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Biomedical subjects

J F Rodier

Publications and source records attributed to J F Rodier.

At least 37 records · Page 2Linked to original sources
PubMed1998

[Effect of preoperative administration of Lugol's solution on thyroid blood flow in hyperthyroidism].

A study of 50 patients with hyperthyroidism was conducted to evaluate the effect of preoperative administration of Lugol's iodine solution on thyroid blood flow. Highly significant reductions in diameter, time-averaged velocity, and volume flow of the superior thyroid artery were demonstrated after administration of Lugol's solution. The Duplex ultrasound scanning used in this study is a noninvasive, inexpensive, accurate, and reproducible technique suitable for analysis of thyroid blood flow in hyperthyroidism. On the basis of current ultrasonographic results and low postoperative morbidity in patients, Lugol's solution is well tolerated and may be recommended for use before thyroidectomy, especially for diffuse toxic goiters and Graves disease.

Adult↗
PubMed1998

[Cervical lymphadenopathy revealing differentiated thyroid cancer. Review of the literature and therapeutic approach].

Well-differentiated thyroid cancer (i.e. papillary microcarcinoma) may be revealed by a clinically palpable cervical node, especially in young patients. Primary tumor specificity (small-sized, superior location, invasion, multifocality) and characteristics of cervical node involvement (with synchronous central and lateral multiple node spread) require appropriate treatment by a skilled surgeon. Contrary to the primary tumor treatment (total thyroidectomy), surgical management of the cervical node basins remains controversial. Only a special knowledge of the specificity of this disease and cervical lymphatic anatomy will ensure a good prognosis for the patient.

Adult↗
PubMed1997

'Dosimetric breast size': a new and useful parameter for the prediction of local recurrence after breast conservative treatment.

To evaluate the risk of local recurrence following breast-conserving therapy for breast cancer, we measured the distance between each entry point of the irradiation on the surface of the breast in line with the axis of the external and internal tangential fields (dosimetric breast size). 652 breast cancer patients were retrospectively analysed, with a median age of 51 years and a median follow-up of 99 months (range 84-192). There were 50 local recurrences, 44 isolated and 6 associated with nodal recurrence or metastases. The global rates of local recurrences at 5 and 10 years were 5.3% and 9%, respectively (Kaplan-Meier analysis). Following a Cox's multivariate analysis, the only significant and independent parameters related to local recurrence were quality of excision, age at diagnosis and dosimetric breast size. For a small dosimetric breast size (< or = 10 cm), the rate of local recurrence was 14.1 compared with 11.8 for medium dosimetric breast size (> 10 cm-< or = 12 cm) and 5.2 for large dosimetric breast size (> 12 cm). If the analysis was restricted to only those with complete excision, then the relative risk for a patient with a small dosimetric breast size was three times that for a large breast size.

Adult↗
PubMed1996

[Oncocytic cancers of the thyroid. Hürthle cell cancers].

Hürthle cell cancers of the thyroid have been a subject of debate for many years because it is difficult to differentiate between benign and malignant tumours. Diverse therapeutic strategies have thus ensued. Recent work describing the morphologic and biologic criteria for a more precise diagnosis have led to better therapeutic strategies. We report a series of 85 tumours of the thyroid with Hürthle cells including 19 Hürthle cell tumours (22%) operated between 1976 and 1994. Hürthle cell tumour represented 6.7% of 282 thyroid cancers operated during the same period. The mean age of the patients was 56.6 years (range 23 to 78 years) and 63% of the tumours were large > or = 4 cm (classed T3T4). Treatment was total thyroidectomy in 79% of the cases. 5-year survival was 58.3% and 25% of the cases had metastatic extension at the time of initial treatment. Hürthle cell cancer have now been recognized as a particular anatomic and clinical entity. They were formerly confounded with vesicular cell cancers but now have been separated into a single entity due to a poor prognosis, lack of response to radioactive iodine and high incidence of metastasis. The current histological criteria make diagnosis more precise and allow more logical treatment with total thyroidectomy. A few familial cases have been reported. Although less frequent than in medullary cancer, this form would suggest that a genetic survey should be conducted for this particular type of thyroid cancer.

Adenocarcinoma↗
PubMed1994

[Cuniculatum carcinoma. 6 cases and review of the literature].

The cuniculatum carcinoma is a rare type of epidermoid carcinoma. We report 6 cases with different localizations ("oral cavity and larynx", vulva, lower limb) treated over a 23-year period. Diagnosis is particularly difficult and requires careful clinical examination completed by deep surgical biopsy for histology. The aetiology of the tumour is not well defined. It presents as a slow growing wart with local malignancy and chronic suppuration. Extension to lymph nodes is rare. Histologically there is proliferative deep malpighian infiltration with an aspect of normal cell maturation. Galeries are hollowed out giving the aspect of a rabbit burrow (cuniculatum). Surgery is the only treatment, generally without lymph node curage. Radiotherapy is contraindicated due to anaplastic transformation.

Adolescent↗
PubMed1993

Influence of mastectomy techniques on estrogen and progesterone receptor analysis in carcinoma of the breast.

Gradual tumor tissue devascularization during mastectomy is thought to decrease estrogen (ER) and progesterone (PgR) receptor activity. To determine whether or not hormone receptor values could be influenced by different mastectomy techniques, 62 patients with carcinoma of the breast had a Tru-cut needle (Baxter Healthcare Corporation) biopsy (premastectomy sample) and underwent modified radical mastectomy (postmastectomy sample) either before (group 1, 40 patients) or after (group 2, 22 patients) axillary lymph node dissection. When the two surgical procedures were compared in 33 patients in whom it could be assessed, no significant tendency (p = 0.51 for ER and p = 0.36 for PgR) for the postmastectomy sample to have hormone receptors levels less than samples taken at biopsy was detected. Overall, in the two groups (44 assessable patients), comparison with respect of each patient, between premastectomy and postmastectomy samples showed that the variations in either ER or PgR receptor values, determined by immunoenzymatic assays, were not statistically significant (p = 0.32 for ER and p = 0.21 for PgR). The current results indicated the relative stability of steroid receptors during the two modified radical mastectomy procedures and suggested that a systematic reference determination of hormone receptors on biopsy before modified radical mastectomy is unnecessary.

