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F Bonichon

Publications and source records attributed to F Bonichon.

At least 91 records · Page 5Linked to original sources
PubMed1987

Distinct entities among low-grade non-Hodgkin's malignant lymphomas. Analysis of a series of 377 cases.

A series of 377 low-grade non-Hodgkin's lymphomas, observed in the same Institute, was analysed. Pathological types following the Kiel classification were crossed with the usual parameters of patients (sex, age) and disease (tumoural extension, main anatomical involvement, biological data, course of the disease). Small differences appeared for the survivals for the overall series. By contrast many significant differences were observed for sex, age, dissemination of the disease, special tissue involvement, monoclonal gammopathy, complete remission rate and further involvement in case of relapse. These parameters allow one to distinguish different clinicopathological entities after the morphological cellular features. Such correspondences appear meaningful and might be offered by any other classification which should not be based only on the prognosis.

Age Factors↗
PubMed1987

Micrometastases to axillary lymph nodes from carcinoma of breast: detection by immunohistochemistry and prognostic significance.

Metastases to axillary lymph nodes is an important factor in predicting prognosis and survival in primary operable carcinoma of the breast. A series of post mastectomy lymph nodes (150 cases) was selected in this retrospective study, in which the initial diagnosis had been no metastases by light microscopy and in which a long follow-up was available (average 10 years). The original H&E sections from these cases were immunostained to detect metastases which might not have been previously appreciated. The study was performed using a cocktail of 5 monoclonal antibodies directed against epithelial antigens. The object was to explore the possibility of detection of occult micrometastases by immunohistochemistry and to evaluate their prognostic significance. Micrometastases with individual cells and cell clusters were readily detected by this technique in 14% of all cases. It also became apparent towards the end of the study that micrometastases could be detected with equal sensitivity by any one of the 5 monoclonal antibodies. Positive staining of malignant cells was found to be more frequent in invasive lobular carcinoma (ILC) than in invasive ductal carcinoma (IDC). However, for the IDC group a striking association was found between micrometastases and both recurrence and survival rate. The ILC sample was considered too small for meaningful interpretation. We recommend the use of immunohistochemical techniques using monoclonal antibodies for the detection of occult metastases in lymph nodes to improve the prediction of recurrence and survival in invasive ductal carcinoma of the breast.

Adult↗
PubMed1987

[From a clinical data base to the conception of treatment protocols. Example in operable cancers of the breast].

At Fondation Bergonié, a data base has been settled since ten years concerning all the patient who had been treated there for breast cancer. Collection of these data, compared with those reported in the medical literature, have allowed us to discuss orientations for clinical research, and to establish coherent treatment protocols fitting as much patients as possible. Eventually an interdisciplinary consensus was obtained on clinical trials to be performed, according to prognostic variables defined, and the foreseeable duration of patients inclusion and accrual.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

[Development of a knowledge-based system for aiding therapeutic decision in breast cancer].

The SENEX project has been initiated at the fondation Bergonié in 1985 and is intended for providing physicians in general hospitals with knowledge based systems for the management of cancer treatment protocols. The design and building of a knowledge-based system for the management of breast cancer protocols (SENEX) was the first goal of this project. SENEX has been developed using a commercially available development tool (Personal Consultant Plus, Texas-instruments) derived from EMYCIN. It runs on IBM and compatible microcomputers. The knowledge base embeds the formal knowledge contained in the breast cancer protocols currently in use at the fondation Bergonié, and some judgmental knowledge acquired form breast cancer experts. Production rules and frames allowed us to adequately represent and structure this knowledge and the problem solving processes related to the management of breast cancer. A preliminary informal evaluation of the system has shown that it performs at the expert-level in giving advice for patients included in formal protocols. Its use and acceptability are good. However, we have to add judgmental knowledge into the knowledge base and to interface the system with a temporal data base management system to improve the overall performances of SENEX. Moreover the effectiveness of the system remains to be demonstrated before one can anticipate is routine use in clinical practice.

Breast Neoplasms↗
PubMed1986

[Hormonotherapy of metastatic breast cancer with tamoxifen and medroxyprogesterone acetate. Randomized trial comparing alternating sequences with successive applications].

