Descriptor: "MESH: Neoplasm Staging" / Publication Year Range: Last 50 years - Searchworks@Jio Institute Digital Library Search Results

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168 results on '"MESH: Neoplasm Staging"'

1. First-line single-agent pembrolizumab for PD-L1-positive (tumor proportion score ≥ 50%) advanced non-small cell lung cancer in the real world: impact in brain metastasis: a national French multicentric cohort (ESCKEYP GFPC study)

Author: Renaud Descourt, Laurent Greillier, Maurice Perol, Charles Ricordel, Jean-Bernard Auliac, Lionel Falchero, Radj Gervais, Rémi Veillon, Sabine Vieillot, Florian Guisier, Marie Marcq, Grégoire Justeau, Laurence Bigay-Game, Marie Bernardi, Pierre Fournel, Hélène Doubre, Julian Pinsolle, Karim Amrane, Christos Chouaïd, Chantal Decroisette, Service d'Oncologie Thoracique (BREST - ICH), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Institut de cancérologie et hématologie, CHU Marseille, Aix Marseille Université (AMU), Hospices Civils de Lyon (HCL), Centre Léon Bérard [Lyon], Service de pneumologie [Rennes] = Pneumology [Rennes], CHU Pontchaillou [Rennes], CH, Mantes-La-Jolie, Centre Hospitalier de Villefranche sur Saône, Partenaires INRAE, Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN), CHU Bordeaux [Bordeaux], Catalan Institute of Oncology [Perpignan], Equipe Quantification en Imagerie Fonctionnelle (QuantIF-LITIS), Laboratoire d'Informatique, de Traitement de l'Information et des Systèmes (LITIS), Université Le Havre Normandie (ULH), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Université Le Havre Normandie (ULH), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA), Centre Hospitalier Départemental - Hôpital de La Roche-sur-Yon (CHD Vendée), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Institut de Cancérologie de la Loire Lucien Neuwirth, Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Hôpital Foch [Suresnes], Université Grenoble Alpes - UFR Médecine (UGA UFRM), Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), IMRB - CEPIA/'Clinical Epidemiology And Ageing : Geriatrics, Primary Care and Public Health' [Créteil] (U955 Inserm - UPEC), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), and Centre Hospitalier Annecy-Genevois [Saint-Julien-en-Genevois]
Subjects: safety, Cancer Research, geriatric assessment, efficacy, MESH: Neoplasms, Glandular and Epithelial, Immunology, [SDV.CAN]Life Sciences [q-bio]/Cancer, Guidelines, Thymic carcinoma, Non-small cell lung cancer, Chemotherapy, Immunology and Allergy, MESH: Cohort Studies, [STAT.AP]Statistics [stat]/Applications [stat.AP], Advanced stage, MESH: Humans, MESH: Thymoma, Radiotherapy, toxicity, Brain metastases, MESH: Retrospective Studies, Real-world study, MESH: Neoplasm Staging, targeted therapy, [INFO.INFO-MO]Computer Science [cs]/Modeling and Simulation, MESH: Prospective Studies, lung cancer, quality of life, Oncology, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, Surgery, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Pembrolizumab, [PHYS.PHYS.PHYS-DATA-AN]Physics [physics]/Physics [physics]/Data Analysis, Statistics and Probability [physics.data-an], MESH: Thymus Neoplasms
Abstract: Few real-world data are available in patients with advanced metastatic non-small cell lung cancer (NSCLC) treated with first-line immunotherapy, particularly in those with brain metastases at treatment initiation.This was a national, retrospective, multicenter study that consecutively included all patients with PD-L1-positive (tumor proportion score ≥ 50%) advanced NSCLC who initiated first-line treatment with pembrolizumab as a single agent between May 2017 (date of availability of pembrolizumab in this indication in France) to November 22, 2019 (approval of the pembrolizumab-chemotherapy combination). Data were collected from medical records with local response assessment.The cohort included 845 patients and 176 (20.8%) had brain metastases at diagnosis. There were no significant differences in outcomes for patients with and without brain metastases: 9.2 (95% CI 5.6-15) and 8 (95% CI 6.7-9.2, p = 0.3) months for median progression-free survival (PFS) and, 29.5 (95% CI 17.2-NA) and 22 (95% CI 17.8-27.1, p = 0.3) months for median overall survival (OS), respectively. Overall response rates were 47% and 45% in patients with and without cerebral metastases. In multivariate analysis, performance status 2-4 vs. 0-1 and neutrophil-to-lymphocyte ratio ≥ 4 vs. 4 were the main independent negative factors for OS; brain metastasis was not an independent factor for OS.In this large multicenter cohort, nearly 20% of patients initiating pembrolizumab therapy for advanced NSCLC had cerebral metastases. There was no significant difference in response rates, PFS and OS between patients with and without brain metastases.
Published: 2022

2. Size and Predictive Factors of Microscopic Tumor Extension in Locally Advanced Non-Small Cell Lung Cancer

Author: Nicolas Giraud, Claire Meynard, Catherine Durdux, Audrey Mansuet-Lupo, Armelle Guénégou-Arnoux, Diane Damotte, Geoffroy Boulle, P. Giraud, Paul Imbault, Antonio Bobbio, Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université de Paris (UP), Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), and HAL-SU, Gestionnaire
Subjects: medicine.medical_specialty, Lung Neoplasms, medicine.medical_treatment, Cell, Planning target volume, Locally advanced, Magnification, Adenocarcinoma, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, Computed Tomography, 0302 clinical medicine, Microscopic tumoral extension, Non-small cell lung cancer, Carcinoma, Non-Small-Cell Lung, Nodal status, Humans, Medicine, Radiology, Nuclear Medicine and imaging, Lung cancer, Conformal radiation therapy, Neoplasm Staging, Retrospective Studies, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, MESH: Humans, business.industry, MESH: Adenocarcinoma, MESH: Carcinoma, Squamous Cell, MESH: Retrospective Studies, MESH: Neoplasm Staging, medicine.disease, MESH: Lung Neoplasms, 3. Good health, Radiation therapy, medicine.anatomical_structure, Oncology, 030220 oncology & carcinogenesis, Carcinoma, Squamous Cell, Non small cell, Radiology, business, Clinical Target Volume, MESH: Carcinoma, Non-Small-Cell Lung, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; Purpose: Radiation therapy for locally advanced non-small cell lung cancer (NSCLC) should treat the whole tumor, including its microscopic extensions, and protect adjacent organs at risk as much as possible. The aim of our study is to evaluate the size of microscopic tumor extension (MEmax) in NSCLC, and search for potential predictive factors.Methods and materials: We retrospectively selected 70 patients treated with postoperative radiation therapy for a NSCLC with N2 nodal status, then 34 additional patients operated for a squamous cell lung cancer with N1 or N2 nodal status. On the digitized slides originating from the resected tumors of these 104 patients, we outlined the border of the tumor, as seen with the naked eye. We then searched for microscopic tumor extension outside of these borders with a magnification as high as 40 × and measured the maximum size of MEmax.Results: The median MEmax in the whole cohort was 0.85 mm (0-9.95). The MEmax was
Published: 2021

3. Nivolumab, nivolumab–ipilimumab, and VEGFR-tyrosine kinase inhibitors as first-line treatment for metastatic clear-cell renal cell carcinoma (BIONIKK): a biomarker-driven, open-label, non-comparative, randomised, phase 2 trial

Author: Yann-Alexandre Vano, Réza Elaidi, Mostefa Bennamoun, Christine Chevreau, Delphine Borchiellini, Diane Pannier, Denis Maillet, Marine Gross-Goupil, Christophe Tournigand, Brigitte Laguerre, Philippe Barthélémy, Elodie Coquan, Gwenaëlle Gravis, Nadine Houede, Mathilde Cancel, Olivier Huillard, Philippe Beuzeboc, Laure Fournier, Arnaud Méjean, Xavier Cathelineau, Nicolas Doumerc, Philippe Paparel, Jean-Christophe Bernhard, Alexandre de la Taille, Karim Bensalah, Thibault Tricard, Thibaut Waeckel, Géraldine Pignot, Elena Braychenko, Stefano Caruso, Cheng-Ming Sun, Virginie Verkarre, Guillaume Lacroix, Marco Moreira, Maxime Meylan, Antoine Bougouïn, Letuan Phan, Christelle Thibault-Carpentier, Jessica Zucman-Rossi, Wolf Herman Fridman, Catherine Sautès-Fridman, Stéphane Oudard, Cancer Research and Personalized Medicine - CARPEM [Paris], Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Association pour la Recherche de Thérapeutiques Innovantes en Cancérologie [Paris] (ARTIC), Institut Mutualiste de Montsouris (IMM), Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Lutte contre le Cancer Antoine Lacassagne [Nice] (UNICANCER/CAL), UNICANCER-Université Côte d'Azur (UCA), Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille), Université de Lille-UNICANCER, Service d'Oncologie Médicale [Centre hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Hôpital Saint-André, Hôpital Henri Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre Eugène Marquis (CRLCC), Institut de Cancérologie de Strasbourg Europe (ICANS), Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN), Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Centre de Recherche en Cancérologie de Marseille (CRCM), Aix Marseille Université (AMU)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut de Cancérologie du GARD ICG - CHU Nîmes (Instit Cancéro - GARD), Clinique d'Oncologie et de Radiothérapie [Tours] (CORAD), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau, Hôpital Foch [Suresnes], Service des Explorations Fonctionnelles Physiologiques [CHU Toulouse], Pôle Urologie - Néphrologie - Dialyse - Transplantations - Brûlés - Chirurgie plastique - Explorations fonctionnelles et physiologiques [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Hospices Civils de Lyon (HCL), Nouvel Hôpital Civil de Strasbourg, Service de Néphrologie-Dialyse-Transplantation rénale [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)
Subjects: MESH: Humans, MESH: Carcinoma, Renal Cell / drug therapy, MESH: Angiogenesis Inhibitors / adverse effects, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH: Neoplasm Staging, MESH: Male, MESH: Prospective Studies, MESH: Ipilimumab, MESH: Lipase, Oncology, MESH: Tumor Microenvironment, MESH: Sunitinib, MESH: Biomarkers, MESH: Antineoplastic Combined Chemotherapy Protocols / adverse effects, MESH: Female, MESH: Nivolumab / adverse effects, MESH: Protein Kinase Inhibitors / adverse effects
Abstract: International audience; Background: We previously reported a 35-gene expression classifier identifying four clear-cell renal cell carcinoma groups (ccrcc1 to ccrcc4) with different tumour microenvironments and sensitivities to sunitinib in metastatic clear-cell renal cell carcinoma. Efficacy profiles might differ with nivolumab and nivolumab-ipilimumab. We therefore aimed to evaluate treatment efficacy and tolerability of nivolumab, nivolumab-ipilimumab, and VEGFR-tyrosine kinase inhibitors (VEGFR-TKIs) in patients according to tumour molecular groups.Methods: This biomarker-driven, open-label, non-comparative, randomised, phase 2 trial included patients from 15 university hospitals or expert cancer centres in France. Eligible patients were aged 18 years or older, had an Eastern Cooperative Oncology Group performance status of 0-2, and had previously untreated metastatic clear-cell renal cell carcinoma. Patients were randomly assigned (1:1) using permuted blocks of varying sizes to receive either nivolumab or nivolumab-ipilimumab (ccrcc1 and ccrcc4 groups), or either a VEGFR-TKI or nivolumab-ipilimumab (ccrcc2 and ccrcc3 groups). Patients assigned to nivolumab-ipilimumab received intravenous nivolumab 3 mg/kg plus ipilimumab 1 mg/kg every 3 weeks for four doses followed by intravenous nivolumab 240 mg every 2 weeks. Patients assigned to nivolumab received intravenous nivolumab 240 mg every 2 weeks. Patients assigned to VEGFR-TKIs received oral sunitinib (50 mg/day for 4 weeks every 6 weeks) or oral pazopanib (800 mg daily continuously). The primary endpoint was the objective response rate by investigator assessment per Response Evaluation Criteria in Solid Tumors version 1.1. The primary endpoint and safety were assessed in the population who received at least one dose of study drug. This trial is registered with ClinicalTrials.gov, NCT02960906, and with the EU Clinical Trials Register, EudraCT 2016-003099-28, and is closed to enrolment.Findings: Between June 28, 2017, and July 18, 2019, 303 patients were screened for eligibility, 202 of whom were randomly assigned to treatment (61 to nivolumab, 101 to nivolumab-ipilimumab, 40 to a VEGFR-TKI). In the nivolumab group, two patients were excluded due to a serious adverse event before the first study dose and one patient was excluded from analyses due to incorrect diagnosis. Median follow-up was 18·0 months (IQR 17·6-18·4). In the ccrcc1 group, objective responses were seen in 12 (29%; 95% CI 16-45) of 42 patients with nivolumab and 16 (39%; 24-55) of 41 patients with nivolumab-ipilimumab (odds ratio [OR] 0·63 [95% CI 0·25-1·56]). In the ccrcc4 group, objective responses were seen in seven (44%; 95% CI 20-70) of 16 patients with nivolumab and nine (50% 26-74) of 18 patients with nivolumab-ipilimumab (OR 0·78 [95% CI 0·20-3·01]). In the ccrcc2 group, objective responses were seen in 18 (50%; 95% CI 33-67) of 36 patients with a VEGFR-TKI and 19 (51%; 34-68) of 37 patients with nivolumab-ipilimumab (OR 0·95 [95% CI 0·38-2·37]). In the ccrcc3 group, no objective responses were seen in the four patients who received a VEGFR-TKI, and in one (20%; 95% CI 1-72) of five patients who received nivolumab-ipilimumab. The most common treatment-related grade 3-4 adverse events were hepatic failure and lipase increase (two [3%] of 58 for both) with nivolumab, lipase increase and hepatobiliary disorders (six [6%] of 101 for both) with nivolumab-ipilimumab, and hypertension (six [15%] of 40) with a VEGFR-TKI. Serious treatment-related adverse events occurred in two (3%) patients in the nivolumab group, 38 (38%) in the nivolumab-ipilimumab group, and ten (25%) patients in the VEGFR-TKI group. Three deaths were treatment-related: one due to fulminant hepatitis with nivolumab-ipilimumab, one death from heart failure with sunitinib, and one due to thrombotic microangiopathy with sunitinib.Interpretation: We demonstrate the feasibility and positive effect of a prospective patient selection based on tumour molecular phenotype to choose the most efficacious treatment between nivolumab with or without ipilimumab and a VEGFR-TKI in the first-line treatment of metastatic clear-cell renal cell carcinoma.
Published: 2022

4. Switch maintenance chemotherapy versus observation after carboplatin and weekly paclitaxel doublet chemotherapy in elderly patients with advanced non–small cell lung cancer: IFCT-1201 MODEL trial

Author: Didier Debieuvre, Pierre-Jean Souquet, Jean-Louis Pujol, Jérôme Dauba, Jeannick Madelaine, Olivier Molinier, J. Otto, Jacques Le Treut, Fabrice Barlesi, Elisabeth Quoix, Patrick Aldo Renault, Eric Pichon, Alexandra Langlais, Virginie Westeel, L. Moreau, Franck Morin, Jacques Margery, Clarisse Audigier-Valette, Armelle Lavolé, Patrick Dumont, Denis Moro-Sibilot, CHU Strasbourg, Centre Hospitalier Intercommunal Toulon-La Seyne sur Mer - Hôpital Sainte-Musse, CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Le Mans (CH Le Mans), Service de Pneumologie, oncologie thoracique et allergologie respiratoire [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre de Recherche en Cancérologie de Marseille (CRCM), Aix Marseille Université (AMU)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier du Pays d'Aix, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre Hospitalier Layné, Université Côte d'Azur (UCA), Hôpital pasteur [Colmar], Service de pneumologie [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Hospitalier de Chauny, Partenaires INRAE, Hôpital d'instruction des Armées Percy, Service de Santé des Armées, Groupe hospitalier de la région de Mulhouse Sud-Alsace (GHRMSA), Centre hospitalier de Pau, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Intergroupe Francophone de Cancérologie Thoracique [Paris] (IFCT), Intergroupe Francophone de Cancérologie thoracique, CHU Grenoble, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Service de Pneumologie - Oncologie Thoracique - Maladies Pulmonaires Rares [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Aix Marseille Université (AMU), and Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS)
Subjects: Male, 0301 basic medicine, Oncology, Cancer Research, Lung Neoplasms, Time Factors, medicine.medical_treatment, NSCLC, Deoxycytidine, Carboplatin, chemistry.chemical_compound, Elderly, MESH: Aged, 80 and over, 0302 clinical medicine, Maintenance therapy, MESH: Progression-Free Survival, MESH: Carboplatin, Carcinoma, Non-Small-Cell Lung, Antineoplastic Combined Chemotherapy Protocols, Aged, 80 and over, MESH: Aged, MESH: Antimetabolites, Antineoplastic, Drug Substitution, Age Factors, MESH: Neoplasm Staging, Progression-Free Survival, 3. Good health, MESH: Maintenance Chemotherapy, MESH: Antineoplastic Combined Chemotherapy Protocols, Pemetrexed, 030220 oncology & carcinogenesis, Disease Progression, Female, MESH: Disease Progression, France, medicine.drug, Antimetabolites, Antineoplastic, medicine.medical_specialty, Paclitaxel, Maintenance, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH: Drug Administration Schedule, Drug Administration Schedule, Maintenance Chemotherapy, 03 medical and health sciences, Internal medicine, medicine, Carcinoma, Humans, Chemotherapy, MESH: Paclitaxel, MESH: Pemetrexed, Lung cancer, Aged, Neoplasm Staging, MESH: Age Factors, MESH: Humans, Performance status, business.industry, MESH: Time Factors, MESH: Deoxycytidine, medicine.disease, Gemcitabine, MESH: Drug Substitution, MESH: Male, MESH: Lung Neoplasms, MESH: France, 030104 developmental biology, chemistry, business, MESH: Female, MESH: Carcinoma, Non-Small-Cell Lung
Abstract: International audience; Purpose: Maintenance chemotherapy is a reasonable choice for patients with metastatic non-small cell lung carcinoma (NSCLC) not progressing after induction therapy with a platinum-based doublet. Nevertheless, there have been no studies dedicated to elderly patients.Patients and methods: We conducted a randomised trial in patients aged 70-89 years, with advanced NSCLC (with neither EGFR mutation nor ALK rearrangement), who had not progressed after four cycles of monthly carboplatin and weekly paclitaxel in order to compare maintenance with either pemetrexed (500 mg/m2 d1, 22) in patients with non-squamous cell carcinoma or gemcitabine (1,150 mg/m2 d1, 8, 22) in squamous cell carcinoma to simple observation. The patients were required to have a performance status (PS) 0-2, mini-mental score >23, and creatinine clearance ≥45 mL/min. The primary end-point was overall survival (OS).Results: 632 patients were enrolled from May 2013 to October 2016. Of the 328 (52.3%) patients randomised after induction therapy, 166 patients were assigned to the observation arm, versus 162 to the switch maintenance arm, 119 of whom received pemetrexed and 43 gemcitabine. The median OS from randomisation was 14.1 months (95% confidence interval [CI]: 12.0-17.0) in the observation arm and 14 months (95% CI: 10.9-16.9) in the maintenance arm (p = 0.72). The median progression-free survival (PFS) from randomisation was 2.7 months (95% CI: 2.6-3.1) in the observation arm versus 5.7 months (95% CI: 4.8-7.1) in the maintenance arm (p < 0.001).Conclusion: Switch maintenance therapy significantly prolonged PFS but not OS and, thus, should not be proposed to elderly patients with advanced NSCLC.
Published: 2020

5. Radiotherapy for laryngeal cancers

Author: J. Biau, Y. Pointreau, P. Blanchard, C. Khampan, P. Giraud, M. Lapeyre, P. Maingon, Imagerie Moléculaire et Stratégies Théranostiques (IMoST), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne (UCA)
Subjects: MESH: Radiation-Sensitizing Agents, Radiation-Sensitizing Agents, Intensity-modulated radiotherapy, Recommandations, MESH: Laryngeal Neoplasms, Laryngectomy, [SDV.CAN]Life Sciences [q-bio]/Cancer, Radiothérapie conformationnelle avec modulation d’intensité, Recommendations, MESH: Postoperative Care, Doses, Délinéation, Humans, Radiology, Nuclear Medicine and imaging, Laryngeal Neoplasms, Neoplasm Staging, Postoperative Care, MESH: Humans, MESH: Organ Sparing Treatments, Larynx cancer, Induction Chemotherapy, Delineation, MESH: Radiotherapy, Intensity-Modulated, MESH: Neoplasm Staging, MESH: Laryngectomy, MESH: Radiation Oncology, MESH: Induction Chemotherapy, Indication, MESH: France, Tumeurs laryngée, Oncology, MESH: Cisplatin, Dose, Radiation Oncology, Dose Fractionation, Radiation, France, Radiotherapy, Intensity-Modulated, Cisplatin, Indications, MESH: Dose Fractionation, Radiation, Tomography, X-Ray Computed, MESH: Tomography, X-Ray Computed, Organ Sparing Treatments, MESH: Radiotherapy, Image-Guided, Radiotherapy, Image-Guided, Société française de radiothérapie oncologique
Abstract: International audience; We present the update of the recommendations of the French society of oncological radiotherapy on radiotherapy of laryngeal cancers. Intensity modulated radiotherapy is the standard of care radiotherapy for the management of laryngeal cancers. Early stage T1 or T2 tumours can be treated either by radiotherapy or conservative surgery. For tumours requiring total laryngectomy (T2 or T3), an organ preservation strategy by either induction chemotherapy followed by radiotherapy or chemoradiotherapy with cisplatin is recommended. For T4 tumours, a total laryngectomy followed by radiotherapy is recommended when feasible. Dose regimens for definitive and postoperative radiotherapy are detailed in this article, as well as the selection and delineation of tumour and lymph node target volumes.
Published: 2022

6. Quality of Life During Chemotherapy for Breast Cancer in a West African Population in Dakar, Senegal: A Prospective Study

Author: Mamadou Diop, Papa Massamba Diene, Ahmadou Dem, Anthony Gonçalves, Mouhamadou Ba, Audrey Monneur, Pierre Annede, Domitille Dano, Ousseynou Sarr, Ibrahima Thiam, Patricia Marino, Awa Sadikh Badiane, Kanta Ka, Doudou Diouf, Julien Mancini, Clémence Hénon, Dupuis, Christine, Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Institut Gustave Roussy (IGR), Biomarqueurs prédictifs et nouvelles stratégies moléculaires en thérapeutique anticancéreuse (U981), Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Aristide Le Dantec Hospital [Dakar, Senegal], Aix Marseille Université (AMU), and Hôpital de la Timone [CHU - APHM] (TIMONE)
Subjects: Cancer Research, Pediatrics, medicine.medical_treatment, [SDV]Life Sciences [q-bio], MESH: Nausea, MESH: Linear Models, 0302 clinical medicine, Quality of life, MESH: Vomiting, Surveys and Questionnaires, Original Report, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, MESH: Treatment Outcome, education.field_of_study, MESH: Middle Aged, Nausea, MESH: Neoplasm Staging, Middle Aged, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Senegal, 3. Good health, [SDV] Life Sciences [q-bio], West african, Treatment Outcome, Oncology, 030220 oncology & carcinogenesis, Female, Adult, medicine.medical_specialty, Vomiting, Population, MEDLINE, Antineoplastic Agents, Breast Neoplasms, lcsh:RC254-282, 03 medical and health sciences, MESH: Drug Therapy, Breast cancer, Drug Therapy, MESH: Senegal, medicine, Humans, MESH: Surveys and Questionnaires, education, Neoplasm Staging, Chemotherapy, MESH: Humans, business.industry, MESH: Quality of Life, MESH: Adult, medicine.disease, MESH: Prospective Studies, Linear Models, Quality of Life, MESH: Antineoplastic Agents, Neoplasm staging, business, MESH: Female, MESH: Breast Neoplasms
Abstract: PURPOSE The prevalence of breast cancer is increasing in low- to middle-income countries such as Senegal. Our prospective study assessed the quality of life (QoL) of patients with breast cancer undergoing chemotherapy in Senegal. PATIENTS AND METHODS Our study included women with breast cancer undergoing chemotherapy as initial treatment at the Center Aristide Le Dantec University Hospital in Dakar. Clinical, sociodemographic, and QoL data were collected and analyzed at three different times: baseline, 3 months, and 6 months after the start of systemic therapy. Health-related QoL was assessed using a Functional Assessment of Cancer Therapies-Breast (FACT-B) questionnaire after translation into the Wolof language. Linear mixed-effects models were performed to assess the changes in QoL scores. RESULTS Between July 2017 and February 2018, 120 patients were included in the study. Their median age was 45 years. Most patients (n = 105; 92%) had locally advanced disease (T3 to T4 stage) and lymph node involvement (n = 103; 88%), and half had metastatic disease. The FACT-B total scores significantly improved over time (β = 1.58; 95% CI, 0.50 to 2.67; P < .01). Nausea and vomiting were significantly associated with a decrease in FACT-B total scores (β = −16.89, 95% CI, −29.58 to −4.24, P = .012; and β = −13.44, 95% CI, −25.15 to −1.72, P = .028, respectively). CONCLUSION Our study confirmed the feasibility of standardized QoL assessment in Senegalese patients with breast cancer. Our results indicated a potential improvement of QoL over the course of chemotherapy. Optimizing nausea and vomiting prevention may improve QoL.
Published: 2019

7. Early and late morbidity of local excision after chemoradiotherapy for rectal cancer

Author: A. Valverde, Eric Rullier, M. Capdepont, B Lelong, F. Marchal, G. Portier, Jean-Luc Faucheron, M. Rivoire, Philippe Rouanet, M. Jafari, B. Meunier, B Teste, M Prudhomme, Quentin Denost, I Sielezneff, Jean-Jacques Tuech, A. Dubois, Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], UNICANCER - Institut régional du Cancer Montpellier Val d'Aurelle (ICM), CRLCC Val d'Aurelle - Paul Lamarque, Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU), Groupe Hospitalier Diaconesses Croix Saint-Simon, Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Centre Léon Bérard [Lyon], Hôpital Michallon, Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille), Université de Lille-UNICANCER, Chirurgie Générale et Digestive [Purpan], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CHU Pontchaillou [Rennes], Hôpital de la Timone [CHU - APHM] (TIMONE), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] (UNICANCER/ICL), UNICANCER, Hôpital Hôtel-Dieu de Clermont-Ferrand, and CHU Clermont-Ferrand
Subjects: Local excision, medicine.medical_specialty, AcademicSubjects/MED00910, Colorectal cancer, medicine.medical_treatment, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, 030230 surgery, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Humans, Medicine, Neoadjuvant therapy, Neoplasm Staging, MESH: Chemoradiotherapy, MESH: Treatment Outcome, MESH: Humans, Rectal Neoplasms, business.industry, MESH: Rectal Neoplasms, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Chemoradiotherapy, MESH: Neoplasm Staging, General Medicine, medicine.disease, Total mesorectal excision, Surgical morbidity, Surgery, Treatment Outcome, MESH: Morbidity, 030220 oncology & carcinogenesis, Original Article, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, sense organs, Morbidity, AcademicSubjects/MED00010, business, Neoadjuvant chemoradiotherapy
Abstract: Background Local excision (LE) after chemoradiotherapy is a new option in low rectal cancer, but morbidity has never been compared prospectively with total mesorectal excision (TME). Early and late morbidity were compared in patients treated either by LE or TME after neoadjuvant chemoradiotherapy for rectal cancer. Method This was a post-hoc analysis from a randomized trial. Patients with clinical T2/T3 low rectal cancer with good response to the chemoradiotherapy and having either LE, LE with eventual completion TME, or TME were considered. Early (1 month) and late (2 years) morbidities were compared between the three groups. Results There were no deaths following surgery in any of the three groups. Early surgical morbidity (20 per cent LE versus 36 per cent TME versus 43 per cent completion TME, P = 0.025) and late surgical morbidity (4 per cent versus 33 per cent versus 57 per cent, P Conclusion The rate of surgical complications after neoadjuvant chemoradiotherapy in the LE group was half that of TME group at 1 month and 10 times lower at 2 years. LE is a safe approach for organ preservation and should be considered as an alternative to watch-and-wait in complete clinical responders and to TME in subcomplete responders.
Published: 2021

