PubMed Health⌕ Search

Biomedical subjects

G Contesso

Publications and source records attributed to G Contesso.

At least 91 records · Page 5Linked to original sources
PubMed1989

Ten-year results of a randomized trial comparing a conservative treatment to mastectomy in early breast cancer.

A randomized trial was conducted at the Institut Gustave-Roussy (IGR) between 1972 and 1980 comparing tumorectomy and breast irradiation with modified radical mastectomy. One hundred and seventy-nine patients with an infiltrating breast carcinoma up to 20 mm in diameter at macroscopic examination were included: 88 had conservative management, and 91 a mastectomy. All patients had a low-axillary dissection with immediate histological examination. For the patients with positive axillary nodes, a complete axillary dissection was undertaken. Overall survival, distant metastasis, contralateral breast cancer and locoregional recurrence rates were not significantly different between the two treatment groups.

Adenocarcinoma↗
PubMed1989

Human breast tumors: a comparison between the biochemical method of measuring estrogen and progesterone receptors and that of an immunohistochemical method.

In a series of 94 human mammary carcinomas, the determination of total estrogen (ER) and progesterone (PR) receptors by a single saturating dose method (5 nM for ER, 10 nM for PR) using dextran-coated charcoal was compared to an immunohistochemical method utilizing ER monoclonal antibody (ER-ICA test). There was a good correlation expressed in positive terms between the ER-ICA test and the biochemical determination of ER (94% of concordance) with a statistical value of P less than 0.01 being found between the concentration of ER (biochemical) and the percentage of labeled cells (ER-ICA). The ER-ICA test complements the ER and PR (biochemical) and is particularly useful for ER determinations on small tumor specimens as no additional tissue other than that from the biopsy is required.

Breast Neoplasms↗
PubMed1989

Fibroblast and myofibroblast participation in malignant fibrous histiocytoma (MFH) of bone. Ultrastructural study of eight cases with immunohistochemical support.

Eight malignant fibrous histiocytomas (MFH) of bone were studied with immunohistochemistry and electron microscopy. Ultrastructurally, fibroblasts and myofibroblasts were the main tumor cells in four cases and abundant in two other cases; these cells showed immunohistochemical positivity to alpha 1-antitrypsin, vimentin and anti-muscle antigen (HHF 35). Moreover, histiocytic-like tumor cells were electron-microscopically detected in four cases, being the main tumor cell type in two of the cases; immunohistochemically these cells expressed positivity to alpha-1-antichymotrypsin (A1ACT), alpha-1-antitrypsin (A1AT) and vimentin. Present results confirm the cellular heterogeneity of MFH of bone, in which fibroblasts and myofibroblasts transformed cells play a histogenetical role, suggesting the existence of close links with classic fibrosarcoma of bone.

Actins↗
PubMed1989

[The value of magnetic resonance imaging in the surveillance of fibromatosis. A study of 10 cases].

Retrospective study of 10 patients followed for fibromatosis after initial treatment by magnetic resonance imaging. There is a close correlation between an intense signal on weighted T2 images and tumour recurrence. Inversely, a low signal on the weighted T2 image indicated fibrotic sequelae without tumour recurrence. The examination should commence with the weighted T2 sequence. The injection of contrast medium may be an alternative.

Adult↗
PubMed1989

A new approach allowing an early prognosis in breast cancer: the ratio of estrogen receptor (ER) ligand binding activity to the ER-specific mRNA level.

We have performed a quantitative analysis of steady-state levels of ER-mRNA for 88 untreated, primary breast carcinomas. We compared the amount of specific mRNA with the amount of ER receptor measured, through ligand binding activity, by calculating the ratio R = [ER-protein/ER-mRNA]. This analysis showed that the relative level of ER-mRNA displayed a large range of values partly related to the concentration of ER-protein. We found a greater percentage of tumors with a high R ratio value in the tumor population containing elevated levels of ER-protein. A statistical analysis performed on a homogeneous population of 63 patients shows no correlation between the R ratio, lymph-node involvement and histological grade. However, R appears to be significantly related to the risk of relapse within a relatively short period of time following the first observation. An R value higher than 1.5 appears to constitute a significant and early prognostic factor of recurrence (P = 0.003).

