[Quality of life analysis in patients treated for breast cancers]. / Analyse de la qualité de la vie chez des patientes traitées pour un cancer du sein.

OBJECTIVES: Evaluate the different quality of life parameters in treated breast cancer patients. TYPE OF STUDY: Retrospective analysis from 1977 to 1987. STUDY SITE: Bichat, Lariboisière and Tenon Hospitals. PATIENTS: 239 operated patients, with or without irradiation following or before chemotherapy, with or without hormonotherapy. Patients were divided into 4 groups according to age. STUDY PARAMETERS: Essentially, gynaecologic consequences of treatments (flush, menstrual cycles, fertility, vaginal dryness, breast reconstruction), effect of tamoxifen on genital organs and osteopenia. MAIN RESULTS: Tamoxifen acts as an oestrogen both on genital organs and bones. CONCLUSION: The impact of substitutive hormone therapy on quality of life should be evaluated in randomized studies.

[Indications and results of ileal neobladder during the development of cervix uteri cancer. Study of 32 cases]. / Indications et résultats des néo-vessies iléales au cours de l'évolution des cancers du col utérin. Etude de 32 cas

32 uretero-ileoplasties were carried out during the course of carcinoma of the uterine cervix, where therapeutic complications required an urinary by-pass operation. A trans-ileal by-pass to the skin ensured better renal function and comfort than that provided by a skin ureterostomy. The operation carried out in 20 cases after curative radiotherapy,.remains possible with a reasonably low risk: 2 deaths. However, survival depends on the cancer. The operation is legitimate and advisable in urinary lesions due to treatment, but one wonders whether the operation is justified in cases where the carcinoma is inoperable. Present means of resuscitation made this surgery acceptable as far as the immediate risk is concerned and survival is undoubtedly comfortable. On may thus carry out again radical operations provided the lesions are limited and there is no fibropelvis after high dose cobalt-radiotherapy. But purely palliative trans-ileal urinary by-pass operations remain debatable. Their indications depend on the general condition of the patient, the desire of the surgeon to operate and the functional result of these palliative operations should not be lost by carrying out too radical an operation which will shorten survival time.

[Thecal tumors of the ovary. 14 cases]. / Les tumeurs thècales de l'ovaire. 14 cas

Out of 524 tumours of the ovary seen over a 20 year period, the diagnosis was that of a thecal tumour in 14 cases. In addition to the symptoms common to all ovarian tumours, in 7 cases there was metrorrhagia, including 4 post-menopausal. Vaginal cytology after the menopause was abnormally young in 6 cases. In 7 cases out of 13 the endometrium was hyperplasic. In only 5 cases were urinary oestrogen levels increased. At operation, the tumour was bilateral in 3 cases and ascites was present in 4. Histological findings were as follows: 6 thecomas, 4 fibro-thecomas, 1 luteinised thecal tumour, 3 tumours with granular cells and 1 case associated with a Brenner tumour. Two of these "mixed tumours" were malignant, with a fatal outcome. All the others were cured by operation. In young women in whom conservative procedures were used there were 4 subsequent pregnancies. The following questions were posed: The coexistence of ascites with tumours totally free of secretory cells (3 cases); The existence in true thecal tumours of signs of hyperoestrogenism (5 out of 6) whilst fibro-thecomas are not associated with any abnormal production of oestrogen.