An exceptional migration of ureteral stent after antegrade placement: A case report.

We report an exceptional migration of ureteral stent in patient who underwent a robot-assisted laparoscopic right pyelotomy. After stone removal, an antegrade ureteral stenting (7-french; Double J) was performed without fluoroscopic control. A radiographic control was performed the next day and highlighted a migration into the cardiovascular system. The Double J was removed percutaneously through the right femoral vein under fluoroscopic guidance.

[Is a routine second transurethral resection of the bladder still necessary after hexaminolévulinate photodynamic diagnosis-assisted TURBT?] / La résection transurétrale de vessie de réévaluation est-elle toujours nécessaire en cas de primo-résection sous luminofluorescence par hexaminolévulinate ?

OBJECTIVES: The aim of our study was to assess the impact of blue light cystoscopy with hexaminolevulinate on residual tumor rates at second-look transurethral resection of the bladder (TURB). MATERIAL AND METHODS: Among all patients undergoing TURB in our center between 2012 and 2017, 52 patients had a second-look after a first complete TURB with a delay<3months. We compare patients with standard white light cystoscopy/TURB then second-look blue light cystoscopy/re-TURB (group A, n=30) and patients with blue light cystoscopy/TURB at the initial procedure then white light cystoscopy/re-TURB (group B, n=22). The residual tumor rates at second-look, restaging and changing in therapeutic strategy, as well as recurrence free survival and progression rate were compared. RESULTS: Residual tumor at the time of second-look cystoscopy was detected in 42.3% of cases in our cohort, with a significant difference between the two groups (63.3% in group A versus 0% in group B, <0.001). In group A, 16.7% (5/30) of patients had upstaging and/or upgrading at second-look cystoscopy, resulting in a change in therapeutic strategy in most cases (4/5) while none upstaging was observed in group B. In multivariate analysis, the use of luminofluorescence at the first TURB was the only independent predictive factor of residual tumor (P=0.0031). CONCLUSION: The quality of the initial TURB, when performed by using blue light cystoscopy, had a significant impact on the rate of residual tumor at the second-look resection and could modify therapeutic strategy of NMIBC. LEVEL OF EVIDENCE: 4.

Prevention of second primary tumours with etretinate in squamous cell carcinoma of the oral cavity and oropharynx. Results of a multicentric double-blind randomised study.

Patients who are cured from head and neck carcinomas remain at high risk for developing a second primary in the head and neck area. It is now clear that retinoids exert a prophylactic action on the development of epithelial cancers when tested on laboratory animals and on human premalignant lesions. They are now used in the chemoprevention of epithelial cancers in randomised trials evaluating their efficacy. We prospectively studied 316 patients who developed squamous cell carcinoma of the head and neck, classified as T1/T2, N0/N1 < or 3 cm, M0 according to the UICC TNM classification. Patients were randomly assigned to receive orally, either etretinate (a loading dose of 50 mg/day for the first month, followed by a dose of 25 mg/day in the following months) or a placebo for 24 months. Adjuvant treatment began no later than 15 days after surgery and/or the initiation of radiotherapy. The 5-year survival rate and disease-free survival rate are similar in the two groups. There are no significant differences regarding either local, regional and distant relapses. After a median follow-up of 41 months (range 0-81), 28 patients in the etretinate group and 29 in the placebo group developed a second cancer with, respectively, 12 and 13 in the head and neck region. Adjuvant treatment was definitively discontinued mainly due to toxicity in 33% of patients in the etretinate group versus 23% in the placebo group (P < 0.05). Etretinate, a second-generation retinoid, does not prevent second primary tumours in patients who have been treated for squamous cell carcinoma of the oral cavity and oropharynx.

[Supratentorial glioblastoma in adults. Therapeutic results]. / Glioblastomes sus-tentoriels de l'adulte. Résultats thérapeutiques.

This retrospective study concerns 55 adult patients with supratentorial glioblastoma. The tumours were treated by complete or partial surgical excision whenever possible (31 cases), radiotherapy (22 cases) in doses of 60 Gy over 6 to 7 weeks (40 Gy with telecobalt and 20 Gy with superimposed electrons) and multiple chemotherapy (10 cases) with VM26 and CCNU or BCNU. Although the number of patients in some categories was too small for statistical evaluation, the results obtained were in agreement with those found in the literature and indicative of what can be expected. In patients with inoperable tumours the mean survival was increased from 2 to 8 months by radiotherapy or chemotherapy given separately, and from 2 to 9 or 10 months only when these two methods were combined. The mean survival of patients with partial tumoral excision was 2.5 months extended to 10 months after post-operative radiotherapy; one patient in this group who received both radiotherapy and chemotherapy is still alive after more than 5 years. In patients with macroscopically satisfactory excision, the 12 months good quality survival obtained by surgery was apparently prolonged to 22 months with radiotherapy; 3 of these patients who had both radiotherapy and chemotherapy after surgery are alive and in good condition after 15, 16 and 28 months respectively.

