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G Andry

Publications and source records attributed to G Andry.

At least 19 recordsLinked to original sources
PubMed2006

Acrylamide, an in vivo thyroid carcinogenic agent, induces DNA damage in rat thyroid cell lines and primary cultures.

Chronic treatment of rats with acrylamide induces various tumors among which thyroid tumors are the most frequent. The aim of the present study was to develop an in vitro model of acrylamide action on thyroid cells to allow the investigation of the mechanism of this tumorigenic action. The first part of the study considered as targets, characteristics of thyroid metabolism, which could explain the thyroid specificity of acrylamide action: the cAMP mitogenic effect and the important H2O2 generation by thyroid cells. However, acrylamide did not modulate H2O2 or cAMP generation in the thyroid cell models studied. No effect on thyroid cell proliferation was observed in the rat thyroid cell line FRTL5. On the other hand, as shown by the comet assay, acrylamide induced DNA damage, as the positive control H2O2 in the PC Cl3 and FRTL5 rat thyroid cell lines, as well as in thyroid cell primary cultures. The absence of effect of acrylamide on H2AX histone phosphorylation suggests that this effect does not reflect the induction of DNA double strand breaks. DNA damage leads to the generation of mutations. It is proposed that such mutations could play a role in the carcinogenic effect of acrylamide. The mechanism of this effect can now be studied in this in vitro model.

Acrylamide↗
PubMed2005

[Secondary malignant tumors of the parotid].

AIM OF THE STUDY: Secondary malignant tumors of the parotid gland are uncommon. They arise from primary tumors located in the head and neck or from distant primary tumors. The formers are dominated by squamous cell carcinomas and melanomas, the latters by renal and lung cancers. Distinction between malignant primary tumors and metastasis of other primary tumors to the parotid gland is very important to appreciate, because the result of this will change therapeutic procedure and the evaluation of prognosis. METHODS: A series of 23 patients with tumors metastatic to the parotid gland are reported. All clinical and pathological data were reviewed. The management of secondary tumors of the parotid gland and the results were analyzed in order to try to identify common features and implications for management. RESULTS: The most frequent histologic types were squamous cell carcinoma and melanoma. Most primary tumors occurred in the head and neck. Metastasis to the parotid gland presented with a median time of 18 months after diagnosis of the primary tumor. All the patients had a parotid mass. No patient had facial nerve weakness. Parotid metastases were treated by superficial parotidectomy with preservation of the facial nerve in all cases, associated in 14 cases with a homolateral selective neck dissection and in 6 cases with a homolateral radical neck dissection. Twenty-one patients were submitted to radiation therapy. Seven patients died after the treatment: in 3 cases, death was due to a local recurrence with cervical relapse; 4 patients presented cervical and metastatic lesions. CONCLUSION: This retrospective review confirmed that patients with involvement of cervical nodes and metastatic parotid tumors have a worse prognosis than those without involvement of cervical nodes. The addition of postoperative radiotherapy provides no additional benefit.

Adult↗
PubMed2005

Acute respiratory failure from tracheopathia osteoplastica.

Tracheopathia osteoplastica is a benign cartilaginous and osseous metaplasia of the laryngo-tracheobronchial tree diagnosed more commonly in adults over 50 years of age. We report here the case of a 54-year-old man who underwent thyroidectomy for multinodular goiter. Immediately after an uneventful surgery, he developed an acute respiratory failure with radiologic picture of Adult Respiratory Distress Syndrome. Mechanical ventilation was set up again, bronchoscopy with biopsy disclosed a massive tracheobronchial haemorrhage from a tracheopathia osteoplastica. Supportive treatment was successfully provided and the patient resumed to a normal life 14 days after the operation.

Acute Disease↗
PubMed2005

Acute respiratory failure from tracheopathia osteoplastica.

