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1.
Cancer Radiother ; 21(1): 45-50, 2017 Feb.
Article in French | MEDLINE | ID: mdl-28223032

ABSTRACT

PURPOSE: To identify retrospectively prognostic factors of primary breast sarcoma and review its treatment modalities. MATERIALS AND METHODS: This is a descriptive study on 30 cases of primary breast sarcoma. We carried out a univariate and multivariate analysis correlating clinical, pathological and therapeutic parameters with disease-free survival and overall survival. RESULTS: The mean age was 46.8 years. The mean tumour size was 10cm. The 30 cases were 18 phyllodes sarcomas, eight angiosarcomas, three liposarcomas and a case of granulocytic sarcoma. Sixteen patients had adjuvant radiotherapy and only seven patients received adjuvant chemotherapy. The median follow-up was 64 months. Overall survival rates at 3 and 5 years were 49.1% and 33.7%. Disease-free survival rates at 3 and 5 years were 22.8% and 15.2% respectively. The analytical study of the following parameters: tumour size and presence or absence of node or distant metastases, showed no correlation with overall survival nor with disease-free survival. Furthermore, adjuvant radiotherapy did not improve overall survival (P=0.298; hazard ratio [HR]=1 [0.982-1.04]) nor disease-free survival (P=0.61; HR=0.942 [0.862-1.029]). By univariate analyses, we identified a correlation between overall survival, surgical margins (>1cm) (P=0005; HR=3.4 [1.217-9.919]) and tumour necrosis (P=0.028; HR=0.099 [0.014-0.682]). We did not find any independent prognostic factor by multivariate analysis. CONCLUSION: The prognosis of primary breast sarcoma seems to depend essentially on optimal surgical excision (margin over 1cm). The only potential histological parameter correlated with the prognosis is the presence of tumour necrosis. The histological subtype should not be considered as a prognostic marker for overall or disease-free survival in patients with primary breast sarcoma.


Subject(s)
Breast Neoplasms/epidemiology , Sarcoma/epidemiology , Academies and Institutes , Adolescent , Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/diagnostic imaging , Breast Neoplasms/therapy , Combined Modality Therapy , Disease Progression , Disease-Free Survival , Female , Hemangiosarcoma/epidemiology , Hemangiosarcoma/therapy , Humans , Liposarcoma/epidemiology , Liposarcoma/therapy , Mastectomy/methods , Middle Aged , Neoplasm Recurrence, Local , Phyllodes Tumor/epidemiology , Phyllodes Tumor/therapy , Prognosis , Radiotherapy, Adjuvant , Retrospective Studies , Sarcoma/diagnostic imaging , Sarcoma/therapy , Sarcoma, Myeloid/epidemiology , Sarcoma, Myeloid/therapy , Treatment Outcome , Tunisia/epidemiology , Young Adult
4.
Bull Cancer ; 97(4): 453-60, 2010 Apr.
Article in French | MEDLINE | ID: mdl-20392687

ABSTRACT

INTRODUCTION: Breast cancer screening increased the ratio of small tumours. These tumours have a low lymph node metastatic potential. Sentinel node detection allows detecting axillary lymph node invasion without the morbidity of complete axillary lymph node dissection. OBJECTIVES: In this study we report the results of the learning curve of sentinel node detection in the Institut Salah-Azaïz of Tunis. MATERIALS AND METHODS: It is a prospective study between January 2004 and December 2005 in which 115 patients were included with breast cancer less than 3 cm without antecedents of breast surgery. All these women had sentinel node dissection by a colorimetric method and 30% had a combined method (colorimetric and isotopic). RESULTS: The rate of detection was 97.3% (n = 112). An extemporaneous examination was performed in 91 patients. The rate of negative forgery of the extemporaneous examination was 4.3% and the sensitivity of 95.7%. There are no false positive with the extemporaneous exam. The sentinel lymph node was the only node invaded in 15 patients (44%). In 3 patients, the sentinel node was healthy whereas the axillary dissection was positive, so the false negative rate is about 2.6%. CONCLUSION: Sentinel node dissection is a reliable and feasible technique. It however requires a training of the surgeon, the pathologist and the nuclear doctor. It allows to reduce the morbidity of the treatment of the breast cancer by avoiding "useless" axillary dissection out in patients without node invasion. The increase in the number of the small cancers discovered during screening makes it possible to increase the number of patients who can profit from this technique.