8. Adjuvant pembrolizumab versus placebo in resected stage III melanoma (EORTC 1325-MG/KEYNOTE-054): distant metastasis-free survival results from a double-blind, randomised, controlled, phase 3 trial

Author: Christoph Hoeller, Marie-Francoise Avril, Pietro Quaglino, François Aubin, Lars Bastholt, Takashi Inozume, Virginia Ferraresi, Michael B. Jameson, Kevin B. Kim, Oliver Bechter, Dirk Schadendorf, Kenji Yokota, Carmen Loquai, Maria-Jose Passos, Inge Marie Svane, Michele Maio, Catherine Barrow, Frank Meiss, Nageatte Ibrahim, Andrzej Mackiewicz, Phillip Parente, Tatsuya Takenouchi, Caroline Dutriaux, Piotr Rutkowski, Alfonsus J M van den Eertwegh, Paola Queirolo, Catriona M. McNeil, Peter Mohr, Felix Kiecker, Susana Puig, Friedegund Meier, Lutz Kretschmer, Alexander C.J. van Akkooi, Alex Menzies, Timothy Crook, Christian U. Blank, Suzana Matkovic, Michael C. Brown, Ragini R. Kudchadkar, Max Levin, Rüdiger Hein, Tanja Skytta, Gerald P. Linette, Clemens Krepler, Adnan Khattak, Ernest Marshall, Joseph Kerger, Oddbjorn Straume, Laurent Mortier, Jochen Utikal, Micaela Hernberg, James Larkin, Yoshio Kiyohara, Mario Mandalà, Henrik Schmidt, Daniil Stroyakovskiy, Pablo Luis Ortiz Romero, Naoya Yamazaki, John Walker, Anna Maria Di Giacomo, Lionel Geoffrois, Jean-Philippe Lacour, Caroline Robert, Vincent Descamps, Shahneen Sandhu, Gil Bar-Sela, Paul C. Nathan, Marcin Dzienis, Ralf Gutzmer, Claus Garbe, Andrey Meshcheryakov, Patrick Combemale, Martin Fehr, Guzel Mukhametshina, Helena Kapiteijn, Geke A. P. Hospers, Jun Aoi, Andrew Haydon, Rutger H. T. Koornstra, Marie-Thérèse Leccia, Sigrun Hallmeyer, Pier Francesco Ferrucci, Jean-Jacques Grob, Leonel Hernandez-Aya, Jan-Christoph Simon, Vanna Chiarion Sileni, Alain Algazi, Lidija Sekulovic, Sandrine Marreaud, Bernard Fitzharris, Jacob Schachter, Xinni Song, Wolf-Henning Boehncke, Rahima Jamal, Paul Lorigan, Maureen J.B. Aarts, Reinhard Dummer, Mike McCrystal, César Martins, Reiner Hofmann-Wellenhof, Alexander M.M. Eggermont, Carola Berking, Elaine Dunwoodie, Bernard Guillot, Michal Kicinski, Philippe Saiag, Céleste Lebbé, Thierry Lesimple, Stefan Suciu, Michal Lotem, Paula Ferreira, Mohammed M. Milhem, Laurent Machet, Patrick Terheyden, Anna Katharina Winge-Main, Peter Hersey, Jean-Francois Baurain, Axel Hauschild, Stéphane Dalle, Jean-Philippe Arnault, Paolo A. Ascierto, Gerard Groenewegen, Florent Grange, Georgina V. Long, Victoria Atkinson, Philippa Corrie, Matteo S. Carlino, Thomas Jouary, Daniel Hendler, Richard Casasola, Ashita Waterston, Jessica C. Hassel, University Medical Center [Utrecht], Azienda Ospedaliera Ospedale Papa Giovanni XXIII [Bergamo, Italy], The University of Sydney, Princess Alexandra Hospital, Brisbane, University of Queensland [Brisbane], Centre Léon Bérard [Lyon], Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), N.N. Blokhin National Medical Research Center of Oncology, Edith Cowan University (ECU), Royal Marsden NHS Foundation Trust, Universitat de Barcelona (UB), Instituto de Salud Carlos III [Madrid] (ISC), Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology (MCMCC), Universitätsklinikum Essen [Universität Duisburg-Essen] (Uniklinik Essen), Radboud University Medical Center [Nijmegen], Washington University School of Medicine in St. Louis, Washington University in Saint Louis (WUSTL), University Hospital of Siena, Amsterdam UMC - Amsterdam University Medical Center, Hôpital de la Timone [CHU - APHM] (TIMONE), Centre de Recherche en Cancérologie de Marseille (CRCM), Aix Marseille Université (AMU)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hannover Medical School [Hannover] (MHH), Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal (UdeM), The Christie NHS Foundation Trust [Manchester, Royaume-Uni], Merck & Co. Inc, European Organisation for Research and Treatment of Cancer [Bruxelles] (EORTC), European Cancer Organisation [Bruxelles] (ECCO), Institut Gustave Roussy (IGR), Oncologie dermatologique, Département de médecine oncologique [Gustave Roussy], Institut Gustave Roussy (IGR)-Institut Gustave Roussy (IGR), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université de Montpellier (UM), Internal medicine, and CCA - Cancer Treatment and quality of life
Subjects: Male, Skin Neoplasms, Medizin, Pembrolizumab, law.invention, Cancer development and immune defence Radboud Institute for Health Sciences [Radboudumc 2], MESH: Aged, 80 and over, 0302 clinical medicine, Randomized controlled trial, law, Monoclonal, 80 and over, MESH: Double-Blind Method, 030212 general & internal medicine, Neoplasm Metastasis, Humanized, Melanoma, MESH: Aged, Aged, 80 and over, education.field_of_study, MESH: Middle Aged, Hazard ratio, MESH: Neoplasm Staging, Middle Aged, Oncology, 030220 oncology & carcinogenesis, Female, Adult, Aged, Antibodies, Monoclonal, Humanized, Double-Blind Method, Humans, Neoplasm Staging, medicine.medical_specialty, MESH: Melanoma, Population, [SDV.CAN]Life Sciences [q-bio]/Cancer, Placebo, Antibodies, 03 medical and health sciences, All institutes and research themes of the Radboud University Medical Center, Internal medicine, medicine, Adjuvant therapy, education, Cancer staging, MESH: Humans, business.industry, MESH: Skin Neoplasms, MESH: Adult, MESH: Neoplasm Metastasis, MESH: Male, Clinical trial, MESH: Antibodies, Monoclonal, Humanized, business, MESH: Female
Abstract: Background: The European Organisation for Research and Treatment of Cancer (EORTC) 1325/KEYNOTE-054 trial assessed pembrolizumab versus placebo in patients with resected high-risk stage III melanoma. At 15-month median follow-up, pembrolizumab improved recurrence-free survival (hazard ratio [HR] 0·57 [98·4% CI 0·43–0·74], p1 mm), IIIB, or IIIC (without in-transit metastasis), and with an Eastern Cooperative Oncology Group performance status of 0 or 1 were eligible. Patients were randomly assigned (1:1) via a central interactive voice response system to receive intravenous pembrolizumab 200 mg or placebo every 3 weeks for up to 18 doses or until disease recurrence or unacceptable toxicity. Randomisation was stratified according to disease stage and region, using a minimisation technique, and clinical investigators, patients, and those collecting or analysing the data were masked to treatment assignment. The two coprimary endpoints were recurrence-free survival in the intention-to-treat (ITT) population and in patients with PD-L1-positive tumours. The secondary endpoint reported here was distant metastasis-free survival in the ITT and PD-L1-positive populations. This study is registered with ClinicalTrials.gov, NCT02362594, and EudraCT, 2014-004944-37. Findings: Between Aug 26, 2015, and Nov 14, 2016, 1019 patients were assigned to receive either pembrolizumab (n=514) or placebo (n=505). At an overall median follow-up of 42·3 months (IQR 40·5–45·9), 3·5-year distant metastasis-free survival was higher in the pembrolizumab group than in the placebo group in the ITT population (65·3% [95% CI 60·9–69·5] in the pembrolizumab group vs 49·4% [44·8–53·8] in the placebo group; HR 0·60 [95% CI 0·49–0·73]; p
Published: 2021

9. Adjuvant pembrolizumab versus placebo in resected stage III melanoma (EORTC 1325-MG/KEYNOTE-054): health-related quality-of-life results from a double-blind, randomised, controlled, phase 3 trial

Author: Bottomley, A., Coens, C., Mierzynska, J., Blank, C. U., Mandalà, M., Long, G. V., Atkinson, V. G., Dalle, S., Haydon, A. M., Meshcheryakov, A., Khattak, A., Carlino, M. S., Sandhu, S., Puig, S., Ascierto, P. A., Larkin, J., Lorigan, P. C., Rutkowski, P., Schadendorf, D., Koornstra, R., Hernandez-Aya, L., Di Giacomo, A. M., van den Eertwegh, A. J. M., Grob, J. -J., Gutzmer, R., Jamal, R., van Akkooi, A. C. J., Krepler, C., Ibrahim, N., Marreaud, S., Kicinski, M., Suciu, S., Robert, C., Eggermont, A. M. M., EORTC Melanoma Group, Lesimple, T., Maio, M., Linette, G., Mortier, L., Svane, I. M., Schachter, J., Brown, M., Hersey, P., Barrow, C., Kudchadkar, R., Dutriaux, C., Song, X., Quaglino, P., Queirolo, P., Meier, F., Stroyakovskiy, D., Guillot, B., Romero, P. L. O., Bastholt, L., Garbe, C., Grange, F., Mohr, P., Algazi, A., Bechter, O., Hernberg, M., Loquai, C., Meiss, F., Chiarion Sileni, V., Bar-Sela, G., Fitzharris, B., Saiag, P., Arnault, J. -P., Simon, J. -C., Stephens, R., Baurain, J. -F., Lebbe, C., Combemale, P., Dummer, R., Hauschild, A., Parente, P., Yamazaki, N., Milhem, M., Leccia, M. -T., Geoffrois, L., Kretschmer, L., Dunwoodie, E., Walker, J., Lotem, M., Hendler, D., Mackiewicz, A., Sekulovic, L., Dzienis, M., Hospers, G. A. P., Siano, M., Hassel, J., Corrie, P., Passos, M. -J., Levin, M., Hoeller, C., Machet, L., Hallmeyer, S., Waterston, A., Descamps, V., Kiecker, F., Aarts, M., Schmidt, H., Raimundo, A., Nyakas, M., Lacour, J. -P., Berking, C., Ferrucci, P. F., Jameson, M., Kim, K., Yokota, K., Kerger, J., Aubin, F., Groenewegen, G., Kapiteijn, H., Boehncke, W. -H., Utikal, J., Casasola, R., Marshall, E., Ferraresi, V., Richtig, E., Matkovic, S., Inozume, T., Crook, T., Mcneil, C., Kiyohara, Y., Avril, M. -F., Hein, R., Terheyden, P., Nathan, P., Aoi, J., Skytta, T., Jouary, T., Takenouchi, T., Straume, O., Martins, C., Mukhametshina, G., Boehncke, Wolf-Henning, Internal medicine, CCA - Cancer Treatment and quality of life, European Organisation for Research and Treatment of Cancer [Bruxelles] (EORTC), European Cancer Organisation [Bruxelles] (ECCO), Ospedale 'Santa Maria della Misericordia' = University Hospital 'Santa Maria della Misericordia', The University of Sydney, Princess Alexandra Hospital, Brisbane, University of Queensland [Brisbane], Centre Léon Bérard [Lyon], Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Edith Cowan University (ECU), Universitat de Barcelona (UB), The Christie NHS Foundation Trust [Manchester, Royaume-Uni], Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology (MCMCC), Radboud University Medical Center [Nijmegen], Washington University School of Medicine in St. Louis, Washington University in Saint Louis (WUSTL), University Hospital of Siena, Amsterdam UMC - Amsterdam University Medical Center, Hôpital de la Timone [CHU - APHM] (TIMONE), Centre de Recherche en Cancérologie de Marseille (CRCM), Aix Marseille Université (AMU)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hannover Medical School [Hannover] (MHH), Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal (UdeM), Merck & Co. Inc, AP-HP. Université Paris Saclay, Institut Gustave Roussy (IGR), University Medical Center [Utrecht], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université de Montpellier (UM), Merck Sharp & Dohme., and Guided Treatment in Optimal Selected Cancer Patients (GUTS)
Subjects: Male, Skin Neoplasms, Medizin, Skin Neoplasms / drug therapy, Pembrolizumab, law.invention, Cancer development and immune defence Radboud Institute for Health Sciences [Radboudumc 2], MESH: Aged, 80 and over, 0302 clinical medicine, Melanoma / pathology, Randomized controlled trial, law, Monoclonal, 80 and over, Clinical endpoint, MESH: Double-Blind Method, 030212 general & internal medicine, Humanized, Melanoma, MESH: Aged, ddc:616, Aged, 80 and over, education.field_of_study, MESH: Middle Aged, Antibodies, Monoclonal, Humanized, Neoplasm Staging, Quality of Life, Double-Blind Method, Adult, Aged, Middle aged, Humans [MeSH], Hazard ratio, MESH: Neoplasm Staging, Middle Aged, Oncology, 030220 oncology & carcinogenesis, Female, Humans, medicine.medical_specialty, Melanoma / psychology, Skin Neoplasms / psychology, MESH: Melanoma, Antibodies, Monoclonal, Humanized / therapeutic use, Population, [SDV.CAN]Life Sciences [q-bio]/Cancer, Placebo, Antibodies, Melanoma / mortality, 03 medical and health sciences, Internal medicine, medicine, Adjuvant therapy, education, Skin Neoplasms / pathology, MESH: Humans, Melanoma / drug therapy, business.industry, MESH: Skin Neoplasms, MESH: Quality of Life, MESH: Adult, Skin Neoplasms / mortality, MESH: Male, Clinical trial, MESH: Antibodies, Monoclonal, Humanized, business, MESH: Female
Abstract: Background: The European Organisation for Research and Treatment of Cancer (EORTC) 1325-MG/KEYNOTE-054 trial in patients with resected, high-risk stage III melanoma demonstrated improved recurrence-free survival with adjuvant pembrolizumab compared with placebo (hazard ratio 0·57 [98·4% CI 0·43-0·74]; pMethods: This double-blind, randomised, controlled, phase 3 trial was done at 123 academic centres and community hospitals across 23 countries. Patients aged 18 years or older with previously untreated histologically confirmed stage IIIA, IIIB, or IIIC resected cutaneous melanoma, and an Eastern Cooperative Oncology Group performance status score of 1 or 0 were eligible. Patients were randomly assigned (1:1) using a central interactive voice-response system on the basis of a minimisation technique stratified for stage and geographic region to receive intravenously 200 mg pembrolizumab or placebo. Treatment was administered every 3 weeks for 1 year, or until disease recurrence, unacceptable toxicity, or death. The primary endpoint of the trial was recurrence-free survival (reported elsewhere). HRQOL was a prespecified exploratory endpoint, with global health/quality of life (GHQ) over 2 years measured by the EORTC QLQ-C30 as the primary analysis. Analyses were done in the intention-to-treat population. This study is registered with ClinicalTrials.gov, NCT02362594, and EudraCT, 2014-004944-37, and long-term follow-up is ongoing.Findings: Between Aug 26, 2015, and Nov 14, 2016, 1019 patients were assigned to pembrolizumab (n=514) or placebo (n=505). Median follow-up was 15·1 months (IQR 12·8-16·9) at the time of this analysis. HRQOL compliance was greater than 90% at baseline, greater than 70% during the first year, and greater than 60% thereafter for both groups. Because of low absolute compliance numbers at later follow-up, the analysis was truncated to week 84. Baseline GHQ scores were similar between groups (77·55 [SD 18·20] in the pembrolizumab group and 76·54 [17·81] in the placebo group) and remained stable over time. The difference in average GHQ score between the two groups over the 2 years was -2·2 points (95% CI -4·3 to -0·2). The difference in average score during treatment was -1·1 points (95% CI -3·2 to 0·9) and the difference in average score after treatment was -2·2 points (-4·8 to 0·4). These differences are within the 5-point clinical relevance threshold for the QLQ-C30 and are therefore clinically non-significant.Interpretation: Pembrolizumab does not result in a clinically significant decrease in HRQOL compared with placebo when given as adjuvant therapy for patients with resected, high-risk stage III melanoma. These results support the use of adjuvant pembrolizumab in this setting. placebo when given as adjuvant therapy for patients with resected, high-risk stage III melanoma. These results support the use of adjuvant pembrolizumab in this setting. placebo when given as adjuvant therapy for patients with resected, high-risk stage III melanoma. These results support the use of adjuvant pembrolizumab in this setting.
Published: 2021

10. Organ preservation with chemoradiotherapy plus local excision for rectal cancer: 5-year results of the GRECCAR 2 randomised trial

Author: Anne Dubois, Jean-Jacques Tuech, Philippe Rouanet, M. Bertrand, Anne Rullier, Marc Pocard, Quentin Denost, Véronique Vendrely, Bertrand Trilling, Mehrdad Jafari, Alain Valverde, G. Portier, Cécile de Chaisemartin, Nora Frulio, Julien Asselineau, Eric Frison, Denis Smith, Eric Rullier, Bernard Meunier, Michel Rivoire, Igor Sieleznieff, Frédéric Marchal, Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], CIC Bordeaux, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), UNICANCER - Institut régional du Cancer Montpellier Val d'Aurelle (ICM), CRLCC Val d'Aurelle - Paul Lamarque, Hôpital Charles Nicolle [Rouen], Groupe Hospitalier Diaconesses Croix Saint-Simon, Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Centre Léon Bérard [Lyon], Hôpital Michallon, Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille), Université Lille Nord de France (COMUE)-UNICANCER, Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], CHU Pontchaillou [Rennes], Hôpital de la Timone [CHU - APHM] (TIMONE), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] (UNICANCER/ICL), UNICANCER, CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand, Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Pellegrin, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Salvy-Córdoba, Nathalie, Université de Lille-UNICANCER, and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)
Subjects: medicine.medical_specialty, [SDV.MHEP.CHI] Life Sciences [q-bio]/Human health and pathology/Surgery, MESH: Survival Rate, MESH: Chemoradiotherapy, Adjuvant, Colorectal cancer, medicine.medical_treatment, MESH: Neoadjuvant Therapy, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, MESH: Intention to Treat Analysis, MESH: Proportional Hazards Models, 03 medical and health sciences, 0302 clinical medicine, MESH: Aged, 80 and over, [SDV.CAN] Life Sciences [q-bio]/Cancer, medicine, Prospective cohort study, Survival rate, Neoadjuvant therapy, MESH: Kaplan-Meier Estimate, MESH: Aged, Intention-to-treat analysis, MESH: Middle Aged, MESH: Humans, Hepatology, MESH: Organ Sparing Treatments, business.industry, MESH: Proctectomy, Hazard ratio, Gastroenterology, MESH: Rectal Neoplasms, MESH: Adult, MESH: Neoplasm Staging, medicine.disease, Total mesorectal excision, MESH: Neoplasm Metastasis, MESH: Prospective Studies, MESH: Male, 3. Good health, Surgery, 030220 oncology & carcinogenesis, MESH: Disease-Free Survival, 030211 gastroenterology & hepatology, business, MESH: Neoplasm Recurrence, Local, MESH: Female, Chemoradiotherapy
Abstract: Summary Background GRECCAR 2 was the first multicentre, randomised trial to compare local excision with total mesorectal excision in downstaged low rectal cancer. Encouraging oncological results were noted at 3 years' follow-up but needed to be corroborated with longer follow-up. In this study, we aimed to report the 5-year oncological outcomes, including local recurrence, metastatic disease, and survival. Methods Patients age 18 years and older with T2T3 low rectal cancer, of maximum size 4 cm, who were clinically good responders after chemoradiotherapy (residual tumour ≤2 cm) were randomly assigned before surgery to either local excision or total mesorectal excision. Randomisation was centralised and not stratified and used permuted blocks of size eight. In the local excision group, a completion total mesorectal excision was performed if pathological tumour stage was ypT2–3. The primary objective of this study was to assess the 5-year oncological outcomes of local recurrence, metastatic disease, disease-free survival, overall survival, and cancer-specific mortality, which were the secondary endpoints of GRECCAR 2. We used Kaplan-Meier estimates and Cox modelling to estimate and compare recurrence and survival in modified intention-to-treat and as-treated populations. This trial was registered with ClinicalTrials.gov , number NCT00427375 . Findings Between March 1, 2007, and Sept 24, 2012, 148 patients who were good clinical responders were randomly assigned to treatment, three patients were excluded after randomisation (because they had metastatic disease, tumour >8 cm from anal verge, or withdrew consent), leaving 145 for analysis: 74 in the local excision group and 71 in the total mesorectal excision group. Median follow-up was 60 months (IQR 58–60) in the local excision group and 60 months (57–60) in the total mesorectal excision group. 23 patients died and five were lost to follow-up. In the local excision group, 26 had a completion total mesorectal excision for ypT2–3 tumour. In the modified intention-to-treat analysis, there was no difference between the local excision and total mesorectal excision groups in 5-year local recurrence (7% [95% CI 3–16] vs 7% [3–16]; adjusted hazard ratio [HR] 0·71 [95% CI 0·19–2·58]; p=0·60), metastatic disease (18% [CI 11–30] vs 19% [11–31]; 0·86 [0·36–2·06]; p=0·73), overall survival (84% [73–91] vs 82% [71–90]; 0·92 [0·38–2·22]; p=0·85), disease-free survival (70% [58–79] vs 72% [60–82]; 0·87 [0·44–1·72]; p=0·68), or cancer-specific mortality (7% [3–17] vs 10% [5–20]; 0·65 [0·17–2·49]; p=0·53). Interpretation The 5-year results of this multicentre randomised trial corroborate the 3-year results, providing no evidence of difference in oncological outcomes between local excision and total mesorectal excision. Local excision can be proposed in selected patients having a small T2T3 low rectal cancer with a good clinical response after chemoradiotherapy. Funding National Cancer Institute of France.
Published: 2020

11. Artificial intelligence-guided tissue analysis combined with immune infiltrate assessment predicts stage III colon cancer outcomes in PETACC08 study

Author: S. Nguyen, Quentin Klopfenstein, Oana Cojocarasu, Francis Fein, Mohamed Gasmi, Cynthia Reichling, Pierre-Laurent Puig, Karine Le Malicot, Jean Paul Lagasse, Côme Lepage, Pierre-Luc Etienne, Jean-Marc Gornet, Julien Taieb, Jean-François Emile, Hakim Becheur, Dominique Luet, François Ghiringhelli, André Vanoli, Hervé Perrier, Marie Christine Kaminsky, Valentin Derangère, Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), and UNICANCER
Subjects: 0301 basic medicine, Colorectal cancer, Lymphocyte, 0302 clinical medicine, Antineoplastic Combined Chemotherapy Protocols, Medicine, immunohistopathology, MESH: Lymphocytes, Tumor-Infiltrating, biology, Gastroenterology, MESH: Neoplasm Staging, Prognosis, 3. Good health, MESH: Antineoplastic Combined Chemotherapy Protocols, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Colonic Neoplasms, Stromal cell, CD3, adjuvant treatment, colorectal cancer, [SDV.CAN]Life Sciences [q-bio]/Cancer, Adenocarcinoma, Disease-Free Survival, MESH: Prognosis, 03 medical and health sciences, Lymphocytes, Tumor-Infiltrating, Immune system, computerised image analysis, Stroma, Artificial Intelligence, Image Interpretation, Computer-Assisted, Humans, MESH: Artificial Intelligence, Neoplasm Invasiveness, Pathological, Neoplasm Staging, MESH: Colonic Neoplasms, MESH: Humans, business.industry, MESH: Adenocarcinoma, MESH: Neoplasm Invasiveness, medicine.disease, 030104 developmental biology, MESH: Disease-Free Survival, biology.protein, Artificial intelligence, [INFO.INFO-BI]Computer Science [cs]/Bioinformatics [q-bio.QM], business, MESH: Image Interpretation, Computer-Assisted, CD8
Abstract: ObjectiveDiagnostic tests, such as Immunoscore, predict prognosis in patients with colon cancer. However, additional prognostic markers could be detected on pathological slides using artificial intelligence tools.DesignWe have developed a software to detect colon tumour, healthy mucosa, stroma and immune cells on CD3 and CD8 stained slides. The lymphocyte density and surface area were quantified automatically in the tumour core (TC) and invasive margin (IM). Using a LASSO algorithm, DGMate (DiGital tuMor pArameTErs), we detected digital parameters within the tumour cells related to patient outcomes.ResultsWithin the dataset of 1018 patients, we observed that a poorer relapse-free survival (RFS) was associated with high IM stromal area (HR 5.65; 95% CI 2.34 to 13.67; pConclusionThese findings suggest that artificial intelligence can potentially improve patient care by assisting pathologists in better defining stage III colon cancer patients’ prognosis.
Published: 2020

