How should we treat mucinous appendiceal neoplasm? By laparoscopy or laparotomy? A case report.

Appendicular mucocele (AM) usually denotes a dilatation of the appendiceal lumen as a result of mucus accumulation that may be related to various neoplastic and non-neoplastic processes. Most of them are discovered incidentally. Treatment consists in complete resection avoiding rupture of the cyst in the peritoneal cavity.

Febrile neutropenia: a critical review of the initial management.

The present state of the art for management of patients with febrile neutropenia has been reviewed as well as potential ways to improve it in the future. A major advance has been the possibility to predict, accurately and early, the risk of complications and death in those patients. While the algorithm for therapy in low-risk patients is presently straightforward, significant progresses are needed for patients who are at higher risk of presenting severe complications.

Prevention of febrile neutropenia in chemotherapy-treated cancer patients: Pegylated versus standard myeloid colony stimulating factors. Do we have a choice?

The pertinent literature on clinical studies comparing the respective value of myeloid colony stimulating factors to pegfilgrastim as a prevention of febrile neutropenia in chemotherapy-treated cancer patients has been reviewed. Pegfilgrastim is definitely not inferior to filgrastim or other myeloid colony stimulating agents with respect to duration of grade IV neutropenia and delivery of full chemotherapy dose on time; several comparative studies indicate a trend to less frequent febrile neutropenia with pegfilgrastim.

[Study of the genesis of bronchial epidermoid carcinoma: evolution or the expression of proteins, messenger RNAs and microRNAs at all stages of the process of carcinogenesis].

We characterized the successive and cumulative molecular modifications associated with transition in the histological stages of lung squamous carcinogenesis (normal epithelium from smokers, hyperplasia, metaplasia, mild, moderate and severe dysplasia, in situ carcinoma and invasive carcinoma) to improve our understanding of the mechanisms involved and identify new biomarkers for the early detection of lung squamous cell carcinoma. We employed immunohistochemistry, immunofluorescence, gene expression microarrays and quantitative RT-PCR to successively assess the expression of various proteins involved in cellular proliferation and apoptosis as well as messenger RNAs and microRNAs expression. Based on our data, we have improved the classification of bronchial preneoplastic lesions and furthered our understanding of the pathways involved in early lung carcinogenesis.

[Quality of life after radical surgery and radiotherapy for advanced or recurrent laryngeal and hypopharyngeal cancers].

Aim: To determine the functional disabilities and overall quality of life of patients operated for advanced (Stages III-IV) or recurrent squamous cell carcinomas (SCCA) after radiation therapy of the (pharyngo)larynx.

Methods: From 1984 to 1997, 135 patients were consecutively treated for SCCA of the (pharyngo)larynx. There were 118 men and 17 women with a mean age of 60 years.

[Other thoracic cancers. Mesothelioma: treatment].

Malignant pleural mesothelioma is a rare tumour of poor prognosis. Available therapeutics have restricted efficacy. Pleuro-pneumonectomy is the only treatment with curative intent but it could be offered to a limited and well selected group of patients.

[Early-stage NSCLC. Resectable non-small cell lung cancers: (neo) adjuvant chemotherapy].

The therapeutic approach of resectable non small cell lung cancer has evolved during the last decade. The addition of cisplatin-based chemotherapy, given either before or after surgery, led to a significant increase in overall survival. This effect is essentially pronounced in stage II-III diseases.

[Etiology, epidemiology, biology. Lung carcinogenesis].

Lung cancer is a complex disease involving various oncogenic pathways. Its early detection, at pre-invasive stages, could offer the opportunity of improving the bad prognosis of this cancer. Pre-invasive stages exist for different forms of lung cancer and some of them are recognized as being preneoplastic: dysplasias and in situ carcinoma, atypical adenomatous hyperplasia and diffuse idiopathic pulmonary neuroendocrine cell hyperplasia are supposed to be precursors of squamous cell carcinomas, adenocarcinomas and carcinoid tumors, respectively.

A phase III randomised study comparing concomitant radiochemotherapy as induction versus consolidation treatment in patients with locally advanced unresectable non-small cell lung cancer.

As concomitant chemoradiotherapy for stage III NSCLC is associated with survival advantage in comparison to a sequential approach, we conducted a phase III randomised study aiming to determine the best sequence and safety of chemotherapy (CT) and chemoradiotherapy (CT-RT), using a regimen with cisplatin (CDDP), gemcitabine (GEM) and vinorelbine (VNR). Unresectable stage III NSCLC patients received CDDP (60 mg/m(2)), GEM (1g/m(2), days 1 and 8) and VNR (25mg/m(2), days 1 and 8) with reduced dosage of GEM and VNR during radiotherapy (66Gy). Two cycles of CT with radiotherapy followed by two further cycles of CT alone were administered in arm A or the reverse sequence in arm B.

The use of low-energy laser (LEL) for the prevention of chemotherapy- and/or radiotherapy-induced oral mucositis in cancer patients: results from two prospective studies.

Background: Low-energy laser (LEL) treatment has been suggested as an effective and safe method to prevent and/or treat oral mucositis induced by chemotherapy and/or radiotherapy; however, it has not gained wide acceptance so far.

Materials And Methods: We conducted two clinical trials testing the LEL technique: firstly, as a secondary prevention in patients with various solid tumors treated with chemotherapy who all developed severe mucositis after a previous identical chemotherapy and, secondly, as therapeutic intervention (compared to sham illumination in a randomized way) in patients with hematological tumors receiving intensive chemotherapy and having developed low-grade oral mucositis.

Results: We entered 26 eligible patients in the first study and 36 were randomized in the second study.

Fistula and stenosis after 135 (pharyngo)laryngectomies.

