Biomedical subjects

M P Laroussinie

Publications and source records attributed to M P Laroussinie.

5 recordsLinked to original sources

PubMed1995

[Pelvic lymph node invasion in cancer of the uterine cervix].

Pelvic lymph node invasion is an important prognostic factor for cervical cancer. It is generally accepted that iliac lymph nodes must be treated systematically, but the extent of lymph node dissections is open to discussion. One hundred and eighty two cases of cervical cancer with lymph node invasion were treated at the Institut Curie between 1960 and 1988, by colpohysterectomy with lymph node dissection (168 cases) combined with preoperative brachytherapy and, in some cases, pre- and/or postoperative radiotherapy; in 14 cases, only an exploratory operation was performed. External iliac lymph node invasion was found in 95% of cases, situated in the middle and internal chains. Common iliac lymph node invasion was found in 24% of cases, but was only exceptionally isolated (3%). It is therefore possible, by means of well defined, localized external iliac dissection, with frozen section histological examination, to determine the exact lymph node status. Lumboaortic lymph node invasion was found in 8.2% of cases. The overall survival rate was 49% at 5 years and 40.5% at 10 years. Factors which influence survival are: the cervical volume (p = 0.015), the unilateral or bilateral nature of invasion (p = 0.0015), the number of lymph nodes invaded (two or more than two) (p = 0.0001), capsular rupture (p = 0.0008), lymph node adhesions other than venous (p = 0.0002), common iliac invasion (p = 0.0001). On Cox's model, the principal factors were the number of lymph nodes invaded, adhesion other than venous, common iliac invasion; on the other hand, venous adhesion does not modify the prognosis. The five-year survival rates following external iliac dissections and complete pelvic dissections were not significantly different. Finally, postoperative radiotherapy ensured a higher five-year survival rate than preoperative radiotherapy, but the cervical volume was greater and primary invasion was more frequent in these cases. Postoperative radiotherapy of 15 grays after preoperative radiotherapy did not appear to modify the survival and therefore appears to be useless.

Adult↗

PubMed1993

[In defense of intra-uterine inseminations].

Intrauterine insemination (IUI) has been used for treatment of infertility for many years with discouraging results (8.3% in the analysis of Dorangeon and Quereux). A new approach of IUI, using ovarian stimulation, ovulation monitoring and sperm preparation has significantly improved the results. The obtained pregnancy rate (15 to 25%) are now comparable to those reported with IVF or GIFT. Therefore IUI should be offered to patients with patent tubes prior to their referral for the more invasive procedure FIV or GIFT.

Clinical Trials as Topic↗

PubMed1993

[Cancer of the ovary and the hormonal context].

Screening for ovarian cancer can only be worthwhile if it is applied to a population at risk. Recent studies show that there is a significant lowering of the risk for cancer of the ovary after all contraceptive preparations containing oestrogens and progestogens have been used. The longer these preparations are used the greater the protection for the user and this protection continues for a long time after treatment has stopped. One finds, in truth, that if the ovary is put functionally at rest whether it is because ovulation has been stopped by pregnancy or by oral contraception or by a premature menopause, or late puberty, the ovaries are somewhat protected from cancer. On the other hand, women whose reproductive life is long without being interrupted as far as ovarian function is concerned, have a higher risk of developing cancer and, therefore, would be worthwhile screening. Furthermore, on the other hand the problems of stimulating the ovaries when treating for sterility must be considered in the relationship to the possibility of provoking cancer of the ovary. A better knowledge of the hormone status would make it easier to decide what cases should be screened for epithelial cancer of the ovary so that the prognosis can be less disastrous than it is.

Age Factors↗

PubMed1992

[Chickenpox and pregnancy].

The authors report a case of chickenpox exposure during the first three months of pregnancy. Ultrasonographic monitoring of the fetus revealed signs of fetal infection starting from 32 weeks of amenorrhea (hepatomegaly, ascites, pleural effusion) but clinical examination of the child at birth showed nothing abnormal. The diagnosis was confirmed by the development of herpes zoster in the child after birth. The difficulty of determining a fetal prognosis during pregnancy is emphasised.

Adult↗

PubMed1988

[Treatment of urogenital prolapse with exertion-induced urinary incontinence using the Bologna technic. Apropos of 90 cases].

The authors describe this operation, which is carried out as a single procedure which they have been doing since 1982. Then the results in 90 patients are studied. The post-operative controls carried out on the clinical state of the patient and on the urodynamic tests show that this operation is very successful, both in curing stress incontinence and in giving a good anatomical result for correcting prolapse of the anterior wall of the vagina. In over one-third of the cases the post-operative follow-up has been carried out for 2 years or more. This follow-up has shown that the relapse rate over a period of time, both for the stress incontinence and the prolapse, is nil. The principal snags that still remain are: post-operative infection in about a third of cases; the rare but possible development of an enterocele and of dyspareunia (2%).

Adult↗