Tracheopathia osteoplastica is a benign cartilaginous and osseous metaplasia of the laryngo-tracheobronchial tree diagnosed more commonly in adults over 50 years of age. We report here the case of a 54-year-old man who underwent thyroidectomy for multinodular goiter. Immediately after an uneventful surgery, he developed an acute respiratory failure with radiologic picture of Adult Respiratory Distress Syndrome. Mechanical ventilation was set up again, bronchoscopy with biopsy disclosed a massive tracheobronchial haemorrhage from a tracheopathia osteoplastica. Supportive treatment was successfully provided and the patient resumed to a normal life 14 days after the operation.

Biopsy, Needle↗
PubMed2005

Skin metastases from a head and neck carcinoma: a prognostic factor?

BACKGROUND: Distant metastases in head and neck cancer are often to the lung, and rarely to the skin sites. METHOD: To ascertain that a skin metastasis indicates a poor prognosis, a review was conducted of patients with head and neck cancer. RESULTS: Three out of seven patients had evidence of local recurrence at the time of development of the skin metastases, and three out of seven had evidence of distant metastases. The average survival time was 1 month after the development of skin metastases. CONCLUSION: Skin metastases may represent the first clinical evidence of impending recurrence or distant metastasis. The development of skin metastasis is associated with a poor prognosis. Current treatment options are limited in their efficacity.

Aged↗
PubMed2005

Wide localized excision and reconstruction for minor salivary gland tumours.

BACKGROUND: Insufficient excision is one of the main factors leading to recurrence of minor salivary gland tumours. Our aim is to perform large resections with immediate reconstruction in order to provide local control, as well as to achieve better cosmetic and functional results. METHODS: Four consecutive patients suffering from minor salivary gland tumours of the upper aerodigestive tract were treated: two had adenoid cystic carcinomas (one of the lateral oropharyngeal mucosa, one of the retromolar area); one had a polymorphous low-grade carcinoma (at the base of the tongue); and one had mucoepidermoid carcinoma (on the floor of the mouth). Two radial forearm free-flaps, a trapezius myocutaneous pedicled flap (including an adjacent osseous part of the scapula), and a sternocleidomastoid muscular pedicled flap were used, respectively, for reconstruction. Additional external radiation was used for three patients (60 cGy). RESULTS: The postoperative course was uneventful for each patient, and the ability to chew and swallow was rapidly restored. Two patients, locally controlled, with adenoid cystic carcinomas died: one from brain metastases (four years post-surgery), the other with pulmonary metastases (eight-years post-surgery). One patient is alive with a recurrent tumour of the pterygomaxillary fossa (without trismus) sixteen years after the original operation; another patient is free of recurrent disease at the base of the tongue but has recently undergone surgery, with success, for two pulmonary metastases sixty months after the initial surgery. CONCLUSIONS: For minor salivary gland carcinoma of the head and neck, large resection with immediate reconstruction affords fast recovery and long-lasting locoregional control. Additional radiotherapy is feasible.

Aged↗
PubMed2004

Parapharyngeal metastases from thyroid cancer.

AIM: To emphasise the pattern of lymphatic dissemination in the parapharyngeal space from thyroid cancer. PATIENTS AND METHOD: Among 696 patients treated for thyroid cancer between 1986 and 2001, parapharyngeal metastasis was diagnosed in three patients, previously treated for papillary thyroid carcinoma. RESULTS: All three patients have been treated by surgical resection through lateral cervical approach. Two of them were controlled regionally whereas the remaining one had a submucosal pharyngeal metastasis locally resected 27 months after parapharyngeal resection. CONCLUSIONS: Parapharyngeal metastasis is rare, but should be a recognized pattern of lymphatic dissemination from thyroid carcinoma to avoid unnecessary radioiodine and because surgical resection is efficacious with acceptable morbidity.

Carcinoma, Papillary↗
PubMed2004

[Intrathyroid metastasis: 11 cases].