Breast Neoplasms↗
PubMed1988

Medullary breast carcinoma. A reevaluation of 95 cases of breast cancer with inflammatory stroma.

The hallmarks of diagnosis of medullary breast cancer (MedBC) used by the authors since 1977 have been that the tumor is well circumscribed, has syncytial architecture in greater than 75% of its surface, contains diffuse inflammatory infiltrate, has atypical nuclei, and forms no glandular pattern. In order to assess the clinical utility of these criteria, we studied a series of 95 previously untreated, surgically operable patients with breast carcinoma at the Institut Gustave-Roussy (IGR) between 1960 and 1979. A diagnosis of MedBC was initially made for these patients or suspected based on abundant inflammatory stroma observed in a histologic evaluation. Using these criteria, 26 cases were identified as typical medullary carcinoma (TMC), 23 cases as atypical medullary carcinoma (AMC), and 46 cases as nonmedullary carcinoma (NMC). The 26 cases of TMC represent a very small fraction of the total infiltrating operable breast carcinomas diagnosed at IGR during the same time period. The prognosis for these 26 patients was much more favorable than for the other groups. They had a 10-year disease-free survival of 92% compared with 53% for the AMC group and 51% for the NMC group. Neither distant metastasis nor secondary primaries of the same histology were seen. Therefore, it is possible with the use of strict histologic criteria to distinguish a group of patients with a much more favorable prognosis. This histologic diagnosis alone renders a most favorable prognosis for the patient even if other factors such as large tumor size and lymph node involvement are present and, by inference, the only therapy needed is the removal of all tumor. In contrast, atypical forms have a prognosis no different from other atypical types of breast carcinomas without inflammatory stroma, and adjuvant therapy appears to be justified if other factors warrant it.

Breast Neoplasms↗
PubMed1988

The role of magnetic resonance imaging in the evaluation of Ewing sarcoma. A report of 27 cases.

The experience with magnetic resonance imaging (MRI) in 27 patients with Ewing sarcoma is reported and compared with computed tomography (CT) and plain films. Plain radiography proved to be the best imaging method to asses probable histological diagnosis in all cases (n = 6). For the evaluation of chemotherapeutic response (n = 4), CT and MRI gave the same information about the variation in size of the tumor. In this small series, the high signal in T2 weighted images was not altered significantly by therapy. In preoperative evaluation (n = 14), MRI gave better information than CT of soft tissue involvement and extension within the bone marrow in two cases each. The ability of MRI to accurately define extension through the epiphyseal plate in two cases permitted limb salvage which otherwise would not have been possible. In the long-term follow-up (n = 12), three patients without recurrence one year after therapy showed a low signal in the surgical area in T2 weighted images. Nine patients had a high signal in T2 weighted images: four were reactive lesions, two had obvious recurrence, and one was a hematoma. In the two remaining cases plain films and CT were normal, in the presence of both active tumor and reactive lesions. It was not possible with MRI to differentiate active tumor from reactive change, even after Gd-DTPA infusion.

Adolescent↗
PubMed1988

Malignant peripheral neuroectodermal tumours of bone other than Askin's neoplasm: characterization of 14 new cases with immunohistochemistry and electron microscopy.

Peripheral neuroectodermal tumours (PNET) of bone are rare and mimic those seen in soft tissue (peripheral neuroepithelioma of soft tissue). Their differential diagnosis from Ewing's sarcoma (Es) is extremely difficult by optical means. Here we report 14 new cases of PNET of bone (other than Askin's neoplasm) located primarily in the limbs, pelvic girdle and scapula. Clinically and radiologically they displayed Ewing's sarcoma-like features: mean age was 14.4 years, male/female ratio being 3:11. Metastasis was present in 6 cases at diagnosis (5 with bone metastasis). Prognosis was poor; thirteen patients died; only one with a metatarsal located tumour is alive and free of disease. The mean survival rate was 25 months following diagnosis and treatment with radio- and multimodal chemotherapy. Histologically the 14 cases displayed Homer-Wright rosettes and pseudorosette-like structures, as well as a fibrillary background and lobular pattern. Immunohistochemistry revealed positivity in a number of neural markers when using paraffin-embedded material: NSE, B-2-microglobuline, HNK-1 (leu-7) and E-36 antibodies. At EM level the cell cytoplasms evidenced dense-core granules with neurosecretion, neurotubules and intermediate filaments like those seen in peripheral neuroepithelioma.