12. Somatic mutational spectrum analysis in a prospective series of 104 gastrointestinal stromal tumors

Author: Jean-François Emile, Christiane Mougin, Sandrine Magnin, Loic Chaigneau, David Guenat, Jean-Luc Prétet, Olivier Deroo, Christophe Borg, Franck Monnien, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Service d'Oncologie Médicale [CHRU Besançon], Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (RIGHT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Université de Franche-Comté (UFC), Laboratory of Human Genetics of Infectious Diseases, Prétet, Jean-Luc, and Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (UR 3181) (CEF2P / CARCINO)
Subjects: Male, 0301 basic medicine, Oncology, Cancer Research, Receptor, Platelet-Derived Growth Factor alpha, MESH: Receptor, Platelet-Derived Growth Factor alpha, medicine.disease_cause, Polymerase Chain Reaction, law.invention, MESH: Gastrointestinal Neoplasms, Exon, MESH: Aged, 80 and over, 0302 clinical medicine, law, Prospective Studies, Polymerase chain reaction, Gastrointestinal Neoplasms, MESH: Aged, Aged, 80 and over, Sanger sequencing, MESH: Middle Aged, MESH: Neoplasm Staging, Exons, General Medicine, Middle Aged, Prognosis, 3. Good health, MESH: Proto-Oncogene Proteins c-kit, Proto-Oncogene Proteins c-kit, 030220 oncology & carcinogenesis, symbols, Female, MESH: Biomarkers, Tumor, KRAS, MESH: Gastrointestinal Stromal Tumors, medicine.drug, Adult, medicine.medical_specialty, MESH: Mutation, Gastrointestinal Stromal Tumors, DNA repair, [SDV.CAN]Life Sciences [q-bio]/Cancer, PDGFRA, Biology, MESH: Prognosis, Proto-Oncogene Proteins p21(ras), MESH: Proto-Oncogene Proteins p21(ras), 03 medical and health sciences, symbols.namesake, [SDV.CAN] Life Sciences [q-bio]/Cancer, Internal medicine, Biomarkers, Tumor, medicine, Humans, neoplasms, Aged, Neoplasm Staging, MESH: Humans, MESH: Adult, MESH: Polymerase Chain Reaction, Imatinib, Molecular medicine, MESH: Prospective Studies, MESH: Male, digestive system diseases, 030104 developmental biology, Mutation, MESH: Exons, MESH: Female
Abstract: International audience; Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors distinguished by driver mutations in proto-oncogenes KIT or PDGFRA in 85-90% of cases. These mutations have been linked to the response to imatinib, a multikinase inhibitor, and have independent prognostic impact. Here, we describe the prospective study of the molecular characteristics of 104 GISTs from French adult patients analyzed routinely through the National Hospital Program of Molecular Cancer Diagnosis. All patients with GISTs diagnosed at the University Hospital of Besançon between August 2005 and October 2014 were prospectively included in the present study. KIT, PDGFRA and KRAS-codons 12 and 13 as well as BRAF codon 600 mutations were analyzed by Sanger sequencing or SNaPshot. KIT and PDGFRA mutations were detected in 71.2 and 19.2% of the cases, respectively. A total of 43 different mutations were detected of which 13 had never been described. As expected, KIT exon 9 and PDGFRA exon 18 mutations were associated with small bowel and gastric localizations respectively. No mutation was found in KRAS and BRAF. Molecular studies are critical to improve the management of GISTs. Our study enhances the current knowledge by describing 13 new mutations in KIT. A common molecular pattern in all KIT exon 11 substitutions is also described for the first time in this study but its significance remains unknown since genetic and environmental risk factors favoring the development of GISTs such as DNA repair defects and exposure to carcinogens are not currently known.
Published: 2017

13. Magnetic resonance imaging in breast cancer management in the context of neo-adjuvant chemotherapy

Author: Patrice Taourel, David Azria, E. Pages, Céline Bourgier, William Jacot, P. Rouanet, P. Crochet, Ingrid Millet, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut Montpelliérain Alexander Grothendieck (IMAG), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), and CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)
Subjects: In vivo magnetic resonance spectroscopy, medicine.medical_specialty, medicine.medical_treatment, MESH: Neoadjuvant Therapy, Context (language use), Breast Neoplasms, MESH: Lymph Nodes, [SDV.CAN]Life Sciences [q-bio]/Cancer, Disease, MESH: Disease Management, 030218 nuclear medicine & medical imaging, MESH: Magnetic Resonance Imaging, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, medicine, Breast MRI, Humans, Lymph node, Neoplasm Staging, Chemotherapy, MESH: Humans, medicine.diagnostic_test, business.industry, Disease Management, Magnetic resonance imaging, Neo-adjuvant chemotherapy, Hematology, MESH: Neoplasm Staging, medicine.disease, Magnetic Resonance Imaging, Neoadjuvant Therapy, 3. Good health, medicine.anatomical_structure, Oncology, Chemotherapy, Adjuvant, MESH: Chemotherapy, Adjuvant, 030220 oncology & carcinogenesis, Female, Radiology, Lymph Nodes, business, MESH: Female, MESH: Breast Neoplasms, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, MRI
Abstract: International audience; This review discusses the clinical applications of magnetic resonance imaging (MRI) for the assessment of neo-adjuvant chemotherapy (NAC) indication, axillary lymph node status, preNAC cancer prognosis, early and intermediate response to NAC, and post-NAC residual disease in patients with breast cancer. Contrast-enhanced MRI with analysis of the tumor morphological features and qualitative enhancement kinetics must be considered as the standard method for pre-NAC breast cancer staging and post-NAC residual disease assessment. Diffusion-weighted imaging (DWI) is easy to perform and may increase the specificity of breast MRI for tumor staging, and also for the assessment of tumor multifocality and multicentricity and lymph node status. It also provides an ancillary added value in the early and post-NAC response evaluation. Changes in the functional tumor volume are the main criterion for the early response analysis. Other MRI methods, such as quantitative perfusion analysis, MR spectroscopy and texture analysis, are still under study.
Published: 2018

14. Pièce opératoire ypT0N0 après séquence chimiothérapie néo-adjuvante – cystectomie pour TVIM : épidémiologie et impact pronostique. Une mise au point du CCAFU Vessie

Author: Pignot, G., Houédé, N., Roumiguié, M., Audenet, F., Brunelle, S., Colin, P., Comperat, E., Larre, S., Masson-Lecomte, A., Neuzillet, Y., Xylinas, E., Méjean, A., Roupret, M., Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Hôpital de Rangueil, CHU Toulouse [Toulouse], Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Hôpital Privé La Louvière, Service d'anatomie pathologique [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Universitaire de Reims (CHU Reims), Hôpital Foch [Suresnes], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Pitié-Salpêtrière [AP-HP], and Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
Subjects: MESH: Tumor Burden, MESH: Combined Modality Therapy, Neoplasm, Residual, Survival, MESH: Societies, Medical, MESH: Neoadjuvant Therapy, Urinary Bladder, [SDV.CAN]Life Sciences [q-bio]/Cancer, Cystectomy, Medical Oncology, MESH: Prognosis, MESH: Urinary Bladder, Antineoplastic Combined Chemotherapy Protocols, Pronostic, Chemotherapy, Humans, MESH: Incidence, MESH: Neoplasm, Residual, MESH: Muscle Neoplasms, Societies, Medical, MESH: Medical Oncology, Neoplasm Staging, MeSH, MESH: Carcinoma, Transitional Cell, Carcinoma, Transitional Cell, Muscle Neoplasms, MESH: Humans, Incidence, Bladder cancer, MESH: Cystectomy, MESH: Neoplasm Staging, Prognosis, Combined Modality Therapy, Cancer de la vessie, Neoadjuvant Therapy, MESH: Urinary Bladder Neoplasms, Tumor Burden, MESH: France, MESH: Antineoplastic Combined Chemotherapy Protocols, Urinary Bladder Neoplasms, Survie, France, Neoplasm Recurrence, Local, MESH: Neoplasm Recurrence, Local, Chimiothérapie, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; INTRODUCTION:Neoadjuvant chemotherapy (NAC) is recommended for localized muscle-invasive bladder cancer when patients are fit for cisplatin-based chemotherapy. A pathological complete response can be observed, corresponding to ypT0N0 stage on the radical cystectomy specimen. This review discusses the incidence, prognosis and potential therapeutic impact of complete response on pathological specimen in NAC treated patients.METHODS:A comprehensive review of the literature was conducted using Medline database, with no time frame. The articles were selected using the following keywords association: "Bladder cancer" (Mesh) AND "Neoadjuvant chemotherapy" (Mesh) AND "pT0" (Mesh).RESULTS:After NAC, ypT0N0 rates vary from 9 to 46% among the series, reported rates that are higher compared to those of pT0 without NAC administration. The incidence depends on the chemotherapy regimen (maximal local effect with cisplatin-based chemotherapy) and the pathological type of the disease (presence of variant histologies). Molecular analyses of bladder cancer could probably help in the near future to identify and predict NAC responders. Pathological complete response is associated with a favorable prognosis in terms of recurrence-free and overall survival. Nevertheless, disease recurrences are still observed in 10-15% of cases, which underlies the importance of local treatment and close follow-up even in these patients.CONCLUSION:ypT0N0 rate is approximately 25% after NAC, that is 4.3 higher than after bladder resection alone. The prognosis is better than that with residual tumor on specimen and is comparable to that of pT0 without NAC administration.
Published: 2018

15. Initial staging of squamous cell carcinoma of the oral cavity, larynx and pharynx (excluding nasopharynx). Part 2: Remote extension assessment and exploration for secondary synchronous locations outside of the upper aerodigestive tract. 2012 SFORL guidelines

Author: D. de Raucourt, P.-Y. Salaun, J.-C. Ferrié, Sébastien Vergez, F. Dubrulle, Dominique Chevalier, E. de Monès, Michel Lapeyre, Sylvain Morinière, B. Barry, Stéphane Temam, Philippe Schultz, F. Lagarde, C. Bertolus, S. Tronche, Service d'ORL, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Department of Maxillofacial Surgery, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Department of Nuclear Medicine, Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO)-Université de Brest (UBO), Service de Radiologie (LILLE - Radio), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de Radiologie (POITIERS - Radio), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Département de cancérologie cervico-faciale [Gustave Roussy] (CCF), Institut Gustave Roussy (IGR), Service d'ORL et de Chirurgie Cervico-Faciale (LILLE - ORL et CCF), Department of Head and Neck Surgery, Hôpital Larrey [Toulouse], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Service d'ORL et de Chirurgie Cervico-Faciale (ORLEANS - ORL et CCF), Centre Hospitalier Régional d'Orléans (CHRO), Service d'ORL et de Chirurgie Cervico-Faciale (STRASBOURG - ORL et CCF), CHU Strasbourg, Service de Radiothérapie (CLERMONT FERRAND - Radiothérapie), CHU Clermont-Ferrand, Service d'ORL et de Chirurgie Cervico-Faciale (PARIS - BICHAT - ORL et CCF), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), SFORL (SFORL), SFORL, Service d'Oto-Rhino-Laryngologie (O.R.L.) et de Chirurgie Cervico-Faciale [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Service d'ORL et de Chirurgie Cervico-Faciale (TOURS - ORL et CCF), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Service de Chirurgie Maxillo-Faciale ( PARIS - PSL - Chir Maxillo-Faciale ), Assistance publique - Hôpitaux de Paris (AP-HP), Centre Hospitalier Régional Universitaire de Brest ( CHRU Brest ), Groupe d'Etude de la Thrombose de Bretagne Occidentale ( GETBO ), Université de Brest ( UBO ), Service de Radiologie ( LILLE - Radio ), Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Service de Radiologie ( POITIERS - Radio ), CHU de Poitiers, Département de cancérologie cervico-faciale [Gustave Roussy] ( CCF ), Institut Gustave Roussy ( IGR ), Service d'ORL et de Chirurgie Cervico-Faciale ( LILLE - ORL et CCF ), University Hospital Rangueil-Larrey, Service d'ORL et de Chirurgie Cervico-Faciale ( ORLEANS - ORL et CCF ), Centre Hospitalier Régional d'Orléans ( CHR ), Service d'ORL et de Chirurgie Cervico-Faciale ( STRASBOURG - ORL et CCF ), Service de Radiothérapie ( CLERMONT FERRAND - Radiothérapie ), Service d'ORL et de Chirurgie Cervico-Faciale ( PARIS - BICHAT - ORL et CCF ), Assistance publique - Hôpitaux de Paris (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], SFORL ( SFORL ), Service d'ORL et de Chirurgie Cervico-Faciale ( CAEN - ORL et CCF ), CHU Caen, Service d'ORL et de Chirurgie Cervico-Faciale ( TOURS - ORL et CCF ), and CHRU Tours
Subjects: Larynx, Pathology, MESH: Thoracic Neoplasms, Lung Neoplasms, Esophageal Neoplasms, MESH : Pharyngeal Neoplasms, [SDV]Life Sciences [q-bio], MESH : Mouth Neoplasms, MESH: Laryngeal Neoplasms, Oral cavity, Metastasis, MESH: Magnetic Resonance Imaging, MESH: Mouth Neoplasms, 0302 clinical medicine, Risk Factors, MESH: Risk Factors, Squamous cell carcinoma, MESH : Tomography, X-Ray Computed, MESH : Neoplasm Staging, MESH : Neoplasms, Second Primary, MESH : Endoscopy, MESH : Carcinoma, Squamous Cell, Neoplasm Metastasis, 030223 otorhinolaryngology, Head and neck, MESH: Bronchial Neoplasms, MESH : Laryngeal Neoplasms, MESH : Bronchial Neoplasms, Bronchial Neoplasms, Smoking, Neoplasms, Second Primary, MESH: Carcinoma, Squamous Cell, MESH: Neoplasm Staging, MESH : Thoracic Neoplasms, MESH : Risk Factors, Magnetic Resonance Imaging, MESH: Positron-Emission Tomography, 3. Good health, MESH : Smoking, MESH: Pharyngeal Neoplasms, medicine.anatomical_structure, 030220 oncology & carcinogenesis, MESH : Neoplasm Metastasis, MESH: Esophageal Neoplasms, Carcinoma, Squamous Cell, Fdg pet ct, Mouth Neoplasms, Radiology, MESH: Tomography, X-Ray Computed, CT, MRI, Initial staging, medicine.medical_specialty, MESH: Neoplasms, Second Primary, MESH: Smoking, Alcohol Drinking, Synchronous secondary location, Flexible endoscopy of the esophagus, MESH: Endoscopy, 03 medical and health sciences, MESH : Magnetic Resonance Imaging, medicine, Humans, Basal cell, MESH : Lung Neoplasms, Laryngeal Neoplasms, Neoplasm Staging, MESH: Humans, [ SDV ] Life Sciences [q-bio], business.industry, MESH : Humans, Pharynx, MESH : Positron-Emission Tomography, Endoscopy, Pharyngeal Neoplasms, Thoracic Neoplasms, MESH: Neoplasm Metastasis, FDG-PET/CT, MESH: Lung Neoplasms, MESH : Alcohol Drinking, Upper aerodigestive tract, Otorhinolaryngology, Positron-Emission Tomography, Surgery, MESH : Esophageal Neoplasms, business, Tomography, X-Ray Computed, MESH: Alcohol Drinking
Abstract: International audience; OBJECTIVES: This report presents the French Society of ORL (SFORL) guidelines for exploration for remote metastasis and synchronous second cancer in initial staging of head and neck squamous cell carcinoma. MATERIALS AND METHODS: An exhaustive literature review was analyzed by a multidisciplinary work-group. RESULTS: The thorax is the most frequent location of remote metastases and synchronous second cancer outside of the upper aerodigestive tract. Thoracic CT is recommended as first-line examination in all cases (grade B). 18-FDG PET/CT is recommended when the thoracic CT image is doubtful or in case of high metastatic risk (grade B), for the detection of non-pulmonary remote metastasis. Esophageal exploration is recommended in case of significant risk of synchronous esophageal cancer (hypopharyngeal or oropharyngeal tumor, chronic alcohol intoxication) (grade B). The reference examination is flexible endoscopy of the upper digestive tract (grade B). CONCLUSION: The present grade B recommendations rationalize the roles of the various first-line radiological and endoscopic examinations for remote metastasis and synchronous second cancer, so as to limit the number of examinations performed, thereby reducing the time needed for initial staging.
Published: 2013
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16. Results From a Prospective, Open-Label, Phase II Trial of Bendamustine in Refractory or Relapsed T-Cell Lymphomas: The BENTLY Trial

Author: Arnaud Jaccard, Momar Diouf, Gandhi Damaj, Thierry Lamy, Pascale Cony-Makhoul, Krimo Bouabdallah, Bertrand Joly, Roch Houot, Guillaume Cartron, Steven Le Gouill, Emmanuel Gyan, Remy Gressin, Jean-Pierre Vilque, Bachra Choufi, Marie-Christine Béné, Sophie Park, Michael Bubenheim, Laurence Sanhes, Aline Schmidt-Tanguy, Laurent Voillat, Jean-Marc Schiano-de Collela, Anne Banos, Alain Saad, Olivier Tournilhac, Jean-Pierre Marolleau, Antoine Martin, CHU Amiens-Picardie, Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Bordeaux [Bordeaux], CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Hôpital Duchenne, CH Boulogne sur Mer, CIC - Tours, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital de Bayonne, Centre Hospitalier de la Côte Basque (CHCB), CHU Limoges, Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Clermont-Ferrand, Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Centre Hospitalier Chalon-sur-Saône William Morey, Hôpital Sud-Fancilien, CH Sud-Fancilien, Centre de Recherche en Cancérologie Nantes-Angers (CRCNA), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM)-Hôtel-Dieu de Nantes-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Laennec-Centre National de la Recherche Scientifique (CNRS)-Faculté de Médecine d'Angers-Centre hospitalier universitaire de Nantes (CHU Nantes), Hôpital de Béziers, CH Béziers, Centre Hospitalier d'Annecy, Centre hospitalier d'Annecy, Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN), Hôpital de Perpignan, Centre Hospitalier Saint Jean de Perpignan, CHU Rouen, Normandie Université (NU), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Hôpital Avicenne [AP-HP], Institut National de la Santé et de la Recherche Médicale (INSERM)-EFS-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF), CH de la Côte Basque, UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU), and Le Corre, Morgane
Subjects: Male, MESH: Remission Induction, Cancer Research, medicine.medical_treatment, Salvage therapy, MESH: Antineoplastic Agents, Alkylating, Gastroenterology, MESH: Aged, 80 and over, 0302 clinical medicine, Bendamustine Hydrochloride, Prospective Studies, Aged, 80 and over, MESH: Aged, education.field_of_study, MESH: Middle Aged, Remission Induction, MESH: Neoplasm Staging, MESH: Follow-Up Studies, Middle Aged, MESH: Lymphoma, T-Cell, Peripheral, Prognosis, MESH: Drug Resistance, Neoplasm, MESH: Lymphoma, T-Cell, Cutaneous, Lymphoma, T-Cell, Cutaneous, MESH: Salvage Therapy, 3. Good health, Survival Rate, Oncology, 030220 oncology & carcinogenesis, Nitrogen Mustard Compounds, Female, MESH: Neoplasm Recurrence, Local, medicine.drug, Adult, Bendamustine, medicine.medical_specialty, MESH: Survival Rate, Population, [SDV.BC]Life Sciences [q-bio]/Cellular Biology, Neutropenia, MESH: Prognosis, 03 medical and health sciences, Refractory, Internal medicine, [SDV.BBM] Life Sciences [q-bio]/Biochemistry, Molecular Biology, medicine, Humans, [SDV.BBM]Life Sciences [q-bio]/Biochemistry, Molecular Biology, education, Antineoplastic Agents, Alkylating, [SDV.BC] Life Sciences [q-bio]/Cellular Biology, Survival rate, Aged, Neoplasm Staging, Salvage Therapy, Chemotherapy, MESH: Humans, business.industry, MESH: Nitrogen Mustard Compounds, Lymphoma, T-Cell, Peripheral, MESH: Adult, medicine.disease, MESH: Male, MESH: Prospective Studies, Lymphoma, Surgery, Drug Resistance, Neoplasm, Neoplasm Recurrence, Local, business, MESH: Female, Follow-Up Studies, 030215 immunology
Abstract: Purpose To determine the efficacy and safety of bendamustine as a single agent in refractory or relapsed T-cell lymphomas. Patients and Methods Patients with histologically confirmed peripheral T-cell lymphoma (PTCL) or cutaneous T-cell lymphoma who progressed after one or more lines of prior chemotherapy received bendamustine at 120 mg/m2 per day on days 1 through 2 every 3 weeks for six cycles. The primary end point was overall response rate (ORR). Secondary end points were duration of response (DOR), progression-free survival (PFS), and overall survival (OS). Results Of the 60 patients included, 27 (45%) were refractory to their last prior chemotherapy, and the median duration of the best previous response was 6.6 months. Histology was predominantly angioimmunoblastic lymphadenopathy and PTCL not otherwise specified. The disease was disseminated in the majority of patients (87%). The median number of previous lines of chemotherapy was one (range, one to three). Twenty patients (33%) received fewer than three cycles of bendamustine, mostly because of disease progression. In the intent-to-treat population, the ORR was 50%, including complete response in 17 patients (28%) and partial response in 13 patients (22%). Bendamustine showed consistent efficacy independent of major disease characteristics. The median values for DoR, PFS, and OS were 3.5, 3.6, and 6.2 months, respectively. The most frequent grade 3 to 4 adverse events were neutropenia (30%), thrombocytopenia (24%), and infections (20%). Conclusion Bendamustine showed an encouraging high response rate across the two major PTCL subtypes, independent of age and prior treatment, with acceptable toxicity in refractory or relapsed T-cell lymphoma.
Published: 2013

17. Randomized phase 2 neoadjuvant trial evaluating anastrozole and fulvestrant efficacy for postmenopausal, estrogen receptor-positive, human epidermal growth factor receptor 2-negative breast cancer patients: Results of the UNICANCER CARMINA 02 French trial (UCBG 0609)

Author: Sandrine Lavau-Denes, Pierre Kerbrat, Jean-Marc Nabholz, Marie-Christine Mathieu, Martine Trassard, Pascal Cherel, Jérôme Lemonnier, Corinne Balleyguier, Anne-Laure Martin, B Sigal, Veronique Boussion, Sofia Rivera, Véronique Becette, Fabienne Thibault, L. Venat-Bouvet, Séverine Alran, Rémy Salmon, Emmanuelle Mouret-Fourme, Céline Bourgier, Marie-Ange Mouret-Reynier, Florence Lerebours, Institut Curie [Paris], Institut Gustave Roussy (IGR), Centre Jean Perrin [Clermont-Ferrand] (UNICANCER/CJP), UNICANCER, Service d'Oncologie médicale [CHU Limoges], CHU Limoges, CRLCC Eugène Marquis (CRLCC), Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), R&D UNICANCER, Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCL/UNICANCER), and UNICANCER-UNICANCER
Subjects: 0301 basic medicine, Oncology, Cancer Research, Receptor, ErbB-2, medicine.medical_treatment, Estrogen receptor, clinical response, neoadjuvant endocrine therapy, 0302 clinical medicine, MESH: Aged, 80 and over, MESH: Carcinoma, Lobular, Antineoplastic Combined Chemotherapy Protocols, Breast-conserving surgery, Neoadjuvant therapy, Aged, 80 and over, MESH: Aged, postmenopausal, MESH: Middle Aged, Estradiol, fulvestrant, Carcinoma, Ductal, Breast, MESH: Neoplasm Staging, MESH: Follow-Up Studies, Middle Aged, MESH: Fulvestrant, Prognosis, Neoadjuvant Therapy, MESH: Nitriles, 3. Good health, Postmenopause, Survival Rate, MESH: Receptor, ErbB-2, MESH: Antineoplastic Combined Chemotherapy Protocols, 030220 oncology & carcinogenesis, Female, France, MESH: Estradiol, breast-conserving surgery, MESH: Postmenopause, medicine.drug, medicine.medical_specialty, MESH: Anastrozole, MESH: Survival Rate, anastrozole, MESH: Neoadjuvant Therapy, Anastrozole, Breast Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, survival, MESH: Prognosis, 03 medical and health sciences, Breast cancer, breast cancer, Internal medicine, Nitriles, medicine, Humans, Survival rate, Aged, Neoplasm Staging, MESH: Humans, Fulvestrant, business.industry, Cancer, Triazoles, medicine.disease, MESH: France, MESH: Carcinoma, Ductal, Breast, Carcinoma, Lobular, 030104 developmental biology, MESH: Triazoles, phase 2, hormone receptor-positive, business, MESH: Female, MESH: Breast Neoplasms, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Follow-Up Studies
Abstract: International audience; BACKGROUND:Treatment strategies for locally advanced breast cancer in elderly patients too frail to receive neoadjuvant chemotherapy and the introduction of new classes of drugs in the early 2000s have led to the consideration of endocrine therapy as a neoadjuvant treatment for younger hormone receptor (HR)-positive, postmenopausal patients not eligible for primary breast-conserving surgery (BCS).METHODS:This was a multicenter, phase 2, randomized trial designed to evaluate as its primary objective the clinical response rate after up to 6 months of neoadjuvant endocrine therapy (NET) alone in HR-positive/human epidermal growth factor receptor 2 (HER2)-negative patients with 1 mg of anastrozole (arm A) or 500 mg of fulvestrant (arm B). Secondary objectives included the BCS rate, tumor response assessment (breast ultrasound and magnetic resonance imaging), pathological response (Sataloff classification), safety profile, relapse-free survival (RFS), and predictive markers of responses and outcomes.RESULTS:From October 2007 to April 2011, 116 women (mean age, 71.6 years) with operable infiltrating breast adenocarcinoma (T2-T4, N0-N3, M0) were randomized to receive anastrozole or fulvestrant. The clinical response rates at 6 months were 52.6% (95% confidence interval [CI], 41%-64%) in arm A and 36.8% (95% CI, 25%-49%) in arm B. BCS was performed for 57.6% of arm A patients and 50% of arm B patients. The RFS rates at 3 years were 94.9% in arm A and 91.2% in arm B. The Preoperative Endocrine Prognostic Index status was significantly predictive of RFS. Both treatments were well tolerated.CONCLUSIONS:Both drugs are effective and well tolerated as NET in postmenopausal women with HR-positive/HER2-negative breast cancer. NET could be considered a treatment option in this subpopulation. Cancer 2016;122:3032-3040. © 2016 American Cancer Society.
Published: 2016

18. Association of HLA-G+3142 C > G polymorphism and breast cancer in Tunisian population

Author: Hanene Chelbi, Ahmed Baligh Laaribi, Refaat Sebai, Amel Mezlini, Hamza Ben Yahia, Amna Ben Hassine, Olfa Dziri, Nour Zidi, Wafa Babay, Nadia Boujelebene, Hela Rifi, Inès Zidi, Université de Tunis El Manar (UTM), Departement Medecine Oncologique [Tunis], Institut Salah Azaiz [Tunis] (ISA), Departement Anatomopathologie [ISA, Tunis], Laboratoire de Parasitologie Médicale, Biotechnologies et Biomolécules (LR11IPT06), Institut Pasteur de Tunis, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), and Faculté des Sciences Mathématiques, Physiques et Naturelles de Tunis (FST)
Subjects: Carcinogenesis, MICRORNAS, [SDV]Life Sciences [q-bio], VARIANTS, SUSCEPTIBILITY, medicine.disease_cause, 0302 clinical medicine, Breast cancer, Gene Frequency, HLA-G, Genotype, ANTIGEN-G EXPRESSION, MESH: Breast Neoplasms/pathology, Sequence Deletion, MESH: Genetic Association Studies, MESH: Genotype, Genetics, MESH: Aged, MESH: Middle Aged, MESH: Risk, PLASMA, Age Factors, MESH: Genetic Predisposition to Disease, MESH: Neoplasm Staging, Middle Aged, MESH: Carcinogenesis, +G%22">+3142 C > G, 3. Good health, MESH: Breast Neoplasms/genetics, SHLA-G MOLECULES, 030220 oncology & carcinogenesis, +3142 C&gt, SECRETION, Female, MESH: Tunisia, Adult, Risk, Tunisia, HLA-G GENE, CARCINOMA, Immunology, Breast Neoplasms, Human leukocyte antigen, Biology, REGION, 03 medical and health sciences, MESH: Polymorphism, Genetic, medicine, Carcinoma, MESH: Gene Frequency, Humans, Genetic Predisposition to Disease, Allele, Polymorphism, MESH: HLA-G Antigens/genetics, Allele frequency, Genetic Association Studies, Aged, Neoplasm Staging, HLA-G Antigens, MESH: Age Factors, 14-bp Insertion/deletion, Polymorphism, Genetic, MESH: Humans, MESH: Sequence Deletion/genetics, MESH: Adult, medicine.disease, Molecular biology, MESH: Female, 030215 immunology
Abstract: International audience; HLA-G is highly expressed in cancer. Also, it is associated to its progression. Here, we explored the relationship between two HLA-G polymorphisms with breast cancer (BC) and tried to make a correlation with sHLA-G levels. We genotyped 104 patients with BC and 83 controls (CTRL) for HLA-G 14-bp insertion/deletion (Ins/Del) and HLA-G +3142 C > G polymorphisms. The mutations were identified with PCR and PCR-RFLP. The sHLA-G dosage was performed on plasma samples by a specific ELISA. A significant association with BC was found concerning the G allele in the +3142 C > G polymorphism (p = 0.0004). The G/G genotype is the protective genotype (1 % in BC patients vs. 13.1 % in CTRL, OR 0.065, 95 % CI 0.008-0.523). No statistically significant differences were observed for the 14-bp Ins/Del polymorphism between BC patients and controls frequencies. The protection by G/G genotype of +3142 C > G polymorphism is maintained in young patients (< 50 years, p = 0.0006) and in early-diagnosed BC patients (< 50 years, p = 0.0033). In addition, an association was found between the haplotypes inferred by both HLA-G polymorphisms and BC susceptibility. Indeed, the (DelG) haplotype is found as the protective haplotype against BC (OR 0.269, 95 % CI 0.081-0.895, p = 0.023). The ELISA dosage of sHLA-G revealed increased levels in BC compared to CTRL (p < 0.0001). We demonstrated also that sHLA-G is closely associated with advanced stages of BC without significance. sHLA-G is increased in TNM IV and SBR III subgroups. It is also enhanced in patients with a tumor size over 20 mm and in triple-negative patients. Taken together, our findings demonstrate, for the first time, the association of HLA-G +3142 C > G polymorphism with BC susceptibility in Tunisian population. Our results revealed also a potential implication of sHLA-G in advanced stages of BC.
Published: 2016