Aged↗
PubMed1993

[Insular carcinoma of the thyroid. Apropos of a case and review of the literature].

We present a new case report of "Insular" thyroid carcinoma. The first series was published, in 1984, by Carcangiu et al. The propensity for local recurrence and early distant metastases explains the poor prognosis of this carcinoma and demands aggressive therapy at the time of diagnosis. This includes radical surgery, radiotherapy with possible chemotherapy. Clinical and pathological arguments suggest that this carcinoma could be an intermediate stage in the process of loss of differentiation of some thyroid neoplasms.

Carcinoma↗
PubMed1993

[Malignant hemangioendothelioma of the thyroid. Pathologic study of a case].

The authors report a case of malignant tumor of the thyroid in a 79 years old woman with a long standing goiter for 20 years but who did not live in endemic mountainous goiter area. The right lobe of the thyroid was surgically removed in February 1992 because increasing in size. Pathologic diagnosis was non malignant cystic lesion. Two months later, a recurrence with dyspnea urged a tracheostomy. The patient died 9 days later because of intra bronchial and pleura hemorrhage. The morphological and immuno-histochemical investigations showed angiosarcomatous features and positive reactivity with Factor VIII and UEA 1 markers in the tumour and pulmonary metastases. The diagnosis of Malignant hemangio-endothelioma was concluded.

Aged↗
PubMed1992

Radical surgery and conservative treatment of ductal carcinoma in situ of the breast.

70 cases of strictly intraductal breast carcinoma were treated from January 1975 to December 1987. 34 patients underwent radical modified mastectomy, and 36 patients had local excision (2), lumpectomy (26) or quadrantectomy (8), with a complementary irradiation in 34/36 cases (with boost in 32). The main histological subtype is comedocarcinoma (25/70). One local relapse (3%) is noted in radical surgery group at 55 months. 3 local relapses (9%) are noted in conservative treatment group, respectively at 27, 48 and 52 months. The obvious factor influencing the local recurrence is the inefficient surgical excision. Since breast screening programs may lead to early duct carcinoma in situ identification, our results suggest that appropriate conservative surgery associated to radiation therapy could be an adequate alternative to mastectomy in the treatment of this in situ lesion.

Adult↗
PubMed1992

[Ovarian metastases from colorectal cancers. Current place of prophylactic bilateral ovariectomy].

Ovarian metastases occur in the course of colorectal adenocarcinomas on 3 to 14% of cases. They are bilateral in 50-70% of cases and frequently occult (6 to 25%) and constitute a factor of poor short-term prognosis (median survival: 18 months). After analysing the features of ovarian metastases from colorectal cancers, the authors discuss the current place of prophylactic bilateral oophorectomy in terms of its indications and results. Although this procedure should clearly be performed routinely in postmenopausal patients, it is more controversial in women of reproductive age who, according to some authors, nevertheless constitute a group at high risk of ovarian metastases. The contribution of this prophylactic oophorectomy to the improvement in the prognosis of colorectal neoplasms has not been statistically established to date and needs to be demonstrated by means of prospective studies.

Colorectal Neoplasms↗
PubMed1992

[Treatment of the pelvis after total pelvic exenteration. Experience of the Regional Paul Strauss Cancer Center of Strasbourg].

Intestinal morbidity after total pelvic exenteration presents usually as fistulae. These appear particularly if irradiation has been carried out in the pelvis or the abdomen before surgery, and particularly as a result of the types of surgery carried out in the emptied pelvis. An analysis of 92 exenterations of the pelvis of which 52 were total exenterations led us to look at how treatments in the pelvis have evolved technically and to analyse the contribution they have made to reducing the number of fistulae and obstructions found as a result of this major surgery. Making a "sac" by packing the pelvis as suggested by the pioneer of this exceptionally extensive pelvic surgery gradually has been replaced by the use of endogenous material such as the omentum and more recently by the use of absorbable synthetic materials (vicryl) which give rise to progressive reperitonealisation. The authors approve of this last way of dealing with the emptied pelvic cavity because the synthetic material is very well tolerated clinically and the polyglactine 910 mesh is not predisposed to infection when it is used to make a hammock to prevent chronic radiation enteritis by holding the small intestines out of the pelvis.

Cancer Care Facilities↗
PubMed1992

[Latissimus dorsi myocutaneous flap closure in mastectomies after chemotherapy of advanced and progressive breast cancers].

A latissimus dorsi myocutaneous flap now appears to be the best solution to closing large carcinological exeresis of the breast. After an analysis of a series of 14 cases of advanced cancer (T3 or T4) or of progressive cancers (PeV3) of the breast treated by inductive chemotherapy and which underwent surgery at the Strasbourg CRLCC (France), the authors stress the simplicity and reliability of the method, which can make it possible to carry out an extensive and complete exeresis, which is of primordial importance in the control of the local tumor. Its excellent trophic quality made it possible to start radiochemotherapeutic adjuvant treatments rapidly. The other methods (myocutaneous flap of the rectus abdominis, Kiricuta's epiploic flap, neighboring autoplasties) now persist only in cases of advanced breast tumor in which the greater dorsal flap is contraindicated.

Adult↗