Biomedical subjects
J Faivre
Publications and source records attributed to J Faivre.
[Basal cell nevus syndrome and medulloblastoma].
Explore the source record for details and available documents.
[Colorectal cancers disclosed by an obstruction. Frequency and prognosis in a population].
The registry of digestive tumors of the department of Cote-d'Or recorded between 1976 and 1982, among 1543 colorectal cancers, 142 cases (9.2%) diagnosed with acute obstruction. Distribution of the tumors along the large bowel was as follows: rectal cancers were rarely obstructive (3.8%) whereas it was a more common feature in the sigmoid (14.2%), the caecum (12.2%) and the transverse colon (15.8%). Symptoms preceded the acute obstruction in 39.7% of the cases. Limited tumors were rare in obstructive cancers, 2.8% were Dukes A, 30.3% Dukes B; the corresponding data for non obstructive cancers were 15.6 and 27.7% respectively (P less than 0.01). Treatment was surgical in 97.9% of obstructive cancers. Surgery was more often palliative in obstructive tumors (45.8%) than in the other types of tumors (21.3%; P less than 0.01). The postoperative mortality rate was 30.9%, ie 21.6% after curative surgery, 30% after palliative surgery, 43.6% after derivative surgery. The overall survival rates for obstructive cancers were 42.7% after one year and 17.6% after 5 years; they were respectively 59.1 and 31.1% for non obstructive cancers (P less than 0.001). After curative surgery and excluding postoperative mortality prognosis was the same for obstructive and obstructive cancers within the same Dukes' stage. This study permitted to highlight the rather high frequency of obstructive colorectal cancers, and their bad prognosis linked to the extension of the tumors and to high postoperative mortality rates.
Biliary tract cancers in Cote-d'Or (France): incidence and natural history.
The registry of digestive tract tumours established for the department of Cote-d'Or (France) was used to study the epidemiological characteristics and the natural history of biliary tract cancers. Age standardised incidence rates for gallbladder cancers were 2.7/100,000 for women and 0.9/100,000 for men. The corresponding rates for extrahepatic bile duct cancers were 0.5/100,000 and 1.7/100,000, and for ampulla of Vater cancer 0.3/100,000 and 0.3/100,000. The three cancers differ in their descriptive epidemiology and should be considered separately in epidemiological analytical investigations. The incidence of each of the three diseases increased with age, and cancers of known histological type were mainly adenocarcinomas. Some gallbladder cancers were undifferentiated or squamous cell carcinomas. There was no significant variation in incidence for gallbladder cancer and extrahepatic bile duct cancer over the eight years of the study. The association with gallstones was frequent in gallbladder cancer: 70.5% compared to 13.0% in other biliary tract cancers (less than 0.001). Although the association of gallbladder cancer with gallstones is frequent, few patients with cholelithiasis experience development of a gallbladder cancer. It is necessary to identify among patients with gallstones a subgroup at high risk of gallbladder cancer in whom prophylactic surgery might be justified. Biliary tract cancers are seldom diagnosed early: lymph nodes or visceral metastases were present in 77% of gallbladder cancers, in 83% of extrahepatic bile duct cancers, and in 55% of ampulla of Vater cancers at the time of diagnosis. The corresponding resectability rates were 46.1%, 11.9%, and 38.9%. The five-year overall survival rates were 2.9% for gallbladder cancer, 0% for extrahepatic bile duct cancer, and 18.3% for ampulla of Vater cancer. The corresponding five-year survival rates after surgery for cure were 10.3%, 0%, and 35.7%. Biliary tract cancer still represent a great therapeutic challenge.
[Diagnosis and follow-up of Russel's diencephalic cachexia by echography, x-ray computed tomography and nuclear magnetic resonance].
A diencephalic astrocytoma was diagnosed by ultrasonography in a 5 months old girl with nystagmus and emaciation. A 27 months follow-up with ultrasonography, computed tomography and magnetic resonance imaging, showed an initial improvement after irradiation and afterwards the development of complications with ventricular dilatation and parenchymal calcifications.
[Screening for colorectal cancer: a national problem].
Explore the source record for details and available documents.
