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R Blondet

Publications and source records attributed to R Blondet.

14 recordsLinked to original sources
PubMed2006

Sarcomas and malignant phyllodes tumours of the breast--a retrospective study.

BACKGROUND: Although most breast cancers are adenocarcinomas of the mammary gland, primary breast sarcomas may also arise from mammary gland mesenchymal tissue. The annual incidence of primary breast sarcoma is low and has been estimated at 45 new cases per 10 million women. These tumours are at high risk of recurrence and are known to have poor prognosis. Phyllodes tumours represent a specific subset of these breast soft tissue tumours. They are composed of a connective tissue stroma and epithelial elements. Pathological presentation ranges from grade I to malignant phyllodes tumours (grade III) where the stromal component clearly exhibits a sarcoma pattern. MATERIALS AND METHODS: SAPHYR (SArcoma and PHYllode Retrospective) is a retrospective study of the experience of Leon Bérard Cancer Centre (Lyon, France) from 1966 to August 2004. SAPHYR aims to describe the characteristics of primary breast sarcomas and to define potential survival factors to be evaluated in future prospective studies. RESULTS: We included 70 patients. Half of them presented at least one recurrence (35/70). Median disease-free-survival (DFS) was 1.15 years. At 3 years, median overall survival had not been reached and more than 61% of the patients were alive. Quality of surgical resection was significantly (p=0.036) different whether patients were in the R0 group (72%) or not (38%). No survival difference was found between malignant phyllodes (grade III) and other primary breast sarcomas (angiosarcomas excluded). Histology revealed three significantly (p=0.0003) different prognostic groups: phyllodes grade I and II (DFS=57%), angiosarcomas (DFS=7%) and phyllodes grade III and other primary breast sarcomas (DFS=45%). DISCUSSION: Phyllodes tumours and primary breast sarcomas are totally different from epithelial breast cancers and should be considered as a distinct group of rare tumours. The first goal of treatment is to achieve negative margins (R0). We propose to treat the patients according to the clinical practice guidelines in use for soft tissue sarcomas and address them to a reference centre for sarcoma. Treating rare tumours in the same place should permit us to standardise pathological data and to include patients into multicentric radiotherapy or chemotherapy protocols to improve overall survival. As further prospective studies are needed, European oncology groups must join their forces to create a prospective Rare Cancer Network.

Adult↗
PubMed1996

Pseudoaneurysm of the superficial temporal artery.

Ours is the first report of pseudoaneurysm of the superficial temporal in a 90-year-old woman. Although falls with associated head and scalp injuries in the geriatric population are common, pseudoaneurysm of the superficial temporal artery is rarely reported, probably due to the generally protected course of the superficial temporal artery across the skull. Clinicians' familiarity with this entity is important for early diagnosis and intervention.

Accidental Falls↗
PubMed1991

[Surgery of pulmonary metastasis from malignant melanoma. Results and criteria of surgical excision].

Lung metastases from malignant melanoma are frequent and they often inaugurate the metastatic stage. Exceptionally, they present as one or a few nodules, and in the absence of any other secondary lesion these cases raise the problem of surgical eradication. A retrospective multicentre study was carried out in a series of 38 patients and its results were compared to the data obtained from a review of 435 published cases in order to assess the value of surgery in terms of survival and to delimit its indications as closely as possible. Our series of 38 patients comprised 20 men and 18 women aged from 22 to 93 years (mean 51 years, median 55 years). The primary tumour was located in the trunk in 47 p. 100 of the cases; it was nodular in 33 p. 100 and superficial but extensive in 37.5 p. 100. The time elapsed before the metastases appeared varied from 0 to 108 months (median 40 months). Surgery had been radical in 70 p. 100 of the patients and usually limited, tumorectomies and segmentectomies accounting for 51 p. 100 of the operations. RESULTS. In this series the duration of survival varied between 2 and 144 months (mean 26 months, median close to 15 months), with a 20 p. 100 probability of survival at 5 years (fig. 1). Disease free survival varied from 0 to 144 months (mean 22.5 months, median 10.5 months) (fig. 2, curve 1). The parameters of response as regards patients, primary tumour, metastases and treatment were analysed. Response was uninfluenced by sex and slightly influenced by age, with a difference of borderline significance between subjects under and over 50. The primary tumour characteristics did not affect survival, and the features of metastases were of extremely varied importance. The number of operable metastases was not determinant. On the other hand, the presence of mediastinal lesions, either isolated or associated with lung lesions, worsened the prognosis of terms of survival and much more significantly so in terms of remission (fig. 3 and 4). The evaluation of evolutive characteristics, such as date of appearance and tumour doubling time, was inconclusive. Survival was of the same duration after wide and limited surgery, so that tumorectomy or segmentectomy should preferably be performed. The results of surgical treatment were determinant, with a highly significant difference in survival between radical and incomplete surgery (fig. 5 and fig. 2, curve 2). DISCUSSION. The median survival of patients operated upon for lung metastases is diversely evaluated in the literature as 8 to 29 months (table V), the mean figure of 16 months being virtually the same as that of our series. In this, as in most of the previously published series, the maximum duration of survival was beyond 8 to 10 years. The mean survival rate at 5 years is very close to the one we have recorded (20 p. 100) (table V). Compared with other treatments of lung metastases, surgery may be considered as capable of prolonging survival by 6 months; this is not much unless we add the possibility of a 5-year survival in 1 out of 5 operated patients and the possibility of a survival exceeding 8 or 10 years in 2 to 5 p. 100 of the cases. Some prognostic factors seem to constitute positive or negative criteria of operability. This is the case with mediastinal lesions which may consist of a metastasis of metastasis or of a lymph node invasion associated or not with the lung lesion, but in any case correspond to the involvement of more than one site. Mediastinal lesions must be systematically looked for and treated as contraindications of surgery, as shown by the differences in survival recorded in our series. Opinions differ as regards the value of evolutive parameters of the metastasis. For some authors, a more than 5 years interval before the metastasis appears is associated with a good chance of prolonged survival, whereas a less than 6 months or 1 year interval reflects a steadily high progressiveness and in practice precludes surgery. The value of the

Adult↗
PubMed1990

[Developments in the treatment of osteosarcoma since 1979. Report of the statistics at the Centre Léon-Bérard].

