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J Dauplat

Publications and source records attributed to J Dauplat.

At least 91 records · Page 5Linked to original sources
PubMed1994

Taxol (paclitaxel) safety in patients with platinum pretreated ovarian carcinoma: an interim analysis of a phase II multicenter study.

The objective of this phase II, multicenter, prospective study was to evaluate the safety and the response rate of paclitaxel administered to patients with ovarian cancer. Eligible patients had histologically proven ovarian carcinoma and measurable or evaluable disease and had received at least one platinum-containing regimen and no more than three prior chemotherapy regimens. Paclitaxel was given as a continuous intravenous (i.v.) infusion over 3 hours every 3 weeks. Dose was determined by the number of prior chemotherapy regimens. Patients with one or two prior chemotherapy regimens received 175 mg/m2 (group A) and patients with three prior chemotherapy regimens 135 mg/m2 paclitaxel (group B) after premedication. Treatment was repeated every 3 weeks. An interim safety analysis for the first 99 evaluable patients, 72 treated with 175 mg/m2 and 27 treated with 135 mg/m2 paclitaxel, is reported here. Median number of courses analyzed per patient was four (range, 1 to 6) in the two groups, for a total of 393 courses evaluable for toxicity (286 in group A, 107 in group B). World Health Organization (WHO) grade 3-4 neutropenia was observed in 29.6% of courses in group A and in 23.3% in group B. Two group A patients, 1 at courses 3 and 4 and 1 at course 6, experienced WHO grade 2 fever or infection associated with a WHO grade 4 neutropenia.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[Immediate breast reconstruction following mastectomy for recurrence after conservative treatment].

The authors report their experience with immediate breast reconstruction following salvage mastectomy for local recurrence of invasive breast cancer after conservative treatment. From January 1987 to December 1992, among 91 immediate breast reconstructions, 41 were performed for this indication. The results and complications were analyzed for each of the three techniques used: simple prosthesis (n = 5), latissimus dorsi flap with prosthesis (n = 26), trans abdominalis musculocutaneous flap--TRAM flap (n = 10). Immediate flap reconstruction appears to be required in cases of either early or late local relapse since the skin has been irradiated and the mastectomy must be extensive. The transrectus abdominalis flap allows more extensive resection and gives better cosmetic results without the need for a prosthesis.

Adult↗
PubMed1994

[Latissimus dorsi myocutaneous flaps in oncologic breast surgery. 101 cases].

The authors report their experience of the use of a latissimus dorsi myocutaneous flap in reparative surgery after total or partial mastectomy for invasive breast cancer. The series, including 101 cases, was separated into four groups on the basis of the context: I--thoracic radionecrosis (5 cases); II--chest wall cover (24 cases); III--immediate breast reconstruction (57 cases); deferred breast reconstruction (15 cases). The well-known vascular reliability of this pediculated flap was confirmed here by the low incidence of necrosis (3%), always marginal. Other complications were not attributable to the flap itself but to concomitant radiodystrophic skin lesions and the presence of the prosthetic implant in the case of breast reconstruction.

Adult↗
PubMed1993

Advanced ovarian cancer. Drug resistance, supportive care and dose intensity.

BACKGROUND: Both intrinsic and acquired drug resistance occur in ovarian cancer. Much work on in vivo or in vitro, obtained drug resistance has been done and this knowledge is presently being converted into clinical studies. MATERIALS AND METHODS: The review focuses on the detoxifying system, MDR (multidrug resistance), and supportive care in relation to dose intensity. RESULTS: In vitro models suggest that the amount of glutathione, glutathione S-transferase activity or metallothioneins could play a role in the outcome of chemotherapy treatment. The results of human tumour samples studies however do not support this idea. Expression of the cell membrane P-glycoprotein in tumour cells appears in vitro to be an important adverse prognostic factor concerning the effect of natural products. Again the results in human tumour samples vary. The supportive agent sodium thiosulphate protects against cisplatin induced nephrotoxicity, but the exact role of sulphur compounds in ameliorating the neurotoxicity is not yet established. The neuropeptide Org 2766 may be a possible neuroprotector. Hemopoietic growth factors such as GM-CSF, G-CSF and interleukin-3, protect the bone marrow to varying degrees. Autologous bone marrow transplantation induces high, but often short lasting response rates in chemotherapy resistant patients. CONCLUSIONS: More clinical studies on intervention of drug resistance and on high dose chemotherapy are needed to define the role of these strategies in ovarian cancer.

