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J Genin

Publications and source records attributed to J Genin.

At least 37 records · Page 2Linked to original sources
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↗
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↗
PubMed1987

Musculoskeletal tumors: follow-up with MR imaging after treatment with surgery and radiation therapy.

Magnetic resonance (MR) imaging was used as a follow-up technique in 60 patients who underwent surgery and/or radiation therapy for primary malignant musculoskeletal tumors. MR imaging was performed on a 1.5-T imager with T1- and T2-weighted imaging sequences; MR imaging findings were confirmed by means of posttreatment surgery and histologic analysis or follow-up for at least 1 year. If a low-signal-intensity lesion was seen on T2-weighted images in a patient who had undergone radiation therapy or surgery, the patient usually did not have active tumor (sensitivity, 96%). If a high-signal-intensity lesion was seen after a patient had undergone only surgery, the patient had active tumor (six of six such cases). In patients who had undergone only radiation therapy, however, the presence of a high-signal-intensity lesion may indicate either active tumor or radiation-induced inflammatory changes. Thus, in such cases, differential diagnosis of active tumor may be difficult, if not impossible, to make from MR images.

Bone Neoplasms↗
PubMed1987

The importance of histologic grade in long-term prognosis of breast cancer: a study of 1,010 patients, uniformly treated at the Institut Gustave-Roussy.

In a study of 1,010 patients with solitary, unilateral, nonmetastatic breast cancer, the histologic grade, assessed by a multifactorial analysis (Cox model) to study its significance with other prognostic factors, was found to be an important, independent factor. For 612 operable patients, two laboratory characteristics, the number of histologically positive nodes and the histologic grade, were the most valuable predictors. These two factors alone form a predictive index that may be an excellent and simple guide for the clinical decision of subsequent therapy. For 398 patients with inoperable breast cancer (ie, tumor greater than or equal to 7 cm, N2-3, inflammatory, skin fixation, and clinically rapidly growing forms), the histologic grade (performed on drill or cutting needle biopsy) was again a most important (and with inflammatory forms the most important) predictor of prognosis in these patients. Our data support that performing our modified histoprognostic grading of Scarff and Bloom is simple, reproducible, incurs no additional cost, may be carried out in the simplest histology laboratory, and finally, defines an important risk factor in all patients. It should be routine for all breast cancer specimens. Furthermore, studies of adjuvant therapy should stratify patients for this variable.

Adult↗
PubMed1987

[The role of the pathologist in the treatment of osteogenic sarcoma].

The pathologist today has an important role in the treatment of osteosarcoma. He contributes during the operation by advising about the extent of the tumour and after the operation by studying the operative specimen to assess the extent of the tumour, and, when primary chemotherapy has been used, to estimate the effectiveness of the treatment by counting the percentage of viable tumour cells so that the type of chemotherapy used subsequently can be adapted to the situation. Only trained teams can make the best use of these studies.

Humans↗
PubMed1986

[Pre- and postoperative anatomo-clinical correlations apropos of 30 conservative resections of osteogenic sarcomas. Surgical inferences].

The extent of osteogenic sarcoma has been measured in 30 bones obtained after local resection and compared with pre-operative evaluation. In only one case was the articular cartilage involved and the whole joint was resected. Other cases with a metaphyseal localisation were treated by disarticulation. Articular cartilage appears to provide good protection against local extension. In contrast, the growth cartilage, which was present in 11 cases, was crossed by tumour on three occasions. In only one case of diaphyseal localisation was a resection made across the tumour which had been previously rendered necrotic by chemotherapy. In most of the diaphyseal localisations, the post-operative study revealed that the resection had been over-extensive. Tomodensitometry is not very reliable in the precise evaluation of the extent of diaphyseal involvement.

Bone Neoplasms↗
PubMed1985

Problems and pitfalls in the use of computed tomography for the local evaluation of long bone osteosarcoma: report on 30 cases.

Forty-eight, computed tomography (CT) examinations undertaken in 30 patients with osteosarcoma of long bones were studied in detail, their diagnostic information being compared with that obtained from corresponding plain films. The latter were of more value in assessing peripheral bony involvement, by cortical extension and periosteal reaction, while the former, in general, permitted more accurate observation of extensions into adjacent soft tissues. Recognition of such extensions, however, was vitiated when they arose in relation to the proximal ends of the tibia, fibula, and humerus and when a haematoma had developed as a result of a biopsy. Plain films were also of more value in appreciation of response to chemotherapy. On the other hand CT is the only examination which permits a satisfactory study of intramedullary extensions of the tumour and in consequence is invaluable in determining the exact sites required for local resection. No cases of skip metastases were observed in our series, although similar appearances due to nutrient vessels or bony ridges, remote from the primary tumour, were noted on several occasions. Differentiation of these densities proved to be easy, particularly in the case of nutrient vessels when examination of the contralateral bone showed them to be symmetrical. Several authors have described the role of CT in the evaluation of local extensions. This paper reports the difficulties and errors encountered by us.

