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Biomedical subjects

J Faivre

Publications and source records attributed to J Faivre.

At least 199 records · Page 11Linked to original sources
PubMed1994

[Risk of locoregional recurrence after resection of cancer of the rectum].

Using the Registre des Tumeurs Digestives of the Côte-d'Or, a survey was conducted to study the risk of local recurrence of patients after curative surgery for rectum cancer diagnosed between 1976 and 1984 in the above mentioned department. Data was available in May 1987 for 448 patients, or 95% of the recorded cases. The cumulative local recurrence rate was 5.9% at 1 year, 19.1% at 3 years and 24.4% at 5 years. It was independent of sex, age, site of the cancer, time of diagnosis and length of distal margin (for cancers treated by anterior resection). On the other hand, the risk of local recurrence varied with macroscopic appearance (distinguishing fungating cancers from other macroscopic types), size (less than 6 cm on more than 6 cm), extension into the bowel wall (cancer limited or not to the wall) and degree of node invasion (no node involvement, 1 or 2 invaded nodes, more than 2 invaded nodes). The results of Cox model indicate that these 4 variables independently influence the risk of local recurrence. These data, which are interesting because of having been collected from a general population, are useful in planning therapeutic trials and in specifying postoperative surveillance methods. They suggest that, independently of extension into the bowel wall and node involvement, the macroscopic appearance and size of the cancer influence the risk of local recurrence.

Aged↗
PubMed1993

Influence of socioeconomic status on prognosis of colorectal cancer. A population-based study in Côte D'Or, France.

BACKGROUND: The prognostic significance of the socioeconomic status of patients treated for colorectal cancer, although stated in some studies, remains controversial. METHODS: The authors studied a population-based series of 771 patients with colorectal cancer diagnosed in Cote D'Or, France, between January 1976 and December 1980. Survival was studied for the first 5 years after diagnosis. The relationship between socioeconomic status, assessed by comfort of housing, and the main clinical prognostic factors was examined. The influence of comfort of housing on prognosis was studied with the Cox model, while controlling for these factors. Interactions between type of housing and other prognostic factors also were tested. RESULTS: Compared with patients living in a comfortable house, patients in the medium or no-comfort categories were more likely to receive diagnosis at an advanced stage (P = 0.03) and be treated by palliative therapy (P = 0.0005). After adjustment for these factors and age, sex, place of residence, and tumor site, patients living in no comfort had a twofold higher risk of dying during the follow-up period compared with patients living in comfortable housing, with the relative risk being 1.5 for the medium comfort category (95% confidence intervals, 1.3-3.2 and 1.2-1.7, respectively). This effect was more remarkable in patients with early-stage tumors than in patients with advanced tumors. CONCLUSIONS: Such findings should prompt public health measures for earlier access to care structures for people in a lower social class and research for a better understanding of the host-tumor relationship.

Age Factors↗
PubMed1993

[Nutrition and colorectal cancer].

Results from case-control studies and prospective studies suggest that diet is involved in the causation of large bowel cancer either as initiator, promoter, or inhibitor of carcinogenesis. There is fairly consistent evidence concerning the protective effect of green vegetables. There is some evidence relating fat intake or protein intake to colorectal cancer whereas fiber intake or calcium intake would be inversely related to colorectal cancer. Recent data suggest that tobacco could be involved in adenoma formation and alcohol in adenoma growth. Available data are not sufficient to serve as a basis for firm specific dietary advice. In the present situation it is attractive to investigate available hypotheses within the framework of intervention trials.

Colorectal Neoplasms↗
PubMed1993

Cerebral non-Hodgkin's lymphoma discovered when treating Hodgkin's disease.

Case report of the appearance of a highly malignant cerebral non-Hodgkin's lymphoma of a diffuse large cell type, type B, occurring at the immediate onset of chemotherapy for a stage IV (mediastino-pulmonary) Hodgkin's disease (nodular sclerosis) diagnosed in a 16-year-old boy. The treatment of this cerebral lymphoma associated primary chemotherapy with high dose methotrexate, high dose aracytine, etoposide, and ifosfamide. The chemotherapy proved to be highly efficient, producing complete remission. Thoracic and abdominal irradiation for Hodgkin's disease was performed concomitantly with chemotherapy for the non-Hodgkin's lymphoma. This treatment was followed by 36 Gy of cerebral irradiation. Thirty-six months after the discovery of the cerebral non-Hodgkin's lymphoma the patient was still disease-free and doing well.

