Author: "Olivier Graesslin" / Topic: 03 medical and health sciences - Searchworks@Jio Institute Digital Library Search Results

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1. Sentinel lymph node biopsy and morbidity outcomes in early cervical cancer: Results of a multicentre randomised trial (SENTICOL-2)

Author: Yves Fouche, Marc Baron, Florent Boutitie, G. Houvenaeghel, Daniel Raudrant, Eric Leblanc, Catherine Uzan, V. Fourchotte, J-M Classe, P. Morice, Anne-Sophie Bats, Fabrice Lecuru, C. Pomel, L. Boulanger, Jean Levêque, G. Mage, Olivier Graesslin, Patrice Mathevet, Frederic Guyon, Emile Daraï, Vanessa Conri, Philippe Descamps, Jean-Jacques Baldauf, Henri Marret, A S Bats, Denis Querleu, Virginie Fourchotte, Laurent Magaud, B. Ott, Serge Douvier, E. Stoeckle, P. Rouanet, P. Mathevet, Manuel González Barón, D. Lanvin, and Y. Delpech
Subjects: Adult, 0301 basic medicine, Cancer Research, medicine.medical_specialty, medicine.medical_treatment, Sentinel lymph node, Uterine Cervical Neoplasms, Adenocarcinoma, Hysterectomy, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Prospective Studies, Radical surgery, Radical Hysterectomy, Lymph node, Cervical cancer, Sentinel Lymph Node Biopsy, business.industry, Middle Aged, Sentinel node, Prognosis, medicine.disease, Surgery, Survival Rate, Dissection, 030104 developmental biology, medicine.anatomical_structure, Oncology, 030220 oncology & carcinogenesis, Carcinoma, Squamous Cell, Lymph Node Excision, Female, Lymphadenectomy, Morbidity, Neoplasm Recurrence, Local, business, Follow-Up Studies
Abstract: Introduction Pelvic lymph node dissection has been the standard of care for patients with early cervical cancer. Sentinel node (SN) mapping is safe and feasible and may increase the detection of metastatic disease, but benefits of omitting pelvic lymph node dissection in terms of decreased morbidity have not been demonstrated. Materials and methods In an open-label study, patients with early cervical carcinoma (FIGO 2009 stage IA2 to IIA1) were randomly assigned to SN resection alone (SN arm) or SN and pelvic lymph node dissection (SN + PLND arm). SN resection was followed by radical surgery of the tumour (radical hysterectomy or radical trachelectomy). The primary end-point was morbidity related to the lymph node dissection; 3-year recurrence-free survival was a secondary end-point. Results A total of 206 patients were eligible and randomly assigned to the SN arm (105 patients) or SN + PLND arm (101 patients). Most patients had stage IB1 lesion (87.4%). No false-negative case was observed in SN + PLND arm. Lymphatic morbidity was significantly lower in the SN arm (31.4%) than in the SN + PLND arm (51.5%; p = 0.0046), as was the rate of postoperative neurological symptoms (7.8% vs. 20.6%, p = 0.01, respectively). However, there was no significant difference in the proportion of patients with significant lymphoedema between the two groups. During the 6-month postoperative period, the difference in morbidity decreased over time. The 3-year recurrence-free survival was not significantly different (92.0% in SN arm and 94.4% in SN + PLND arm). Conclusion SN resection alone is associated with early decreased lymphatic morbidity when compared with SN + PLND in early cervical cancer.
Published: 2021

2. Management of borderline ovarian tumours during pregnancy: Results of a French multi-centre study

Author: Geoffroy Canlorbe, M. Koskas, Matthieu Mezzadri, Charles Coutant, Marcos Ballester, Chantal Touboul, Sofiane Bendifallah, L. Ouldamer, Camille Mimoun, Olivier Graesslin, Henri Azaïs, Cyrille Huchon, Emilie Raimond, Pauline Chauvet, Tristan Gauthier, Cherif Akladios, M. Zilliox, M. Lapointe, Yohann Dabi, Pierre-Adrien Bolze, Ludivine Dion, Vincent Lavoué, Alexandre Bricou, Lise Lecointre, Nicolas Bourdel, P. Collinet, Xavier Carcopino, Institut Pascal (IP), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne (UCA)-Institut national polytechnique Clermont Auvergne (INP Clermont Auvergne), and Université Clermont Auvergne (UCA)-Université Clermont Auvergne (UCA)
Subjects: medicine.medical_specialty, medicine.medical_treatment, Cystectomy, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Laparotomy, medicine, Humans, Multicenter Studies as Topic, 030212 general & internal medicine, Stage (cooking), Child, Laparoscopy, ComputingMilieux_MISCELLANEOUS, Neoplasm Staging, Retrospective Studies, Ovarian Neoplasms, 030219 obstetrics & reproductive medicine, medicine.diagnostic_test, business.industry, Obstetrics and Gynecology, Magnetic resonance imaging, medicine.disease, Surgery, Serous fluid, Reproductive Medicine, Population study, Female, Neoplasm Recurrence, Local, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: Objective To assess the diagnostic and prognostic characteristics of borderline ovarian tumours (BOTs) detected during pregnancy, and to establish an inventory of French practices. Materials and methods A retrospective multi-centre case study of 14 patients treated for BOTs, diagnosed during pregnancy between 2005 and 2017, in five French pelvic cancerology expert centres, including data on clinical characteristics, histological tumour characteristics, surgical procedure, adjuvant treatments, follow-up and fertility. Results The mean age of patients was 29.3 [standard deviation (SD) 6.2] years. Most BOTs were diagnosed on ultrasonography in the first trimester (85.7 %), and most of these cases (78.5 %) also underwent magnetic resonance imaging to confirm the diagnosis (true positives 54.5 %). Most patients underwent surgery during pregnancy (57 %), with complete staging surgery in two cases (14.3 %). Laparoscopy was performed more frequently than other procedures (50 %), and unilateral adnexectomy was more common than cystectomy (57.5 %). Tumour size influenced the surgical approach significantly (mean size 7.5 cm for laparoscopy, 11.9 cm for laparoconversion, 14 cm for primary laparotomy; P = 0.08), but the type of resection did not. Most patients were initially diagnosed with International Federation of Gynecology and Obstetrics stage IA (92.8 %) tumours, but many were upstaged after complete restaging surgery (57.1 %). Most BOTs were serous (50 %), two cases had a micropapillary component (28.5 %), and one case had a micro-invasive implant. BOTs were bilateral in two cases (14.2 %). Mean follow-up was 31.4 (SD 14.8) months. Recurrent lesions occurred in two patients (14.2 %) and no deaths have been recorded to date among the study population. Conclusion BOTs remain rare, but this study – despite its small sample size – supports the hypothesis that BOTs during pregnancy have potentially aggressive characteristics.
Published: 2021

3. Signification pronostique du ratio d’atteinte ganglionnaire inguinale dans le carcinome épidermoide vulvaire

Author: Chantal Touboul, Emile Daraï, Xavier Carcopino, E Serre, Olivier Graesslin, Lobna Ouldamer, Marcos Ballester, Groupe de Recherche Francogyn, Gilles Body, Emilie Raimond, Caroline Diguisto, and Sofiane Bendifallah
Subjects: Gynecology, 03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, Reproductive Medicine, business.industry, 030220 oncology & carcinogenesis, medicine, Obstetrics and Gynecology, Lymph node metastasis, 030204 cardiovascular system & hematology, business
Abstract: Resume Objectifs Le but de ce travail etait d’evaluer l’impact clinique du ratio de la dissemination metastatique ganglionnaire inguinale (LNR) chez les patientes prises en charge pour un cancer vulvaire de type epidermoide. Materiel et methodes La cohorte de l’etude etait representee par des patientes prises en charge pour un carcinome epidermoide vulvaire, entre janvier 2005 et decembre 2015, dans 5 institutions francaises avec bases de donnees prospectives. Population Au toal, 636 femmes, parmi lesquelles 508 (79,9 %) ont eu une chirurgie ganglionnaire inguinale. Le seuil significatif du LNR a ete determine par la methode du minimal valeur de p. Critere de jugement principal Comparaison de la survie globale et sans recidive selon le LNR. Resultats Au total, 176 femmes (34,6 %) avaient au moins un ganglion atteint. Il existait une difference significative de survie globale et de survie sans recidive selon que le LNR, soit > 0,2 ou non. Conclusion L’evaluation, dans notre etude, du ratio de ganglions positifs, semble demontrer que celui-ci pourrait etre considere comme un facteur pronostique a part entiere.
Published: 2020

4. Prise en charge chirurgicale des cancers gynécologiques en période de pandémie COVID-19 – Recommandations du Groupe FRANCOGYN pour le CNGOF

Author: Geoffroy Canlorbe, Ludivine Dion, Vincent Lavoué, Emilie Raimond, P. Collinet, Cherif Akladios, Nicolas Bourdel, Yohann Dabi, Chantal Touboul, Olivier Graesslin, Henri Azaïs, Matthieu Mezzadri, Alexandre Bricou, Lise Lecointre, Marcos Ballester, Camille Mimoun, Tristan Gauthier, Frédéric Kridelka, Pauline Chauvet, Pierre-Adrien Bolze, Sofiane Bendifallah, Xavier Carcopino, C. Huchon, Charles Coutant, M. Koskas, and L. Ouldamer
Subjects: Cervical cancer, medicine.medical_specialty, 030219 obstetrics & reproductive medicine, Hysterectomy, medicine.diagnostic_test, business.industry, General surgery, medicine.medical_treatment, Endometrial cancer, Sentinel lymph node, Obstetrics and Gynecology, Cancer, medicine.disease, Radiation therapy, 03 medical and health sciences, 0302 clinical medicine, Reproductive Medicine, 030220 oncology & carcinogenesis, Obstetrics and Gynaecology, medicine, Hyperthermic intraperitoneal chemotherapy, business, Endometrial biopsy
Abstract: INTRODUCTION: Recommendations for the management of patients with gynecological cancer during the COVID-19 pandemic period. MATERIAL AND METHOD: Recommendations based on the consensus conference model. RESULTS: In the case of a COVID-19 positive patient, surgical management should be postponed for at least 15 days. For cervical cancer, the place of surgery must be re-evaluated in relation to radiotherapy and Radio-Chemotherapy-Concomitant and the value of lymph node staging surgeries must be reviewed on a case-by-case basis. For advanced ovarian cancers, neo-adjuvant chemotherapy should be favored even if primary cytoreduction surgery could be envisaged. It is lawful not to offer hyperthermic intraperitoneal chemotherapy during a COVID-19 pandemic. In the case of patients who must undergo interval surgery, it is possible to continue the chemotherapy and to offer surgery after 6 cycles of chemotherapy. For early stage endometrial cancer, in case of low and intermediate preoperative ESMO risk, hysterectomy with bilateral annexectomy associated with a sentinel lymph node procedure should be favored. It is possible to consider postponing surgery for 1 to 2 months in low-risk endometrial cancers (FIGO Ia stage on MRI and grade 1-2 endometrioid cancer on endometrial biopsy). For high ESMO risk, it ispossible to favor the MSKCC algorithm (combining PET-CT and sentinel lymph node biopsy) in order to omit pelvic and lumbar-aortic lymphadenectomies. CONCLUSION: During COVID-19 pandemic, patients suffering from cancer should not lose life chance, while limiting the risks associated with the virus.
Published: 2020

5. Prise en charge des abcès tubo-ovariens (ATO) et des formes compliquées d’infections génitales hautes. RPC infections génitales hautes CNGOF et SPILF

Author: O. Garbin, Olivier Graesslin, Renaud Verdon, Emilie Raimond, and Martin Koskas
Subjects: medicine.medical_specialty, 030219 obstetrics & reproductive medicine, medicine.diagnostic_test, business.industry, Pelvic pain, medicine.medical_treatment, Obstetrics and Gynecology, Context (language use), medicine.disease, Adnexal mass, Surgery, 03 medical and health sciences, 0302 clinical medicine, Reproductive Medicine, Laparotomy, Pelvic inflammatory disease, Medicine, 030212 general & internal medicine, medicine.symptom, business, Laparoscopy, Abscess, Pelvic examination
Abstract: A tubo-ovarian abscess (ATO) should be suspected in a context of pelvic inflammatory disease (PID) in case of severe pain associated with the presence of general signs and palpation of an adnexal mass at pelvic examination. Imaging allows most often a rapid diagnosis, by ultrasound or CT, the latter being irradiant but also allowing to consider the differential diagnoses (digestive or urinary diseases) in case of pelvic pain. MRI, non-irradiating examination, whenever it is feasible, provides relevant information, more efficient, guiding quickly the diagnosis. The diagnosis of tubo-ovarian abscess should lead to the hospitalization of the patient, the collection of bacteriological samples, the initiation of a probabilistic antibiotherapy associated with drainage of the purulent collection. In severe septic forms (generalized peritonitis, septic shock), surgery (laparoscopy or laparotomy) keeps its place. In other situations, ultrasound-guided trans-vaginal puncture in the absence of major hemostasis disorders or severe sepsis is a less morbid alternative to surgery and provides high rates of cure. Today, ultrasound-guided trans-vaginal puncture has been satisfactory evaluated in the literature and is part of a logic of therapeutic de-escalation. Randomized trials evaluating laparoscopic drainage versus radiological drainage should be able to answer, in the coming years, questions that are still outstanding (impact on chronic pelvic pain, fertility). The recommendations for the management of ATO published in 2012 by the CNGOF remain valid, legitimizing the place of radiological drainage associated with antibiotic therapy.
Published: 2019

6. Les infections génitales hautes. Mise à jour des recommandations pour la pratique clinique – texte court

Author: Olivier Graesslin, C. Cazanave, Amélie Charvériat, Karine Faure, Jean-Luc Brun, B. de Barbeyrac, Renaud Verdon, Bernard Castan, Stéphanie Mignot, and Xavier Fritel
Subjects: 03 medical and health sciences, 030219 obstetrics & reproductive medicine, 0302 clinical medicine, Reproductive Medicine, 030220 oncology & carcinogenesis, Obstetrics and Gynecology, 3. Good health
Abstract: Resume Objectifs Mettre a jour les recommandations sur la prise en charge des infections genitales hautes (IGH). Methodes La litterature a ete actualisee a partir des mots cles associes aux IGH de 2012 a 2018 dans les bases de donnees Cochrane, PubMed et Embase. Toutes les etudes publiees en langue francaise ou anglaise pertinentes ont ete considerees. Les donnees ont ete decrites avec un niveau de preuve, de facon a etablir un grade de recommandations. Resultats Une IGH doit etre evoquee devant une douleur pelvienne spontanee associee a une douleur uterine ou annexielle provoquee a l’examen gynecologique (grade B). L’echographie pelvienne est recommandee pour eliminer une complication a type de collection (grade C). Des prelevements de l’endocol et des collections intraperitoneales sont recommandes afin d’obtenir un diagnostic microbiologique (grade B). Le schema antibiotique de 1re intention des IGH non compliquees est la ceftriaxone 1 g, 1 fois, par voie intramusculaire (IM) ou intraveineuse (IV), associee a la doxycycline 100 mg × 2/j et au metronidazole 500 mg × 2/j par voie orale (PO) pendant 10 jours (grade A). Le schema antibiotique de 1re intention des IGH compliquees est la ceftriaxone 1 a 2 g/j IV jusqu’a amelioration clinique, associee a la doxycycline 100 mg × 2/j, IV ou PO, et au metronidazole 500 mg × 3/j, IV ou PO, pendant 14 jours au total (grade B). Les abces tubo-ovarien de plus de 3 cm doivent etre draines (grade B). Un suivi est necessaire chez les femmes atteintes d’infections sexuellement transmissibles (IST) (grade C). L’usage des preservatifs est recommande (grade B). Un prelevement vaginal microbiologique est recommande 3 a 6 mois apres une IGH (grade C), avant l’insertion d’un dispositif intra-uterin (grade B), a l’occasion d’une demande d’interruption volontaire de grossesse ou de la realisation d’une hysterosalpingographie. Il est preferable d’administrer une antibiotherapie ciblee sur la bacterie depistee plutot que de recourir a une antibioprophylaxie systematique dans ces situations. Conclusion Les IGH sont prises en charge par des examens paracliniques reproductibles et une triple antibiotherapie adaptee aux IST et au microbiote vaginal.
Published: 2019

7. Les femmes ménopausées : recommandations pour la pratique clinique du CNGOF et du GEMVi (Texte court)

Author: J.-M. Pouillès, Nathalie Chabbert-Buffet, G. Boutet, Carole Mathelin, E. Maris, Lorraine Maitrot-Mantelet, C. Hocke, Geneviève Plu-Bureau, G. André, Florence Trémollières, M. Duclos, G. Robin, A. Gosset, Olivier Graesslin, J.-M. Lecerf, P. Lopes, Justine Hugon-Rodin, Naima Hamdaoui, Christine Rousset-Jablonski, Xavier Fritel, CHU Toulouse [Toulouse], Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Sorbonne Université (SU), Unité de Gynécologie Médicale, AP-HP, Hôpital Port-Royal, Université de Paris, Sorbonne Paris Nord University, INSERM U1153, INRAE U1125, CNAM, Nutritional Epidemiology Research Team (EREN), Epidemiology and Statistics Research Center-University of Paris (CRESS), Ctr Leon Berard, Université de Lyon, Hospices Civils de Lyon (HCL), Health Service and Performance Research (HESPER), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service Médecine du Sport et Explorations Fonctionnelles [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand, Unité de Nutrition Humaine (UNH), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Université Clermont Auvergne (UCA), Hôpital Pellegrin, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, CHU Bordeaux [Bordeaux], Université de Montpellier (UM), Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CHU Lille, CHU Marseille, Institut de Cancérologie de Strasbourg Europe (ICANS), Les Hôpitaux Universitaires de Strasbourg (HUS), 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), France Polyclin Atlantique St Herblain, Centre hospitalier universitaire de Nantes (CHU Nantes), Institut Mère Enfant Alix de Champagne, Centre hospitalier universitaire de Poitiers (CHU Poitiers), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and Centre Léon Bérard [Lyon]
Subjects: medicine.medical_specialty, 030219 obstetrics & reproductive medicine, Postmenopausal women, business.industry, Obstetrics and Gynecology, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, 3. Good health, Clinical Practice, 03 medical and health sciences, 0302 clinical medicine, Reproductive Medicine, 030220 oncology & carcinogenesis, Family medicine, Medicine, business, ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2021

