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J L Guillet

Publications and source records attributed to J L Guillet.

14 recordsLinked to original sources
PubMed2001

Response to neo-adjuvant intraperitoneal and intravenous immunochemotherapy followed by interval secondary cytoreduction in stage IIIc ovarian cancer.

DESIGN: The aim of this study was to determine the effect of intraperitoneal (i.p.) neo-adjuvant immunochemotherapy, followed by secondary interval cytoreduction in bulky ovarian carcinoma, considered inoperable at first exploratory laparotomy. PATIENTS AND METHODS: From 1980 to 1996, 13 naive patients with stage IIIc ovarian cancer underwent an initial laparotomy. Cytoreduction was judged too dangerous in these patients due to the large bulk of the tumor and the extent of peritoneal carcinomatosis. Simple biopsies were performed. The patients received an intraperitoneal cisplatin-based protocol monthly plus immunotherapy (DGZ). The interval secondary cytoreduction was started either when the patients seemed to be in complete remission or after a minimum of 4 courses of chemotherapy if the patients' results were stagnant or deteriorated. Immunochemotherapy was then resumed for a total of up to 10 courses. RESULTS: At secondary cytoreduction, six patients were in complete remission as demonstrated histologically and cytologically. Seven patients were in incomplete remission. In six, debulking was completed without visceral resection. The seventh patient still had nodules more than 2 cm in diameter. Median overall survival was 57 months (range: 6-165). CONCLUSION: Intraperitoneal immunochemotherapy was effective in bulky tumors, making optimal secondary cytoreduction possible in almost all cases.

Adult↗
PubMed2000

[Pathology of gestational trophoblastic tumors].

Gestational trophoblastic tumours result from an abnormal proliferation of different types of trophoblasts. The morphological pattern, together with the immunohistochemical aspect, the cytogenetic data and the clinical profile, helps identify each pathological entity. Hydatiform moles represent malformed placentas caused by genetic aberrations of the villous trophoblast. A complete hydatiform mole displays an hydropic degeneration of all the chorionic villi with a more or less marked proliferation of trophoblasts. A partial hydatiform mole is made up of molar vesicles interspersed with normal chorionic villi. In an invasive hydatiform mole or chorioma destruens, molar vesicles penetrate the myometrium giving rise to a mass distorting the uterine wall. A choriocarcinoma is a malignant proliferation of atypical villous trophoblasts without villi formation. Necrosis, haemorrhage, vascular invasion and distant metastases strongly compromise its outcome. A trophoblastic implantation site tumor, clearly less frequent, results from a proliferation of extravillous trophoblasts, particular for their secretion of human placental lactogen hormone (hPL). This tumour, exceptionally malignant, should be differentiated from the exaggerated placental site and its variants. Except for the placental site trophoblastic tumour, and whatever the outcome (benign or malignant), all gestational trophoblastic tumours secrete the beta-subunit of the chorionic gonadotropic hormone (beta-hCG) more or less abundantly. The serum or urinary level of this unit is proportional to the tumour volume and represents a fundamental basis for the follow-up of these tumours. Multidisciplinary care of high-risk cases allows us to cure the disease, and helps the patient recover her reproductive uterine function.

Chorionic Gonadotropin, beta Subunit, Human↗
PubMed1993

[Proximal tubal obstruction. Treatment by recanalization and transcervical dilatation].

Forty-three fluoroscopic transcervical fallopian tube recanalizations were performed in 30 consecutive patients whose infertility was due to proximal tubal obstruction demonstrated by hysterosalpingography and laparoscopy. All had been recommended tubal microsurgery or in vitro fertilization. Thirty fallopian tubes (81 percent) were successfully recanalized, with balloon dilatation in 20 (57 percent). Six intrauterine and one ectopic pregnancies resulted from successful tuboplasty. Six women who did not conceive underwent follow-up hysterosalpingography 6 months on average after tuboplasty; 2 were found to have tubal reocclusion. There was no difference in our results between patients simply recanalized and those in whom recanalization was combined with balloon dilatation. We conclude that transcervical balloon tuboplasty is an effective treatment of infertility caused by proximal tubal obstruction.

Adult↗
PubMed1989

[Paradoxical effects of tamoxifen on the woman's uterus. Apropos of 7 cases of myoma that appeared while under anti-estrogen treatment].

