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J M Lutz

Publications and source records attributed to J M Lutz.

25 records · Page 2Linked to original sources

[Incidents of brain tumors observed in the Grenoble area (canton of Meylan) 1979-1990].

A high excess of risk (standardized incidence ratio S.I.R.: 320 [190-490]) of intracranial tumors among men living within the county of Meylan, in the suburb area of Grenoble, as compared with the overall population was shown by the Isère Cancer Registry, for the period 1979-1984. There has been no change of this excess of risk between 1979 and 1990 (S.I.R. = 190). The pathological homogeneity of this cluster (neuroglial tumors) among men is noticeable. This county is known as a concentration of high-tech and intellectual professional activities. A descriptive study was conducted on the 24 cases diagnosed between 1979 and 1990, based on retrospective interviews of patient's family. Ethnical origins, blood groups, personal and familial medical history (with special interest in cranial injuries), socio economic status, chemicals, radiations and electro-magnetic exposures, acoustic and visual exposures (such as noises and T.V.), drinking water, tobacco and food consumptions, were investigated. Educational level, occupation, and European ethnic origin are all pointing to the same direction: a higher risk in high level social classes and high level professions. An analytical study is going on, that would give a deeper insight in these phenomenons.

Adult↗

[Epidemiology of testicular cancer].

Testicular carcinoma is a rare disease, with an incidence ranging from 0.2 (Blacks in Connecticut) to 7.8 (Denmark) in the World, and ranging from 2.5 to 4.3 in French Cancer Registries. An increase among young men has recently been described in Denmark and in England (Mortality Data between 1936 and 1976). Survival is 75% after five years, all histological types combined. No role as a risk factor "per se" has been confirmed for Genetics alone (Twins study in Finland), but a familial RR of 6 has been observed among first degree relatives of testicular carcinoma cases. Most interesting is a study by A.R. Moss, showing a RR of 4.4 among cases whose mother on had a breast cancer, as it emphasizes a possible role or hormones for non seminomatous testicular cancer.

Adolescent↗

[Hepatic metastasis of unknown primary site].

In this retrospective study, 91 patients (30%) out of a series of 304 with metastatic cancer of unknown primary site were found to have liver metastases. The liver was the only metastatic site in 28 (31%) cases and was associated with other sites in 63 (69%) cases. Median age was 62 yr in 61 male patients and 59 yr in 30 female patients. Thirty patients were submitted to an extensive investigation in search of the primary tumor, including systematic endoscopies: no primary cancer was found in these patients. In 61 other patients, only symptom-oriented investigations were performed and the primary cancer was found in 11 cases. The histologic type was adenocarcinoma in 71 (78%) cases, undifferentiated in 11 (12%) cases, epidermoid in 5 (6%) cases and determined by cytology alone in 4 cases. The median survival was 4 months in patients with metastases in the liver only, and 5 months in the other patients. This difference was not significant, so prognostic factors such as the Karnofsky index, weight loss, CEA and LDH levels were evaluated in the entire group; these factors do not have significant prognostic value. By contrast, when patients were able to receive chemotherapy, median survival was better (4 months) than without (median survival: 1 month; P = 0.005). In addition, in the case of objective response to chemotherapy, the median survival was 9 months versus 3.5 months for patients without objective response (P = 0.001). Seventy-three out of 91 patients (80%) were treated with chemotherapy regimen; 65 patients were evaluable: the objective response rate was 11 +/- 7% (7/65). Different regimens were used. With a non-toxic combination of fluorouracil, vinblastine and cyclophosphamide, 3 partial responses greater than or equal to 50% out of 43 patients (7 +/- 8%) were obtained. No significant advantage was observed when adriamycin was added to FU (4/13): 31 +/- 25%. Second- or third line chemotherapy regimen due to progression of the disease after the first-line combination provided only one objective response out of 36 patients. According to this retrospective study we recommend that overinvestigation be avoided in patients, with liver metastases of unknown primary site and that these patients be treated with non-toxic drug combinations.

Adenocarcinoma↗

[Incidence of colonic and rectal tumors as a function of the urban and rural characteristics of the residential area in the Isère district (1979-1985), France].

From 1979 to 1985, 1443 new malignant tumors of the colon and 1017 of the rectum appear in the departement of Isère (France). Using the urban category of "Zone de Peuplement Industriel et Urbain" (Z.P.I.U), we were able to classify place of residence within 3 strata, according to the proportion of inhabitants of the rural (or urban) type. For both sexes, incidence of colon carcinomas is higher in urban categories than in rural ones. For males, incidence of rectal carcinomas is higher within areas of the rural type. Going from the urban category of the rural one, "urban" being the level of reference. Relative Risks for men are 1,0.9 and 0.6 for the colon, and 1, 1.3 and 1.2 for the rectum. For women, RR's are 1,0.8, and 0.7 for colon, and 1,1.0, and 0.8 for the rectum. Same results are described in the literature, with higher risks for colon cancers in urban areas. Our results reporting lower incidence for rectal carcinomas in Isère among men, are in contradiction with other results in the literature. This work supports the idea that epidemiology of large bowel carcinomas should focus onto segments. Second, when categories of residence allow it, it is worthwhile looking at gradients that bring more information on the relation, than the simple dichotomy: urban versus rural.

Colonic Neoplasms↗

[Critical analysis of a clustering method applied to the study of geographic distribution of cancer].

Cancer registration permits to elaborate atlases that describe the spatial distribution of incidence within the registration area. The division of this area in small units is usually an administrative one, leading a wide range of unit sizes. Hence, results of indirect standardization are often difficult to interpret, due to the large variability of the observed cases. We used Huel's method (1986), which is based on the grouping of contiguous geographical zones that have the same incidence level. Here are displayed the results for cancer incidence within the "département de l'Isère" (France). We focus on method mechanisms and on the impact of the choice of the risk level.

Cluster Analysis↗