EVALUATION DE LA PRISE EN CHARGE GLOBALE DES PATIENTS PORTEURS DE TUMEURS AVANCEES DES VOIES AERODIGESTIVES SUPERIEURES PDF Download
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Author: GILLES.. DE LA ROCHE SAINT ANDRE
Publisher:
ISBN:
Category :
Languages : fr
Pages :
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Author: GILLES.. DE LA ROCHE SAINT ANDRE
Publisher:
ISBN:
Category :
Languages : fr
Pages :
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Author: Quentin Martinez
Publisher:
ISBN:
Category :
Languages : fr
Pages : 202
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Introduction : Le cancer des Voies Aérodigestives Supérieures (VADS) est actuellement le 6ème cancer le plus fréquent en France. Les sujets âgés représentent une population croissante avec actuellement 24% des cas. De nouvelles données apparaissent sur la prise en charge de ce cancer chez le sujet âgé. Cependant, peu d'études se sont intéressées aux sujets très âgés.Objectif : Nous avons étudié l'épidémiologie et la prise en charge du cancer des VADS chez les patients de plus de 80 ans dans notre centre.Matériel et Méthodes : Nous avons mené une étude rétrospective monocentrique au CHU de Clermont-Ferrand entre Janvier 2012 et Décembre 2017. Les patients inclus devaient présenter un premier cancer des VADS type Carcinome Epidermoïde et découvert à partir de 80 ans. Les patients qui avaient un antécédent de cancer des VADS ont été exclus. Les données étaient recueillies à partir du dossier médical informatique. Elles concernaient les antécédents médicaux, la décision, la prise en charge thérapeutique, les complications et la date de décès. Afin d'évaluer l'impact de l'âge sur la décision thérapeutique, un comité de relecture (CR) des dossiers a été créé, mettant l'âge en aveugle des médecins participants.Résultats : Nous avons recensé 129 cas. Les cancers de la cavité buccale représentaient 66% des tumeurs ; 43% des patients ont été opérés et 55% ont reçu une radiothérapie. Les traitements à visée curative et la prise en charge chirurgicale sont associés à un meilleur contrôle locorégional. La médiane de survie globale (SG) était de 1,8 an ±0,6. Les critères de bon pronostic pour la survie étaient un score ASA faible (SG : 3,5 ans), les stades tumoraux I et II (SG : 4,7 ans). Enfin, l'âge avait un véritable impact sur la décision thérapeutique.Conclusion : Les résultats chez les patients âgés de 80 ans avec un cancer des VADS stade I et II étaient similaires à ceux des patients plus jeunes. Pour les sujets atteints d'une maladie de stade III-IV la survie était médiocre et le traitement le plus souvent unimodal. Ces résultats indiquent que l'âge chronologique ne doit pas justifier un traitement a minima pour les stades I et II. Des outils gériatriques doivent être utilisés pour identifier les patients âgés éligibles à un traitement optimal dans les stades avancés.
Author: Jean Lacau Saint Guily
Publisher: Elsevier Masson
ISBN: 2294750438
Category : Medical
Languages : fr
Pages : 349
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Actualités et innovations en cancérologie des voies aérodigestives supérieures
Author: International Agency for Research on Cancer
Publisher:
ISBN:
Category : Medical
Languages : en
Pages : 180
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Book Description
This volume reviews the evidence for a causal link between sexually transmitted infection with human papillomavirus (HPV) and the occurrence of cervical cancer, from a variety of different angles. Epidemiological studies and clinical, pathological, and cytological aspects of HPV infection are reviewed. Modern methods for analyzing HPV-DNA types by molecular biological techniques are described, and the statistical problems to be overcome in epidemiological work are explained. The volume was prepared by a broad team of experts from around the world, who met in Copenhagen in March 1988 to reach a consensus on the present state of understanding and to establish directions for future work.
Author: Nathan I. Cherny
Publisher: Oxford University Press, USA
ISBN: 0199656096
Category : Medical
Languages : en
Pages : 1281
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Book Description
Emphasising the multi-disciplinary nature of palliative care the fourth edition of this text also looks at the individual professional roles that contribute to the best-quality palliative care.