8. Prognostic Value and Risk Factors of Peritoneal Carcinomatosis Recurrence for Patients with Endometrial Cancer: A Multicenter Study from the FRANCOGYN Group

Author: Marcos Ballester, Vincent Lavoué, A Gaudet Chardonnet, Henri Azaïs, Lobna Ouldamer, Pierre Collinet, Alexandre Bricou, Geoffroy Canlorbe, Cyrille Huchon, Charles Coutant, Sofiane Bendifallah, Emile Daraï, Cyril Touboul, Olivier Graesslin, Emilie Raimond, Martin Koskas, Catherine Uzan, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Groupe Hospitalier Diaconesses Croix Saint-Simon, Centre Hospitalier Universitaire de Reims (CHU Reims), Pathologies biliaires, fibrose et cancer du foie [CHU Saint-Antoine], Centre de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-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)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-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)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, CHI Créteil, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHI Poissy-Saint-Germain, Chemistry, Oncogenesis, Stress and Signaling (COSS), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Cochin [AP-HP], Pathologies biliaires, fibrose et cancer du foie [CRSA], Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), and Université de Rennes (UR)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Oncology, medicine.medical_specialty, medicine.medical_treatment, [SDV]Life Sciences [q-bio], 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Surgical oncology, Internal medicine, Humans, Medicine, Prospective Studies, Risk factor, Prospective cohort study, Peritoneal Neoplasms, Neoplasm Staging, Retrospective Studies, Chemotherapy, business.industry, Endometrial cancer, Mortality rate, Odds ratio, Prognosis, medicine.disease, Endometrial Neoplasms, 3. Good health, Serous fluid, 030220 oncology & carcinogenesis, Female, 030211 gastroenterology & hepatology, Surgery, Neoplasm Recurrence, Local, business
Abstract: International audience; Background. The prognosis for patients with endometrial cancer (EC) peritoneal carcinomatosis (PC) recurrence has received little study. This study aimed to determine specific risk factors and prognosis of EC with PC recurrence (PCR) versus no PC recurrence (NPCR). Methods. Data of all patients with EC who received primary surgical treatment between January 2000 and February 2017 were abstracted from the French FRANCOGYN Research Group database. Clinical and pathologic variables were compared between the two groups (PCR vs. NPCR). Multivariate analysis was performed to define prognostic factors for peritoneal recurrence. Overall survivals (OS) of patients after recurrence were compared using the Kaplan-Meier method. Results. The study analyzed 1466 patients, and 257 of these patients (17.5%) had recurrence. At presentation, 63 of these patients had PC. International Federation of Gynecology and Obstetrics (FIGO) stages 3 and 4 disease were significantly associated with PCR versus NPCR (odds ratio 2.24; 95% confidence interval 1.23-4.07; p = 0.008). The death rate for the patients with PC was 47.6%, with a median survival of 12 months after diagnosis of recurrence. According to the histologic subtype, OS was 29 months (Q1-Q3, 13-NA) for endometrioid carcinomas, 7.5 months (Q1-Q3, 4-15) for serous carcinomas, and 10 months (Q1-Q3, 5-15) for clear cell carcinomas. Chemotherapy for treatment of PCR was associated with improved OS after recurrence (OSAR; p = 0.0025). Conclusion. An initial advanced stage of EC is a risk factor for PCR. For women with PCR, a diagnosis of type 1 EC recurrence more than 12 months after the initial treatment and management of PCR with chemotherapy is associated with improved OSAR. Prospective studies are needed to determine the precise optimal management required in this clinical situation and to assess the relevance of biomarkers to predict the risk of PCR for EC patients.
Published: 2021

9. Prognosis impact of posttreatment pelvic MRI in patients treated for stage IB2-IIB cervical cancer with chemoradiation therapy

Author: Cyril Touboul, Olivier Graesslin, François Golfier, Marcos Ballester, Sophie Knight, Alexandre Bricou, Yohan Kerbage, Pierre Adrien Bolze, Sofiane Bendifallah, Cyrille Huchon, Ludivine Dion, Emilie Raimond, Yohann Dabi, Florence Rodriguez, Vincent Lavoué, Lobna Ouldamer, Geoffroy Atrous, Xavier Carcopino, Pierre Collinet, Myriam Mimouni, Tiphaine Moussilmani, Julien Mancini, Jonchère, Laurent, Institut méditerranéen de biodiversité et d'écologie marine et continentale (IMBE), Avignon Université (AU)-Aix Marseille Université (AMU)-Institut de recherche pour le développement [IRD] : UMR237-Centre National de la Recherche Scientifique (CNRS), Hôpital Nord [CHU - APHM], Biostatistique et technologies de l'information et de la communication (BioSTIC) - [Hôpital de la Timone - APHM] (BiosTIC ), Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance Publique - Hôpitaux de Marseille (APHM), Hospices Civils de Lyon (HCL), Groupe Hospitalier Diaconesses Croix Saint-Simon, Hôpital Jeanne de Flandre [Lille], Nutrition, croissance et cancer (U 1069) (N2C), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Chemistry, Oncogenesis, Stress and Signaling (COSS), Université de Rennes (UR)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHI Créteil, Institut Mère Enfant Alix de Champagne, Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), CHI Poissy-Saint-Germain, Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-CRLCC Eugène Marquis (CRLCC)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Centre National de la Recherche Scientifique (CNRS)-Institut de recherche pour le développement [IRD] : UMR237-Aix Marseille Université (AMU)-Avignon Université (AU), Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM), Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: medicine.medical_specialty, Survival, [SDV.MHEP.CHI] Life Sciences [q-bio]/Human health and pathology/Surgery, medicine.medical_treatment, Uterine Cervical Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, Disease, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, Hysterectomy, 030218 nuclear medicine & medical imaging, Lesion, 03 medical and health sciences, 0302 clinical medicine, [SDV.CAN] Life Sciences [q-bio]/Cancer, Predictive Value of Tests, Recurrence, medicine, Humans, In patient, Pelvic MRI, Stage (cooking), Neoplasm Staging, Retrospective Studies, Cervical cancer, medicine.diagnostic_test, business.industry, Magnetic resonance imaging, Chemoradiotherapy, General Medicine, Middle Aged, medicine.disease, Prognosis, Magnetic Resonance Imaging, 3. Good health, Survival Rate, Oncology, Chemoradiation, 030220 oncology & carcinogenesis, Female, Surgery, Radiology, Neoplasm Recurrence, Local, medicine.symptom, business
Abstract: International audience; OBJECTIVES: To evaluate the performances of systematic posttreatment pelvic magnetic resonance imaging (PPMRI) in predicting prognosis of patients treated with chemoradiation therapy (CRT) for locally advanced cervical cancer (LACC). MATERIALS AND METHODS: Multi-institutional data from 216 patients presenting FIGO IB2-IIB cervical cancer for which PPMRI was performed following CRT were retrospectively reviewed. Incomplete response was defined as the identification of persistent lesion on PPMRI. Primary endpoints were patients’ 5-year recurrence free (RFS) and overall (OS) survivals. Secondary endpoint was the identification of residual histologic disease on hysterectomy specimens when completion surgery was performed. RESULTS: PPMRI identified an incomplete response in 102 (47.2%) cases. A 70% or more reduction in tumor size on PPMRI was identified as the best predictive cut-off for recurrence (37.7% sensitivity and 78.7% specificity) and death (50% sensitivity and 77.9% specificity) with significant impact on those risks (HRa: 0.42; 95%CI: 0.23-0.77 and HRa: 0.18; 95%CI: 0.06-0.50, respectively). Completion hysterectomy was performed in 117 (54.4%) cases, with histologic residual disease in 55 (47.4%). PPMRI demonstrated 74.5% sensitivity and 50.8% specificity in predicting residual disease. Although survival of patients with complete response at PPMRI was not impacted by completion hysterectomy, it significantly increased 5-year RFS and OS of those with incomplete response: 38.7% vs. 65.3% (p
Published: 2021

10. Recurrence Pattern of Cervical Cancer Based on the Platinum Sensitivity Concept: A Multi-Institutional Study from the FRANCOGYN Group

Author: Geoffroy Canlorbe, Emile Daraï, Cyrille Huchon, Cyril Touboul, Marcos Ballester, Olivier Graesslin, Tiphaine de Foucher, Xavier Carcopino, Pierre Adrien Bolze, Sofiane Bendifallah, Ludivine Dion, Emilie Raimond, François Golfier, Cherif Akladios, Vincent Lavoué, Pierre Collinet, Clémentine Owen, Yohan Kerbage, Lobna Ouldamer, Cecile Hennebert, Y. Dabi, Alexandre Bricou, Lise Lecointre, CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Intercommunal de Créteil (CHIC), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Pontchaillou [Rennes], CHU Pitié-Salpêtrière [AP-HP], Hospices Civils de Lyon (HCL), Les Hôpitaux Universitaires de Strasbourg (HUS), Hôpital Jeanne de Flandre [Lille], Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut méditerranéen de biodiversité et d'écologie marine et continentale (IMBE), Avignon Université (AU)-Aix Marseille Université (AMU)-Institut de recherche pour le développement [IRD] : UMR237-Centre National de la Recherche Scientifique (CNRS), Hôpital Nord [CHU - APHM], Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Institut Mère Enfant Alix de Champagne, Groupe Hospitalier Diaconesses Croix Saint-Simon, Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], 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 Hospitalier Régional Universitaire de Tours (CHRU TOURS), Service de Gynécologie-Obstétrique, Maternité, Chirurgie Gynécologique [CHU Pitié-Salpêtrière], and Centre National de la Recherche Scientifique (CNRS)-Institut de recherche pour le développement [IRD] : UMR237-Aix Marseille Université (AMU)-Avignon Université (AU)
Subjects: Oncology, medicine.medical_specialty, Prognostic factor, Multivariate analysis, Standard of care, endocrine system diseases, medicine.medical_treatment, lcsh:Medicine, Article, 03 medical and health sciences, platinum sensitivity, 0302 clinical medicine, Internal medicine, medicine, Lymph node, 030304 developmental biology, Cervical cancer, 0303 health sciences, Chemotherapy, Platinum sensitivity, business.industry, lcsh:R, General Medicine, recurrence pattern, medicine.disease, female genital diseases and pregnancy complications, 3. Good health, medicine.anatomical_structure, 030220 oncology & carcinogenesis, business, Ovarian cancer, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, advanced cervical cancer
Abstract: The standard of care for patients with advanced cervical cancer (ACC) includes platinum-based chemotherapy. The concept of platinum sensitivity is a major prognostic factor for patients with ovarian cancer. The aim of this study was to validate the applicability of the platinum sensitivity concept to ACC patients, and to estimate its prognostic interest in terms of overall survival (OS) and pattern of recurrence (location, timing). Data of women with histologically proven FIGO 2019 stages IB3&ndash, IV ACC, treated between May 2000 and November 2017 with platinum-based regimens, were retrospectively abstracted from 12 institutions from the FRANCOGYN Group. Respective 3-year OSs were 52% (95% CI: 40.8%&ndash, 66.8%), 21.6% (95% CI: 12.6%&ndash, 37.2%), and 14.6% (95% CI: 4.2%&ndash, 50.2%), in case of recurrence &lt, 6 months, between 6 and 17 months, and &ge, 18 months (p &lt, 0.001). Risk of metastatic or multisite recurrence was significantly higher in case of recurrence &lt, 6 months, and risk of local or isolated infradiaphragmatic nodal recurrence was significantly higher in case of recurrence &gt, 0.001). In multivariate analysis, platinum sensitivity status was a strong prognostic factor for OS after recurrence, independent of histological grade, lympho-vascular space involvement, final lymph node status, and treatment. Platinum sensitivity status may help to classify patients in three prognostic subgroups for OS after recurrence, and appears to be a strong prognostic factor correlated to the pattern of recurrence.
Published: 2020

11. PROGNOSTIC VALUE OF POSTTREATMENT FEDG-PET IMAGING FOLLOWING COMBINED CHEMORADIATION THERAPY IN LOCALLY ADVANCED CERVICAL CANCER

Author: Julien Mancini, Emilie Raimond, Yohan Kerbage, Marcos Ballester, Cyril Touboul, Xavier Carcopino, Ludivine Dion, Vincent Lavoué, Myriam Mimouni, Yohann Dabi, Cyrille Huchon, Alexandre Bricou, Sophie Knight, Pierre Collinet, François Golfier, Olivier Graesslin, Geoffroy Atrous, Lobna Ouldamer, Pierre Adrien Bolze, Sofiane Bendifallah, Institut méditerranéen de biodiversité et d'écologie marine et continentale (IMBE), Centre National de la Recherche Scientifique (CNRS)-Institut de recherche pour le développement [IRD] : UMR237-Aix Marseille Université (AMU)-Avignon Université (AU), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Intercommunal de Créteil (CHIC), Hospices Civils de Lyon (HCL), Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], CHU Tenon [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), Groupe Hospitalier Diaconesses Croix Saint-Simon, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Nutrition, croissance et cancer (U 1069) (N2C), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Chemistry, Oncogenesis, Stress and Signaling (COSS), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Reims (CHU Reims), Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Centre d’Études et de Conservation des Œufs et du Sperme [CHU Jean Verdier] (CECOS), Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Avignon Université (AU)-Aix Marseille Université (AMU)-Institut de recherche pour le développement [IRD] : UMR237-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université de Rennes (UR)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Jonchère, Laurent, Service de Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-CRLCC Eugène Marquis (CRLCC)-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)
Subjects: Adult, medicine.medical_specialty, Neoplasm, Residual, Locally advanced, Uterine Cervical Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, Disease, Completion surgery, Disease-Free Survival, 03 medical and health sciences, 0302 clinical medicine, [SDV.CAN] Life Sciences [q-bio]/Cancer, Humans, Medicine, In patient, chemoradiation, Neoplasm Staging, Retrospective Studies, Cervical cancer, 030219 obstetrics & reproductive medicine, business.industry, FEDG-PET, Medical record, Obstetrics and Gynecology, Chemoradiotherapy, Pet imaging, Middle Aged, medicine.disease, 3. Good health, Treatment Outcome, Reproductive Medicine, Positron-Emission Tomography, 030220 oncology & carcinogenesis, Vaginal brachytherapy, Female, France, Radiology, prognosis, Neoplasm Recurrence, Local, Radiopharmaceuticals, business
Abstract: International audience; Objectives - To evaluate the performances of posttreatment FEDG-PET to predict the prognosis of patients treated with concurrent chemoradiotherapy (CT/RT) for locally advanced cervical cancer. Materials and methods - The medical records of 131 patients treated in 9 French academic institutions for IB2-IIB cervical cancer and for which a posttherapy FEDG-PET was performed were reviewed. All patients received CT/RT, possibly completed with vaginal brachytherapy (VBT) and completion surgery. Posttreatment FEDG-PET was performed within 3 months after completion of CT/RT or VBT. Incomplete metabolic response (IMR) was defined as the persistence of FEDG uptake. Results - An IMR was identified in 44 (33.6 %) cases. IMR was associated with higher risk of recurrence (aHR = 2.8; 95 %CI: 1.3-5.7; p = 0.006) and death (aHR = 4.5 ;95 %CI: 1.4-13.8; p = 0.009). Completion surgery was performed in 61 (46.9 %) patients with histologic cervical residual disease identified in 31 (50.8 %). FEDG-PET sensitivity and specificity in predicting cervical residual disease following CT/RT was 48.4 % (95 %CI: 30.8-66) and 80 % (95 %CI: 65.7-94.3), respectively. Conclusions - In patients treated with CT/RT for locally advanced cervical cancer, despite limited performances to predict cervical residual disease, posttreatment FEDG-PET is predictive of patients' prognosis and long-term outcome.
Published: 2020

12. Comparison of survival outcomes between laparoscopic and abdominal radical hysterectomy for early-stage cervical cancer: A French multicentric study

Author: Olivier Graesslin, Amélie Benbara, Vincent Lavoué, Emilie Raimond, Xavier Carcopino, François Zaccarini, Sofiane Bendifallah, Lobna Ouldamer, Cyrille Huchon, Pierre-Adrien Bolze, Emile Daraï, Cyril Touboul, Geoffroy Canlorbe, Anna Santy, Pierre Collinet, Yohann Dabi, François Golfier, CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), CHI Créteil, CHU Pontchaillou [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES), Assistance Publique - Hôpitaux de Marseille (APHM), Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Pitié-Salpêtrière [AP-HP], Centre Hospitalier Universitaire de Reims (CHU Reims), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHI Poissy-Saint-Germain, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Université de Rennes (UR)
Subjects: medicine.medical_specialty, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Matched-Pair Analysis, Uterine Cervical Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Open surgery, Hysterectomy, Disease-Free Survival, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Laparotomy, medicine, Radical hysterectomy, Humans, Survival outcomes, Stage (cooking), Radical Hysterectomy, Laparoscopy, Retrospective Studies, Cervical cancer, 030219 obstetrics & reproductive medicine, medicine.diagnostic_test, business.industry, Obstetrics and Gynecology, Postoperative complication, Length of Stay, Middle Aged, medicine.disease, Survival Analysis, 3. Good health, Surgery, Reproductive Medicine, 030220 oncology & carcinogenesis, Propensity score matching, Female, France, business
Abstract: International audience; OBJECTIVES: A recent randomized controlled trial has reconsidered the use of laparoscopy for treating patients with early-stage cervical cancer with radical hysterectomy (RH). We aimed to evaluate if surgical approach had an impact on surgical and oncological outcomes in these patients in a French setting. METHODS: Data of 1706 patients with cervical cancer treated between 1996 and 2017 were extracted from maintained databases of 9 French University hospitals. Patients, with FIGO stage IA2 to IIB tumors, treated by radical hysterectomy were selected for further analysis. A propensity score matching was used with a ratio of 2:1 in favor of laparoscopic approach was used. The Kaplan Meier method was used to estimate the survival distribution. RESULTS: 34 patients treated with laparotomy were matched with 61 patients treated by minimally invasive surgery (MIS). There was no difference regarding overall survival (91 % vs 81 %, p > 0.05) or disease-free survival (82 % vs 78 %, p > 0.05). There was no difference regarding surgical outcomes with no excess of postoperative complication in patients with MIS. Hospital stay was significantly longer in patients operated on laparotomy. CONCLUSION: In our study, there was no evidence of a difference in survival between minimally invasive surgery and laparotomy in patients treated with radical hysterectomy for early-stage cervical cancer.
Published: 2020