Adolescent↗
PubMed1988

Invasive apocrine carcinoma of the breast: a long term follow-up study of 34 cases.

We have reviewed the morpho-functional criteria for infiltrating apocrine carcinomas of the breast and analysed long term follow-up of this entity. Thirty-four cases of pure apocrine carcinomas were retrieved from the files of the Dept. of Pathology, IGR, France, for the years 1955-1982. Each case was matched with two controls of other infiltrating ductal carcinomas according to the most important prognostic parameters: nodal status, histograde, anatomic tumor size, and patient age. No significant difference between the survival curves of the two groups was seen. Apocrine carcinoma, although possessing peculiar morphological, ultrastructural, biochemical, and immunohistochemical features to merit recognition as a separate histologic variant of breast cancer, by itself has no apparent clinical significance.

Adult↗
PubMed1988

Epidermal growth factor receptor in human breast cancers: correlation with estrogen and progesterone receptors.

Epidermal growth factor receptor (EGFR), determined by the Scatchard curve method, was found in 22 cases of a random series of 100 patients with breast carcinoma. Two groups of patients were identified, one (n = 16) with a low concentration (0-50 fm/mg protein) of EGFR but with a high affinity (Kd = 3.2 nM), and the other (n = 6) with a high concentration (90-210 fm/mg protein) of EGFR but with a lower affinity (Kd = 6.3 nM). A significant inverse relationship was found between the presence of EGFR and receptors for estrogen (p less than 0.001) and progesterone (p = 0.001). EGFR was found in no (0/8) tumors with Grade I histoprognostic grade, 17% (10/58) Grade II, and 38% (11/29) Grade III (p less than 0.05). EGFR is present therefore in poorly differentiated tumors and associated with other factors of poor prognosis. Our in vivo analyses confirm results found in tissue culture derived from human breast carcinoma cells.

Breast Neoplasms↗
PubMed1988

Radical radiotherapy alone in non-operable breast cancer: the major impact of tumor size and histological grade on prognosis.

This retrospective study involved 319 non-operable breast cancer patients treated by radiotherapy alone with doses of 65 Gy at the Institut Gustave-Roussy (IGR). These patients either had operable tumors but were unfit for general anesthesia or had inoperable tumors due to local contraindications. Most of them had advanced tumors: 21% less than 7 cm; 30% N2 or N3; 30% with inflammatory carcinomas. The 5- and 10-year survival was 40 and 19%, respectively. The local and distant relapse-free rate was 56 and 33% at 5 years and 44 and 28% at 10 years respectively. Results were analyzed according to tumor size, clinical node involvement, histologic grade, age, skin invasion and tumor dose. A multivariate analysis demonstrated that tumor size (p = 10(-3)) and histological grade (HG) (p = 10(-2)) were both significant factors predicting local relapse. Histological grade (p = 10(-3)), tumor size (p = 10(-2)) and clinical node involvement (p = 10(-2)) were the most significant factors predicting distant relapses. An individual risk (IR) of local recurrence and of distant recurrence was defined according to the above factors and was demonstrated to be good prognostic index. Tumor doses above 80 Gy did not increase local control. We recommend the general use of histological grading as it seems important for prediction of local and distant control in patients treated by radiotherapy alone.

Actuarial Analysis↗
PubMed1988

Importance of tumor cells in axillary node sinus margins ('clandestine' metastases) discovered by serial sectioning in operable breast carcinoma.

