-D. There was no correlation between the concentrations of 52K-cath-D and estrogen receptor, but the estrogen receptor status (greater than or less than 10 fmol/mg protein) was correlated to the 52K-cath-D status (greater than or less than 15 pmol/mg protein) according to the chi 2 test (P less than 0.001). The correlation with progesterone receptor concentrations and status was low (r = 0.43) and absent, respectively. There was no correlation with Scarff and Bloom stages, tumor size, or patient's age. The percentage of patients with invaded lymph nodes was significantly higher (80%) in the subgroup with the highest total 52K-cath-D levels (greater than or equal to 42 pmol/mg protein), representing only 12% of the population but not in the total population. On the basis of this prospective study, before clinical follow-up can be evaluated, we conclude that in the total population examined, the 52K-cath-D concentration was only correlated with estrogen receptor status, but not with any other prognostic parameter.

Aged↗
PubMed1988

Tumorectomy and radiotherapy in early breast cancer: a report on 392 patients.

This study includes 392 patients (231 Stage I and 161 Stage II) treated by tumorectomy followed by radiotherapy. The overall actuarial survival for all the patients is 86.5% at 5 years and 78% at 10 years. The 5-year NED survival is 70.2%. The survival rates are depending on the loco-regional extension: Stage I: 92% survival at 5 years and 84% at 10 years; Stage II: 82% survival at 5 years and 75% at 10 years. The percentage of local recurrences were 13% for all stages (10.6% for Stage I, 16% for Stage II), of lymph node recurrences: 1.5% for all stages, 1.3% for Stage I, 2% for Stage II, of distant metastases: 11.2% for all stages, 8% for Stage I and 16% for Stage II. The loco-regional control rates were analyzed according to the TNM classification and discussed and compared to several literature data. The breast preservation rates were at 5 years 85% for Stage I and 80.9% for Stage II. Cosmetic results are judged as good in 80% by doctors and in 90% by patients themselves with very low complication rates.

Adenocarcinoma↗
PubMed1988

[Cancer of the rectum: treatment by a radiosurgical combination of 328 patients. Mono- and multivariate analysis of prognostic factors].

From 1973 to 1983, 328 patients have been treated for rectal carcinoma in the Centre Paul Lamarque by preoperative radiotherapy (40 Grays) followed by surgical excision. The average age was 64 years and the sex ratio was 2:1. Abdominoperineal resection was performed in 219 patients anterior resection in 99 patients and transanal resection in 10 patients. Overall 3 years survival was 82 p. 100 and 5 year survival was 73 p. 100. The five year local recurrence rate was 9.4 p. 100 with 3.5 p. 100 of patients having liver metastases. Monovariate analysis revealed that the local recurrence rate was influenced by tumor circumference (p = 0.005), tumor reduction after radiotherapy (p less than 0.001), histological type (p = 0.049), lymph node metastases and tumor infiltration (p = 0.001). Survival was influenced by lymph node metastases, tumor infiltration (p = 0.001) and histological type (p = 0.01). The multivariate analysis revealed that prognosis was influenced by lymph node metastases and tumor infiltration. The "down staging" induced by the radiotherapy did not modify the predictive value of these 2 prognostic parameters when compared to groups treated by surgery only.

Adult↗
PubMed1988

[The role of surgery in primary gastric non-Hodgkin's malignant lymphoma].

A total of 15 cases of primary gastric non-Hodgkin's malignant lymphoma (PGML) seen between 1974 and 1985 were reviewed, and data obtained combined with reports in the literature, to define the place of surgery in this affection becoming the monopoly of chemotherapists. The indication for surgery is indisputable when the diagnosis is in doubt, and justified for ulcerated and preperforating forms and in extirpable tumoral forms of loco malignancy. It should be avoided in high grade PGML unless the operation does not delay chemotherapy. Total gastrectomy should not be performed by principle but by necessity. Abdominal exploration should include lymph node and liver biopsies. An effective total care of these patients requires close cooperation between medical and surgical teams.

Adult↗
PubMed1988

Endometrial cancer: a comparative analysis of the therapeutic results and causes of failure after treatment by radiation combined with surgery or radiation therapy alone.

The present study involved 215 endometrial carcinoma patients. Ninety-nine were treated by combined irradiation and surgery (preoperative external irradiation and intracavitary insertion followed by total hysterectomy and lymphadenectomy). Radiotherapy alone was used with 116 patients i.e. whole pelvis external irradiation and Heyman radium packing (40 patients) or afterloading techniques with Fletcher-Suit-Delclos applicators and cesium (76-patients). The 5-year NED survival rate was 78.7% in the combined therapy group and 44% in the exclusive radiotherapy group. The locoregional recurrence rates were 10% in the combined group and 28% in the exclusive radiotherapy group. These results are discussed in relation to data in the literature and to biases introduced due to patient selection in this nonrandomized study. Five-year survival rates, locoregional recurrence rates and sites of failures are analyzed according to the different treatments. Modifications of the external irradiation and intracavitary techniques allowed us to obtain better results and fewer complications.

Adenocarcinoma↗
PubMed1987

Immunodetection of estrogen receptor and 52,000-dalton protein in fine needle aspirates of breast cancer tumors.

The double immunohistochemical detection of estrogen receptor (ER) and the estrogen-regulated 52,000-dalton protein (52kDa-P) was performed on 35 fine needle aspirates of primary breast cancers. The nuclear ER, stained brown, was differentiated from the 52kDa-P, stained in red, in the cytoplasm of the same cells. The significant correlation obtained between the percentages of positive aspirated cells and the cytosolic concentrations of these two markers showed the validity of semiquantitative detection in fine needle aspirates, which appeared to be more representative of the content of these markers in tumors than was the detection in a single tissue section. Tumor heterogeneity also was defined by this double immunostaining, since among the tumors positive for both ER and 52kDa-P (18 of 35 cases), a heterogeneous group of 12 tumors contained the markers in two distinct cell populations, whereas a more homogeneous group of 6 tumors contained double-stained cells. The first information provided by this study is that the 52kDa-P is not correlated with the ER. This absence of correlation is in accordance with other studies and indicates that the 52kDa-P is associated with tumor proliferation and possibly invasion, rather than with hormone responsiveness or differentiation. The feasibility and validity of double immunostaining of these two markers in human breast cancer aspirates should stimulate larger studies--with clinical follow-up of the patients--aimed at establishing the clinical usefulness of this presurgical test.

Biopsy, Needle↗
PubMed1987

The antiprogestin RU486 in advanced breast cancer: preliminary clinical trial.

Twenty-two oophorectomized or postmenopausal women with metastatic breast cancer resistant to several medical therapies (tamoxifen, or other endocrine therapy, and chemotherapy) were treated in a first trial with 200 mg per day of RU486 for 1 to 3 months. The long-term tolerance was good but there was a moderate decrease in plasma potassium. Plasma cortisol was increased 2-fold without clinical hypo- or hypercorticism. Twelve patients had a partial response or a stabilization of secondary deposits for 6 weeks but the response rate at 3 months was 18%. When available, estrogen and progesterone receptor levels were positive in these patients. This preliminary trial shows for the first time that the antiprogestin RU486 is well tolerated for medium term treatment. It suggests that it might be active on advanced breast cancer becoming resistant to tamoxifen.

Breast Neoplasms↗