13. Risk factors for recurrence of borderline ovarian tumors in France: A multicenter retrospective study by the FRANCOGYN group

Author: Cyrille Huchon, Sofiane Bendifallah, P. Collinet, Olivier Graesslin, Lobna Ouldamer, E. Sangnier, Camille Mimoun, Alexandre Bricou, Lise Lecointre, Emilie Raimond, Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Université de Paris (UP)
Subjects: Adult, medicine.medical_specialty, Multivariate analysis, Time Factors, Adolescent, [SDV]Life Sciences [q-bio], Conservative Treatment, 03 medical and health sciences, Ovarian tumor, Young Adult, 0302 clinical medicine, Surgical oncology, Risk Factors, Internal medicine, medicine, Humans, Stage (cooking), Survival rate, ComputingMilieux_MISCELLANEOUS, Aged, Neoplasm Staging, Retrospective Studies, Aged, 80 and over, Ovarian Neoplasms, Univariate analysis, Analysis of Variance, 030219 obstetrics & reproductive medicine, business.industry, Incidence (epidemiology), Age Factors, Obstetrics and Gynecology, Retrospective cohort study, Middle Aged, 3. Good health, Survival Rate, Reproductive Medicine, 030220 oncology & carcinogenesis, Female, France, Neoplasm Recurrence, Local, business, Follow-Up Studies
Abstract: Introduction Borderline ovarian tumors (BOTs) although rare, have shown an increase in the incidence worldwide. Although the survival rate is high, the recurrence rate is estimated to be between 5% and 34%. The objective of this study was to identify risk factors for recurrence of BOTs. Methods This retrospective multicenter study included 493 patients treated surgically for BOT between January 2001 and December 2018. Results Thirty-seven patients showed recurrence (group R, 7.5%), while 456 did not (group NR, 92.5%). With an average follow-up of 30.5 months (1-276), the overall recurrence rate was 7.5%. Recurrence rates for the BOT and invasive types were 5.7% (n = 28) and 1.4% (n = 7), respectively. The mean time to recurrence was 44.1 (3-251) months. Univariate analysis showed that age at diagnosis, type of surgical procedure, histological type, and FIGO stage were factors influencing recurrence. Multivariate analysis showed that the risk factors for recurrence of BOT were conservative treatment (OR = 7 [95% CI 3.01-16.23]; p Discussion To the best of our knowledge, this multicenter study was one of the largest studies on the risk factors for BOT recurrence. Conservative treatment and advanced FIGO stage were identified as risk factors for BOT recurrence. These results reinforce the need for restaging of patients who did not have an optimal initial surgical staging so as not to avoid missing a tumor in the advanced stage. Referral to a surgical oncology center is suggested to optimize overall patient management.
Published: 2020

14. Magnetic resonance imaging evaluation of cervical length by the women's age: a retrospective cohort study

Author: David Charlotte, René Gabriel, S. Bonneau, Mathilde Dumange, Christine Hoeffel, Stéphane Sanchez, Emilie Raimond, Jan Chrusciel, Olivier Graesslin, and Manel Djelouah
Subjects: Male, medicine.medical_specialty, Cervix Uteri, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, medicine, Humans, 030212 general & internal medicine, Child, Cervical length, Preterm delivery, Retrospective Studies, 030219 obstetrics & reproductive medicine, medicine.diagnostic_test, business.industry, Infant, Newborn, Obstetrics and Gynecology, Retrospective cohort study, Magnetic resonance imaging, Anthropometry, medicine.disease, Magnetic Resonance Imaging, Sagittal plane, Cervical Length Measurement, medicine.anatomical_structure, Reproductive Medicine, Premature Birth, Female, Radiology, business
Abstract: The anthropometric characteristics of the uterus evolve with pubertal development in girls. It is therefore permissible to ask until these anthropometric characteristics change, in order to know if the cervical length criterion defined for preterm delivery threats is applicable to all ages. The main objective of our study was to analyze the evolution of cervical length with the women's age outside pregnancy to overcome factors related to pregnancy that can affect cervical length.This retrospective descriptive study over a period of 1 year from March 2017 to March 2018. The cervical length measurements were performed by Magnetic Resonnance Imaging. The cervical length was defined by sagittal T2-weighted magnetic resonance imaging (MRI) as the distance on a straight line between the external cervical os (at the point of divergence of the anterior and posterior lips) and the internal cervical os identified by an intersection between the line of the hypersignal of the glandular epithelium and a line passing through the isthmus.A total of 209 patients were included. The cervical length ranged from 25.2 mm on average in children under 16 years (23.6-27.1 mm) to 39.7 mm between 36 and 40 years (27.9 -58.9 mm). There was a linear association between age and cervical length, irrespective of maternal anthropometric data (Pearson's coefficient ρ = 0.43, 95% CI 0.32-0.54 (p0.01). In multivariate analysis, the only factors associated with cervical length were women's age (p0.01) and the prior delivery (p0.01).The cervical length is correlated with women age and the prior delivery.
Published: 2020

15. Ovarian Cancer in the Elderly Time to Move towards a More Logical Approach to Improve Prognosis-A Study from the FRANCOGYN Group

Author: Xavier Carcopino, Henri Azaïs, Cyril Touboul, Cherif Akladios, Geoffroy Canlorbe, Martin Koskas, Nicolas Bourdel, Pauline Chauvet, Mathieu Mezzadri, Tristan Gauthier, Hélène Costaz, Cyrille Huchon, Pierre Collinet, Frederik Kridelka, Yohann Dabi, Camille Mimoun, Lobna Ouldamer, Alexandre Bricou, Lise Lecointre, Sofiane Bendifallah, Krystel Nyangoh Timoh, Ludivine Dion, Pierre-Adrien Bolze, Olivier Graesslin, Vincent Lavoué, Emilie Raimond, Marcos Ballester, Jean Levêque, CHU Pontchaillou [Rennes], Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 ), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Pitié-Salpêtrière [AP-HP], Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA), Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], 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 Gynécologie-Obstétrique, Maternité, Chirurgie Gynécologique [CHU Pitié-Salpêtrière], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: medicine.medical_specialty, endocrine system diseases, health care facilities, manpower, and services, medicine.medical_treatment, [SDV]Life Sciences [q-bio], lcsh:Medicine, frailty, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, chemotherapy, elderly, Article, surgery, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, In patient, Survival rate, Chemotherapy, 030219 obstetrics & reproductive medicine, Surgical approach, business.industry, lcsh:R, Logical approach, social sciences, General Medicine, University hospital, medicine.disease, humanities, 3. Good health, ovarian cancer, Multicenter study, 030220 oncology & carcinogenesis, business, Ovarian cancer
Abstract: Background and objective: Elderly and/or frail women with ovarian cancer are often undertreated. The aim of the study is to compare the effects of age and frailty on surgical approaches, postoperative complications, and prognosis in elderly women with ovarian cancer. Methods: A retrospective multicenter study of women &ge, 70 years were treated for ovarian cancer at seven French university hospitals between 2007 and 2015. Results: Of the 1119 women treated for ovarian cancer during the study period, 147 were &ge, 70 years and had complete data. Of these women, 65 were aged 70&ndash, 74 years, and 82 were aged &ge, 75 years. Overall, 77% of the younger women (49/65) received optimal treatment compared with 51% (40/82) of the older women (p = 0.018). Women &ge, 75 years underwent fewer bowel resections (32% vs. 67%, p &lt, 0.001) and experienced fewer postoperative complications (22.6% vs. 38.9%, p &lt, 0.001), 53.2% of the women in this age group were treated by primary surgery or surgery only. These women also received more chemotherapy with platinum only (15% [9/56] vs. 2% [1/57], p = 0.007) and less bevacizumab (9% [5/56] vs. 32% [18/57], p = 0.003). Patients with greater frailty (a modified Charlson Comorbidity Index [mCCI] score &gt, 3) had a five-year survival rate of 30% versus 62% for those with a score &le, 3 (p &lt, 0.001). Conclusions: Surgeons modify their approach to treating ovarian cancer in women &ge, 75 years probably to reduce immediate postoperative complications. The prognosis is significantly worse in patients with greater frailty. Improvements to the sequence of treatments administered, with priority given to neoadjuvant chemotherapy in patients with greater frailty, could help increase the number of women who receive optimal treatment and improve their prognosis.
Published: 2020

16. Management and Survival of Elderly and Very Elderly Patients with Ovarian Cancer: An Age-Stratified Study of 1123 Women from the FRANCOGYN Group

Author: Geoffroy Canlorbe, Hélène Costaz, Pierre-Adrien Bolze, Sofiane Bendifallah, Olivier Graesslin, Cyrille Huchon, Pierre Collinet, Marcos Ballester, Alexandre Bricou, Lise Lecointre, Yolaine Joueidi, Cherif Akladios, Emilie Raimond, Jean Levêque, Krystel Nyangoh Timoh, Nicolas Bourdel, Xavier Carcopino, Cyril Touboul, Frédéric Kridelka, Yohann Dabi, Camille Mimoun, Lobna Ouldamer, Henri Azaïs, Pauline Chauvet, Martin Koskas, Tristan Gauthier, Mathieu Mezzadri, Ludivine Dion, Vincent Lavoué, CHU Pontchaillou [Rennes], Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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 ), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, and Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-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: Oncology, medicine.medical_specialty, health care facilities, manpower, and services, medicine.medical_treatment, [SDV]Life Sciences [q-bio], lcsh:Medicine, frailty, chemotherapy, elderly, Article, surgery, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Overall survival, 030212 general & internal medicine, Chemotherapy, business.industry, Endometrial cancer, lcsh:R, social sciences, General Medicine, medicine.disease, humanities, 3. Good health, ovarian cancer, 030220 oncology & carcinogenesis, Cohort, Ovarian cancer, business
Abstract: Elderly women with ovarian cancer are often undertreated due to a perception of frailty. We aimed to evaluate the management of young, elderly and very elderly patients and its impact on survival in a retrospective multicenter study of women with ovarian cancer between 2007 to 2015. We included 979 women: 615 women (62.8%) &lt, 65 years, 225 (22.6%) 65&ndash, 74 years, and 139 (14.2%) &ge, 75 years. Women in the 65&ndash, 74 years age group were more likely to have serous ovarian cancer (p = 0.048). Patients &gt, 65 years had more &gt, IIa FIGO stage: 76% for &lt, 65 years, 84% for 65&ndash, 74 years and 80% for &ge, 75 years (p = 0.033). Women &ge, 75 years had less standard procedures (40% (34/84) vs. 59% (104/177) for 65&ndash, 74 years and 72% (384/530) for &lt, 65 years (p &lt, 0.001). Only 9% (13/139) of women &ge, 75 years had an Aletti score &gt, 8 compared with 16% and 22% for the other groups (p &lt, 0.001). More residual disease was found in the two older groups (30%, respectively) than the younger group (20%) (p &lt, 0.05). Women &ge, 75 years had fewer neoadjuvant/adjuvant cycles than the young and elderly women: 23% &ge, 75 years received &lt, 6 cycles vs. 10% (p = 0.003). Univariate analysis for 3-year Overall Survival showed that age &gt, 65 years, FIGO III (HR = 3.702, 95%CI: 2.30&ndash, 5.95) and IV (HR = 6.318, 95%CI: 3.70&ndash, 10.77) (p &lt, 0.001), residual disease (HR = 3.226, 95%CI: 2.51&ndash, 4.15, p &lt, 0.001) and lymph node metastasis (HR = 2.81, 95%CI: 1.91&ndash, 4.12, 0.001) were associated with lower OS. Women &gt, 65 years are more likely to have incomplete surgery and more residual disease despite more advanced ovarian cancer. These elements are prognostic factors for women&rsquo, s survival regardless of age. Specific trials in the elderly would produce evidence-based medicine and guidelines for ovarian cancer management in this population.
Published: 2020

17. Single port laparoscopy (SPL): Retrospective study evaluating postoperative pain in comparison with conventional laparoscopy (CL)

Author: Mayi Gnofam, Eva Sangnier, Perrine Moussy-Berteaux, Laurence Bednarczyk, Olivier Graesslin, Emile Mereb, and Marine Lallemant
Subjects: Adult, medicine.medical_specialty, Postoperative pain, medicine.medical_treatment, Salpingo-oophorectomy, Conventional laparoscopy, Single-port laparoscopy, 03 medical and health sciences, 0302 clinical medicine, Outcome Assessment, Health Care, Operating time, Humans, Medicine, Aged, Retrospective Studies, Pain, Postoperative, 030219 obstetrics & reproductive medicine, Adnexal surgery, business.industry, Significant difference, Outcome measures, Obstetrics and Gynecology, Retrospective cohort study, Middle Aged, Surgery, Reproductive Medicine, Adnexal Diseases, 030220 oncology & carcinogenesis, Female, Laparoscopy, business
Abstract: To compare postoperative pain after single port laparoscopy (SPL) approach with conventional laparoscopy (CL) in case of adnexectomy.This is a retrospective monocentric study involving patients who underwent adnexal surgery by SPL or CL for a suspected benign disease or as a preventive measure. The main outcome measure was the level of postoperative pain.A total of 87 patients were enrolled. Within 2h, the numerical scale (NS) was 1.9 in SPL group and 2.0 in the CL group (P=0.85). The next day, the NS was 1.8 in SPL group and 1.5 in CL group (P=0.55). The operating time was significantly shorter in SPL group (33 versus 56min, 95% CI [-31; -15], P0.001) and no rupture of ovarian cysts occurred in this group. There was no significant difference concerning complications, length of hospital stay, general satisfaction and POSAS (Patient and Observer Scar Assessment Scale) score.This study confirms the feasibility of single-port laparoscopic adnexectomy. We have not shown significant difference in postoperative pain but the operating time was significantly reduced under the guise of an experienced surgeon.
Published: 2018

18. Identification of a low risk population for parametrial invasion in patients with early-stage cervical cancer

Author: Cyril Touboul, Marcos Ballester, Cyrille Huchon, Xavier Carcopino, Emilie Raimond, Olivier Graesslin, Vincent Lavoué, Alexandre Bricou, Emile Daraï, Geoffroy Canlorbe, Claire Willecocq, Pierre Collinet, Bassam Haddad, Yohann Dabi, Charles Coutant, Lobna Ouldamer, Sofiane Bendifallah, HAL UVSQ, Équipe, Université Paris-Est Créteil Val-de-Marne - Faculté de médecine (UPEC Médecine), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service de Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], CHU Tenon [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), Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie (UPMC), Université Pierre et Marie Curie - Paris 6 (UPMC), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Service de Gynécologie et Obstétrique [Rennes] = Gynaecology [Rennes], CHU Pontchaillou [Rennes], Département de Néonatologie [CHU de Rennes], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de gynécologie-obstétrique [Hôpital Jean Verdier], Université Paris 13 (UP13)-Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), CHI Créteil, Carcinose Angiogenèse et Recherche Translationnelle, Angiogenese et recherche translationnelle (CART U965), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Gynécologie-Obstétrique [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université, Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Service de Gynécologie et Obstétrique [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes]-hôpital Sud, Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], Sorbonne Université (SU)-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), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris 13 (UP13)
Subjects: medicine.medical_specialty, Multivariate analysis, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Early-stage, Radical surgery, Urology, Uterine Cervical Neoplasms, lcsh:Medicine, Kaplan-Meier Estimate, General Biochemistry, Genetics and Molecular Biology, Low-risk, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Predicting, medicine, Humans, Neoplasm Invasiveness, Stage (cooking), Aged, Neoplasm Staging, Cervical cancer, Univariate analysis, 030219 obstetrics & reproductive medicine, Hysterectomy, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Parametrial, Proportional hazards model, business.industry, Research, Parametrial invasion, lcsh:R, General Medicine, Middle Aged, medicine.disease, 3. Good health, [SDV] Life Sciences [q-bio], 030220 oncology & carcinogenesis, Multivariate Analysis, Female, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: Background Recent studies have challenged radical procedures for less extensive surgery in selected patients with early-stage cervical cancer at low risk of parametrial invasion. Our objective was to identify a subgroup of patients at low risk of parametrial invasion among women having undergone surgical treatment. Methods Data of 1447 patients with cervical cancer treated between 1996 and 2016 were extracted from maintained databases of 10 French University hospitals. Patients with early-stage (IA2–IIA) disease treated by radical surgery including hysterectomy and trachelectomy, were selected for further analysis. The Kaplan–Meier method was used to estimate the survival distribution. A Cox proportional hazards model including all the parameters statistically significant in univariate analysis, was used to account for the influence of multiple variables. Results Out of the 263 patients included for analysis, on final pathology analysis 28 (10.6%) had parametrial invasion and 235 (89.4%) did not. Factors significantly associated with parametrial invasion on multivariate analysis were: age > 65 years, tumor > 30 mm in diameter measured by MRI, lymphovascular space invasion (LVSI) on pathologic analysis. Among the 235 patients with negative pelvic lymph nodes, parametrial disease was seen in only 7.6% compared with 30.8% of those with positive pelvic nodes (p
Published: 2018

19. Définition des centres experts en endométriose

Author: Philippe Descamps, Arnaud Wattiez, Thomas Hebert, Aubert Agostini, C. Mezan de Malartic, François Golfier, P. Rousset, M. Poilblanc, Jean-Luc Brun, Pierre Panel, P. Collinet, I. Chanavaz-Lacheray, Emile Daraï, L. Piechon, Pierre-Adrien Bolze, Olivier Graesslin, H. Dechaud, H. Martigny, and Charles Chapron
Subjects: 03 medical and health sciences, 030219 obstetrics & reproductive medicine, 0302 clinical medicine, Reproductive Medicine, Political science, Obstetrics and Gynecology, 030212 general & internal medicine, Humanities
Abstract: Resume Objectif Le College national des gynecologues obstetriciens francais (CNGOF), en accord avec la Societe de chirurgie gynecologique et pelvienne (SCGP), a constitue en 2017 une commission chargee de definir les centres experts en endometriose, afin d’optimiser la prise en charge des patientes atteintes en France. Methode La commission endometriose comportait des membres issus d’hopitaux universitaires, d’hopitaux generaux et de structures privees, representant a la fois les aspects medicaux, chirurgicaux et radiologiques de l’endometriose. L’avis d’associations des patientes a ete sollicite en prealable a la redaction de ce travail. Le texte final a ete presente et valide a l’unanimite des membres du conseil d’administration du CNGOF dans sa seance du 13 octobre 2017. Resultats A partir de l’etat des lieux de la prise en charge de l’endometriose en France et des opportunites des dix dernieres annees, la commission a pu definir les contours des centres experts en endometriose. Les objectifs, le cahier des charges, le mode de fonctionnement, les missions et les sources de financement de ces centres ont ete decrit. Les missions d’organisation territoriale, de soin global et de recours, de communication et d’enseignement, ainsi que de recherche et d’evaluation ont ete definies. Conclusion Du fait de son impact quotidien et des couts de sante qu’elle induit en France, l’endometriose justifie la creation des centres experts que la labellisation par les autorites de sante permettra d’officialiser, idealement dans le cadre du plan de sante national.
Published: 2018

