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Author: Augustin Reynard
Publisher:
ISBN:
Category :
Languages : fr
Pages : 158
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Book Description
Le traitement des cancers avancés de l'ovaire repose sur une chirurgie de cytoréduction et une chimiothérapie. La chimiothérapie néo-adjuvante prend une place importante, mais le moment optimal où doit être effectuée la chirurgie d'intervalle reste à définir. Nous avons réalisé une étude rétrospective bicentrique portant sur 292 patientes ayant un cancer avancé de l'ovaire jugé non résécable après 3 cures de chimiothérapie néo-adjuvante. Nous comparions 4 groupes : chimiothérapie seule(72 cas), opérées après 4-5 cures (64cas), opérées après 6 cures (107 cas) et opérées après plus de 9 cures (49 cas) pour déterminer s'il existe un nombre optimal de cures de chimiothérapie néo-adjuvante. Notre travail n'a pas mis en évidence de différence de survie sans récidive ou de survie globale entre les 3 groupes de patientes opérées. Il vaut toujours mieux opérer les patientes quand une exérèse complète paraît réalisable. Nous n'avons pas observé de différence significative en terme de morbidité entre les groupes de patientes opérées. Notre étude semble montrer que différer la chirurgie de cytoréduction au-delà de 3 cures de chimiothérapie n'apparaît pas délétère, que ce soit sur la survie ou la morbidité. Cela mériterait d'être confirmé par un essai prospectif randomisé.
Author: Augustin Reynard
Publisher:
ISBN:
Category :
Languages : fr
Pages : 158
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Book Description
Le traitement des cancers avancés de l'ovaire repose sur une chirurgie de cytoréduction et une chimiothérapie. La chimiothérapie néo-adjuvante prend une place importante, mais le moment optimal où doit être effectuée la chirurgie d'intervalle reste à définir. Nous avons réalisé une étude rétrospective bicentrique portant sur 292 patientes ayant un cancer avancé de l'ovaire jugé non résécable après 3 cures de chimiothérapie néo-adjuvante. Nous comparions 4 groupes : chimiothérapie seule(72 cas), opérées après 4-5 cures (64cas), opérées après 6 cures (107 cas) et opérées après plus de 9 cures (49 cas) pour déterminer s'il existe un nombre optimal de cures de chimiothérapie néo-adjuvante. Notre travail n'a pas mis en évidence de différence de survie sans récidive ou de survie globale entre les 3 groupes de patientes opérées. Il vaut toujours mieux opérer les patientes quand une exérèse complète paraît réalisable. Nous n'avons pas observé de différence significative en terme de morbidité entre les groupes de patientes opérées. Notre étude semble montrer que différer la chirurgie de cytoréduction au-delà de 3 cures de chimiothérapie n'apparaît pas délétère, que ce soit sur la survie ou la morbidité. Cela mériterait d'être confirmé par un essai prospectif randomisé.
Author: Laure-Emilie Rebstock
Publisher:
ISBN:
Category :
Languages : fr
Pages : 0
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Book Description
Introduction. Le cancer de l'ovaire est une pathologie de mauvais pronostic étant découverte fréquemment à un stade avancé. Le traitement consiste en une chirurgie de cytoréduction complète associée à une chimiothérapie. La chimiothérapie néoadjuvante constituant une alternative en cas d'impossibilité de chirurgie première, y a-t-il un réel intérêt pronostique à réaliser une chirurgie secondaire, laquelle, avec quelle morbidité et à quel délai ? Matériel et méthodes. Les patientes porteuses d'un cancer de l'ovaire de type épithélial et de stade avancé (III-IV) étaient recensées au sein de l'Institut de Cancérologie de Lorraine, de manière rétrospective, du 01/01/1997 au 31/12/2009. Cent quatorze patientes ont bénéficié d'une chimiothérapie première. Trois groupes ont été constitués : chimiothérapie exclusive, chirurgie d'intervalle (après 3-4 cures) et chirurgie retardée (après 5 cures ou plus). Résultats. En analyse multivariée (facteurs confondants : âge, OMS, comorbidités), les groupes 2/3 avaient une meilleure survie globale que le groupe 1 (p=0,01). On n'observe pas de différence significative concernant l'efficacité, la complexité et la morbidité chirurgicale entre les groupes 2 et 3. Discussion. La chirurgie d'intervalle apporte un bénéfice en termes de survie quand le résidu tumoral est CC-0 ou CC-1 avec une morbidité acceptable. En ce qui concerne le délai optimal de la chirurgie, notre étude ne permet pas de conclure mais on observe une tendance à une diminution de la complexité et de la morbidité thérapeutique sans diminution de la survie dans le groupe chirurgie retardée.
