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J Masselot

Publications and source records attributed to J Masselot.

At least 19 recordsLinked to original sources

Combined radio-surgical treatment in early invasive cervix carcinoma according to prognostic factors. Experience of the Gustave-Roussy Institute.

In the Gustave-Roussy Institute the standard protocol of limited stages (IB, proximal II) of cervix carcinoma, combines endocavitary brachytherapy (low dose rate) and surgery (BSOH + lymphadenectomy) are eventually followed by external beam irradiation. According to age of patients and to prognostic factors adaptations of this combined treatment are discussed: young patient (40 years) with small tumor, large volume of primary tumor (4 cm), lymphatic node involvement. Analysis of the results in 2 series of patients entirely treated at the Gustave-Roussy Institute: survival, local control, metastases, complications.

Age Factors

[Evaluation of the role of MRI at 1.5 T in the staging of the initial extension of cancer of the uterine cervix].

To evaluate the sensibility and specificity of MRI in the initial staging of carcinoma of the uterine cervix, a retrospective study of 41 patients (48 MR scans) was undertaken. The sensitivity of T2-weighted images in the detection and determination of tumor location was 90% and specificity was 100%. On T2-weighted images, the signal intensity of the tumor was high in 64%. Determination of tumor size was correct in 80%. The ability of MRI to demonstrate the extension to the uterine corpus was acceptable with a sensitivity of 63% and a specificity of 100%. The extra-uterine extension was difficult to appreciate especially for parametrial, vaginal and bladder involvement with a sensitivity of 38%, 43 and 67% respectively. Concerning the lymph nodes involvement, the sensitivity was 38%. The results of this study point out the ability of MRI to evaluate the size and location of the tumor. The accuracy of MRI to appreciate the involvement of the parameters, vagina and bladder is disappointing.

Adolescent

[Imaging of cancer of the uterine cervix].

Recently, magnetic resonance imaging (MRI) and transrectal or transvaginal ultrasound (TRUS, TVUS) had an important place in imaging techniques of cervical carcinomas and raise the question of modifying the imaging strategies. For the diagnosis of primitive tumor, those techniques cannot take the place of clinical examination and gross examination. In the assessment of parametrial involvement, TRUS which has better accuracy than clinical examination, and MRI which is considered as the most accurate technique, have an important role to play. In the follow-up and the detection of recurrences, MRI is actually considered as the best imaging technique. The authors, according to recent data in literature and their own experience, present basic concepts of imaging strategies for staging and follow-up of cervical carcinomas.

Evaluation Studies as Topic

Clinical and radiologic analysis of 13 cases of primary neuroectodermal tumors of bone.

Radiographs and clinical charts were reviewed in a series of 13 cases of primary neuroectodermal bone tumors, involving 9 males and 4 females, aged from 3 to 32 years (average: 15 years). The average delay between the onset and diagnosis was 5 months. Fever and other systemic symptoms were present in 6 cases; in 4 cases a fracture was the mode of presentation. Seven patients had metastases (4 involving bone) at the time of presentation. Only one patient is still alive after 5 years. In the 10 patients who died as a direct result of the tumor, death occured on average 8 months following diagnosis if metastases were present initially, and 36 months after the diagnosis otherwise. Tumors predominantly involved the leg (7 cases), the pelvis (2 cases), and the humerus (2 cases), the involvement being both diaphyseal and metaphyseal. The radiologic appearance is that of an aggressive, poorly demarcated tumor, with cortical destruction, periosteal reaction and soft tissue invasion. Comparison with Ewing sarcoma shows little radiologic or clinical difference, except for a poorer prognosis in neuroectodermal bone tumors. Both bone tumors may have a similar neuroectodermal origin, with Ewing sarcoma representing the undifferentiated variety.

Adolescent

[Imaging of malignant tumors of the uterus and ovary].

Authors discuss the role of new imaging methods in the management of malignant tumors of the ovaries and uterus. After briefly reviewing the imaging methods and particularly lymphangiograms, they discuss the value of these techniques for each tumor. The indications of these techniques detailed in the last chapter.

Diagnostic Imaging

Lymphography in the initial evaluation of endometrial carcinoma.

Two hundred eighty-eight patients with endometrial carcinoma underwent a bipedal lymphography. The proportion of positive lymphangiograms is related to the clinical stage, the histologic grade, and the depth of myometrial invasion. Lymphography is not a significant predictor of survival taking into account the other prognostic factors. A histological examination of the lymph nodes was carried out for 138 patients. Lymphography is not very sensitive but is highly specific, detecting only 50% of metastases with a false positive rate that is too high. It therefore is of little diagnostic and prognostic value for operable patients. It is, however, useful for the followup of lymph nodes of patients treated by radiation therapy.

Evaluation Studies as Topic

[Contribution of gadolinium DOTA in primary tumors of bone and soft tissue].

20 patients with a primary musculo skeletal tumor were investigated by MRI to assess the efficacy of Gd DOTA. The essential contribution is that it distinguishes the active parts of the lesion, intratumoral necrosis or sequelae cavities that do not take up the contrast medium. The injection does not allow for differentiation between tumor recurrence and treatment-induced inflammatory abnormality.

Adult

Postoperative pulmonary complications: general anesthesia with postoperative parenteral morphine compared with epidural analgesia.

