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J Dauplat

Publications and source records attributed to J Dauplat.

At least 37 records · Page 2Linked to original sources
PubMed2001

[Stewart-Treves syndrome following mastectomy for breast cancer: a case report].

INTRODUCTION: Stewart-Treves syndrome has been defined by the eponymous authors as a lymphangiosarcoma in a setting of postmastectomy upper extremity lymphoedema. EXEGESIS: The clinical record of one patient with Stewart-Treves syndrome is analyzed. The primary angiosarcoma of the skin represented by a purple nodule occurred on a chronic lymphoedematous arm following radical mastectomy and axillary lymph node dissection for breast carcinoma performed 9 years earlier. Immunohistochemistry tests formally eliminated epithelial cutaneous metastasis and produced evidence in favour of conjunctive vascular tissue origin of the tumor. CONCLUSION: Conservative surgery for breast cancer, application of axillary sentinel node biopsy in the lymphatic staging and prevention of arm lymphoedema should reduce the incidence of this syndrome.

Arm↗
PubMed2001

[Uterine sarcoma in patients receiving tamoxifen therapy. Apropos of 2 cases].

INTRODUCTION: Tamoxifen--a non steroidal triphenylethyl compound--in addition to having antiestrogenic properties may provoke weak estrogenic effects, the well known "paradoxical effects" on the female genital tractus. Concern has been raised about prolonged tamoxifen treatment and subsequent occurrence of endometrial adenocarcinoma; subsequent attention has been drawn through high risk histologic subtypes including poorly differentiated patterns and uterine sarcomas. EXEGESIS: We report two cases of uterine sarcoma arising in postmenopausal women taking tamoxifen, 20 mg daily during 38 and 42 months, for breast carcinoma: one leiomyosarcoma and one endometrial stromal sarcoma; both cases were asymptomatic and detected by pelvic sonography. CONCLUSION: Further studies will be required to establish if there is a relationship between long term tamoxifen exposure and highly aggressive types of cancer of the uterine corpus exhibiting adverse histologic features such as uterine sarcomas. There is no consensus regarding uterine surveillance of women receiving tamoxifen. We advocate an annual gynecologic examination plus imaging by means of transvaginal ultrasonography.

Aged↗
PubMed2001

Ovarian cancer.

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Chemotherapy, Adjuvant↗
PubMed2001

[High-dose chemotherapy in advanced epithelial ovarian cancer].

Since more than thirty years, ovarian cancer is wellknown to be chemosensitive. However, long term results of advanced stages remain low with 5 years overall survival around 20%. That's why high-dose chemotherapy in this chemosensitive disease has to be considered. Here, authors report the french, european and american experiences in three clinical settings: first in consolidation after complete or very good partial response, second after relapse or for refractory disease, third as first line treatment to increase clinical and pathological complete responses and improve prognosis. The more promising results concern high-dose chemotherapy as consolidation setting. The preliminary results of the french multicentric randomized phase III study (high-dose versus conventional dose) gives a favorable trend for high-dose approach as consolidation. This unique trial would definitively establish the place of high-dose chemotherapy in the first line treatment of advanced epithelial ovarian cancer.

Antineoplastic Agents↗
PubMed2001

[Management of ovarian cancer].

Ovarian carcinoma is the worst gynecologic cancer due to an advanced stage at diagnosis in two thirds of the cases. Advanced stages are usually characterized by a large tumor burden on the ovaries as well as metastatic disease in the peritoneal cavity. Early stages are more common in young women and the surgical treatment should comprise the tumor excision and a comprehensive abdominal staging to be sure that there is no extension beyond the ovaries--unilateral oophorectomy can preserve the fertility before childbearing. No treatment is needed after surgery in stage I without poor prognostic factors. Adjuvant chemotherapy should be applied postoperatively in the other cases. The best likelihood of prolonged survival is observed after optimal debulking surgery and chemotherapy in advanced stages. If possible surgery should be performed at first but in most advanced stage with large tumor volume in the upper abdomen according to clinical and CT-scan examination, the concept of chemosurgical debulking should be considered. Interval surgery underwent after three or four courses of front line chemotherapy but this strategy should be further evaluated by clinical trials. Currently paraplatin associated with paclitaxel is the most commonly used regimen due to its effectiveness and lower toxicity. In a near future progress can be expected with new protocols. Thank to aggressive surgery and chemotherapy many patients should be able to reach a complete remission of their disease but most of them will still die of recurrent disease. At this point, two questions should be answered: 1) how to manage the residual abdominal disease in order to prevent the recurrence. No consolidation treatment demonstrated any superiority but the French experience and trial with high dose chemotherapy supported by autologous stem cells transplantation showed recently positive results? 2) How to manage the recurrent disease with sometime indication for secondary surgical debulking and always chemotherapy? This is the field for testing new drugs or new strategies. A large number of patients should enter clinical trials in order to answer these questions and due to the very poor prognosis of this disease large attention should be given to the quality of life of theses patients.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2000