Sixty-eight women with metastatic breast cancer occurring less than five years positives after the treatment of the primary tumour, with estrogens and/or progesterone receptors (EPR), were randomized. Sixty-four patients were available for evaluation of efficacy and toxicity. Thirty patients received treatment A: tamoxifen 30 mg per day alternating every two weeks with medroxyprogesterone acetate (MPA) 1 000 mg per day orally. Thirty-four received treatment B: tamoxifen 30 mg per day and after relapse, high dosage of MPA alone. The distribution of the evaluable metastasis and the value of the ER are the same in the two groups. The total responses or the responses by metastatic site were as follows: complete response, one case in each treatment group, partial response, 6 and 10 cases, no change, 14 and 17 cases and progressive disease, 9 and 6 cases respectively. The duration of the response was the same in the two groups with a median of 6 months (extremes of 30 and 19 months). Among the patients under protocol B, 19 received MPA after failure of tamoxifen: eight responded (3 partial responses and 5 no change). Toxicity was slight but 2 treatments in group A were discontinued. Alternated sequential hormonal treatment is theoretically attractive for these patients with known and positive EPR but it is not more efficient than the two hormonotherapies applied successively.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

[Prognosis of follicular lymphoma in a series of 180 cases].

In this series, the prognosis and the course of 180 cases of follicular lymphomas, classified according to Kiel's classification, seen before any treatment, treated and followed in the same institution were analyzed. In the first part, 6 primary prognostic factors were identified: compression, age of patient, stage, general symptoms, pathological subtype, lymphography. The most significant parameter (p less than 10(-10], obtained secondarily, was complete remission obtained in 63.9% of patients. In the second part, a multivariate analysis permitted to identify a few groups of patients for whom the probability of complete remission varied between 25 and 100%. Knowledge of these prognostic parameters may help to tailor treatment to each case and to obtain the best survival possible.

Adult↗
PubMed1986

[Data collection from patients treated for Hodgkin's disease. Relation to quality of life].

One hundred and fifty patients treated for Hodgkin's disease (stage I to IIIA) in a cooperative trial, answered a questionnaire dealing partly with their information, after 2 to 7 years of complete remission. This information appears insufficient for the majority of patients (52%), at least as far as treatment and its complications are concerned. There are many significant relations with other parameters which suggest that a good level of information may improve quality of life of patients. These observations tend to increase information of patients with Hodgkin's disease, provided it is adapted to each patient.

Follow-Up Studies↗
PubMed1986

[Prognostic significance of isolated local recurrences in breast cancer following mastectomy and axillary node excision. Apropos of 77 recurrences in 2362 patients].

During the years 1958-1984, 2 362 patients presenting with breast carcinoma were treated at the Fondation Bergonié by modified radical mastectomy and followed or not by radiotherapy or adjuvant chemotherapy. A retrospective analysis of this series showed that 77 patients (3.3%) presented an isolated locoregional recurrence as the first sign of treatment failure. A chest wall recurrence alone was noted in 47 patients, while 30 presented an involvement of the lymph nodes, sometimes associated with chest wall disease. The prognosis' factors of isolated locoregional recurrence, studied by multidimensional analysis by Cox's model are by decreasing order the disease free interval and the Scarf and Bloom's histologic grade. The median survival is 29 months after isolated locoregional recurrence and the survival curve is very similar to that of patients with isolated bone metastatic recurrences (median survival of 26 months) and slightly better than the median survival of patients with non osseous metastasis (median survival of 16 months).

Axilla↗
PubMed1986

[Psychosocial repercussions of the the treatment of Hodgkin's disease. Assessment by questionnaire with 150 patients].

One hundred and fifty patients, treated for Hodgkin's disease (stages I-IIIA) in a cooperative trial and remaining in complete remission after 2 to 7 years, answered a questionnaire dealing with psychosocial status and quality of life. Many informations were gathered and studied by multiparametric methods. Quality of life of patients appears determined by three kinds of parameters: patients' characteristics (age, sex, family and work status); stage of the disease determining the intensity and duration of treatment; practical conditions of treatment. These last parameters may be improved by therapeutic team and all care-takers to decrease bad consequences of disease and treatment and also to increase quality of life after cure.

Adolescent↗
PubMed1984

Soft-tissue sarcomas of adults; study of pathological prognostic variables and definition of a histopathological grading system.

