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M F Tournade

Publications and source records attributed to M F Tournade.

67 records · Page 4Linked to original sources
PubMed1983

Effectiveness of preoperative chemotherapy in Wilms' tumor: results of an International Society of Paediatric Oncology (SIOP) clinical trial.

The results of a controlled clinical trial of preoperative radiotherapy compared to chemotherapy in patients with nephroblastoma are presented. Of 397 histologically proven cases of Wilms' tumor registered at 34 centers between January 1977 and July 1979, 164 were eligible for the trial and were randomized to receive preoperative radiotherapy and chemotherapy (group R, 76 patients) or preoperative chemotherapy (group C, 88 patients). The results were evaluated in terms of the number of surgical tumor ruptures and of local tumor extent at pathologic examination, reflecting the effectiveness of the preoperative treatment. Survival and recurrence-free survival in the two treatment groups were also taken into account. The stage distribution was comparable in the two groups, with 52% stage I tumors in group R, and 43% in group C. Significant changes in the pathologic pattern were more frequent in group R than in group C (53% versus 17%). From these data it is concluded that preoperative chemotherapy is as good as preoperative radiotherapy in terms of prevention of tumor rupture. In addition, it was shown that 43% of an unselected population of patients with Wilms' tumor could be treated without any radiotherapy when chemotherapy had been given preoperatively.

Adolescent↗
PubMed1983

[Ovarian cancer in France. Epidemiological, clinical and histological status].

With 2 436 deaths in 1979, ovarian cancer is relatively infrequent in France comprising but 5 per cent of female mortality from malignant disease. However, the rate of increase in mortality is considerable, 70 per cent between 1955 and 1979 or 2,9 per cent per year, greater than that for female bladder and breast cancer. The estimated morbidity and mortality rates (age-adjusted to the world standard population) were 7,5 and 5,4 per 100,000 per annum respectively for 1979, figures in the mid range of international data. This is situated below the rates observed in Scandinavia and North America which occupied the first ranks. The high proportion of metastatic dissemination (55%) at the time of diagnosis and the variety of morphological types (80% being epithelial cancers) emerges from clinical data relating to a series of 2,937 ovarian cancers diagnosed by the "Enquête Permanente Cancer". The 5-year survival rate was 13 per cent with only 50 per cent being alive at the end of the first year. To improve these poor results it is necessary to identify new risk factors in a future French epidemiological study using case control and prospective approaches.

Adult↗
PubMed1983

[Neuroblastomas treated at the Gustave-Roussy Institute from 1975 to 1979. 173 cases].

From 1975 to 1979, 173 children with neuroblastoma were treated according to the same protocol at the Institut Gustave-Roussy. They were classified according to the site of the primary tumor (abdominal: 122; thoracic: 29; others: 22) and according to TNM staging (stage I: 8; stage II: 24; stage III: 35; stage IV: 99; stage V: 2). Depending on stage and age, treatment consisted of surgery and radiotherapy associated with cyclic multiagent chemotherapy (vincristine, Adriamycin, cyclophosphamide). It resulted in a significant improvement of prognosis in stage III patients, especially those with abdominal tumors. In the latter group, prognosis depended mainly on the possibilities of resection of the tumors. Therefore, making these tumors operable remains the major goal of therapy in such patients. Radiotherapy is quite efficient in sterilizing the small post-surgical residual tumors. Prognosis in children over 1 year of age with metastases still remains very poor, even though the quality of the survival is improved.

Abdominal Neoplasms↗
PubMed1982

Echographic aspects of hepatic metastases of nephroblastomas.

We report a retrospective study of 293 cases of nephroblastoma treated at the Gustave Roussy Institute (I.G.R.) from 1971 to 1980, and 39 similar cases treated at the Curie Institute (I.C), from June 1977 to June 1981. Twenty-two cases of hepatic metastases were found. We were primarily interested in the echographic aspects of the lesions and particularly in their evolution. Despite the fact that the patients came from different centers with varying types of work-up, ten cases were fully documented and are presented in detail. They show the use to which ultrasound may be put.

Adolescent↗
PubMed1981

[The treatment of Wilm's tumor, improvements and new trends. A study of 724 cases treated at the Gustave-Roussy Institute. 1952-1980 (author's transl)].

Study of 724 cases of Wilm's tumor treated between 1952 and 1980 at the Gustave-Roussy Institute, according to 5 successive therapeutic protocols with or without chemotherapy (Actinomycin alone or Actinomycin and Vincristine). Recovery rates change from 44 to over 90% during this period. Improvement of survival was first obtained by the efficient treatment of metastases, then by preventing their development with systematic chemotherapy with Actinomycin and Vincristine. Rate of survival without relapse changed from 38 to 71 and 86%. Thus, the decrease in the number of patent metastases subjected to heavy treatments responsible for severe respiratory and orthopedic sequelae improved the quality of survival of these children.

Adolescent↗
PubMed1980

Lymph node invasion and prognosis in nephroblastoma.