[Standards, options, and recommendations for initial management of patients with malignant ovarian epithelial tumors].

UNLABELLED: Suprapubic and transvaginal pelvic ultrasound exploration is indicated for suspected ovarian tumor (standard). Diagnosis and search for extension require surgery and pathology examination. Systematic preoperative computed tomography is not recommended (standard). Surgery for cancer of the ovary is a specialized procedure requiring skill in cancer, gynecology, visceral surgery and laparoscopic surgery. If the patient is referred to a specialized center after a primary procedure considered to be inadequate, a new procedure is recommended for staging. Residual tumor volume after the primary procedure has prognostic value. Systematic second look procedures are not recommended for routine practice (standard). For patients with grade IA G1 tumors, there is no indication for complementary treatment (standard). For patients with grade IA G2-3 or clear cell tumors, IB, IC, IIA, there is no standard. OPTIONS: no complementary treatment, complementary chemotherapy using platinum, complementary external abdominopelvic radiotherapy. A complementary treatment is recommended for grades IC and IIA. Complementary treatment for grades IIB (no residual tissue), IIC (with residual tissue), III (no residual tissue), is based on: complementary chemotherapy with platinium, complementary external abdominopelvic radiotherapy (options). Complementary treatment for advanced forms (IIB (with residual tissue), IIC (with residual tissue), III (with residual tissue) and IV) is based on polychemotherapy with platinium (standard). OPTIONS: platinium combined with paclitaxel (intravenous), platinium combined with cyclophosphamide and/or doxorubicin (intravenous) or intraperitoneal cisplatin combined with cyclophosphamide (intravenous). The chemotherapy work-up includes physical examination, assay of serum markers (particularly CA125) and abdominopelvic computed tomography (proof level B) (standard). Physical examination is recommended for monitoring patients in complete remission with no sign of suspected recurrence (standard). This document was reviewed in April 1977. The working group again validated the Standards, OPTIONS and Recommendations, without modifications in June 1999.

Antineoplastic Agents, Hormonal↗
PubMed2000

Ovarian cancer.

Explore the source record for details and available documents.

Journal Article↗
PubMed2000

[Parathyroidectomy by elective route with perioperative measurement of parathyroid hormone. Report of 80 cases].

STUDY AIM: The aim of this study was to report a series of 80 patients treated by unilateral neck exploration for a sporadic primary hyperparathyroidism. PATIENTS AND METHOD: Between April 1992 and November 1998, 80 patients (65 women and 15 men, mean age: 63.5 years) with a single gland enlargement localized by ultrasonography, were operated on through a short unilateral neck incision, under general anesthesia in 72 cases and local in eight cases. The enlarged gland was removed with intraoperative pathological examination and intraoperative monitoring of parathyroid hormone. RESULTS: Mean duration of surgery was 25 minutes. There was no postoperative mortality or morbidity. Mean duration of hospital stay was two days. The enlarged gland was an adenoma in 75 cases and an hyperplasia in five. Adequate intraoperative parathyroid hormone decrease was observed. Postoperative calcemia was normal in 78 patients (97.5%). Among 76 surviving patients, with a 31-month follow-up, there was only a suspicion of persistent hyperparathyroidism in two patients. CONCLUSIONS: Minimal invasive approach by unilateral neck exploration may be performed with safety and efficiency in patients with a single gland enlargement under intraoperative monitoring of parathyroid hormone.