The prognostic implications of small emboli of carcinoma cells in the sinus margins of axillary lymph nodes ('clandestine' metastases) discovered by serial node sectioning at 2 mm intervals was analysed. All patients, previously untreated, were admitted between 1967 and 1978 and underwent mastectomy and axillary node dissection. Our study examined the risk of distant metastases of 1153 patients with from 0 to 3 involved axillary lymph nodes. A Cox multivariate analysis was performed, taking into account the classical prognostic factors (menopausal status, histoprognostic grade, and anatomic tumor size), and for nodal status including the notion of clandestine (CM) or parenchymal metastases (PM). Compared to patients without axillary metastases, patients with one node involved with CM had a relative risk of distant metastases of 1.7, identical to the risk for patients with one node with PM; and patients with one node containing PM and a second CM, had a relative risk of 2.2. Serial node sectioning discovers nodal metastases that would otherwise not be detected. These CM have important clinical implications and should be taken into account when considering adjuvant manipulations.

Axilla↗
PubMed1988

[Experience with protocol T10 in the pediatric service at the Gustave-Roussy Institute].

Between April and September 1986, 60 patients with osteosarcoma have been treated according to the T10 protocol in the Pediatrics Department of the Gustave Roussy Institute in Villejuif, France. Limb sparing could be achieved in 49 patients and amputation was necessary in 11. The necrosis of the primary tumor was total or subtotal in 33 cases and incomplete in the 27 others. With a median follow-up of 28 months, the actuarial survival is 85% at 48 months and the actuarial disease-free survival is 58%; the disease-free survival of "good responders" is 75% and 32% for "bad responders".

Adolescent↗
PubMed1988

Polyadenylic-polyuridylic acid as adjuvant in the treatment of operable breast cancer: recent results.

A randomized trial of polyadenylic-polyuridylic acid (Poly(A).Poly(U) given as an adjuvant in the treatment of operable breast cancer, has included 300 patients of the Institut Gustave-Roussy from September 1972 to December 1979; 145 patients were allocated to conventional treatment alone and 155 to conventional treatment plus Poly(A).Poly(U). Reviews after mean periods of follow-up of 50 and 87 months were previously published. The present review performed after a mean follow-up period of 111 months confirmed a significant increase in the overall survival of patients with invaded nodes treated with Poly(A).Poly(U). The best results were achieved in the subset of patients with up to three affected nodes who showed a significant increase of both overall and relapse-free survival. The benefit seemed to be greater in postmenopausal women (P = 0.07). Present status of other ongoing trials of adjuvant Poly(A).Poly(U) is presented.

Breast Neoplasms↗
PubMed1988

Early metastatic cancer of unknown primary origin at presentation. A clinical study of 302 consecutive autopsied patients.

We studied 302 consecutive autopsied patients who presented with carcinoma of unknown primary origin. The most frequent metastatic sites were the nodes, lung, and bone. The primary site was identified while patients were alive in 27% and at autopsy in 57%; the site remained unidentified in 16%. The pancreas (26.5%), lung (17.2%), kidney (4.6%), and colorectum (3.6%) were the most frequent primary sites, but the reliability of diagnostic tests used in the search for this site was disappointing. Survival was identical in patients whose primary site was discovered while alive, at autopsy, or remained unknown. The number of metastases at presentation was the major prognostic factor. Analysis of autopsy data demonstrated that patients with carcinoma of unknown primary origin pursue a different course than expected when the primary site is the first manifestation of the disease. On the basis of these results and the results of other modern series, we suggest an approach consisting of a limited initial workup but with greater emphasis on modern histochemistry studies and immunohistopathologic and other kinetic and morphologic parameters to understand the patient tumor characteristics better and base the clinical management on an individual basis.

Actuarial Analysis↗
PubMed1988

[Contribution of gadolinium DOTA in primary tumors of bone and soft tissue].

20 patients with a primary musculo skeletal tumor were investigated by MRI to assess the efficacy of Gd DOTA. The essential contribution is that it distinguishes the active parts of the lesion, intratumoral necrosis or sequelae cavities that do not take up the contrast medium. The injection does not allow for differentiation between tumor recurrence and treatment-induced inflammatory abnormality.

Adult↗