[Primary coblat therapy and secondary surgery for supra-glottal carcinoma (author's transl)]. / Cobaltothérapie première et chirurgie de rattrapage dans les cancers sus-glottiques.

This statistical study concerned 218 carcinomas of the laryngeal vestibule and margin treated at the Curie Foundation between 1958 and 1967, by primary cobalt therapy followed when necessary by secondary total laryngectomy. It shows that cobalt therapy alone gives excellent results in early forms (T1 and T2) even in the presence of N1 or N2 nodes. By contrast, the proportion of cures is much lower in T3 and T4 forms. Secondary total laryngectomy was used in only 25 cases out of 127 failures. The postoperative course was often difficult (4 fatal complications and 3 pharyngostomies) but 7 of the patients were cured at 5 years. The use of a surgical technique with minimal trauma and in particular respecting the integrity of the carotid gutters has been associated, in a more recent series, with a notable improvement in the results obtained (one cure out of 2 at 3 years).

[Trial prevention of mammary epithelioma metastases by a progestagen-estrogen combination]. / Essai de prévention des métastases des épithéliomas mammaires par l'association progestagène-oestrogène

The authors studied the effects of a combined oestrogenprogestogen treatment on the natural history of mammary tumours during a maximum period of seven and a half years. The group consisted of 135 patients divided into two on an age basis, sixty-six women still menstruating, and sixty-nine menopausal. A statistical study has shown that there is no significant difference between the treated and non-treated groups in the two groups of women studied. One can therefore deduce that the treatment has no effect on the evolution of mammary tumours whatever the age of the patient.

PIP: A group of 135 women, with breast cancer, 66 still menstruating and 69 menopausal, were treated with a combined progestogen-estrogen for a maximum of 7 1/2 years to prevent metastasis. Previous studies indicated excellent results in the short-term effect of such treatment. This study, however, showed that the evolution and recurrence is identical in those women treated and those in the control group. The conclusion was that the combination has no effect on the metastasis of breast cancers.

[Value of the cytologic diagnosis of adenopathies by aspiration biopsy. Cytohistologic comparison of 1756 cases]. / Valeur du diagnostic cytologique des adénopathies par ponction aspiration. Confrontation cyto-histologique de 1756 cas

The value of the cytologic diagnosis by aspiration needle biopsy is analysed in a series of 1756 adenopathies, verified by histological examination (1311 malignant nodes and 445 inflammatory or normal lymph nodes). The result is that a large number of lymph node tumours, either primary or secondary, are identified by the cytologic examination (from 77% to 91% of the cases according to the explored zone). Furthermore the virtually non existent percentage of false positive results (3% of the cases) proves the great accuracy of this method in the diagnosis of malignancy. In contrast, the diagnosis of benign nature must never be stated without biopsy (2% to 4% of the cases are erroneous by negative according to the explored zone). Indeed, even if benign cells are obtained, nothing allows to eliminate a malignant tumour or a limited inflammatory zone, not reached by the needle.

[Radiotherapy of cerebral tumor in the adult with the exception of hemispheric glioma]. / Radiothérapie des tumeurs cérébrales de l'adulte à l'exclusion des gliomes hémisphériques

The results obtained in this series of 120 patients with brain tumors, excepting hemispheric gliomas, appear particularly comforting. Radiosensitiveness of medulloblastomas, pinealomas and to some extent of ependymomas, was of course known. On the contrary, the radio-sensitiveness of some astrocytary processes, or supposed astrocytomas, well or moderately differentiated (gliomas of the IIIrd. ventricle, opto-chiasmatic gliomas, gliomas of the brain stem) appears to have been appreciable and it has been possible to obtain numerous stabilizations equivalent to cures. An histologic chek-up prior to roentgentherapy appears to authors as strictly necessary and might be easily enough obtained thanks to the stereotaxic procedures. Authors are not of mind that the present series will be burdened with radio-necrotic like complications. They think that the tumoral doses might be increased of 5 p. 100 and even of 10 p. 100, while maintaining the same protraction and a fractioning of the same order: treatments of 5 to seven weeks consisting in 5 to 6 sessions per week). It is presently too soon for valuing the efficiency of an adjuvant chemotherapy.

Laryngeal carcinomas.

This study is based upon 214 cases of laryngeal carcinoma treated at the Foundation Curie, Paris, France, from January, 1958, to 1968. The results in terms of five-year survival have been: (see article). A statistical study of these results was made by Professor Daudel and demonstrated the absence of significant difference for the groups of tumors classed T1 and in Stage I and II treated either by radiocobalt or by surgery, whether followed or not by radiotherapy. By contrast there was a clearly significant difference in favor of surgery for the group of tumors classified as T2, T3, T4, or in Stage III. This significant difference in favor of primary surgery disappeared if we excluded the patients who died of intercurrent illnesses or of a second cancer not involving the larynx, and when we took into account those cures obtained by surgery in the event of failure of radiation and inversely, of those cures having been obtained by radiation therapy in the event of failure of surgery.

The value of aspiration cytology in the diagnosis of breast cancer: experience at the Fondation Curie.

Aspiration cytology was performed on 2772 breast masses, all of which subsequently had open biopsies. Of the 1745 histologically malignant tumors, 1539 (88%) had a concordant cytologic diagnosis: 54 (0.3%) were diagnosed as probably malignant; 63 (3.6%) were false negatives; and 80 (0.5%) had inadequate smears for diagnosis. Of the histologically benign lesions, 916 (89%) had a concordant cytology: only 3 (0.3%) were false positives; cancer was suggested in 42 (0.4%); and the smears were inadequate in 66 cases (6.4%). Very small or very large sized cancer and a high degree of differentation were major causes of false negative aspirates. Recurrent tumors in those breasts exclusively treated by radiotherapy were documented by cytology in 56 of 69 cases (78%). Aspiration cytology is highly reliable when the diagnosis of cancer is made, but should be ignored if no malignant cells are observed.

[Cytological examination. Solid breast tumors examined by means of fine-needle puncture]. / Examen cytologique. Tumeurs solides du sein par ponction à l'aiguille fine

The value of cytological diagnosis of solid tumours of the breast where the cells were obtained by suction aspiration through a needle has been analysed in a consecutive series of 2,401 cases, all of which were checked by histological examination. They consisted of 1,745 malignant tumours and 656 benign tumours. The cytological diagnosis of malignancy was confirmed, almost always, error being practically non-existent (4 out of 1,000). This confirms that this simple and rapid test is very valuable in the diagnosis of mammary cancer. On the other hand, when the diagnosis of a benign tumour was made a certain number of cancers were missed (3.6 per cent). This is not therefore as valuable a test when the result is negative as when the result is positive. All the same, in certain cases it can suggest the diagnosis without giving the precise type of lesion, which can only be finally diagnosed histologically.