19. Impact of a tailored oral vitamin D supplementation regimen on serum 25-hydroxyvitamin D levels in early breast cancer patients: a randomized phase III study

Author: Anna Durigova, L. Roca, Nelly Firmin, Pierre-Jean Lamy, William Jacot, Véronique D'Hondt, S. Gallet, Stéphane Pouderoux, L. Abach, Jean-Pierre Bleuse, Gilles Romieu, Delphine Topart, S. Mirr, Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Département d'oncologie Médicale, CRLCC Val d'Aurelle - Paul Lamarque, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), CRLC Val d'Aurelle-Paul Lamarque, and Herrada, Anthony
Subjects: 0301 basic medicine, vitamin D, MESH: Dietary Supplements, chemotherapy, Gastroenterology, 0302 clinical medicine, MESH: Vitamin D, Clinical endpoint, Medicine, MESH: Aged, education.field_of_study, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, MESH: Middle Aged, Hematology, MESH: Neoplasm Staging, Middle Aged, Chemotherapy regimen, MESH: Drug-Related Side Effects and Adverse Reactions, 3. Good health, Oncology, 030220 oncology & carcinogenesis, MESH: Vitamin D Deficiency, Female, Adult, medicine.medical_specialty, Drug-Related Side Effects and Adverse Reactions, Population, Breast Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, vitamin D deficiency, 03 medical and health sciences, Breast cancer, [SDV.CAN] Life Sciences [q-bio]/Cancer, Internal medicine, Vitamin D and neurology, Humans, early breast cancer, education, Aged, Neoplasm Staging, MESH: Humans, business.industry, MESH: Quality of Life, MESH: Adult, Vitamin D Deficiency, medicine.disease, Surgery, Clinical trial, Regimen, 030104 developmental biology, Dietary Supplements, Quality of Life, business, MESH: Female, MESH: Breast Neoplasms, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: Background A minority of early breast cancer (EBC) patients treated with adjuvant or neoadjuvant chemotherapy have sufficient baseline vitamin D (vitD) level. This randomized phase III study assessed the safety and efficacy of a tailored, high-dose, oral vitD supplementation in restoring a normal 25-hydroxy vitD (25OHD) level in this population. Patients and methods Participants received a 6-month conventional (C) vitD and calcium supplementation or a 6-month high-dose oral vitD regimen tailored on the deficiency (T) and a conventional calcium supplementation. The primary end point was the 6-month percentage of 25OHD serum level normalization. Results A total of 215 patients including 197 patients with vitD deficiency were recruited, and 195 patients were randomized (T, 100; C, 95). Compliance to the daily oral supplementation was 68.4% and 67% in the C and T arms, respectively. Discontinuous high-dose vitD compliance appeared higher in the T arm (77%). At 6 months, more patients presented with a normalized vitD level in the T arm (30% versus 12.6%; P = 0.003). Supplementation was well tolerated, and no significant difference in the treatment-related toxicity between the two arms was reported. Fifty-two patients without vitD normalization from the C arm switched to the T arm after 6 months. At 12 months, 44% of these patients achieved vitD normalization. Conclusion A tailored high-dose oral vitD supplementation safely allows a higher percentage of the serum 25OHD level normalization compared with a conventional regimen in chemotherapy-treated EBC patients. As compliance to a daily oral supplementation remains poor in this setting, an adaptation of the treatment schedule is warranted. Clinical trial number NCT01480869.
Published: 2016

20. Current standards and new innovative approaches for treatment of pancreatic cancer

Author: Jean-Luc Van Laethem, Michel Ducreux, Ahmet Ayav, Florence Huguet, Jean-Baptiste Bachet, Caroline Caramella, Aurélien Lambert, Raphaël Maréchal, Thierry Conroy, Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université Paris Descartes - Paris 5 (UPD5)-Université de Lorraine (UL), Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] (UNICANCER/ICL), UNICANCER, Service d'Hépato-Gastro-Entérologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Chirurgie Digestive Hépatobiliaire et Endocrine [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service d'oncologie-radiothérapie [CHU Tenon], CHU Tenon [AP-HP], Institut Gustave Roussy (IGR), Service de Gastro-Entérologie, d'Hépato-Pancréatologie et d'Oncologie Digestive - Endoscopie Digestive (hôpital Erasme), Hôpital Erasme [Bruxelles] (ULB), Faculté de Médecine [Bruxelles] (ULB), Université libre de Bruxelles (ULB)-Université libre de Bruxelles (ULB)-Faculté de Médecine [Bruxelles] (ULB), Université libre de Bruxelles (ULB)-Université libre de Bruxelles (ULB), Institut de Cancérologie de Lorraine - Alexis Vautrin (ICL), Service d'Hépato-Gastroentérologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Service d’Oncologie-Radiothérapie [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Tenon [APHP], and Université Libre de Bruxelles [Bruxelles] (ULB)-Hôpital Erasme (Bruxelles)
Subjects: 0301 basic medicine, Oncology, Cancer Research, Palliative care, Staging, FOLFIRINOX, medicine.medical_treatment, MESH: Therapies, Investigational, Targeted therapy, Imaging, 0302 clinical medicine, Antineoplastic Combined Chemotherapy Protocols, MESH: Molecular Targeted Therapy, Molecular Targeted Therapy, Precision Medicine, Neoadjuvant therapy, Therapies, Investigational, Palliative Care, MESH: Neoplasm Staging, Reference Standards, Neoadjuvant Therapy, 3. Good health, MESH: Antineoplastic Combined Chemotherapy Protocols, Chemotherapy, Adjuvant, MESH: Chemotherapy, Adjuvant, 030220 oncology & carcinogenesis, MESH: Palliative Care, MESH: Reference Standards, MESH: Pancreatic Neoplasms, MESH: Neoplasm Recurrence, Local, medicine.drug, Diagnostic Imaging, medicine.medical_specialty, MESH: Neoadjuvant Therapy, Adenocarcinoma, MESH: Precision Medicine, 03 medical and health sciences, Pancreatic cancer, Internal medicine, medicine, Humans, Chemotherapy, Survival rate, Neoplasm Staging, MESH: Humans, Radiotherapy, business.industry, MESH: Diagnostic Imaging, MESH: Adenocarcinoma, medicine.disease, Gemcitabine, Pancreatic Neoplasms, Radiation therapy, 030104 developmental biology, Surgery, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Neoplasm Recurrence, Local, business
Abstract: International audience; Pancreatic adenocarcinoma remains a devastating disease with a 5-year survival rate not exceeding 6%. Treatment of this disease remains a major challenge. This article reviews the state-of-the-art in the management of this disease and the new innovative approaches that may help to accelerate progress in treating its victims. After careful pre-therapeutic evaluation, only 15-20% of patients diagnosed with a pancreatic cancer (PC) are eligible for upfront radical surgery. After R0 or R1 resection in such patients, evidence suggests a significantly positive impact on survival of adjuvant chemotherapy comprising 6 months of gemcitabine or fluorouracil/folinic acid. Delayed adjuvant chemoradiation is considered as an option in cases of positive margins. Borderline resectable pancreatic cancer (BRPC) is defined as a tumour involving the mesenteric vasculature to a limited extend. Resection of these tumours is technically feasible, yet runs the high risk of a R1 resection. Neoadjuvant treatment probably offers the best chance of achieving successful R0 resection and long-term survival, but the best treatment options should be determined in prospective randomised studies. Gemcitabine has for 15 years been the only validated therapy for advanced PC. Following decades of negative phase III studies, increasing evidence now suggests that further significant improvements to overall survival can be achieved via either Folfirinox or gemcitabine + nab-paclitaxel regimens. Progress in systemic therapy may improve the chances of resection in borderline resectable pancreatic cancer (BRPC) or locally advanced PC. This requires first enhancing knowledge of the genetic events driving carcinogenesis, which may then be translated into clinical studies.
Published: 2016

21. Predictive factors of the survival of women with invasive breast cancer in French Guiana: the burden of health inequalities

Author: Sophie Belliardo, Maylis Douine, Tristan Roue, Sylvain Labbé, Mathieu Nacher, Juliette Plenet, Registre des Cancers de Guyane, Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Centre d'Investigation Clinique Antilles-Guyane (CIC - Antilles Guyane), CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Institut National de la Santé et de la Recherche Médicale (INSERM)-Université des Antilles et de la Guyane (UAG), The present study was funded by the Health Regional Agency of French Guiana., The authors thank Professor J.P. Droz for a critical reading of the manuscript., Université des Antilles et de la Guyane (UAG)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de Fort de France-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], and ADENIS, ANTOINE
Subjects: Cancer Research, Pediatrics, Survival, Immigration, Health Services Accessibility, MESH: Healthcare Disparities/statistics & numerical data, 0302 clinical medicine, Breast cancer, MESH: Aged, 80 and over, Risk Factors, MESH: Risk Factors, Medicine, 030212 general & internal medicine, Early Detection of Cancer, MESH: Breast Neoplasms/pathology, media_common, Aged, 80 and over, MESH: Aged, MESH: Middle Aged, Relative survival, Carcinoma, Ductal, Breast, Age Factors, MESH: Neoplasm Staging, Place of birth, Middle Aged, Prognosis, MESH: Emigrants and Immigrants, 3. Good health, French Guiana, Survival Rate, Oncology, MESH: Breast Neoplasms/mortality, 030220 oncology & carcinogenesis, MESH: Survival Analysis, Female, Immigrant, Adult, medicine.medical_specialty, MESH: Socioeconomic Factors, MESH: Early Detection of Cancer/statistics & numerical data, MESH: French Guiana/epidemiology, MESH: Survival Rate, media_common.quotation_subject, Emigrants and Immigrants, Breast Neoplasms, MESH: Carcinoma, Ductal, Breast/mortality, MESH: Prognosis, 03 medical and health sciences, South America Word count : 2278, MESH: Health Services Accessibility, parasitic diseases, Humans, Healthcare Disparities, Survival rate, Survival analysis, Aged, Neoplasm Staging, MESH: Age Factors, MESH: Humans, business.industry, MESH: Adult, medicine.disease, Survival Analysis, MESH: Carcinoma, Ductal, Breast/pathology, Cancer registry, Metropolitan France, Socioeconomic Factors, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female, Demography
Abstract: International audience; This study aimed to compare the relative survival of patients with invasive breast cancer between women from French Guiana (a French territory in South America) and metropolitan France. No study hadever compared survival of breast cancer on the basis of immigrant status in France. Our study underlined that access to care for migrants is challenging whichwgenerates health inequalities. Background The prognosis of breast cancer in French Guiana is worse than in France with 23 deaths per 100 incident cases against 17 per 100 in metropolitan France. This study aimed to compare relative survival of patients with invasive breast cancer (IBC) between women from French Guiana and metropolitan France and to determine risk factors influencing breast cancer survival in French Guiana.Materials and methods Data were collected from the Cancer registry of French Guiana. We comparedthe relative survival of women with IBC between French Guiana and metropolitan France. We used Cox's proportional hazard regression to evaluate the effect of prognostic factors on cancer-specific mortality in French Guiana. Results We included all 269 cases of IBC in women diagnosed in French Guiana between 2003 and 2009. The overall 5-year relative survival rate of patients with IBC was 79% in French Guiana and 86% in metropolitan France. The place of birth (foreign country versus French territory), the tumor stage at the time of diagnosis, the mode of diagnosis (symptoms versus screening), the presence of hormone receptors in the tumor and the histologic type were the variables associated with survival differences. None of the other study variables were significantly associated with prognosis. Conclusion Access to care for migrants is challenging,which leads to health inequalities. Early detection through prevention programs is crucial to increaseIBC survival notably for foreign-born patients.
Published: 2016

22. Influence of sample return time and ambient temperature on the performance of an immunochemical faecal occult blood test with a new buffer for colorectal cancer screening

Author: Jeanne-Marie Bidan, Sylvain Manfredi, Samia Hamza, Côme Lepage, Jean Faivre, Vincent Dancourt, Antoine Drouillard, Registre Bourguignon des Cancers Digestifs, Lipides - Nutrition - Cancer (U866) ( LNC ), Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon ( ENSBANA ) -Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon ( ENSBANA ) -Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Association de dépistage des cancers en Côte-d'Or (ADECA 21) ( ADECA 21 ), Mutualité française, Laboratoire du Centre d'examens de santé de la CPAM de Côte-d'Or ( Lab CES CPAM Dijon ), Caisse Primaire de l'Assurance Maladie ( CPAM ), Lipides - Nutrition - Cancer (U866) (LNC), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon (ENSBANA)-Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon (ENSBANA)-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Association de dépistage des cancers en Côte-d'Or (ADECA 21) (ADECA 21), Laboratoire du Centre d'examens de santé de la CPAM de Côte-d'Or (Lab CES CPAM Dijon), and Caisse primaire d'assurance maladie (CPAM)
Subjects: Male, Cancer Research, Multivariate analysis, Time Factors, Epidemiology, Colorectal cancer, MESH: Reagent Kits, Diagnostic, MESH : Aged, MESH : Hemoglobins, MESH : Early Detection of Cancer, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, Return time, Screening programme, Immunoenzyme Techniques, Hemoglobins, MESH : Specimen Handling, MESH : Female, MESH : Neoplasm Staging, MESH : Reagent Kits, Diagnostic, MESH : Temperature, Early Detection of Cancer, MESH: Aged, MESH: Middle Aged, MESH : Prognosis, Temperature, MESH: Follow-Up Studies, MESH: Neoplasm Staging, Middle Aged, Prognosis, Predictive value, MESH: Temperature, MESH: Hemoglobins, MESH : Occult Blood, Oncology, Colorectal cancer screening, Occult Blood, Female, Seasons, MESH : Colorectal Neoplasms, Colorectal Neoplasms, MESH : Time Factors, Adenoma, medicine.medical_specialty, Sample (material), MESH : Male, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH: Prognosis, Specimen Handling, Animal science, MESH : Immunoenzyme Techniques, medicine, Humans, MESH: Early Detection of Cancer, MESH : Middle Aged, MESH: Specimen Handling, MESH: Immunoenzyme Techniques, Aged, Neoplasm Staging, MESH: Adenoma, MESH: Humans, MESH : Seasons, business.industry, MESH: Time Factors, MESH : Humans, Public Health, Environmental and Occupational Health, MESH : Follow-Up Studies, medicine.disease, MESH: Male, Surgery, MESH : Adenoma, Reagent Kits, Diagnostic, Faecal occult blood test, business, MESH: Occult Blood, MESH: Female, MESH: Seasons, MESH: Colorectal Neoplasms, Follow-Up Studies
Abstract: IF 2.415; International audience; The haemoglobin concentration measured by faecal immunochemical tests (FIT) may be decreased in cases of delayed sample return or high temperature. It is an issue of great importance. The aim of this study was to investigate the effects of sample return time and of season on the performance of an FIT (FOB-Gold) with a new buffer. The study included 20 371 participants involved in the French organized colorectal cancer (CRC) screening programme. The probability of a positive screening test, detection rates and positive predictive values for CRC and advanced adenoma were analysed according to sample return time and season of screening. A sample of positive FIT was stored for 7 days in an incubator at 20°C or 30°C. The positivity rate was 4.1% for a sample return time of up to 3 days, 4.1% for 4-5 days and 4.6% for 6-7 days (P=0.25). In multivariate analysis, there was no association between positivity rates, detection rates and positive predictive values for CRC and advanced adenoma and the sample return time or the season of screening. At a constant temperature of 20°C, there was a decrease in the haemoglobin concentration of 5.1% after 7 days. The decrease reached 20.5% at a temperature of 30°C. It was only 4.5% during the first 4 days of storage in the incubator. With the new buffer, delay in sample return or season did not affect the clinical outcome. When temperatures reach 30°C, the faecal sample must be returned promptly.
Published: 2016

23. Utility of a molecular prescreening program in advanced colorectal cancer for enrollment on biomarker-selected clinical trials†

Author: Kanwal Pratap Singh Raghav, Li Liang, Robert A. Wolff, J. Morris, Bryan K. Kee, Imad Shureiqi, Van K. Morris, Thibault Mazard, Lianchun Xiao, Funda Meric-Bernstam, Gordon B. Mills, James L. Abbruzzese, Cathy Eng, Kenna Rael Shaw, Eduardo Vilar, Scott Kopetz, Michael J. Overman, Arvind Dasari, Rachna T. Shroff, David R. Fogelman, Dipen M. Maru, Stanley R. Hamilton, Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), and CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)
Subjects: 0301 basic medicine, MESH: Neoplasm Proteins, Male, Multivariate analysis, Colorectal cancer, Eligibility Determination, 0302 clinical medicine, MESH: Aged, 80 and over, MESH: DNA Methylation, MESH: CpG Islands, targeted, MESH: Aged, Aged, 80 and over, MESH: Middle Aged, Hematology, MESH: Neoplasm Staging, Middle Aged, 3. Good health, Neoplasm Proteins, Oncology, 030220 oncology & carcinogenesis, Biomarker (medicine), Female, MESH: Biomarkers, Tumor, Fluorouracil, Colorectal Neoplasms, Adult, medicine.medical_specialty, colorectal cancer, [SDV.CAN]Life Sciences [q-bio]/Cancer, 03 medical and health sciences, MESH: Eligibility Determination, Internal medicine, medicine, Biomarkers, Tumor, Humans, MESH: Patient Selection, molecular, Aged, Neoplasm Staging, Gynecology, MESH: Humans, Performance status, business.industry, screening, Patient Selection, Cancer, MESH: Adult, Odds ratio, Original Articles, DNA Methylation, medicine.disease, prescreening, MESH: Male, Clinical trial, 030104 developmental biology, CpG Islands, business, MESH: Female, MESH: Fluorouracil, MESH: Colorectal Neoplasms, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: BACKGROUND: Incorporation of multiple enrichment biomarkers into prospective clinical trials is an active area of investigation, but the factors that determine clinical trial enrollment following a molecular prescreening program have not been assessed. PATIENTS AND METHODS: Patients with 5-fluorouracil-refractory metastatic colorectal cancer at the MD Anderson Cancer Center were offered screening in the Assessment of Targeted Therapies Against Colorectal Cancer (ATTACC) program to identify eligibility for companion phase I or II clinical trials with a therapy targeted to an aberration detected in the patient, based on testing by immunohistochemistry, targeted gene sequencing panels, and CpG island methylation phenotype assays. RESULTS: Between August 2010 and December 2013, 484 patients were enrolled, 458 (95%) had a biomarker result, and 157 (32%) were enrolled on a clinical trial (92 on biomarker-selected and 65 on nonbiomarker selected). Of the 458 patients with a biomarker result, enrollment on biomarker-selected clinical trials was ninefold higher for predefined ATTACC-companion clinical trials as opposed to nonpredefined biomarker-selected clinical trials, 17.9% versus 2%, P < 0.001. Factors that correlated positively with trial enrollment in multivariate analysis were higher performance status, older age, lack of standard of care therapy, established patient at MD Anderson, and the presence of an eligible biomarker for an ATTACC-companion study. Early molecular screening did result in a higher rate of patients with remaining standard of care therapy enrolling on ATTACC-companion clinical trials, 45.1%, in contrast to nonpredefined clinical trials, 22.7%; odds ratio 3.1, P = 0.002. CONCLUSIONS: Though early molecular prescreening for predefined clinical trials resulted in an increase rate of trial enrollment of nonrefractory patients, the majority of patients enrolled on clinical trials were refractory to standard of care therapy. Within molecular prescreening programs, tailoring screening for preidentified and open clinical trials, temporally linking screening to treatment and optimizing both patient and physician engagement are efforts likely to improve enrollment on biomarker-selected clinical trials. CLINICAL TRIALS NUMBER: The study NCT number is NCT01196130.
Published: 2016

24. A new internet tool to report peritoneal malignancy extent. PeRitOneal MalIgnancy Stage Evaluation (PROMISE) application

Author: François Quenet, Frédéric Marchal, François-Noël Gilly, Laurent Villeneuve, Jean-Marc Guilloit, M. Carretier, S. Carrere, Clarisse Eveno, Julien Fontaine, Faheez Mohamed, Delphine Vaudoyer, S. Isaac, A. Chevallier, A. Dohan, Cécile Brigand, P. Rousset, F. Poizat, Peggy Dartigues, Julio Abba, Frédéric Dumont, Nicolas Pirro, C. Petorin, Frédéric Guyon, G. Lang-Averous, S. Evrard, Gérard Lorimier, Karine Abboud, P. Rat, E. Mery, G. Pourcher, Jack Porcheron, Pablo Ortega-Deballon, M. Messager, Rea Lo Dico, Nicolas Goasguen, Pierre Meeus, R. Tetreau, Houda Ben Rejeb, S. Durand-Fontanier, P. Peyrat, A. Mariani, Dominique Elias, D. Bouzard, D. Geffroy, D. Delroeux, J.M. Bereder, C. de Chaisemartin, Christophe Mariette, R. Kianmanesh, Pierre-Jean Valette, Jean-Jacques Tuech, M. H. Laverrière, B. Lelong, Guillaume Piessen, C. Labbé, Mehdi Karoui, S. Velasco, Guillaume Passot, Diane Goéré, V. Barrau, G. Balague, V. Loi, Olivier Glehen, P. Rousselot, Jean-Marc Regimbeau, Emilie Thibaudeau, Thomas Courvoisier, V. Verriele-Beurrier, Frédéric Bibeau, G. Desolneux, M. Chassang, Marc Pocard, Magali Svrcek, Jérémie H. Lefevre, J. Lacroix, O. Fay, Franck Zinzindohoué, Catherine Arvieux, Naoual Bakrin, Denis Pezet, A. Leroux, Cédric Nadeau, Charles Sabbagh, Romuald Wernert, Bruno Heyd, Pascale Mariani, S. Msika, S. Valmary-Degano, L. Ghouti, A. Thivolet, Clarisse Dromain, R. Kaci, G. Ferron, Pôle Information Médicale Evaluation Recherche (IMER), Hospices Civils de Lyon (HCL), Ciblage thérapeutique en Oncologie (EA3738), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Département de chirurgie, CRLCC Val d'Aurelle - Paul Lamarque, and Département de radiothérapie
Subjects: MESH: Medical Records, medicine.medical_specialty, Scoring application, [SDV.CAN]Life Sciences [q-bio]/Cancer, Medical Records, Peritoneal malignancy, 03 medical and health sciences, Peritoneal Neoplasm, 0302 clinical medicine, MESH: Patient Care Team, Predictive Value of Tests, Medicine, Resectability, MESH: Peritoneal Neoplasms, Humans, Stage (cooking), Peritoneal Neoplasms, Neoplasm Staging, Patient Care Team, Internet, MESH: Humans, business.industry, Medical record, MESH: Peritoneum, Reproducibility of Results, General Medicine, MESH: Neoplasm Staging, Peritoneal cancer index, MESH: Predictive Value of Tests, 3. Good health, Surgery, MESH: Reproducibility of Results, MESH: Internet, Oncology, 030220 oncology & carcinogenesis, Predictive value of tests, Conventional PCI, Peritoneal Cancer Index, 030211 gastroenterology & hepatology, Radiology, Peritoneal diseases, Extent disease, Peritoneum, business, Peritoneal carcinomatosis, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; Based on the importance of assessing the true extent of peritoneal disease, PeRitOneal MalIgnancy Stage Evaluation (PROMISE) internet application (www.e-promise.org) has been developed to facilitate tabulation and automatically calculate surgically validated peritoneal cancer index (PCI), and other surgically validated scores as Gilly score, simplified peritoneal cancer index (SPCI), Fagotti and Fagotti-modified scores. This application offers computer-assistance to produce simple, quick but precise and standardized pre, intra and postoperative reports of the extent of peritoneal metastases and may help specialized and non-specialized institutions in their current practice but also facilitate research and multicentre studies on peritoneal surface malignancies.
Published: 2016

25. PRODIGE 34-FFCD 1402-ADAGE: Adjuvant chemotherapy in elderly patients with resected stage III colon cancer: A randomized phase 3 trial

