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Biomedical subjects

B Vankemmel

Publications and source records attributed to B Vankemmel.

At least 19 recordsLinked to original sources

Comparison of surgery and radiotherapy in T1 and T2 glottic carcinomas.

We retrospectively studied 356 patients who received treatment for T1 and T2 glottic carcinomas. Two hundred and thirty patients were treated with surgery (200 by cordectomy, 15 by vertical partial laryngectomy, and 15 by subtotal laryngectomy). Radiotherapy was used to treat 126 patients. There were 206 T1 and 24 T2 lesions in the surgically treated group and 107 T1 and 19 T2 lesions in the radiotherapy group. Sixty-four patients received radiotherapy because it was the treatment of choice (scheduled radiotherapy) and 62 patients received radiotherapy because they had medical contraindications for surgery (default radiotherapy). Actuarial survival rates at 5 years were 84% for patients who underwent surgery and 78% for patients who underwent scheduled radiotherapy. In the surgically treated group, there were 10 local recurrences in 170 patients with tumors of the true vocal cord, eight recurrences in 36 patients with anterior commissure lesions, and 6 recurrences in 24 patients with tumors extending to the arytenoid. In the scheduled radiotherapy group, there were 7 local recurrences in 38 patients with true vocal cord tumors, 6 recurrences in 20 patients with anterior commissure tumors, and 5 recurrences in 6 patients with tumors extending to the arytenoid. We conclude that survival is similar in these patients whether they receive operative treatment or scheduled radiotherapy. However, in the radiotherapy group, local recurrences were more frequent in patients with tumors extending to the arytenoid. We advocate extended functional surgery for patients with T1 and T2 glottic lesions except for those with small tumors arising from the middle third of the vocal cord.

Carcinoma, Squamous Cell

[Mobile tongue cancer. Prognostic value of lymph node invasiveness. Apropos of 744 cases].

Between 1974 and 1983, 744 carcinomas of the mobile tongue were treated at Centre Oscar Lambret. 54% of the tumours were T1 T2 and 66% N0 (84% for T1 T2 - 46% for T3 T4) (UICC, 1979). The 3 and 5 year survival rates were 47% and 35% for N0 patients versus 17% and 11% for patients with palpable cervical node. In 598 patients without a previous history of neoplasm, this cancer was isolated at first examination. The pronostic study was carried out only on this group. Palpable lymph node reduced the 5 year survival to one third by affecting the local and neck control and risk of distant metastases. 311 patients underwent at least an unilaterale neck dissection. The 5 years survival rate for N- group (68%) was double that of the N+ R- group (32%) which in turn was double that of the N+ R- group (14%). The presence of 3 or more positive nodes or one infra-omohyoid node divided the survival by 3 (22 and 20% respectively versus 68% for N- patients).

Adult

[Cancer of the upper aerodigestive tract. Global study of 2418 cases].

The authors present the general results of a retrospective study on 2418 patients treated between 1976 and 1980. Primaries were located on buccopharynx in 51% of cases, pharyngolarynx in 45% and nasopharynx or nasal and paranasal cavities in 4%. Two out of 3 tumours were classified T3 T4 (UICC 1979) and 1 out of 2 patients presented with palpable cervical lymph nodes. Taking into account persistent diseases and recurrences, failure at primary sites occurred in 40% of patients, in the neck in 20%, distant metastases in 10%. Synchronous and/or metachronous cancers were observed in 1 out of 3 patients. Actuarial survival rates were 2/3 at 1 year, 1/3 at 3 years, 1/4 at 5 years and 1/7 at 8 years. Endolaryngeal tumours had the best prognosis while hypopharyngeal tumours had the worst prognosis.

Adult

[Different modalities of the radiosurgical combination in the treatment of tumors of lateral buccopharyngeal junction].

