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Biomedical subjects

L Boccon-Gibod

Publications and source records attributed to L Boccon-Gibod.

At least 253 records · Page 14Linked to original sources
PubMed1987

[Epidermoid carcinoma of the bladder. Apropos of 46 cases].

In order to define the prognosis of pure squamous carcinomas of the bladder, on the one hand (group I), and the possible aggravating role of the presence of squamous tissue in an invasive renal cell tumour, on the other hand (group II), 46 cases files of patients treated between 1975 and 1984 were analysed retrospectively. Group I consisted of 18 cases of pure squamous carcinoma (11 men with a mean age of 71 years and 7 women with a mean age of 74 years). 66% of cases presented with haematuria, but urinary cytology was of little help. The diagnosis was established by transurethral resection with 18 grade 3 tumours: stage A in 4 cases and stage B in 14 cases. 10 patients had unilateral (8 cases) or bilateral (2 cases) complications of the upper urinary tract. The presence of lymph node and/or haematogenous metastases was investigated by bone scan, hepatic ultrasonography, pulmonary tomography and, most importantly, by bipedal lymphography combined with percutaneous cyto-aspiration of suspicious nodes. 4 patients presented with invasion of the obturator lymph nodes (2 cases) and iliac lymph nodes (2 cases). 9 patients were treated by total cysto-prostatectomy, 6 patients by radiotherapy (60 Grays) and 3 patients did not receive any treatment. The overall survival was 12.5% after 2 years. None of the patients treated by radiotherapy were alive after 2 years. 29% of the patients treated by surgery survived for 2 years, but none of them were alive after 5 years, essentially as a result of local recurrence.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1987

[Lymphography with lymph node puncture biopsy. A reliable procedure for assessing the lymphatic spread of bladder tumors].

119 patients with bladder tumors of category Ta, Tis, T4, considered for radical treatment because of local conditions were studied by pedal lymphography (LAG) and percutaneous fine needle aspiration biopsy (FNA). 41% had a positive LAG. Adequate material was obtained for FNA in 94% of the patients. Of 70 patients with normal LAG none had a positive FNA; only 36% of those with a positive LAG had a positive FN. The high rate of positive LAG with negative FNA is attributed to inflammatory changes due to previous transurethral resection. Radical lymphadenectomy (LND) was done in 64 patients of whom 54 had a negative FNA. In this group, 8 (17%) had a positive LND. There was no mortality and morbidity was mild. LAG with FNA has a role in the pre-operative staging of bladder carcinoma.

Aged↗
PubMed1987

[Infiltrating cancer of the bladder with lymph node invasion: is total cystectomy justified?].

In order to assess the potential benefits of radical cystectomy in bladder cancer associated with pelvic lymph node metastasis, a retrospective study compared 2 groups of patients with T2-T3 N+ bladder cancer: 10 treated by radical cystectomy and 14 treated conservatively once the diagnosis of nodal metastasis had been established by fine needle node aspiration or lymphadenectomy. The survival rates were identical in both groups: 80% of the patients died within 2 years, 60% during the first year after diagnosis, mainly due to distant metastasis. No patient in the conservative arm required salvage cystectomy because of local progression. It is concluded that radical cystectomy is of little benefit in T2-T3 N+ bladder cancer, a disease which is no longer amenable to purely local treatment.

Aged↗
PubMed1986

Cyproterone acetate lead-in prevents initial rise of serum testosterone induced by luteinizing hormone-releasing hormone analogs in the treatment of metastatic carcinoma of the prostate.

Luteinizing hormone-releasing hormone (LH-RH) analogs are an effective treatment of metastatic carcinoma of the prostate. However, they induce an initial rise in serum testosterone responsible for 10-30% of diseases flares. The efficacy of the antiandrogen cyproterone acetate (CPA) was tested in 15 patients with metastatic carcinoma of the prostate. 10 patients were given 100 mg CPA t.i.d. from day 1 to 14 in association with the LH-RH analog Buserelin, 500 micrograms t.i.d., from day 7 to 14.5 patients were given CPA and Buserelin at the same doses from day 1 to 7. Serum testosterone determinations were obtained on days 1-7, 8, 11 and 14, at 08.00 h, and on days 8, 11, 1 h after each analog injection in group 1, and on days 1, 4 and 7 at 08.00 h and 1 h after each analog injection in group 2. All the patients were then treated by orchidectomy. Pretreatment with CPA blunted the initial rise of testosterone which never rose above pretreatment levels. Simultaneous treatment had no demonstrable effects on the rise of serum testosterone. It is concluded that pretreatment with CPA allows a safer use of LH-RH analogs in the treatment of metastatic carcinoma of the prostate.

Aged↗
PubMed1986

[Urodynamic study of urinary incontinence following prostatic adenomectomy].