Adult↗
PubMed1993

Advanced epithelial ovarian cancer: 1993 consensus statements.

BACKGROUND: Over the last few days of a 5-day international workshop held in June 1993, a group of specialists in the field of advanced epithelial ovarian cancer tried to reach consensus on a number of issues with implications for standard practice and for research. METHODS: Five groups of experts considered several issues which included: biologic factors, prognostic factors, surgery, management recommendations, dose intensity, supportive care, drug resistance, second-line treatment, investigational drugs, and tumour markers. Discussing the management recommendations, the group attempted to arrive at answers to four questions: Is there in fact a cure rate for advanced ovarian carcinoma? Are there prognostic factors which help to identify patients who will not do well with current therapy? What is the current best therapy for advanced ovarian carcinoma? What directions should research take in advanced ovarian cancer? In a plenary meeting these issues were discussed. RESULTS: Consensus statements were achieved on all topics mentioned above. This article reports on the statements written by the chairmen and approved by the consensus group.

Antineoplastic Agents↗
PubMed1993

[Bowel resections in cancers of the ovary ].

The authors report a retrospective series of 32 patients who were operated on by resection of bowel at various stages during the progress of epithelial pathology of malignant ovaries. These operations were carried out in one group during the initial operation, in a second group during a "second-look" operation and in a third group when late recurrences had occurred. Removal of bowel was possible to remove completely or to optimum effect malignant cell bearing areas in 22 cases (59%) and less than optimal reductions in 15 cases (41%). Forty-five different segments of bowel were resected consisting of 18 of the rectum and sigmoid, 11 of the right side of the colon, 9 transverse or left colon, and 5 of the small intestine and 2 of the stomach. One patient died from cardio-respiratory failure immediately after the operation. Seven cases had septic abdominal complications but they settled quickly without further surgery. It was not possible on studying the follow-up of these patients to find any statistically significant improvement in those who had complete or optimum resection as compared with those who were less completely operated on, and those who were operated on in a late stage of the illness. All the same even if it is not possible to show that there is a significant improvement in survival in the populations that have been compared in this study, it does seem advisable to practice bowel resection in order to reduce as much as possible cancer bearing cells so that chemotherapy can be applied more effectively and thus improve the prognosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Actuarial Analysis↗
PubMed1993

[Uterine metastases originating from breast cancer. Apropos of 12 cases].

The authors report a retrospective clinicopathologic analysis based on 12 cases of uterine metastases from breast cancer. The myometrium was more often involved than the endometrium, and a metastatic lesion occurred in an interstitial leiomyoma in one case. Bilateral ovarian involvement was associated in 11 cases. The histopathological type was predominantly represented by invasive lobular breast cancer in 10 cases: in this series, 3 subtypes were identified, the solid variant (6 cases), the classical variant (2 cases), and the alveolar variant (2 cases). The steroid receptor status in the tumor specimens was found to be constantly positive. The literature concerning the pathologic diagnosis was reviewed: most breast cancers metastasizing to the female genital tract and to the peritoneal surface appeared to be invasive lobular cancers.

Aged↗
PubMed1993

Advanced ovarian cancer. Dose intensity.

BACKGROUND: The rationale for dose intensity is based on pre-clinical observations in experimental model systems of cancer as well as upon retrospective studies correlating the impact of dose intensity upon response rates and survival. MATERIALS AND METHODS: A review has been performed based on trials attempting to compare the effects of two different dose intensities of either cisplatin or carboplatin, combinations of cisplatin and carboplatin, combined platinum with additional agents, and high-dose chemotherapy, regimens requiring hematologic support. RESULTS: The early phase II trials suggested that there may be an important dose response range over clinically achievable platinum doses, but randomized trials have failed to consistently show a clinically significant improvement with high-dose therapy. Reasons for this may be differences in patient selection, that total dose is the most important factor, or that a more than two-fold increase in dose intensity is needed to detect differences in response and survival rates. Phase I and II studies indicate that high, but short lasting, response rates can be achieved with high-dose therapy with haematopoietic support in refractory patients, but the toxicity is substantial. Paclitaxel dose intensity is presently being studied in several trials. CONCLUSIONS: Future trials of dose intensity should be focused upon patients with small volume disease and drug sensitive tumours.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1993

[Intestinal metastases from breast cancer. Apropos of 8 cases].