INTRODUCTION: Non-thyroid cancers rarely metastasize into the thyroid gland. The aim of this retrospective study was to report a series of thyroid metastases and to emphasize their unusual occurrence and their poor prognosis. METHODS: Between January 1987 and June 1999 eleven patients underwent thyroidectomy for isolated, metastatic diseases of non thyroidal origin (mean age 61 yrs, 54.5% female). The primary tumors were: pulmonary squamous cell carcinoma (n=5), renal cell carcinomas (n=2), esophageal squamous cell carcinoma (n=1), leiomyosarcoma (n=1), oropharynx squamous cell carcinoma (n=1), and breast carcinoma (n=1). Analyzing these cases, there is a marked preponderance of lung cancers, renal cancer coming second in order of frequency. Clinical manifestations are: thyroid nodule without hormonal disturbance; others signs are dysphonia and/or dysphagia. RESULTS: Ten patients underwent preoperative fine-needle aspiration, nine of ten were suggestive of metastatic disease. The mean time from resection of the primary tumor to thyroid metastases was 25 months (range 1-96 months). Total thyroidectomy (n=9) or lobectomy (n=2) was performed without morbidity or mortality. No patients have had recurrent disease in the neck. Median survival after treatment was 10 months (range 1-29 months). Course of death were mainly disseminated metastases. CONCLUSION: For isolated metastatic cancer to the thyroid, surgical resection should be performed in order to avoid potential morbidity of tumor recurrence in the neck, even if the prognosis remains poor, for the majority of the cases.

Biopsy, Needle↗
PubMed2004

[Metastatic prostate carcinoma mimicking a parotid tumor: a case report].

We report a case of prostate carcinoma metastatic to the mandible that had been initially suspected as being a primary tumor of the parotid. The initial symptom was hard swelling in the left parotid region. No pathologic fracture was diagnosed. The metastatic lesion was diagnosed 4 years after diagnosis of the carcinoma of the prostate. This is a very interesting event because of its unusual localization.

Adenocarcinoma↗
PubMed2004

[Pharyngolaryngectomy for advanced and recurrent cancer: prognostic factors and complications].

INTRODUCTION: The aim of this study was to evaluate the results of the initial surgical treatment and salvage treatment for advanced laryngopharyngeal cancer. METHODS: From 1984 to 1997, primary surgical treatment was undertaken in 60 patients. 75 patients underwent surgical salvage following radiotherapy. RESULTS: 55/135 patients (40.7%) experienced local regional relapse. The overall survival at 5 years was 43.9% in the first group of patients treated initially with surgery. In the group of patients treated with salvage surgery, the overall survival at 5 years was 40.2%. A multivariate analysis showed that involved lymph nodes (p = 0.0004), a nutritional score inferior to 5 (p = 0.03), positive resection margins (hazard ratio 2.05; 95% c.i. 1.03 to 4.04 ; p = 0.03), a local-regional relapse (p = 0.04) and appearance of metastasis (p = 0.03) were independent risk factors for overall survival. Survival is dependent from each factor, and each factor is independent from each other Stenosis was rare: 5.1% in the present series. A pharyngocutaneous fistula developed in 49.6% of patients. After a multivariate analysis, the site of the tumor (odds 2.26; 95% c.i. 1.05 to 4.85; p = 0.03) had an influence for apparition of a fistula. CONCLUSION: Initial surgical surgery and salvage surgery of respectively 43.9% and 40.2% overall survival compares favorably with the literature. Despite progress made with reconstruction, morbidity is still elevated in a selected group defined after analysis of pronostic factors.

Aged↗
PubMed2002

From chemoprevention and organ preservation programmes to postoperative management: major achievements and strategies of the EORTC Head and Neck Cancer Group.

The purpose of this article is to review the most significant results of the clinical studies conducted in the past two decades by the EORTC Head and Neck Cancer Group (HNCG). As for phase III trials, the HNCG investigated, besides the efficacy of chemopreventive drugs, the impact of cytostatic agents on various therapeutic targets, in combination or not with surgery and chemotherapy. These targets were: (a) chemo-prevention in curatively treated early stage disease; (b) organ preservation programmes in patients with operable tumour, comparing immediate surgery versus first-line chemotherapy; (c) postoperative management of locally advanced tumours, comparing radio-chemotherapy versus radiotherapy alone. Other phase II and phase III studies were also completed to investigate drug activity in advanced and/or recurrent head and neck squamous cell and adenoid cystic carcinomas. The present article will also analyse the strategies developed within the Group in the field of translational research.

