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J F Delaloye

Publications and source records attributed to J F Delaloye.

At least 19 recordsLinked to original sources
PubMed2003

The value of bone marrow scintigraphy using 99mTc monoclonal antigranulocyte antibodies in complement to bone scintigraphy in detecting bone metastases from primary breast cancer.

This prospective study evaluates bone marrow scintigraphy (BMS) in detecting bone metastases from primary breast cancer when performed in complement to conventional bone scan (BS). Sixty women predominantly with low-stage disease underwent BS followed by BMS within 1-35 days using BW250/183 antigranulocyte antibodies. A receiver operating characteristic (ROC) analysis was performed to compare BS to BS+BMS on a patient-by-patient basis using a 'gold standard' composed of subsequent computed tomography, magnetic resonance imaging, X-ray or BS examinations and at least a 12 month follow-up. Metastases were present in eight out of 60 patients (13%). Specificity was improved by BS+BMS compared to BS alone (90%, 65%) as well as positive predictive value (62%, 27%), accuracy (87%, 72%), positive (10.4, 2.4) and negative (0.20, 0.00) likelihood ratios. Sensitivity (100%, 88%) and negative predictive value (100%, 97%) were similar for BMS+BS and BS alone. As a result of BMS, clinical management was modified in 15 patients (25%). In conclusion, BMS supplements BS by improving specificity, positive predictive value and accuracy in detecting breast cancer bone metastases. The ROC curves show improved specificity for BS+BMS at the same sensitivity compared to BS alone. Consequently, BMS may be useful in low-stage subjects with positive or equivocal BS for metastases.

Adult↗
PubMed2002

Granular cell tumor of the breast: a diagnostic pitfall.

We report a rare case of benign granular cell tumor of the breast associated with multiple similar lesions of the scalp, the right shoulder, the right flank, the abdominal wall and the vulva, treated with wide excisions.

Journal Article↗
PubMed2001

Colposcopic evaluation after a repeat atypical squamous cells of undetermined significance (ASCUS) smear.

OBJECTIVES: Management of patients with atypical squamous cells of undetermined significance (ASCUS) remains controversial. We chose to repeat the Pap smear after four months. If ASCUS persisted in this second test, the patient was advised to undergo colposcopy. Our objective is to determine the clinical significance and the prediction of neoplasia among these patients through a colposcopic examination. METHODS: Of 29,827 patients who had a Pap smear, ASCUS were detected in 1387 (5%) and persisted in the repeat smear of 225 (16%). Colposcopy and an additional Pap smear were performed on 186 patients. RESULTS: Out of 186 colposcopic evaluations, 91 (49%) were normal and the patients had a negative Pap smear. Colposcopy was abnormal in 95/186 patients (51%) (Table 1). Histology of the directed biopsies revealed 38 (21%) low-grade squamous intraepithelial lesions (LSIL) and 17 (9%) high-grade squamous intraepithelial lesions (HSIL). Forty patients (21%) with normal biopsies had ASCUS for the third time in the Pap smear. CONCLUSIONS: Colposcopic evaluation after a repeated Pap smear with ASCUS is an appropriate cost-effective management. Finding 30% of LSIL or HSIL justifies this additional investigation.

Adolescent↗
PubMed2000

Effect of grade on disease-free survival and overall survival in FIGO stage I adenocarcinoma of the endometrium.

OBJECTIVE: To analyse the effect of differentiation on disease-free survival (DFS) and overall survival (OS) in patients with stage I adenocarcinoma of the endometrium. PATIENTS AND METHODS: From 1979 to 1995, 350 patients with FIGO stage IA-IC with well (G1), moderately (G2) or poorly (G3) differentiated tumors were treated with surgery and high dose-rate brachytherapy with or without external radiation. Median age was 65 years (39-86 years). RESULTS: The 5-year DFS was 88+/-3% for the G1 tumors, 77+/-4% for the G2 tumors, and 67+/-7% for the G3 tumors (P=0.0049). With regard to the events contributing to DFS, the 5-year cumulative percentage of local relapse was 4.6% for the G1 tumors, 9.0% for the G2 tumors, and 4.6% (P=0.027) for the G3 tumors. Cumulative percentage of metastasis was 1.4, 6.3 and 7.2% (P<0.001), respectively, whereas percentages of death were 6.0, 7.9 and 20.7% (P<0.001). The 5-year OS was 91+/-3, 83+/-4 and 76+/-7%, respectively (P=0.0018). In terms of multivariate hazard ratios (HR), the relative differences between the three differentiation groups correspond to an increase of 77% of the risk of occurrence of either of the three events considered for the DFS (HR=1.77, 95% CI [0.94-3.33]), (P=0.078) for the G2 tumors and of 163% (HR=2.63, 95% CI [1.27-5.43]), (P=0.009) for the G3 tumors with respect to the G1 tumors. The estimated relative hazards for OS are, respectively, in line with those for DFS: HR=1.51 (P=0.282) for the G2 tumors; and HR=3.37 (P=0.003) for the G3 tumors. CONCLUSION: Patients with grade 1 tumors are those least exposed to either local relapse, metastasis, or death. In contrast patients with grade 2 tumors seem to be at higher risk of metastasis, whereas patients with grade 3 tumors appear at higher risk of death. Since we have looked at the first of three competing events (local relapse, metastasis and death), this suggests that patients with grade 3 tumors probably progress to death so fast that local relapse, if any, cannot be observed.

