Validation of the prognostic indices for the recurrence-free interval of patients with parotid ca... more Validation of the prognostic indices for the recurrence-free interval of patients with parotid carcinoma, the development of which was described in a previous report, is needed to be confident of their generalizability and justified prospective use. Cooperative Group on Head and Neck Cancer database contains 231 patients with parotid carcinoma from six tertiary referral centers who were seen between 1985-1994. This database was used to validate the predictive value of the prognostic indices, PS1 (pretreatment index predicting recurrence) and PS2 (posttreatment index predicting recurrence), in patients with parotid carcinoma. Validation methods included calculation of both indices for each patient, comparison of coefficients, construction of survival curves using the published cutoff points, and calculation of concordance measure C. Wald tests for optimization of scale and weights of the contributing variables, and for possible score improvement by including other variables, were also performed. The 5-year disease-free rate was 62% (standard error ϭ 4% ). PS1 was calculated for 183 patients. The previously set cutoff points resulted in 5-year diseasefree rates that ranged from 92% (PS1 ϭ 1) to 42% for the least favorable group (PS1 ϭ 4). Concordance measure C was 0.74. The postoperative score, PS2, was calculated for 171 patients. Previous cutoff points resulted in 5-year disease-free rates that ranged from 90% (PS2 ϭ 1) to 40% (PS2 ϭ 4). Concordance measure C was 0.71. Both PS1 and PS2 did not improve using the findings in this independent material. sample. This finding demonstrates that the prognosis of a parotid carcinoma patient can be quantified by using a weighted combination of the parameters of age, pain, clinical T (cT) classification, clinical N (cN) classification, skin invasion, facial nerve dysfunction, perineural growth, and involved surgical margins. A quantified prognosis, in terms of the recurrence-free interval, can be used to provide information to the patient, to perform clinical trials, and eventually to make clinical decisions. A user-friendly translation and computerized calculation of the indices should be the next step toward generalized prospective use and repetitive evaluation of the indices.
Tracheotomy : how to deal with it? Tracheotomy is one of the oldest surgical procedures and many ... more Tracheotomy : how to deal with it? Tracheotomy is one of the oldest surgical procedures and many different techniques are still in use. This guideline is focused on the indications, the choice of technique, open tracheotomy versus percutaneous tracheotomy, the complications, the materials and the management of the patient with a tracheotomy tube.
The tumors of the submaxillary gland are rare. The authors are reviewing 23 cases gathered from t... more The tumors of the submaxillary gland are rare. The authors are reviewing 23 cases gathered from three Departments over ten years. The tumors of the submaxillary gland are malignant in as many as 50% of all cases! When the lesion is benign, pleiomorphic adenoma is the most frequent possibility. The authors emphasize the necessity of early and complete surgical treatment, requiring at least total submaxillectomy in case of benign tumor. Cervical mode dissection will be considered if the tumor is malignant.
Breast lymphoma accounts for less than 1% of all non-Hodgkin'... more Breast lymphoma accounts for less than 1% of all non-Hodgkin's lymphomas and approximately 0.1% of all breast neoplasms. Most breast lymphomas are classified as diffuse large B-cell lymphomas or as mucosa associated lymphoid tissue lymphomas. Concurrent cases of breast lymphoma and cervical cancer are extremely rare. We report a case of a 46-year-old woman of unknown ethnic origin diagnosed with concurrent diffuse large B-cell lymphoma of the breast and squamous cell cancer of the cervix that was detected and followed with F-18 fluorodeoxyglucose (FDG) positron emission tomography and/or computed tomography (PET/CT). The metastatic pattern of this case of breast lymphoma is similar to that of a typical metastatic breast carcinoma. These findings have never been described in the literature. PET/CT also demonstrated an incidentally intense FDG focus in the uterine cervix ultimately leading to the pathologic diagnosis of squamous cell carcinoma of the uterine cervix. An appropriate...
The development of reconstructional techniques in cervico-facial surgery has led to the proposal ... more The development of reconstructional techniques in cervico-facial surgery has led to the proposal of surgical solutions, in conjunction with radiotherapy, for the extensive epidermoid carcinomas of the oropharynx and hypopharynx that were formerly rejected by the surgeon. However these stage III or IV epidermoid carcinomas carry a heavy proportion of "high" recurrences, i.e. situated in the parapharyngeal, oropharyngeal and rhinopharyngeal regions. The reasons for this are: the lymphatic continuity between the oro- and hypopharynx and the parapharyngeal regions and the base of the skull; the limitation of neck dissections higher up at the tip of the mastoid and the lower parotid border; the limitation of postoperative irradiation directed upwards. Therefore for these lesions we propose an extended therapeutic programme comprising pre-operative chemotherapy based on cisplatinum, bleomycin and methotrexate, an adequately wide surgical resection followed by reconstruction and an irradiation extending upwards by two lateral fields to the oropharynx, the rhinopharynx and the parapharynx.