Chemoprevention↗
PubMed2002

[Percutaneous gastrostomy for cervicofacial cancer: Bordet Institute experience].

INTRODUCTION: The establishment of a direct enteral feeding route is critical in the overall treatment of many patients with head and neck cancer. This study evaluated the indications, success rate, and complications associated with endoscopic gastrostomies. MATERIALS & METHODS: 71 endoscopic percutaneous gastrostomies were created in 67 patients. The main indication for gastrostomy was the need for nutritional support in malignant head and neck tumors. Two localizations, buccal cavity and oropharynx, comprised 45% of the cases (32/71). RESULTS: All the procedures were successful. The one severe complication (peritonitis) required laparotomy. The duration of enteral nutrition via gastrostomy varied from two days to more than two years. There were no long-term complications. CONCLUSION: The method is simple, cost-saving and is very important to prevent malnutrition, the most predictive parameter for the occurrence of major postoperative complications.

Adult↗
PubMed2001

[Fibrosarcomatous variant of dermatofibrosarcoma protuberans: clinicopathologic analysis of 4 cases].

We present a series of 4 cases of fibrosarcomatous dermatofibrosarcoma protuberans. This variant, which is composed of areas of typical DFSP associated with more cellular, fascicular foci, reminiscent of fibrosarcoma, should be recognised because of its more aggressive behavior, with a significant metastatic potential (15%). Our series illustrates the clinical, morphological, immunohistochemical and cytogenetic features of this uncommon tumor, with emphasis on differential diagnosis.

Adult↗
PubMed2001

[Isolated pelvic metastasis of thyroid cancer].

Thyroid cancer rarely metastasizes to the pelvis. We report a case where the metastasis was found two years before the thyroid cancer. Treatment included initial surgery with resection of the metastatic tumor and reconstruction of the acetabulum with bone cement, and secondly total thyroidectomy, node dissection and I131. Surgical treatment of locoregional recurrence had no influence on the clinical course leading to the patient's death. Early diagnosis of unique metastasis of a thyroid cancer is important in terms of prognosis and quality of life. This case is exceptional due to the unique bone metastasis and treatment options for acetabular metastases. Therapeutic options should be adapted according to algorithms reported in the literature.

Acetabulum↗
PubMed2001

[Prognostic factors in epidermoid carcinoma of the mobile tongue classified as T1-T2].

INTRODUCTION: Our aim was to evaluate the results and the prognosis of squamous cell carcinoma of the mobile part of the tongue stage T1-T2 treated by surgery and radiotherapy at the Institute Jules Bordet from January 1950 to 31th December 1993. METHODS: According to the classification TNM (UICC 1978) 165 consecutive patients classified as follow: 73 T1No (stage I), 64 T2No (stage II), 7 T1N1 and 20 T2N1 (stage III) and 1 patient T2N2 (stage IV). All patients underwent surgery beforehand. 136 patients received additional brachytherapy. RESULTS: In this study were included 117 men and 48 women with an average age of 60 years. The rate of relapse on the primary tumoral site amounted to 16,4% and the residual relapse to 40%. The survival note without relapse was evaluated respectively at 3 years in 67% of the tumours T1 (against 28% for the T2), at 5 years for 59% for tumours T1 (against 26% for T2). From the clinical point of view the survival rate without relapse was of 5 years for 61% of stage I, 29% of stage II and 24% of stage III. A more extensive investigation shows the statistic influence, such as age (p<0.004), size of the tumour (p<0.007) and its shape (p<0.0007) on the total survive rate. The state of the nodes (p<0.02) and the safety margins (p<0.04) are statistically less associated. The survival rate with no relapse according to a study considering statistical factors, is significantly influenced by the size (p<0.0002) and age (p<0.0003). CONCLUSION: T1-T2 stages of the mobile tongue are characterized by a limited local spread but a more regional spread and diversified therapeutic approach with prognostic factors influencing the survival rate without forgetting the part played by the TNM classification.

