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Biomedical subjects

M F Tournade

Publications and source records attributed to M F Tournade.

At least 55 records · Page 3Linked to original sources
PubMed1990

Wilm's tumor with pulmonary metastases at diagnosis: the significance of primary chemotherapy. International Society of Pediatric Oncology Nephroblastoma Trial and Study Committee.

Data from patients with pulmonary metastases (PM) from Wilms' tumor at diagnosis (stage IV) were collected from six European centers. All patients were pretreated with a chemotherapy (CT) regimen consisting of vincristine (VCR), dactinomycin (AD), and Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH). After nephrectomy, local therapy for residual pulmonary disease was considered to avoid whole-lung irradiation. Only four of 36 patients still had multiple inoperable metastases after preoperative CT. Thirty patients survived. Four of them were irradiated. Of the six patients who died, four died of PM, one died of abdominal recurrence, and one of therapy-related disease. Disease-free survival and actuarial survival rates are 83% with a mean follow-up of 4 years postnephrectomy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

How to establish equivalence between treatments: a one-sided clinical trial in paediatric oncology.

The design of clinical trial to establish the equivalence of two treatments differs from that of an efficacy trial. The conventional null hypothesis of equivalent treatment efficacy is replaced by a null hypothesis of inequivalence which must be tested by appropriate statistics. In addition, the maximum allowable value of the true difference between the efficacy of two equivalent treatments must be specified. In oncology, such a trial is necessary when a standard treatment is replaced by a new less toxic one of equivalent efficacy. The statistical formulation is one-sided. A trial comparing two pre-operative treatments in childhood nephroblastoma is presented here and analysed according to this methodology.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

A phase II study of ifosfamide in the treatment of relapses in Wilms' tumor.

The purpose of this study was to evaluate the antitumor activity and tolerability of ifosfamide (IFO) at a dose of 3 g/m2, given on 2 consecutive days every 2 weeks, in advanced Wilms' tumor patients in whom conventional therapy had failed. Mesna and hyperhydration were concomitantly given to minimize bladder toxicity. A total of 21 patients with advanced Wilms' tumor were entered in the study. The response observed after two courses was complete in 6 patients and partial in 5; 10 did not respond; the median duration of response was 2 months (range, 1-7 months). Leucopenia caused a delay in therapy for 1 or 2 weeks in only three cases. Neither fever nor infection were observed. Of 7 patients who developed hematuria, 3 were among the 17 who concurrently received mesna. The urotoxicity did not interfere with subsequent therapy in these three cases.

Adolescent↗
PubMed1989

Bilateral Wilms' tumor: long-term survival and some epidemiological features.

Sixty-seven children with a bilateral Wilms' tumor (BWT) who were registered to the International Society of Pediatric Oncology (SIOP) nephroblastoma trial and studies 1, 2, and 5, conducted between 1971 and 1980, were analyzed. The overall 10-year survival was 64%. While most deaths due to tumor occurred within 3 years after diagnosis of bilateral disease, five patients died after 3 years (20%), three with synchronous and two with metachronous BWT. The survival rates for the 42 children with synchronous BWT (follow-up time, 6 1/2 to 14 years) and the 25 children with metachronous BWT (follow-up time, 5 to 13 years) were 69% and 56%, respectively. Due to an improvement in the synchronous group, overall survival improved over the years: 47%, 72%, and 70%, in SIOP 1, 2, and 5, respectively. Age at diagnosis and most advanced tumor stage affected prognosis. Children presenting a tumor manifestation before the age of 2 years had better prognosis than older children. This difference is significant in synchronous BWT. Prognosis for children with local stage 1 or 2 was better than for those with local stage 3. Median age at initial presentation in BWT was lower than in unilateral nephroblastoma and lower in metachronous BWT than in synchronous BWT. Young children presenting with unilateral nephroblastoma should have a careful follow-up of the contralateral kidney for at least the next 3 1/2 years, as most contralateral tumors will develop during this period.

Age Factors↗
PubMed1988

Epidemiological features of Wilms' tumor: results of studies by the International Society of Paediatric Oncology (SIOP).

This descriptive epidemiology study of 1,040 children with Wilms' tumor (WT) registered in the International Society of Paediatric Oncology (SIOP) clinical trials confirms the findings reported by the National Wilms' Tumor Study. The male:female rate was 0.89:1. The mean age at diagnosis of the 43 bilateral cases was significantly younger than children with unilateral renal involvement (32.4 vs 45 months). However, the mean ages of diagnosis for unilateral multicentric and for unicentric WT were very similar. On the other hand, the mean age at diagnosis of children with sporadic aniridia and hypospadias was younger than the mean age of patients with or without other congenital malformations. Thus aniridia as well as hypospadias could be indices of the first mutation, according to the Knudson and Stron hypothesis. WT was reported in two members of each of five families. However, these familial cases were comparable in terms of demographic and clinical features to the nonfamilial ones. These data suggest that the heritable fraction of WT is relatively small and that genetic and environmental factors interact in the development of WT.

Congenital Abnormalities↗
PubMed1988

Ifosfamide is an active drug in Wilms' tumor: a phase II study conducted by the French Society of Pediatric Oncology.