The pathological features of 155 adult patients with soft-tissue sarcomas were studied retrospectively, in an attempt to set up a grading system for these tumors. As the first step, seven histological criteria (tumor differentiation, cellularity, importance of nuclear atypia, presence of malignant giant cells, mitosis count, pattern of tumor necrosis and presence of vascular emboli) were evaluated in a monofactorial analysis. Five of these (tumor differentiation, cellularity, mitosis count, tumor necrosis, and vascular emboli) were correlated with the advent of metastases and with survival. A multivariate analysis, using a Cox model, selected a minimal set of three factors (tumor differentiation, mitosis count, and tumor necrosis) the combination of which was necessary and sufficient to retain all the prognostic information. A grading system was elaborated, which turned out to be correlated with the advent of metastasis and with patients' survival. A second multivariate analysis introducing clinical prognostic features showed that the histological grade was the most important prognostic factor for soft-tissue sarcomas. Thus, this grading system appears to be highly interesting because of its prognostic value and the facility of its elaboration. However, its reproducibility should be tested.

Adolescent↗
PubMed1984

[Histological types of 876 breast cancers according to the 1981 WHO classification].

This work presents the results of the classification by histological types of 876 cancers, operated on between November 1979 and December 1982, according to the new WHO's classification of 1981. Noninfiltrating cancers represent 6.5 per cent of the total. Among the infiltrating cancers (93.5%), the individualization of the type "infiltrating duct carcinoma with a marked intraductal component" (14.5%) is interesting for this form justifies a special treatment in consideration of its multicentric and sometimes bilateral character. Its purely quantitative criteria of definition is subject to criticism and discussion.

Breast Neoplasms↗
PubMed1982

[Axillary lymph nodes in breast cancer. Comparison of standard histological analytical technics and macroscopic serial sections].

Lymph nodes in breast cancer have been examined by two histological techniques in 324 patients who underwent axillary node dissection. A routine pathologic examination consisted in the examination of only one pathological section while in the other, the lymph nodes were macroscopically serially sectioned. With the latter, an increase of 18.8 per cent in the number of detected metastases was noted. However this increase can be considered of prognostic and therapeutic importance only in 8.6 per cent of cases: half corresponding to those cases in which more than the initial threshold number of three lymph nodes were found, the other half corresponding to those cases in which one lymph node was found while the initial examination was negative. In the latter case, the increase of lymph node involvement was mainly due to "clandestine" metastases, i.e. lymphatic embolisation of micrometastases.

Adenocarcinoma↗
PubMed1982

[Prognosis of lymphosarcomas. Multivariate analysis in a series of 334 patients].

In this retrospective study, we analysed prognostic factors of 334 previously untreated patients with non Hodgkin's malignant lymphoma. The importance of the different prognostic variables was first studied with survival curves. Next, using a "segmentation" method and a logistic regression analysis, we studied the factors influencing the complete remission rate which is the most important prognostic factor. For the "low-grade" lymphosarcomas, with the segmentation method, we obtained five patients groups for which the complete remission rates varied between 7 and 95.5 per cent according to clinical staging, age and mediastinal involvement. For the "high-grade" lymphosarcomas, we obtained four patients groups in which the complete remission rates varied between 8.7 and 84.7 per cent according to mediastinal and sub-diaphragmatic involvement and clinical staging. Lastly, the Cox model was used in order to determine the best variable combination capable of predicting the survival of patients with clinical stages I or II. These variables were pathological grading, complete initial remission, clinical staging and BCG immunotherapy. With scores deduced from the Cox model, we were able to determine three prognostic groups for which the survivals at 3 years were very significantly different (7 to 89%).

Adolescent↗
PubMed1977

[Scintigraphy using Technetium 99 m pyrophosphate in detection of bone metastasis of breast cancers. Analysis of 310 examinations].

Three hundred and ten bone scintigraphies were carried out in patients with a carcinoma of the breast. The results of these studies were compared not only with radiological findings but also the clinical and paraclinical course of the patients, the period of observation being between 8 and 44 months. Amongst the scintigrams in which no abnormality was detected, approximately 3.3% were obtained in patients with osteolytic metastases, the majority of these patients also having a rapidly growing primary tumourmamongst the patients with zones of hyperfixation and, at the same time, non-fixing metastases, 14/22 diedvery rapidly with diffuse bone metastases, this confirming the notion of poor prognosis in this "false negative" group. 11.3% of the abnormal results involved patients who showed no bone lesions more than 6 months after radio-isotopic examination "false positives". Of these, 12/18 were single lessions (41%). 14% of examinations carried out on a routine basis demonstrated metastases for which clinical and/or radiological confirmation was obtained only 2 to 9 months later.

Bone Neoplasms↗