Background: Despite progress made with reconstruction, morbidity is still elevated after (pharyngo)laryngectomy. The present study was designed to determine the incidence and predisposing factors of the complications following (pharyngo)laryngectomy.

Methods: Primary surgical treatment was delivered in 60 patients.

B-cell lymphoma presenting with renal failure associated to spontaneous tumor lysis syndrome and urinary tract obstruction.

The acute tumor lysis syndrome (ATLS) may be a dramatic complication of anticancer treatment. It occurs mostly in haematological malignancies and less commonly in solid tumors. Spontaneous tumor lysis syndrome (STLS) has been reported more frequently in Burkitt's lymphomas than in other haematological tumors, and exceptionally in solid tumors like small-cell lung carcinoma and germ-cell tumors.

[Stage IV non-small cell lung cancer. What is the best treatment for relapse?].

Medical treatment for relapse of advanced stage non small cell bronchial carcinoma has become standard medical practice. This article reviews the subject, taking account of the author's personal experience, available clinical practice guidelines, published systematic reviews, randomised trials, implementation studies and targeted therapies.

Does clinical and radiological response predict complete tumor control in N2-N3 squamous cell head and neck cancer after non-operative management of the neck?

Conclusion: A complete clinical and radiological response observed following chemotherapy and radiotherapy is not predictive of the absence of residual disease. Moreover, salvage neck surgery does not always seem to be an effective strategy. Consequently, early neck dissection should be advised for patients with complete clinical and radiological response (CCRR) after chemoradiotherapy for tumors with N2-N3 disease.

Intrathecal donor lymphocyte infusion for the treatment of suspected refractory lymphomatous meningitis: a case report.

A 43-year-old female with large T-cell non-Hodgkin's lymphoma and central nervous system (CNS) involvement underwent HLA-identical-sibling peripheral blood stem cell transplantation (SCT) during her third complete remission. She presented a possible refractory CNS relapse 5 months after the transplant. She was then treated with intrathecal (IT) donor lymphocyte infusions (DLI).

Infection in the neutropenic and stem cell transplant patient.

The spectrum of infectious complications in neutropenic patients after stem cell or bone marrow transplant is not very different from that seen in other neutropenic patients, with the possible exception of fungal infections. The prevention and therapy of these infections remain a major challenge. The management of neutropenic patients after stem cell or bone marrow transplant has markedly benefited from the development of new antiviral agents and the use of granulocyte/macrophage colony stimulating factors.

Thyroid transcription factor 1--a new prognostic factor in lung cancer: a meta-analysis.

Background: The aim of this study was to determine the prognostic role for survival of thyroid transcription factor 1 (TTF-1) in lung cancer.

Methods: Studies evaluating survival and TTF-1 in lung cancer patients, published until August 2005, were assessed with a methodological scoring system. The required data for estimation of individual hazard ratios (HRs) for survival were extracted from the publications and a combined HR was calculated.

Antifungal therapy in febrile neutropenic patients: review of treatment choices and strategies for aspergillar infection.

Rationale: Invasive fungal infections, especially aspergillosis, are a major problem in patients who undergo aggressive therapy for haematological malignancies. Presently, the standard therapy for demonstrated aspergillar infection is voriconazole. Because the morbidity and the mortality of proven aspergillar infection is relatively high, empirical and preemptive approaches have been explored.

[Psychology, psychiatry and oncology: recent and future findings].

There is an important development of research at the interface of psychology, psychiatry and oncology. There are now precise knowledges about assessment and type of difficulties experimented by patients and their significant others. The content of psychological interventions needed to optimize quality of care is starting to be better defined.

Sequence- and concentration-dependent effects of acute and long-term exposure to the bisphosphonate ibandronate in combination with single and multiple fractions of ionising radiation doses in human breast cancer cell lines.

Both bisphosphonates and radiotherapy are highly effective for the management of bone metastases. Our in vitro study examined the cytotoxic effects resulting from combinations of ibandronate and ionising radiations (RX) in various sequences on breast cancer cells. Single radiation doses were given before, at halftime of, or after acute ibandronate incubation (48 h).

Has Cox-2 a prognostic role in non-small-cell lung cancer? A systematic review of the literature with meta-analysis of the survival results.

Cyclooxygenase-2 (COX-2) is overexpressed in lung cancer, especially in adenocarcinoma (ADC). Our aim was to determine the prognostic value of COX-2 on survival in patients with lung cancer. Studies evaluating the survival impact of COX-2 in lung cancer, published until December 2005, were selected.

Human marrow mesenchymal stem cell culture: serum-free medium allows better expansion than classical alpha-MEM medium.

The expansion of mesenchymal stem cells (MSCs) strongly depends on the culture conditions and requires medium supplemented with 10-20% fetal calf serum (FCS) to generate relevant numbers of cells. However, the presence of FCS is a major obstacle for their clinical use. Therefore, we have evaluated the capacity of expansion of MSC in a commercial serum-free medium (UC) supplemented with a serum substitute (ULTROSER) in comparison with a classical medium alpha-MEM containing 15% FBS.

Additive growth inhibitory effects of ibandronate and antiestrogens in estrogen receptor-positive breast cancer cell lines.

Introduction: Bisphosphonates are inhibitors of osteoclast-mediated tumor-stimulated osteolysis, and they have become standard therapy for the management of bone metastases from breast cancer. These drugs can also directly induce growth inhibition and apoptosis of osteotropic cancer cells, including estrogen receptor-positive (ER+) breast cancer cells.

Methods: We examined the anti-proliferative properties of ibandronate on two ER+ breast cancer cell lines (MCF-7 and IBEP-2), and on one ER negative (ER-) cell line (MDA-MB-231).