Adult↗
PubMed2000

Clinical aspects of early and late hypocalcaemia afterthyroid surgery.

AIM: This study aimed to evaluate hypocalcaemia (time-course) and need for calcium administration after thyroid surgery in 135 consecutive cases (69 bilateral subtotal thyroidectomies, 50 unilateral lobectomies, 13 total thyroidectomies and three isthmectomies) for benign lesions and for differentiated carcinoma in 89% and 11% respectively. RESULTS: In unilateral lobectomy, two parathyroid glands were identified and preserved in 72%, and one gland in 28% of the patients; calcaemia decreased by 10% on average in the early post-operative period (P<0.001). Calcium treatment (average: 2.3 days) was administered to 34% of the patients, these patients had lower nadir post-operative calcaemia than those who did not receive calcium: 2.03 vs 2.14 mmol/l (P<0.001). Their calcaemias reverted to normal within 1 week after surgery and remained normal thereafter without further calcium administration. In bilateral procedures, four parathyroid glands were preserved in 40%, three in 42%, two in 16%, and only one in 2% of the cases. Calcaemia decreased by 15% on average (P<0.001), and early hypocalcaemia was common and severe in some patients: nadir post-operative calcaemia <2.0 mmol/l in 61%, and <1.75 mmol/l in 6% of the cases. Post-operative hypocalcaemia was more pronounced after total than subtotal thyroidectomy (1.86+/-0.19 vs 1.98+/-0.14 mmol/l P=0.014), and also after lymph node dissection (1.83+/-0.11 mmol/l). Serum parathormone (PTH) decreased from 36 ng/l before surgery to 17 ng/l in the week thereafter (P=0.001). There was a linear relationship between the number of preserved parathyroid glands and early hypocalcaemia. The percentage of patients requiring calcium treatment was: 24 h (15%), 2-7 days (26%), 8-180 days (33%), >1 year (9%). DISCUSSION: The number of parathyroid glands preserved in situ did not help predict the duration of post-surgical calcium treatment, nor the final outcome of hypocalcaemia. However, when total calcium levels were compared in patients having had one or two glands preserved vs three or four parathyroid glands, it was possible to show that despite prolonged calcium administration, late calcaemias remained significantly lower during the first 6 months in patients with a smaller number of parathyroid glands. Hypoparathyroidism, defined functionally on the basis of requirement of calcium supplementation 1 year after surgery, occurred in 8.6% of patients after bilateral lobectomy (despite measurable but inappropriately low-PTH concentration). This outcome could have been predicted earlier (after 3 to 6 months) and the patients perhaps given the benefit of definitive vitamin D treatment earlier, in order to avoid late and prolonged hypocalcaemia. Evaluation after 1 year showed that only one patient out of 82 bilateral lobectomies (1.2%) had permanent hypoparathyroidism and needed calcium whereas hypocalcaemia was persistent in one out of four patients who had undergone a staged procedure (i.e. heterolateral lobectomy years after a previous operation).

Adolescent↗
PubMed2000

[Reconstructive surgical techniques after palliative tumor excision].

Palliative care is more and more of concern in medical information. If there is no exact definition about the real place of surgery in this concept, the rule of reconstructive surgery is even less clear. The goal of this paper is to try to define, on one hand the general characteristics of palliative surgery, and on the other hand, to underline the role of reconstructive surgery in four specific indications: the head and neck area, the thorax, the pelvis and the extremities. The resection surgery, associated with flap coverage, may seems an excessive treatment in such palliative indications. Nevertheless, the results presented here tend to demonstrate that, after careful patient selection a better quality of life could be obtained with an acceptable surgery-induced morbidity (regarding preoperative disability). More than technical aspect, it is by a different approach of the problem that this type of surgery is to be distinguished.

Adult↗