Author: Aparicio , Thomas, Francois , Eric, Cristol-Dalstein , Laurence, Carola , Elisabeth, Maillard , Emilie, Paillaud , Elena, Retornaz , Frédérique, Faroux , Roger, André , Thierry, Bedenne , Laurent, Seitz , Jean-François, Service de Gastro-entérologie [Avicenne], Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Avicenne-Université Paris 13 ( UP13 ), Centre Antoine Lacassagne, CRLCC Antoine Lacassagne, UNICANCER - Institut régional du Cancer [Montpellier] ( ICM ), CRLCC Val d'Aurelle - Paul Lamarque, CH Creil/Senlis, Fédération Francophone de la Cancérologie Digestive, FFCD, Lipides - Nutrition - Cancer (U866) ( LNC ), Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon ( ENSBANA ), Unité de médecine gériatrique ( Gériatrie - Henri Mondor ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Hôpital Albert Chenevier, Centre Gérontologique Départemental de Marseille ( CGD 13 ), Service de chirurgie digestive (CH de La Roche-sur-Yon), Centre Hospitalier Départemental - Hôpital de La Roche-sur-Yon, Service d'Oncologie Médicale [CHU Saint -Antoine], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Saint-Antoine [APHP], Service d'oncologie digestive et hépato-gastro-entérologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille ( APHM ) - Hôpital de la Timone [CHU - APHM] ( TIMONE ), Ligue Nationale Contre le Cancer, Université Paris 13 (UP13)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Lutte contre le Cancer Antoine Lacassagne [Nice] (UNICANCER/CAL), UNICANCER-Université Côte d'Azur (UCA), UNICANCER - Institut régional du Cancer Montpellier Val d'Aurelle (ICM), Lipides - Nutrition - Cancer (U866) (LNC), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bourgogne (UB)-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon (ENSBANA)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, Unité de médecine gériatrique (Gériatrie - Henri Mondor), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Hôpital Albert Chenevier, Centre Gérontologique Départemental de Marseille (CGD 13), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), and Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE)
Subjects: Male, Organoplatinum Compounds, Oxaloacetates, MESH : Antineoplastic Combined Chemotherapy Protocols, Leucovorin, MESH : Aged, MESH : Leucovorin, Deoxycytidine, Activities of Daily Living, Antineoplastic Combined Chemotherapy Protocols, MESH : Neoplasm Staging, MESH : Female, Digestive System Surgical Procedures, MESH: Treatment Outcome, MESH: Digestive System Surgical Procedures, MESH: Aged, MESH: Organoplatinum Compounds, MESH : Chemotherapy, Adjuvant, MESH: Neoplasm Staging, MESH: Antineoplastic Combined Chemotherapy Protocols, Treatment Outcome, MESH : Colonic Neoplasms, MESH: Chemotherapy, Adjuvant, Chemotherapy, Adjuvant, Colonic Neoplasms, MESH : Fluorouracil, MESH : Disease-Free Survival, Female, [ SDV.MHEP.HEG ] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Fluorouracil, Efficacy, MESH : Male, MESH : Treatment Outcome, MESH : Organoplatinum Compounds, MESH : Capecitabine, Disease-Free Survival, MESH : Deoxycytidine, Humans, MESH : Digestive System Surgical Procedures, Capecitabine, Aged, Neoplasm Staging, MESH: Colonic Neoplasms, MESH: Humans, MESH: Activities of Daily Living, MESH: Deoxycytidine, MESH : Humans, MESH: Capecitabine, MESH: Quality of Life, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, MESH : Quality of Life, MESH: Male, MESH: Disease-Free Survival, Quality of Life, MESH: Leucovorin, MESH : Activities of Daily Living, MESH: Fluorouracil, MESH: Female
Abstract: IF 2.719; International audience
Published: 2016

26. Feasibility Study of EndoTAG-1, a Tumor Endothelial Targeting Agent, in Combination with Paclitaxel followed by FEC as Induction Therapy in HER2-Negative Breast Cancer

Author: Andrea Gombos, Stefan Michiels, Fabienne Lebrun, Dimitrios Zardavas, Christos Sotiriou, Ahmad Awada, Lieveke Ameye, Jean-Marie Nogaret, Michail Ignatiadis, Evandro de Azambuja, Marion Maetens, Denis Larsimont, Celine Wilke, Marianne Paesmans, Véronique D'Hondt, Martine Piccart, Lissandra Dal Lago, Fanny Bustin, Marie-Catherine Vanderbeeken, Marc Lemort, Isabelle Veys, Herrada, Anthony, Clinique d'Oncologie Médicale [Brussels, Belgium], Université libre de Bruxelles (ULB)-Institut Jules Bordet [Bruxelles], Faculté de Médecine [Bruxelles] (ULB), Université libre de Bruxelles (ULB)-Université libre de Bruxelles (ULB)-Faculté de Médecine [Bruxelles] (ULB), Université libre de Bruxelles (ULB), Laboratoire de recherche translationnelle sur le cancer du sein [Brussels, Belgium], Breast International Group [Brussels, Belgium] (BIG aisbl), Département de Radiologie [Brussels, Belgium] (ULB), Medigene AG [Planegg, Germany], Service de biostatistique et d'épidémiologie (SBE), Direction de la recherche clinique [Gustave Roussy], Institut Gustave Roussy (IGR)-Institut Gustave Roussy (IGR), Méthodologie et épidémiologie clinique en oncologie moléculaire (U1018 (Équipe 2)), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Gustave Roussy (IGR), IJB was the sponsor of this study and Medigene AG provided the EndoTAG-1 and an educational grant. Medigene AG provided support in the form of salaries for author CW., Institut Jules Bordet [Bruxelles], and Université libre de Bruxelles (ULB)-Université libre de Bruxelles (ULB)
Subjects: medicine.medical_treatment, Psychologie appliquée, Diagnostic Radiology, 0302 clinical medicine, Animal Cells, Antineoplastic Combined Chemotherapy Protocols, Medicine, lcsh:Science, MESH: Treatment Outcome, MESH: Middle Aged, Induction Chemotherapy, Sciences bio-médicales et agricoles, MESH: Induction Chemotherapy, 3. Good health, MESH: Antineoplastic Combined Chemotherapy Protocols, Oncology, Paclitaxel, Fluorouracil, 030220 oncology & carcinogenesis, MESH: Biomarkers, Tumor, Cellular Types, Biologie, Clinical Oncology, medicine.medical_specialty, Imaging Techniques, Immune Cells, Immunology, Urology, Surgical and Invasive Medical Procedures, MESH: Epirubicin, 03 medical and health sciences, Breast cancer, Drug Therapy, [SDV.CAN] Life Sciences [q-bio]/Cancer, Humans, Cyclophosphamide, Blood Cells, MESH: Humans, lcsh:R, Biology and Life Sciences, MESH: Cyclophosphamide, MESH: Adult, medicine.disease, 030104 developmental biology, chemistry, lcsh:Q, Neoplasm Grading, Clinical Medicine, MESH: Female, MESH: Fluorouracil, 0301 basic medicine, MESH: Combined Modality Therapy, Receptor, ErbB-2, Cancer Treatment, lcsh:Medicine, MESH: Neoplasm Grading, MESH: Magnetic Resonance Imaging, White Blood Cells, chemistry.chemical_compound, Breast Tumors, Medicine and Health Sciences, Multidisciplinary, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Pharmaceutics, Radiology and Imaging, MESH: Neoplasm Staging, Middle Aged, Combined Modality Therapy, Magnetic Resonance Imaging, MESH: Receptor, ErbB-2, Treatment Outcome, Surgical Oncology, Female, Research Article, medicine.drug, Epirubicin, Adult, Neutropenia, Breast Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, Research and Analysis Methods, Diagnostic Medicine, Breast Cancer, Biomarkers, Tumor, Hypersensitivity, Chemotherapy, MESH: Paclitaxel, Neoplasm Staging, business.industry, Cancers and Neoplasms, Induction chemotherapy, Cell Biology, Surgery, Clinical Immunology, business, MESH: Breast Neoplasms, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: Background: EndoTAG-1, a tumor endothelial targeting agent has shown activity in metastatic triple-negative breast cancer (BC) in combination with paclitaxel. Methods: HER2-negative BC patients candidates for neoadjuvant chemotherapy were scheduled to receive 12 cycles of weekly EndoTAG-1 22mg/m2 plus paclitaxel 70mg/m2 followed by 3 cycles of FEC (Fluorouracil 500mg/m2, Epirubicin 100mg/m2, Cyclophosphamide 500mg/m2) every 3 weeks followed by surgery. Primary endpoint was percent (%) reduction in Magnetic Resonance Imaging (MRI) estimated Gadolinium (Gd) enhancing tumor volume at the end of EndoTAG-1 plus paclitaxel administration as compared to baseline. Safety, pathological complete response (pCR) defined as no residual tumor in breast and axillary nodes at surgery and correlation between % reduction in MRI estimated tumor volume and pCR were also evaluated. Results: Fifteen out of 20 scheduled patients were included: Six patients with estrogen receptor (ER)-negative/HER2-negative and 9 with ER-positive/HER2-negative BC. Nine patients completed treatment as per protocol. Despite premedication and slow infusion rates, grade 3 hypersensitivity reactions to EndoTAG-1 were observed during the 1st, 2nd, 3rd and 6th weekly infusion in 4 patients, respectively, and required permanent discontinuation of the EndoTAG-1. Moreover, two additional patients stopped EndoTAG-1 plus paclitaxel after 8 and 9 weeks due to clinical disease progression. Two patients had grade 3 increases in transaminases and 1 patient grade 4 neutropenia. pCR was achieved in 5 of the 6 ER-/HER2- and in none of the 9 ER+/HER2- BC patients. The mean % reduction in MRI estimated tumor volume at the end of EndoTAG-1 plus paclitaxel treatment was 81% (95% CI, 66% to 96%, p, SCOPUS: ar.j, info:eu-repo/semantics/published
Published: 2016

27. Prognostic Value of Extranodal Extension and Other Lymph Node Parameters in Patients With Upper Tract Urothelial Carcinoma

Author: Jay D. Raman, Thomas F. Chromecki, Eugene K. Cha, Christian Seitz, Gerhard Donner, Harun Fajkovic, Claudio Jeldres, Karim Bensalah, Vitaly Margulis, Armin Pycha, Mesut Remzi, Giacomo Novara, Alon Z. Weizer, Yair Lotan, Wassim Kassouf, Vincenzo Ficarra, Kazumasa Matsumoto, Eiji Kikuchi, Francesco Montorsi, Marco Roscigno, Pierre I. Karakiewicz, Douglas S. Scherr, Eckart Breinl, Shahrokh F. Shariat, Weill Medical College of Cornell University [New York], Cancer Prognostics and Health Outcomes Unit, Université de Montréal (UdeM), Department of Urology, University of Texas Southwestern Medical Center [Dallas]- The University of Texas Health Science Center at Houston (UTHealth), Departement of Oncological and Surgical Sciences, Universita degli Studi di Padova, Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], University of Michigan [Ann Arbor], University of Michigan System, Keio University School of Medicine [Tokyo, Japan], Hospital Weinviertel-Korneuburg-Landesklinikum Korneuburg, General Hospital of Bolzano, Health Robotics S.r.l., Department of urology, Università Vita-Salute San Raffaele, Service d'urologie [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Fajkovic, Harun, Cha Eugene, K., Jeldres, Claudio, Donner, Gerhard, Chromecki Thomas, F., Margulis, Vitaly, Novara, Giacomo, Lotan, Yair, Raman Jay, D., Kassouf, Wassim, Seitz, Christian, Bensalah, Karim, Weizer, Alon, Kikuchi, Eiji, Roscigno, Marco, Remzi, Mesut, Matsumoto, Kazumasa, Breinl, Eckart, Pycha, Armin, Ficarra, Vincenzo, Montorsi, Francesco, Karakiewicz Pierre, I., Scherr Douglas, S., and Shariat Shahrokh, F.
Subjects: Male, Oncology, MESH: Chi-Square Distribution, urothelial carcinoma carcinoma, MESH: Lymphatic Metastasis, medicine.medical_treatment, 030232 urology & nephrology, carcinoma, Nephrectomy, lymph node excision, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, MESH: Proportional Hazards Models, neoplasm metastasis, 0302 clinical medicine, Risk Factors, MESH: Risk Factors, MESH: Ureteral Neoplasms, Stage (cooking), Lymph node, Neoadjuvant therapy, MESH: Treatment Outcome, MESH: Statistics, Nonparametric, MESH: Follow-Up Studies, MESH: Neoplasm Staging, Prognosis, MESH: Urinary Bladder Neoplasms, 3. Good health, Treatment Outcome, medicine.anatomical_structure, Chemotherapy, Adjuvant, MESH: Chemotherapy, Adjuvant, Lymphatic Metastasis, 030220 oncology & carcinogenesis, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Lymph, Radiology, MESH: Neoplasm Recurrence, Local, medicine.medical_specialty, Urology, urinary tract, urothelium, Statistics, Nonparametric, MESH: Prognosis, 03 medical and health sciences, Internal medicine, medicine, Carcinoma, Humans, Neoplasm Staging, Proportional Hazards Models, Retrospective Studies, Chi-Square Distribution, MESH: Humans, Ureteral Neoplasms, MESH: Lymph Node Excision, business.industry, Carcinoma in situ, MESH: Retrospective Studies, Retrospective cohort study, medicine.disease, MESH: Male, MESH: Nephrectomy, Urinary Bladder Neoplasms, Neoplasm Recurrence, Local, business, MESH: Female, Follow-Up Studies
Abstract: International audience; PURPOSE: We assessed the prognostic value of extranodal extension and other lymph node parameters in a large multicenter cohort of patients with lymph node metastasis after radical nephroureterectomy. MATERIALS AND METHODS: We retrospectively analyzed the records of 222 patients with lymph node metastasis treated with radical nephroureterectomy for upper tract urothelial carcinoma without neoadjuvant therapy. Each lymph node metastasis was microscopically evaluated for extranodal extension. RESULTS: A median of 4 lymph nodes (IQR 8) was removed. Two lymph nodes (IQR 2) were positive. Lymph node density was 51.3% (IQR 71.7%). Overall 110 patients (49.5%) had extranodal extension, which was associated with more advanced pT stage (p = 0.026). On multivariable analysis extranodal extension was associated with disease recurrence (p = 0.01) and cancer specific mortality (p = 0.013). When stratified by a 30% cutoff, lymph node density was associated with disease recurrence and cancer specific mortality on univariable but not multivariable analysis (p = 0.048 and 0.049, respectively). Adding extranodal extension to a multivariable model including pT stage and tumor architecture improved predictive accuracy for disease recurrence from 70.3% to 74.5% (p
Published: 2012

28. Therapeutic vaccination with TG4010 and first-line chemotherapy in advanced non-small-cell lung cancer: a controlled phase 2B trial

Author: Didier Debieuvre, Jean-Marc Limacher, Elisabeth Quoix, A. Madroszyk, Marc Buyse, Jean-Yves Bonnefoy, Z. Papai, Erich Stoelben, Gisèle Lacoste, Piotr Koralewski, Hervé Lena, Denis Braun, Alain Rivière, Marie-Pierre Chenard, Bérangère Bastien, Jean-Luc Breton, Annette Tavernaro, Rodryg Ramlau, Bruce Acres, Nadine Bizouarne, Virginie Westeel, Service de pneumologie, CHU Strasbourg-Hopital Civil, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ) -Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Laboratoire d'Ingénierie des Systèmes Mécaniques et des MAtériaux ( LISMMA ), Université Paris 8 Vincennes-Saint-Denis ( UP8 ) -SUPMECA - Institut supérieur de mécanique de Paris, Centre Hospitalier de Belfort-Montbéliard, Service de Pneumologie, CHI de la Haute-Saône, International Drug Development Institute ( IDDI ), Service d'Anatomie Pathologique Générale, CHU Strasbourg-Hôpital de Hautepierre [Strasbourg], Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Laboratoire d'Ingénierie des Systèmes Mécaniques et des MAtériaux (LISMMA), Université Paris 8 Vincennes-Saint-Denis (UP8)-SUPMECA - Institut supérieur de mécanique de Paris (SUPMECA), CH Belfort-Montbéliard, and International Drug Development Institute (IDDI)
Subjects: Male, Lung Neoplasms, MESH: Chi-Square Distribution, MESH : Antineoplastic Combined Chemotherapy Protocols, medicine.medical_treatment, MESH: Membrane Glycoproteins, MESH : Aged, MESH: Risk Assessment, Deoxycytidine, Gastroenterology, MESH: Cancer Vaccines, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, 0302 clinical medicine, Antineoplastic Combined Chemotherapy Protocols, MESH: Vaccinia virus, Clinical endpoint, MESH : Neoplasm Staging, MESH: Treatment Outcome, Vaccines, Synthetic, 0303 health sciences, Membrane Glycoproteins, MESH: Middle Aged, MESH : Vaccinia virus, MESH : Antimetabolites, Antineoplastic, MESH : Chemotherapy, Adjuvant, 3. Good health, MESH: Antineoplastic Combined Chemotherapy Protocols, Oncology, 030220 oncology & carcinogenesis, Antimetabolites, Antineoplastic, medicine.medical_specialty, MESH: Vaccines, Synthetic, Risk Assessment, Disease-Free Survival, MESH : Cisplatin, 03 medical and health sciences, Humans, MESH : Middle Aged, MESH : Lung Neoplasms, MESH : Vaccines, Synthetic, Adverse effect, MESH: Kaplan-Meier Estimate, Aged, Chi-Square Distribution, MESH: Humans, MESH : Carcinoma, Non-Small-Cell Lung, MESH : Chi-Square Distribution, MESH: Deoxycytidine, MESH : Humans, MESH: Adult, MESH: Interleukin-2, MESH : Proportional Hazards Models, medicine.disease, MESH: Lung Neoplasms, MESH: Disease-Free Survival, Cisplatin, MESH: Female, MESH: Mucin-1, Time Factors, MESH : Membrane Glycoproteins, Kaplan-Meier Estimate, MESH: Proportional Hazards Models, Risk Factors, MESH: Risk Factors, Carcinoma, Non-Small-Cell Lung, MESH : Female, MESH : Risk Assessment, MESH: Aged, MESH: Antimetabolites, Antineoplastic, MESH : Cancer Vaccines, MESH: Neoplasm Staging, Middle Aged, MESH : Adult, MESH : Risk Factors, Europe, Treatment Outcome, Chemotherapy, Adjuvant, MESH: Chemotherapy, Adjuvant, MESH : Mucin-1, MESH : Disease-Free Survival, Female, MESH : Time Factors, medicine.drug, Adult, Combination therapy, MESH : Male, MESH : Europe, Vaccinia virus, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH : Treatment Outcome, Neutropenia, Cancer Vaccines, MESH : Interleukin-2, MESH : Kaplan-Meier Estimate, MESH : Deoxycytidine, Internal medicine, medicine, Lung cancer, Neoplasm Staging, Proportional Hazards Models, 030304 developmental biology, Chemotherapy, Performance status, business.industry, Mucin-1, MESH: Time Factors, Gemcitabine, MESH: Male, Surgery, MESH: Cisplatin, Interleukin-2, MESH: Europe, business, MESH: Carcinoma, Non-Small-Cell Lung
Abstract: International audience; BACKGROUND: Chemotherapy is the standard of care for advanced stages of non-small-cell lung cancer (NSCLC). TG4010 is a targeted immunotherapy based on a poxvirus (modified vaccinia virus Ankara) that codes for MUC1 tumour-associated antigen and interleukin 2. This study assessed TG4010 in combination with first-line chemotherapy in advanced NSCLC. METHODS: 148 patients with advanced (stage IIIB [wet] or IV) NSCLC expressing MUC1 by immunohistochemistry, and with performance status 0 or 1, were enrolled in parallel groups in this open-label, phase 2B study. 74 patients were allocated to the combination therapy group, and received TG4010 (10(8) plaque forming units) plus cisplatin (75 mg/m(2) on day 1) and gemcitabine (1250 mg/m(2) on days 1 and 8) repeated every 3 weeks for up to six cycles. 74 patients allocated to the control group received the same chemotherapy alone. Patients were allocated using a dynamic minimisation procedure stratified by centre, performance status, and disease stage. The primary endpoint was 6-month progression-free survival (PFS), with a target rate of 40% or higher in the experimental group. Analyses were done on an intention-to-treat basis. This study is completed and is registered with ClinicalTrials.gov, number NCT00415818. FINDINGS: 6-month PFS was 43*2% (32 of 74; 95% CI 33*4-53*5) in the TG4010 plus chemotherapy group, and 35*1% (26 of 74; 25*9-45*3) in the chemotherapy alone group. Fever, abdominal pain, and injection-site pain of any grade according to National Cancer Institute Common Toxicity Criteria were more common in the TG4010 group than in the chemotherapy alone group: 17 of 73 patients (23*3%) versus six of 72 (8*3%), 12 (16*4%) versus two (2*8%), and four (5*5%) versus zero (0%), respectively. The most common grade 3-4 adverse events were neutropenia (33 [45*2%] of patients in the TG4010 plus chemotherapy group vs 31 [43*1%] in the chemotherapy alone group) and fatigue (18 [24*7%] vs 13 [18*1%]); the only grade 3-4 events that differed significantly between groups were anorexia (three [4*1%] vs 10 [13*9%]) and pleural effusion (none vs four [5*6%]). 38 of 73 patients (52*1%) in the TG4010 plus chemotherapy group and 34 of 72 (47*2%) in the chemotherapy alone group had at least one serious adverse event. INTERPRETATION: This phase 2B study suggests that TG4010 enhances the effect of chemotherapy in advanced NSCLC. A confirmatory phase 2B-3 trial has been initiated. FUNDING: Transgene SA, Advanced Diagnostics for New Therapeutic Approaches (ADNA)/OSEO.
Published: 2011

29. 18F-FLT and 18F-FDG positron emission tomography for the imaging of advanced well-differentiated gastro-entero-pancreatic endocrine tumours

Author: Francesco Giammarile, Valérie Hervieu, Didier Le Bars, Jean-Philippe Vuillez, Catherine Lombard-Bohas, Jean-Yves Scoazec, Catherine Cornu, Claire Houzard, Françoise Borson-Chazot, Claire Bournaud, Sandrine Masson, Thomas Walter, Marc Janier, Claire Billotey, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Laboratoire de Physico-Chimie des Matériaux Luminescents (LPCML), Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, E04, Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'Etude et de Recherche Multimodal Et Pluridisciplinaire en imagerie du vivant (CERMEP - imagerie du vivant), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-CHU Grenoble-Hospices Civils de Lyon (HCL)-CHU Saint-Etienne-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), DOCOMO Euro-Labs, DOCOMO Communications Laboratories Europe GmbH-DOCOMO Communications Laboratories Europe GmbH-Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Université de Lyon, Laboratoire Central d'Anatomie et de Cytologie Pathologiques [Hôpital Edouard Herriot - HCL], Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL)-Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL)-Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Radiopharmaceutiques biocliniques, Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Evaluation et modélisation des effets thérapeutiques, Département biostatistiques et modélisation pour la santé et l'environnement [LBBE], Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), CIC CHU Lyon (inserm), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Lyon Sud [CHU - HCL] ( CHLS ), Hospices Civils de Lyon ( HCL ), Laboratoire de Physico-Chimie des Matériaux Luminescents ( LPCML ), Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique ( CNRS ), Centre de Recherche en Cancérologie de Lyon ( CRCL ), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ) -Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Centre d'Exploration et de Recherche Médicales par Émission de Positons ( CERMEP ), Université Joseph Fourier - Grenoble 1 ( UJF ) -Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-CHU Grenoble-Hospices Civils de Lyon ( HCL ) -CHU Saint-Etienne-Université Jean Monnet [Saint-Étienne] ( UJM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), DOCOMO Communications Laboratories Europe GmbH-DOCOMO Communications Laboratories Europe GmbH-Centre de Recherche en Cancérologie de Lyon ( CRCL ), Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ) -Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ) -Centre de Recherche en Cancérologie de Lyon ( CRCL ), Université Joseph Fourier - Grenoble 1 ( UJF ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Laboratoire de Biométrie et Biologie Evolutive ( LBBE ), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique ( Inria ) -Centre National de la Recherche Scientifique ( CNRS ), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé ( CREATIS ), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon ( INSA Lyon ), Université de Lyon-Institut National des Sciences Appliquées ( INSA ) -Institut National des Sciences Appliquées ( INSA ) -Hospices Civils de Lyon ( HCL ) -Université Jean Monnet [Saint-Étienne] ( UJM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-CHU Grenoble-Hospices Civils de Lyon (HCL)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), and Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Male, MESH : Aged, Neuroendocrine tumors, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, 030218 nuclear medicine & medical imaging, 0302 clinical medicine, MESH: Fluorodeoxyglucose F18, MESH : Intestinal Neoplasms, MESH : Stomach Neoplasms, MESH : Neoplasm Staging, MESH : Female, Prospective cohort study, MESH: Aged, MESH: Middle Aged, medicine.diagnostic_test, Ultrasound, MESH : Neuroendocrine Tumors, Cell Differentiation, MESH: Stomach Neoplasms, MESH: Neoplasm Staging, General Medicine, MESH : Adult, Middle Aged, MESH: Positron-Emission Tomography, 3. Good health, Neuroendocrine Tumors, MESH: Dideoxynucleosides, Positron emission tomography, 030220 oncology & carcinogenesis, MESH : Dideoxynucleosides, Female, MESH: Pancreatic Neoplasms, Radiology, MESH : Cell Differentiation, Preclinical imaging, MESH: Cell Differentiation, Adult, medicine.medical_specialty, MESH: Neuroendocrine Tumors, MESH : Male, [SDV.CAN]Life Sciences [q-bio]/Cancer, 03 medical and health sciences, Fluorodeoxyglucose F18, Stomach Neoplasms, Intestinal Neoplasms, Brain positron emission tomography, medicine, Humans, Endocrine system, MESH : Middle Aged, Radiology, Nuclear Medicine and imaging, MESH: Intestinal Neoplasms, Aged, Neoplasm Staging, MESH: Humans, business.industry, MESH : Humans, MESH : Positron-Emission Tomography, MESH: Adult, MESH : Fluorodeoxyglucose F18, medicine.disease, MESH: Male, Dideoxynucleosides, Pancreatic Neoplasms, Positron-Emission Tomography, business, MESH: Female, MESH : Pancreatic Neoplasms, Progressive disease
Abstract: International audience; PURPOSE: Gastro-entero-pancreatic (GEP) endocrine tumours are a heterogenous group of tumours of variable localization and prognosis. It has been suggested that positron emission tomography (PET) using 2-[18F]fluoro-2-deoxy-D-glucose (18F-FDG) may have a prognostic value and help to identify patients at risk of progression. [18F]fluoro-3'-deoxy-3'-L-fluorothymidine (18F-FLT) has been recently developed as a PET proliferation tracer. At present, there are no studies investigating its role in GEP. The aim of this prospective study was to assess the value of 18F-FLT-PET for the evaluation of GEP. MATERIALS AND METHODS: Ten patients with biopsy-proven locally advanced or metastasized, well-differentiated GEP neuroendocrine tumours were prospectively enrolled and scheduled for 18F-FDG and 18F-FLT-PET. Images were compared with other conventional diagnostic procedures, namely computed tomography, ultrasound, somatostatin receptor scintigraphy and with clinical and diagnostic follow-up. RESULTS: Evaluation criteria were interpreted in terms of assumed presence of tumoral tissue. According to the patient's status, FDG was positive in five out of the seven patients with stable disease and in two out of the three patients with progressive disease. No positive case was identified by 18F-FLT in either the primary or the metastatic tumour site, whatever the status of patients, and this was probably a reflection of the slow proliferation rate of tumours. CONCLUSION: These preliminary data suggest that 18F-FLT-PET is not a suitable tracer for the evaluation of advanced well-differentiated GEP tumours. FDG showed good diagnostic performance but does not help to identify patients at risk of progression.
Published: 2011

