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Biomedical subjects

J Lemerle

Publications and source records attributed to J Lemerle.

At least 217 records · Page 12Linked to original sources
PubMed1976

Wilms' tumor: natural history and prognostic factors: a retrospective study of 248 cases treated at the Institut Gustave-Roussy 1952-1967.

A statistical analysis of 248 histologically proven cases of Wilms' tumor treated at the Institut Gustave-Roussy, Villejuif, France, from 1952 to 1967, is presented. Two years recurrence-free survival and five years survival have been selected as prognostic criteria. Patients under two years of age have significantly fewer metastases and a better five-year survival rate than those over two. Stage is stronly correlated with recurrences and survival. Influence of tumor size, number of tumor nodules, tumor rupture, adhesions, regional lymph node involvement, and renal vein infiltration is shown. Detailed analysis of histopathologic features indicates that a favorable clinical course is significantly related to the number of different varieties of epithelial differentiation (tubular, glomerular, microcystic) found in any tumor, whatever the abundance of each of them. Presence of striated muscular cells, however abundant, does not influence survival or metastatic rates. Cases where irradiation given prior to surgery resulted in complete destruction of tumor cells, form a distinctive group of very unfavorable prognosis. Relapse of tumor occurs in 54% of cases, 10% presenting with metastases. Involved sites are listed. No correlation is found between date of metastases and other parameters. The three major prognostic factors of age, stage, histologic pattern, bear prognostic value separately. Stage and age are linked, as well as histology and age. Stage and histology are not linked. Age in itself therefore seems less important. It is concluded that these well-defining treatment for each individual case.

Age Factors↗
PubMed1976

Preoperative versus postoperative radiotherapy, single versus multiple courses of actinomycin D, in the treatment of Wilms' tumor. Preliminary results of a controlled clinical trial conducted by the International Society of Paediatric Oncology (S.I.O.P.).

The preliminary results of a controlled clinical trial organized by the S.I.O.P. of radiotherapy and chemotherapy in patients with nephroblastoma are presented. Forty-two centers have participated. Between September 1971 and October 1974, 398 patients were registered; 195 were eligible for the trial and were randomized. The remaining 203 patients were excluded from the trial, but were followed in the same way as the patients in the trial. The results were evaluated in terms of recurrence-free survival rate and survival rate. Results in patients who received preoperative and postoperative radiotherapy (group A, 73 patients) were compared with the results in patients who recieved only postoperative radiotherapy (group B, 64 patients). The tumor ruptured at surgery in three patients of group A, and in 20 patients of group B, a difference that is statistically significant. No significant difference in survival and recurrence-free survival between groups A and B is observed at present. Results in patients treated with a single course of actinomycin D (group I, 80 patients) were compared with the results in patients treated with multiple courses (group II, 80 patients). At present, no significant difference is found between the two groups.

Adolescent↗
PubMed1976

Trial and study on nephroblastomas S.I.O.P. No. 1.

The International Society of Paediatric Oncology (S.I.O.P.) organised a study and trial on nephroblastomas in September 1971. This first trial was stopped in October 1974. In this period, 398 patients were included in trial and study. Patients came from 42 Centres in 14 countries. Eligible for the clinical trial were 195 patients. The clinical trial consisted of 2 parts: Part 1. Radiotherapy: Pre- and post-operative radiotherapy versus post-operative radiotherapy alone. Part 2. Chemotherapy: One single course of actinomycin D versus multiple courses of actinomycin D. For the radiotherapy trial, 137 cases were suitable after randomization. Concerning the recurrence-free survival, there were no significant differences following the actuarial statistical method. The same for survival. There was a high rate of ruptures in the post-operative group. These ruptured cases caused a higher rate of metastases and asked for a heavier treatment. Especially because of these ruptured cases the conclusion is drawn that pre- and post-operative radiotherapy is a better way of treatment for nephroblastomas when they cannot be expected to be a stage I tumour on clinical grounds. For the chemotherapy trial, 160 cases were suitable. There was no difference between the group of patients receiving a single course versus multiple courses of actinomycin D. Disease-free interval and survival in both groups in all stages were the same. The conclusion is drawn that this way of treatmetn does not make any difference. In a second study, chemotherapy with two agents is considered in two groups of patients receiving 6 months chemotherapy vincristine and actinomycin D versus 15 months.

Child↗
PubMed1975

Radiation enteritis in children. A retrospective review, clinicopathologic correlation, and dietary management.

The clinicopathologic features of radiation enteritis are reviewed in 44 children receiving whole abdominal radiation therapy between 1961-1972 at the Institut Gustave-Roussy. Five of 14 long-term survivors (36%) developed severe delayed radiation injury with small bowel obstruction, occurring within 2 months after completion of irradiation. All had previously had acute radiation reaction during therapy. Histologic appearance in the small bowel at the time of delayed radiation injury revealed severe villus blunting, lymphatic dilatation, and moderately dense inflammatory infiltrate. All patients with delayed radiation injury showed marked clinical improvement coincident with a fractionated low-residue, low-fat diet, free of gluten and free of milk and milk products. The abnormal small bowel roentgenographs and small bowel biopsies reverted to a normal appearance in association with the diet. No exacerbation of radiation enteritis has been seen following dietary therapy.

Adolescent↗