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- 저자 : Pierre Denys (검색결과 3 건)
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Emmanuelle Arsène,Géraldine Bleu,Benjamin Merlot,Loïc Boulanger,Denis Vinatier,Olivier Kerdraon,Pierre Collinet 대한부인종양학회 2015 Journal of Gynecologic Oncology Vol.26 No.2
Objective: Since European Society for Medical Oncology (ESMO) recommendations and French guidelines, pelvic lymphadenectomyshould not be systematically performed for women with early-stage endometrioid endometrial cancer (EEC) preoperativelyassessed at presumed low- or intermediate-risk. The aim of our study was to evaluate the change of our surgical practices afterESMO recommendations, and to evaluate the rate and morbidity of second surgical procedure in case of understaging after thefirst surgery. Methods: This retrospective single-center study included women with EEC preoperatively assessed at presumed low- orintermediate-risk who had surgery between 2006 and 2013. Two periods were defined the times before and after ESMOrecommendations. Demographics characteristics, surgical management, operative morbidity, and rate of understaging werecompared. The rate of second surgical procedure required for lymph node resection during the second period and its morbiditywere also studied. Results: Sixty-one and sixty-two patients were operated for EEC preoperatively assessed at presumed low-or intermediate-riskbefore and after ESMO recommendations, respectively. Although immediate pelvic lymphadenectomy was performed morefrequently during the first period than the second period (88.5% vs. 19.4%; p<0.001), the rate of postoperative risk-elevating orupstaging were comparable between the two periods (31.1% vs. 27.4%; p=0.71). Among the patients requiring second surgicalprocedure during the second period (21.0%), 30.8% did not undergo the second surgery due to their comorbidity or old age. For the patients who underwent second surgical procedure, mean operative time of the second procedure was 246.1±117.8minutes. Third operation was required in 33.3% of them because of postoperative complications. Conclusion: Since ESMO recommendations, second surgical procedure for lymph node resection is often required for womenwith EEC presumed at low- or intermediate-risk. This reoperation is not always performed due to age/comorbidity of thepatients, and presents a significant morbidity.
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Intermittent Self-catheterization in Older Adults: Predictors of Success for Technique Learning
Claire Hentzen,Rebecca Haddad,Samer Sheikh Ismael,Benoit Peyronnet,Xavier Gamé,Pierre Denys,Gilberte Robain,Gérard Amarenco 대한배뇨장애요실금학회 2018 International Neurourology Journal Vol.22 No.1
Purpose: The main goal of this retrospective study is to explore the predictors of success in learning clean intermittent selfcatheterization (CISC) in patients over 65 years of age. The secondary goal is to assess whether in this population, the risk of failure to perform CISC is greater, compared with patients under 65 with similar pathologies. Methods: All patients older than 65 consulting between January 2011 and January 2016 for learning CISC were included. A control population younger than 65 matching with sex, body mass index, and pathology was selected. Results: One hundred sixty-nine of the 202 patients (83.7%) over 65 succeeded in learning CISC. Obesity (P<0.05), low pencil and paper test (PP test) (P<0.01) and low functional independence measure (FIM) (P<0.01) scores were risk factors of failure. No significant differences were found with sex or pathology. In multivariate analysis, low PP test perineum access (odds ratio [95% confidence interval], 2.30 [1.32–4.42]), low FIM motor (1.04 [1.01–1.08]), and FIM cognition (1.18 [1.03–1.37]) scores were independent factors of learning failure. Compared to control group, age over 65 was not predictive of failure (P=0.15). Conclusions: Our study shows that success in learning CISC does not depend on age but on difficulties in mobility, access to perineum and probably cognitive disorders.
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Charlotte Vaysse,Cyril Touboul,Thomas Filleron,Eliane Mery,Eva Jouve,Pierre Leguevaque,Philippe Morice,Eric Leblanc,Denis Querleu 대한부인종양학회 2011 Journal of Gynecologic Oncology Vol.22 No.1
Objective: Early stage primary carcinoma of the fallopian tube (PCFT) is an uncommon condition when strict criteria are applied. The aim of this study was to compare the outcome stage IA-IB PCFT to a matched group of ovarian cancer (OC). Methods: Between 1990 and 2008, 32 patients with stage IA-IB of PCFT were recorded in the database of three French Institutions. A control group of patients with OC was constituted. Results: Eleven eligible PCFT cases and 29 OC controls fulfilled the stringent inclusion criteria. Median follow-up was 70.2 months. Five-year overall survival was 83.3% (95% confidence interval [CI], 27.3 to 97.5) for PCFT and 88.0% (95% CI, 66.9 to 96.0) for OC (p=0.93). In the subgroup of patients with grade 2-3, the outcome was similar in PCFT compared to OC patients (p=0.75). Five-year relapse-free survival was respectively 62.5% (95% CI, 22.9 to 86.1) and 85.0% (95% CI, 64.6 to 94.2) in the PCFT and OC groups (p=0.07). In the subgroup of patients (grade 2-3), there was no difference between PCFT and OC (p=0.65). Conclusion: The findings did not reveal any difference in prognosis between early stage of PCFT and OC when grade is taken into account. Management of PCFT should mirror that of ovarian carcinoma. Objective: Early stage primary carcinoma of the fallopian tube (PCFT) is an uncommon condition when strict criteria are applied. The aim of this study was to compare the outcome stage IA-IB PCFT to a matched group of ovarian cancer (OC). Methods: Between 1990 and 2008, 32 patients with stage IA-IB of PCFT were recorded in the database of three French Institutions. A control group of patients with OC was constituted. Results: Eleven eligible PCFT cases and 29 OC controls fulfilled the stringent inclusion criteria. Median follow-up was 70.2 months. Five-year overall survival was 83.3% (95% confidence interval [CI], 27.3 to 97.5) for PCFT and 88.0% (95% CI, 66.9 to 96.0) for OC (p=0.93). In the subgroup of patients with grade 2-3, the outcome was similar in PCFT compared to OC patients (p=0.75). Five-year relapse-free survival was respectively 62.5% (95% CI, 22.9 to 86.1) and 85.0% (95% CI, 64.6 to 94.2) in the PCFT and OC groups (p=0.07). In the subgroup of patients (grade 2-3), there was no difference between PCFT and OC (p=0.65). Conclusion: The findings did not reveal any difference in prognosis between early stage of PCFT and OC when grade is taken into account. Management of PCFT should mirror that of ovarian carcinoma.
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