Results are presented of combined transmaxillary buccopharyngectomy-radiotherapy treatment of 290 tumors of lateral buccopharyngeal junction. Post-therapeutic course was uncomplicated but 8 postoperative deaths are reported. Secondary extension of tumor was noted in 109 patients and another cancer in 64. Actuarial survival at 3 years was 54%, at 5 years 39% and at 10 years 17%. Lingual and muscle extensions were the most difficult to control and first intention excision is therefore performed when bone invasion has occurred. In contrast, total dose radiotherapy should probably precede surgery for forms with lingual and/or muscle extension.

Adult

[Total ethmoidectomy by frontal and transmaxillary approach].

Four patients with cancer of ethmoid with extension to base of skull were treated by total ethmoidectomy through a subfrontal and transmaxillary approach, the complementary paralateronasal approach being necessary in only one case. Apart from the approach routes, particular features of the technique used were essentially the size of the frontal flap extending to orbital roof, and mainly the confection of a pericranial flap formed of epicranial aponeurosis lined with frontoparietal periosteum and pedunculated at the orbital border. Exposure of the tumor by the neurosurgical and sublabial transmaxillary route allows correct excision of cancers extending to cribriform plate. The pericranial plate completes the traditional base of skull plastic operation and appears to reduce risk of cerebromeningeal complications. The technique is proposed for cancer infiltrating meninges: it is valid whatever the age of patients.

Adenocarcinoma

[Carcinomas of the upper aerodigestive tract before age 40 (excluding children). Apropos of 100 cases].

A series of 100 young adults with carcinoma of upper respiratory and digestive tracts; and examined successively, is reviewed. As in older adults, the oropharynx was the most frequent localization with, in contrast, fewer endolaryngeal tumors and more rhinopharyngeal cancers. Progression appeared to be more rapid in young adults and alcohol and smoking a more important factor than in the older age group. Overall prognosis in the older age group. Overall prognosis seemed somewhat better for these younger patients. Epidemiologic surveys would appear to be essential.

Adolescent

[Carcinomas of the upper aerodigestive tract in the female. Apropos of 132 cases].

A series of 132 female patients with carcinoma of upper respiratory and digestive tracts, and examined successively, is reviewed. The mean age of the group was sensibly higher than that of the group of male patients used as reference. Progressive stages of the disease were similar in the female and male groups. The must frequent localization was buccopharyngeal, naso-sinusal and nasopharyngeal lesions being observed more frequently than in men. Alcohol and smoking were perhaps less important factors in women. Overall prognosis was better in the female group. Detailed epidemiologic surveys involving. This population would appear to be essential.

Adolescent

[The use of the pectoralis major myocutaneous flap in cervicofacial and particularly buccopharyngeal, surgery. Apropos of 42 cases].

During the last two years, we have used a pectoralis major myocutaneous flap in 42 cases (28 after radiotherapy). The immediate post-operative periods were very simple and the flap reliability was remarkable: only three partial necrosis and no total necrosis were observed. This technique seems to be an important contribution in the field of buccopharyngeal surgery, especially in the case of extensive tumors involving the tongue. In that case, initial radiotherapy followed by extensive surgery with myocutaneous flap reconstruction seems to be the best therapeutic strategy. It is the authors' feelings that local control will probably be better but long term results will be still poor. Effectively, in case of extended tumors general prognosis has to be taken in account as well as local prognosis.

Adult

Lymph node invasion in hypopharynx and lateral epilarynx carcinoma: a prognostic factor.

Hypopharynx (HC: pyriform fossa, postcricoïd area, and posterior wall) and lateral epilarynx carcinomas (LEC: aryepiglottic fold, pharyngoepiglottic fold, and arytenoïd) have a high tendency to cervical lymph node invasion. Such nodal extension is a well-known prognostic factor. This study is based on a retrospective review of 884 clinical records of previously untreated HC or LEC. Seventy percent of patients revealed palpable nodes at their first examination, with a higher percentage for HC (73%) than LEC (62%). The 5-year survival rate was divided by three in the presence of contralateral, bilateral, or fixed nodes, or in cases of nodes exceeding 3 cm. Multiple positive nodes, extracapsular spread, or lower-neck positive nodes significantly decreased survival, doubled the number of neck recurrences, and tripled the number of distant metastases while control at the primary site remained unvaried.

Adult