30. Surgery for Hilar Cholangiocarcinoma: A Multi-institutional Update on Practice and Outcome by the AFC-HC Study Group

Author: David Fuks, Jacques Belghiti, Philippe Bachellier, Olivier Farges, Karim Boudjema, Daniel Cherqui, Jean Marc Regimbeau, François-René Pruvot, Yves-Patrice Le Treut, Jacques Baulieux, Service de chirurgie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Chirurgie Hépatobiliaire et Digestive [Rennes] = Hepatobiliary and Digestive Surgery [Rennes], CHU Pontchaillou [Rennes], Foie, métabolismes et cancer, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Digestive Surgery and Transplantation, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de chirurgie digestive, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )
Subjects: Male, Preoperative management, 030230 surgery, MESH: Length of Stay, Cholangiocarcinoma, High morbidity, Postoperative Complications, MESH: Aged, 80 and over, 0302 clinical medicine, MESH: Liver Neoplasms, MESH: Postoperative Complications, Hospital Mortality, Prospective Studies, 10. No inequality, Surgical treatment, Aged, 80 and over, MESH: Aged, Perioperative management, Liver Neoplasms, Gastroenterology, MESH: Neoplasm Staging, MESH: Hepatectomy, Embolization, Therapeutic, 3. Good health, Drainage, Female, 030211 gastroenterology & hepatology, Adult, Reoperation, Surgical resection, medicine.medical_specialty, MESH: Reoperation, Perioperative Care, MESH: Drainage, 03 medical and health sciences, MESH: Cross-Sectional Studies, medicine, Hepatectomy, Humans, In patient, MESH: Hospital Mortality, MESH: Perioperative Care, Mortality, Aged, Neoplasm Staging, MESH: Humans, MESH: Lymph Node Excision, business.industry, General surgery, MESH: Adult, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Length of Stay, Hilar cholangiocarcinoma, MESH: Cholangiocarcinoma, MESH: Male, MESH: Prospective Studies, Surgery, MESH: Embolization, Therapeutic, Cross-Sectional Studies, Lymph Node Excision, Bile Ducts, Morbidity, MESH: Bile Ducts, business, MESH: Female
Abstract: International audience; INTRODUCTION: Surgical resection is the only option for long-term survival in patients with hilar cholangiocarcinoma (HC), but it is associated with high morbidity and mortality. The aim of the present study was to prospectively assess the perioperative management and short-term outcomes of surgical treatment of HC in a recent, multi-institutional study with a short inclusion period. METHODS: Between January and December 2008, a register prospectively collected data on patients operated on for HC (exploratory or curative surgery) in eight tertiary centers. The register focused on perioperative management, resectability, surgical procedures employed, morbidity, and mortality. The study cohort consisted of 56 patients (40 men and 16 women) with a median age of 63 years (range, 33-83 years). RESULTS: Among the 56 patients, 47 (84%) were jaundiced and 42 (75%) tumors were classified as Bismuth-Corlette type III-IV. Nine patients (16%) underwent staging laparoscopy and four (7%) received neoadjuvant chemotherapy. Preoperative biliary drainage (endoscopy, 42%) was performed in 38 (81%) jaundiced patients and portal vein embolization (right side, 83%) was performed prior to surgery in 18 patients (32%). Among these 56 patients, curative resection was achieved in 39 (70%). All underwent major liver resection (>3 segments), bile duct resection, and lymphadenectomy. Thirteen patients (36%) underwent portal vein resection, one of whom also required pancreaticoduodenectomy. Eighty-two percent of resected patients (n = 32) had no proof of malignancy prior to hepatectomy. Clear surgical margins were obtained in 77% (n = 30). The postoperative mortality was 8% and complications occurred in 72% of the resected patients. Seven (25%) patients required reoperation, and 15 (54%) patients required percutaneous drainage. In a univariate analysis, the risk factors for morbidity were intraoperative blood transfusion (p = 0.009) and vascular clamping (p = 0.006). The median length of hospitalization was 20 ± 13 days. CONCLUSION: Curative resection for HC is associated with a high rate of R0 resection. However, surgery is associated with high levels of morbidity and mortality, despite intensive perioperative management.
Published: 2011

31. Role of Preoperative Optimization of the Liver for Resection in Patients with Hilar Cholangiocarcinoma Type III

Author: Damien Olivié, Stéphane Grandadam, Philippe Compagnon, Yannick Malledant, Alexis Arnaud, Bernard Launois, Bernard Meunier, Karim Boudjema, Service de Chirurgie Hépatobiliaire et Digestive [Rennes] = Hepatobiliary and Digestive Surgery [Rennes], CHU Pontchaillou [Rennes], Foie, métabolismes et cancer, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service de radiologie et imagerie médicale [Rennes] = Radiology [Rennes], and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )
Subjects: Male, MESH: Lymphatic Metastasis, 030230 surgery, Gastroenterology, Cholangiocarcinoma, 0302 clinical medicine, Surgical oncology, Clinical endpoint, MESH: Peritoneal Neoplasms, Peritoneal Neoplasms, MESH: Treatment Outcome, Incidence (epidemiology), Hazard ratio, MESH: Neoplasm Staging, MESH: Follow-Up Studies, Jaundice, Survival Rate, Treatment Outcome, Liver, Oncology, Lymphatic Metastasis, 030220 oncology & carcinogenesis, Female, medicine.symptom, MESH: Preoperative Care, medicine.medical_specialty, MESH: Survival Rate, MESH: Bile Duct Neoplasms, Preoperative care, 03 medical and health sciences, Internal medicine, Preoperative Care, medicine, Humans, Neoplasm Invasiveness, Survival rate, Neoplasm Staging, Retrospective Studies, MESH: Humans, business.industry, MESH: Retrospective Studies, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Retrospective cohort study, MESH: Neoplasm Invasiveness, MESH: Cholangiocarcinoma, MESH: Male, MESH: Bile Ducts, Intrahepatic, Bile Ducts, Intrahepatic, Bile Duct Neoplasms, Surgery, business, MESH: Female, MESH: Liver, Follow-Up Studies
Abstract: International audience; BACKGROUND: Long-term survival after complete resection of hilar cholangiocarcinoma remains disappointing. The aim of this retrospective study was to assess the impact of liver optimization on postoperative outcome of hilar cholangiocarcinoma type III. MATERIALS AND METHODS: In a retrospective, single-center analysis, outcomes in patients with hilar cholangiocarcinoma type III who underwent resection after preoperative liver optimization (preoperative transhepatic biliary drainage [PTBD], bile replacement, and/or portal vein embolization [PVE]) were compared with nonoptimized controls. RESULTS: Of 41 patients undergoing surgery, 38 patients undergoing curative intent procedures were identified, of whom 15 underwent preoperative optimization. After PTBD, direct bilirubin decreased from 218.0 ± 184.2 to 75.9 ± 42.7 μmol/L (P = 0.03), and there was a trend toward decreased AST and ALT levels. Overall, 3- and 5-year survival rates were 47.9 ± 9.1 and 41.9 ± 9.8%. The primary endpoint, 5-year survival after surgery, was not significantly different between groups. Preoperative jaundice was identified as an independent prognostic factor for poor outcome (hazard ratio [HR] 2.12, P = 0.02). Four patients (10.5%) without preoperative optimization died of liver failure within the first 30 days postsurgery, preceded in three cases by intra-abdominal abscesses. PTBD was associated with a lower rate of postoperative intra-abdominal abscesses; however this factor was not independently predictive of higher survival. CONCLUSION: Preoperative optimization of the liver in hilar cholangiocarcinoma Type III reduced the incidence of intra-abdominal abscesses, but its impact on postoperative survival remains unclear.
Published: 2010

32. Detection of alpha- and beta-human papillomavirus (HPV) in cutaneous melanoma: a matched and controlled study using specific multiplex PCR combined with DNA microarray primer extension

Author: Jean Luc Prétet, Bernadette Kantelip, Christiane Mougin, Tarik Gheit, Jean Baptiste Ruer, Line Pépin, François Aubin, Chrystelle Vidal, Massimo Tommasino, Laboratoire d'anatomie pathologique [Besancon], Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Jean Minjoz-Université de Franche-Comté ( UFC ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Université Libre de Bruxelles [Bruxelles] ( ULB ), Service d'Anatomie pathologique [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), and Université libre de Bruxelles (ULB)
Subjects: Male, Oncology, Skin Neoplasms, Microarray, Gammapapillomavirus, MESH : Aged, MESH : Gammapapillomavirus, Alphapapillomavirus, Polymerase Chain Reaction, Biochemistry, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, MESH: Aged, 80 and over, 0302 clinical medicine, MESH : Alphapapillomavirus, MESH : Neoplasm Staging, MESH : Female, MESH : DNA, Viral, Melanoma, MESH : Polymerase Chain Reaction, Oligonucleotide Array Sequence Analysis, Skin, MESH: Human papillomavirus 16, Aged, 80 and over, MESH: Aged, Human papillomavirus 16, 0303 health sciences, education.field_of_study, MESH: Middle Aged, MESH : Prognosis, HPV infection, virus diseases, MESH: Neoplasm Staging, Middle Aged, MESH : Adult, Prognosis, female genital diseases and pregnancy complications, 3. Good health, MESH : Oligonucleotide Array Sequence Analysis, MESH: Young Adult, 030220 oncology & carcinogenesis, Female, Adult, medicine.medical_specialty, MESH: Melanoma, MESH : Male, Population, MESH : Melanoma, MESH : Young Adult, [SDV.CAN]Life Sciences [q-bio]/Cancer, Dermatology, Biology, MESH: Betapapillomavirus, MESH: Prognosis, Young Adult, 03 medical and health sciences, MESH: Skin, Internal medicine, Multiplex polymerase chain reaction, MESH : Skin, medicine, Betapapillomavirus, Humans, MESH : Middle Aged, MESH : Aged, 80 and over, education, MESH: Alphapapillomavirus, Molecular Biology, Aged, Neoplasm Staging, 030304 developmental biology, MESH: Humans, MESH : Betapapillomavirus, MESH: Skin Neoplasms, MESH : Skin Neoplasms, MESH : Humans, MESH : Human papillomavirus 16, Cancer, MESH: Adult, MESH: Polymerase Chain Reaction, medicine.disease, DNA extraction, MESH: Male, MESH: DNA, Viral, DNA, Viral, MESH: Oligonucleotide Array Sequence Analysis, Cutaneous melanoma, Immunology, MESH: Female, MESH: Gammapapillomavirus
Abstract: International audience; There are few contradictory studies investigating the involvement of HPV in melanoma. We designed a controlled study to evaluate the HPV DNA prevalence in melanoma. One hundred patients with cutaneous malignant melanoma diagnosed between 2002 and 2006 were included. Complementary wide excision (healthy skin) was performed in 85 patients and was used as internal control. After DNA extraction, 68 different HPV types were studied using a multiplex PCR combined with microarray primer extension. We did not observe any statistical significant difference in terms of HPV DNA prevalence in melanoma (38.8%) and in healthy skin from wide excision (42.4%). Twenty-one different HPV types were detected but only one type was present in the majority of our samples (80/85 melanoma vs 59/66 HS). The distribution of HPV genera and types was similar in melanoma and HS, and beta-HPV was predominant (30.6% and 31.8%). Among alpha-HPV (10.6%), high-risk mucosal HPV16 was predominant. Among beta-HPV, melanoma harboured significantly more type 22 than control normal skin from the same patients and significantly less type 21 than paired control normal skin. No correlation between clinical and pathological melanoma characteristics and HPV DNA prevalence was found. Our data do not support a role of HPV infection in melanocarcinogenesis, but confirm the previous data suggesting that HPV DNA is widely distributed among the population and that occult HPV infections are frequent. Furthermore, specific HPV types, such as a-HPV16 and beta-HPV species 2 may be involved in a sub-group of melanoma.
Published: 2009

33. Cetuximab plus chemotherapy in patients with advanced non-small-cell lung cancer (FLEX): an open-label randomised phase III trial

Author: Pirker, Robert, Pereira, Jose R, Szczesna, Aleksandra, Von Pawel, Joachim, Krzakowski, Maciej, Ramlau, Rodryg, Vynnychenko, Ihor, Park, Keunchil, Yu, Chih-Teng, Ganul, Valentyn, Roh, Jae-Kyung, Bajetta, Emilio, O'Byrne, Kenneth, De Marinis, Filippo, Eberhardt, Wilfried, Goddemeier, Thomas, Emig, Michael, Gatzemeier, Ulrich, Renseigné, Non, Chouaid, Christos, Department of Medicine I and Clinical Pathology, Universität Wien, Institut de Recherche Pierre Fabre, Centre de Recherche Pierre Fabre (Centre de R&D Pierre Fabre), PIERRE FABRE-PIERRE FABRE, Epidémiologie des maladies infectieuses et modélisation (ESIM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), R Pirker, JR Pereira, Roh JK, E Bajetta, K O'Byrne, de Marinis F, W Eberhardt, Goddemeier T, M Emig, Gatzemeier U, équipe de l'étude FLEX ., Szczesna A, von Pawel J, M Krzakowski, R Ramlau, Vynnychenko I, K Park, CT Yu, and V Ganul
Subjects: Male, Lung Neoplasms, medicine.medical_treatment, Cetuximab, Gastroenterology, MESH: Antibodies, Monoclonal, MESH: Proportional Hazards Models, MESH: Aged, 80 and over, 0302 clinical medicine, Carcinoma, Non-Small-Cell Lung, Antineoplastic Combined Chemotherapy Protocols, Medicine, MESH: Treatment Outcome, Aged, 80 and over, MESH: Aged, 0303 health sciences, MESH: Middle Aged, Antibodies, Monoclonal, Vinorelbine, MESH: Neoplasm Staging, General Medicine, Middle Aged, 3. Good health, ErbB Receptors, Survival Rate, MESH: Antineoplastic Combined Chemotherapy Protocols, Treatment Outcome, MESH: Young Adult, MESH: Survival Analysis, 030220 oncology & carcinogenesis, Female, medicine.drug, Adult, medicine.medical_specialty, Adolescent, MESH: Survival Rate, MESH: Vinblastine, Antineoplastic Agents, MESH: Receptor, Epidermal Growth Factor, Antibodies, Monoclonal, Humanized, Vinblastine, Young Adult, 03 medical and health sciences, Internal medicine, Humans, Lung cancer, Survival rate, Aged, Neoplasm Staging, Proportional Hazards Models, 030304 developmental biology, Cancer staging, MESH: Adolescent, Chemotherapy, MESH: Humans, business.industry, Cancer, MESH: Adult, medicine.disease, Survival Analysis, MESH: Male, MESH: Lung Neoplasms, Surgery, MESH: Cisplatin, MESH: Antineoplastic Agents, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Cisplatin, business, MESH: Female, MESH: Carcinoma, Non-Small-Cell Lung, Necitumumab
Abstract: International audience; BACKGROUND: Use of cetuximab, a monoclonal antibody targeting the epidermal growth factor receptor (EGFR), has the potential to increase survival in patients with advanced non-small-cell lung cancer. We therefore compared chemotherapy plus cetuximab with chemotherapy alone in patients with advanced EGFR-positive non-small-cell lung cancer. METHODS: In a multinational, multicentre, open-label, phase III trial, chemotherapy-naive patients (>or=18 years) with advanced EGFR-expressing histologically or cytologically proven stage wet IIIB or stage IV non-small-cell lung cancer were randomly assigned in a 1:1 ratio to chemotherapy plus cetuximab or just chemotherapy. Chemotherapy was cisplatin 80 mg/m(2) intravenous infusion on day 1, and vinorelbine 25 mg/m(2) intravenous infusion on days 1 and 8 of every 3-week cycle) for up to six cycles. Cetuximab-at a starting dose of 400 mg/m(2) intravenous infusion over 2 h on day 1, and from day 8 onwards at 250 mg/m(2) over 1 h per week-was continued after the end of chemotherapy until disease progression or unacceptable toxicity had occurred. The primary endpoint was overall survival. Analysis was by intention to treat. This study is registered with ClinicalTrials.gov, number NCT00148798. FINDINGS: Between October, 2004, and January, 2006, 1125 patients were randomly assigned to chemotherapy plus cetuximab (n=557) or chemotherapy alone (n=568). Patients given chemotherapy plus cetuximab survived longer than those in the chemotherapy-alone group (median 11.3 months vs 10.1 months; hazard ratio for death 0.871 [95% CI 0.762-0.996]; p=0.044). The main cetuximab-related adverse event was acne-like rash (57 [10%] of 548, grade 3). INTERPRETATION: Addition of cetuximab to platinum-based chemotherapy represents a new treatment option for patients with advanced non-small-cell lung cancer. FUNDING: Merck KGaA.
Published: 2009

34. Can renal mass biopsy assessment of tumor grade be safely substituted for by a predictive model?

Author: Jacques Tostain, Paul Perrotte, Walter Artibani, Daniel Liberman, Eric Lechevallier, Alexandre de la Taille, Giovanni Lughezzani, Maxine Sun, Pierre I. Karakiewicz, Vincenzo Ficarra, Antoine Valeri, Jean Luc Descotes, Peter F.A. Mulders, Claudio Jeldres, Arnaud Mejean, Jean Jacques Patard, Luca Cindolo, Richard Zigeuner, De Villemeur, Hervé, Department of Urology, University of Montreal, Cancer Prognostics and Health Outcome Unit, Université de Montréal (UdeM), Department of urology, Università Vita-Salute San Raffaele, Service d'urologie, and Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)
Subjects: Nephrology, medicine.medical_treatment, renal biopsy, renal cell carcinoma, Aetiology, screening and detection [ONCOL 5], carcinoma, Nephrectomy, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, MESH: Biopsy, MESH: Aged, 80 and over, Renal cell carcinoma, Aged, 80 and over, MESH: Aged, Univariate analysis, MESH: Middle Aged, medicine.diagnostic_test, kidney, renal cell, statistical, models, biopsy, Europe, MESH: Neoplasm Staging, MESH: Carcinoma, Renal Cell, Middle Aged, Kidney Neoplasms, MESH: Reproducibility of Results, MESH: Young Adult, Adult, MESH: Forecasting, medicine.medical_specialty, Adolescent, Urology, [SDV.CAN]Life Sciences [q-bio]/Cancer, Young Adult, [SDV.CAN] Life Sciences [q-bio]/Cancer, Translational research [ONCOL 3], Internal medicine, Biopsy, medicine, Carcinoma, Humans, Carcinoma, Renal Cell, Aged, Neoplasm Staging, MESH: Adolescent, Models, Statistical, MESH: Humans, business.industry, Reproducibility of Results, MESH: Adult, Nomogram, medicine.disease, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, Surgery, MESH: Nephrectomy, MESH: Kidney Neoplasms, business, MESH: Models, Statistical, Forecasting, Kidney disease
Abstract: Item does not contain fulltext PURPOSE: Fuhrman grade represents a key determinant of the natural history of small renal masses that represent renal cell carcinoma. We tested whether renal mass biopsy prediction of Fuhrman grade in the nephrectomy specimen could be safely substituted for by an accurate statistical model. To date the best available model has shown poor accuracy (55.6%), which is close to flipping a coin (50%) and clearly inadequate for use in clinical practice. MATERIALS AND METHODS: We identified 1,139 patients with T1aN0M0 renal cell carcinoma treated with partial or radical nephrectomy at 11 participating institutions from 1989 to 2004. This cohort was used in univariate and multivariate logistic regression models predicting high Fuhrman grade (III-IV) at nephrectomy. Predictors included age at diagnosis, gender, tumor size and symptom classification. Multivariate logistic regression coefficients were used to generate a nomogram. RESULTS: The rate of Fuhrman grade III-IV in patients with T1aN0M0 renal cell carcinoma was 12.3%. Stratifying patients with Fuhrman grade III-IV by age, gender, histological subtypes and sample size failed to reveal statistically significant differences. On univariate analysis predicting Fuhrman grade III-IV at nephrectomy only tumor size was a statistically significant predictor (p = 0.05). The most accurate multivariate nomogram for Fuhrman grade III-IV prediction was 58.3% (95% CI 57.8-58.9) accurate. Of all tested predictors only tumor size achieved independent predictor status (p = 0.009). CONCLUSIONS: Our analysis derived in European patients shows that statistical models cannot safely replace renal mass biopsy based prediction of Fuhrman grade III-IV at nephrectomy. Our findings corroborate a report from the United States in which a similar model had 55.6% accuracy. Jointly the studies indicate that statistical models are unreliable and cannot safely be substituted for renal mass biopsy in North American or European patients.
Published: 2009

35. Incidence and survival of gastric non-Hodgkin's lymphoma: A population-based study from the Association of the French Cancer Registries (FRANCIM)

Author: Danzon, Arlette, Belot, Aurélien, Maynadié, Marc, Remontet, Laurent, Dupont, Anne Claire Gossart, Carbonnel, Franck, Renseigné, Non, FRANCIM, Réseau des registres français du cancer, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (UR 3181) (CEF2P / CARCINO), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service de Biostatistique, Hospices Civils de Lyon (HCL), Biostatistiques santé, Département biostatistiques et modélisation pour la santé et l'environnement [LBBE], Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Département des maladies chroniques et traumatismes, Institut de Veille Sanitaire (INVS), Registre des hémopathies malignes de Côte d'Or, Service de biostatistique, Agents pathogènes et inflammation - UFC (EA 4266) (API), Université de Franche-Comté (UFC), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Hospices Civils de Lyon ( HCL ), Laboratoire de Biométrie et Biologie Evolutive ( LBBE ), Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique ( Inria ) -Centre National de la Recherche Scientifique ( CNRS ), Agents pathogènes et inflammation - UFC (EA 4266) ( API ), and Université de Franche-Comté ( UFC )
Subjects: Male, Multivariate analysis, MESH: Registries, MESH : Age Distribution, MESH : Aged, 0302 clinical medicine, MESH: Lymphoma, Non-Hodgkin, Risk Factors, MESH: Risk Factors, Epidemiology, MESH : Stomach Neoplasms, MESH : Neoplasm Staging, MESH : Female, Registries, MESH: Incidence, 030212 general & internal medicine, Age of Onset, MESH : Sex Distribution, MESH: Aged, MESH : Prognosis, MESH: Middle Aged, Relative survival, Incidence, Lymphoma, Non-Hodgkin, Incidence (epidemiology), MESH: Sex Distribution, Not Otherwise Specified, MESH: Stomach Neoplasms, MESH: Neoplasm Staging, Hematology, General Medicine, Middle Aged, MESH : Adult, Prognosis, MESH : Risk Factors, MESH : Incidence, MESH : Age of Onset, 3. Good health, Oncology, MESH: Young Adult, MESH: Survival Analysis, 030220 oncology & carcinogenesis, Female, [ SDV.MHEP.HEG ] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, France, Adult, medicine.medical_specialty, Adolescent, MESH : Male, MESH: Age of Onset, MESH : Young Adult, MESH: Multivariate Analysis, MESH: Prognosis, Young Adult, 03 medical and health sciences, Age Distribution, Stomach Neoplasms, MESH : Adolescent, Internal medicine, medicine, Humans, MESH : Middle Aged, MESH : Lymphoma, Non-Hodgkin, Radiology, Nuclear Medicine and imaging, Sex Distribution, MESH : France, MESH: Age Distribution, Survival analysis, Aged, Neoplasm Staging, MESH: Adolescent, MESH: Humans, business.industry, MESH : Humans, MESH : Multivariate Analysis, Cancer, MESH: Adult, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, medicine.disease, Survival Analysis, MESH: Male, MESH: France, Multivariate Analysis, Immunology, MESH : Survival Analysis, Age of onset, business, MESH: Female, MESH : Registries
Abstract: International audience; BACKGROUND: Most epidemiological studies on gastric lymphomas (GL) were carried out before changes in therapy were introduced. The aim of the study was to measure the incidence of GL and to estimate survival. MATERIAL AND METHODS: Data were provided by the Association of the French Cancer Registries database. Age-standardized incidence rates were calculated for 786 incident cases diagnosed between 1978 and 2002. Crude and relative survival were calculated for 361 cases diagnosed between 1989 and 1997. Effects specific to sex, age at diagnosis, year of diagnosis, and grade of malignancy were estimated in multivariate analysis. RESULTS: Incidence was stable during the study period. However, high-grade GL frequency increased whereas low-grade and not otherwise specified (NOS) GL frequencies were respectively stable and decreased. At 5 years, relative survival was 63% in men and 60% in women. Patients aged 75 or older had a five-year relative survival of 33%. Age at diagnosis was the only significant prognostic factor in multivariate analysis. Time trend improvement in prognosis was observed. DISCUSSION: Results in elderly patients show that therapeutic regimens should be specifically designed and assessed for them. The prognosis improvement trend is probably related to the implementation of changes in management of patients and has to be confirmed by more recent data.
Published: 2009

36. The IASLC Lung Cancer Staging Project: Proposals for the Inclusion of Broncho-Pulmonary Carcinoid Tumors in the Forthcoming (Seventh) Edition of the TNM Classification for Lung Cancer

Author: William D, Travis, Dorothy J, Giroux, Kari, Chansky, John, Crowley, Hisao, Asamura, Elisabeth, Brambilla, James, Jett, Catherine, Kennedy, Ramon, Rami-Porta, Valerie W, Rusch, Peter, Goldstraw, J P, van Meerbeeck, Department of Pathology, Memorial Sloane Kettering Cancer Center [New York], Cancer Research and Biostatistics, Cancer Research Center, Department of Thoracic Surgery, National Cancer Centre, INSERM U823, équipe 2 (Bases Moléculaires de la Progression des Cancers du Poumon), Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM)-Département d'anatomie et cythologie pathologique, CHU Grenoble-Hôpital Michallon-Hôpital Michallon, Oncology and Pulmonary and Critical Care Medicine, Mayo Clinic, Strathfield Private Hospital Campus, The University of Sydney, Hospital Mutua de Terrassa, Royal Brompton Hospital, and Brambilla, Christian
Subjects: Stage, Male, Oncology, Lung Neoplasms, Survival, Neuroendocrine tumors, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Typical carcinoid, TNM, MESH: Aged, 80 and over, 0302 clinical medicine, MESH: Child, Surveillance, Epidemiology, and End Results, Medicine, Stage (cooking), Child, 10. No inequality, Lung, Aged, 80 and over, MESH: Aged, AJCC, MESH: Middle Aged, MESH: Neoplasm Staging, Atypical carcinoid, Middle Aged, 3. Good health, Survival Rate, Carcinoma, Bronchogenic, MESH: Young Adult, 030220 oncology & carcinogenesis, MESH: SEER Program, Female, Lung cancer staging, Adult, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Adolescent, MESH: Survival Rate, UICC, Carcinoid tumors, [SDV.CAN]Life Sciences [q-bio]/Cancer, TNM staging system, Young Adult, 03 medical and health sciences, [SDV.CAN] Life Sciences [q-bio]/Cancer, Internal medicine, Carcinoma, Humans, Lung cancer, neoplasms, Aged, Neoplasm Staging, MESH: Adolescent, MESH: Humans, business.industry, MESH: Adult, medicine.disease, Carcinoid, MESH: Male, digestive system diseases, MESH: Lung Neoplasms, MESH: Carcinoma, Bronchogenic, 030228 respiratory system, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, business, MESH: Female, SEER Program
Abstract: International audience; OBJECTIVE: In the 2003 Supplement for tumor, node, metastasis (TNM) Staging classification it states that TNM staging "applies to all types of carcinoma including small cell carcinoma; however, it does not apply to carcinoids." Despite this caveat, most publications on typical and atypical carcinoids use the TNM staging system for nonsmall cell carcinoma and are able to demonstrate prognostic significance for the different stages. For this reason, as the next TNM Staging proposal is being considered, we sought to investigate the carcinoid cases submitted to the International Association for the Study of Lung Cancer (IASLC) database, as well as the National Cancer Institute Surveillance Epidemiology and End Results (SEER). MATERIALS AND METHODS: In the data collected for the IASLC Staging Project database over the time period 1990 to 2000, there were 513 broncho-pulmonary carcinoids. A total of 1619 broncho-pulmonary carcinoid cases diagnosed over the period 1990-2002 were analyzed from the SEER database, including 1437 surgical cases. Pathologic slides were not available for histologic review. RESULTS: Most of tumors in both the IASLC and SEER databases were Stage I (82% and 78%, respectively), as defined by the IASLC proposals for the 7th edition of TNM staging system. T status was a statistically significant predictor of survival for both the SEER data (p < 0.0001) and the IASLC database (p = 0.0156), though for different reasons. N status showed significant survival correlations in both data sets (p < 0.0001). The effect of M status was significant (p < 0.0001) within the SEER data and not studied in the IASLC cases, which were almost exclusively M0. We found that all three T, N, and M categories as defined for non-small cell lung cancer are generally useful for staging of pulmonary carcinoid tumors. Significant differences in survival for overall stages I versus II versus III/IV were identified in both data sets. Patients with multiple same lobe nodules had a 100% 5-year survival, which may be a reason to reevaluate their status in the IIB category in future analyses. CONCLUSIONS: In summary, the IASLC proposals for the 7th edition of TNM are helpful in predicting prognosis for broncho-pulmonary carcinoid tumors. It is the recommendation of the IASLC Staging project that TNM be applied to broncho-pulmonary carcinoid tumors. A prospective collection of data through an International Registry of Pulmonary Neuroendocrine Tumors planned by the IASLC will allow for further detailed analysis of staging data for broncho-pulmonary carcinoids.
Published: 2008