20. Pulmonary cavitations with increased 18F-FDG uptake revealing a thoracic endometriosis

Author: Anne Durlach, Olivier Graesslin, Gaëtan Deslée, Paul Lalire, Valérian Dormoy, Amaury Jacquet, Sandra Dury, Gonzague Delepine, Dimitri Papathanassiou, Jeanne-Marie Perotin, Pauline Mulette, C. Launois, and François Lebargy
Subjects: Abdominal pain, medicine.medical_specialty, 030219 obstetrics & reproductive medicine, Lung, business.industry, Endometriosis, Standardized uptake value, Pulmonologist, General Medicine, medicine.disease, Ground-glass opacity, 3. Good health, 03 medical and health sciences, Thoracic endometriosis, 0302 clinical medicine, medicine.anatomical_structure, Parenchyma, medicine, 030212 general & internal medicine, Radiology, medicine.symptom, business
Abstract: Rationale Thoracic endometriosis is a rare disorder that can involve airways, pleura and lung parenchyma. It is the most frequent form of extra-abdominopelvic endometriosis. Multiple lung cavitations are a rare feature of thoracic endometriosis. Patient concerns A 46-year-old woman was referred to our hospital after incidental finding of multiple pulmonary cavitations with surrounding areas of ground glass opacity on a thoraco-abdominal computed tomography-scan performed for abdominal pain. Retrospectively, the patient also reported mild hemoptysis occurring 4 months ago. Diagnoses Positron emission tomography-computed tomography scan revealed moderate and homogeneous [18F] fluoro-2-deoxy-D-glucose (18F-FDG) uptake in pulmonary cavitations (maximum standardized uptake value 5.7). The diagnosis of thoracic endometriosis was confirmed by histological examination of surgical resection of a left lower lobe cavitation. Interventions and outcome Gonadotropin-releasing hormone analogues associated with add-back therapy was started. Four months after initiating pharmacological treatment, the chest computed tomography-scan showed a dramatic decrease in lung cavitations size. Lessons Thoracic endometriosis is a rare disorder requiring a multidisciplinary management including gynaecologist, pulmonologist, radiologist, nuclear physician, pathologist and thoracic surgeon for early diagnosis and treatment. Our case report highlights that an increased 18F-FDG uptake can be found in thoracic endometriosis syndrome presenting as multiple lung cavitations.
Published: 2021

21. DEPIST 21: Information and knowledge of pregnant women about screening strategies including non-invasive prenatal testing for Down syndrome

Author: Coralie Barbe, Marion Gornet, L. Duminil, Jean-Paul Bory, Emilie Raimond, Pauline Brun, Olivier Graesslin, and Karl Wehbe
Subjects: Adult, Health Knowledge, Attitudes, Practice, medicine.medical_specialty, Down syndrome, Noninvasive Prenatal Testing, 03 medical and health sciences, 0302 clinical medicine, Patient satisfaction, Blood serum, Pregnancy, Risk Factors, Surveys and Questionnaires, Humans, Medicine, Sampling (medicine), Prospective Studies, Advanced maternal age, Reimbursement, 030219 obstetrics & reproductive medicine, business.industry, Obstetrics, Non invasive, Obstetrics and Gynecology, medicine.disease, Reproductive Medicine, Cell-free fetal DNA, 030220 oncology & carcinogenesis, Female, Pregnant Women, Down Syndrome, business
Abstract: Objective To evaluate the knowledge of pregnant women and provide information about Down syndrome (DS) screening, including non-invasive prenatal testing (NIPT). Materials and methods A prospective unicenter study of pregnant women recruited during their first trimester foetal ultrasound was carried out. Single pregnancies from 11 to 17 + 6 weeks of amenorrhoea (SA) without a history of DS were included. “Pre” and “post” questionnaire were fulfilled before and after the consultation. Patient characteristics, prior information, information provided during the consultation, and patient satisfaction were also analysed. Results A total of 273 were included in the study, and 147 completed surveys (pre and post) were examined. In pre-consultation, 82 % of women know that integrated screening includes maternal serum markers and nuchal translucency (n = 103). Concerning NIPT for DS, 8% (n = 11) of women declare having been informed before the ultrasound. A minority of patients know modalities of reimbursement (n = 33, 26 %) and invasive sampling is mandatory for diagnosis when NIPT is positive (n = 37, 28 %). Significant improvement in right answers was obtained for three questions: “nuchal translucency is included in the combined screening test for DS” (p = 0,007); “blood serum markers is included in the combined screening for DS” (p = 0,009) and advanced maternal age increases risk for DS” (p = 0,004). Total score in the post questionnaire was significantly higher than the “pre” consultation questionnaire (14,7 ± 2.8 versus 14,1 ± 2.9; p = 0.01). Conclusion Patients show a high level of knowledge on screening strategies for DS in pre-consultation. They benefit from the consultation on global knowledge, NIPT, and ultrasound notions.
Published: 2021

22. Pelvic inflammatory diseases: Updated French guidelines

Author: Bernard Castan, Cngof, Stéphanie Mignot, Amélie Charvériat, Karine Faure, Renaud Verdon, Jean-Luc Brun, Spilf, Charles Cazanave, Bertille de Barbeyrac, Xavier Fritel, Olivier Graesslin, Centre National de Référence des Méningocoques et Haemophilus influenzae - National Reference Center Meningococci and Haemophilus influenzae (CNR), Institut Pasteur [Paris], Centre hospitalier universitaire de Poitiers (CHU Poitiers), Service des maladies infectieuses, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Unité de Maladies Infectieuses et Tropicales [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 de Gynécologie [CHU Clermont-Ferrand], CHU Estaing [Clermont-Ferrand], and CHU Clermont-Ferrand-CHU Clermont-Ferrand
Subjects: medicine.medical_specialty, [SDV]Life Sciences [q-bio], Sexually Transmitted Diseases, Intrauterine device, Pelvic Pain, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Metronidazole, Pelvic inflammatory disease, medicine, Humans, Hysterosalpingography, Antibiotic prophylaxis, Ultrasonography, 030219 obstetrics & reproductive medicine, medicine.diagnostic_test, Bacteria, business.industry, Pelvic pain, Ceftriaxone, Obstetrics and Gynecology, Bacterial Infections, Genitalia, Female, medicine.disease, tubo-ovarian abscess, 3. Good health, Anti-Bacterial Agents, Reproductive Medicine, 030220 oncology & carcinogenesis, Doxycycline, Practice Guidelines as Topic, Female, France, medicine.symptom, business, medicine.drug, Pelvic Inflammatory Disease
Abstract: Pelvic inflammatory diseases (PID) must be suspected when spontaneous pelvic pain is associated with induced adnexal or uterine pain (grade B). Pelvic ultrasonography is necessary to rule out tubo-ovarian abscess (TOA) (grade C). Microbiological diagnosis requires endocervical and TOA sampling for molecular and bacteriological analysis (grade B). First-line treatment for uncomplicated PID combines ceftriaxone 1 g, once, IM or IV, doxycycline 100 mg ×2/day, and metronidazole 500 mg ×2/day PO for 10 days (grade A). First-line treatment for complicated PID combines IV ceftriaxone 1-2 g/day until clinical improvement, doxycycline 100 mg ×2/day, IV or PO, and metronidazole 500 mg ×3/day, IV or PO for 14 days (grade B). Drainage of TOA is indicated if the pelvic fluid collection measures more than 3 cm (grade B). Follow-up is required in women with sexually transmitted infections (STIs) (grade C). The use of condoms is recommended (grade B). Vaginal sampling for microbiological diagnosis is recommended 3-6 months after PID (grade C), before the insertion of an intrauterine device (grade B), and before elective termination of pregnancy or hysterosalpingography. When specific bacteria are identified, antibiotics targeted at them are preferable to systematic antibiotic prophylaxis.
Published: 2019

23. Impact of vaginal brachytherapy in intermediate and high-intermediate risk endometrial cancer: a multicenter study from the FRANCOGYN group

Author: Geoffroy Canlorbe, Emile Daraï, Charles Coutant, Pierre Alain Reboux, Marcos Ballester, Charles Henry Canova, Henri Azaïs, Olivier Graesslin, Pierre Collinet, Jean Levêque, Cyril Touboul, Sofiane Bendifallah, Alexandre Bricou, Lobna Ouldamer, Delphine Hudry, Cyrille Huchon, Martin Koskas, Vincent Lavoué, Catherine Uzan, Emilie Raimond, CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], CHU Tenon [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 de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-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)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Nutrition, croissance et cancer (U 1069) (N2C), Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Reims (CHU Reims), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, Service de gynécologie et obstétrique [Créteil], CHI Créteil, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de gynécologie-obstétrique [Hôpital Jean Verdier], Université Paris 13 (UP13)-Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Gynécologie et Obstétrique [Rennes] = Gynaecology [Rennes], CHU Pontchaillou [Rennes], Chemistry, Oncogenesis, Stress and Signaling (COSS), Institut National de la Santé et de la Recherche Médicale (INSERM)-CRLCC Eugène Marquis (CRLCC)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Jonchère, Laurent, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UR)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris 13 (UP13), Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: medicine.medical_specialty, medicine.medical_treatment, Brachytherapy, Urology, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Endometrial Cancer, 03 medical and health sciences, 0302 clinical medicine, Uterine Corpus, [SDV.CAN] Life Sciences [q-bio]/Cancer, Risk Factors, Adjuvant therapy, Humans, Medicine, Aged, Neoplasm Staging, Retrospective Studies, Local Neoplasm Recurrence, Aged, 80 and over, 030219 obstetrics & reproductive medicine, business.industry, Endometrial cancer, High intermediate risk, Obstetrics and Gynecology, General Medicine, Middle Aged, medicine.disease, Endometrial Neoplasms, 3. Good health, Radiation therapy, [SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Oncology, Multicenter study, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Case-Control Studies, 030220 oncology & carcinogenesis, Practice Guidelines as Topic, Vaginal brachytherapy, Female, Radiotherapy, Adjuvant, Original Article, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, Neoplasm Recurrence, Local, business, Adjuvant
Abstract: International audience; Objective - According to recent European Society of Medical Oncology, European Society of Gynaecological Oncology and European Society of Radiotherapy and Oncology guidelines, adjuvant vaginal brachytherapy (VB) is optional in patients with intermediate risk (IR) and high-intermediate risk (HIR) endometrial cancer (EC). The aim of this French retrospective, multicenter study was to assess the impact of VB in these groups on local recurrence rate, local recurrence-free survival (RFS) and overall survival (OS).Methods - Data of 191 patients with IR and HIR EC who underwent primary surgery with or without VB and no other adjuvant treatment between 2000 and 2016 were extracted from the FRANCOGYN database. Rate of local recurrence, OS and local RFS in these two groups were compared using the Kaplan-Meier method. Results - The number of patients with IR and HIR EC were 118 and 73 respectively. VB was used in 92 patients in IR group and 43 in HIR group. Median follow-up was 22 months. In the HIR group, the local recurrence rate was significantly higher in the no adjuvant therapy group in comparison with the VB group (16.7% and 0% respectively, p=0.02). There was also a significant improvement in local RFS (p=0.01) in VB group. In IR EC, there is no significant difference on local recurrence rate (4.2% and 3.2%, respectively, p=1.00) or local RFS (p=0.54) between the two groups.Conclusions - VB is an efficient adjuvant treatment for patients with HIR EC. VB is not associated with an improvement of RFS or OS in IR EC patient.
Published: 2019

24. Hemorrhagic pancreatic cyst during third trimester of pregnancy: A case-report

Author: P. Amaro, L. Duminil, T. Piardi, René Gabriel, S. Bonneau, Olivier Graesslin, J. Cousson, Emilie Raimond, Departamento de Fìsica [Lisboa] (DF), Faculdade de Ciências e Tecnologia = School of Science & Technology (FCT NOVA), Universidade Nova de Lisboa = NOVA University Lisbon (NOVA)-Universidade Nova de Lisboa = NOVA University Lisbon (NOVA), Laboratoire Kastler Brossel (LKB (Lhomond)), Université Pierre et Marie Curie - Paris 6 (UPMC)-Fédération de recherche du Département de physique de l'Ecole Normale Supérieure - ENS Paris (FRDPENS), École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Reims (CHU Reims), and Institut Mère Enfant Alix de Champagne
Subjects: medicine.medical_specialty, Pregnancy, 030219 obstetrics & reproductive medicine, Obstetrics, business.industry, [SDV]Life Sciences [q-bio], Obstetrics and Gynecology, Third trimester, medicine.disease, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Reproductive Medicine, Pancreatic cyst, medicine, 030211 gastroenterology & hepatology, business, ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2019

25. Incidence, patterns and prognosis of first distant recurrence after surgically treated early stage endometrial cancer: Results from the multicentre FRANCOGYN study group

Author: Jean Lévêque, Charles Coutant, Emile Daraï, Lobna Ouldamer, Vincent Lavoué, Sofiane Bendifallah, Gilles Body, Marcos Ballester, Pierre Collinet, Alexandre Bricou, Cyril Touboul, Olivier Graesslin, Groupe de Recherche Francogyn, Emilie Raimond, Nutrition, croissance et cancer (U 1069) (N2C), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], CHU Tenon [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 de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-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)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, Service de Gynécologie et Obstétrique [Rennes] = Gynaecology [Rennes], CHU Pontchaillou [Rennes], and Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Oncology, medicine.medical_specialty, Lung Neoplasms, [SDV]Life Sciences [q-bio], Diaphragm, Bone Neoplasms, Disease, 030204 cardiovascular system & hematology, Malignancy, Disease-Free Survival, Metastasis, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Medicine, Humans, Stage (cooking), Aged, Neoplasm Staging, Aged, 80 and over, Lung, business.industry, Brain Neoplasms, Incidence (epidemiology), Endometrial cancer, Liver Neoplasms, Cancer, General Medicine, Middle Aged, medicine.disease, 3. Good health, Endometrial Neoplasms, Survival Rate, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Lymphatic Metastasis, Surgery, Female, France, Lymph Nodes, Neoplasm Recurrence, Local, business
Abstract: Patterns of distant metastatic failure of endometrial cancer (EC) by specific anatomic site are not well described in the literature. In this manuscript, we evaluated the metastatic patterns of EC cancer and analysed the potential distribution of metastatic disease in this malignancy. Methods A total of 1444 women with EC were identified. Of which we extracted women with locoregional and distant recurrence or with distant recurrence alone. Women were scored based on first site of metastasis: multiple versus one site: bone, brain, lung, liver or sus diaphragmatic lymph nodes. Results 110 women developed distant metastatic disease with (n = 37(33.6%)) or without (n = 73(66.4%)) locoregional recurrence, including 39 women with exclusive first site of metastatic disease and 34 women with multiple sites of metastatic disease. When considering all women, the most common exclusive first site of metastasis was lung (42.8%). The median time to develop distant metastases was shorter after the completion of treatment for exclusive brain metastatic disease compared with other sites of metastatic− disease (7 months vs, 9 for lung, 10 for liver, 19 for bone and 27 months for sus-diaphragmatic LN; P = 0.004). The rate of 3-year overall survival was higher in the sus-diaphragmatic LN metastase group (83.3% vs 50.6% for lung, 37.3% for bone, 16.7% for brain and 0% for liver; P = 0.0059). Conclusion The present study has demonstrated the site-specific patterns of metastases. These data support current clinical practice of screening for site-specific metastatic disease after initial treatment of early stage EC based on concerning women-specific signs or symptoms.
Published: 2019

26. Pregancy denial and early infant developpement: a case-control observational prospective study

Author: Valérie Verlomme, Israel Nisand, Laurianne Vulliez, Julien Eutrope, Julie Auer, Didier Riethmuller, Stéphanie Saad-Saint-Gilles, Anne-Laure Sutter, Gisèle Apter, Alexandre Novo, Anne-Catherine Rolland, Agnès Bourgeois-Moine, Coralie Barbe, Julie Le Foll, Joëlle Belaisch-Allart, Marc Dommergues, Sylvie Viaux, Emmanuelle Tessier, Dominique Dallay, Olivier Parant, Violaine Gubler, Olivier Graesslin, Alain Miton, Anne Danion, Institut de recherches interdisciplinaires sur les sciences et la technologie (IRIST), and Université de Strasbourg (UNISTRA)
Subjects: Pediatrics, medicine.medical_specialty, media_common.quotation_subject, lcsh:BF1-990, [SHS.PSY]Humanities and Social Sciences/Psychology, Denial, Psychological, Study Protocol, 03 medical and health sciences, Child Development, 0302 clinical medicine, Denial, Clinical Protocols, Pregnancy, medicine, Humans, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, General Psychology, Retrospective Studies, media_common, Infant, Newborn, Infant, Retrospective cohort study, General Medicine, medicine.disease, Object Attachment, Child development, Mother-Child Relations, 030227 psychiatry, Pregnancy Complications, Clinical trial, lcsh:Psychology, Case-Control Studies, Gestation, Female, Observational study, France, Psychology, Follow-Up Studies
Abstract: International audience; Background The denial of pregnancy is the non-recognition of the state of the current pregnancy by a pregnant woman. It lasts for a few months or for the whole pregnancy, with generally few physical transformations. In this study, we will consider the denial of pregnancy as a late declaration of pregnancy (beyond 20 weeks of gestation) as well as a lack of objective perceptions of this pregnancy. The main objective of this study is to explore the relationship between pregnancy denial and the development of the infant (attachment pattern of the infant, early interactions of mother-infant dyads, and early development of the infant). Methods The design is a case-control prospective study, which will compare two groups of mother-infant dyads: a “case” group with maternal denials of pregnancy and a “control” group without denials of pregnancy. A total of 140 dyads (mother + infant) will be included in this study (70 cases and 70 controls) and followed for 18 months. The setting is a national recruitment setting with 10 centers distributed all over France. The follow-up of the “cases” and the “controls” will be identical and will occur over 5 visits. It will include measures of the infant attachment pattern, the quality of early mother-infant interaction and infant development. Discussion This study aims to examine the pathogenesis of pregnancy denial as well as its consequences on early infant development and early mother-infant interaction. Trial registration Clinical Trial Number: NCT02867579 on the date of 16 August 2016 (retrospectively registered).
Published: 2019

