Biomedical subjects

G Piessen

Publications and source records attributed to G Piessen.

6 recordsLinked to original sources

PubMed2006

[Type I neurofibromatosis, pheochromocytoma and somatostatinoma of the ampulla. Literature review].

Gastrointestinal involvement in Von Recklinghausen's neurofibromatosis (autosomal dominant disease) is observed in 25% of patients and is frequently represented by duodenal carcinoids. We report a case of somatostatinoma of the ampulla in a 42-year-old female with neurofibromatosis and pheochromocytoma and show a literature review about the association of neurofibromatosis and somatostatinoma. This pathological association appears non hasardous and surgical ampullectomy offers a good alternative to pancreaticoduodenectomy in localised tumors treatment.

Adrenal Gland Neoplasms↗

PubMed2006

Impact of preoperative radiochemotherapy on postoperative course and survival in patients with locally advanced squamous cell oesophageal carcinoma.

BACKGROUND: The aim of this study was to determine the effect of neoadjuvant radiochemotherapy (RCT) on postoperative complications and survival after surgery for locally advanced oesophageal squamous cell carcinoma. METHODS: Postoperative course and survival were compared in 144 patients who had neoadjuvant RCT and 80 control patients who had surgery alone for locally advanced oesophageal squamous cell carcinoma (radiological stage T3, N0 or N1, M0). RESULTS: The two groups were comparable in terms of American Society of Anesthesiologists grade, age, sex, weight loss, tumour location, presence of lymph node metastasis and surgical approach. Postoperative mortality rates were 6.3 and 9 per cent (P=0.481), with morbidity rates of 40.3 and 41 percent (P=0.887) in the RCT and control group respectively. Complete resection (R0) rates were 74.3 and 48 percent respectively (P<0.001). Significant downstaging was observed in the RCT group (P<0.001), with 16.0 percent of patients having a complete pathological response. Median survival was 29 versus 15 months, and the 5-year survival rate 37 versus 17 percent (P=0.002) in RCT and control groups respectively. CONCLUSION: Neoadjuvant RCT significantly enhanced R0 resection and survival rates in patients with stage T3 oesophageal squamous cell carcinoma, with no increase in postoperative mortality and morbidity rates.

Adult↗

PubMed2005

[Mesenteric panniculitis].

Mesenteric panniculitis also named retractile mesenterite is a rare tumor-like lesion that thickens and shortens the mesentery. It is characterized by the association of inflammation, necrosis or fibrosis involving the adipose tissue of the bowel mesentery. The pathophysiology of this disease remains unclear despite associations with inflammatory diseases or malignancies, especially lymphomas that have been described. When symptomatic, patients may present with abdominal pain, palpable abdominal mass or intestinal obstruction. The disease remains asymptomatic in 30 to 50% of cases. Abdominal CT plays an important role in suggesting the diagnosis and can be useful in distinguishing the several conditions that can mimic mesenteric panniculitis. Nevertheless, pathologic examination of surgical excisional biopsies or sometimes percutaneous biopsies remains necessary to confirm the diagnosis and exclude an underlying infection or malignancy. Medical treatment may consist of therapy with anti inflammatory or immunosuppressive agents and can be proposed in highly symptomatic diseases. Surgical treatment should be exclusively attempted when intestinal obstruction or ischemia occur. Most of the time, it consists in intestinal derivation or segmental resection because complete excision of the lesions is often not possible. Mesenteric panniculitis usually has an uneventful clinical course and resolves spontaneously in a variable delay.

Diagnosis, Differential↗

PubMed2005

[Cervical and upper-third thoracic oesophageal carcinoma: a single pathological entity?].

AIM OF THE STUDY: Cervical and upper-third thoracic oesophageal carcinomas are considered as a single pathological entity. The aim of this study was to compare postoperative and oncological results after surgical resection in these two locations. MATERIAL AND METHODS: Postoperative and oncological results were compared retrospectively in 155 patients who underwent surgery for carcinoma of the cervical (C group, n = 21) or upper-third thoracic (TS group, n = 134) oesophagus. RESULTS: The two groups were comparable regarding the pre-, peroperative and histological data. Postoperative mortality and morbidity rates in the C and TS groups were 4.8% and 10.4% (P= 0.413) and 57.1 and 50.7% (P= 0.585), respectively. R0 resection and recurrence rates were 61.9% and 73.1% (P= 0.289) and 50.0% and 51.1% (P= 0.941), respectively. Five-year survival rates were 0% and 35% in the overall population (P= 0.098) and 0 and 49% in the R0 population (P= 0.047), respectively. By multivariate analysis, cervical location of the tumour was found to be an independent factor of poor prognosis (relative risk= 3.1, 95% confidence interval= 1.3-7.8, P= 0.014). CONCLUSION: Prognosis after surgical resection of cervical oesophagus carcinoma is very poor. Surgery in this location should be proposed in case of chemoradiation failure.

Adult↗

PubMed2004

Surgery alone in the curative treatment of localised oesophageal carcinoma.

AIM: To document the results of surgery alone in patients with localised oesophageal carcinoma. METHODS: Between January 1982 and 2002, 179 consecutive patients who underwent curative oesophagectomy for stage 0, I or II oesophageal carcinoma, without neo-adjuvant treatment, were analysed retrospectively. RESULTS: Postoperative mortality and morbidity rates were 2.8 and 30.7%, respectively. The overall actuarial survival rate at 5 years was 59%. No patients with more than four invaded lymph nodes survived 5 years. A lymph node ratio more than 0.2, more than four invaded lymph nodes and an advanced pTNM stage were predictors of poor prognosis. CONCLUSION: Long-term survival after surgery alone for localised oesophageal carcinoma can be achieved in some 2/3rds of patients. These results should be considered before designing neo-adjuvant therapeutic regimen or embarking into exclusive treatment alternate to oesophagectomy.

Adult↗

PubMed2003

[Patients surviving 5 years after curative oesophagectomy for oesophageal cancer].

AIM OF THE STUDY: To analyse the clinical and pathological parameters of 5-year survival patients after curative oesophageal resection for cancer and to identify factors predictive of long-term survival. METHODS: The data of 370 patients who underwent oesophagectomy with curative intent from January 1982 for oesophageal squamous cell carcinoma (n = 320) or adenocarcinoma (n = 50) were reviewed. After excluding postoperative deaths (n = 20), these patients were surviving (S group, n = 113) or dead (NS group, n = 237) with a 60-month follow-up. Uni- and multivariate analysis allowed comparison between the two groups. RESULTS: Postoperative mortality and morbidity rates were 4.0% and 37.6%, respectively. Parameters related to 5-year survival were: absence of preoperative malnutrition or dysphagia, transhiatal resection, no reoperation, limited tumour, histological response to neoadjuvant treatment, absence of lymph node capsular invasion, number of invaded lymph nodes < or = 4, invaded lymph node ratio < or = 0.1, absence of tumour recurrence or metachronous primary cancer. On multivariate analysis, factors predictive of 5-year survival were: absence of preoperative dysphagia (P < 0.001), stage 0-I-IIA tumour (P<0.001) and absence of metachronous cancer (P = 0.016). CONCLUSION: Complete surgical resection allows 5-year survival. Factors predictive of long-term survival assessed in preoperative evaluation, dysphagia and tumour stage, should be useful to select patients for neoadjuvant treatment.

Adenocarcinoma↗