Bone Neoplasms↗
PubMed1985

[Alveolar soft part sarcomas. Apropos of 6 cases and review of the literature].

This is a clinicopathologic study of 6 cases of alveolar soft-part sarcoma. The patients age ranges from 8 to 47 years. All patients are women. In 5 cases the localization of the primary tumor is the lower extremities. Histologically the tumors have a distinctive organoid pattern outlined by thin-walled capillaries and are composed of nests of large polyhedral cells with abundant finely granular, acidophilic cytoplasm. Two tumors, among the 4 tested cases, have cytoplasmic PAS positive diastase-resistant crystalline structures. Electron microscopic study of one tumor shows intracytoplasmic glycogen, small membrane-bound electron-dense granules, Golgi lamellae and crystalline structures. Immunoperoxidase study performed in one case reveals a positivity with antikeratin and anti-enolase (NSE) antibodies. The prognosis of this tumor is poor. The main metastasis are in the lung and in the brain. Often the patients develop metastasis before detection of the primary tumor. The histogenesis of alveolar soft part sarcoma and the identity of the characteristic crystalloids remain open for discussion.

Adult↗
PubMed1985

[Mesenchymal breast sarcomas. Apropos of 25 cases].

Breast sarcoma are rare, representing 1% of all malignant breast tumours. This is a retrospective study of 25 patients with a breast sarcoma, treated at Institut Gustave Roussy from 1954 to 1981. Thirty six per cent of these arose in a cystosarcoma phyllodes. A variety of histologies were found, the main one being malignant fibrohistiocytoma (44%). Nodal involvement was rare (4%) and, as in other sarcoma, hematogenous spread of metastases was more usual. Local recurrence occurred in 44% of cases and distant metastases (usually pulmonary) in 24%. The 3 year disease-free survival was 60% and the major prognostic factor was the mitotic index. Surgery is the treatment of choice of these tumours, supplemented by local irradiation in those cases where only a tumorectomy has been performed. The role of adjuvant chemotherapy remains undefined.

Adolescent↗
PubMed1985

[Conservative surgical treatment of osteogenic sarcoma of the limbs. Technics and functional results].

Sixty-three osteogenic sarcomata of the limbs in patients aged between 10 and 20 years were treated by en bloc resection combined with chemotherapy. A review was made after an average follow-up of less than four years, which is too short a time to assess the carcinologic value of this type of treatment but sufficiently long to assess functional results and surgical technique. The resection was made through apparently normal tissues, thanks to meticulous pre-operative investigation and an appreciation of the extent of the tumour at operation. The tissues contaminated by a biopsy were removed. Three local recurrences were seen and in three other cases further extension in the operated limb was due to metastases. Reconstruction almost always utilised inert prosthetic implants often made during the pre-operative phase of chemotherapy. In cases of resection of the upper tibia an original procedure was developed to reconstruct the quadriceps using muscle-plasties. In 32 out of 39 knees, the immediate functional result was good. Only 10 still survived after two years, with nine good functional results. The authors conclude that en bloc resection is preferable to amputation in young patients both for those who will have a limited survival and those who will have long survival because of improvements in chemotherapy treatment. The risk of secondary loosening requires the use of more grafting procedures in reconstruction.

Adolescent↗
PubMed1985

[Nasal chondroma associated with Ollier's disease. Apropos of a case observed at the Gustave-Roussy Institute].

A patient with a nasal chondroma and Ollier's disease treated at the Institut Gustave-Roussy, Villejuif, had a long past medical history of over 10 years, starting with a nasal lesion diagnosed as a myxoma. Follow up clinical and radiologic examinations failed to detect recurrences. The discovery, ten years after excision of tumor, of multiple skeletal enchondromas raised the hypothesis of Ollier's disease, this being responsible for the myxoid chondroma of the nasal cavities. A past medical history of surgery to the left lower limb presenting a valgus deformity, and of a left suborbital angioma treated by curietherapy confirmed the diagnosis of Ollier's disease and suggested that of a Maffuci syndrome. Prognosis of the disease is dominated by the risk of onset of chondrosarcoma.

Adult↗
PubMed1982

[Management of pulmonary metastases from osteosarcomas].