Adolescent↗
PubMed1993

Age and prognosis of non-small cell lung cancer. Usefulness of a relative survival model.

The aim of our study was the comparative evaluation of a relative survival model and a Cox model to determine the prognostic factors of survival for patients with surgically cured non-small cell lung cancer (NSCLC). We focused particularly on the exact role of age in this survival. 156 patients treated between 1975 and 1988 were studied. Both univariate and multivariate analyses were performed, using the actuarial method and the Cox model for crude survival and the Hakulinen model for relative survival. This study confirmed the poor prognosis of NSCLC, even if a curative surgical procedure has been possible, with a 5-year survival of 48% for stage I tumours but only 6% for stage III tumours. The most significant prognostic factor was the postsurgical TNM staging. The relative survival method of Hakulinen dismissed age as a significant prognostic factor. Our study underlines the usefulness of relative survival methods which should be more frequently employed to allow comparisons between series of different origin and to set up multicentre therapeutic trials.

Adult↗
PubMed1993

[Breast reconstruction after mastectomy or breast amputation].

The authors give their personal experience at Montreuil Hospital. Always it's secondary reconstruction, never immediately Three problems: The restoration of the mammary gland. Its can d: by musculo skin flaps or skin expanders. The restoration of the areolar and the nipple Many techniques are used: tattooing or, free skin graft contralateral. The attitude about the contralateral breast It must take into account: of desire of the patient; of volume of the breast; of existence or not of ptosis. It's very important to reduce the scars. The periareolar technique is the best.

Body Image↗
PubMed1993

[Forum on tissue expansion. Value of cutaneous expansion for the covering of synthetic materials used in cranioplasty. Apropos of a case].

The authors present a case of cover of synthetic material by expanded skin. In a context of post-sepsis revision, this cover proved to be of excellent quality, superior to normal scalp. The specific characteristics of tissue expansion may possible explain, in this context, the superiority of the expanded skin. The authors intend to adopt a similar therapeutic approach is such a situation should arise in the future.

Female↗
PubMed1993

[Diagnostic modalities and treatment of cancer of the pancreas. Evolution in the population in the department of Côte d'Or from 1976 to 1988].

There is no study establishing time trends for the diagnostic and therapeutic approaches to pancreatic cancer based on population data. The data of the Registry of Digestive Tumors of Côte-d'Or (France) were used to this end in 544 cancers diagnosed between 1976 and 1988. The proportion of the histologically confirmed cases increased annually by 13.4% (P < 0.001). This was mainly due to progress in percutaneous biopsy (+25.7% per year between 1983 and 1988, P < 0.001). As regards the diagnosis, ultrasonography was used more frequently (+21.9% per year, P < 0.001) as well as CT scan since its introduction in 1983 (+19.6% per year, P < 0.001). Pancreatic cancer was diagnosed by sonography in 16.7% of the cases in 1976 and 70.6% in 1988 (mean annual variation: +5.7%, P < 0.001). The proportions for CT scan were 12.8% in 1983 and 23.5% in 1988 (mean annual variation: +3.5%, NS). There was no significant change in the use of retrograde cholangiopancreatography over time. Other diagnosis criteria were less frequently used: laparoscopy was no longer used after 1983 and intraoperative diagnosis was made less frequently (-2.5% per year, P < 0.001). Endoscopy or radiographic data were rarely used as a diagnosis criterion. These changes in approaches to the diagnosis of pancreatic cancer were not accompanied by any progress in diagnosis stage, therapeutic approach or survival suggesting that when clinical symptoms become evident, pancreatic cancer is already advanced. Therapeutic advances, early diagnosis in patient at risk or identification or reasons for pancreatic cancer are the only means of progress in this problem.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

Adenoma--carcinoma sequence or "de novo" carcinogenesis? A study of adenomatous remnants in a population-based series of large bowel cancers.