This study concerns the effects of anti-oestrogens which from now on are an integral part of back-up treatment for cancer of the breast. Seven cases where fibroids led to the need for laparotomy occurred in menopausal women who had been treated with tamoxifen. This has led us to discuss the paradoxical effect of this molecule, which is said to be anti-oestrogenic. This ambivalence is confirmed by studying the literature. These cases raise two questions which we try to answer: 1. Is the action of tamoxifen really anti-oestrogenic? 2. What management should be carried out to lessen the likelihood of tamoxifen treatment leading to laparotomy?

Adult↗
PubMed1986

[Polychemotherapy of ovarian cancer via combined intravenous and intraperitoneal routes. Technic and preliminary results].

20 patients with F.I.G.O. stages III ovarian cancer were entered into a randomised trial between January 1980 and March 1984. After a surgical resection as complete as possible, 10 of these patients received an intravenous chemotherapy with Adriamycin, Vincaleucoblastin Bleomycin, Fluorouracil and Ifosfamid monthly for 10 months. The other 10 patients received the same combined chemotherapy but by a double route: Intravenously and intraperitoneally. The results were judged at "second look surgery". 1 Of the 10 patients who were treated intravenously, 2 who had had a complete surgical resection had no recurrence. Of the remaining 8 patients who had had an incomplete resection, 4 still had residual lesions that could not be removed completely.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

[Amputation of the rectum by the perineosacral approach for anorectal cancer. Indications, results. Apropos of 27 cases].

Twenty seven patients were operated on by perineo-sacral route for anal or rectal cancer. This technique used between 1965-1982 at the Institut Curie was selected because the patients were very old and/or presented with major visceral disease, where the abdomino-perineal resection was not indicated. There was no post-operative death. The margin were free of disease in every patients. 6/27 died within the 6 post-operative months mainly from cardiovascular disease. While most patients were irradiated pre operatively perineal healing was obtained within 6 months in 18/21 cases. 5 patients died of cancer during the two years following surgery. 16/21 are NED with a follow up 1-12 years. Perineo-sacral route is a good alternative from APR in old patients with cardio-vascular disease.

Age Factors↗
PubMed1984

[Neo-vagina by sigmoid reconstruction. Apropos of 12 cases of vaginal aplasia].

Sigmoid transplants for reconstruction of an aplastic vagina were performed in 12 patients. The technique of cleavage, through a simple perineal or a double approach, raises two problems. First, the slow spontaneous epithelialization means that the new passage must be lined with a skin graft, which is rarely totally successful and prolongs the hospital stay period. Second, the need to wear a mandrin permanently in order to preserve the anatomical result. Sigmoid transplants provide a good and lasting functional result without too many postoperative problems: when performed in young patients, with healthy colons, the morbidity is not modified when compared with that of cleavage operations.

Adult↗
PubMed1983

[Operable cancers of the rectum: preoperative radiotherapy. Retrospective study of 192 cases treated at the Curie Institute].

Pre-operative irradiation in operable cancer of the rectum remains controversial. This is a report of a retrospective study about 192 patients treated between 1958 and 1980 at the Institut Curie (Paris) for a rectal cancer. An abdomino-perineal resection was done in 144 patients, 83 as a primary procedure and 61 after a pre-operative irradiation. During the same period 48 patients had an anterior resection. We put in this study the only patients who underwent curative surgery. Irradiation was given with high voltage by a four field "box technique". The tumour received 40 to 50 grays in 5 to 6 weeks. The operation was done at least 6 weeks after the end of the irradiation. There was no difference for the sex, and age of the patients, and in the size of the tumour before treatment, between the patients irradiated and those operated on as a primary procedure. There was no difference in the operative mortality as well as the 3, 5, and 10 year survival in the two groups. Pre-operative irradiation did not change the number of perineal recurrences or the number of visceral metastases. The healing of the perineum was significantly longer in the irradiated patients (p less than 0.001). The survival was closely related to the Dukes classification. The number of Dukes A patients was significantly higher (p = 0.02) after irradiation: 26/61 (43%) vs 19/83 (23%) when the patients were not irradiated. In our experience pre-operative irradiation can shrink some large tumours helping the surgical act.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