Search PubMed⌕ Search

Biomedical subjects

J Arseneau

Publications and source records attributed to J Arseneau.

29 records · Page 2Linked to original sources
PubMed1986

Tamoxifen versus placebo: double-blind adjuvant trial in elderly women with stage II breast cancer.

One hundred eighty-one elderly women with stage II breast cancer were prospectively randomized to receive tamoxifen or placebo for 24 months in a double-blind adjuvant trial conducted by the Eastern Cooperative Oncology Group. They were stratified prior to randomization on the basis of the number of positive axillary nodes and the estrogen receptor status of their primary tumor. One hundred seventy were considered eligible and analyzed in this trial. The median age was 71 years with a range from 65 to 84 years. Twenty-one percent of the patients were over the age of 75 and 33% were between 71 and 75 years. Estrogen receptor status was positive in 85% of the patients and unknown in another 12%. Progesterone receptor status was positive in 35%, negative in 16%, and unknown in 49%. With a median follow-up of 55 months, the overall percent disease free at 4 years is 73 for the tamoxifen arm and 52 for the placebo arm (P = .003). Significant benefit is seen following tamoxifen in the subsets with 4-10 positive axillary lymph nodes, those who were estrogen receptor positive, or progesterone receptor unknown, and those who had a tumor size less than 3 cm. Most other subsets benefited as well. There were more distant (29 vs. 13) and bone only (15 vs. 3) sites of first recurrence in the placebo arm, whereas locoregional recurrences were similar (8 each). The recorded toxicity was similar, except for more hot flashes observed among women in the tamoxifen arm.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1985

Adjuvant tamoxifen treatment of elderly women with stage II breast cancer. A double-blind comparison with placebo.

One hundred seventy elderly women with stage II breast cancer, stratified on the basis of the number of positive axillary nodes and estrogen receptor status, were randomly assigned to receive tamoxifen or placebo for 24 months in a prospective, double-blind, adjuvant trial. The median age was 71 years with a range from 65 to 84 years. The overall percentage of patients disease-free at 4 years was 76% for those given tamoxifen and 52% for those given placebo (p = 0.0004). Benefit was seen in all subgroups of patients treated with tamoxifen. Two years of tamoxifen therapy represents an effective postoperative adjuvant treatment for elderly women with stage II breast cancer, resulting in improved time to relapse, statistically fewer distant first recurrences, and minimal toxicity. No improvement in overall survival has been seen yet.

Aged↗
PubMed1983

Cis-platin based combination chemotherapy for advanced ovarian cancer. High overall response rate with curative potential only in women with small tumor burdens.

Thirty-eight women with advanced ovarian cancer were given monthly cycles of intravenous cyclophosphamide, Adriamycin (doxorubicin) and cis-platin, and oral hexamethylmelamine. Of 26 with tumor which would be evaluated for response, 42% had complete remission and 50% partial remission. Median time to disease progression from entry for all 38 patients was 13 months, and median survival 23.5 months. The bulk of tumor at the time chemotherapy was begun was the only significant prognostic factor for time to disease progression and survival. Of the seven women surviving free of disease a median of three years later, five had no mass greater than 2 centimeters in diameter at entry. Toxicity was predominantly myelosuppression and vomiting, with mild peripheral neuropathy in 27% and no significant renal or cardiac toxicity. The response rate of 92% is much higher than that previously reported with melphalan, and the survival considerably longer. The toxicity is acceptable, given the substantial improvement in results.

Adult↗
PubMed1983

The cecal diaphragm.

A detailed radiologic, colonoscopic, and histologic analysis is described in the case of a cecal web presenting as a "cecal mass." The demonstration of a transverse band-like lucency proximal to the ileocecal valve should prompt careful double-contrast barium studies, to which endoscopy may be added, enabling a correct diagnosis to be made.

Aged↗
PubMed1982

Ovarian stromal tumors containing lutein or Leydig cells (luteinized thecomas and stromal Leydig cell tumors)--a clinicopathological analysis of fifty cases.

Fifty ovarian stromal tumors that had a predominant pattern of fibroma or thecoma but also contained cells typical of steroid hormone-secreting cells are reported. Forty-six tumors were classified as luteinized thecomas because the steroid cells resembled lutein cells and lacked crystalloids of Reinke. Four were classified as stromal Leydig cell tumors because crystalloids were identified in the steroid cells. The luteinized thecomas occurred at an average age of 46 years and were associated with estrogenic manifestations in 50% and androgenic changes in 11% of the cases. In the remaining cases there was no clinical or pathological evidence of steroid hormone production at the time of diagnosis. Six patients, two of whom were virilized, were pregnant. Four tumors appeared malignant on histologic examination. One of these tumors was rapidly fatal, the outcome is unknown in a second case, the third patient is alive and well at 5 years, and the fourth tumor was diagnosed too recently for evaluation of its behavior. The stromal Leydig cell tumors occurred at an average age of 61 years and were associated with virilization in one case, endometrial hyperplasia in another case, and endometrial hyperplasia with carcinoma in a third case. The fourth tumor was unassociated with endocrine manifestations. Luteinized thecomas and stromal Leydig cell tumors are indistinguishable except for the presence of crystalloids of Reinke in the latter. In view of the prolonged search that is necessary to find these structures in some stromal Leydig cell tumors and their well-known absence in the majority of testicular Leydig cell tumors, it is reasonable to assume that an unknown proportion of tumors in the luteinized thecoma category are unrecognized stromal Leydig cell tumors.