27. Patterns of recurrence and prognosis in locally advanced FIGO stage IB2 to IIB cervical cancer: Retrospective multicentre study from the FRANCOGYN group

Author: Xavier Carcopino, Cyril Touboul, Marcos Ballester, Emilie Raimond, Pierre Collinet, Vincent Lavoué, Olivier Graesslin, Cyrille Huchon, Alexandre Bricou, Geoffroy Canlorbe, Emile Daraï, J. Varinot, Marie-Emmanuelle Neveu, Tiphaine de Foucher, L. Monnier, Lobna Ouldamer, Sofiane Bendifallah, Service de Gynécologie-Obstétrique [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Sorbonne Université, Centre de Recherche Saint-Antoine (CR Saint-Antoine), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Nutrition, croissance et cancer (U 1069) (N2C), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Tours, Service de gynécologie-obstétrique [Hôpital Jean Verdier], Université Paris 13 (UP13)-Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Gynécologie et Obstétrique [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes]-hôpital Sud, Service de Pathologie [CHU Tenon], Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), Service de gynécologie-obstétrique [Hôpital Nord - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], Institut méditerranéen de biodiversité et d'écologie marine et continentale (IMBE), Avignon Université (AU)-Aix Marseille Université (AMU)-Institut de recherche pour le développement [IRD] : UMR237-Centre National de la Recherche Scientifique (CNRS), Service de Gynécologie-Obstétrique, Centre Hospitalier Universitaire de Reims (CHU Reims)-Hôpital Maison Blanche-Institut Mère Enfant, Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie (UPMC), Université Pierre et Marie Curie - Paris 6 (UPMC), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Carcinose Angiogenèse et Recherche Translationnelle, Angiogenese et recherche translationnelle (CART U965), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Thérapies Laser Assistées par l'Image pour l'Oncologie - U 1189 (ONCO-THAI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Universitaire de Cancérologie [Sorbonne Université] (IUC), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), ESIM - Déterminants Sociaux de la Santé et du Recours aux Soins (DS3), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Hôpital Bretonneau, Hôpitaux Universitaires de Paris Seine-Saint-Denis, Service de Gynécologie et Obstétrique [Rennes] = Gynaecology [Rennes], CHU Pontchaillou [Rennes], CRLCC Eugène Marquis (CRLCC), Institut de Recherche pour le Développement (IRD) Marseille (IRD Marseille), Centre Hospitalier Universitaire de Reims (CHU Reims), Centre Hospitalier Intercommunal de Créteil (CHIC), Hôpital Jeanne de Flandre [Lille], AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Universitaire de Cancérologie [Paris] (IUC), 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), Sorbonne Université (SU)-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)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université, Hôpital Nord [CHU - APHM]-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Tenon [APHP], Université Paris 13 (UP13)-Hôpital Jean Verdier [Bondy], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes]-Hôpital Sud, Centre National de la Recherche Scientifique (CNRS)-Institut de recherche pour le développement [IRD] : UMR237-Aix Marseille Université (AMU)-Avignon Université (AU), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), Thérapies Laser Assistées par l'Image pour l'Oncologie (ONCO-THAI), and Service de gynécologie et obstétrique [Poissy - Saint-Germain-en-Laye]]
Subjects: Oncology, Survival, medicine.medical_treatment, Brachytherapy, Uterine Cervical Neoplasms, 0302 clinical medicine, Recurrence, Cumulative incidence, Stage (cooking), Lymph node, Peritoneal Neoplasms, Cervical cancer, Aged, 80 and over, 030219 obstetrics & reproductive medicine, General Medicine, Chemoradiotherapy, Middle Aged, 3. Good health, Survival Rate, medicine.anatomical_structure, Time to recurrence, 030220 oncology & carcinogenesis, Lymphatic Metastasis, Vagina, Female, Adult, medicine.medical_specialty, Locally advanced, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Hysterectomy, Disease-Free Survival, 03 medical and health sciences, Young Adult, Internal medicine, medicine, Humans, Aged, Neoplasm Staging, Retrospective Studies, Locally advanced cervical cancer, [SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health, business.industry, Pattern, medicine.disease, Concomitant, Surgery, Neoplasm Recurrence, Local, business, Follow-Up Studies
Abstract: Introduction Evidence-based data describing patterns of recurrence and prognosis in women with FIGO stage IB2 to IIB locally advanced cervical cancer (LACC) are scarce. The purpose of this study was to analyse patterns of recurrence in LACC and their correlation with prognosis, depending on FIGO stage, lymph node (LN) status and treatment modalities. The endpoints of this study were the type of recurrence (locoregional or distant, and time to recurrence), the recurrence free survival, the overall survival and the cumulative incidence for both locoregional and distant recurrence. Materials and methods Data of women with FIGO stage IB2 to IIB CC treated between April 1996 and May 2016 were retrospectively abstracted from nine French institutions. Results The median follow-up for the 501 women included was 35.6 months. Recurrences were observed in 158 (31.5%), with a mean time to recurrence of 20.7 months. Women with IIB CC had poorer prognosis, lower 3-year RFS and higher 3-year cumulative incidence of both locoregional and distant recurrences. Women with positive or unknown LN status had poorer prognosis with higher 3-year cumulative incidence of distant recurrence. Women who underwent concomitant chemo-radiotherapy ± vaginal brachytherapy had poorer prognosis, with lower 3-year RFS and higher 3-year cumulative incidence of distant recurrence. Conclusions Recurrence location and time to recurrence differ widely depending on the FIGO stage, LN status and treatment modalities, with potential impact on follow-up modalities and therapeutic approaches.
Published: 2019

28. Surgical treatment of vulvar cancer: Impact of tumor-free margin distance on recurrence and survival. A multicentre cohort analysis from the francogyn study group

Author: Marcos Ballester, Lobna Ouldamer, C Touboul, Sofiane Bendifallah, Emile Daraï, Xavier Carcopino, C Delorme, Emilie Raimond, and Olivier Graesslin
Subjects: Adult, medicine.medical_specialty, Disease-Free Survival, Vulvar Lichen Sclerosus, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Margin (machine learning), medicine, Humans, Surgical treatment, Aged, Neoplasm Staging, Retrospective Studies, Aged, 80 and over, 030219 obstetrics & reproductive medicine, Squamous cell cancer, Vulvar Neoplasms, business.industry, Sentinel Lymph Node Biopsy, Margins of Excision, General Medicine, Vulvar cancer, Middle Aged, medicine.disease, Prognosis, Surgery, Tumor Burden, Survival Rate, Oncology, Multicenter study, 030220 oncology & carcinogenesis, Carcinoma, Squamous Cell, Lymph Node Excision, Female, France, Neoplasm Recurrence, Local, business, Carcinoma in Situ, Cohort study
Abstract: In vulvar cancer, it is admitted that tumor-free margin distance is one of the most important element for locoregional control. It is currently recommended to surgically remove the tumor with at least an 8 mm tumor-free margin. The aim of this study was to evaluate the impact of tumor-free margin distance on recurrence and survival in vulvar cancer.From 2005 to 2016, 112 patients surgically treated for a vulvar squamous cell cancer were included in a retrospective multicenter study. Overall, disease-free and metastasis-free survivals were analyzed according to tumor-free margin distance.Patients were divided into three groups: group 1 (margin3 mm, n = 47); group 2 (margin ≥3 mm to 8 mm, n = 48) and group 3 (margin ≥8 mm, n = 17). During the study, 26,8% patients developed recurrence (n = 30) after a median of 8 months (1-69). Analysis of 5-year overall survival, as well as disease-free and metastasis-free survivals, did not reveal a difference between groups. We performed a subgroup analysis in patients with a tumor-free margin8 mm (group 1 and 2). It showed that histological lesions observed closest to the edge of the specimen were more often invasive or in situ carcinoma lesions in group 1 than in group 2, in which VIN lesions were mainly observed at this location. After re-excision, no patients in group 1 and 50% (n = 2) patients in group 2 developed recurrence.This study did not reveal a significant impact of tumor-free margin distance on recurrence and survival in vulvar cancer. Moreover, the benefit of re-excision seems stronger when tumor-free margins are positive or very close (3 mm), cases in which invasive or in situ lesions are often present closest to the edge of the specimen.
Published: 2019

29. La chimiothérapie hyperthermique intra-péritonéale (CHIP) sauvée par les preuves : la carcinose ovarienne, cible privilégiée de la CHIP ?

Author: Martin Koskas, Cyrille Huchon, Olivier Graesslin, Pierre Collinet, Geoffroy Canlorbe, Groupe de Recherche Francogyn, Lobna Ouldamer, Xavier Carcopino, Cyril Touboul, Charles Coutant, Cherif Akladios, Alexandre Bricou, Pierre Adrien Bolze, Sofiane Bendifallah, Emile Daraï, Marcos Ballester, Vincent Lavoué, Service de Gynécologie et Obstétrique [Rennes] = Gynaecology [Rennes], CHU Pontchaillou [Rennes], Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Thérapies Laser Assistées par l'Image pour l'Oncologie - U 1189 (ONCO-THAI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre de Recherche Saint-Antoine (UMRS893), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Strasbourg, Service de gynécologie-obstétrique [Hôpital Nord - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], Institut méditerranéen de biodiversité et d'écologie marine et continentale (IMBE), Avignon Université (AU)-Aix Marseille Université (AMU)-Institut de recherche pour le développement [IRD] : UMR237-Centre National de la Recherche Scientifique (CNRS), Service de gynécologie-obstétrique [Hôpital Jean Verdier], Université Paris 13 (UP13)-Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CIC - CHU Bichat, Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, Service de Chirurgie Gynécologique Oncologique et Obstétrique [CHU Lyon Sud], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Nutrition, croissance et cancer (U 1069) (N2C), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Carcinose Angiogenèse et Recherche Translationnelle, Angiogenese et recherche translationnelle (CART U965), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, Centre de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-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)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Nord [CHU - APHM]-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), Centre National de la Recherche Scientifique (CNRS)-Institut de recherche pour le développement [IRD] : UMR237-Aix Marseille Université (AMU)-Avignon Université (AU), Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris 13 (UP13), Service de Gynécologie et Obstétrique [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes]-hôpital Sud, CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Service de Gynécologie-Obstétrique [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université, Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes]-Hôpital Sud, Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Thérapies Laser Assistées par l'Image pour l'Oncologie (ONCO-THAI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Tenon [APHP], Université Paris 13 (UP13)-Hôpital Jean Verdier [Bondy], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc (CRLCC - CGFL), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Tours, and Service de gynécologie et obstétrique [Poissy - Saint-Germain-en-Laye]]
Subjects: Gynecology, [SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health, Cancer Research, medicine.medical_specialty, business.industry, [SDV.CAN]Life Sciences [q-bio]/Cancer, Hematology, General Medicine, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, medicine.disease, 3. Good health, Peritoneal carcinomatosis, 03 medical and health sciences, 0302 clinical medicine, Oncology, 030220 oncology & carcinogenesis, medicine, Carcinoma, Radiology, Nuclear Medicine and imaging, 030212 general & internal medicine, Ovarian cancer, business, ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2019

30. Uterus-like mass: A case report

Author: A. Janvier, P. Birembaut, Olivier Graesslin, L. Duminil, Christine Hoeffel, S. Bonneau, Emilie Raimond, C. David, J Burette, CEA-Direction des Energies (ex-Direction de l'Energie Nucléaire) (CEA-DES (ex-DEN)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Laboratoire Kastler Brossel (LKB (Lhomond)), Université Pierre et Marie Curie - Paris 6 (UPMC)-Fédération de recherche du Département de physique de l'Ecole Normale Supérieure - ENS Paris (FRDPENS), École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Reims (CHU Reims), Dynamique cellulaire et moléculaire de la muqueuse respiratoire, Université de Reims Champagne-Ardenne (URCA)-IFR53-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Reims Champagne-Ardenne (URCA), Institut Mère Enfant Alix de Champagne, Fédération de recherche du Département de physique de l'Ecole Normale Supérieure - ENS Paris (FRDPENS), École normale supérieure - Paris (ENS-PSL), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Paris (ENS-PSL), and Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS)
Subjects: business.industry, [SDV]Life Sciences [q-bio], Obstetrics and Gynecology, Anatomy, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Text mining, Reproductive Medicine, 030220 oncology & carcinogenesis, Medicine, Uterus-like mass, business, ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2019

31. Cervical cancer recurrence: Proposal for a classification based on anatomical dissemination pathways and prognosis

Author: Florence Huguet, Emilie Raimond, Marcos Ballester, Emile Daraï, Pierre Collinet, J. Varinot, Lobna Ouldamer, Geoffroy Canlorbe, Alexandre Bricou, Cyrille Huchon, Sofiane Bendifallah, Vincent Lavoué, Cyril Touboul, Olivier Graesslin, Tiphaine de Foucher, and Xavier Carcopino
Subjects: Adult, medicine.medical_specialty, Uterine Cervical Neoplasms, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Single site, 0502 economics and business, medicine, Humans, Peritoneal Neoplasms, Aged, Pelvic Neoplasms, Retrospective Studies, Cervical cancer, Aged, 80 and over, business.industry, Optimal treatment, 05 social sciences, Middle Aged, medicine.disease, Prognosis, Combined Modality Therapy, Surgery, Survival Rate, Oncology, Median time, 030220 oncology & carcinogenesis, Abdominal Neoplasms, Lymphatic Metastasis, 050211 marketing, Female, Neoplasm Recurrence, Local, business, Follow-Up Studies
Abstract: Introduction Precise definitions of recurrences and optimal treatment strategy are yet to be clearly defined among patients with cervical cancer (CC). The purpose of this study was to develop a reproducible classification of CC recurrence. Materiel and methods Data of women with FIGO stages I-IV CC treated between January 2000 and January 2015 were retrospectively abstracted from nine French institutions. We proposed a rTNM classification for recurrence: locoregional (rT), nodal (rN), or distant organ (rM). According to rTNM prognosis, we then defined a rSTAGE classification (I, II, IIIA, IIIB, IVA, IVB). Results Among the 1028 women treated for FIGO stages I-IV CC during the study period, 216 recurrences were observed (21%). The 3-year survival after recurrence was 38.8%, with a median time to recurrence of 9 months (95% CI, 30.9–48.7). A trend for a lower 3-year survival after recurrence was observed in women with multiple-site vs single-site recurrence (p = 0.1). Among the women in the rT group, a difference in 3-year survival after recurrence was found between rT1 single site, rT2 single site and rT3 single site (p = 0.02). The 3-year survival after recurrence was 69.1%, 49.2%, 37.5%, 34.2%, 23.1% and 24.4% for rStage I, II, IIIA, IIIB, IVA and IVB, respectively (p = 0.007). Conclusion rTNM classifications and rSTAGE are discriminatory and allow all recurrence modalities to be classified.
Published: 2019

32. Melatonin Levels in Preterm and Term Infants and Their Mothers

Author: Valérie Biran, Fabrice Decobert, Jean-François Benoist, J. Schroedt, Thomas Schmitz, Marina Colella, Sophie Guilmin-Crepon, Priscilla Boizeau, Anne-Laure Virlouvet, Nathalie Bednarek, Alice Frérot, Olivier Baud, Pierre Gressens, Jean-Marie Launay, Bruno Claustrat, Adyla Yacoubi, Bassam Haddad, Roselyne Garnotel, Jérome Barre, Corinne Alberti, Evelyne Jacqz-Aigrain, and Olivier Graesslin
Subjects: 0301 basic medicine, Melatonin/analogs & derivatives/blood, Physiology, melatonin, brain development, Urine, lcsh:Chemistry, 0302 clinical medicine, Pregnancy, Gestational Weeks, term infants, Infant, Premature/blood, lcsh:QH301-705.5, Spectroscopy, Melatonin, ddc:618, Gestational age, Brain, Radioimmunoassay, General Medicine, Brain development, Neuroprotection, 3. Good health, Computer Science Applications, neuroprotection, Female, Brain/embryology, medicine.symptom, Prematurity, Infant, Premature, hormones, hormone substitutes, and hormone antagonists, medicine.drug, endocrine system, Term infants, Neurogenesis, Mothers, Brain damage, Catalysis, Article, Inorganic Chemistry, 03 medical and health sciences, medicine, Humans, Physical and Theoretical Chemistry, Melatonin secretion, Molecular Biology, business.industry, Organic Chemistry, prematurity, Infant, Newborn, Infant, 030104 developmental biology, Multicenter study, lcsh:Biology (General), lcsh:QD1-999, business, 030217 neurology & neurosurgery, Biomarkers
Abstract: The prevention of perinatal brain damage following preterm birth remains a public health priority. Melatonin has been shown to be a promising neuroprotectant in neonatal preclinical models of brain damage, but few studies have investigated melatonin secretion in newborns. We hypothesized that melatonin circulating levels would be lower in preterm compared to term infants. We conducted a prospective, longitudinal, multicenter study to assess melatonin, and 6-sulfatoxy-melatonin (aMT6s) concentrations, measured by radioimmunoassay. Among 209 neonates recruited, 110 were born before 34 gestational weeks (GW) and 99 born after 34 GW. Plasma melatonin concentrations, measured at birth and on Day 3 were below detectable levels (&le, 7 pg/mL) in 78% and 81%, respectively, of infants born before 34 GW compared to 57% and 34%, respectively, of infants born after 34 GW. The distribution of plasma melatonin concentrations was found to be correlated with gestational age at both time-points (p &lt, 0.001). Median urine aMT6s concentrations were significantly lower in infants born before 34 GW, both on Day 1 (230 ng/L vs. 533 ng/L, p &lt, 0.0001) and on Day 3 (197 ng/L vs. 359 ng/L, p &lt, 0.0001). In conclusion, melatonin secretion appears very low in preterm infants, providing the rationale for testing supplemental melatonin as a neuroprotectant in clinical trials.
Published: 2019

