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1.
Gynecol Obstet Fertil Senol ; 49(9): 677-683, 2021 Sep.
Article in French | MEDLINE | ID: mdl-33484900

ABSTRACT

INTRODUCTION: Current guidelines (ASCO, ESTRO, and ESGO) recommend para-aortic lymphadenectomy (PAL) for lymph node staging in patients with a negative initial PET-CT in locally advanced cervical cancer (LACC), with the aim to determine the radiation fields for radiochemotherapy. The main goal of this study was to compare overall survival (OS) in two groups, which differed according to the para-aortic lymph node staging technique used: imaging alone versus imaging and PAL. Secondary objectives were to determine recurrence-free survival (RFS), the proportion of false negatives on PET-CT, and surgery-related complications. METHODS: We conducted a retrospective, observational study on data from the Côte d'Or gynaecological cancer registry collected from 2003 to 2016, and compared two groups of LACC with different techniques for staging para-aortic lymph nodes: PET-CT alone (iN group) (n=99) and PET-CT associated with PAL (pN group) (n=35) for a total of 134 patients. RESULTS: OS (HR=1.04 (95% CI: 0.53-2.03); P=0.9) and RFS (HR=0.65 (95% CI: 0.29-1.45); P=0.29) were similar in both groups. There were 11.4% of false negatives in PET-CT, and 2.9% of patients who underwent PAL experienced complications. The staging method, iN or pN, had no impact on the time to the implementation of concomitant radiochemotherapy. CONCLUSION: For lymph node staging in LACC, PAL after a PET-CT as compared with PET-CT staging alone, had no significant impact on OS or RFS.


Subject(s)
Uterine Cervical Neoplasms , Female , Fluorodeoxyglucose F18 , Humans , Lymph Node Excision , Lymph Nodes/diagnostic imaging , Lymph Nodes/pathology , Lymphatic Metastasis , Neoplasm Staging , Positron Emission Tomography Computed Tomography , Registries , Retrospective Studies , Uterine Cervical Neoplasms/diagnostic imaging , Uterine Cervical Neoplasms/pathology , Uterine Cervical Neoplasms/therapy
2.
Eur J Paediatr Neurol ; 20(3): 439-43, 2016 May.
Article in English | MEDLINE | ID: mdl-26924168

ABSTRACT

BACKGROUND: Miller Fisher syndrome (MFS) is an acute polyradiculoneuritis regarded as an uncommon clinical variant of Guillain-Barré syndrome (GBS). MFS is characterized by the acute onset of the clinical triad of ophthalmoplegia, cereballar ataxia and areflexia. Atypical forms of MFS presenting as isolated ophthalmoplegia without ataxia have been rarely described, mostly in adults. PATIENTS: We present two cases of acute isolated bilateral ophthalmoplegia in childhood, both occurring shortly after Campylobacter jejuni enteritis. Serum analysis of anti-ganglioside antibodies revealed elevated levels of anti-GQ1b IgG and IgM. We observed in both children complete spontaneous resolution several weeks after onset. CONCLUSION: The cases of the two patients confirm the rare but possible occurrence of atypical MFS in young children a few weeks after gastrointestinal infection. Identification of high levels of anti-GQ1b antibodies in the serum may help confirm the diagnosis of MFS even when its clinical presentation is incomplete.


Subject(s)
Gangliosides/immunology , Miller Fisher Syndrome/complications , Miller Fisher Syndrome/diagnosis , Ophthalmoplegia/etiology , Acute Disease , Antibodies/blood , Campylobacter Infections/complications , Campylobacter jejuni , Child , Child, Preschool , Gastroenteritis/complications , Humans , Male
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