Adenocarcinoma↗
PubMed2000

Bilateral Krukenberg tumor of the ovary during pregnancy.

This case report concerns a 35-year-old woman suffering from gravidic cholestasis, thrombocytosis and iterative vomiting episodes who underwent an elective cesarean section at week 35 because of recent herpetic vulvitis. Large bilateral ovarian tumors were observed which were interpreted as pregnancy luteomas. Nevertheless a biopsy of the right ovary was performed. Histologic examination revealed massive luteinization of the ovarian stroma. In addition, large tumor cells were found dispersed throughout the ovary as well as in vascular spaces as either isolated or clustered signet-ring cells. In search of the primary tumor, gastroscopy revealed a gastric ulcer in the antrum. The biopsies of the ulcer margins as well as those taken at distance demonstrated signet-ring cells in the lamina propria. Bilateral salpingo-oophorectomy and total gastrectomy were performed. In spite of postoperative chemotherapy, the patient died of disease 5 months after diagnosis.

Adult↗
PubMed2000

[Sentinel lymph node biopsy in breast cancer: the Lausanne experience].

A total of 40 patients (mean age 51 yrs; 36-89 yrs) with clinically T1-T2(< 3 cm)N0M0 breast cancer underwent sentinel node (SN) mapping with radioactive tracer (99mTc) injection only in 21 patients, with Patent blue V in 1 patient, or with both techniques in 19 patients. The preoperative injection of 99mTc (20-40 MBq) was followed by lymphoscintigraphy. A handheld gamma probe was used to detect the SN in the operative room. A lumpectomy and an axillary dissection were performed in all the patients. SNs could be identified in 39/40 patients, resulting in a sensitivity of 98%. Successful localization of the SNs was accomplished by isotope only in 19/20 patients, by blue dye only in 1/1 patient, and by both methods in 19/19 patients; in 2 of these 19 patients, SNs were identified by blue dye only. Axillary metastases were found in 12/40 patients (30%), the SN being the only nodal metastasis in 8/12 patients (75%). Six of these 12 patients (50%) had only evidence of micrometastasis. Negative SNs on serial sections stained with hematoxylin-eosin (H&E) were evaluated with cytokeratin immunostain (C11). In all cases of negative SNs the remaining axillary nodes were also free of tumor, resulting in a negative predictive value of 100%. We conclude that SN mapping is a highly accurate method for staging the axillary node status in breast cancer patients. Optimal localization is achieved by the combination of injection of 99mTc-colloid and blue dye as evidence by the cases of positive SN identified by only one of both methods.

Adult↗
PubMed2000

[Chemoprevention of breast cancer: a hope justified?].

Chemoprevention of breast cancer, a dream? In one American study (National Surgical Adjuvant Breast and Bowel Project, NSABP-P1) tamoxifen decreased the incidence of invasive and non-invasive breast cancer, whereas in two English and Italian studies, it did not reduce this risk. Differences in the study population for the trials may underly these conflicting findings. New drugs, the SERMs, may be more promising.

Adult↗
PubMed1998

[Pro or contra Papanicolaou cytologic smear every 3 years].

OBJECTIVE: To analyse the possibility of three-yearly screening for cervical cancer after two consecutive normal annual smears. METHOD: Review of the literature. RESULTS: In Switzerland 78% of women are screened spontaneously for cervical cancer. For 70% of this group the last smear was less than 18 months before. In other European countries or in North America programmed screening is every 3 or even 5 years. A lowered mortality rate is observed depending on the interval between screening. The benefit is only 2.7% between 3-yearly (90.8%) and yearly smears (93.5%). Finding an oncogenic HPV [16, 18, 31, 45] whilst investigating low grade cervical intraepithelial neoplasia (CIN1) is associated with a 17% risk of conversion into high grade cervical intraepithelial neoplasia (CIN3) within 3 years. CONCLUSION: In Switzerland the conditions for screening on a 3-yearly basis are not fulfilled. We recommend an interval of only 2 years after 2 normal annual smears.