Author: Richard Hain
Publisher: Oxford University Press
ISBN: 019882131X
Category : Medical
Languages : en
Pages : 535
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Book Description
The importance of palliative care for children facing life threatening illness and their families is now widely acknowledged as an essential part of care, which should be available to all children and families, throughout the child's illness and at the end of life. The new edition of the Oxford Textbook of Palliative Care for Children brings together the most up to date information, current knowledge, evidence, and developments of clinical practice in the field. The book is structured into four sections. 'Foundations of Care' describes core issues, the foundations on which paediatric palliative care is based. 'Child and Family Care' looks at different aspects of psychological, social, and cultural care for the sick child or young person, and their family. These chapters cover the time course of the illness, around the time of death and support for the bereaved family. 'Symptom Care' focuses on the uses of medication, specific symptoms, and their management. Finally, 'Delivery of Care' examines practical approaches to care in different environments and the needs of clinicians. Two new editors join the team from Canada and South Africa, reflecting our aims to contribute towards the development of care for children across the world, and to be a resource for both experienced clinicians and those new to the field. Comprehensive in scope, exhaustive in detail, and definitive in authority, this third edition has been thoroughly updated to cover new practices, current epidemiological data, and the evolving models that support the delivery of palliative medicine to children. This includes two new chapters, looking in detail at 'Decision Making' and 'Perinatal Care', and a new section highlighting the emerging importance of 'Palliative Care for Children in Humanitarian Crises'. This book is an essential resource for anyone who works with children worldwide.
Author:
Publisher:
ISBN: 9789240698345
Category : MEDICAL
Languages : en
Pages :
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Author: Eduardo Franco
Publisher: Wiley-Blackwell
ISBN: 9780632047659
Category : Medical
Languages : en
Pages : 488
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Book Description
The European Research Organisation on Genital Infection and Neoplasia (or EUROGIN) brings together clinicians and scientists who work on genital infections and their relationship to cancer. The aim of EUROGIN is to promote and develop research, training, screening, prevention and information on genital infections, precancers and cancers in women. This book reviews the latest developments in the epidemiology, natural history and screening of cervical cancer. It also deals with management of cervical cancer, development of vaccines against the human papilloma virus (its major causative agent), and new technologies such as automated screening, HPV Testing and adjuvant tests to cytology. The final and most important part of the book is a lengthy list of guidelines developed by these EUROGIN experts: a major outcome for which the meetings are held.
Author: Paul F. Nora
Publisher: W B Saunders Company
ISBN: 9780721621340
Category : Medical
Languages : en
Pages : 1412
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Book Description
A comprehensive discussion of the principles and techniques of clinical surgery in a text/atlas combination. Major sections on thoracic surgery, paediatric surgery, and lower alimentary tract and para-alimentary tract surgery are included.
Author: Jürgen Runge
Publisher: CRC Press
ISBN: 1000431150
Category : Science
Languages : en
Pages : 412
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This book celebrates the relaunch of the African Pollen Database, presents state-of-the-art of modern and ancient pollen data from sub-Saharan Africa, and promotes Open Access science. Pollen grains are powerful tools for the study of past vegetation dynamics because they preserve well within sedimentary deposits and have a huge diversity in ornamentation that allows different taxa to be determined. The reconstruction of past vegetation from the examination of ancient pollen records thus can be used to characterize the nature of past landscapes (e.g. abundance of forests vs. grasslands), provide insights into changes in biodiversity, and gain empirical evidence of vegetation response to climatic change and human activity. In this, the 35th Volume of "Palaeoecology of Africa", we bring together new data and extensive synthetic reviews to provide novel insights into the relationships between human evolution, human activity, climate change and vegetation dynamics during the Quaternary, the last 2.6 million years. Current and ongoing climate and land-use change is exerting pressure on modern vegetation formations and threatening the livelihoods and wellbeing of many peoples in Africa. In this book the focus is on the Quaternary because it is during this geological period that the modern vegetation formations developed into their current configurations against a backdrop of high magnitude global climate change (glacial-interglacial cycles), human evolution, and a growing human land-use footprint. In this book the latest information is presented and collated from around the African continent to parameterize past vegetation states, identify the drivers of vegetation change, and assess the vegetation resilience to change. To achieve this research from two broad themes are covered: (i) the present is the key to the past (i.e. studies which improve our understanding of modern environments so that we can better interpret evidence from the past), and (ii) the past is the key to the future (i.e. studies which unlock information on how and why vegetation changed in the past so one can better anticipate trajectories of future change). This Open Access book will provide a strong foundation for future research exploring past ecological, environmental and climatic change within Africa and the surrounding islands. The book is organized regionally (covering western, eastern, central, and southern Africa) and it contains specialized articles focused on particular topics (such as modern pollen-vegetation relationships and fire as a driver of vegetation change), as well as regional and pan-African syntheses drawing together decades of research to assess key scientific questions (including the role of climate in driving vegetation change and the role of vegetation change in human evolution). These articles will be useful to students and teachers from high school to the highest level of university who are interested in the origins and dynamics of vegetation in Africa. Furthermore, it is also meant to provide societally relevant information that can act as an inspiration for the development of sustainable management practices for the future.