[De novo interstitial deletion of the long arm of chromosome 2: 46,XXX,del(2)(q14q21), associated with premature craniosynostosis].
A female newborn with premature cranial synostosis and facial dysmorphism including bulging forehead, hypertelorism, downward slanting palpebral fissures, low set ears and a short nose with broad flattened nasal bridge, was shown to have the karyotype 46,XX,del(2)(q14q21). We suggest that the appearance of isolated or associated premature fusion of cranial sutures is related to a structural alteration of the long arm of chromosome 2.
[Cancer of the gallbladder in the Côte d'Or].
The registry of digestive tract tumours established for the department of Côte d'Or was used to study the epidemiologic characteristics and treatment of gallbladder cancer. During 8 years (1976-1983), 139 new cases were recorded. Age standardized incidence rates based on world standard population were 3.1/100,000 for females, 0.9/100,000 for males. As in all population-based studies, there was a female predominance. As compared with the data of other cancer registries the risk in the Côte d'Or is in the intermediate range. The incidence of gallbladder cancer was similar in urban and rural areas, but high risk lieus were identified by the study. The most frequent histologic type was adenocarcinoma (79.5 p. 100). Only 20.9 p. 100 of the patients underwent curative surgery. The overall 1-year survival rate was 14.4 p. 100 and the 5-year survival rate was 2.9 p. 100. The 5-year survival rate was 11.5 p. 100 after curative surgery. These results underline the fact that the prognosis of gallbladder cancer in a well defined population remains poor. The frequency of gallstones was 73.3 p. 100 in females and 56.5 p. 100 in males. Although this association is frequent few people with cholelithiasis develop gallbladder cancer. Among patients with gallstones, a subgroup at high risk of gallbladder cancer, in whom prophylactic surgery might be justified, remains to be identified.
[Survival in colorectal cancers in population statistics].
Available population based survival statistics for colorectal cancers were compared. The results based on relative survival rates showed similar data in Finland, Norway, Geneva and Cote d'Or. The survival rates were lower in Great Britain and Iceland. Several factors complicate survival comparisons: age, exact localization of the tumour, definitions and distribution of tumour stages. Adjustment of these factors is necessary. If their definitions differ, no conclusion can be based upon the data. Population based survival figures provide public health authorities with a basis for monitoring cancer patient care. They are also useful for assessing the resources required for cancer treatment, follow-up and rehabilitation. They provide clinicians with survival data for reference.
Haematopoietic malignancies in Côte d'Or (France): a population based study.
A registry of haematopoietic malignancies was established on January 1, 1980 in order to accurately determine the incidence and epidemiological features of these diseases in the department of Côte d'Or (population 478,000). Over five years (1980-1984), 704 new cases were recorded. The crude incidence rates were 32.7 per 100,000 for males and 24.9 per 100,000 for females. The corresponding age standardized rates were 26.4 and 16.7. The sex ratio was 1.6:1. In males, chronic lymphocytic leukaemias were the most common haematopoietic malignancies, followed by non Hodgkin's lymphomas, acute leukaemias and multiple myelomas. In females, multiple myelomas and acute leukaemias preceded non Hodgkin's lymphomas and chronic lymphocytic leukaemias. For men and women, the risk of haematopoietic malignancies was higher in urban areas than in rural areas. Compared to population based registries in other countries, incidence rates are among the highest reported and are particularly high for chronic lymphocytic leukaemia.
[Proctology. Surgical technics].
Explore the source record for details and available documents.
[Cancer of the esophagus in the department of Côte-d'Or].