Author: Konstantinos N. Chatzigeorgiou
Publisher: Nova Science Publishers
ISBN:
Category : Metastasis
Languages : en
Pages : 234
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Book Description
Ovarian cancer is the most common cause of death among all gynecological neoplasms. Ovarian epithelial cancer represents approximately 90% of all ovarian malignant tumours. The most usual pattern of spread and probably the earliest kind of metastasis of ovarian cancer is intraperitoneal spread, caused by apoptosis of viable cancer cells, even in cases where the ovarian surface has no visible rupture. Approximately 70% to 75% of all ovarian cancers are being diagnosed with peritoneal carcinomatosis and ascites in advanced stages III and IV. Peritoneal carcinomatosis from ovarian cancer may occur either concomitantly with the primary tumour or as a recurrence pattern of spread. Standard treatment consists of surgical debulking and postoperative systemic chemotherapy. Response rates to first-line chemotherapy with platinum/taxane combinations are high, about 70-80%, but the vast majority of patients will relapse. Peritoneal seeding is a major cause of surgical treatment failure among those patients, even after optimal debulking. However, progressing ovarian cancer tends to remain within the peritoneal cavity or, better-expressed, ovarian cancer is a cancer of the peritoneum. The administration of cytotoxic agents directly into the peritoneal cavity as treatment for malignancy was initially evaluated more than 40 years ago. Over the past two decades regional therapy of ovarian cancer has evolved from just an interesting pharmacokinetic concept into a viable management option for women with advanced disease. Several authors, and among them some of the world's leading experts on this field present the current knowledge and their experience on peritoneal carcinomatosis from ovarian cancer.
Author: Robert E. Bristow
Publisher: CRC Press
ISBN: 0429578857
Category : Medical
Languages : en
Pages : 681
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Book Description
Updated and expanded, the third edition of Surgery for Ovarian Cancer focuses on essential techniques for the effective management of ovarian cancer. It reflects the most contemporary science and surgical applications for the management of patients with ovarian cancer and related peritoneal surface malignancies. This new edition takes a step-by-step approach and includes new intraoperative photographs and videos illustrating surgical procedures. It is principally devoted to the technical aspects of cytoreductive surgery, with chapters divided according to anatomic region. The chapters cover relevant anatomical considerations, surgical challenges specific to each region, and operative approaches and techniques favored by the authors. The list of contributing authors has been expanded from the previous edition and includes international and world-renowned experts from the fields of gynecologic oncology and surgical oncology. The topics of minimally invasive surgery, secondary cytoreduction, palliative surgery, and postoperative care are also covered in detail. New to the third edition are chapters on preoperative risk stratification, regional therapeutics and peritonectomy procedures, and quality assurance relating to ovarian cancer surgery. This comprehensive text is essential reading for all practitioners working with patients with ovarian cancers.
Author: Miguel A. Rodriguez-Bigas
Publisher: Springer Science & Business Media
ISBN: 144196603X
Category : Medical
Languages : en
Pages : 615
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Book Description
Colorectal cancer is the third most commonly diagnosed cancer in the US and the third most recently linked to cancer deaths. The national annual incidence rate of colorectal cancer is approximately 148,000+, striking slightly more females than males. The lifetime risk of colorectal cancer is 5-6%, however patients with a familial risk (with two or more first or second degree relatives) make up 20% of the patients. Persons who carry genetic mutations linked to hereditary colorectal cancer are the most likely to develop the disease.
