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Biomedical subjects

P Debourdeau

Publications and source records attributed to P Debourdeau.

At least 19 recordsLinked to original sources
PubMed2001

Influence of the delay of adjuvant postoperative radiation therapy on relapse and survival in oropharyngeal and hypopharyngeal cancers.

PURPOSE: To determine whether the delay between surgery and the beginning of radiation therapy influences survival or the risk of local-regional relapse in oropharyngeal or hypopharyngeal squamous cell carcinomas. METHODS AND MATERIALS: From 2052 patients referred to the Henri Becquerel Center for the radiation therapy of an oropharyngeal or hypopharyngeal cancer between January 1, 1981 and December 31, 1992, 420 were included in a retrospective study. Exclusion criteria were another cancer, metastasis, incomplete resection, lack of homolateral lymph node resection, or previous chemotherapy. Radiation therapy delivered 45 to 75 Gy on initial location and lymph node. Follow-up was performed until December 31, 1997. A Cox proportional hazard regression analysis was used to evaluate the prognostic factors. RESULTS: The delay between surgery and radiation therapy was not found to be a significant prognostic factor for survival or risk of local-regional relapse. The only parameters found to influence local-regional and survival control were margins' pathologic state (respectively p < 0.0001 and p = 0.015) and T (p < 0.0001) and N (respectively p < 0.0001 and p = 0.0004) stages. In terms of local-regional relapse only, age was a prognostic factor (p = 0.048), and a trend was noted for tumor emboli in vessels or nerves (p = 0.061). CONCLUSION: In patients with oropharyngeal or hypopharyngeal squamous cell carcinoma, the delay between surgical procedure and radiation therapy does not influence survival or risk of local-regional relapse. Radiation therapy might be subjected to complete healing in these patients.

Analysis of Variance↗
PubMed2001

[Unusual testicular tumor: an ectopic spleen].

The authors report a case of discontinuous splenogonadal fusion diagnosed after left orchidectomy. Ectopic spleen in the scrotum is a rare congential anomaly frequently associated with other anomalies, especially limb defects. The diagnosis is difficult. Preoperative isotope scanning and intraoperative pathological examination can be performed to avoid unnecessary orchidectomy.

Adolescent↗
PubMed2001

[Bacterial cerebral aneurysms without infectious endocarditis: analysis of a case and review of the literature].

INTRODUCTION: Bacterial intracerebral aneurysms, which are a common complication of infectious endocarditis, are unusual without Osler's disease. EXEGESIS: From the case report of a man with a bilateral bacterial intracranial aneurysm without endocarditis resulting in an hypopituitarism, we undertook a literature review of bacterial intracerebral aneurysms without endocarditis. CONCLUSION: Although this review has found few cases, this kind of aneurysms seems to have different features from those secondary to infective endocarditis: younger age of incidence, majority of Staphylococcus aureus, clinical presentation as a thrombophlebitis of the cavernous sinus, location of aneurysm on bigger cerebral artery.

Adolescent↗
PubMed2000

[Horton's disease in the course of chronic hepatitis C].

BACKGROUND: Vascularitis is a well-known extrahepatic manifestation of chronic hepatitis C. Mixed cryoglobulinemia is the most common form. To our knowledge, the present case is the first report associating chronic hepatitis C and temporal arteritis. CASE REPORT: A 56-year-old man with chronic hepatitis C in the precirrhogenic phase presented with fever and weight loss. The patient complained of pain of the scapular and pelvic girdles and headache and physical examination revealed claudication of the jaw and abolition of the upper limb pulses. Biopsy of the temporal artery confirmed the diagnosis of Horton's disease. The patient also had bilateral stenosis of the sub-clavian arteries. DISCUSSION: This observation of Horton's disease involving large vessels in a patient with chronic hepatitis C suggests that an infectious factor might trigger vascularitis.

Adrenal Cortex Hormones↗
PubMed1999

[Treatment of thrombotic microangiopathies].