Subject(s)
Breast Neoplasms/pathology , Lymph Nodes/pathology , Sentinel Lymph Node Biopsy/methods , Axilla , False Negative Reactions , False Positive Reactions , Feasibility Studies , Female , Humans , Lymphatic Metastasis/pathology , Prospective Studies , Sensitivity and Specificity , Tunisia
5.
Gynecol Obstet Fertil ; 31(1): 43-5, 2003 Jan.
Article in French | MEDLINE | ID: mdl-12659783

ABSTRACT

The primitive endometrioid carcinoma of the fallopian tube is exceptional. Only three cases have been reported in the literature. Its rise on tubal endometriosis like for the ovary needs to meet the strict histological criteria established by Sampson and Scott in 1953. We report one case observed on a patient aged 45 years, who needed a total hysterectomy with bilateral annexectomy for menometrorrhagias associated to uterine leiomyomas which resisted to medical treatment. The finding of a primitive intra-epithelial endometrioid carcinoma of the left fallopian tube developed on bilateral tubo-ovarian endometriosis was fortuitously found during histological examination. Our observation seems to be unique since it shows an evident filiation between the lesions of tubal endometriosis and the adjoining endometrioid carcinoma contrary to the similar unique case reported in the literature where the link between the two lesions has not been demonstrated.


Subject(s)
Carcinoma, Endometrioid/pathology , Endometriosis/pathology , Fallopian Tube Diseases/pathology , Fallopian Tube Neoplasms/pathology , Carcinoma, Endometrioid/complications , Carcinoma, Endometrioid/therapy , Endometriosis/complications , Endometriosis/therapy , Fallopian Tube Diseases/complications , Fallopian Tube Diseases/therapy , Fallopian Tube Neoplasms/complications , Fallopian Tube Neoplasms/therapy , Female , Humans , Middle Aged
6.
Gastroenterol Clin Biol ; 25(6-7): 707-10, 2001.
Article in French | MEDLINE | ID: mdl-11673737

ABSTRACT

A 52-year-old Tunisian patient had fever, impaired health and several opportunistic infections (Campylobacter jejuni, Mycobacterium hominis, Herpes virus, Giardia intestinalis, Vibrio metschnikovii). Lymphocytopenia was noted (348/mm3; CD4+: 2.2%; CD4+/CD8+: 0.1). Polymerase chain rection search for HIV was negative in serum and in tumor tissue. Diagnosis of primary digestive Kaposi sarcoma was established at autopsy due to the deep location of the lesions. There was an ulcerofungating tumor spreading over 1.3 m of the duodenojejunum. This is the fourth reported case of CD4+ lymphocytopenia, a new and very rare immunodeficiency syndrome recently defined by the Centers for Disease Control. We detected human herpes virus 8 by immunohistochemistry of tumor tissue. Human herpes virus 8 is implicated in the pathogenesis of Kaposi sarcoma.


Subject(s)
CD4-Positive T-Lymphocytes , Duodenal Neoplasms/pathology , Duodenal Neoplasms/virology , HIV Seronegativity , Herpesviridae Infections/complications , Herpesvirus 8, Human , Jejunal Neoplasms/pathology , Jejunal Neoplasms/virology , Lymphopenia/complications , Opportunistic Infections/complications , Anorexia/virology , Autopsy , Biopsy , CD4 Lymphocyte Count , Diarrhea/virology , Duodenal Neoplasms/complications , Duodenal Neoplasms/immunology , Fatal Outcome , Female , Fever/virology , Herpesviridae Infections/diagnosis , Herpesviridae Infections/virology , Humans , Immunohistochemistry , Jejunal Neoplasms/complications , Jejunal Neoplasms/immunology , Lymphopenia/blood , Lymphopenia/diagnosis , Middle Aged , Opportunistic Infections/microbiology , Polymerase Chain Reaction
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