Between July 1976 and July 1984, 1106 cold thyroid nodules have been operated on UCL. Teaching Ho... more Between July 1976 and July 1984, 1106 cold thyroid nodules have been operated on UCL. Teaching Hospital; 128 were diagnosed as carcinoma (11,5%) and 15 were diagnosed as medullary carcinoma of the thyroid gland (1,3% of all the cold nodules and 12% of all carcinomas of the thyroid). This article presents the case of two families exhibiting a characteristic clinical history of Medullary Carcinoma of the thyroid or CMT. The authors describe briefly the clinical signs; they point out that it is absolutely necessary to ask for a blood calcitonine level control in case of cold thyroid nodule or cervical lymphadenopathie. Once the diagnosis of Medullary Carcinoma of the thyroid gland is reached, screening of the Family, at least the first degree relatives should be undertaken, in order to reveal subclinical cases, which could be detected by laboratory investigations at an early subclinical stage. The treatment of the CMT is always surgery; it consists of total thyroidectomy with a modified neck dissection or a radical neck dissection, if lymph nodes are more than 3 cm or are fixed. Any way the recurrent nerve nodes have to be looked for, and if positive a Mediastinal lymph node dissection should be carried out. A control of the calcitonine hormone blood level should be asked for twice a year to detect any metastases or recurrence.
Objective: To propose national recommendations for the initial assessment of a mass in the neck i... more Objective: To propose national recommendations for the initial assessment of a mass in the neck in children. Methods: Comprehensive review of the available literature and consensus discussion with national experts in the field. Results: Consensus guidelines are proposed concerning the work up of children presenting with a mass in the neck.
The authors report their experience of three cases of carotid corpuscle tumors: two are bilateral... more The authors report their experience of three cases of carotid corpuscle tumors: two are bilateral and pertaining to the same family, one of them is associated with a bilateral tympano-jugular glomus. First they review the epidemiology and definitions of such tumors and then they develop the various clinical aspects and differential diagnosis of these tumors. They insist on the necessity of a CT scan examination and of an angiography. They give their experience of the preoperative embolization of the tumour vessels. They expose various aspects of the surgical technique, pointing out the interest of a large access, the need of a regular surgery and the necessary collaboration between head and neck surgeons and vascular surgeons. Finally they discuss the opportuneness to operate bilateral glomic tumors.
Primary cutaneous apocrine adenocarcinoma (PCAC) is an extremely rare neoplasm involving the swea... more Primary cutaneous apocrine adenocarcinoma (PCAC) is an extremely rare neoplasm involving the sweat glands. Due to a lack of cases, there is no consensus for the systemic treatment of locally advanced or metastatic PCAC. Anti‐androgen therapy may have activity in inoperable or metastatic PCAC with high androgen receptor (AR) expression.
Validation of the prognostic indices for the recurrence-free interval of patients with parotid ca... more Validation of the prognostic indices for the recurrence-free interval of patients with parotid carcinoma, the development of which was described in a previous report, is needed to be confident of their generalizability and justified prospective use. Cooperative Group on Head and Neck Cancer database contains 231 patients with parotid carcinoma from six tertiary referral centers who were seen between 1985-1994. This database was used to validate the predictive value of the prognostic indices, PS1 (pretreatment index predicting recurrence) and PS2 (posttreatment index predicting recurrence), in patients with parotid carcinoma. Validation methods included calculation of both indices for each patient, comparison of coefficients, construction of survival curves using the published cutoff points, and calculation of concordance measure C. Wald tests for optimization of scale and weights of the contributing variables, and for possible score improvement by including other variables, were also performed. The 5-year disease-free rate was 62% (standard error ϭ 4% ). PS1 was calculated for 183 patients. The previously set cutoff points resulted in 5-year diseasefree rates that ranged from 92% (PS1 ϭ 1) to 42% for the least favorable group (PS1 ϭ 4). Concordance measure C was 0.74. The postoperative score, PS2, was calculated for 171 patients. Previous cutoff points resulted in 5-year disease-free rates that ranged from 90% (PS2 ϭ 1) to 40% (PS2 ϭ 4). Concordance measure C was 0.71. Both PS1 and PS2 did not improve using the findings in this independent material. sample. This finding demonstrates that the prognosis of a parotid carcinoma patient can be quantified by using a weighted combination of the parameters of age, pain, clinical T (cT) classification, clinical N (cN) classification, skin invasion, facial nerve dysfunction, perineural growth, and involved surgical margins. A quantified prognosis, in terms of the recurrence-free interval, can be used to provide information to the patient, to perform clinical trials, and eventually to make clinical decisions. A user-friendly translation and computerized calculation of the indices should be the next step toward generalized prospective use and repetitive evaluation of the indices.
Tracheotomy : how to deal with it? Tracheotomy is one of the oldest surgical procedures and many ... more Tracheotomy : how to deal with it? Tracheotomy is one of the oldest surgical procedures and many different techniques are still in use. This guideline is focused on the indications, the choice of technique, open tracheotomy versus percutaneous tracheotomy, the complications, the materials and the management of the patient with a tracheotomy tube.