[An unusual form of neoplastic lymphangitis in an irradiated field]. / Une forme particulière de lymphangite néoplasique en zone irradiée.

The authors describe an exceptional form of neoplastic lymphangitis occurring in old people some years after surgery and irradiation of a cancer (parotid, breast), the special character of which is that it draws exactly the fields of irradiation. This lymphangitis is at first smooth and later covered with neoplastic nodes which join together. Evolution is in any case the death after some weeks or months. Different pathogenetic hypotheses are discussed, involving the mechanisms of biology of cancer and radiations.

[Results of the radiotherapy in the non Hodgkin's lymphomas treatment (author's transl)]. / Résultats de la radiothérapie dans le traitement des lymphomes non hodgkiniens (ex-lympho-réticulo-sarcomes).

In our 98 patients all treated by association chemotherapy + cobaltherapy, 37 cases were stages III and IV and 71 cases were of diffuse pathology classification. Meanwhile the results were not so poor: 66% at 5 years survival (all stages) and 69% for stages I and II. The curves of survival rate generally stabilize at 7 years. The prognostic depend of the pathology class: diffuse LBS and diffuse HBS have an evolution similar to acute leukemia (44.5% and 19% at 7 years survival), on the opposite nodular LBS, diffuse LCS have 100% survival at 7 years. Diffuse cases have visceral relapses (liver, bone marrow, Waldeyer ring) or generalized lymphatic involvement; nodular cases have generally localized and only lymph-nodes relapses. The best results by large fields irradiation suggest a contiguous extension of the disease, but there is also distant lymph nodes relapses. In the nodular cases, relapses can be generally cured by localized radiotherapy. In the diffuse case, we do not know if it is better to give total lymphnode irradiation (or to give more chemotherapy with economic irradiation). 10 gastro-intestinal cases were treated by moving strip technique with excellent tolerance and 67.5% at 5 years survival. These results show that interesting results may be obtained in non Hodgkin lymphomas by association of chemotherapy, with selective and moderately large fields irradiation, even in disseminated cases, even in diffuse cases.

[Treatment of breast carcinoma. Results of telecobaltherapy associated to surgery (author's transl)]. / Traitement du cancer du sein. Résultats de l'association télécobalthérapie-chirurgie chez 156 malades.

The study was performed on 156 cases of breast carcinoma treated since 1968 with a follow up of 5 to 9 years. The global actuarial survival in 73,5%. The stages T1 T2 N0 treated by tumor excision gave a prominent result: 93% 5 years survival while preserving the breast. Among grave signs the importance of axillar involvement is outlined: the 5 years survival is 65,5% with N1 M0 while 73,5% with N0 - M0. Local recurrences are rare (8%) and generally in extensive cases. Sequelae are rare (3 to 13%), the most frequent is the arm lymphodema which is related more to the Halstedt surgical procedure than to post operative irradiation. These results in agreement with other publications emphasize the importance of post operative irradiation. Only in the high risk cases one must try in addition to radiotherapy a chemotherapy treatment.

[Application of the Moving Strip Technique of Fletcher in the radiation treatment of primary malignant tumours of the ovary (author's transl)]. / Application de la technique d'irradiation en bandes de l'abdomen (Moving Strip Technique de Fletcher) au traitement des tumeurs malignes primitives de l'ovaire.

The moving Strip Technique for irradiation of the abdomen perfected by Fletcher and Delclos represents considerable progress in terms of radiotherapy for carcinomas of the ovary by virtue of its simplicity, good tolerance, the homogeneous dose delivered to the entire abdominal cavity and the absence of sequelae. It is possible to deliver a dose of the order of 2.500 rads in 10 days to each abdominal segment, this being equivalent of 3,500 rads in 3,5 weeks. This moderate dose is aimed only at dealing with micronodular invasion and the superimposition of added local doses is required for residual tumour, marked using clips. Of 18 cases treated, including. 15 et stages III and IV, overall survival at 4 years is 52.5%. Two patients at stage III survived for more than 2 years with radiotherapy alone, whilst all at stages I and II are still alive. Have survived for more than two years with radiotherapy alone, whilst all at stages I and II are still alive. From a histological standpoint, the worst group seems to be adenocarcinomas (all dead). Systematic sequential surgery for excision or reduction, chemotherapy to dry out ascites, moving strip irradiation with superimposed doses locally and long term chemotherapy should make it possible to improve the prognostic results of this tumour, for which the outlook remains poor.