BACKGROUND Merkel cell carcinoma is a rare and potentially aggressive cancer of the skin. Cumulative data from small retrospective series have supported treatment by wide excision and adjuvant ...radiotherapy. However, wide excision may be difficult to perform in patients with tumors of the head and neck or in older populations with comorbidities that may be incompatible with general anesthesia. OBSERVATIONS Nine patients (group 1) with stage I (without lymph node involvement) Merkel cell carcinoma primary tumors were treated in our center by radiotherapy alone. The rate of recurrence was compared between this group and 17 additional patients (group 2) with stage I Merkel cell carcinoma who received conventional treatment (surgery followed by radiotherapy). RESULTS The median follow-up was 3.0 years (range, 8 months to 7 years) for group 1 and 4.6 years (range, 5 months to 11 years) for group 2. During this period, we observed 1 relapse and 1 progression of disease in group 2. No statistical difference was found in overall and disease-free survival between the 2 groups of patients. CONCLUSION This study demonstrates the possibility of treating inoperable Merkel cell carcinoma by radiotherapy alone, with outcomes similar to those of classic treatment.Arch Dermatol. 2003;139:1587-1590-->
Use of antibiotic prophylaxis (AP) in clean breast cancer surgery is still controversial. We assessed the efficacy of preoperative AP in a prospective study of 171 clean breast cancer procedures ...following previous anticancer chemotherapy. From June 1998 to July 2001, we analyzed 171 procedures. In 133 cases. AB with cefuroxime was performed. Wound infection rate was 3 out of 171 procedures (WI rate of 2/131 with AP compared with 1/37 without AP, p = 1.0). This study suggests that AP is not systematically required in breast cancer surgery following previous anticancer chemotherapy.
Résumé: L’objectif de cette étude est d’évaluer le niveau d’anxiété et de dépression de patients exposés à la tomographie par émission de positons (TEP), la compréhension des modalités et finalités ...de l’examen médical, et les liens entre l’apport d’information sur le déroulement et l’objet de cet examen, l’anxiété ressentie et les symptômes dépressifs des patients avant et après cet examen. Trente patients atteints d’un cancer ont complété un même questionnaire à quatre reprises: une semaine avant la passation de la TEP, juste avant l’examen, lors de la consultation d’annonce des résultats, et quinze jours après l’annonce des résultats de l’examen. Outre des informations générales, ce questionnaire portait sur le niveau d’anxiété évalué par la STAI-YA, le niveau de dépression mesuré par la CES-D et la compréhension générale des modalités et finalités de la TEP. Globalement, les patients présentent un niveau d’anxiété élevé, et cela quel que soit le moment de la passation de l’inventaire. De plus, les patients indiquent être davantage anxieux avant la réalisation de l’examen que lors de l’annonce des résultats et quinze jours après cette annonce. En revanche, aucune symptomatologie dépressive ne semble se dégager. Globalement, les patients estiment avoir reçu suffisamment d’informations sur cet examen médical, et les scores de bonnes réponses au questionnaire de compréhension générale de la TEP attestent ce constat. Seuls trois éléments semblent moyennement compris. En outre, l’apport d’informations sur le déroulement de l’examen et ses finalités ne semble pas lié à l’anxiété ou à la dépression des patients avant ou après la TEP.
Abstract: The aim of this study was to assess 1) anxiety and depression felt by patients exposed to the PET, 2) comprehension of the methods and objectives of the examination, and 3) links between the contribution of information on the conduct and the object of this examination, the anxiety and depression felt by patients before and after the PET. Thirty cancer patients completed the same questionnaire four times: 1) one week before the PET, 2) just before the PET, 3) just before the consultation to receive the results, and 4) 15 days after the results notification. In addition to general information, these questionnaires dealt with level of anxiety (STAI), level of depression (CES-D) and the general comprehension of the methods and objectives of the PET. Overall, patients’ anxiety levels are generally increased, and this is irrespective of when the questionnaire is completed. Furthermore, patients are more anxious before the PET than during the consultation to receive the results and 15 days later. No effect was found for depression. The majority of patients considered they had received sufficient information about the examination, and correct response scores for the medical information questionnaire were high. Only three items were not really understood. Furthermore, anxiety, depression and medical information about the conduct and the object of this examination seem not to be related either before or after the PET.
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