The management of pulmonary metastases from osteosarcomas rests at present on thoracic surgery combined with chemotherapy. Until the beginning of the seventies chemotherapy proved very disappointing. With adriamycin, methotrexate in high doses followed by folinic acid and, more recently, platinum cis-dichlorodiamine, remissions, which are usually partial, are obtained in a significant proportion of patients (at least 30%). The addition of less active agents such as vincristine, cyclophosphamide, actinomycin D and bleomycin is helpful. Among 31 patients with pulmonary metastases from treated osteosarcomas seen at the Gustave Roussy Institute, 18 underwent thoracic surgery as the first treatment; in 10, surgery was followed by chemotherapy with adriamycin, vincristine, methotrexate in high doses + folinic acid + cyclophosphamide. Five patients are in complete remission 27, 30, 49, 50 and 77 months after the surgical procedure. 12 patients were initially treated with a similar chemotherapeutic regimen; a subsequent thoracic surgical procedure was undertaken in two patients who died 18 and 30 months after the pulmonary metastases had appeared. In one patient, the metastases were treated by irradiation. These results are compared to previous reports in the medical literature.

Humans↗
PubMed1982

[Osteogenic sarcomas of the limbs. Radical treatment of the primary tumor: choosing between irradiation and amputation ].

In osteogenic sarcomas of the extremities, radical therapy of the primary tumor now seems more precisely delineated. In most cases, especially in large tumors with lytic lesions or fractures, and in children. Irradiation is indicated only in small tumors with condensation, and in tumors of the proximal metaphysis of the humerus. Conservative surgical treatment with carcinologically satisfactory resection of involved bone followed by reconstruction, is currently under evaluation. Such treatment is indicated in specific cases: children in the final stage of growth, and small tumors without major involvement of soft tissues that respond to preoperative chemotherapy.

Adolescent↗
PubMed1982

[Adjuvant therapy in the management of osteosarcomas: the O3 trial (EORTC and ISPO) ].

The European Organization for Research on the Treatment of Cancer (EORTC) and the international Society of Pediatric Oncology (ISPO) have set up a randomized controlled trial designed to compare three different regimens of adjuvant therapy applied after treatment of the primary tumor (usually by radical surgery): a prolonged course of chemotherapy (41 weeks) combining adriamycin, methotrexate in high doses followed by folinic acid, vincristine, and cyclophosphamide; radiotherapy delivering 20 grays to the lungs; and a short course of chemotherapy (8 weeks) combining adriamycin, methotrexate in high doses, folinic acid and vincristine, associated with irradiation of the lungs as in the preceding protocol. At the time being, 156 patients have been included in this study. If conclusions are to be drawn from this trial, a total of 300 patients seems necessary.

Antineoplastic Agents↗
PubMed1981

[Liposarcoma in adults. Prognostic factors in a series of 84 cases (author's transl)].

A retrospective study of 84 patients with liposarcoma treated at the Gustave Roussy Institute between 1956 and 1978 has elicited a number of factors which influence the prognosis, namely: (1) the site of the initial tumour: patients with liposarcoma of the head, trunk and extremities have a better survival rate than those with retroperitoneal tumours or tumours of the pelvic and pectoral girdles; (2) the histological type: differentiated forms have a brighter prognosis than undifferentiated forms; (3) the size of the tumour: tumours of less than 10 cm in diameter have a more favourable prognosis than larger tumours; and (4) the patient's age, which in fact correlates with the histological type. Local recurrences are common but do not seem to worsen the prognosis. The only curative treatment is surgery, but radiotherapy reduces the risk of local recurrences and chemotherapy may be considered in cases with poor prognosis.

Adult↗
PubMed1981

[Resection-reconstruction of the knee for bone tumor (author's transl)].

The authors report 17 cases of primary tumors of the knee treated by wide resection, removing "en bloc" the entire epiphysis in 14 cases and in the remaining 3 most of the epiphysis. The series consisted of 8 giant cell tumors of which 6 were followed for between three and fifteen years, and for 9 tumors of moderate malignancy amongst which 1 fibrosarcoma, 1 parosteal osteosarcoma and 3 cartilaginous tumors which were followed between five and fourteen years. All were free of metastatic spread except 1 fibrosarcoma whose resection was debatable. Arthrodesis was carried out on all but 2 patients received prosthesis. The arthrodeses were made by autogenous grafts protected in 11 cases by intramedullary rod, in 1 case by a plate, and in 3 cases by both. The series contains one amputation and three fractures necessitated secondary grafting with replacement of rod in two cases. The results are analysed in carcinological and technical shemes. The value of resection and the importance of grafting over the arthrodesis are emphasised. In the long term, resection-arthrodesis means the conservation of a stable and functional limb, permitting an active life one year postoperatively. Massive prosthesis are only exceptionally indicated.

Adolescent↗