The registry of digestive tract tumors established for the department of Côte-d' Or was used to study the incidence and characteristics of oesophageal cancer in the area. The crude annual incidence rate was 15.5/100,000 for males, ans 1.1/100,000 for females. The corresponding age standardized rate (world standard) were 12.7 and 0.6. The sex ratio was 21.2. As compared to other cancer registries the Côte-d' Or is in intermediate range for males, in the low range for females. The incidence of oesophageal cancer was similar in urban and rural areas. The risk of oesophageal cancer in males was five times higher in workers than in high executives and professionals. There was no significant variation in oesophageal cancer incidence over the 8 years of the study. Rates tended to decrease slightly in both sexes. Most cancers were squamous cell carcinomas (92%). Adenocarcinomas represented 5% of the cases. The risk of an associated tumour of the upper respiratory and digestive tract was important (17.5%). Only 10.4% of the patients underwent curative surgery, while 53.4% were referred for radiotherapy alone. The overall 1-year survival rate was 18.4%, and the 5-year survival rate was 2.8%. The 5-year survival rate was 7.2% after curative surgery, and 3.2% after radiotherapy. These results underline the fact that the prognosis of oesophageal cancer in a well defined population where only one patient out of ten can benefit from curative surgery, remains poor.
[Management by specialists of patients with digestive cancers in the Department of Côte-d'Or].
The relative frequency of consultation of the different specialists involved in the diagnosis and treatment of cancer is not well known in France. This study was completed with data collected by the Digestive Tract Cancer Registry in Côte d'Or. Among 3.192 digestive tract cancers diagnosed between 1976 and 1982, 64 p. 100 were treated by gastroenterologists or surgeons. Only 18% of the patients consulted an oncologist. The frequency of consultation of gastroenterologists in the care of digestive tract cancers was independent on the location of the cancer but varied with the place of residence, fluctuating from 69.7% for patients living in the town of Dijon, to 39.9% for patients living in a town with a regional hospital without gastroenterologist. The inverse phenomenon was observed for oncologists. They treated 63.2% of the patients with esophageal cancer and 31.2 p. 100 of patients with rectal cancer, but less than 10 p. 100 of the patients with gastric, colonic, liver, biliary tract or pancreatic cancer. The number of surgeons consulted depended essentially on the operability of the cancer. Between 1976 and 1982 consultation with gastroenterologists and surgeons by patients with digestive tract cancer increased by 4.4 p. 100 (p less than 0.05) and 2.1 p. 100 per year (p less than 0.01), respectively. The frequency of consultation of oncologists remained stable: +0.3 p. 100 per year. These results confirm the importance of a training policy oriented towards specialists who are not oncologists. They must take note of their importance in the diagnosis and the organization of the fight against digestive tract cancers.
[Does Ming's classification of gastric carcinomas have epidemiologic or prognostic value?].
The population based registry of digestive tract tumours of the country of Cote-d'Or was used to assess the epidemiological and prognostic value of Ming classification. The 211 gastric carcinomas operated or autopsied between 1976 and 1981 in this population were reviewed on a pathological basis. The expansive type (46.0%) was nearly as frequent as the infiltrative type (47.9%). In 6.2% of the cases it was impossible to classify carcinomas in one of these two types. The male/female ratio was higher in the expansive type (3.0) than in the infiltrative type (2.2) and the mean age of patients at the time of diagnosis was higher in the expansive type (69.5 years) than in the infiltrate type (66.4 years p less than 0,05). Ming classification was difficult to use with superficial carcinomas: 9 out of 12 could not be classified. Among invasive cancers only 1.5% were not classified in one of the two types. Polypoid and fungating carcinomas were more often of the expansive type (70.1%). On the contrary infiltrative carcinomas (ulcerated or not) corresponded to the infiltrative type of Ming in 65.6%. It was not possible to extrapolate the WHO classification to the Ming classification. Infiltrative carcinomas were more often associated with hyperplastic stroma (38.1%) than did expansive carcinomas (5.2%) the proportion of carcinomas limited to the digestive wall was higher in the expansive type (21.7%) than in the infiltrative type (5.0%). The survival rate was better in the expansive type (41.4%) than in the infiltrative type (30.1%) but the difference was not significant. The prognosis depended partly on the time of diagnosis. The results suggest that Ming classification has an epidemiological interest. It allows us to distinguish two types of carcinomas that appear quite different on basis of their growth and penetration capacity. However its prognostic interest appears limited.
[Mastoplasty without cutaneous resection. A new technic for the treatment of ptosis and hypertrophy of the breast].
