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Biomedical subjects

Christine Theodore

Publications and source records attributed to Christine Theodore.

10 recordsLinked to original sources
PubMed2005

Cancer of the penis.

Cancer of the penis is rare in Europe, accounting for less than 0.5% of all cancers. Phimosis and poor hygiene are strong risk factors whereas neonatal circumcision is a contributing factor in the prevention of this disease. More than 95% of penile carcinomas are squamous cell carcinomas. Early disease (stage I-II) is curable in most patients, who can be treated by conventional penile amputation or, in selected cases, by organ preserving techniques, including Moh's micrographic surgery, laser ablation or radiation therapy (external-beam, brachytherapy). For more advanced primary tumours, penile amputation is required. Survival of patients with penile cancer is strongly related to the presence and extent of nodal metastases. Bilateral inguinal lymphadenectomy is recommended for palpable lymph nodes that persist 3 or more weeks after removal of the primary tumour and a course of antibiotic therapy. In patients with proven inguinal lymph node metastases, bilateral ileoinguinal dissection should be performed. When the nodes are clinically negative, "prophylactic" inguinal lymphadenectomy may be a reasonable approach in patients with invasive tumours (T2 or greater), high grade tumours, or tumours exhibiting vascular invasion. The role of chemotherapy, as adjuvant and neoadjuvant or primary treatment in metastatic disease, needs to be further explored in prospective clinical trials.

Carcinoma, Squamous Cell↗
PubMed2005

[Follow-up of urothelial tumours. Guidelines of the Comité de Cancérologie de l'Association Française d'Urologie].

The follow-up of urothelial tumours is designed to allow early detection of recurrence or progression, for which treatment is possible. Recent interesting points are: the more frequent and simpler use of the new classification into low grade and high grade, essentially applied to the management and surveillance of tumours involving the mucosa or lamina propria; and the limited place of urinary markers.

Carcinoma, Transitional Cell↗
PubMed2004

Bladder-conserving surgery and interstitial brachytherapy for lymph node negative transitional cell carcinoma of the urinary bladder: results of a 28-year single institution experience.

BACKGROUND AND PURPOSE: We retrospectively analyzed results for lymph node negative transitional cell carcinoma of the bladder treated with brachytherapy. PATIENTS AND METHODS: From 1975-2002, 58 patients received preoperative external irradiation, partial cystectomy (in 69%), iliac node dissection, and iridium-192. Pathologic stage was: 10 pT1, 41 pT2, and 7 pT3. A median total brachytherapy dose of 60 Gy was delivered to the tumor bed. RESULTS: Mean follow-up was 76 months (range, 0.5-296). Tumor stage significantly impacted cause-specific and disease-free survival (P=0.02). Eight pT1 patients were free of disease and 2 died of other cause. For pT2 patients, 5-year cause-specific and overall survival rates were, respectively, 70% (CI 95%: 53-87) and 60% (CI 95%: 43-77). Three pT3 patients died of cancer. For the pT2 patients, the probability of 5-year local control was 65% (CI 95%: 47-83) and being alive without disease with a functional bladder, 50% (CI 95%: 33-67). Previous transurethral resection (TUR) increased the bladder relapse risk among pT2 patients (P=0.03). Twelve patients had severe acute complications and 5 had severe late effects. A high dose of external irradiation increased risk of late complications (P=0.01). Most complications occurred in patients treated before 1985. CONCLUSIONS: Highly select patients presenting with pT2 tumors less than 5 cm with no history of previous TUR may be successfully treated with low-dose external irradiation, limited partial cystectomy, and interstitial brachytherapy. High-risk pT1 patients may also benefit. Postoperative complications and late side effects are minimized with modern management. We recommend lifelong cystoscopic surveillance, with prompt surgical salvage for recurrence.

Aged↗
PubMed2004

'Burned-out' primary testicular cancer.

OBJECTIVE: To report the natural history of 'burned-out' testicular tumour (a testicular tumour that has regressed spontaneously with no treatment and that generally presents at the stage of metastases). PATIENTS AND METHODS: We report five cases of burned-out testicular tumours to illustrate the clinical, radiological and histopathological features, and discuss the hypothesis of natural history of these neoplasms. RESULTS: The findings in the five patients tended to indicate that metastatic progression appears to induce spontaneous regression of the previous tumour site. Patients explored for extragonadal germ cell tumour present with various clinical features depending on the site of the metastases. CONCLUSION: Despite the controversial hypotheses of the origin of these tumours, extragonadal germ cell tumours should be considered to be metastases of a 'burned-out' primary testicular tumour that must be investigated. When a primary testicular tumour is detected, the testis must be removed, and standard chemotherapy yields good long-term results. The hypothesis of an immunological reaction against the tumour inducing the spontaneous necrosis of the primary tumour and possibly the metastases should be considered. Immunological screening should be proposed in patients to investigate this interesting model of spontaneous tumour regression.

Adolescent↗
PubMed2004

[Urothelial tumors].

Explore the source record for details and available documents.

Carcinoma, Transitional Cell↗
PubMed2003

Advanced seminoma--treatment results and prognostic factors for survival after first-line, cisplatin-based chemotherapy and for patients with recurrent disease: a single-institution experience in 145 patients.

BACKGROUND: Advanced seminoma is a rare clinicopathologic entity. To the authors' knowledge, very few sizeable reports published to date have studied the outcome of patients with advanced seminoma after first-line and salvage therapy, and few have dealt with prognostic factors initially or in patients with recurrent disease. METHODS: The records of 145 men with advanced seminoma who were treated with cisplatin-based first-line chemotherapy regimens were reviewed. Six patient characteristics, including age, prior radiotherapy, primary tumor site, initial serum lactate dehydrogenase and human chorionic gonadotropin levels, and disease stage, were studied as initial prognostic factors. In patients with recurrent disease, outcome according to the site of recurrence and the salvage treatment was also reviewed. RESULTS: A complete response was obtained in 130 patients (90%) after cisplatin-based first-line chemotherapy, and the 5-year overall survival rate was 81% (95% confidence interval [95% CI], 73-87%). Nonpulmonary visceral metastasis at diagnosis was the only initial adverse prognostic factor. Thirty-one patients (21%) developed recurrent disease. Recurrence in the liver or the central nervous system was a major adverse prognostic factor, with a 5-year overall survival rate of 7% (95% CI, 1-32%), compared with 58% (95% CI, 33-79%) in patients who had lymph node, lung, or bone recurrences. The only durable complete remission after a liver recurrence was obtained with high-dose chemotherapy followed by autologous stem cell transplantation. All 12 patients who were treated for primary mediastinal seminoma with cisplatin-based chemotherapy alone were long-term disease free survivors. CONCLUSIONS: Overall, the prognosis of patients with advanced seminoma was good after cisplatin-based, first-line chemotherapy. Metastasis in the liver or the central nervous system, initially or at recurrence, is currently the only proven adverse prognostic factor.

Adult↗