Adult↗
PubMed2000

[Breast cancer detected by a stellar opacity. Histologic characteristics: 155 cases].

UNLABELLED: Retrospective study (1985-1998) concerning surgical and histopathological features of 155 subclinical breast cancers revealed by spiculated opacity on screening mammograms. MATERIALS AND METHODS: The patients were 44-78 years old (mean age, 58.5 years), 129 were postmenopausal. Preoperative localization was stereotactic in 57 instances (36.5%), sonographic in 98 instances (63.5%). Maximum tumor diameter varied from four to 25 millimeters (mean diameter 11 mm), below 10 min in 97 cases, below 5 mm in 15 cases. Axillary lymph node dissection was performed immediately (95%) or secondarily (5%). RESULTS: Subclinical breast tumors exhibiting spiculated picture were infiltrating carcinomas: Infiltrating ductal carcinoma (IDC) in 130 cases (84%), infiltrating lobular carcinoma (ILC) in 25 cases (16%). Not any ductal carcinoma in situ (DCIS) was detected by such an irregular opacity. The grading according to Scarff-Bloom-Richardson was used in IDC: 95 grade I (73%), 31 grade II (24%), four grade III (3%). Hormone receptor status was obtained upon 145 tumors: both estrogen receptors were present in 125 cases (86%). Axillary lymph node involvement (N+) was found in ten cases (6%), always concerning IDC > 5 mm. Conservative surgery was achieved in mort cases (97%). DISCUSSION: Subclinical breast cancers revealed by spiculated opacity were predominantly corresponding to infiltrating process IDC or ILC, in contrast with breast cancers revealed by microcalcifications, mainly meaning DCIS. In our experience mammographically-detected spiculated malignant tumors were not bearing unfavourable pathological or biological features: they appeared commonly well differentiated and hormonosensitive, furthermore axillary lymph nodes were rarely involved.

Adult↗
PubMed2000

Potential allogeneic graft-versus-tumor effect in a patient with ovarian cancer.

A 33-year-old woman developed progressive ovarian cancer resistant to classical chemotherapy agents. We performed a bone marrow allograft after a myeloablative regimen. During hematological recovery, she developed acute graft-versus-host disease (GVHD). From this time her tumor diminished progressively. One year post transplant she has limited chronic liver GVHD and is still free of disease. The complete remission of advanced ovarian cancer was probably related to the GVHD which might therefore provide a new treatment option for this disease.

Adenocarcinoma, Papillary↗
PubMed2000

[First line chemotherapy for advanced ovarian cancer in 2000: standards and questions].

Ovarian cancer is wellknown to be chemosensitive since more than thirty years. However, long term results of this disease remain low. That's why standard first line chemotherapy is evolving to attempt to increase disease free survival and overall survival. Before cisplatin, standard chemotherapy was an alkylant used alone, mainly melphalan. With cisplatin disponibility, cisplatin based chemotherapy like cisplatin-cyclophosphamide with or without doxorubicin (CP or CAP) is used. Carboplatin can replace cisplatin because theses two platinum compounds have the same tumoral efficacy. Carboplatin is less toxic and its administration is more easy; so carboplatin with cyclophosphamide is actually the standard combination for elderly patients. Paclitaxel-cisplatin or carboplatin became the new actual standard combination. However, questions are asked concerning first-line chemotherapy for advanced ovarian cancer. Some of them are resolved like optimal number of cycles (6 in average), intensity-dose of cisplatin (25 mg/m2/week or 75 mg/m2 every 3 weeks) or for carboplatin (300 mg/m2 every 3 weeks or dose calculation according to AUC of 5 to 7.5 mg/ml x min). Another questions are ongoing like the place of anthracyclins or new drugs in front-line, the use of intra-peritoneal way for cisplatin and the role of intensive chemotherapy or immunotherapy as consolidation.

Antibiotics, Antineoplastic↗
PubMed2000

[Assessment of different histoprognosis grading systems for primary ovarian cancer: 100 patients given the same treatment for primary ovarian adenocarcinoma].