A new technique is presented for the treatment of mammary ptosis and hypertrophy. Its originality lies in the absence of skin resection and the use of the preserved derma for the reconstruction of the breast. In simple ptose, the derma will increase the stability of the mammary gland. In hypertrophy, the derma replaces the mammary gland, reducing the size of the secondary involutions.
Gastric carcinoma in Côte d'Or (France). A population-based study.
The registry of digestive cancer in the Department of Cote d'Or, France, recorded newly diagnosed cases of gastric cancer between 1976 and 1980. The annual incidence rate, adjusted to the world population, was 15.2/100,000 for men and 6.1/100,000 for women. Stomach cancer incidence showed a substantial decline during the 5 yr of the study and this decline was more pronounced in men than in women. The operability rate was 62.4% and the resectability rate was 40.2%. Operative mortality after curative surgery was 17.6%. For all subjects, 17.6%, 29.1%, and 26.0% had localized, regional, and distant disease, respectively. The remaining 27.3%, not operated upon, with no evidence of metastases, had unclassifiable disease. The overall 5-yr corrected survival rate was 16.5%. In the absence of curative surgery all patients died in the 4 yr after diagnosis. After curative surgery the 5-yr corrected survival rate (excluding operative mortality) was 42.8%. The most important determinant of the survival was the pathological stage of the tumor. The age-corrected 5-yr survival was 98.7% for cases limited to the digestive wall, 45.5% for cases involving the serosa, and 26.6% for cases with locoregional extension. These results support the fact that, although declining, gastric cancer remains relatively frequent. Its overall prognosis in a well-defined population, where cases limited to the digestive wall are rare, remains poor.
[Cancers of the rectum and colon in the Côte-d'Or department: treatment, prognosis].
The population based registry of digestive cancers in the french county of Côte-d'Or enables a study of the treatment and prognosis of colorectal cancers. During 1976-1981, 587 rectal cancers and 717 colon cancers were diagnosed. Curative resection was performed in 61 p. 100 of rectal and colon cancers. Operative mortality after curative resection was 9.7 p. 100 for rectal cancers and 13.1 p. 100 for colon cancers. The overall 5 year observed survival rate was 26.5 p. 100 for rectal cancers and 29.8 p. 100 for colon cancers. After curative surgery, 5 year corrected survival rates was 57.2 p. 100 for rectal cancers and 66.9 p. 100 for colon cancers. Five year survival rate was related to the topography of the cancer (it was lower for caecal cancers), to the macroscopic type of growth (it was higher for exophytic carcinomas than for infiltrative carcinomas) and to the size (it was higher for tumors less than 3 cm than for larger tumors). The major determinant of the survival was the pathological stage of the tumor. Patients with Dukes' A lesions at the time of curative surgery had almost the same life expectancy as persons without rectum or colon cancer. These data suggest that a substantial improvement in prognosis might result from earlier diagnosis of the disease. This commands modifications in the policy of detection of colorectal cancers.
[Malpighian cancer of the anal canal in Côte-d'Or. Epidemiological and therapeutic aspects].
The registry of digestive tract tumours established for the department of Côte-d'Or was used to study the incidence and the treatment of squamous cell cancer of the anal canal. In the course of 7 years (1976-1982), 45 new cases of anal canal cancer were recorded. Age standardized rates using world standard population are 1.3/100,000 for females, 0.3/100,000 for males. As compared to other cancer registries, Côte-d'Or is in the high range for females, in the average range for males, the cases included 44% with T1-T2 tumours (less than 4 cm), 47% with T3-T4 tumours (more than 4 cm) and 9% unknown (Tx). Lymph node involvement was found in 1/3 of cases, metastatic disease in 11%. Six patients were treated by local excision, 13 by abdomino-perineal resection (combined with postoperative radiotherapy in 5 cases), 20 by radiotherapy (combined with a derivation in 2 cases) and 6 by symptomatic treatment. For T1-T2 normal anal function was preserved in 79% of cases. The 5 year local recurrence rate for curative treatment was 44%. The 5 year observed survival rate was 42.6%; the 5 year relative survival rate was 53.3%. The survival was related to the age, to the sex, to the size of the tumour, and to the nodal status.