The tumors of the submaxillary gland are rare. The authors are reviewing 23 cases gathered from t... more The tumors of the submaxillary gland are rare. The authors are reviewing 23 cases gathered from three Departments over ten years. The tumors of the submaxillary gland are malignant in as many as 50% of all cases! When the lesion is benign, pleiomorphic adenoma is the most frequent possibility. The authors emphasize the necessity of early and complete surgical treatment, requiring at least total submaxillectomy in case of benign tumor. Cervical mode dissection will be considered if the tumor is malignant.
Breast lymphoma accounts for less than 1% of all non-Hodgkin'... more Breast lymphoma accounts for less than 1% of all non-Hodgkin's lymphomas and approximately 0.1% of all breast neoplasms. Most breast lymphomas are classified as diffuse large B-cell lymphomas or as mucosa associated lymphoid tissue lymphomas. Concurrent cases of breast lymphoma and cervical cancer are extremely rare. We report a case of a 46-year-old woman of unknown ethnic origin diagnosed with concurrent diffuse large B-cell lymphoma of the breast and squamous cell cancer of the cervix that was detected and followed with F-18 fluorodeoxyglucose (FDG) positron emission tomography and/or computed tomography (PET/CT). The metastatic pattern of this case of breast lymphoma is similar to that of a typical metastatic breast carcinoma. These findings have never been described in the literature. PET/CT also demonstrated an incidentally intense FDG focus in the uterine cervix ultimately leading to the pathologic diagnosis of squamous cell carcinoma of the uterine cervix. An appropriate...
The development of reconstructional techniques in cervico-facial surgery has led to the proposal ... more The development of reconstructional techniques in cervico-facial surgery has led to the proposal of surgical solutions, in conjunction with radiotherapy, for the extensive epidermoid carcinomas of the oropharynx and hypopharynx that were formerly rejected by the surgeon. However these stage III or IV epidermoid carcinomas carry a heavy proportion of "high" recurrences, i.e. situated in the parapharyngeal, oropharyngeal and rhinopharyngeal regions. The reasons for this are: the lymphatic continuity between the oro- and hypopharynx and the parapharyngeal regions and the base of the skull; the limitation of neck dissections higher up at the tip of the mastoid and the lower parotid border; the limitation of postoperative irradiation directed upwards. Therefore for these lesions we propose an extended therapeutic programme comprising pre-operative chemotherapy based on cisplatinum, bleomycin and methotrexate, an adequately wide surgical resection followed by reconstruction and an irradiation extending upwards by two lateral fields to the oropharynx, the rhinopharynx and the parapharynx.
Between July 1976 and July 1984, 1106 cold thyroid nodules have been operated on UCL. Teaching Ho... more Between July 1976 and July 1984, 1106 cold thyroid nodules have been operated on UCL. Teaching Hospital; 128 were diagnosed as carcinoma (11,5%) and 15 were diagnosed as medullary carcinoma of the thyroid gland (1,3% of all the cold nodules and 12% of all carcinomas of the thyroid). This article presents the case of two families exhibiting a characteristic clinical history of Medullary Carcinoma of the thyroid or CMT. The authors describe briefly the clinical signs; they point out that it is absolutely necessary to ask for a blood calcitonine level control in case of cold thyroid nodule or cervical lymphadenopathie. Once the diagnosis of Medullary Carcinoma of the thyroid gland is reached, screening of the Family, at least the first degree relatives should be undertaken, in order to reveal subclinical cases, which could be detected by laboratory investigations at an early subclinical stage. The treatment of the CMT is always surgery; it consists of total thyroidectomy with a modified neck dissection or a radical neck dissection, if lymph nodes are more than 3 cm or are fixed. Any way the recurrent nerve nodes have to be looked for, and if positive a Mediastinal lymph node dissection should be carried out. A control of the calcitonine hormone blood level should be asked for twice a year to detect any metastases or recurrence.
Objective: To propose national recommendations for the initial assessment of a mass in the neck i... more Objective: To propose national recommendations for the initial assessment of a mass in the neck in children. Methods: Comprehensive review of the available literature and consensus discussion with national experts in the field. Results: Consensus guidelines are proposed concerning the work up of children presenting with a mass in the neck.
The authors report their experience of three cases of carotid corpuscle tumors: two are bilateral... more The authors report their experience of three cases of carotid corpuscle tumors: two are bilateral and pertaining to the same family, one of them is associated with a bilateral tympano-jugular glomus. First they review the epidemiology and definitions of such tumors and then they develop the various clinical aspects and differential diagnosis of these tumors. They insist on the necessity of a CT scan examination and of an angiography. They give their experience of the preoperative embolization of the tumour vessels. They expose various aspects of the surgical technique, pointing out the interest of a large access, the need of a regular surgery and the necessary collaboration between head and neck surgeons and vascular surgeons. Finally they discuss the opportuneness to operate bilateral glomic tumors.
Primary cutaneous apocrine adenocarcinoma (PCAC) is an extremely rare neoplasm involving the swea... more Primary cutaneous apocrine adenocarcinoma (PCAC) is an extremely rare neoplasm involving the sweat glands. Due to a lack of cases, there is no consensus for the systemic treatment of locally advanced or metastatic PCAC. Anti‐androgen therapy may have activity in inoperable or metastatic PCAC with high androgen receptor (AR) expression.
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Papers by Marc Hamoir