Twenty-one patients with advanced Wilms' tumor entered a phase II study with high-dose ifosfamide (3 g/m2 over two days every 15 days). Mesna and hyperhydration were associated with minimal bladder toxicity. After two courses, five partial responses and six complete responses were observed. Ten patients did not respond. The median duration of response was 2 months (range, 1 to 7). Therapy was delayed because of leukopenia for 1 or 2 weeks in only three cases. Fever and infection were not observed. Seven patients presented with hematuria, three of whom were among the 17 patients coadministered mesna, which did not interfere with subsequent therapy.

Adolescent↗
PubMed1988

[A French genetic and epidemiologic study on nephroblastoma: preliminary results].

Preliminary results of genetic and epidemiological study of Wilms' tumor in France are given in this paper. The higher age at diagnosis in unilateral than in bilateral cases supports the bimutational theory of Knudson. The excess of cancer deaths found in relatives of patients might be due to genetic non specific factors of susceptibility to cancer.

Child↗
PubMed1987

Sarcomatous Wilms' tumour with clear cells and hyalinization. A study of 38 tumours in children from the SIOP nephroblastoma file.

The International Society of Paediatric Oncology (SIOP) nephroblastoma trial and studies 1, 2 and 5 include 33 sarcomatous Wilms' tumours with a clear cell pattern and five with a hyalinizing pattern among 909 renal tumours. Bone metastases developed in 22 (67%) and one patient (20%) respectively compared with 14 patients (1.6%) in the rest of the series. Both subgroups had clear cells and hyalinization. A constant and characteristic feature of the clear cell tumours was an alveolar vascular pattern which aids in the recognition of this tumour even in fibrous and sclerotic forms. Sarcomatous Wilms' tumour with a hyalinizing pattern had homogeneous areas of sclerosis with clustering of tumour cells but lacked the vascular pattern. Two tumours showed atypia similar to that in malignant rhabdoid tumour of the kidney but had no cytoplasmic inclusions. Five year recurrence-free survival for the entire series was 68%, for sarcomatous clear cell tumours, 42% and for sarcomatous tumours with hyalinizing pattern, 20%.

Adolescent↗
PubMed1986

Abdominal recurrences in Wilms' tumours: a report from the SIOP Wilms' tumour trials and studies.

The Wilms' tumour trials and studies conducted from 1971 to 1980 registered 1042 patients. Of these, 82 patients developed an abdominal recurrence. Particulars of these were studied. Half of the recurrences occurred in stage III patients. Often several untoward prognostic factors could be identified, such as large tumour size, difficult operation, incomplete excision, peritoneal adhesions or metastases, tumour extending to renal vein or vena cava. A tumour rupture increases the chance for an abdominal recurrence, especially if appropriate radiotherapy is not given. In many of these cases, postoperative radiotherapy seems to have been insufficiently tailored to the operative findings. For stage III cases, a careful discussion between surgeon, radiotherapist, and pathologist should lead to the optimal radiotherapy field size and dose for each individual patient, so that the risk of abdominal recurrence can be reduced.

Abdominal Neoplasms↗
PubMed1985

Hematopoietic recovery following autologous bone marrow transplantation: role of cryopreservation, number of cells infused and nature of high-dose chemotherapy.

Twenty-nine patients were treated with single or combined high-dose melphalan therapy followed by autologous bone marrow transplantation. Hematopoietic recovery from these treatments was studied. No correlation was found between the number of GM-CFC infused and the time required for hematopoietic recovery. It is suggested that this correlation is only demonstrable for low 'doses' of infused bone marrow cell and/or GM-CFCs. The role of bone marrow cell preservation techniques was examined and results were similar for fresh and cryopreserved bone marrow. The erythrocyte, lymphocyte and granulocyte levels of the patients reported here reached a normal or subnormal hematological steady state 3 months after autograft. Our results confirm the value of cryopreservation techniques. Hematopoietic recovery was short and of the same duration whether the patients were given single or combined high-dose melphalan before autologous bone marrow transplantation. These results also demonstrate the value of such transplantation in shortening the myelosuppression caused by high-dose chemotherapy.

Adolescent↗
PubMed1985

The advantages of preoperative therapy in Wilms' tumour. A summarised report on clinical trials conducted by the International Society of Paediatric Oncology (SIOP).