33. Comparison of pelvic and para-aortic lymphadenectomy versus para-aortic lymphadenectomy alone for locally advanced FIGO stage IB2 to IIB cervical cancer using a propensity score matching analysis: Results from the FRANCOGYN study group

Author: Emile Daraï, Florence Huguet, Marcos Ballester, Pierre Collinet, Vincent Lavoué, Geoffroy Canlorbe, Emilie Raimond, J. Varinot, Xavier Carcopino, Cyrille Huchon, Groupe de Recherche Francogyn, Lobna Ouldamer, Sofiane Bendifallah, Tiphaine de Foucher, Cyril Touboul, Alexandre Bricou, Olivier Graesslin, CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Pierre et Marie Curie - Paris 6 (UPMC), Institut Universitaire de Cancérologie [Sorbonne Université] (IUC), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Department of Obstetrics and Gynaecology, Centre Hospitalier Régional Universitaire de Tours, Hôpital Bretonneau, Tours, France., Department of Obstetrics, Gynecology and Reproductive Medicine, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, France., CRLCC Eugène Marquis (CRLCC), Institut méditerranéen de biodiversité et d'écologie marine et continentale (IMBE), Avignon Université (AU)-Aix Marseille Université (AMU)-Institut de recherche pour le développement [IRD] : UMR237-Centre National de la Recherche Scientifique (CNRS), Service de gynécologie-obstétrique [Hôpital Nord - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], Department of Obstetrics and Gynaecology, Institute Alix de Champagne University Hospital, Reims, France., Department of Obstetrics and Gynecology, Centre Hospitalier Intercommunal, Créteil, France., Department of Gynecologic Surgery, Jeanne de Flandre Hospital, CHU de Lille, Lille, France., Department of Obstetrics and Gynecology, Poissy-St Germain Hospital, Poissy, France., Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Universitaire de Cancérologie [Paris] (IUC), and Department of Obstetrics and Gynaecology, Hôpital Nord, APHM, Aix-Marseille University (AMU), CNRS, IRD, Marseille, France.
Subjects: Adult, medicine.medical_specialty, Survival, medicine.medical_treatment, Locally advanced, Urology, Uterine Cervical Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Pelvis, 03 medical and health sciences, 0302 clinical medicine, Nodal status, medicine, Para aortic lymphadenectomy, Humans, Aorta, Abdominal, Stage (cooking), Propensity Score, Lymph node, Aged, Neoplasm Staging, Cervical cancer, Locally advanced cervical cancer, [SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health, 030219 obstetrics & reproductive medicine, business.industry, Lymphadenectomy, General Medicine, Middle Aged, medicine.disease, Prognosis, humanities, 3. Good health, Survival Rate, MESH: Locally advanced cervical cancer, medicine.anatomical_structure, Oncology, 030220 oncology & carcinogenesis, Lymphatic Metastasis, Propensity score matching, Lymph Node Excision, Surgery, Female, Neoplasm Recurrence, Local, business
Abstract: Introduction Pre-treatment evaluation of nodal status is crucial in women presenting with locally advanced cervical cancer (LACC). However, the prognostic impact of surgical staging remains to be proved, as published results comparing surgical versus radiological staging are contradictory. The aim of this study was to compare the prognosis of women with FIGO stage IB2–IIB CC who underwent surgical nodal staging including either exclusive para-aortic lymphadenectomy (PAL) or comprehensive pelvic + para-aortic lymphadenectomy (P-PAL). Materials and methods Data of 314 women with FIGO stage IB2 to IIB CC treated between January 2000 and January 2015 were retrospectively abstracted from nine French institutions. The prognosis and outcomes were compared by Propensity score (PS) matching (PSM) analysis. Results The median follow-up was 33 months (2–114). When comparing women who underwent PAL vs P-PAL, the recurrence rates were 26% (37/144) and 28% (41/144), respectively (p = 0.595). The respective 3-year recurrence free survival (RFS) for P-PAL and PAL were 72.9% (95% CI, 65.7–81.0) and 70.7% (95% CI, 62.4–80.2), (p = 0.394). The respective 3-year overall survival (OS) rates for P-PAL and PAL were 86.8% (95% CI, 81.1–92.9) and 78.6% (95% CI, 70.4–87.7) (p = 0.592). In the sub-group of women with lymph node metastases, RFS was improved for women who underwent P-PAL compared to those with exclusive PAL (p = 0.027), with no difference in OS (p = 0.187). Conclusions Comprehensive P-PAL does not seem to be of significant therapeutic benefit compared to exclusive PAL.
Published: 2018

34. Urgences gynécologiques : étude prospective sur les motifs de consultation et devenir des patientes

Author: L Duminil, M A Louges, A Lipere, Olivier Graesslin, S Sanchez, and J Calvo
Subjects: Gynecology, 03 medical and health sciences, medicine.medical_specialty, 030219 obstetrics & reproductive medicine, 0302 clinical medicine, Reproductive Medicine, business.industry, Obstetrics and Gynecology, Medicine, 030212 general & internal medicine, General Medicine, business
Abstract: Resume But Etablir le profil, le motif et le devenir des patientes consultant aux urgences gynecologiques afin d’ameliorer la prise en charge et la gestion des reelles urgences. Materiels et methodes Etude epidemiologique descriptive prospective incluant 308 patientes consultant aux urgences gynecologiques entre le 15 mai et le 25 juin 2013 au centre hospitalier universitaire de Reims. Resultats Deux cent cinquante-sept patientes (83,4 %) sont venues sans etre adressees par un autre professionnel de sante. Deux cent trente-huit patientes (77,3 %) avaient deja consulte au moins une fois aux urgences pour un motif gynecologique. Quatre-vingt-dix-neuf patientes (32,1 %) n’avaient pas de suivi gynecologique regulier. Deux cent dix-neuf patientes (71,1 %) ont consulte pour des douleurs abdomino-pelviennes et/ou des metrorragies. L’âge moyen etait de 30 ans (±11). Le temps d’attente moyen etait de 40 minutes. L’examen complementaire le plus prescrit etait l’echographie pelvienne : 255 patientes en ont eu une (82,8 %). Vingt-deux patientes (7,1 %) ont ete hospitalisees : 10 pour des raisons chirurgicales (3,2 %) et 12 pour des raisons medicales (3,9 %). Sur les 51 patientes adressees par un professionnel de sante, 9 ont ete hospitalisees (17,6 %) alors que sur les 257 patientes qui sont venues de leur propre initiative, seules 12 patientes ont ete hospitalisees (4,7 %). Les patientes adressees par un medecin generaliste etaient plus susceptibles d’etre hospitalisees avec un OR = 4,34 (IC a 95 % : 1,51–12,05, p = 0,002). Le principal diagnostic des patientes retournant a domicile etait les grossesses intra-uterines evolutives pour 92 patientes (29,9 %). Conclusion Chez la majorite des patientes consultant aux urgences gynecologiques en milieu hospitalier, on retrouve essentiellement des pathologies relevant plutot de la medecine de ville que du service des urgences.
Published: 2016

35. Predicting poor prognosis recurrence in women with endometrial cancer: a nomogram developed by the FRANCOGYN study group

Author: Emile Daraï, Gilles Body, Vincent Lavoué, Sofiane Bendifallah, Marcos Ballester, Lobna Ouldamer, Pierre Collinet, Emilie Raimond, Jean Lévêque, Charles Coutant, Olivier Graesslin, Cyril Touboul, Nutrition, croissance et cancer (U 1069) (N2C), Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Epidemiologie, Systèmes d'information, Modélisation, Institut National de la Santé et de la Recherche Médicale (INSERM), Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], CHU Tenon [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 Expert en Endométriose [CHU Tenon] (GRC6 C3E), Institut Mère Enfant Alix de Champagne, Hôpital Jeanne de Flandres, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, CHU Pontchaillou [Rennes], Oncogenesis Stress Signaling (OSS), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CRLCC Eugène Marquis (CRLCC), Centre de Recherche Saint-Antoine (UMRS893), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Groupe de recherche clinique Centre Expert en Endométriose (GRC 6 - C3E), Sorbonne Université (SU), and Université de Rennes (UR)-CRLCC Eugène Marquis (CRLCC)
Subjects: 0301 basic medicine, Oncology, Risk, Cancer Research, medicine.medical_specialty, recurrence, medicine.medical_treatment, [SDV.CAN]Life Sciences [q-bio]/Cancer, nomogram, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Internal medicine, medicine, metastasis, Humans, 10. No inequality, Retrospective Studies, Receiver operating characteristic, Proportional hazards model, business.industry, Endometrial cancer, peritoneal carcinomatosis, Retrospective cohort study, Nomogram, medicine.disease, Prognosis, Confidence interval, Endometrial Neoplasms, Nomograms, 030104 developmental biology, 030220 oncology & carcinogenesis, endometrial cancer, Clinical Study, Lymphadenectomy, Female, business
Abstract: International audience; Background - The purpose of this study was to develop a nomogram to predict 'poor prognosis recurrence' (PPR) in women treated for endometrial cancer (EC). Methods - The data of 861 women who received primary surgical treatment between January 2001 and December 2013 were abstracted from a prospective multicenter database. Data were randomly split into two sets: training and validation with a predefined 2/3 ratio. A Cox proportional hazards multivariate model of selected prognostic features was performed in the training cohort (n=574) to develop a nomogram predicting PPRs. The nomogram was validated in the validation cohort of 287 patients. Results - In the training cohort, 82 (14.3%) developed subsequent PPR. Age, histologic type and grade, lymphovascular space invasion status, FIGO stage, and nodal staging (SLN±pelvic and/or para-aortic lymphadenectomy) were independently associated with subsequent PPR. The nomogram showed an area under the receiver operating characteristic curve (AUC) of 0.82 (95% confidence interval (CI), 0.73-0.89) in the training set. The validation set showed a good discrimination with an AUC of 0.75 (95% CI, 0.65-0.83). Conclusions - We have developed a robust tool that is able to predict subsequent PPRs in women with FIGO I-III EC.
Published: 2016

36. Recommendations for the surgical management of gynecological cancers during the COVID-19 pandemic - FRANCOGYN group for the CNGOF

Author: Martin Koskas, Marcos Ballester, Ludivine Dion, Cyril Touboul, Geoffroy Canlorbe, Vincent Lavoué, Yohann Dabi, Tristan Gauthier, Emilie Raimond, Cherif Akladios, Charles Coutant, Xavier Carcopino, Frédéric Kridelka, Matthieu Mezzadri, Pierre-Adrien Bolze, Lobna Ouldamer, Henri Azaïs, Alexandre Bricou, Lise Lecointre, Sofiane Bendifallah, Pierre Collinet, Camille Mimoun, Pauline Chauvet, Nicolas Bourdel, Olivier Graesslin, and Cyrille Huchon
Subjects: Cervical cancer, medicine.medical_specialty, 030219 obstetrics & reproductive medicine, Hysterectomy, business.industry, medicine.medical_treatment, Endometrial cancer, General surgery, Sentinel lymph node, Obstetrics and Gynecology, Cancer, COVID-19, Introduction, Guideline, Management, Gynaecological cancer, medicine.disease, Radiation therapy, 03 medical and health sciences, 0302 clinical medicine, Reproductive Medicine, 030220 oncology & carcinogenesis, Obstetrics and Gynaecology, Medicine, Lymphadenectomy, Hyperthermic intraperitoneal chemotherapy, business
Abstract: Introduction In the context of the COVID-19 pandemic, specific recommendations are required for the management of patients with gynecologic cancer. Materials and method The FRANCOGYN group of the National College of French Gynecologists and Obstetricians (CNGOF) convened to develop recommendations based on the consensus conference model. Results If a patient with a gynecologic cancer presents with COVID-19, surgical management should be postponed for at least 15 days. For cervical cancer, radiotherapy and concomitant radiochemotherapy could replace surgery as first-line treatment and the value of lymph node staging should be reviewed on a case-by-case basis. For advanced ovarian cancers, neoadjuvant chemotherapy should be preferred over primary cytoreduction surgery. It is legitimate not to perform hyperthermic intraperitoneal chemotherapy during the COVID-19 pandemic. For patients who are scheduled to undergo interval surgery, chemotherapy can be continued and surgery performed after 6 cycles. For patients with early stage endometrial cancer of low and intermediate preoperative ESMO risk, hysterectomy with bilateral adnexectomy combined with a sentinel lymph node procedure is recommended. Surgery can be postponed for 1–2 months in low-risk endometrial cancers (FIGO Ia stage on MRI and grade 1–2 endometrioid cancer on endometrial biopsy). For patients of high ESMO risk, the MSKCC algorithm (combining PET-CT and sentinel lymph node biopsy) should be applied to avoid pelvic and lumbar-aortic lymphadenectomy. Conclusion During the COVID-19 pandemic, management of a patient with cancer should be adapted to limit the risks associated with the virus without incurring loss of chance.
Published: 2020

37. Lymphadenectomy in elderly patients with high-intermediate-risk, high-risk or advanced endometrial cancer: Time to move from personalized cancer medicine to personalized patient medicine!

Author: Jean Levêque, Geoffroy Canlorbe, Charles Coutant, Krystel Nyangoh Timoh, Martin Koskas, Cyril Touboul, Vincent Lavoué, Nina Hudry, Pierre Collinet, Adelaïde Racin, Marcos Ballester, Emile Daraï, Olivier Graesslin, Lobna Ouldamer, Alexandre Bricou, Sofiane Bendifallah, Emilie Raimond, Cyrille Huchon, Groupe de Recherche Francogyn, CHU Pontchaillou [Rennes], Chemistry, Oncogenesis, Stress and Signaling (COSS), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), ESIM - Déterminants Sociaux de la Santé et du Recours aux Soins (DS3), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Hôpital Bretonneau, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, CHI Créteil, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris 13 (UP13), CHI Poissy-Saint-Germain, CIC - CHU Bichat, Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-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)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université de Rennes (UR)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche Saint-Antoine (CRSA), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)
Subjects: Databases, Factual, medicine.medical_treatment, Logistic regression, Paraaortic lymphadenectomy, Cohort Studies, 0302 clinical medicine, Elderly, Precision Medicine, ComputingMilieux_MISCELLANEOUS, Aged, 80 and over, 030219 obstetrics & reproductive medicine, General Medicine, Prognosis, 3. Good health, Oncology, 030220 oncology & carcinogenesis, Lymphatic Metastasis, Female, France, Cancer-specific survival, medicine.medical_specialty, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Risk Assessment, Disease-Free Survival, 03 medical and health sciences, Cancer Medicine, Internal medicine, High-risk endometrial cancer, medicine, Humans, Neoplasm Invasiveness, Geriatric Assessment, Aged, Neoplasm Staging, Retrospective Studies, Proportional hazards model, business.industry, Endometrial cancer, High intermediate risk, Retrospective cohort study, Lymphadenectomy, medicine.disease, Survival Analysis, Endometrial Neoplasms, Logistic Models, Multivariate Analysis, Lymph Node Excision, Surgery, Lymph Nodes, business, Forecasting
Abstract: Pelvic and paraaortic lymphadenectomy are recommended for women with high-intermediate, high-risk and advanced endometrial cancer (EC). Lymphadenectomy is less frequently performed in elderly patients than in younger patients. We examined the survival of elderly women diagnosed with high-risk EC according to whether lymphadenectomy was performed or not.We selected women over 70 years with high-intermediate risk, high-risk or advanced EC from a multicenter retrospective cohort of women diagnosed between 2001 and 2013. Multivariate logistic regression models and Cox proportional hazards survival methods for overall survival (OS), disease-free survival (DFS) and cancer-specific survival (CSS) were used for analyses.71 women had lymphadenectomy and were compared with the 213 who did not. Recurrence was similar in both groups (42% vs 33%, respectively, p = 0.17) but more deaths were reported in the group without lymphadenectomy (38% vs 23%, respectively, p 0.001). There was no difference in adjuvant treatment in the two groups (17% vs 27%, respectively, p = 0.27). Elderly patients without lymphadenectomy had lower 3-year DFS (56% vs 71%, p = 0.076), CSS (67% vs 85%, p 0.001) and OS (50% vs 71% p 0.001). The Cox proportional hazard models showed independently poorer prognosis in women without lymphadenectomy (3.027, 95% CI 1.58-5.81, p 0.001), histology type 2 (3.46, 95% CI 1.51-7.97, p = 0.003) and lymphovascular space involvement (3.47, 95% CI 1.35-8.98, p = 0.01) on 3-year CSS.No lymphadenectomy in elderly patients with high-risk or advanced EC is independently associated with poorer prognosis. Elderly patients with EC should benefit from lymphadenectomy when indicated.
Published: 2018

38. A Proposal for a Classification for Recurrent Endometrial Cancer: Analysis of a French Multicenter Database From the FRANCOGYN Study Group