In a prospective study, patients undergoing abdominal cancer surgery were randomly allocated to receive either general anesthesia with fentanyl intravenously and postoperative analgesia with parenteral morphine (GA group) or general anesthesia combined with epidural bupivacaine and epidural morphine for postoperative pain relief (EP group). Analgesia was tested on a visual pain scale. Pulmonary complications were evaluated by clinical complications, blood gas analysis, x-ray film changes, and pulmonary volumes (vital capacity, forced expiratory volume in 1 second). Measurements were performed on the day before the operation and on the first 5 postoperative days. In the EP group the pain relief was significantly better on the first day (p less than 0.03). Whatever the criteria used, the rates of pulmonary complications were similar in the two groups: clinical complications 21% versus 26%, radiologic complications 50% versus 64% for GA and EP groups, respectively. Postoperative PaO2 and spirometric values were similar in the two groups. Postoperative epidural analgesia may improve the patient's comfort but does not decrease the incidence of pulmonary complications.

Abdomen

[Computed tomography of uterine and ovarian cancer].

The authors try to specify the place of Tomodensitometry in utero-ovarian cancers. The examination technique presents no particularities: at best, the interval and the depth of the cuts must be selected. In cervical cancers, the poor appreciation on TDM of adnexal and vaginal involvement renders this examination unsuitable for staging. On the contrary, it is absolutely necessary in order to make the diagnosis of recurrences. In cancers of the body of the uterus, almost always operated on, TDM presents very little interest for the initial work-up except for patients who are difficult to examine or are going to undergo irradiation. As for ovarian tumors, TDM may be useful to detect intra-hepatic metastases before the first operation, to monitor patients undergoing chemotherapy: peritoneal carcinosis is inconstantly detected and TDM cannot replace a second look.

Female

[Factors linked to the development of pleuro-pulmonary metastases in breast cancer. Preliminary study].

The risk of death after pleuro-pulmonary metastasis was studied on a sample of 55 patients treated for breast cancer between 1954 and 1978. The women treated by tamoxifen, aminoglutethimide, or radiotherapeutic castration, at the time of the appearance of their metastasis, had a significantly lower risk of death than the women treated by other methods, or who were left untreated. The characteristics of the initial tumor, the delay between the primary tumor and the metastasis, the rhythm of systematic chest X-rays, and the use of chemotherapy did not significantly decrease this risk. The management of controlled therapeutic trials is suggested to confirm these results.

Aminoglutethimide

[Value of magnetic resonance imaging of cancers of the uterine cervix and corpus. Preliminary study apropos of 9 cases of cancer of the corpus and 20 cases of cancer of the cervix].

We studied nine cases of endometrial carcinoma and twenty of cervix carcinoma. Correlation with histology is made after curietherapy in 8 cases of endometrial carcinoma. Tumor is not always seen and particularly when there is no mass effect on macroscopic examination. Myometrial invasion is not seen with accuracy: the interruption of "junctional zone" is not a good sign. The cervix tumors are well seen on T2 sequences before any treatment. There extra uterine extension is difficult to appreciate. The best results of RMI were in the follow-up after radiotherapy. Therefore it appears actually to us the best indication of RMI.

Evaluation Studies as Topic

[Value of x-ray computed tomography in the monitoring of cancer of the ovary. Apropos of 69 cases].

The authors have studied retrospectively, a group of 69 patients with primitive carcinoma of the ovary who underwent at most one CT examination following the first surgical treatment. In 26 out of these, CT was done within the three months following a second surgical operation. Peritoneal metastases were inconsistently seen (5 true positive, 9 true negative, 0 false positive, 9 false negative). The sensitivity is 36%, the specificity 100% and the accuracy 65%. The score is better in the detection of lymphatic, hepatic and intestinal metastases.

Adolescent

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

Chest computed tomography (CT) in patients with micronodular lung metastases of differentiated thyroid carcinoma.

Forty thoracic CT scans have been performed on 27 patients with micronodular lung metastases of differentiated thyroid carcinoma. Lung nodules were visualized in 14 out of 19 patients (78%) with functioning lung metastases, although their chest X rays were normal. However, only a small number of peripheral micronodules can be visualized by CT scan since the central micronodules remain undistinguishable from adjacent vessel structures. A close relationship has been found between the number of micronodules and the thyroglobulin (Tg) serum level. In patients previously treated by 131I for proven lung metastases and who had no uptake for several years, but in whom Tg remained detectable in the serum, CT scans have shown micronodules in 7 of the 13 patients with normal chest X rays. The present data suggest that these nodules are mainly a result of fibrosis. CT scanning appears to be an important complementary tool with regard to 131I whole body scintigraphies in the radiologic diagnosis of lung nodules and in the assessment of radioiodine therapy.

Adolescent

Contribution of computed tomography in six sacrococcygeal chordomas.

Six sacrococcygeal chordomas were studied with CT at the Institut Gustave-Roussy. Only one was examined at the time of the initial diagnosis and CT made a valuable contribution to this. In other cases, CT determined the possibility of initial surgical excision and the field of radiotherapy and helped make a reliable diagnosis of local recurrences. CT seems to be the best examination to use for the early diagnosis of chordomas and recurrences, which will perhaps help improve the prognosis of this serious disease.

Adult

[Cancer of the prostate: value of x-ray computed tomography in the preradiotherapeutic evaluation. Apropos of 49 cases reviewed at the Gustave-Roussy Institute].

Fourty nine patients having a prostatic carcinoma had a CT examination. CT should be used only if bone metastasis lack and if a curative treatment is possible. Study of local extension is misleading and ultrasound, especially transrectal, is a better method to appreciate the volume of the tumor. On the contrary, CT detects quite often nodes metastasis which will modify the treatment. If CT is negative, lymphangiogram must be done because it is a more precise method to evaluate the node structure. Percutaneous node biopsy may confirm node metastasis.

Aged