During 1971-1980, three consecutive clinical studies on nephroblastoma were conducted by the International Society of Paediatric Oncology (SIOP). Besides several questions on different postoperative treatment modalities, the emphasis of these trials was to determine the role of preoperative therapy. In SIOP-1 (1971-1974) we compared preoperative radiotherapy to immediate surgery. There is no difference in survival or recurrence-free survival between both groups. Tumour ruptures, however, did occur significantly less in the pretreated group, and the recurrence-free survival is clearly lower in patients with intraoperative tumour rupture. These results were confirmed by SIOP-2, a non-randomised study conducted between 1974 and 1976. The question tackled by SIOP-5 (1977-1980) was whether preoperative chemotherapy could be a substitute for preoperative radiotherapy. The two preoperative therapies produced equally satisfactory results in terms of recurrence-free survival and 4-year survival rates, and the reduction in the number of operative ruptures. In addition, it was shown that with preoperative chemotherapy about 45% of an unselected population of patients with Wilms' tumour can be treated and cured without any irradiation and its well-known sequelae. The actual need for radiotherapy in stage II tumours with negative lymph node involvement (about 30% of the patients after pretreatment) is under investigation in SIOP-6. Cytohistological grading is equally possible after chemotherapy, and also without pretreatment. If antitumour treatment is begun before histopathological diagnosis, then the risk of overtreating patients with benign conditions, or of administering an inappropriate treatment to patients with malignant tumours of other types, is about 6%.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

Mesoblastic nephromas: a study of 29 tumours from the SIOP nephroblastoma file.

In a series of 889 Wilms' tumours we found 29 pure mesoblastic nephromas. The age of the patients varied from newborn to 22 months, but only five were older than four months. Two histologic types were recognized--leiomyomatous (9) and cellular (20) with a fibrohistiocytic appearance. The leiomyomatous type was almost invariably in stage I, smaller and present in younger infants. At operation half of the cellular type has ruptured or infiltrated the renal pelvis or perirenal tissue. Two patients died of postoperative complications. All others are alive after four years and free from disease.

Female↗
PubMed1985

[A new case of non-secreting adrenocortical tumor in a child].

Adrenocortical tumors are very rare, especially in their non secretory form. A 15 years old boy was hospitalized for evolutive fever since 6 weeks associated with asthenia and abdominal pain. Infections hematological, neurological and system diseases were eliminated. Abdominal ultrasonography reveal a poly-lobular mass adherent to the spleen and the posterior wall of the stomach. This is confirmed by fibroscopy and barium swallow. Abdominal scanner and scintigraphy did not give any new etiological argument. X Ray thorax is normal. Laparotomy reveals a retro-gastric mass adherent by its superior extremity to the spleen. A complete excision is done. The pathological examination shows all the histologic features of adrenocortical carcinoma. Its extension to the spleen grade this tumour with a height malignancy. No chemotherapy was undertaken, only a clinical, ultrasound and radiography observation with a follow up of 13 months.

Adolescent↗
PubMed1984

Hypercalcemia preferentially occurs in unusual forms of childhood non-Hodgkin's lymphoma, rhabdomyosarcoma, and Wilms' tumor. A study of 11 cases.

Unusual clinical, radiologic, or histologic findings were found in 11 of 17 cases of hypercalcemia associated with childhood tumors. Four children had undifferentiated lymphoblastic lymphoma with extensive bone involvement, but no visceral or neurologic involvement. At diagnosis, four adolescents with rhabdomyosarcoma had numerous metastases, particularly in the breasts and bone marrow. Three infants had renal tumor without bone metastases. Histologically, their tumors differed from classical nephroblastoma and resembled the malignant rhabdoid tumors of the kidney. These findings allow individualization of three distinct groups of tumors with unusual features which may suggest the presence of hypercalcemia. These tumors appear to have a poor prognosis since all patients but one died of their malignancy.

Adolescent↗
PubMed1984

Nephroblastoma with fibroadenomatous-like structures.

Review of the histological sections of the tumours of 889 patients from the files of the SIOP Nephroblastoma trials and studies has revealed 23 cases with a distinctive growth pattern. Due to the similarity of the histological structures with the architecture of adenofibroma (fibroadenoma) of the ovary we have called this type: nephroblastoma with fibroadenomatous-like structures (NFS). We have studied the clinical and histopathological factors and correlated them with recurrence-free survival and actuarial survival and compared them with the whole series of SIOP Nephroblastomas. This subtype appears to be a distinctive clinicopathological entity with favourable prognosis.

Child↗
PubMed1984

Del 11p/aniridia complex. Report of three patients and review of 37 observations from the literature.

Three patients (two females, one male) are reported with bilateral aniridia, Wilms' tumor, more or less moderate mental retardation, decreased catalase activity, and del 11p13. These and 34 case reports from the literature are discussed with respect to: sex ratio, maternal age, type of chromosomal imbalance and frequency of associated rearrangements, prevalence of aniridia and other eye disorders, predisposition to tumor development, genitourinary anomalies, growth and mental retardation, and catalase involvement. Possible gene relationship within the complex locus and with neighbouring 11p genes is discussed.

Acatalasia↗
PubMed1984

[2nd malignant tumors in children. Study of 38 cases].

Thirty-eight children, followed in the pediatric Department of Institut Gustave-Roussy, developed second malignant neoplasms. Intervals between the two neoplasms ranged from 1 to 26 years. The second neoplasms were defined as having a different histologic diagnosis than the first ones: osteosarcoma, fibrosarcoma, thyroid carcinoma, leukemia were the most frequent second neoplasms. The potential carcinogenic part of chemotherapy and radiotherapy is emphasized. In addition, some genetic susceptibility may enhance the carcinogenic effects of therapy. Nevertheless the incidence of second malignant neoplasms is low. Its estimation is discussed here.

Adolescent↗