Author: Geoffroy Canlorbe, Charles Coutant, Emile Daraï, Sofiane Bendifallah, Olivier Graesslin, Amélie Benbara, Marcos Ballester, Vincent Lavoué, Xavier Carcopino, Lionel Carbillon, Emilie Raimond, C Touboul, Pierre Collinet, Mathilde Daix-Moreux, Cyrille Huchon, Lobna Ouldamer, Alexandre Bricou, Service de gynécologie-obstétrique [Hôpital Jean Verdier], Université Paris 13 (UP13)-Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], CHU Tenon [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 Hospitalier Régional Universitaire de Tours (CHRU TOURS), Service de Gynécologie et Obstétrique [Rennes] = Gynaecology [Rennes], CHU Pontchaillou [Rennes], Service de rhumatologie [CHU Saint-Antoine], CHU Saint-Antoine [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), Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, Centre Hospitalier Universitaire de Reims (CHU Reims), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, Service d'obstétrique-gynécologie [Lille], Hôpital Jeanne de Flandre [Lille]-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Institut méditerranéen de biodiversité et d'écologie marine et continentale (IMBE), Avignon Université (AU)-Aix Marseille Université (AMU)-Institut de recherche pour le développement [IRD] : UMR237-Centre National de la Recherche Scientifique (CNRS), Service de gynécologie-obstétrique [Hôpital Nord - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], Service de gynécologie et obstétrique [Créteil], CHI Créteil, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Service de Gynécologie-Obstétrique [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université, Service de Gynécologie et Obstétrique [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes]-hôpital Sud, Service de rhumatologie, inflammation-immunopathologie- biothérapie [CHU Saint-Antoine] (DHU i2B ), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Sorbonne Université (SU), Centre National de la Recherche Scientifique (CNRS)-Institut de recherche pour le développement [IRD] : UMR237-Aix Marseille Université (AMU)-Avignon Université (AU), Hôpital Nord [CHU - APHM]-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), Hôpital Jean Verdier [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris 13 (UP13)
Subjects: medicine.medical_specialty, medicine.medical_treatment, Salpingo-oophorectomy, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Hysterectomy, Gastroenterology, Metastasis, 03 medical and health sciences, 0302 clinical medicine, Endometrial cancer, Recurrence free survival, Internal medicine, medicine, Humans, Recurrences, Neoplasm Metastasis, Survival rate, Retrospective Studies, [SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health, 030219 obstetrics & reproductive medicine, business.industry, Obstetrics and Gynecology, Retrospective cohort study, medicine.disease, Classification, Recurrent Endometrial Cancer, Confidence interval, 3. Good health, Endometrial Neoplasms, Survival Rate, Oncology, 030220 oncology & carcinogenesis, Lymphatic Metastasis, Female, France, Neoplasm Recurrence, Local, business, Relapses
Abstract: ObjectiveEndometrial cancer (EC) recurrences are relatively common with no standardized way of describing them. We propose a new classification for them called locoregional, nodal, metastasis, carcinomatosis recurrences (rLMNC).Patients and MethodsThe data of 1230 women with EC who were initially treated by primary surgery were included in this French multicenter retrospective study. Recurrences were classified based on dissemination pathways: (1) locoregional recurrence (rL); (2) nodal recurrence (rN) for lymphatic pathway; (3) distant organ recurrence (rM) for hematogenous pathway; and (4) carcinomatosis recurrence (rC) for peritoneal pathway. These pathways were further divided into subgroups. We compared recurrence free survival and overall survival (OS) between the 4 groups (rL/rN/rM/rC).ResultsThe median follow-up was 35.6 months (range, 1.70–167.60). One hundred ninety-eight women (18.2%) experienced a recurrence: 150 (75.8%) experienced a single-pathway recurrence and 48 (24.2%) a multiple-pathway recurrence. The 5-year OS was 34.1% (95% confidence interval [CI], 27.02%–43.1%), and the median time to first recurrence was 18.9 months (range, 0–152 months). The median survival after recurrence was 14.8 months (95% CI, 11.7–18.8). Among women with single pathway of recurrence, a difference in 5-year OS (P < 0.001) and survival after recurrence (P < 0.01) was found between the 4 rLNMC groups. The carcinomatosis group had the worst prognosis compared with other single recurrence pathways. Women with multiple recurrences had poorer 5-year OS (P < 0.001) and survival after recurrence (P < 0.01) than those with single metastasis recurrence, other than women with peritoneal carcinomatosis.ConclusionsThis easy-to-use and intuitive classification may be helpful to define EC recurrence risk groups and develop guidelines for the management of recurrence. Its prognosis value could also be a tool to select homogenous populations for further trials.
Published: 2018

39. Does lymphadenectomy improve survival in patients with intermediate risk endometrial cancer? A multicentric study from the FRANCOGYN Research Group

Author: Hélène Behal, Juan Pablo Estevez, Henri Azaïs, Lobna Ouldamer, Geoffroy Canlorbe, Charles Coutant, Pierre Collinet, Sofiane Bendifallah, Vincent Lavoué, Marcos Ballester, Olivier Graesslin, Cyril Touboul, and Lilia Bougherara
Subjects: Oncology, medicine.medical_specialty, medicine.medical_treatment, Population, Sentinel lymph node, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Adjuvant therapy, Medicine, Humans, education, Aged, Retrospective Studies, education.field_of_study, 030219 obstetrics & reproductive medicine, business.industry, Endometrial cancer, Obstetrics and Gynecology, medicine.disease, Prognosis, Lymphovascular, Endometrial Neoplasms, Survival Rate, Dissection, 030220 oncology & carcinogenesis, Lymph Node Excision, Lymphadenectomy, Female, Neoplasm Recurrence, Local, business, Intermediate risk, Follow-Up Studies
Abstract: ObjectiveThe role of lymphadenectomy in intermediate risk endometrial cancer remains uncertain. We evaluated the impact of lymphadenectomy on overall survival and relapse-free survival for patients with intermediate risk endometrial cancer.MethodsWe retrospectively reviewed patients from the FRANCOGYN database with intermediate risk endometrial cancer, based on pre-operative and post-operative criteria (type 1, grade 1–2 tumors with deep (> 50%) myometrial invasion and no lymphovascular space invasion), who received primary surgical treatment between November 2002 and August 2013. We compared overall survival and relapse-free survival between staged and unstaged patients.ResultsFrom 1235 screened patients, we selected 108 patients with intermediate risk endometrial cancer. Eighty-two (75.9%) patients underwent nodal staging (consisting of pelvic +/- para-aortic lymphadenectomy). Among them, 35 (32.4%) had lymph node disease. The median follow-up was 25 months (range 0.4 to 155.0). The overall survival rates were 82.5% for patients staged (CI 64.2 to 91.9) vs 77.9 % for unstaged patients (CI 35.4 to 94.2) (P = 0.73). The relapse-free survival rates were 68.9% for staged patients (CI 51.2 to 81.3) vs 68.8% for unstaged patients (CI 29.1 to 89.3) (P=0.67).ConclusionSystematic nodal staging does not appear to improve overall survival and relapse-free survival for patients with IR EC but could provide information to tailor adjuvant therapy. Sentinel lymph node dissection may be an effective and less invasive alternative staging technique and should provide a future alternative for this population.
Published: 2018

40. Change in hazard rates of recurrence over time following diagnosis of endometrial cancer: An age stratified multicentre study from the FRANCOGYN group

Author: Jean Lévêque, Sofiane Bendifallah, Olivier Graesslin, Goeffroy Canlorbe, Groupe de Recherche Francogyn, Gilles Body, Pierre Collinet, Cyrille Huchon, Emilie Raimond, Cyril Touboul, Lobna Ouldamer, Charles Coutant, Emile Daraï, Marcos Ballester, Vincent Lavoué, and Alexandre Bricou
Subjects: 0301 basic medicine, Adult, medicine.medical_specialty, Salpingo-oophorectomy, Hysterectomy, Metastasis, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, medicine, Advanced disease, Initial treatment, Humans, Prospective Studies, Stage (cooking), Aged, Neoplasm Staging, Aged, 80 and over, business.industry, Endometrial cancer, Hazard ratio, Age Factors, General Medicine, Middle Aged, medicine.disease, Endometrial Neoplasms, Survival Rate, 030104 developmental biology, Increased risk, Oncology, 030220 oncology & carcinogenesis, Lymphatic Metastasis, Surgery, Targeted surveillance, Female, France, Neoplasm Recurrence, Local, business
Abstract: Predicting the pattern of recurrence can aid in the development of targeted surveillance and treatment strategies. The objectives of this study were to identify patterns of recurrence in women with operable endometrial cancer (EC) and to identify high-risk periods for recurrence in function of age.The data of 1153 women who received primary surgical treatment for stage I-III EC between January 2001 and December 2013 were abstracted from a prospectively maintained multicentre database. The time to first recurrence was calculated from the date of diagnosis, and the associated hazard function was examined to determine the peak risk period of recurrence. We categorized age at diagnosis as65 and ≥ 65 years old and analysed the hazard rate (HR) by stratifying age groups.Women with EC aged ≥65 years maintain a significant recurrence rate during follow-up whatever the stratification (locoregional recurrence, distant recurrence, ESMO/ESGO/ESTRO subgroup). Multivariable Cox proportional hazard regression showed that the increased risk of recurrence of EC was associated with advanced age, advanced disease ESMO/ESGO/ESTRO subgroup but not with initial treatment received.The annual HR of recurrence is not uniformly distributed over time but is dynamic and markedly determined by prognostic factors at diagnosis.
Published: 2018

41. The definition of Endometriosis Expert Centres

Author: Arnaud Wattiez, C.M. de Malartic, Emile Daraï, L. Piechon, P. Collinet, Thomas Hebert, H. Martigny, Aubert Agostini, Pierre Panel, M. Poilblanc, Philippe Descamps, I. Chanavaz-Lacheray, P. Rousset, Olivier Graesslin, H. Dechaud, Charles Chapron, Jean-Luc Brun, Pierre-Adrien Bolze, and François Golfier
Subjects: Infertility, medicine.medical_specialty, media_common.quotation_subject, Endometriosis, Fertility, Guidelines as Topic, System of care, 03 medical and health sciences, 0302 clinical medicine, medicine, Severe endometriosis, Humans, 030212 general & internal medicine, Societies, Medical, media_common, Pelvic surgery, 030219 obstetrics & reproductive medicine, business.industry, Public health, Obstetrics and Gynecology, medicine.disease, Reproductive Medicine, Family medicine, Absenteeism, Female, France, Health Facilities, business
Abstract: Endometriosis is a common condition that causes pain and infertility. It can lead to absenteeism and also to multiple surgeries with a consequent risk of impaired fertility, and constitutes a major public health cost. Despite the existence of numerous national and international guidelines, the management of endometriosis remains suboptimal. To address this issue, the French College of Gynaecologists and Obstetricians (CNGOF) and the Society of Gynaecological and Pelvic Surgery (SCGP) convened a committee of experts tasked with defining the criteria for establishing a system of care networks, headed by Expert Centres, covering all of mainland France and its overseas territories. This document sets out the criteria for the designation of Expert Centres. It will serve as a guide for the authorities concerned, to ensure that the means are provided to adequately manage patients with endometriosis.
Published: 2018

42. Therapeutic value of surgical paraaortic staging in locally advanced cervical cancer: a multicenter cohort analysis from the FRANCOGYN study group

Author: Yohann Dabi, Vanille Simon, Xavier Carcopino, Sofiane Bendifallah, Lobna Ouldamer, Vincent Lavoue, Geoffroy Canlorbe, Emilie Raimond, Charles Coutant, Olivier Graesslin, Pierre Collinet, Alexandre Bricou, Emile Daraï, Cyrille Huchon, Marcos Ballester, Bassam Haddad, Cyril Touboul, For the Groupe de Recherche FRANCOGYN, Service de gynécologie et obstétrique [Créteil], CHI Créteil, Service de gynécologie-obstétrique [Hôpital Nord - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], CHU Tenon [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), Sorbonne Université - Faculté de Médecine (SU FM), Sorbonne Université (SU), Hôpital Bretonneau, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CRLCC Eugène Marquis (CRLCC), Service de Gynécologie et Obstétrique [Rennes] = Gynaecology [Rennes], CHU Pontchaillou [Rennes], Service de Gynécologie-Obstétrique, Maternité, Chirurgie Gynécologique [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Centre Hospitalier Universitaire de Reims (CHU Reims), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, Département d'obstétrique[Lille], Hôpital Jeanne de Flandre [Lille]-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de gynécologie-obstétrique [Hôpital Jean Verdier], Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris 13 (UP13), Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, Hôpital Nord [CHU - APHM]-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), Service de Gynécologie-Obstétrique [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université, Service de Gynécologie et Obstétrique [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes]-hôpital Sud, Service de Gynécologie et Obstétrique [Groupe Hospitalier Pitié-Salpêtrière], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris 13 (UP13)-Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: Adult, medicine.medical_specialty, Multivariate analysis, Locally advanced, Uterine Cervical Neoplasms, lcsh:Medicine, Paraaortic lymph nodes invasion, [SDV.CAN]Life Sciences [q-bio]/Cancer, Kaplan-Meier Estimate, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Disease-Free Survival, General Biochemistry, Genetics and Molecular Biology, Metastasis, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Paraaortic lymph nodes, medicine, Humans, Nodal surgical staging, Neoplasm Staging, Proportional Hazards Models, Cervical cancer, Locally advanced cervical cancer, 030219 obstetrics & reproductive medicine, Proportional hazards model, business.industry, Research, lcsh:R, General Medicine, Middle Aged, medicine.disease, 3. Good health, 030220 oncology & carcinogenesis, Locally advanced disease, Multivariate Analysis, Female, Radiology, business, Cohort study
Abstract: Background The prognostic impact of surgical paraaortic staging remains unclear in patients with locally advanced cervical cancer (LACC). The objective of our study was to evaluate the survival impact of surgical staging in patients with LACC and no evidence of paraaortic lymph node (PALN) metastasis on pre-operative imaging work-up. Methods Data of 1447 patients with cervical cancer treated between 1996 and 2016 were extracted from maintained databases of 10 French University hospitals. Patients with locally advanced disease (IB2 or more) treated by concurrent chemoradiation therapy (CRT) and no evidence of paraaortic metastasis on pre-operative imaging work-up were selected for further analysis. The Kaplan–Meier method was used to estimate the survival distribution. A Cox proportional hazards model was used to account for the influence of multiple variables. Results Six hundred and forty-seven patients were included, 377 (58.3%) with surgical staging and 270 (41.7%) without, with a mean follow up of 38.1 months (QI 13.0–56.0). Pathologic analysis revealed positive lymph nodes in 47 patients (12.5%). In multivariate model analysis, surgical staging remained an independent prognostic factor for DFS (OR 0.64, CI 95% 0.46–0.89, p = 0.008) and OS (OR 0.43, CI 95% 0.27–0.68, p
Published: 2018

43. Patterns of care and the survival of elderly patients with high-risk endometrial cancer: A case-control study from the FRANCOGYN group

Author: Geoffroy Canlorbe, Cyrille Huchon, Pierre Collinet, Charles Coutant, Marcos Ballester, Vincent Lavoué, Sofiane Bendifallah, Emilie Raimond, C Touboul, Lobna Ouldamer, Olivier Graesslin, Antoine Rousselin, K. Nyangoh Timoh, Alexandre Bricou, Nina Hudry, Jean Levêque, Emile Daraï, Chemistry, Oncogenesis, Stress and Signaling (COSS), Université de Rennes (UR)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Gynécologie et Obstétrique [Rennes] = Gynaecology [Rennes], CHU Pontchaillou [Rennes], CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Epidémiologie, Systèmes d'Information, Modélisation, Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre Hospitalier Universitaire de Reims (CHU Reims), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, Service de gynécologie et obstétrique [Créteil], CHI Créteil, Service d'obstétrique-gynécologie [Lille], Hôpital Jeanne de Flandre [Lille]-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de gynécologie-obstétrique [Hôpital Jean Verdier], Université Paris 13 (UP13)-Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, Centre de Recherche Saint-Antoine (UMRS893), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-CRLCC Eugène Marquis (CRLCC)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], Sorbonne Université (SU)-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)-Sorbonne Université (SU), Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Cadieu, Muriel, Service de Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Jean Verdier [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris 13 (UP13)
Subjects: Oncology, [SDV.MHEP.CHI] Life Sciences [q-bio]/Human health and pathology/Surgery, medicine.medical_treatment, 0302 clinical medicine, Elderly, 030212 general & internal medicine, Practice Patterns, Physicians', ComputingMilieux_MISCELLANEOUS, Aged, 80 and over, Age Factors, General Medicine, Prognosis, humanities, 3. Good health, Survival Rate, Treatment Outcome, Lymphatic Metastasis, 030220 oncology & carcinogenesis, Female, medicine.medical_specialty, Standard of care, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, 03 medical and health sciences, [SDV.CAN] Life Sciences [q-bio]/Cancer, Internal medicine, High-risk endometrial cancer, medicine, Adjuvant therapy, Humans, Aged, Neoplasm Staging, Patterns of care, Chemotherapy, business.industry, Endometrial cancer, Case-control study, Cancer, medicine.disease, Endometrial Neoplasms, [SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Case-Control Studies, Chemotherapy: cancer-specific survival, Lymph Node Excision, Lymphadenectomy, Surgery, Neoplasm Grading, business
Abstract: The standard of care of endometrial cancer involves complex procedures such as pelvic and para-aortic lymphadenectomy and omentectomy, particularly for high-risk endometrial cancer. Few data are available about these complex surgical procedures and adjuvant therapy in elderly women. We aim to examine treatment and survival of elderly women diagnosed with high-risk endometrial cancer.We performed a case-control study of women diagnosed between 2001 and 2013 with high-risk endometrial cancers. Women older than 70 years (n = 198) were compared with patients70 years (n = 198) after matching on high-risk for recurrence and LVSI status.Elderly patients had lymphadenectomies less frequently compared with younger patients (76% vs 96%, p 0.001) and no adjuvant treatment more frequently (17% vs 8%, p = 0.005) due to less chemotherapy being administered (23% vs 46%, p 0.001). The 3-year DFS, CSS and OS of patients ≥70 years was 52% (43-61), 81% (74-88) and 61% (53-70), respectively. These were significantly lower than the 3-year DFS, CSS, and OS of younger patients, which was 75% (68-82) (p 0.001), 92% (87-96) (p 0.008) and 75% (69-82) (p = 0.018), respectively. Cox proportional hazard models found that elderly women had 57% increased risk of recurrence (hazard ratio 1.57, 95% CI 1.04-2.39) compared with younger patients.Although we found an independently significant lower DFS in elderly patients with high-risk endometrial cancer when compared with young patients, elderly women are less likely to be treated with lymphadenectomy and chemotherapy. Specific guidelines for management of elderly patients with high-risk endometrial cancer are required to improve their prognosis.
Published: 2017

44. Prognostic value of local relapse for patients with endometrial cancer

Author: J. Uzan, Lobna Ouldamer, Sofiane Bendifallah, Alexandre Bricou, Groupe de Recherche Francogyn, Pierre Collinet, Vincent Lavoué, Olivier Graesslin, Charles Coutant, Y. Dabi, Emilie Raimond, C Touboul, Bassam Haddad, Geoffroy Canlorbe, Marcos Ballester, and Emile Daraï
Subjects: Oncology, Risk, medicine.medical_specialty, Multivariate analysis, medicine.medical_treatment, Brachytherapy, Disease, Stage ii, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Carcinoma, Medicine, Humans, Aged, 030219 obstetrics & reproductive medicine, business.industry, Sentinel Lymph Node Biopsy, Endometrial cancer, General Medicine, Middle Aged, medicine.disease, University hospital, Prognosis, Lymphovascular, Endometrial Neoplasms, Survival Rate, 030220 oncology & carcinogenesis, Surgery, Female, France, Neoplasm Recurrence, Local, business
Abstract: The objective of our study was to determine survival and prognostic factors associated with isolated local recurrence of endometrial cancer.Data of 1229 patients with endometrial carcinoma treated between 2000 and 2012 were extracted from maintained databases of nine French University Hospitals as well as from the Senti-Endo trial. Patients with isolated central pelvic and vaginal recurrence were selected for further analysis.Two hundreds and twenty five patients recurred during the inclusion period, 20 with isolated central pelvic recurrence and 23 with vaginal recurrence. Patients without recurrence had initially significantly less lymphovascular space invasion (p = 0.01), less advanced diseases (stage II) (p 0.001) and more often low or intermediate risk tumours than patients with local recurrence. Local recurrence was statistically associated with better overall survival than non-local recurrence (p = 0.028) but dramatically decreased overall survival when compared to patients without any recurrence (p 0.001). The site of recurrence, i.e. vaginal or central pelvic, was significantly associated with overall survival (p = 0.015). Patients without brachytherapy at initial management were more likely to have local recurrence of their disease when compared to those without recurrence (p = 0.03). None of the prognostics factors for survival in patients with local recurrence was statistically significant in multivariate analysis.Local recurrence is a key event in endometrial cancer evolution severely impacting overall survival. Better understanding of the factors associated with prolonged survival is mandatory to improve our management of these patients.
Published: 2017