Seventy-two patients with a localized osteosarcoma were treated between September 1979 and December 1987 by neoadjuvant chemotherapy, local surgery and post-operative chemotherapy. Chemotherapy regimens varied throughout the years but always comprised high dose methotrexate with leucovorin rescue and adriamycin pre-operatively for children under the age of 15, and ifosfamid and cis platinum in adults. Post-operative chemotherapy for bad responders (greater than 10% of residual malignant cells), was at first an association of adriamycin and cis platinum, and later of holoxan and cis platinum. Surgery changed from amputation to local conservative surgery (graft or prosthesis) which is now the most frequent surgery--61% of the patients are alive and disease-free at 5 years. Good responders to pre-operative chemotherapy have a much better prognosis (81% at 5 years) than bad responders (45%). There is no significant difference according to age or pre-operative chemotherapy regimen.

Adolescent↗
PubMed1985

Prognostic value of the topographic grid method in women with T2 N- breast cancer. Statistical results from a series of 203 patients.

In 1977, the authors described the grid method, a topographic technique for mapping the microscopic spread of breast cancer. The current report describes the relapse-free survival of a series of 203 patients with T2 N- mammary cancer (T2 N0 N1 ab N-) who were treated by mastectomy and regional lymph node dissection and have been followed since 1974. A good prognosis did not prevent relapse in 15% to 20% of patients within the first 5 years. To determine whether the grid method can identify patients at high risk within this group, disease-free survival and survival were compared in two subsets, a "limited" group (L) and a "diffuse" group (D). The difference between the two groups was statistically significant for both parameters (88%) versus 77% and 93% versus 85% after 5 years) (P less than 0.01 and P less than 0.02). Other prognostic measures were uniformative. Thus, the grid method has a good prognostic score when compared with the factors usually measured--menopausal status, estrogen receptors, histologic type--and could be used to select appropriate adjuvant therapy in breast cancer.

Breast Neoplasms↗
PubMed1982

Skin preservation by programmed freezing.

There are several occasions when it may be useful to preserve skin grafts for at least 15 days, in a good enough state to provide viable autografts. We describe a technique of cryopreservation which facilitates this type of procedure. Stretched sheets of skin are incubated in a protective medium. Freezing is programmed with cooling rates of 1 degree/min first to 50 degrees C and 5 degrees/min thereafter. The skin is placed in bags that are stored in liquid nitrogen and when required for use is rapidly thawed. Thin and ultra-thin sections of this preserved skin were studied by light and electron microscopy. Cultures wer made from thawed skin and growing cells were found to contain epithelial-like or fibroblast-like elements. When pieces of thawed skin were replaced on their original donor site the autograft was successful. The technique we have described gave consistently good results and its clinical applications need further development and study.

Cryoprotective Agents↗
PubMed1981

Results of combined chemosurgical therapy for pulmonary metastases.

The authors study the results of the combined surgery and postoperative chemotherapy, for treatment of pulmonary metastases. At Léon-Bérard Center, 50 patients have been operated on since 1963. The sites and histologies of the primitive cancers are varied, corresponding to 12 epidermoid cancers, 12 adenocarcinomas, 10 osteogenic sarcomas, 1 Ewing's tumor, 3 malignant melanomas, 6 testicular tumors, and 4 others. The total survival rate is 30% in 4 years. The prognosis is influenced by different factors, which are studied. It depends on the histology of the primitive cancer and the type of the pulmonary excision. It is suggested that postoperative chemotherapy improves the results. It appears that the longer the free interval is between the treatment of the primitive cancer and the discovery of the pulmonary metastasis, the better the prognosis. The correlation between the time lapse of the free interval and the survey after pulmonary excision is studied. The conclusions of the authors are: The association of surgery and chemotherapy improves the results and enforces the indications for surgical excision of pulmonary metastases.

Adenocarcinoma↗
PubMed1977

A new topographic approach to the spread of breast cancer: the grid method.

In a series of 181 patients with breast cancer treated by mastectomy with axillary lymph node dissection, the authors developed and used an improved topographic technique, which they call the "Grid Method", which maps out the extent of a given cance of the breast. Three types of tumor spread are defined: Type 1, limited (L)(31%); Type 2, multifocal (M)(13.2%); and Type 3, extensive (E)(55.8%). This topographic information allows a more accurate assessment of prognosis when used in conjunction with the morphologic findings. Moreover, the topographic "Grid" study is simple to perform and easy to assess. Of prime importance is the relationship between the topographic and mammographic findings.

Axilla↗
PubMed1977

A topographic approach to breast cancer: the relation of topographic and mammographic findings.

One hundred and twenty-eight patients with breast cancer who, on the basis of mammographic study, were treated by mastectomy were analyzed. The purpose of this endeavor was to correlate the roentgenologic features with the pathologic findings. The correlation between them was very good: the type of tumor opacity, the microcalcifications, and the various other radiologic patterns were compatible with both localized and extensive breast cancer. Mammography appears to be valuable in the selection of patients suitable for conservative treatment.

Breast Neoplasms↗