37. Contrast-Enhanced Ultrasound and Prostate Cancer; A Multicentre European Research Coordination Project

Author: Michael Mitterberger, Ferdinand Frauscher, Chris J Harvey, Margot H. Wink, Olivier Rouvière, Leo Palwein, Jean J.M.C.H. de la Rosette, Jean-Yves Chapelon, Hessel Wijkstra, David O. Cosgrove, Inst Pharm & Mol Biotechnol, Universität Heidelberg [Heidelberg], Applications des ultrasons à la thérapie, Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'étude spatiale des rayonnements (CESR), Observatoire Midi-Pyrénées (OMP), Météo France-Centre National d'Études Spatiales [Toulouse] (CNES)-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Météo France-Centre National d'Études Spatiales [Toulouse] (CNES)-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Centre National de la Recherche Scientifique (CNRS)-Institut national des sciences de l'Univers (INSU - CNRS)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées, Signal Processing Systems, and Biomedical Diagnostics Lab
Subjects: Male, medicine.medical_specialty, Biopsy, Urology, 030232 urology & nephrology, Contrast Media, Context (language use), SDG 3 – Goede gezondheid en welzijn, Endosonography, MESH: Biopsy, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, SDG 3 - Good Health and Well-being, Prostate, MESH: Contrast Media, medicine, Humans, Neoplasm Staging, MESH: Endosonography, MESH: Humans, business.industry, Ultrasound, Prostatic Neoplasms, Reproducibility of Results, Cancer, Ultrasonography, Doppler, MESH: Neoplasm Staging, medicine.disease, MESH: Male, 3. Good health, Surgery, MESH: Reproducibility of Results, Europe, medicine.anatomical_structure, MESH: Prostatic Neoplasms, 030220 oncology & carcinogenesis, MESH: Ultrasonography, Doppler, Microbubbles, Hormonal therapy, [SDV.IB]Life Sciences [q-bio]/Bioengineering, MESH: Europe, Radiology, business, Contrast-enhanced ultrasound
Abstract: Context: Contrast-enhanced ultrasound is a real-time imaging technique with the capability of visualizing perfusion patterns. Since tumour growth is associated with changes in vascularisation, this modality is under research for imaging of various tumour types. Studies have shown promising results for the diagnosis of prostate cancer for various imaging techniques; however, the exact value of each technique is still unclear. Objective: To determine the value of contrast-enhanced ultrasound (CEUS) in the detection, localisation, and follow-up of treatment for prostate cancer. Evidence acquisition: In the period 2002-2006, research in four European centres regarding CEUS of the prostate was coordinated in a combined program. This paper describes and combines the results of these studies. Evidence synthesis: Various techniques were developed and researched during the period of this program. Studies showed that prostate cancer could be visualized and localized in up to 78%. Visualization of the tumour enabled better detection; targeted biopsies lead to fewer biopsies per session without loss of detection rate. A combined approach offered the highest detection rate. CEUS could be used to visualize the effects of high-intensity focussed ultrasound and hormonal therapy for prostate cancer with success, and identified patients with an early relapse. Unfortunately, pretreatment evaluation could not identify the nonresponders beforehand. Conclusions: This research project was a first step towards routine use of CEUS in the clinical detection and follow-up of prostate cancer; and new combined studies are initiated. (C) 2008 European Association of Urology. Published by Elsevier B.V. All rights reserved
Published: 2008

38. Cancer cells, adipocytes and matrix metalloproteinase 11: a vicious tumor progression cycle

Author: Marie-Christine Rio, Elena Roza Motrescu, Institut de génétique et biologie moléculaire et cellulaire (IGBMC), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Louis Pasteur - Strasbourg I, Peney, Maité, and Université Louis Pasteur - Strasbourg I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Cell signaling, Clinical Biochemistry, Adipose tissue, Cell Communication, Biology, Biochemistry, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Matrix Metalloproteinase 11, MESH: Matrix Metalloproteinase 11, Neoplasms, Adipocyte, MESH: Cell Communication, Adipocytes, medicine, Animals, Humans, MESH: Animals, MESH: Neoplasms, Molecular Biology, MESH: Adipocytes, Neoplasm Staging, 030304 developmental biology, 0303 health sciences, [SDV.BIBS] Life Sciences [q-bio]/Quantitative Methods [q-bio.QM], MESH: Humans, Cancer, MESH: Neoplasm Staging, medicine.disease, [SDV.BIBS]Life Sciences [q-bio]/Quantitative Methods [q-bio.QM], Desmoplasia, chemistry, Adipogenesis, Tumor progression, 030220 oncology & carcinogenesis, Cancer cell, Disease Progression, Cancer research, MESH: Disease Progression, medicine.symptom
Abstract: This brief review focuses on the emerging role of matrix metalloproteinase 11 (MMP-11) in cancer progression. It has recently been shown that MMP-11 is induced in adipose tissue by cancer cells as they invade their surrounding environment. MMP-11 negatively regulates adipogenesis by reducing pre-adipocyte differentiation and reversing mature adipocyte differentiation. Adipocyte dedifferentiation in turn leads to the accumulation of non-malignant peritumoral fibroblast-like cells, which favor cancer cell survival and tumor progression. This MMP-11-mediated bi-directional cross-talk between invading cancer cells and adjacent adipocytes/pre-adipocytes highlights the central role that MMP-11 plays during tumor desmoplasia and represents a molecular link between obesity and cancer.
Published: 2008

39. European consensus conference on diagnosis and treatment of germ cell cancer: a report of the second meeting of the European Germ Cell Cancer Consensus group (EGCCCG): part I

Author: Robert Huddart, Johannes Classen, Roberto Salvioni, Rainer Souchon, Walter Albrecht, Xavier Garcia del Muro, Malcolm David Mason, Michael Bamberg, Johnathan Joffe, Jutta Scheiderbauer, Annette Dieing, Oscar Leiva Galvis, Niels E. Skakkebæk, Ronald de Wit, William G. Jones, Sophie D. Fosså, Kai Uwe Koehrmann, H. G. Derigs, Silke Gillessen, Martin Fenner, Sergei Tjulandin, C Clemm, Wolfgang Hoeltl, Padraig Warde, Aude Flechon, Luis Paz Ares, Pieter H.M. De Mulder, S. Kliesch, Nicola Nicolai, Thomas Powles, László Kisbenedek, Lothar Weissbach, Craig R. Nichols, Hans von der Maase, Michael Jewett, Jörg Pont, Markus A. Kuczyk, Volker Loy, Christian Wittekind, Peter Albers, Jose Ramon Germa-Lluch, Felix Sedlmayer, Giovanni Rosti, D. Ondruš, Pilar Laguna, Heinz Schmidberger, István Bodrogi, Gabriella Cohn-Cedermark, Eva Cavallin-Ståhl, Jörg Beyer, Tim Oliver, Arthur Gerl, Gedske Daugaard, Stefan Weinknecht, Tobias Pottek, Hans-Joachim Schmoll, Maike de Wit, Rolf Mueller, Maria De Santis, Michael Hartmann, Graham M. Mead, Oliver Rick, Jean Pierre Droz, Christian K. Kollmannsberger, Hans U. Schmelz, Karim Fizazi, Gosse O N Oosterhof, Lori Wood, Thomas Gauler, Aslam Sohaib, Susanne Krege, Ferran Algaba, Alan Horwich, Eva Winter, Stéphane Culine, Giorgio Pizzocaro, Olbjørn Klepp, Axel Heidenreich, Klaus Peter Dieckmann, Jörg T. Hartmann, Mark Schrader, Lajos Géczi, Carsten Bokemeyer, Department of Urology, Klinikum Kassel GmbH, Department of Molecular Genetics and Department of Chemotherapy, National Institute of Oncology, Endocrinologie moléculaire et cellulaire des cancers, Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département d'oncologie Médicale, CRLCC Val d'Aurelle - Paul Lamarque, Dept of Oncology, Rigshospitalet [Copenhagen], Copenhagen University Hospital-Copenhagen University Hospital, Science et Ingénierie des Matériaux et Procédés (SIMaP), Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Institut National Polytechnique de Grenoble (INPG)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), Génomes et cancer (GC (FRE2939)), Université Paris-Sud - Paris 11 (UP11)-Institut Gustave Roussy (IGR)-Centre National de la Recherche Scientifique (CNRS), Departments of Clinical Cancer Research and genetics, Rikshospitalet-Radiumhospitalet Trust, Commissariat à l'énergie atomique et aux énergies alternatives - Laboratoire d'Electronique et de Technologie de l'Information (CEA-LETI), Direction de Recherche Technologique (CEA) (DRT (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Institut de biologie moléculaire des plantes (IBMP), Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA), Dept of Urological Oncology, Phillips university, Academic Radiotherapy Unit, Institute of cancer research, Princess Margaret Hospital, University of Toronto, Department of Chemistry [Rochester], University of Rochester [USA], Department of Medical Oncology, Barts and The London Queen Mary's School of Medicine, Laboratoire Evolution, Génomes et Spéciation (LEGS), Centre National de la Recherche Scientifique (CNRS), Laboratory of Clinical Genetics, Institute of Clinical Oncology, Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), and Medical Oncology
Subjects: Male, MESH: Combined Modality Therapy, Biopsy, Consensus Development Conferences as Topic, 030232 urology & nephrology, Membrane transport and intracellular motility [NCMLS 5], MESH: Biopsy, 0302 clinical medicine, Stage I Seminoma, MESH: Practice Guidelines as Topic, Medicine, Societies, Medical, MESH: Testicular Neoplasms, Consensus conference, MESH: Neoplasm Staging, Neoplasms, Germ Cell and Embryonal, Prognosis, Primary tumor, Combined Modality Therapy, 3. Good health, Europe, 030220 oncology & carcinogenesis, Practice Guidelines as Topic, MESH: Neoplasms, Germ Cell and Embryonal, medicine.medical_specialty, [SDV.OT]Life Sciences [q-bio]/Other [q-bio.OT], Consensus, Urology, MESH: Societies, Medical, MEDLINE, MESH: Prognosis, 03 medical and health sciences, SDG 3 - Good Health and Well-being, Testicular Neoplasms, Interventional oncology [UMCN 1.5], Humans, MESH: Consensus, Testicular cancer, Neoplasm Staging, Gynecology, MESH: Humans, business.industry, MESH: Consensus Development Conferences as Topic, medicine.disease, MESH: Male, Clinical trial, Germ cell cancer, Family medicine, Germ cell tumors, MESH: Europe, business
Abstract: Objectives: The first consensus report presented by the European Germ Cell Cancer Consensus Group (EGCCCG) in the year 2004 has found widespread approval by many colleagues throughout the world. In November 2006, the group met a second time under the auspices of the Department of Urology of the Amsterdam Medical Center, Amsterdam, The Netherlands. Methods: Medical oncologists, urological surgeons, radiation oncologists as well as pathologists from several European countries reviewed and discussed the data that had emerged since the 2002 conference, and incorporated the new data into updated and revised guidelines. As for the first meeting, the methodology of evidence-based medicine (EBM) was applied. The results of the discussion were compiled by the writing committee. All participants have agreed to this final update. Results: The first part of the consensus paper describes the clinical presentation of the primary tumor, its treatment, the importance and treatment of testicular intraepithelial neoplasia (TIN), histological classification, staging and prognostic factors, and treatment of stage I seminoma and non-seminoma. Conclusions: Whereas the vast majority of the recommendations made in 2004 remain valid 3 yr later, refinements in the treatment of early- and advanced-stage testicular cancer have emerged from clinical trials. Despite technical improvements, expert clinical skills will continue to be one of the major determinants for the prognosis of patients with germ cell cancer. In addition, the particular needs of testicular cancer survivors have been acknowledged. (C) 2007 European Association of Urology. Published by Elsevier B.V. All rights reserved.
Published: 2008

40. The IASLC Lung Cancer Staging Project: Proposals for Revision of the M Descriptors in the Forthcoming (Seventh) Edition of the TNM Classification of Lung Cancer

Author: William D. Travis, Masahiro Tsuboi, John Crowley, James R. Jett, David Ball, Eric Vallières, Peter Goldstraw, Dorothy J. Giroux, Ramón Rami-Porta, Department of Pathology, Vrije Universiteit Medical Centre (VUMC), Vrije Universiteit Amsterdam [Amsterdam] (VU)-Vrije Universiteit Amsterdam [Amsterdam] (VU), INSERM U823, équipe 2 (Bases Moléculaires de la Progression des Cancers du Poumon), Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Institut National de la Santé et de la Recherche Médicale (INSERM)-EFS-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM)-EFS-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF), Cancer Research and Biostatistics, Cancer Research Center, Department of Thoracic Surgery, Royal Brompton Hospital, Medical Center [Durham], Duke University [Durham], Kagawa University, Brambilla, Christian, and Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, Staging, MESH: Survival Rate, MESH: Societies, Medical, [SDV.CAN]Life Sciences [q-bio]/Cancer, Atelectasis, Metastases, NSCLC, 03 medical and health sciences, 0302 clinical medicine, [SDV.CAN] Life Sciences [q-bio]/Cancer, MESH: Severity of Illness Index, medicine, Malignant pleural effusion, 10. No inequality, Lung cancer, Survival rate, Pneumonitis, MESH: Humans, business.industry, MESH: Neoplasm Staging, Mediastinal Pleura, respiratory system, medicine.disease, Primary tumor, respiratory tract diseases, MESH: Lung Neoplasms, 3. Good health, Surgery, MESH: International Cooperation, 030228 respiratory system, Oncology, 030220 oncology & carcinogenesis, Radiology, Lung cancer staging, business
Abstract: International audience; PURPOSE: To analyze all nonlymphatic metastatic components (T4 and M1) of the current TNM system of lung cancer, with the objective of providing suggestions for the next edition of the TNM classification for lung cancer. MATERIAL AND METHODS: Data on 100,809 patients were submitted to the International Association for the Study of Lung Cancer International Database. Of these, 5592 selected T4M0 and M1 patients fulfilled the inclusion criteria for the analysis. Specific categories of clinically staged T4 (lesions not continuous with the primary tumor) and M1 cases were compared with respect to overall survival using Kaplan-Meier survival estimates and comparisons via Cox regression analysis. Relevant findings were validated internally by geographic area and type of database and were validated externally by the North American Surveillance, Epidemiology and End Results Registries. RESULTS: Median survival for cT4M0 with malignant pleural effusion was significantly worse than that of other cT4M0 patients (8 months versus 13 months) and was more comparable with M1 cases with metastases to the contralateral lung only (10 months). M1 cases with metastases outside the lung/pleura had a significantly poorer prognosis than those with metastases confined to the lung, with a median survival of 6 months. CONCLUSIONS: Revisions to the TNM classification system for lung cancer should include grouping cases with malignant pleural effusions and cases with nodules in the contralateral lung in the M1a category, and cases with distant metastases should be designated M1b. In addition, cases with nodule(s) in the ipsilateral lung (nonprimary lobe), currently staged M1, should be reclassified as T4M0, in accordance with the recommendations of the T descriptor subcommittee of the IASLC international staging committee.
Published: 2007

41. Disease progression and survival in ALS: First multi‐state model approach

Author: Jean-Claude Desport, Ahmadou Alioum, Philippe Couratier, Carlos Ketzoian, Pierre-Marie Preux, Michel Druet-Cabanac, Juan Gil, Neuroépidémiologie Tropicale et Comparée (NETEC), Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503)-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Université de Limoges (UNILIM), Laboratoire de Biostatistique et d'Informatique Médicale, Université de Limoges (UNILIM), Service de l'Information Médicale et de l'Évaluation [CHU Limoges] (SIME), CHU Limoges, Service d'Hépato-Gastro-Entérologie et Nutrition [CHU Limoges], Service de Santé au Travail [CHU Limoges], Unité Fonctionnelle Registre Général des Cancers du Limousin (UFRGC), and Service de Neurologie [CHU Limoges]
Subjects: Male, Oncology, Pathology, MESH: Taxoids, MESH: Comorbidity, 01 natural sciences, Body Mass Index, Cohort Studies, 010104 statistics & probability, 0302 clinical medicine, Outcome Assessment, Health Care, Epidemiology, Age of Onset, Amyotrophic lateral sclerosis, 10. No inequality, MESH: Cohort Studies, MESH: Amyotrophic Lateral Sclerosis, MESH: Treatment Outcome, MESH: Aged, 2. Zero hunger, MESH: Antimetabolites, Antineoplastic, MESH: Middle Aged, Multi state, Respiration, Clinical course, MESH: Neoplasm Staging, General Medicine, Middle Aged, Markov Chains, MESH: Antineoplastic Combined Chemotherapy Protocols, Neurology, Disease Progression, MESH: Disease Progression, Female, medicine.medical_specialty, MESH: Age of Onset, MESH: Pleural Neoplasms, MESH: Body Mass Index, 03 medical and health sciences, MESH: Markov Chains, MESH: Analysis of Variance, MESH: Severity of Illness Index, Internal medicine, medicine, Humans, MESH: Patient Selection, 0101 mathematics, MESH: Outcome Assessment (Health Care), Aged, Retrospective Studies, MESH: Age Factors, MESH: Respiration, Analysis of Variance, MESH: Humans, business.industry, MESH: Deoxycytidine, Amyotrophic Lateral Sclerosis, Disease progression, MESH: Retrospective Studies, medicine.disease, MESH: Male, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Neurology (clinical), business, MESH: Female, Neurological impairment, Body mass index, MESH: Carcinoma, Non-Small-Cell Lung, 030217 neurology & neurosurgery, Clinical progression
Abstract: Although several prognostic factors have been identified in ALS, there remains some discordance concerning the prognostic significance of the age and clinical form at onset. In order to clarify these findings, we have analysed already known prognostic factors using a multi-state model. Two hundred and twenty-two sporadic ALS patients were followed. A simple unidirectional three-states model was used to summarize clinical course of ALS. States 1 and 2 reflected the progression of neurological impairment and state 3 represented the end of follow-up (tracheotomy or death). Gender, diagnostic delay, body mass index (BMI) and slow vital capacity (SVC) were also recorded. A time-inhomogeneous Markov model with piecewise constant transition intensities was used to estimate the effect of the covariates in each transition. The bulbar form at onset was only correlated with a more rapid clinical progression between state 1 and state 2. In contrast, an advanced age at diagnosis affected only survival from state 2. This methodological approach suggests that these two factors have a different prognostic significance: age at onset is related to patient's survival and the clinical form at onset predicts the progression of motoneuronal impairment in different regions.
Published: 2007

42. Waist circumference, waist-hip ratio, body mass index, and prostate cancer risk: results from the North-American case-control study Prostate Cancer & Environment Study

Author: José Sosa, Jonas Schiffmann, Pierre I. Karakiewicz, Audrey Blanc-Lapierre, Markus Graefen, Marie-Élise Parent, Katharina Boehm, Alessandro Larcher, Fred Saad, Maxine Sun, Cancer Prognostics and Health Outcomes Unit, Université de Montréal (UdeM), Martini-Klinik am Universitätsklinikum Hamburg-Eppendorf, IRCCS Ospedale San Raffaele, Institut Armand Frappier (INRS-IAF), Institut National de la Recherche Scientifique [Québec] (INRS)-Réseau International des Instituts Pasteur (RIIP), and Department of Urology Université de Montréal
Subjects: Male, [SDV]Life Sciences [q-bio], Waist–hip ratio, Abdominal obesity, Body mass index, Waist-to-height ratio, MESH: Aged, education.field_of_study, Prostate cancer, MESH: Middle Aged, MESH: Waist-Hip Ratio, Case-control study, MESH: Follow-Up Studies, MESH: Neoplasm Staging, Middle Aged, Prognosis, MESH: Case-Control Studies, Oncology, Obesity, Abdominal, MESH: Waist Circumference, Waist circumference, medicine.symptom, medicine.medical_specialty, Waist, Urology, Population, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH: Prognosis, MESH: Body Mass Index, MESH: Obesity, Abdominal, Internal medicine, medicine, MESH: United States, Humans, Obesity, education, Aged, Neoplasm Staging, [SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health, MESH: Humans, Body volume index, business.industry, Abdominal fat, Prostatic Neoplasms, Odds ratio, United States, MESH: Male, Surgery, Case-Control Studies, Waist-hip ratio, MESH: Prostatic Neoplasms, business, Follow-Up Studies
Abstract: Introduction The evidence on the association between anthropometric measures quantifying body fatness and prostate cancer (PCa) risk is not entirely consistent. Associations among waist circumference (WC), waist-hip ratio, body mass index (BMI), and PCa risk were assessed in a population-based case-control study. Patients and methods The study included 1933 incident PCa cases diagnosed between 2005 and 2009. Population controls were 1994 age-matched (±5 y) Montreal residents selected from electoral lists. Information on sociodemographics, medical history including PCa screening, height, weight, and waist and hip circumferences was collected through interviews. Logistic regression was used to assess odds ratios (ORs) for the association between anthropometric measures, and overall and grade-specific PCa. Results After adjustment for BMI, an excess risk of high-grade PCa (Gleason≥7) was associated with a WC ≥102 cm (OR = 1.47 [1.22–1.78]) and with a waist-hip ratio >1.0 (OR = 1.20 [1.01–1.43]). Men with a BMI≥30 kg/m 2 had a lower risk of PCa, regardless of grade. Restricting to subjects recently screened for PCa did not alter findings. Conclusion Elevated BMI was associated with a lower risk of PCa, regardless of grade. Contrastingly, abdominal obesity, when adjusted for BMI, yielded results in the opposite direction. Taken together, our observations suggest that the specific body fat distribution (abdominal), for a given BMI, is a predictor of PCa risk, whereas BMI alone is not. BMI and abdominal obesity, especially when measured by the WC, should be examined conjointly in future studies on this issue and may require consideration at patient counseling.
Published: 2015

43. Early surgery for failure after chemoradiation in operable thoracic oesophageal cancer. Analysis of the non-randomised patients in FFCD 9102 phase III trial: Chemoradiation followed by surgery versus chemoradiation alone

Author: Julie, Vincent, Christophe, Mariette, Denis, Pezet, Emmanuel, Huet, Franck, Bonnetain, Olivier, Bouché, Thierry, Conroy, Bernard, Roullet, Jean-François, Seitz, Jean-Philippe, Herr, Frédéric, Di Fiore, Jean-Louis, Jouve, Laurent, Bedenne, M, Ducreux, CHU Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Hôpital Claude Huriez [Lille], CHU Lille, CHU Clermont-Ferrand, Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Normandie Université (NU), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de chirurgie digestive [CHU Rouen], Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Fédération Francophone de la Cancérologie Digestive, FFCD, Hôpital Robert Debré, Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims (CHU Reims), Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université Paris Descartes - Paris 5 (UPD5)-Université de Lorraine (UL), Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] (UNICANCER/ICL), UNICANCER, Hôpital de la Milétrie, Centre hospitalier universitaire de Poitiers (CHU Poitiers), Hôpital de la Timone [CHU - APHM] (TIMONE), Hôpital privé Sainte-Marie - Ramsay Générale de Santé, Hôpital Charles Nicolle [Rouen], Butel J, Desselle P, Brice JC, Tissot B, Votte-Lambert A, Joly J, Burtin P, Arnaud JP, Cellier P, Estermann F, Chauvet B, Maringe E, Ozanne F, Varlet F, Becouarn Y, Avril A, Rougier P, Nordlinger B, Vincendet M, Charneau J, Pillon D, Stremsdoerfer N, Pelletier M, Clavero-Fabri MC, Leduc B, Segol P, Argouach LP, Roussel A, Maurel J, Salame R, Lacourt J, Janoray P, Ruget O, Baudet-Klepping D, Dupont G, Bommelaer G, Ruszniewski P, Hammel P, Chaussade S, Dousset B, Denis B, Wagner JD, Tamby E, Petit T, Weiss AM, Barbare JC, Jouve JL, Phelip JM, Senesse P, Michiels C, Maingon P, Coudert B, Fraisse J, Queuniet A, Gasnault L, Gstach JH, Guichard B, Howaizi M, Geoffroy P, Picot C, Fournet J, Mousseau M, Stampfli C, Michel P, Doll J, Durand S, Buffet C, Triboulet JP, Denimal F, Hebbar M, Quandalle P, Mirabel X, Lledo G, Giovannini M, Souillac P, Untereiner M, Leroy-Terquem E, Lacroix H, Francois E, Lagasse JP, Breteau N, Legoux JL, Etienne JC, Delattre JF, Lubrano D, Levy-Chazal N, Palot JP, Nasca S, Demange L, Nguyen TD, Seng S, Michel P, Teniere P, Thevenet P, Le Brise H, Fleury J, Kammerer J, Cosme H, Novello P, Avignon JP, Berton C, Legueul, Parisot P, Aunis G, Vetter D, Platini C, Cals L, Rouhier D, Robin B, Champetier T, Cartalat A, Marchal C, Guillemin F, Flamenbaum M, Cassan D, Ducreux M., Hôpital Claude Huriez, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU - HÔTEL-DIEU Clermont-Ferrand, Service de chirurgie digestive [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Institut de Cancérologie de Lorraine - Alexis Vautrin (ICL), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims ( CHU Reims ), Maladies chroniques, santé perçue, et processus d'adaptation. Approches épidémiologiques et psychologiques. ( APEMAC - EA 4360 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Université de Lorraine ( UL ), Institut de Cancérologie de Lorraine - Alexis Vautrin ( ICL ), CHU de Poitiers, and Hôpital de la Timone [CHU - APHM] ( TIMONE )
Subjects: Male, Cancer Research, Time Factors, Esophageal Neoplasms, Kaplan-Meier Estimate, MESH: Esophagectomy, law.invention, MESH: Proportional Hazards Models, MESH : Adenocarcinoma, 0302 clinical medicine, Randomized controlled trial, law, Risk Factors, MESH : Esophagectomy, MESH: Risk Factors, MESH : Neoplasm Staging, MESH : Female, MESH : Carcinoma, Squamous Cell, MESH: Treatment Outcome, MESH: Chemoradiotherapy, Randomised controlled trial, education.field_of_study, Hazard ratio, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Carcinoma, Squamous Cell, Chemoradiotherapy, MESH : Chemoradiotherapy, MESH: Neoplasm Staging, MESH : Risk Factors, Neoadjuvant Therapy, 3. Good health, Oesophageal neoplasms, Treatment Outcome, Oncology, Chemoradiation, 030220 oncology & carcinogenesis, MESH: Esophageal Neoplasms, Carcinoma, Squamous Cell, 030211 gastroenterology & hepatology, Female, Esophageal Squamous Cell Carcinoma, France, MESH : Time Factors, medicine.medical_specialty, MESH: Radiotherapy, Adjuvant, MESH : Male, Population, MESH: Neoadjuvant Therapy, Locally advanced, MESH : Treatment Outcome, Adenocarcinoma, MESH : Radiotherapy, Adjuvant, MESH : Kaplan-Meier Estimate, 03 medical and health sciences, Early surgery, medicine, Humans, Basal cell, Salvage surgery, education, MESH : France, Contraindication, MESH: Kaplan-Meier Estimate, Neoplasm Staging, Proportional Hazards Models, MESH: Humans, business.industry, MESH : Humans, MESH: Adenocarcinoma, MESH: Time Factors, Cancer, medicine.disease, MESH : Proportional Hazards Models, MESH: Male, Surgery, Esophagectomy, MESH: France, Radiotherapy, Adjuvant, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH : Esophageal Neoplasms, business, MESH : Neoadjuvant Therapy, MESH: Female
Abstract: International audience; BACKGROUND:Two randomised trials concerning thoracic oesophageal cancer concluded that for squamous cell carcinoma, chemoradiation alone leads to the same overall survival (OS) as chemoradiation followed by surgery. One of these trials, FFCD 9102, randomised only fit, compliant and operable responders to induction chemoradiation between continuation of chemoradiation and surgery. In the present analysis, the outcome in the patients not eligible for randomisation was calculated to determine if attempt of surgery should be recommended.METHODS:Eligible patients had operable T3-N0/N1-M0 thoracic oesophageal cancer. After initial chemoradiation, patients with no clinical response, or with contraindication to follow any attributed treatment, were not randomised. OS was studied first in the whole population of not randomised patients, and then specifically in clinical non-responders. The impact of surgery on OS was studied in these two populations.FINDINGS:Of the 451 registered patients in the trial, 192 were not randomised. Among them, 111 were clinical non-responders. Median OS was significantly shorter for non-randomised patients (11.5 months) than for randomised patients (18.9 months; p=0.0024). However, for the 112 non-randomised patients who underwent surgery, median OS was not different from that in randomised patients: 17.3 versus 18.9 months (p=0.58). Concerning clinical non-responders, median OS was longer for those who underwent surgery compared to non-operated patients: 17.0 versus 5.5 months (hazard ratio (HR)=0.39 [0.25-0.61]; p
Published: 2015

