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Brice Gayet

Publications and source records attributed to Brice Gayet.

5 recordsLinked to original sources
PubMed2005

Intensive systemic chemotherapy combined with surgery for metastatic colorectal cancer: results of a phase II study.

PURPOSE: To evaluate the efficacy and tolerability of the metastatic irinotecan plus oxaliplatin (MIROX) strategy (adjuvant FOLFOX-7 followed by FOLFIRI), in patients with resectable metastatic colorectal cancer. PATIENTS AND METHODS: Forty-seven patients with resectable metastases of colorectal cancer were prospectively enrolled onto this study. Treatment consisted of six cycles of leucovorin 400 mg/m(2), oxaliplatin 130 mg/m(2) in a 120-minute infusion, and fluorouracil (FU) 2,400 mg/m(2) in a 46-hour infusion, every 2 weeks (FOLFOX-7), followed by six cycles of leucovorin 400 mg/m(2), irinotecan 180 mg/m(2) in a 90-minute infusion, bolus FU 400 mg/m(2), and FU 2,400 mg/m(2) as a 46-hour infusion, every 2 weeks (FOLFIRI). Surgery was performed before chemotherapy in 25 patients and after six cycles of FOLFOX-7 in 22 patients (six cycles of FOLFIRI were administered after surgery). RESULTS: All but one of the patients underwent curative surgery. Two patients refused postoperative chemotherapy. Tolerability was generally good. The main toxicities were grade 3 to 4 neutropenia (13%) and thrombocytopenia (11%); no febrile neutropenia or bleeding occurred, and there were no deaths caused by toxicity. Two pathologically confirmed complete responses and 15 partial responses were obtained with FOLFOX-7 in the 22 patients who received this regimen before surgery (overall response rate, 77%; 95% CI, 68 to 86). The median disease-free survival time was 21 months; the median overall survival has not yet been reached. The 2-year overall and disease-free survival rates were 89% and 47%, respectively. CONCLUSION: The MIROX strategy is feasible and well tolerated by patients with resectable metastatic colorectal cancer. Progression-free and overall survival rates are promising, with a median of 38 months of follow-up. This strategy currently is being compared with the leucovorin and FU regimen in a phase III trial.

Adult↗
PubMed2005

Pre-operative predictive factors of early recurrence after resection of adenocarcinoma of the esophagus and cardia.

OBJECTIVES: To determine pre-operative predictive factors of early recurrence in patients with esophageal and cardial adenocarcinoma. PATIENTS AND METHODS: We retrospectively analyzed consecutive patients who underwent resection for esophageal and cardial adenocarcinoma in our institution between October 1992 and October 2001. Patient files were studied and classified according to the occurrence of early recurrence (within one year) (group A) and patients without recurrence (group B). Pre-operative clinical, biological and radiological parameters were recorded. Both groups were compared in univariate and multivariate analysis. RESULTS: One hundred patients underwent surgical resection. Tumor was located in lower esophagus in 71 cases and at the cardia in 29 cases. R0 resection was feasible in 95 cases. Hospital mortality was 2%. Survival rate at 3 years was 56%. Recurrence before 1 year occurred in 28 patients (group A) and not in 72 (group B). In univariate analysis, younger age (P=0.01), dysphagia (P=0.04) and percentage of weight loss (P<0.0004) were significantly different between both groups. Weight loss more than 10% was observed in 2 patients of group B, and in 9 patients of group A. In multivariate analysis, weight loss more than 10% was the only pre-operative factor associated with early recurrence (P=0.018). CONCLUSION: Important weight loss could be a pre-operative predictive factor of early recurrence after resection of esophageal and cardial adenocarcinoma and surgery as first line treatment could be avoided in these patients.

Adenocarcinoma↗
PubMed2003

Major digestive surgery using a remote-controlled robot: the next revolution.

HYPOTHESIS: A remote-controlled robot can be used to perform computer-enhanced major digestive laparoscopic surgery. DESIGN: Cases series for assessment of the feasibility and safety of this technology in major digestive surgery. SETTING: Tertiary care referral center. PATIENTS: Between September 5, 2001, and December 20, 2001, 5 patients (4 men and 1 woman; mean +/- SD age, 66 +/- 5 years) underwent laparoscopic sigmoidectomy, proctectomy, restoration of continuity after Hartmann operation, Whipple procedure, and right liver lobectomy. In each of the procedures, a remote-controlled robot was used to perform some stages of the surgery. During these stages, the surgeon was seated at a distance from the operating table and performed the surgery using the robot, which offers enhanced intracorporeal tool manipulation and spatial vision. RESULTS: Sigmoidectomy was the only procedure that was completely performed with the robot. For the other procedures, the mean +/- SD duration of robot use was 25% +/- 10% of the operative time. Stages of colorectal surgery, retroportal dissection, 2 anastomoses during a Whipple procedure, hepatic pedicle dissection, and initial hepatotomy were performed using the robot. This technology facilitates laparoscopic anastomoses. The principal drawbacks were the time required for robot mobilization, absence of grip strength feedback, limited availability of adapted surgical tools, and the cost of the system. There was no mortality. Two of the 5 patients experienced complications, a postoperative ileus and unexplained sepsis after the Whipple procedure, both of which were treated medically. CONCLUSIONS: For these procedures, laparoscopic computer-enhanced surgery seems safe and feasible. This introduction of computing to major digestive surgery opens the door to enhanced-reality surgery and new types of surgical education.

Aged↗