Eight patients with intestinal metastases from breast cancer are described. The different clinical presentations and pathological types are studied. The difficulty in distinguishing such uncommon secondary sites of breast cancer from primary intestinal cancer is emphasized. Attention should be paid to intestinal symptoms in women with a history of infiltrating lobular breast cancer: in agreement with recent literature data the lobular type seems mainly responsible for gastrointestinal and peritoneal involvement originating from breast cancer (7 cases out of 8 in our series). Prolonged survival could be obtained if no metastases elsewhere were found with appropriate treatment including ablative surgery, chemotherapy and hormonotherapy.

Aged↗
PubMed1993

[Ovarian abscess. A case of a dermoid cyst with a secondary infection].

The authors report a case of an ovarian abscess presenting as acute sciatica with pyrexia in a 36-years-old woman with an intrauterine contraceptive device. Imaging (plain X-ray of abdomen and CT scan) was clear-cut, showing an air pocket as a result of abscess formation and dental calcifications which enabled a preoperative diagnosis of dermoid cyst. The outcome was successful following appropriate surgical treatment and unilateral tubo-oophorectomy.

Abscess↗
PubMed1993

[Association of breast cancer and cancer of the uterus. 34 case reports].

A retrospective series of 34 cases of breast cancer combined with uterine cancer is reported. Cancers of the endometrium differed from cervical cancers by their number, 2.2 x more frequent (22 vs 10) and by the sequence of onset: they generally precede breast cancer, whereas they tend to follow cervical cancers. In contrast to the breast cancer/uterine cervical cancer association, which is considered to be fortuitous, the breast cancer/cancer of the uterine body association appears to be determined by a hormonal context. Through a review of the literature, a unifying endocrine theory is constructed, based on the role of hyperestrogenesis in mammary and endometrial carcinogenesis.

Adult↗
PubMed1993

[Superinfection of ovarian dermoid cyst. Apropos of a case].

One case of a rare complication of dermoid ovarian cyst is reported: infection. Sonographic examination was not helpful, mainly due to a great quantity of gas within the mass. However radiography of the abdomen with the patient upright and CT showed a gas-fluid level, teeth and presence of fat. These findings permitted diagnosis of a complicated ovarian dermoid cyst before surgery.

Adult↗
PubMed1993

[The axillopectoral muscle].

Extending between the pectoralis major and latissimus dorsi muscles, the "pectoro-axillary" muscle, the principal anatomic variation of the axillary wall, forms and ectopic muscle band that can complicate axillary dissection. The origin and features of this supernumerary muscle related to Langer's arch are described with emphasis on its surgical applications.

Breast↗
PubMed1992

[Pelvic and para-aortic lymphadenectomy in primary cancer of the ovary].

The results of pelvic and para-aortic lymphadenectomy performed in 24 patients with primary ovarian cancer are reported. The lymph node invasion rate was 20 percent in stages where the disease was apparently limited to the pelvis, and 73 percent in more advanced stages. Invasion was as frequently found at postoperative second-look laparotomy (54 percent) as at initial exploratory laparotomy (46 percent). Retroperitoneal expansion equally involved the pelvic and para-aortic lymph nodes: among 12 patients with positive lymphadenectomy, 8 had combined pelvic and para-aortic invasion, 2 had exclusively pelvic invasion and 2 had exclusively para-aortic invasion. We would therefore recommend to perform lymphadenectomy during the first operation, particularly in presumed stage I or II cancer, and to dissect the lymph nodes in both the pelvic cavity and the lumbo-aortic region.

Adult↗
PubMed1992

[Demons-Meigs' syndrome. A case of thecoma and ovarian fibroma].

The authors report two cases of Demons-Meigs' syndrome, one following an ovarian fibrothecoma and the other an ovarian fibroma. There was a striking rise in the serum CA 125 level which was higher than 200 UI/ml, suggestive of cancer of the ovary in both cases. With the help of the literature data, the clinicopathological features of this rare condition and the different hypotheses concerning its aetiology are commented.

Aged↗
PubMed1992

Intracholedocal metastatic thrombus of renal adenocarcinoma.

The authors report about the intraoperative discovery of a metastatic thrombus in the common bile duct, produced by a right renal adenocarcinoma metastasized in the Vth segment of the liver. As far as the treatment is concerned, in addition to nephrectomy, the use of a simple device allowed intraluminal irradiation with radioiridium. Although this approach is palliative, it resulted from the desire to maintain the patency of the common bile duct by controlling tumor proliferation within the duct. The pathogenesis of this proliferation is discussed. In our opinion, the favorable outcome after 18 months confirms the merits of this therapeutic attitude, which can be used for such tumoral extensions.

Aged↗