44. Pathologic Findings of Lung Tumors Diagnosed on Baseline CT Screening

Author: Elizabeth Brambilla, William D. Travis, Claudia I. Henschke, David F. Yankelevitz, Adi F. Gazdar, Masayuki Noguchi, Arin Kramer, Darryl Carter, Douglas B. Flieder, Madeline Vazquez, Department of Pathology, Fox Chase Cancer Center, Weill Medical College of Cornell University [New York], Yale University School of Medicine, Département d'anatomie et cythologie pathologique, CHU Grenoble-Hôpital Michallon, The University of Texas Health Science Center at Houston (UTHealth), Université de Tsukuba = University of Tsukuba, Memorial Sloane Kettering Cancer Center [New York], Department of Radiology, Yale School of Medicine [New Haven, Connecticut] (YSM), and Salas, Danielle
Subjects: Male, MESH: Carcinoma, Pathology, medicine.medical_specialty, Lung Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, Pathology and Forensic Medicine, 03 medical and health sciences, MESH: Aged, 80 and over, 0302 clinical medicine, [SDV.CAN] Life Sciences [q-bio]/Cancer, Carcinoma, Humans, Mass Screening, Medicine, MESH: Mass Screening, Atypical adenomatous hyperplasia, Stage (cooking), Lung cancer, Lymph node, Mass screening, Aged, Neoplasm Staging, Aged, 80 and over, MESH: Aged, MESH: Humans, MESH: Middle Aged, business.industry, Cancer, MESH: Neoplasm Staging, Middle Aged, medicine.disease, MESH: Male, MESH: Lung Neoplasms, 3. Good health, medicine.anatomical_structure, 030228 respiratory system, 030220 oncology & carcinogenesis, Adenocarcinoma, Female, Surgery, Radiology, Anatomy, Tomography, X-Ray Computed, MESH: Tomography, X-Ray Computed, business, MESH: Female
Abstract: International audience; Sixty-five people had a resection of their baseline screen-diagnosed lung cancers in the Early Lung Cancer Action Program. Forty-nine of the carcinomas were solitary, and 42 of these were adenocarcinomas. More than 1 carcinoma was found in 16 patients after pathologic examination of the lobectomy specimen; 15 of the 16 second carcinomas were adenocarcinomas, mixed subtype. Eighteen cases were submitted by local pathologists as Bronchioloalveolar carcinomas but were found to be invasive adenocarcinomas according to the World Health Organization classification by the Pathology Review Panel. Of the 65 resected cases, 57 were N0, 7 were N1, and 1 was N2. Upon careful review of the lobectomy specimens, 49 cases had solitary malignancies, 30 were Stage IA, 13 Stage IB, 3 Stage IIA, 2 Stage IIB, and 1 Stage IIIA on the basis of the American Joint Committee on Cancer/International Union for Cancer Control criteria. In the 16 cases found to have multiple malignancies, 6 had histologically different carcinomas and the remaining 10 had histologically identical malignancies. Eighty-three percent (76/92) of the carcinomas invaded the stroma with destruction of normal lung, and 21% (19/92) also showed either pleural or angiolymphatic invasion, even though 88% (57/65) of the carcinomas were free of lymph node metastases. This report describes the pathologic findings of the resected cases. Histopathologic distinctions among atypical adenomatous hyperplasia, bronchioloalveolar carcinomas, and invasive adenocarcinoma are described in detail.
Published: 2006

45. Impact of pathology review of stage and margin status of radical prostatectomy specimens (EORTC trial 22911)

Author: Paul Van Cangh, K. Vekemans, Fritz H. Schröder, K. H. Kurth, Luigi DaPozzo, Theodorus van der Kwast, Hendrik Van Poppel, Michel Bolla, Jean-François Bosset, Laurence Collette, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ) -Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Département de cancérologie et radiothérapie, CHU Grenoble, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Pathology, Urology, and 06 Operations Centre and intensive care
Subjects: Male, Surgical margin, Pathology, Quality Assurance, Health Care, Pathology, Surgical, MESH: Quality Assurance, Health Care, medicine.medical_treatment, Pathological staging, MESH : Aged, 030232 urology & nephrology, MESH : Quality Assurance, Health Care, MESH : Pathology, Surgical, MESH: Observer Variation, MESH : Neoplasm Invasiveness, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, MESH : Adenocarcinoma, 0302 clinical medicine, Medicine, MESH : Neoplasm Staging, 10. No inequality, Observer Variation, MESH: Aged, Univariate analysis, MESH: Middle Aged, Prostatectomy, Hazard ratio, Anatomical pathology, MESH: Neoplasm Staging, General Medicine, Middle Aged, 3. Good health, 030220 oncology & carcinogenesis, MESH: Pathology, Surgical, MESH : Disease-Free Survival, Positive Surgical Margin, MESH : Prostatic Neoplasms, medicine.medical_specialty, MESH : Prostatectomy, MESH : Male, [SDV.CAN]Life Sciences [q-bio]/Cancer, Adenocarcinoma, Disease-Free Survival, Pathology and Forensic Medicine, 03 medical and health sciences, MESH: Prostatectomy, Humans, Neoplasm Invasiveness, MESH : Middle Aged, Molecular Biology, Grading (tumors), Aged, Neoplasm Staging, MESH: Humans, business.industry, MESH: Adenocarcinoma, MESH : Humans, Prostatic Neoplasms, MESH: Neoplasm Invasiveness, MESH : Observer Variation, Cell Biology, MESH: Male, MESH: Prostatic Neoplasms, MESH: Disease-Free Survival, business
Abstract: International audience; Pathological staging and surgical margin status of radical prostatectomy specimens are next to grading the most important prognosticators for recurrence. A central review of pathological stage and surgical margin status was performed on a series of 552 radical prostatectomy specimens of patients, participating in the European Organisation for Research and Treatment of Cancer trial 22911. Inclusion criteria of the trial were pathological stage pT3 and/or positive surgical margin at local pathology. All specimens were totally embedded. Data of the central review were compared with those of local pathologists and related to clinical follow-up. Although a high concordance between review pathology and local pathologists existed for seminal vesicle invasion (94%, kappa=0.83), agreement was much less for extraprostatic extension (57.5%, kappa=0.33) and for surgical margin status (69.4%, kappa=0.45). Review pathology of surgical margin status was a stronger predictor of biochemical progression-free survival in univariate analysis [hazard ratio (HR)=2.16 and p=0.0002] than local pathology (HR=1.08 and p>0.1). The review pathology demonstrated a significant difference between those with and without extraprostatic extension (HR=1.83 and p=0.0017), while local pathology failed to do so (HR=1.05 and p>0.8). The observations suggest that review of pathological stage and surgical margin of radical prostatectomy strongly improves their prognostic impact in multi-institutional studies or trials.
Published: 2006

46. Results after laparoscopic management of serous borderline tumor of the ovary with peritoneal implants

Author: X. Deffieux, Pierre Duvillard, Damienne Castaigne, Sophie Camatte, Philippe Morice, Virginie Fourchotte, Physiologie et physiopathologie de la motricité chez l'homme, Université Pierre et Marie Curie - Paris 6 (UPMC)-IFR70-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de biologie et pathologie médicales [Gustave Roussy], and Institut Gustave Roussy (IGR)
Subjects: Adult, medicine.medical_specialty, Adolescent, MESH: Laparoscopy, Ovarian tumor, Peritoneal Neoplasm, Paracolic gutters, medicine, Humans, MESH: Peritoneal Neoplasms, Neoplasm Invasiveness, Stage (cooking), Cystadenocarcinoma, Laparoscopy, Peritoneal Neoplasms, Neoplasm Staging, Retrospective Studies, Ovarian Neoplasms, MESH: Adolescent, MESH: Humans, MESH: Middle Aged, [SDV.BA.MVSA]Life Sciences [q-bio]/Animal biology/Veterinary medicine and animal Health, medicine.diagnostic_test, business.industry, Obstetrics and Gynecology, MESH: Adult, MESH: Retrospective Studies, MESH: Neoplasm Invasiveness, MESH: Neoplasm Staging, Middle Aged, medicine.disease, MESH: Cystadenocarcinoma, Serous, Cystadenocarcinoma, Serous, Surgery, MESH: Ovarian Neoplasms, Omentectomy, medicine.anatomical_structure, Oncology, Female, Implant, business, MESH: Female
Abstract: International audience; OBJECTIVE: The aim of this study is to assess the clinical outcomes of laparoscopic treatment of borderline ovarian tumor (BOT) with peritoneal implants. METHODS: Retrospective analysis of patients treated initially and/or for recurrent disease using a laparoscopic approach for a stage II or stage III BOT between January 2001 and January 2004. RESULTS: Nine patients underwent a laparoscopic pure treatment of stage II/III serous borderline tumor. Three of them had a previous history of BOT. Three patients had a stage II and 6 a stage III disease. A conservative management was performed in 7 patients. Laparoscopic treatment of peritoneal implants included: omentectomy (or omental biopsies) in 4 patients and/or large peritoneal resection in 5 patients (pelvic peritoneum in all patients associated with peritonectomies of paracolic gutters in 2 and of the peritoneum of the right diaphragmatic peritoneum in 3). Implants were nonivasive in 8 patients. Each of implant had a size
Published: 2005

47. Hepatic artery complications following liver transplantation. Does preoperative chemoembolization impact the postoperative course?

Author: Halidou Niampa, Astrid Herrero, B Gallix, Fabrizio Panaro, Georges-Philippe Pageaux, Jeanne Ramos, Gregoire Mercier, Francis Navarro, Département d'Hépato-Gastroentérologie et de Transplantation Hépatique [CHU Saint-Eloi], Hôpital Saint Eloi (CHRU Montpellier), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université de Montpellier (UM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Hôpital Gui de Chauliac, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Département Image et Traitement Information (ITI), Université européenne de Bretagne - European University of Brittany (UEB)-Télécom Bretagne-Institut Mines-Télécom [Paris] (IMT), Service Médico-Chirurgical des Maladies de l'Appareil Digestif et de Transplantation Hépatique, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), and Retiveau, Nolwenn
Subjects: Male, Cirrhosis, Complications, [SDV.MHEP.CHI] Life Sciences [q-bio]/Human health and pathology/Surgery, Hepatocellular carcinoma, medicine.medical_treatment, Liver transplantation, Hepatic Artery, Postoperative Complications, Risk Factors, Fibrosis, MESH: Liver Neoplasms, MESH: Risk Factors, MESH: Postoperative Complications, MESH: Carcinoma, Hepatocellular, MESH: Middle Aged, Incidence (epidemiology), Liver Neoplasms, MESH: Follow-Up Studies, MESH: Neoplasm Staging, Middle Aged, MESH: Hepatectomy, Prognosis, Thrombosis, Artery, Survival Rate, medicine.anatomical_structure, Female, MESH: Preoperative Care, medicine.medical_specialty, MESH: Liver Transplantation, Carcinoma, Hepatocellular, MESH: Survival Rate, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, Transarterial chemoembolization, MESH: Prognosis, MESH: Chemoembolization, Therapeutic, Necrosis, Anesthesiology, MESH: Hepatic Artery, Preoperative Care, medicine, Hepatectomy, Humans, Chemoembolization, Therapeutic, Neoplasm Staging, Retrospective Studies, MESH: Necrosis, Transplantation, MESH: Humans, business.industry, MESH: Retrospective Studies, medicine.disease, MESH: Male, Surgery, business, MESH: Female, Follow-Up Studies
Abstract: Background Transarterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC) may cause damage to the hepatic artery (HA) and impact the postoperative course of the liver transplantation (LT). We aim to describe the relationship between preoperative TACE and the occurrence of histological and radiological hepatic artery complications (HAC). Methods All cirrhotic patients with HCC undergoing LT between January 2009 and October 2012 were included and divided in two groups: TACE (group 1) and No TACE (group 2). HA histological complications were reviewed and compared. Results Sixty-seven patients were reviewed, 32 in group 1 and 35 in group 2. Both groups were similar in gender, age, cirrhosis origin, and American Society of Anesthesiology (ASA) score. After a mean follow-up of 17 months, 10 radiological HAC occurred: seven in group 1 and three in group 2 (p = 0.02). There was one thrombosis in each group: six non-thrombotic complications in group 1 and two in group 2. Histological screening showed 12 HA injuries in group 1 (three HA wall edemas, five fibrosis, one edema + fibrosis, one hemorragic necrosis + thrombosis, two thrombosis) and three in group 2 (two HA wall edemas, one fibrosis) (p = 0.01). All these injuries were found at the proper HA and at the right/left HA bifurcation level. Conclusions Despite the limits of our study, we found a higher incidence of radiological and histological injury in patients underwent TACE.
Published: 2014

48. Influence des virus de l'hépatite sur les profils clinico-pathologiques et le destin à long terme chez les patients subissant une intervention chirurgicale pour un carcinome hépatocellulaire

Author: Tanase, Anna-Maria, Dumitrascu, Traian, Dima, Simona, Grigorie, Razvan, Marchio, Agnès, Pineau, Pascal, Popescu, Irinel, Center of General Surgery and Liver Transplant [Bucharest, Romania], Fundeni Clinical Institute = Institutul Clinic Fundeni [Bucarest, Roumanie], Organisation Nucléaire et Oncogenèse / Nuclear Organization and Oncogenesis, Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: hepatitis C virus, MESH: Liver Transplantation, recurrence, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, MESH: Romania, MESH: Proportional Hazards Models, MESH: Liver Neoplasms, MESH: Risk Factors, MESH: Carcinoma, Hepatocellular, MESH: Kaplan-Meier Estimate, MESH: Prevalence, MESH: Treatment Outcome, MESH: Age Factors, MESH: Aged, MESH: Hepatitis C, MESH: Middle Aged, MESH: Humans, MESH: Catheter Ablation, MESH: Hepatitis B, MESH: Time Factors, MESH: Retrospective Studies, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, hepatocellular carcinoma, MESH: Neoplasm Staging, MESH: Hepatectomy, digestive system diseases, MESH: Male, MESH: Disease-Free Survival, prognosis, hepatitis B virus, MESH: Female
Abstract: International audience; Background: The global risk of hepatocellular carcinoma (HCC) is largely due to hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. In recent years, however, an increased prevalence of non-viral HCC has been noted. The clinical impact of the presence/absence of viral infections in HCC remains controversial. The present study aimed to assess the effect of hepatitis viruses on demographics, clinical and pathological features and long-term outcome in a large cohort of Romanian patients who underwent surgery for HCC.Methods: The study included 404 patients with HCC who had undergone resection, transplantation or radiofrequency ablation at a single institution between 2001 and 2010. The patients were divided into four groups: 85 patients with hepatitis B virus infection (HBV group), 164 patients with hepatitis C virus infection (HCV group), 39 patients with hepatitis B and C virus co-infection (HBCV group), and 116 patients without viral infection (non-BC group).Results: The patients of both HBV (56.0+/-11.3 years) and HBCV groups (56.0+/-9.9 years) were significantly younger than those of the HCV (61.0+/-8.5 years, P=0.001) and non-BC groups (61.0+/-13.0 years, P=0.002). Interestingly, the prevalence of liver cirrhosis was significantly lower in the non-BC group (47%) than in any other subsets (72%-90%, P
Published: 2014

49. Molecular Classification of Malignant Pleural Mesothelioma: Identification of a Poor Prognosis Subgroup Linked to the Epithelial-to-Mesenchymal Transition

Author: Jessica Zucman-Rossi, Fabien Petel, Gabrielle Couchy, Paul Hofman, Pascal Andujar, Marie-Christine Copin, Aurélie Cazes, Aurélien de Reyniès, Marie-Claude Jaurand, Françoise Galateau-Sallé, Sandrine Imbeaud, Jean-Claude Pairon, Annie Renier, Didier Jean, Françoise Le Pimpec-Barthes, Nabila Elarouci, Ilir Hysi, Jean, Didier, Ligue Nationale Contre le Cancer - Paris, Ligue Nationale Contre le Cancer (LNCC), (le programme) Cartes d'identité des tumeurs (CIT), Ligue Nationales Contre le Cancer (LNCC), Génomique fonctionnelle des tumeurs solides (U674), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Laboratoire d'Anatomie Pathologique [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Institut de biologie et chimie des protéines [Lyon] (IBCP), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Angiogénèse embryonnaire et pathologique, Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre interdisciplinaire de recherche en biologie (CIRB), Labex MemoLife, École normale supérieure - Paris (ENS-PSL), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Collège de France (CdF (institution))-Ecole Superieure de Physique et de Chimie Industrielles de la Ville de Paris (ESPCI Paris), Université Paris sciences et lettres (PSL)-École normale supérieure - Paris (ENS-PSL), Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Labex MemoLife, Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Ligue Nationnale Contre le Cancer, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Diderot - Paris 7 (UPD7), Centre interdisciplinaire de recherche en biologie (CIRB), École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Labex MemoLife, and Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC)
Subjects: Male, Mesothelioma, Cancer Research, Pathology, Lung Neoplasms, Microarray, Gene mutation, [SDV.BBM.BM] Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, 0302 clinical medicine, CDKN2A, CDKN2B, Tumor Cells, Cultured, Cluster Analysis, MESH: Aged, 0303 health sciences, BAP1, MESH: Middle Aged, MESH: Neoplasm Staging, Middle Aged, Prognosis, 3. Good health, Oncology, 030220 oncology & carcinogenesis, [SDV.BBM.GTP] Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN], Female, MESH: Biomarkers, Tumor, Ubiquitin Thiolesterase, medicine.medical_specialty, Epithelial-Mesenchymal Transition, MESH: Mutation, Pleural Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.BC]Life Sciences [q-bio]/Cellular Biology, Biology, [SDV.GEN.GH] Life Sciences [q-bio]/Genetics/Human genetics, MESH: Pleural Neoplasms, MESH: Prognosis, 03 medical and health sciences, MESH: Gene Expression Profiling, [SDV.CAN] Life Sciences [q-bio]/Cancer, [SDV.BBM.GTP]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN], Biomarkers, Tumor, medicine, Humans, MESH: Tumor Suppressor Proteins, MESH: Tumor Cells, Cultured, [SDV.BC] Life Sciences [q-bio]/Cellular Biology, Aged, Neoplasm Staging, 030304 developmental biology, MESH: Humans, MESH: Mesothelioma, Gene Expression Profiling, Tumor Suppressor Proteins, Mesothelioma, Malignant, Cancer, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, MESH: Ubiquitin Thiolesterase, medicine.disease, MESH: Cluster Analysis, MESH: Male, MESH: Lung Neoplasms, Gene expression profiling, MESH: Epithelial-Mesenchymal Transition, [SDV.GEN.GH]Life Sciences [q-bio]/Genetics/Human genetics, Mutation, Cancer research, MESH: Female
Abstract: Purpose: Despite research efforts to develop more effective diagnostic and therapeutic approaches, malignant pleural mesothelioma (MPM) prognosis remains poor. The assessment of tumor response to therapy can be improved by a deeper phenotypical classification of the tumor, with emphasis on its clinico-biological heterogeneity. The identification of molecular profiles is a powerful approach to better define MPM subclasses and targeted therapies. Experimental Design: Molecular subclasses were defined by transcriptomic microarray on 38 primary MPM cultures. A three-gene predictor, identified by quantitative reverse transcription PCR, was used to classify an independent series of 108 frozen tumor samples. Gene mutations were determined in BAP1, CDKN2A, CDKN2B, NF2, and TP53. Epithelial-to-mesenchymal transition (EMT) markers were studied at the mRNA and protein levels. Results: Unsupervised hierarchical clustering on transcriptomic data defined two robust MPM subgroups (C1 and C2), closely related to prognosis and partly to histologic subtypes. All sarcomatoid/desmoplastic MPM were included in the C2 subgroup. Epithelioid MPM were found in both subgroups, with a worse survival prognosis in the C2 subgroup. This classification and its association with histologic subtypes and survival were validated in our independent series using the three-gene predictor. Similar subgroups were found after classification of other MPM series from transcriptomic public datasets. C1 subgroup exhibited more frequent BAP1 alterations. Pathway analysis revealed that EMT was differentially regulated between MPM subgroups. C2 subgroup is characterized by a mesenchymal phenotype. Conclusions: A robust classification of MPM that defines two subgroups of epithelioid MPM, characterized by different molecular profiles, gene alterations, and survival outcomes, was established. Clin Cancer Res; 20(5); 1323–34. ©2014 AACR.
Published: 2014

50. Results in the elderly with locally advanced rectal cancer from the ACCOR12/PRODIGE 2 phase III trial: Tolerance and efficacy

Author: Christophe Hennequin, Thierry Conroy, Véronique Vendrely, Pierre-Luc Etienne, Jean-François Seitz, Sophie Gourgou-Bourgade, Isabelle Martel-Laffay, Beata Juzyna, Marta Jarlier, Jean-Pierre Gerard, Eric Francois, David Azria, Centre de Lutte contre le Cancer Antoine Lacassagne [Nice] (UNICANCER/CAL), UNICANCER-Université Côte d'Azur (UCA), CRLCC Val d'Aurelle - Paul Lamarque, Centre Léon Bérard [Lyon], Service de cancérologie et radiothérapie [Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Clinique Armoricaine de Radiologie [St. Brieuc], Hôpital Saint-André, Service d'oncologie digestive et hépato-gastro-entérologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] (UNICANCER/ICL), UNICANCER, Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université Paris Descartes - Paris 5 (UPD5)-Université de Lorraine (UL), CRLCC Antoine Lacassagne, Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Diderot - Paris 7 ( UPD7 ) -Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], CHU Bordeaux [Bordeaux]-Hôpital Saint -André, Assistance Publique - Hôpitaux de Marseille ( APHM ) - Hôpital de la Timone [CHU - APHM] ( TIMONE ), Institut de Cancérologie de Lorraine - Alexis Vautrin ( ICL ), Maladies chroniques, santé perçue, et processus d'adaptation. Approches épidémiologiques et psychologiques. ( APEMAC - EA 4360 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Université de Lorraine ( UL ), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), and Institut de Cancérologie de Lorraine - Alexis Vautrin (ICL)
Subjects: Oncology, Male, Organoplatinum Compounds, MESH : Retrospective Studies, Colorectal cancer, MESH : Antineoplastic Combined Chemotherapy Protocols, medicine.medical_treatment, MESH : Aged, Deoxycytidine, 0302 clinical medicine, Elderly, MESH: Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols, Rectal Adenocarcinoma, Medicine, MESH : Neoplasm Staging, MESH : Female, Stage (cooking), Rectal cancer, MESH : Rectal Neoplasms, MESH: Treatment Outcome, MESH: Chemoradiotherapy, Aged, 80 and over, MESH: Aged, MESH: Middle Aged, MESH: Organoplatinum Compounds, Age Factors, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, Hematology, Chemoradiotherapy, MESH : Chemoradiotherapy, MESH: Neoplasm Staging, Middle Aged, MESH : Adult, Neoadjuvant Therapy, 3. Good health, Neoadjuvant chemoradiotherapy, Oxaliplatin, MESH: Antineoplastic Combined Chemotherapy Protocols, Treatment Outcome, 030220 oncology & carcinogenesis, MESH : Fluorouracil, 030211 gastroenterology & hepatology, Female, Fluorouracil, medicine.drug, Adult, medicine.medical_specialty, MESH : Male, MESH: Neoadjuvant Therapy, MESH : Treatment Outcome, MESH : Organoplatinum Compounds, MESH : Capecitabine, Capecitabine, 03 medical and health sciences, MESH : Deoxycytidine, Internal medicine, Humans, Radiology, Nuclear Medicine and imaging, MESH : Middle Aged, MESH : Aged, 80 and over, Aged, Neoplasm Staging, Retrospective Studies, MESH: Age Factors, Chemotherapy, MESH: Humans, business.industry, Rectal Neoplasms, MESH : Humans, MESH: Deoxycytidine, MESH: Capecitabine, MESH: Rectal Neoplasms, MESH: Adult, MESH: Retrospective Studies, medicine.disease, Comorbidity, MESH: Male, Clinical trial, Exploratory analysis, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH : Age Factors, business, MESH : Neoadjuvant Therapy, MESH: Female, MESH: Fluorouracil
Abstract: International audience; BACKGROUND:Rectal cancer predominantly affects the elderly. Unfortunately, this age category is under-represented in clinical trials because clinicians are loath to include patients with a high risk of comorbidity.PATIENTS AND METHODS:An exploratory analysis of the ACCORD12/PRODIGE 2 phase III trial was carried out to retrospectively compare the benefit of neoadjuvant chemotherapy between the elderly (≥70 years; n=142) and younger patients (
Published: 2014

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