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 0309388708
Category : Medical
Languages : en
Pages : 201
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Book Description
Mitochondrial replacement techniques (MRTs) are designed to prevent the transmission of mitochondrial DNA (mtDNA) diseases from mother to child. While MRTs, if effective, could satisfy a desire of women seeking to have a genetically related child without the risk of passing on mtDNA disease, the technique raises significant ethical and social issues. It would create offspring who have genetic material from two women, something never sanctioned in humans, and would create mitochondrial changes that could be heritable (in female offspring), and therefore passed on in perpetuity. The manipulation would be performed on eggs or embryos, would affect every cell of the resulting individual, and once carried out this genetic manipulation is not reversible. Mitochondrial Replacement Techniques considers the implications of manipulating mitochondrial content both in children born to women as a result of participating in these studies and in descendants of any female offspring. This study examines the ethical and social issues related to MRTs, outlines principles that would provide a framework and foundation for oversight of MRTs, and develops recommendations to inform the Food and Drug Administration's consideration of investigational new drug applications.
Author: World Health Organization
Publisher: World Health Organization
ISBN: 9241547006
Category : Health & Fitness
Languages : en
Pages : 284
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Book Description
Most women who die from cervical cancer, particularly in developing countries, are in the prime of their life. They may be raising children, caring for their family, and contributing to the social and economic life of their town or village. Their death is both a personal tragedy, and a sad and unnecessary loss to their family and their community. Unnecessary, because there is compelling evidence, as this Guide makes clear, that cervical cancer is one of the most preventable and treatable forms of cancer, as long as it is detected early and managed effectively. Unfortunately, the majority of women in developing countries still do not have access to cervical cancer prevention programmes. The consequence is that, often, cervical cancer is not detected until it is too late to be cured. An urgent effort is required if this situation is to be corrected. This Guide is intended to help those responsible for providing services aimed at reducing the burden posed by cervical cancer for women, communities and health systems. It focuses on the knowledge and skills needed by health care providers, at different levels of care.
Author: Paul Hermanek
Publisher: Springer Science & Business Media
ISBN: 3642793959
Category : Medical
Languages : en
Pages : 303
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Book Description
M. K. Gospodarowicz, P. Hermanek, and D. E. Henson Attention to innovations in cancer treatment has tended to eclipse the importance of prognostic assessment. However, the recognition that prognostic factors often have a greater impact on outcome than available therapies and the proliferation of biochemical, molecular, and genetic markers have resulted in renewed interest in this field. The outcome in patients with cancer is determined by a combination of numerous factors. Presently, the most widely recognized are the extent of disease, histologic type of tumor, and treatment. It has been known for some time that additional factors also influence outcome. These include histologic grade, lymphatic or vascular invasion, mitotic index, performance status, symptoms, and most recently genetic and biochemical markers. It is the aim of this volume to compile those prognostic factors that have emerged as important determinants of outcome for tumors at various sites. This compilation represents the first phase of a more extensive process to integrate all prognostic factors in cancer to further enhance the prediction of outcome following treatment. Certain issues surround ing the assessment and reporting of prognostic factors are also considered. Importance of Prognostic Factors Prognostic factors in cancer often have an immense influence on outcome, while treatment often has a much weaker effect. For example, the influence of the presence of lymph node involvement on survival of patients with metastatic breast cancer is much greater than the effect of adjuvant treatment with tamoxifen in the same group of patients [5].
Author:
Publisher: Academic Press
ISBN: 012803419X
Category : Medical
Languages : en
Pages : 301
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Book Description
Regulatory T Cells in Health and Disease focuses on the mechanism by which T cells become regulatory T cells, the processes which control the number of regulatory T cells in the blood and tissue, and the ways in which regulatory T cell prevent autoimmune disease and interact with infections and cancer. - Contains contributions from leading authorities in the field of regulatory T cell biology - Informs and updates on all the latest developments in the field - Explores the processes which control the number of regulatory T cells in the blood and tissue, and the ways in which regulatory T cell prevent autoimmune disease and interact with infections and cancer
Author:
Publisher: Dorling Kindersley
ISBN: 9780241287286
Category : Arabic language
Languages : en
Pages : 360
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Book Description
Learn more than 6000 French words and phrases with this easy to use dictionary that features illustrations of objects and scenes from everyday life.