Although it is well known that colorectal cancers can arise on a preexisting adenoma or de novo, the relative importance of these two pathways is still highly controversial. The authors studied the proportion of cancers with adenomatous remnants in a nonselected population-based series of 1630 resected colorectal cancers, so that they could estimate by subsite the importance of the adenoma-carcinoma sequence. Four factors appeared to be related independently to the presence of adenomatous tissue within cancers in a multiple logistic model: tumor extension, growth pattern, location, and size. It appeared that infiltrating and ulcero-infiltrating tumors, which represented 39.8% of all resected colorectal cancers, very rarely displayed adenomatous tissue (0.5%), whereas it was more common in fungating and ulcero-fungating cancers (25.8%; P less than 0.001). In these exophytic cancers, the presence of adenomatous tissue was related very closely to the tumor size and extension, and it was seen in as many as 83% of small cancers (less than 2 cm) limited to the mucosa or submucosa. Right colon cancer showed consistently fewer adenomatous remnants than left colon or rectal cancer. These figures suggest that there are roughly two types of colorectal cancers, one of the infiltrating or ulcero-infiltrating type, which usually would arise de novo and account for approximately 40% of all colorectal cancer cases, and the exophytic type, which would mainly follow an adenoma-carcinoma sequence, although some might be de novo cancers, in particular in the right colon.

Adenocarcinoma↗
PubMed1992

Prognosis of gastric carcinoma after curative surgery. A population-based study using multivariate crude and relative survival analysis.

A population-based series of 246 gastric cancer patients operated for cure and who survived the postoperative phase was reviewed to determine prognostic factors after potentially curative treatment. The overall five-year observed survival rate was 34.8%, and the relative survival rate was 43.9%. Previous history of gastric ulceration, tumor location, tumor size, gross appearance, extension within the gastric wall, and number of proximal lymph nodes involved were significantly related to both crude and relative survival rates. Age was a significant prognostic factor when considering crude survival rates, but it had no influence on relative survival rates. Multivariate analysis of crude and relative survival gave similar results except for age. The covariates retained in the final model were, by decreasing importance, extension within the gastric wall, lymph node involvement, gross appearance and tumor location. Combining the two major prognostic criteria, tumor extension through the gastric wall and lymph node involvement, four prognostic categories could be determined with five-year corrected survival rates ranging from 92% in patients with a carcinoma limited to the gastric wall to 17% in patients with more than two positive nodes whatever the extension in the gastric wall. Gross appearance had no influence on prognosis for carcinomas limited to the gastric wall, but had a significant impact on prognosis of more extended carcinomas. From these data, a simple staging system requiring only routinely available pathological data was proposed. This classification could be helpful for planning multicenter clinical trials on this disease where progress in therapy is needed.

Carcinoma↗
PubMed1992

Views of a general population on mass screening for colorectal cancer: the Burgundy Study.

BACKGROUND: The success of a screening program depends on a number of factors, including the validity of the test, its efficacy, its feasibility, and the rate of compliance. Thus, it is important to determine the factors influencing compliance to the screening test in order to obtain a high participation rate. METHODS: A mass screening campaign for colorectal cancer using the Hemoccult test was conducted in Burgundy, France. One year later, a questionnaire was mailed to a random sample of the population to assess the views of the general public (870 persons who had not completed the Hemoccult test, 750 persons who had a negative test, and 100 persons who had a positive test). The compliance rate of this survey was 32.2% among persons who had not completed the screening test, 88.2% among persons with a negative result, and 98.0% among persons with a positive result. RESULTS: The main reason for not participating was not wanting to know more about their health status (34.3%). Of the factors credited with encouraging persons to perform the test, the most important ones were the practitioner's explanations (55.7%) and the leaflet sent by mail (42.5%). The impact of the media campaign was weak. A small portion of the population (4.3%) said that they were very anxious while waiting for the results. Among persons with a positive screening test, only 1.2% regretted having taken it. Among those who took the test, 94.2% said they were ready to do it again; and among those who did not take it, 36.7% would accept it at a second screening. CONCLUSIONS: The data suggest that overall the Hemoccult is well accepted, that the campaign did not upset the population, and that it is worthwhile at the second screening to include those who did not participate in the first screening test.

Aged↗
PubMed1992

Different multiple regression models for estimating survival: use in a population-based series of colorectal cancers.

Two additive models for estimating relative survival, recently available in statistical packages, were compared to the Cox model in order to define practical criteria for choosing one of these three models. The three models were applied to a series of 1062 colorectal cancer incident cases recorded at the "Registre des Tumeurs Digestives de Côte d'Or" to study the impact on survival of age, sex and socio-economic status. The respective advantages of each method and facilities of each program were identified. This study emphasized the importance of multiple regression models for estimating relative survival: from the epidemiologist's point of view, they reinforce the validity of international comparisons of survival statistics, from the clinician's point of view, they permit to identify the real prognostic significance of variables related to life expectancy in the general population.

Age Factors↗