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1.
Int J Gynecol Cancer ; 26(5): 912-7, 2016 06.
Artículo en Inglés | MEDLINE | ID: mdl-27051055

RESUMEN

OBJECTIVES: We conducted a phase 2 trial to assess the feasibility of interval cytoreductive surgery (CS) and hyperthermic intraperitoneal chemotherapy (HIPEC) with cisplatin in patients with stage III and IV pleural ovarian carcinoma in first-line treatment with no macroscopic residual disease after surgery. METHODS: Patients could be treated either with primary CS with HIPEC followed by 6 conventional cycles of chemotherapy or with 3 or 4 cycles of neoadjuvant chemotherapy before CS with HIPEC and 3 postoperative chemotherapy cycles. Hyperthermic intraperitoneal chemotherapy was performed with cisplatin (50 mg/m) for 60 minutes, only in case of complete cytoreduction. RESULTS: Nineteen patients were included in the study, and they all underwent neoadjuvant chemotherapy before CS. Sixteen patients underwent complete CS with HIPEC. There was no mortality, and morbidity of CS with HIPEC was acceptable. The HIPEC procedure did not prevent the administration of the standard first-line treatment. In the 16 patients who underwent CS with HIPEC, the outcomes were very good. CONCLUSION: Our study shows an acceptable toxicity of adding HIPEC to the standard first-line treatment in patients with stage III ovarian carcinoma treated with interval CS. Further studies are needed to confirm the role of HIPEC in the treatment of ovarian carcinoma.


Asunto(s)
Cisplatino/administración & dosificación , Hipertermia Inducida/métodos , Neoplasias Ováricas/terapia , Adulto , Anciano , Antineoplásicos/administración & dosificación , Quimioterapia Adyuvante , Procedimientos Quirúrgicos de Citorreducción , Femenino , Humanos , Infusiones Parenterales , Persona de Mediana Edad , Terapia Neoadyuvante , Neoplasias Ováricas/tratamiento farmacológico , Neoplasias Ováricas/cirugía , Neoplasias Peritoneales , Proyectos Piloto , Estudios Prospectivos
3.
BMC Cancer ; 13: 190, 2013 Apr 12.
Artículo en Inglés | MEDLINE | ID: mdl-23587148

RESUMEN

BACKGROUND: Surgery is a curative treatment for patients with locally advanced colon cancer, but recurrences are frequent for those with stage III disease. FOLFOX adjuvant chemotherapy has been shown to improve recurrence-free survival and overall survival by more than 20% and is nowadays considered a standard of care. However, the vast majority of patients will not benefit from receiving cytotoxic drugs because they have either already been cured by surgery or because their tumor cells are resistant to the chemotherapy, for which predictive factors are still not available. METHODS/DESIGN: PePiTA is a prospective, multicenter, non-randomised trial built on the hypothesis that preoperative chemosensitivity testing using FDG-PET/CT before and after one course of FOLFOX can identify the patients who are unlikely to benefit from 6 months of adjuvant FOLFOX treatment for stage III colon cancer. DISCUSSION: PePiTA is the first study to use the primitive tumor chemosensitivity assessed by metabolic imaging as a guidance for adjuvant therapy in colon cancer. It could pave the way for tailoring the treatment and avoiding useless toxicities for the patients and inadequate expenses for the society. It could also give an interesting insight into tumoral heterogeneity, resistance to chemotherapy, genetic predisposants to oxaliplatin toxicity and immune response to cancer. EUDRACT NUMBER: 2009-011445-13 TRIAL REGISTRATION: ClinicalTrials.gov number, NCT00994864.


Asunto(s)
Adenocarcinoma/tratamiento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias del Colon/tratamiento farmacológico , Reordenamiento Génico , Células Neoplásicas Circulantes/patología , Polimorfismo de Nucleótido Simple/genética , Adenocarcinoma/mortalidad , Adenocarcinoma/patología , Bélgica , Quimioterapia Adyuvante , Neoplasias del Colon/mortalidad , Neoplasias del Colon/patología , Fluorouracilo/uso terapéutico , Estudios de Seguimiento , Humanos , Leucovorina/uso terapéutico , Linfocitos Infiltrantes de Tumor , Estadificación de Neoplasias , Compuestos Organoplatinos/uso terapéutico , Tomografía de Emisión de Positrones , Cuidados Preoperatorios , Pronóstico , Estudios Prospectivos , Calidad de Vida , Tasa de Supervivencia , Tomografía Computarizada por Rayos X
4.
Surg Endosc ; 25(5): 1514-7, 2011 May.
Artículo en Inglés | MEDLINE | ID: mdl-20972581

RESUMEN

BACKGROUND: Scientific evidence demonstrating interest in the laparoscopic approach for surgical repair of colonoscopic perforations is still lacking. The authors retrospectively reviewed the records of 43 patients who suffered from colonic perforations after colonoscopy between 1989 and 2008 in two tertiary centers in order to compare the results of the laparoscopic and the open approaches to repair. METHODS: The patients' demographic data, perforation location, therapy, and outcome were recorded from the medical charts. Forty-two patients were managed operatively (19 laparoscopies and 23 laparotomies). In three patients who underwent explorative laparoscopy, the procedure had to be converted to laparotomy due to surgical difficulties. The patients who underwent laparotomy management had a longer period between the colonoscopy and the surgery (P=0.056) and more stercoral contaminations. RESULTS: The mean hospital stay was shorter for the laparoscopy group (P=0.02), which had fewer postoperative complications (P=0.01) and no mortality (NS). CONCLUSION: This series demonstrates that early laparoscopic management of colonoscopic perforation is safe. Laparoscopic management may lead to reduced surgical and psychological stress for the patient because of its low morbidity and mortality rates and shorter hospital stay. However, the procedure should be converted to a laparotomy if necessary.


Asunto(s)
Colon/lesiones , Colonoscopía/efectos adversos , Perforación Intestinal/cirugía , Laparoscopía , Anciano , Femenino , Humanos , Perforación Intestinal/etiología , Laparoscopía/efectos adversos , Laparotomía/efectos adversos , Tiempo de Internación , Masculino , Persona de Mediana Edad
5.
Gastroenterol Clin Biol ; 29(3): 291-3, 2005 Mar.
Artículo en Francés | MEDLINE | ID: mdl-15864181

RESUMEN

Pseudo-papillary tumors of the pancreas are rare and usually occur in young women. We report a case with a very rare presentation (rupture of esogastric varices complicating biliary cirrhosis secondary to bile duct compression by a pancreatic tumor). After biological and radiological explorations, a duodenopancreatectomy was performed. Diagnosis was confirmed by conventional histology and immunohistochemistry. One year later, the patient remained asymptomatic.


Asunto(s)
Carcinoma Papilar/diagnóstico , Colestasis Intrahepática/diagnóstico , Várices Esofágicas y Gástricas/diagnóstico , Cirrosis Hepática Biliar/diagnóstico , Neoplasias Pancreáticas/diagnóstico , Adolescente , Biopsia , Carcinoma Papilar/cirugía , Femenino , Humanos , Hígado/patología , Neoplasias Pancreáticas/cirugía , Pancreaticoduodenectomía , Rotura , Esplenomegalia/diagnóstico
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