Biomedical subjects
Publications and source records attributed to J M Debois.
A 72-year-old patient is reported presenting with an acute cholocystitis syndrome, caused by an extended and metastasized small cell carcinoma of the gallbladder. He was treated with palliative cholecystectomy and Platinum-based chemotherapy with short-term excellent response. Literature on the subject is reviewed and discussed.
BACKGROUND: Data on the incidence, the risk factors, the possibilities of the different adjuvant therapies in the prevention and the prognosis of a supraclavicular metastatic node in a patient with breast cancer are rather scarce, when compared with the literature on axillary nodes. MATERIALS: Relevant literature. RESULTS: In spite of the low attention in the literature, we could have an insight on its incidence, the impact of positive axillary nodes, the rather low efficiency of chemotherapy in preventing them and the more pronounced effect of locoregional radiotherapy. CONCLUSION: The prognosis is rather dismal as supraclavicular nodes are mostly the prelude to new metastases. Supraclavicular nodes can well be treated but the treatment does not influence survival.
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We report a patient in whom 11 years after the treatment of a breast tumour, bilateral ovarian metastases were disclosed. Surgical exploration confirmed unique ovarian metastases within a 'clean' abdomen and pelvis. The particularities of this case compared with the literature are the rather long interval of 11 years and the fact that no other metastases were present. The literature indeed reveals that most of the patient with ovarian metastases are premenopausal, have bilateral involvement; the ovarian metastases occur within a few years and are frequently accompanied by other metastases.
We report a patient who showed skin metastases a few months after the diagnosis and treatment of a laryngeal carcinoma. Review of the literature confirms its rarity and the severity of its prognosis.
Heterotopic ossification may adversely influence the outcome of total hip arthroplasty, causing discomfort or limiting the range of motion and function of the hip. In this prospective study we examined the influence of prophylactic radiation therapy on the postoperative Harris Hip Score in cementless total hip arthroplasty, with a follow-up from 2 to 5 years. Radiation therapy lowered the incidence of unsatisfactory results and increased the Harris Hip Score in hips with a poor preoperative range of motion.
The author has treated 370 cases of skin cancer of the nose with Cesium-137 brachytherapy. The excellent results with a low recurrence rate of 3% and good cosmetic results are compared with those reported on the literature. The method is more elegant than any reconstructive surgery, which should be reserved for extensive cases.
Heterotopic ossification is the most frequent complication in total hip arthroplasty. In this prospective trial the influence of radiation therapy on heterotopic ossification in cementless total hip arthroplasty was investigated. Radiation therapy reduces the incidence and the degree of heterotopic ossification, especially in hips with a poor preoperative range of motion.
Skin carcinoma of the trunk and limbs is rather infrequent compared to the number occurring in the face. Sunlight exposure is probably the most important reason of this uneven distribution. In contrast to skin cancer of the face, all other localisations can be equally well treated with brachytherapy. Cure is obtained in more than 80% of the cases, whereas recurrence can either be treated again or managed with surgery. Lymph node metastases are however best treated with surgery.
Between 1969 and the end of 1984, 104 patients with stage I to III ovarian carcinoma were referred for treatment. All patients had surgery before referral. There were 42 stage I, 32 stage II and 30 stage III patients. In one third of the patients the previous surgery was incomplete. Another 35 patients with advanced (stage IV) ovarian carcinoma or with an abdomino-pelvic recurrence after surgery were referred for palliative treatment. Distribution of the patients according to age, stage and histologic type was not different from the series reported in the literature. Radiation therapy was given over the pelvis up to 45 Gy midline dose. A lumbo-aortic field, 25 Gy up to the diaphragm, was added for stage III patients. Five year survival after complete surgery was respectively 80.5%, 65.5% and 33.3% for stage I, II and III. After incomplete surgery the data dropped to 70%, 33% and 6.6%. Overall five year survival is nevertheless 57.6%. These results are compared to similar published series (surgery and radiotherapy). The outcome is very similar. Adjuvant radiation therapy in adequate dose over the pelvis is worthwhile for ovarian carcinoma stage I-II, and with lumbo-aortic irradiation for stage III, providing surgery was aggressive.
Treatment with therapy--Cesium137--of skin epithelioma of the pinna on 140 patients is reported. For some extended lesions radiotherapy was applied first. Unlike most published series a low recurrence rate was observed, less than 5%. Moreover most of these recurrences can again be treated with a new brachytherapy session. Almost no case of radionecrosis was observed. The occurrence of cervical metastatic lymph nodes still remains a problem and bears a bad prognosis. Brachytherapy of the epithelioma of the pinna has a very high percentage of cure, even for lesions up to 4 cm. Radionecrosis was never observed.
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Results of treatment of the endometrium carcinoma in 138 patients are reported, primarily treated by intra-uterine Curietherapy, and compared with 70 patients first undergoing an hysterectomy followed by radiation therapy. During the first three years the curves for relapse free as for mortality have a similar course. From the third year on, however, patients first undergoing a Curietherapy seem to do better. Compared to other similar series, mentioned in literature, this series of patients gives the same results, which pleads for a prolongation of this method of treatment.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
A case with uptake in the liver of 99mTc-diphosphonate on scintigraphy is presented. The patient was operated on twelve years before for an ovarium carcinoma. Extensive examinations demonstrated the metastatic nature of the liver tumours. Comparison with the few cases in the literature is made.