Thrombotic thrombocytopenic purpura and hemolytic uremic syndrome appear as the same expression of thrombotic microangiopathy (TMA), which is a single pathological entity affecting small blood vessels leading to hemolytic anemia, circulatory changes with renal (hemolytic uremic syndrome, HUS) or nervous (thrombotic thrombocytopenic purpura, TTP) involvement. Because of his low incidence, prospective randomized clinical trials are difficult to conduct and apart from plasma exchanges (PE) which appear superior to plasma infusions (PI), other therapeutic recommendations are based on retrospective studies or on anecdotal reports with limited number of patients. In the absence of appropriate therapy, mortality rate was initially above 90% in adults with TTP. Plasma infusions and plasma exchanges have dramatically improved prognosis of the disease, since more than 80% of patients respond to therapy with a survival greater than 80 to 90%. Analysis of data of medical literature shows that plasma exchanges can cure 82% of TMA with 15% of refractory TMA and a mortality rate of 14%. In two randomized trials, PE are more effective than PI with a response rate benefit of 25% and an overall survival increase of 15%. Although severe thrombocytopenia is frequently observed, it is important to avoid platelet transfusions. Platelets infusions induce deleterious effects since they add to the severity and the extend of microvascular thrombi formation. Use of glucocorticoids, heparin, antiplatelet therapy, intravenous immunoglobulin and vincristine are associated with variable results and no controlled study supports their use. Splenectomy is still under discussion but could be of interest in case of relapsing thrombotic microangiopathies as an attempt to reduce the rate of TMA recurrence.

Adrenal Cortex Hormones↗
PubMed1999

[Small cell lung carcinoma].

Small cell lung carcinoma represents less than twenty five percent of all lung cancers. Nevertheless, a lot of studies permitted to better define this cancer and to propose specific therapeutic approaches. Clinical symptoms, results and roles of chemotherapy, radiation therapy and surgery are discussed in this review.

Antineoplastic Agents↗
PubMed1996

[Therapeutic intensification and autotransplantation of hematopoietic stem cells in metastatic breast cancers].

The first studies on intensive chemotherapy for metastatic breast cancer conducted in the 80s were disappointing. Despite good response rates, the duration of remission was short and long-term survivals exceptional. Nevertheless, these phase I and II trials helped to develop a better understanding of the potential indications of this new therapeutic approach and apprehend its technical aspects. Over the last 5 years, considerable progress has been made in grafting techniques and hematopoietic support greatly improving the safety of the method. Notwithstanding the financial considerations involved, it must be noted that the efficacy autologous stem cell support, in terms of recurrence-free overall survival, has not yet been demonstrated although the (controversial) results of two randomized controlled trials have recently been published. In France, the PEGASE programs for the study of autologous stem cell support in breast cancer have been developed in an attempt to elucidate the question.

Antineoplastic Agents↗
PubMed1996

[Classical anticoagulant treatment of venous thromboembolic disease in cancer patients. Apropos of a retrospective study of 71 patients].

In order to evaluate the efficiency of classical anticoagulant therapy for venous thromboembolic disease in cancer patients, we retrospectively analysed 71 patients treated with intravenous heparin first and then with antivitamin K. After a mean follow-up of 185 +/- 25 days, 23 patients (33%) were dead; nine patients (12%) had suffered from major haemorrhagic complications, which were not fatal, four of which were due to heparin overdosage; 17 patients (24%) showed recurrent venous thromboembolic disease. According to univariate statistical analysis, risk of major bleeding was not associated with the presence of either thrombocytopenia, abnormal blood coagulation, metastases and/or any other hemorrhagic risk factors; recurrence of venous thromboembolic disease was not associated with the presence of other risk factors for venous thromboembolic disease, nor with the presence or absence of metastases and/or of ongoing chemotherapy. Such results suggest that classical anticoagulant therapy for venous thromboembolic disease in cancer patients is neither effective nor safe. The present retrospective study underlines needs for further prospective analyses in order to evaluate potential benefit from other therapeutic strategies, such as use of low molecular weight heparins and/or vena cava filter placement.

4-Hydroxycoumarins↗
PubMed1995

[Ossified bronchial neuroendocrine tumors: 3 cases].

Large calcium deposits can occur in neuroendocrine tumours of the bronchi and have been observed more frequently with the development of tomodensitometry which is now used for the diagnosis of calcified lung tumours including neuroendocrine tumours. The knowledge of such calcified images should not however mask the possibility of a malignant tumour.

Adult↗