[Cancer incidence among active female workers at Electricité de France-Gaz de France]. / Incidence des cancers chez les salariées en activité d'Electricité de France Gaz de France.

Our aim was to draw up a first general view of cancer pathology among the EDF-GDF women thanks to the cancer register among active employees created by the social security department of the French national electric and gas company EDF-GDF. Between 1978 and 1992, 764 cases of cancer were diagnosed. Breast cancer was the most common (52.4%), followed by gynaecological cancers: uterus (8.6%) and ovary (6.2%), and colon and rectum cancers (5.4%). The age-standardized breast cancer incidence using the 1978-1982 period as a basis increased over time. A higher incidence for breast cancer and a lower incidence for uterus cancer were observed among the EDF-GDF women during the 1978-1982 and 1983-1987 periods, compared to French women of same age. The study of the relationship between breast cancer risk and socioeconomic status, by means of indirect standardization, showed that the breast cancer risk increased with increasing socioeconomic status. Thus manual workers had a lower breast cancer risk than the EDF-GDF woman cohort (SIR = 0.72), foremen had the same risk (SIR = 1.05) and managers had a significantly higher risk (SIR = 1.64). Moreover a case-control study showed that the change in socioeconomic status between the beginning (20 years old) and the middle of a career (35 years old) was important but it was essentially the socioeconomic status at the beginning which determined the breast cancer risk. The results support the hypothesis of a "social class" effect through risk factors during the first part of the life.

[Cancer incidence among active male workers at Electricite de France-Gaz de France]. / Incidence des cancers dans la population masculine des salariés en activité à Electricité de France et Gaz de France.

The social security department of the French national electric and gas company has established a cancer register among a population of about 150,000 active employees based on sick leaves of both short and long duration as well as deaths recorded along with their medical cause. A first study conducted in male workers, aged 20-59, during the 1978-1989 period showed a lower cancer incidence for almost every site of cancer except for leukaemias and others reticuloses tumors of lymphoid and histiocyte tissues, compared with the French general population (SIR = 148 and 218 resp.). Between the 1978-1982 and 1983-1989 periods, a marked decrease (statistically significant) was observed in the incidence of larynx cancer and cancers of all sites usually related with excessive alcohol consumption. During the same period the incidence of pancreatic cancer has almost doubled. Large variations according to socio-economic status were observed for cancers of the lung, the pharynx, the oral cavity and the oesophagus and, also, to a lesser degree, for tumours of the testis and the bladder and leukaemias. The results suggest further studies of occupational factors. Interest and limits of such a compagny register are discussed.

[Value of adjuvant chemotherapy in infiltrating tumors of the bladder]. / Intérêt d'une chimiothérapie adjuvante dans les tumeurs infiltrantes de la vessie.

Two populations of patients with invasive epithelial bladder carcinoma are considered. Group A includes 26 patients with P greater than or equal to 2 MO lesions who, prospectively, received adjuvant postoperative chemotherapy with methotrexate, adriamycin, 5 fluoro-uracil and cisplatinum. Group B includes 24 patients treated in the same institution but without chemotherapy. In group A, 6 patients died from distant metastases. One death was not related to disease progression. The 3-year-disease-free survival rate is 67.7%. Acceptability and tolerance of chemotherapy are satisfactory. In group B, a retrospective analysis after the same radiosurgical approach found in one patient a regional recurrence leading to death 5 years after diagnosis. Twenty patients died from distant metastases. The 3-year-disease-free survival rate is 18.5%. No treatment related deaths occurred in either group. Although biased selection in such conditions is inevitable, the benefit of adjuvant chemotherapy looks rather impressive and encouraging.

[N-Methyl-9 hydroxy-ellipticine (NSC 264-137) in the treatment of malignant metastases. Preliminary results (author's transl)]. / Intérêt de la 2 N-méthyl-9 hydroxy-ellipticine (NSC 264-137) dans le traitement des cancers métastasés. Résultat d'une étude préliminaire.

In a phase II trial 2 N-Methyl-9-Hydroxy-Ellipticine (NMHE) was administered in weekly infusions of 100mg/m2 over 1 hour to patients with malignant metastases. Prior to injection, the drug was dissolved in 250 ml isotonic glucose. The results were evaluated in 67 patients. Objective regression was observed in 23 (34%) and was superior to 50% in 10 cases. Patients showing signs of regression under treatment were mostly those with breast cancer (10/24 cases), soft tissue sarcoma (3/9 cases) and renal cancer (2/8 cases). The main toxic effect was haemolysis (2 cases), probably due to an immunoallergic mechanism. Attention is drawn to the lack of bone marrow toxicity.

[Clinical study and course of 102 cases of chronic pancreatitis]. / Etude clinique et évolutive de 102 cas de pancréatite chronique

Symptomatology, signs and clinical course were studied in 102 cases of chronic pancreatics (CP), confirmed on the basis of strict criteria. Calcifications were present in 72 cases and chronic alcoholism in 81 cases. In seven patients acute pancreatitis, confirmed at surgery, appeared to have preceeded the development of CP. The only clinical difference between calcifying and non-calcifying forms was a higher incidence of steatorrhea in the first group. Cholelithiasis was present in 17 p.cent, alcoholic cirrhosis in 17 p.cent and a peptic ulcer in 24 p.cent of the whole series. Seventy two patients underwent surgery either for a complication in their course (attack of acute pancreatitis, pancreatic pseudo-cyst, cholestatic jaundice, segmental portal hypertension or antro-pyloroduodenal stenosis) or for cholelithiasis. Course assessed in 70 patients studied for more than 2 years was regressive in almost 60 p.cent of cases. There was no difference in the frequency of regression in those patients undergoing surgery and those treated medically only. In all cases, abstention from alcohol is an essential factor to a favourable result.