Five hundred and twelve children with Wilms' tumor Stages I, II, and III registered to the International Society of Pediatric Oncology (SIOP) nephroblastoma trial were analyzed as to the prognostic value of metastatic lymph node involvement. The lymph nodes of 300 patients were submitted for microscopic examination; malignant invasion was reported in 15%. The disease-free and the actuarial survival rates for patients with metastatic lymph node invasion were significantly worse than for those without metastatic lymph node involvement. Radical lymph node dissection neither improved the cure rate nor decreased the rate of abdominal recurrence in patients with lymph node metastases.

Adolescent↗
PubMed1976

Wilms' tumor: natural history and prognostic factors: a retrospective study of 248 cases treated at the Institut Gustave-Roussy 1952-1967.

A statistical analysis of 248 histologically proven cases of Wilms' tumor treated at the Institut Gustave-Roussy, Villejuif, France, from 1952 to 1967, is presented. Two years recurrence-free survival and five years survival have been selected as prognostic criteria. Patients under two years of age have significantly fewer metastases and a better five-year survival rate than those over two. Stage is stronly correlated with recurrences and survival. Influence of tumor size, number of tumor nodules, tumor rupture, adhesions, regional lymph node involvement, and renal vein infiltration is shown. Detailed analysis of histopathologic features indicates that a favorable clinical course is significantly related to the number of different varieties of epithelial differentiation (tubular, glomerular, microcystic) found in any tumor, whatever the abundance of each of them. Presence of striated muscular cells, however abundant, does not influence survival or metastatic rates. Cases where irradiation given prior to surgery resulted in complete destruction of tumor cells, form a distinctive group of very unfavorable prognosis. Relapse of tumor occurs in 54% of cases, 10% presenting with metastases. Involved sites are listed. No correlation is found between date of metastases and other parameters. The three major prognostic factors of age, stage, histologic pattern, bear prognostic value separately. Stage and age are linked, as well as histology and age. Stage and histology are not linked. Age in itself therefore seems less important. It is concluded that these well-defining treatment for each individual case.

Age Factors↗
PubMed1976

Preoperative versus postoperative radiotherapy, single versus multiple courses of actinomycin D, in the treatment of Wilms' tumor. Preliminary results of a controlled clinical trial conducted by the International Society of Paediatric Oncology (S.I.O.P.).

The preliminary results of a controlled clinical trial organized by the S.I.O.P. of radiotherapy and chemotherapy in patients with nephroblastoma are presented. Forty-two centers have participated. Between September 1971 and October 1974, 398 patients were registered; 195 were eligible for the trial and were randomized. The remaining 203 patients were excluded from the trial, but were followed in the same way as the patients in the trial. The results were evaluated in terms of recurrence-free survival rate and survival rate. Results in patients who received preoperative and postoperative radiotherapy (group A, 73 patients) were compared with the results in patients who recieved only postoperative radiotherapy (group B, 64 patients). The tumor ruptured at surgery in three patients of group A, and in 20 patients of group B, a difference that is statistically significant. No significant difference in survival and recurrence-free survival between groups A and B is observed at present. Results in patients treated with a single course of actinomycin D (group I, 80 patients) were compared with the results in patients treated with multiple courses (group II, 80 patients). At present, no significant difference is found between the two groups.

Adolescent↗
PubMedDate not supplied

Reduction of postoperative chemotherapy in children with stage I intermediate-risk and anaplastic Wilms' tumour (SIOP 93-01 trial): a randomised controlled trial.

BACKGROUND: Present treatment for Wilms' tumour is very successful. Now, efforts are aimed at reducing toxicity and burden of treatment by shortening schedules without loss of effectiveness. The objective of this randomised trial was to assess whether postoperative chemotherapy for patients with stage I intermediate-risk and anaplastic Wilms' tumour could be shortened to only 4 weeks from the standard 18 weeks, while maintaining equivalent event-free survival. METHODS: Between June, 1993, and June, 2000, 410 patients were randomly assigned after four doses of vincristine plus one course of dactinomycin postoperatively either to stop further adjuvant chemotherapy (no further chemotherapy group, n=200), or to receive a further two courses of the same chemotherapy (standard group, n=210). Previous treatment consisted of chemotherapy before nephrectomy of four doses of vincristine and two courses of dactinomycin followed by surgical resection of the tumour. Eligible patients were at least 6 months old and had stage I tumours with either intermediate-risk histology or anaplasia. The primary endpoint of this equivalence trial was 2-year event-free survival. Both per-protocol and intention-to-treat analyses were done. FINDINGS: By 2 years, 18 recurrences were reported in the standard group, and 22 in the no further chemotherapy group. Event-free survival was 91.4% (95% CI 87.5-95.2) for the no further chemotherapy group and 88.8% (84.3-93.2) for the standard group (difference=2.6%, upper 97.5% confidence limit 8.4%). The null hypothesis, that experimental treatment is less effective than standard treatment, could be rejected (p=0.008). CONCLUSIONS: Shortening duration of chemotherapy could reduce acute and late side-effects and inconvenience for patient and parents while maintaining effectiveness, and could be beneficial in terms of health costs.

Adolescent↗