Adolescent↗
PubMed1981

Tubular Krukenberg tumor. A problem in histopathologic diagnosis.

A review of a series of 70 Krukenberg tumors seen in consultation disclosed 13 cases with a predominant tubular pattern. Eleven of them had been diagnosed by the referring pathologist as a tumor in the sex cord-stromal category, usually a Sertoli-Leydig cell tumor; no diagnosis was preferred in the other two cases. Three factors contributed to the erroneous diagnoses: a prominent tubular pattern, luteinization of the stroma of the tumor in five cases, and associated virilization in two cases. Each tumor, however, contained typical signet-ring cells that were readily demonstrable with mucicarmine stains. In six cases the tumors were unilateral and in seven, bilateral. Ten patients died of their cancer from 2 to 21 months after the diagnosis had been made. In one case the ovarian tumors were not discovered until autopsy. Two patients are alive 7 and 9 months postoperatively. A primary tumor was found in the stomach in four cases and in the sigmoid colon and appendix in one each. No primary tumor was found in seven cases but an autopsy had been performed in only one of these. The diagnosis of Krukenberg tumor must always be considered in the differential diagnosis of an ovarian tumor with a tubular pattern even though endocrine manifestations are present.

Adult↗
PubMed1980

Combination chemotherapy of advanced ovarian cancer with hexamethylmelamine, cis-Platinum, and doxorubicin after failure of prior therapy.

Forty-nine women received a combination of cis-platinum and hexamethylmelamine (36 also received doxorubicin) for advanced ovarian cancer progressing after therapy that included an alkylating agent or extended field radiation. Twenty-six (53%) had an objective remission that lasted a median of 6 months from start of treatment. Response rate was independent of age, extent of prior therapy, and performance status. A long interval from initial diagnosis to entry, response to therapy, and ambulatory performance predicted improved survival from entry. No patient is surviving free of disease. Myelosuppression and vomiting were moderately severe but tolerable. Azotemia and peripheral neuropathy were infrequent and milk. These drugs have major activity in this poor-risk group and should be studied as part of initial therapy when enhanced efficacy and reduced toxicity are to be expected.

Adult↗
PubMedDate not supplied

Primary malignant mesodermal ovarian sarcomas.

Primary malignant mesodermal ovarian sarcomas are rare tumors and have a poor prognosis. The disease is usually diagnosed at a late stage and 5-year survivals are uncommon. Most patients are treated with debulking surgery followed by adjuvant chemotherapy. We report ten patients treated at a single institution. All patients underwent surgery and 90% received adjuvant chemotherapy. The median survival was 20 months, and only one patient survived beyond 5 years. Newer treatment strategies are urgently needed in the management of this disease.

Adult↗
PubMedDate not supplied

Atypical squamous cells of undetermined significance. A cytohistologic study of 52 cases.

OBJECTIVE: To evaluate the significance of atypical squamous cells of undetermined significance (ASCUS) by correlating the histologic findings following a diagnosis of ASCUS on a cervical cytologic smear. STUDY DESIGN: Eighty-four smears that had been called ASCUS over a five-month period and that had corresponding histologic material were reviewed independently. Only 52 of the 84 cases on which a consensus was reached were retained for the current study. RESULTS: The breakdown of the follow-up histologic diagnoses was as follows: 28 cases (54%) were negative (without squamous intraepithelial lesions [SIL]); 22 cases (42%) showed SILs, of which 14 (27%) were low grade, 5 (10%) were high grade and 3 (5%) had SILs that could not be further classified because of fragmentation of the endocervical curettings. Finally, two cases (4%) proved to be invasive cervical carcinoma on histology despite smears that were satisfactory and not limited by the quantity or quality of material; in these the discrepancy was attributed to sampling error. CONCLUSION: Patients whose cervical cytologic smears fall into the category of ASCUS may, on follow-up, exhibit a wide spectrum of findings, ranging from no pathologic abnormality to frequent SIL and even to invasive carcinoma in rare instances. A diagnosis of ASCUS on smears warrants careful follow-up and investigation.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

Conventional cervical cytologic smears vs. ThinPrep smears. A paired comparison study on cervical cytology.

OBJECTIVE: To compare the time required for evaluation, the diagnostic accuracy and quality of conventional glass slide smears vs. ThinPrep smears in 365 women. STUDY DESIGN: Both smears were obtained at the same time using the Accellon Combi cervical biosampler. Histology served as the diagnostic "gold standard." RESULTS: The average screening time was 1 minute, 23 seconds, shorter per smear with the ThinPrep method as compared to the conventional glass slide (P < .001). Direct diagnostic agreement between the two smear methods was obtained in 311 of 364 evaluable smears (85.4%, kappa = .63). Despite the relatively high rate of "adequate but limited by absence of transformation zone components" observed with the ThinPrep method, the sensitivity and specificity of the ThinPrep method was slightly greater but not statistically significantly different than the conventional technique, irrespective of the disease categories (low and high grade squamous intraepithelial lesion and invasive cancer). CONCLUSION: The shorter time required to screen ThinPrep smears compared to conventional smears in this study was not sufficiently important to offset the current unit price for preparing ThinPrep smears.

Adenocarcinoma↗