The urodynamic study of 31 patients suffering from urinary incontinence after prostatic adenomectomy showed us that there were 3 groups of patients very different in terms of symptoms and treatment: some had a low flow rate with an obstructive syndrome necessitating the treatment of the "obstacle"; others had a low flow rate and poor detrusor contraction and the last group had a high flow rate. Those two groups often need an artificial sphincter. The study is being continued in order to define a preoperative criterion of the risk of incontinence.

Adult↗
PubMed1986

[Cancer of the prostate. The practical problems posed by hormonal escape].

Hormonal escape is defined as the continuation or progression of the course of prostatic cancer despite suppression of testicular androgens. Although 80% of patients are initially sensitive to the suppression of testicular androgens, 10% of patients die within six months, 50% die within three years and only 10% survive ten years. This phenomenon of hormonal escape reflects the selection of hormone-resistant clones rather than an adaptation of the whole population of tumour cells to the new conditions of androgen deprivation. Although various histological and biochemical elements and even a complex prognostic index can predict the duration of sensitivity to hormone treatment, it is virtually impossible to predict the duration of response of a given patient. The duration of response to hormonal treatment is identical, regardless of the modalities of suppression of testicular androgens. It is not significantly affected by either total androgenic deprivation (suppression of adrenal androgens) nor by the combination of cytotoxic drugs with androgenic treatment. When hormonal escape occurs, changing the modalities of androgenic suppression or escalation of the hormone therapy (increased doses of oestrogens, suppression of adrenal androgens, hypophysectomy) are generally of extremely limited value. The use of cytotoxic chemotherapy, with or without androgenic triggering, has not been shown to be significantly more effective than symptomatic treatment. In the current state of knowledge, cytotoxic chemotherapy should be reserved for patients included in rigorous clinical investigation protocols.

Adrenalectomy↗
PubMed1986

[Treatment of superficial tumors and carcinomas in situ of the bladder by intravesical BCG therapy].

89 patients with a superficial tumor of the bladder were treated with intravesical BCG: 150 mg of the Pasteur strain was instilled once a week for 6 weeks, once every other week for 3 months and once a month for 2 years, in 4 groups of patients. Group I: 20 patients with primary carcinoma in situ (CIS); 18 have been monitored for more than 6 months: in each, cytology has become negative; 16 were controlled by TUR: in all but one complete regression of CIS was observed. Group II: 24 patients with stage O tumor; in 16, follow up is greater than 12 months : the recurrence rate dropped from 11.12/100 months patients to 1.52/100 months patients. Group III: 12 patients with stage A tumor: in 10, follow up is greater than 12 months; 2 patients had tumor recurrence. Group IV: 28 patients with stage O or stage A tumor associated with CIS; in 17, followup is greater than 12 months: CIS disappeared in 13, but in 2 recurrences were observed (stage O without CIS). In addition to irritative side effects on the bladder, we observed complications in four cases: epididymitis in 2 patients and BCG spread with granulomatous hepatitis and bronchopulmonary lesions in two others.

Administration, Topical↗
PubMed1986

[Primary polyuria in the female. Classification and evolution].

51 adult female patients with unexplained urinary frequency underwent urodynamic assessment and were followed for at least six months. Half of these patients present with unstable bladder which could not be diagnosed clinically, even retrospectively. In 14 out of 16 cases, the instability resolved with an I.V. injection of an anticholinergic drug. The same treatment administered orally "cured" one half of the patients. This proportion was increased to 5 out of 6 when the drug was administered to patients with a positive I.V. test. Symptoms recurred once treatment was stopped. Ten of the 23 patients with a stable bladder improved spontaneously; anticholinergic drugs, when tried, appeared to have no effect. These results demonstrate the importance of diagnosing bladder instability in patients suffering from frequency and urgency.

Adult↗
PubMed1986

[Bladder tumors. Indications for and results of routine biopsies of the macroscopically healthy mucosa (with a study of surface antigens)].

The routine biopsy of macroscopically normal mucosa has demonstrated the frequency of anomalies (hyperplasia, dysplasia or carcinoma in situ) associated with bladder tumours. 75 patients with urothelial bladder cancer were investigated by a total of 163 endoscopic examinations which, apart from resection of the tumour, included biopsies of macroscopically healthy mucosa. The frequency and severity of the lesions increased with the grade and the stage of the tumour: in cases with stage O/Ta lesions, the percentage of anomalies increased from 15% with grade 1 to 53% with grade 3. At stage A (T1), anomalies were present in 8 out of 10 cases and consisted of carcinoma in situ in one half of cases. Similar figures were obtained for stages B/C (T2, T3). Lesions which may persist in the absence of a visible tumour respond dramatically to intravesical BCG chemotherapy. Analysis of the surface antigens did not reveal any clear correlation between the antigenic status of the tumour and that of the non-tumoural mucosa. These results clarify the indications for biopsies in macroscopically healthy mucosa, which should be limited to follow-up endoscopies and treatment of grade 3 tumours.

Antigens, Neoplasm↗