Female↗
PubMed1997

Radiation therapy duration influences overall survival in patients with cervical carcinoma.

OBJECTIVE: This article analyses the influence of treatment duration on survival in patients with invasive carcinoma of the cervix treated by radical radiation therapy. METHOD: Three hundred and sixty patients with FIGO stage IB-IIIB carcinoma of the cervix were treated in Lausanne (Switzerland) with external radiation and brachytherapy as first line therapy. Median therapy duration was 45 days. Patients were classified according to the duration of the therapies, taking 60 days (the 75th percentile) as an arbitrary cut-off. RESULTS: The 5-year survival was 61% (S.E. = 3%) for the therapy duration group of less than 60 days and 53% (S.E. = 7%) for the group of more than 60 days. In terms of univariate hazard ratio (HR), the relative difference between the two groups corresponds to a 50% increase of deaths (HR = 1.53, 95% CI = 1.03-2.28) for the longer therapy duration group (P = 0.044). In a multivariate analysis, the magnitude of estimated relative hazards for the longer therapies are confirmed though significance was reduced (HR = 1.52, 95% CI = 0.94-2.45, P = 0.084). CONCLUSION: These findings suggest that short treatment duration is a factor associated with longer survival in carcinoma of the cervix.

Adenocarcinoma↗
PubMed1996

[Hereditary gynecological cancers].

This presentation summarizes hereditary cancers of the ovary and of the endometrium, describes risks of women belonging to a family at risk and proposes a therapeutic strategy.

Colorectal Neoplasms, Hereditary Nonpolyposis↗
PubMed1996

Effect of total treatment of time on event-free survival in carcinoma of the cervix.

The objective of this study was to analyze the effect of radiation therapy duration on event-free survival in patients with invasive carcinoma. Three hundred and sixty patients with FIGO stage IB-IIIB carcinoma of the cervix were treated with external radiation and brachytherapy as first line therapy. Median therapy duration was 45 days. Patients were classified according to whether they had rather long therapies, taking 60 days (the 75th percentile) as an arbitrary cutoff. Cumulative incidences of local recurrence, metastasis, and death were estimated. The 5-year event-free survival rate was 59 +/- 3% for the less than 60 days group and 42 +/- 7% for the more than 60 days group (P = 0.003). In terms of univariate hazard ratio (HR), the relative difference between the two groups corresponds to an increase in hazard of any of the three events considered more than the double (HR = 1.756, P = 0.003) for the longer therapy duration group. A multivariate analysis, which included selected prognostic factors, confirmed these results (HR = 1.76, P = 0.017). A short radiation therapy duration is a highly significant prognostic factor associated with longer event-free survival in carcinoma of the cervix.

Adult↗
PubMed1996

Younger age as a bad prognostic factor in patients with carcinoma of the cervix.

OBJECTIVE: To verify the influence of age on the prognosis of cervix carcinoma. STUDY DESIGN: Five hundred and sixty eight patients treated for a FIGO stage IB-IVA with radical irradiation in the Centre Hospitalier Universitaire Vaudois of Lausanne were subdivided according to the following age categories: < or = 45, 46-60, 61-69 and >70 years. Taking the 46-60 years age group as the reference, the hazard ratios (HR) of death and corresponding 95% confidence intervals (95% CI) were estimated by means of a Cox multivariate analysis. RESULTS: The 5-year survival rates were, respectively, 57%, 67%, 60% and 45%. For the youngest women the risk of death was significantly increased (HR = 2.00, 95% CI [1.32-3.00]) and was even more accentuated in advanced stages. CONCLUSION: Age under 45 years is a bad prognostic factor in carcinoma of the cervix.

Adult↗
PubMed1996

Salvage chemotherapy with mitomycin, vindesine, and cisplatin (MiViP) in recurrent carcinoma of the cervix.

The combination of mitomycin (8 mg/m(2), i.v., day 1), vindesine (3 mg /m(2), i.v., days 1 and 8), and cisplatin (60 mg/m(2), i.v., day 1) (MiViP) was evaluated in 12 patients with recurrent carcinoma of the cervix. The number of treatment courses ranged from two to eight, with a median of five. Three patients achieved complete remission and six patients showed partial remission, giving and overall response rate of 75%. The median survival was 18 months, with 22 months for responding patients, and 5 months for nonresponding patients (p < 0.01). The major toxicity was myelosuppression. We conclude that MiViP can effectively be used in recurrent carcinoma of the cervix.

Adult↗