BACKGROUND: Numerous grading systems have been proposed for invasive ovarian epithelial carcinoma. But, conflicting reports have been published addressing the value of grade as an independent prognostic factor. DESIGN: The present study investigated the consistency, reproducibility and prognostic value of four different grading systems in a series of 100 homogeneously treated (cytoreductive surgery & platinum based chemotherapy) patient. All the slides were reviewed in a double-blind manner by 3 pathologists, typed according to the WHO and graded. Multivariate assessment of survival time was performed with the Cox model. RESULTS: Population parameters - mean age: 60 years, - stage (FIGO) III & IV 85% - survival: 5 years OS: stage III & IV=22,5%. No significant difference for survival was observed when the patients were classified with any of the 4 grades evaluated. Prognostic factors: age<60 (p<0,001), optimal surgery (p<0,01), n+(p<0,02), necrosis>50% (p<0,04), mitotic count<15MF/10HPF (p<0,03) and vascular invasion (p<0,03). Those 3 parameters were assigned to a new highly relevant grade. At multivariate analysis, it was significantly associated with DFS and OS (p<0,01). CONCLUSION: Our grade is simple, useful for all histologic types, non subjective and reproducible. Further studies are warranted to confirm its clinical utility.

Adenocarcinoma↗
PubMed2000

[Ovarian transposition by laparoscopy in young women before curietherapy for cervical cancer].

OBJECTIVES: To evaluate the place of ovarian transposition by laparoscopy in an effort to preserve ovarian function without compromising oncological safety among young women requiring intravaginal brachytherapy before surgery for cervical cancer. MATERIAL AND METHODS: The series was represented by 20 cases, all FIGO stage I squamous cell malignant diseases of the cervix. Mean age: 32 years (range 23-40). Oophoropexy (7 instances) or lateral high ovarian transposition (13 instances) was performed by laparoscopy, just before brachytherapy using cesium 137. RESULTS: Continued hormonal function was achieved in 58% of the available cases, 50% (3/6) after oophoropexy, 68% (8/11) after ovarian transposition. Mean follow-up was 8.5 years (range 5-13). The mean radiation dose absorbed by the displaced ovary was 2.6 Gy (range 1. 2-5.9). CONCLUSION: Ovarian transposition through laparoscopy before brachytherapy should be advised for selected stage I squamous type malignant tumor size 2 cm without lymphatic/vascular channel invasion by neoplastic emboli and without lymph node involvement. This procedure has been abandoned in our institution, instead of this, primary surgical treatment is accomplished (laparoscopically-assisted vaginal) radical hysterectomy is associated with orthotopic ovarian conservation.

Adult↗
PubMed1999

[Neoadjuvant chemotherapy of breast cancer. Role of surgery in cases of complete clinical response].

OBJECTIVES: Assess the importance of systematic surgical exploration of the tumor focus in case of complete clinical response to neoadjuvant chemotherapy for operable breast cancer. PATIENTS AND METHODS: Between 1985 and 1997, first intention chemotherapy (4 to 6 cures) was given to 433 breast cancer patients with resectable tumors measuring > or = 3 cm but who required mammectomy. Complete clinical response was observed in 112 patients (26%); 31 of them had normal mammography and ultrasound examinations (7%). Local treatment in this favorable context varied: 82 patients underwent surgery (71 conservative procedures, 11 radical procedures) and 30 patients received radiation therapy alone. RESULTS: Complete histological response was obtained in 22 cases accounting for 6% of the entire series, 27% of the complete clinical responses, and 45% of the complete clinical and imaging responses. The incidence of local recurrence at a mean 107 month follow-up was compared between patients given complementary surgical or radiation therapy after complete clinical response. Recurrence was observed in 10 of the 82 operated patients versus 8 of the 30 nonoperated patients (12% versus 27%, NS). CONCLUSION: Complete clinical response after neoadjuvant chemotherapy does not rule out the need for surgical resection of the tumor focus because the risk of neoplastic reliquats remains high (3 out of 4 cases) and because the surgical specimen provides important histological information for prognosis (in vivo chemosensitivity test). lumpectomy also contributes to reducing the risk of local recurrence.

Breast Neoplasms↗