45. Call for Surgical Nodal Staging in Women with ESMO/ESGO/ESTRO High-Intermediate Risk Endometrial Cancer: A Multicentre Cohort Analysis from the FRANCOGYN Study Group

Author: Vincent Lavoué, Emile Daraï, Lobna Ouldamer, Marcos Ballester, Geoffroy Canlorbe, Sofiane Bendifallah, Emilie Raimond, Jérémy Lévêque, Charles Coutant, Gilles Body, Cyril Touboul, Olivier Graesslin, Pierre Collinet, Nutrition, croissance et cancer (U 1069) (N2C), Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Epidemiologie, Systèmes d'information, Modélisation, Institut National de la Santé et de la Recherche Médicale (INSERM), Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], CHU Tenon [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 Expert en Endométriose [CHU Tenon] (GRC6 C3E), Pathologies biliaires, fibrose et cancer du foie, Centre de Recherche Saint-Antoine (UMRS893), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-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)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Mère Enfant Alix de Champagne, Hôpital Jeanne de Flandres, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, CHU Pontchaillou [Rennes], Oncogenesis Stress Signaling (OSS), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CRLCC Eugène Marquis (CRLCC), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Groupe de recherche clinique Centre Expert en Endométriose (GRC 6 - C3E), Sorbonne Université (SU), and Université de Rennes (UR)-CRLCC Eugène Marquis (CRLCC)
Subjects: Adult, Oncology, medicine.medical_specialty, medicine.medical_treatment, [SDV.CAN]Life Sciences [q-bio]/Cancer, [CHIM.THER]Chemical Sciences/Medicinal Chemistry, Medical Oncology, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Surgical oncology, Internal medicine, medicine, Humans, Neoplasm Invasiveness, Prospective Studies, Prospective cohort study, Lymph node, Survival rate, Societies, Medical, Aged, Neoplasm Staging, Aged, 80 and over, Gynecology, 030219 obstetrics & reproductive medicine, Sentinel Lymph Node Biopsy, business.industry, Endometrial cancer, Middle Aged, medicine.disease, Endometrial Neoplasms, 3. Good health, Survival Rate, Radiation therapy, medicine.anatomical_structure, Lymphatic Metastasis, 030220 oncology & carcinogenesis, Lymph Node Excision, Female, Surgery, Lymphadenectomy, Neoplasm Recurrence, Local, business, Follow-Up Studies, Cohort study
Abstract: International audience; Background - The European Society of Medical Oncology (ESMO)/European Society of Gynaecological Oncology (ESGO)/European Society for Radiotherapy & Oncology (ESTRO) classification for endometrial cancer (EC) now includes a high-intermediate risk (HIR) group of recurrence due to the adverse prognostic role of lymphovascular space involvement (LVSI) and grade 3 for women at intermediate risk. However, optimal surgical staging, and especially the place of lymphadenectomy, remains to be elucidated. We aimed to establish whether systematic nodal staging should be part of surgical staging for women with HIR EC. Methods - We abstracted from a prospectively maintained multicentre database the data of 181 women with HIR EC based on uterine factors (endometrioid type 1, grade 1-2 tumors with deep (≥50%) myometrial invasion and unequivocally positive LVSI, and those with grade 3 tumors with
Published: 2017

46. Association Between Planned Cesarean Delivery and Neonatal Mortality and Morbidity in Twin Pregnancies

Author: Olivier Graesslin, Corinne Dupont, Philippe Deruelle, Michel Dreyfus, Olivier Parant, Fabrice Pierre, Bruno Langer, Pierre Chabanier, Gilles Kayem, Franck Perrotin, René-Charles Rudigoz, Françoise Venditelli, Patrice Poulain, Christophe Vayssière, Norbert Winer, Didier Riethmuller, Loïc Marpeau, C. Prunet, Caroline Bohec, François Goffinet, Eric Verspyck, Loïc Sentilhes, Thomas Schmitz, Patrick Rozenberg, Claude D'Ercole, Pierre-Yves Ancel, Renaud de Tayrac, Olivier Morel, Jean Gondry, Marie-Victoire Senat, Paul Sagot, André Bongain, Laurence Lecomte-Raclet, Elie Azria, La grossesse normale et pathologique: développement et fonctions du placenta et de l'utérus (UMR_S 767), Institut des sciences du Médicament -Toxicologie - Chimie - Environnement (IFR71), Institut National de la Santé et de la Recherche Médicale (INSERM)-Ecole Nationale Supérieure de Chimie de Paris - Chimie ParisTech-PSL (ENSCP), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Ecole Nationale Supérieure de Chimie de Paris - Chimie ParisTech-PSL (ENSCP), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Université Paris Descartes - Paris 5 (UPD5)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique (CRESS - U1153), Université Paris Descartes - Paris 5 (UPD5)-Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA), Service de Gynécologie-Obstétrique (Gynéco-Obs - PAU), Hôpital François Mitterand (PAU - Hop F Mitterand), Service de Gynécologie-Obstétrique-Reproduction, Hôpital l'Archet, Service de Gynécologie - Obstétrique [Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de gynécologie-obstétrique, Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Service de Gynécologie-Obstétrique et Médecine de la Reproduction [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), Santé Individu Société - SIS (SIS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Jean Monnet [Saint-Étienne] (UJM)-Hospices Civils de Lyon (HCL)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Moulin - Lyon 3 (UJML), Université de Lyon-Université Lumière - Lyon 2 (UL2), Université de Picardie Jules Verne (UPJV), CHU Amiens-Picardie, Service de Gynécologie-Obstétrique, Centre Hospitalier Universitaire de Reims (CHU Reims)-Hôpital Maison Blanche-Institut Mère Enfant, Service de gynécologie–obstétrique, CHU Strasbourg-Hôpital de Hautepierre [Strasbourg], CHU Toulouse [Toulouse], Hôpital Bretonneau, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Prévention et promotion de la cancérogénèse par les aliments (ToxAlim-PPCA), ToxAlim (ToxAlim), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Ecole Nationale Vétérinaire de Toulouse (ENVT), Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Ecole d'Ingénieurs de Purpan (INPT - EI Purpan), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Recherche Agronomique (INRA)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Recherche Agronomique (INRA), Service de Gynécologie et Obstétrique [Rennes] = Gynaecology [Rennes], CHU Pontchaillou [Rennes], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Service de Gynécologie-Obstétrique [Bicêtre], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, Réseau périnatal Aurore, Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Departments of Gynaecology and Obstetrics, Clinical Science Institute-National University of Ireland [Galway] (NUI Galway), Service de gynécologie-obstétrique [Angers], Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Département d'échographie et de Médecine fœtale, SIHCUS-CMCO, Institut Pascal (IP), SIGMA Clermont (SIGMA Clermont)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), CHU Clermont-Ferrand, Service de gynécologie et obstétrique [CHU Rouen], Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU), Physiopathologie des Adaptations Nutritionnelles (PhAN), Université de Nantes (UN)-Institut National de la Recherche Agronomique (INRA), Institut National de la Santé et de la Recherche Médicale (INSERM)-Ecole Nationale Supérieure de Chimie de Paris- Chimie ParisTech-PSL (ENSCP)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Ecole Nationale Supérieure de Chimie de Paris- Chimie ParisTech-PSL (ENSCP)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Université Paris Descartes - Paris 5 (UPD5)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Nîmes (CHRU Nîmes), Service de Gynécologie et Obstétrique [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes]-Hôpital Sud, Centre hospitalier universitaire régional de Besançon (CHRU Besançon), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Bicêtre, Institut Pascal - Clermont Auvergne (IP), Sigma CLERMONT (Sigma CLERMONT)-Université Clermont Auvergne (UCA)-Centre National de la Recherche Scientifique (CNRS), Service de gynécologie et obstétrique [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Physiologie des Adaptations Nutritionnelles [UMR_A1280] (PhAN), Institut National de la Recherche Agronomique (INRA)-Université de Nantes (UN), La grossesse normale et pathologique: développement et fonctions du placenta et de l'utérus ( UMR_S 767 ), Institut des sciences du Médicament -Toxicologie - Chimie - Environnement ( IFR71 ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Ecole Nationale Supérieure de Chimie de Paris- Chimie ParisTech-PSL ( ENSCP ) -Centre National de la Recherche Scientifique ( CNRS ) -Institut de Recherche pour le Développement ( IRD ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Ecole Nationale Supérieure de Chimie de Paris- Chimie ParisTech-PSL ( ENSCP ) -Centre National de la Recherche Scientifique ( CNRS ) -Institut de Recherche pour le Développement ( IRD ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Equipe 1 : EPOPé - Épidémiologie Obstétricale, Périnatale et Pédiatrique ( CRESS - U1153 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité ( CRESS (U1153 / UMR_A 1125) ), Institut National de la Recherche Agronomique ( INRA ) -Université Sorbonne Paris Cité ( USPC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut National de la Recherche Agronomique ( INRA ) -Université Sorbonne Paris Cité ( USPC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de Gynécologie-Obstétrique ( Gynéco-Obs - PAU ), Hôpital François Mitterand ( PAU - Hop F Mitterand ), Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Centre Hospitalier Régional Universitaire de Nîmes ( CHRU Nîmes ), Service de Gynécologie - Obstétrique et médecine de la reproduction [Caen], CHU Caen, Santé Individu Société - SIS ( SIS ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Jean Monnet [Saint-Étienne] ( UJM ) -Hospices Civils de Lyon ( HCL ) -Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Université Jean Moulin - Lyon III-Université Lumière - Lyon 2 ( UL2 ), Transporteurs membranaires, chimioresistance et drug-design ( TMCD2 ), Aix Marseille Université ( AMU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Universitaire de Reims ( CHU Reims ) -Hôpital Maison Blanche-Institut Mère Enfant, Service de gynécologie-obstétrique [Caen], Laboratoire Electronique, Informatique et Image ( Le2i ), Université de Bourgogne ( UB ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Centre National de la Recherche Scientifique ( CNRS ), Centre Hospitalier Universitaire de Toulouse - CHU Toulouse (FRANCE), CHRU Tours, Hôpital Bretonneau, Institut National de la Santé et de la Recherche Médicale, ToxAlim ( ToxAlim ), Institut National Polytechnique [Toulouse] ( INP ) -Institut National de la Recherche Agronomique ( INRA ) -Université Paul Sabatier - Toulouse 3 ( UPS ) -Ecole Nationale Vétérinaire de Toulouse, Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -CHU Pontchaillou [Rennes]-Hôpital Sud, 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 ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Bicêtre, Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ), Clinical Science Institute-National University of Ireland [Galway] ( NUI Galway ), CHU Angers, Institut Pascal - Clermont Auvergne ( IP ), Sigma CLERMONT ( Sigma CLERMONT ) -Université Clermont Auvergne ( UCA ) -Centre National de la Recherche Scientifique ( CNRS ), CHU Rouen-Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Normandie Université ( NU ), Physiologie des Adaptations Nutritionnelles ( PhAN ), Institut National de la Recherche Agronomique ( INRA ) -Université de Nantes ( UN ), SIGMA Clermont (SIGMA Clermont)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Institut de Recherche pour le Développement (IRD)-Ecole Nationale Supérieure de Chimie de Paris - Chimie ParisTech-PSL (ENSCP), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Ecole Nationale Supérieure de Chimie de Paris - Chimie ParisTech-PSL (ENSCP), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Santé Individu Société (SIS), Université Lumière - Lyon 2 (UL2)-Université Jean Moulin - Lyon 3 (UJML), Université de Lyon-Université de Lyon-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Hospices Civils de Lyon (HCL)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Institut National de la Recherche Agronomique (INRA)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Ecole Nationale Vétérinaire de Toulouse (ENVT), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université de Toulouse (UT)-Ecole d'Ingénieurs de Purpan (INP - PURPAN), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Recherche Agronomique (INRA)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT), Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Université de Caen Normandie (UNICAEN), Université de Lyon-Hospices Civils de Lyon (HCL)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes]-hôpital Sud, and Université de Toulouse (UT)-Ecole d'Ingénieurs de Purpan (INPT - EI Purpan)
Subjects: Male, Pediatrics, medicine.medical_specialty, medicine.medical_treatment, Population, Twins, Gestational Age, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Infant, Newborn, Diseases, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Pregnancy, Infant Mortality, Medicine, Childbirth, Humans, Caesarean section, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, education, [ SDV.MHEP.GEO ] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, ComputingMilieux_MISCELLANEOUS, education.field_of_study, 030219 obstetrics & reproductive medicine, business.industry, Cesarean Section, Infant, Newborn, Pregnancy Outcome, Obstetrics and Gynecology, Gestational age, Infant, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, medicine.disease, Infant mortality, 3. Good health, Obstetric Labor Complications, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, business, Cohort study
Abstract: International audience; OBJECTIVE: To evaluate the association between the planned mode of delivery and neonatal mortality and morbidity in an unselected population of women with twin pregnancies. METHODS: The JUmeaux MODe d'Accouchement (JUMODA) study was a national prospective population-based cohort study. All women with twin pregnancies and their neonates born at or after 32 weeks of gestation with a cephalic first twin were recruited in 176 maternity units in France from February 2014 to March 2015. The primary outcome was a composite of intrapartum mortality and neonatal mortality and morbidity. Comparisons were performed according to the planned mode of delivery, planned cesarean or planned vaginal delivery. The primary analysis to control for potential indication bias used propensity score matching. Subgroup analyses were conducted, one according to gestational age at delivery and one after exclusion of high-risk pregnancies. RESULTS: Among 5,915 women enrolled in the study, 1,454 (24.6%) had planned cesarean and 4,461 (75.4%) planned vaginal deliveries, of whom 3,583 (80.3%) delivered both twins vaginally. In the overall population, composite neonatal mortality and morbidity was increased in the planned cesarean compared with the planned vaginal delivery group (5.2% compared with 2.2%; odds ratio [OR] 2.38, 95% confidence interval [CI] 1.86–3.05). After matching, neonates born after planned cesarean compared with planned vaginal delivery had higher composite neonatal mortality and morbidity rates (5.3% compared with 3.0%; OR 1.85, 95% confidence interval 1.29–2.67). Differences in composite mortality and morbidity rates applied to neonates born before but not after 37 weeks of gestation. Multivariate and subgroup analyses after exclusion of high-risk pregnancies found similar trends.CONCLUSION: Planned vaginal delivery for twin pregnancies with a cephalic first twin at or after 32 weeks of gestation was associated with low composite neonatal mortality and morbidity. Moreover, planned cesarean compared with planned vaginal delivery before 37 weeks of gestation might be associated with increased composite neonatal mortality and morbidity.
Published: 2017

47. Impact of lymphovascular space invasion on a nomogram for predicting lymph node metastasis in endometrial cancer

Author: Emmanuel Barranger, Emile Daraï, Patrick Aristizabal, Roman Rouzier, Dominique Luton, Karine Bassot, Olivier Graesslin, Françoise Clavel-Chapelon, Martin Koskas, Bassam Haddad, Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Pathologies biliaires, fibrose et cancer du foie [CHU Saint-Antoine], Centre de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-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)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-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)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CIC Hôpital Bichat, Institut National de la Santé et de la Recherche Médicale (INSERM)-UFR de Médecine-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Universitaire de Reims (CHU Reims), Service de gynécologie et obstétrique [Hopital Lariboisière - Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université de Paris (UP), Centre de recherche en épidémiologie et santé des populations (CESP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Centre Hospitalier Intercommunal de Créteil (CHIC), Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], CHU Tenon [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), and Institut Curie [Paris]
Subjects: Adult, Risk, Oncology, medicine.medical_specialty, Lymphovascular space invasion, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Hysterectomy, Nomogram, Decision Support Techniques, Metastasis, 03 medical and health sciences, 0302 clinical medicine, Endometrial cancer, Predictive Value of Tests, Internal medicine, medicine, Humans, Neoplasm Invasiveness, Lymph node, Aged, Neoplasm Staging, Aged, 80 and over, Univariate analysis, 030219 obstetrics & reproductive medicine, Receiver operating characteristic, business.industry, Obstetrics and Gynecology, Middle Aged, medicine.disease, Lymphovascular, Endometrial Neoplasms, 3. Good health, Nomograms, Logistic Models, medicine.anatomical_structure, ROC Curve, Lymphatic Metastasis, 030220 oncology & carcinogenesis, Multivariate Analysis, Linear Models, Lymph Node Excision, Female, Lymphadenectomy, Prediction, business
Abstract: International audience; Objective: The aim of this study was to evaluate the impact of lymphovascular space invasion (LVSI) on nomogram-based predictions of lymph node (LN) metastasis in endometrial cancer. Methods: The data from 485 patients with presumed stage I or II endometrial cancer who underwent hysterectomy and lymphadenectomy were analyzed. Calibration curves were designed and compared for three different subgroups: LVSI-positive tumors (n = 113), LVSI-negative tumors (n = 213) and LVSI-undetermined tumors (n = 159). Results: In the entire population, the nomogram showed good discrimination with an area under the receiver operating characteristic curve (AUC) of 0.80 and was well calibrated. In the subgroup analyses, in LVSI-positive, LVSI-negative and LVSI-undetermined patients, the nomogram was not well calibrated (p of the U index of 0.028, 0.087 and 0.011, respectively) with underestimation in LVSI-positive patients and overestimation in LVSI-negative and LVSI-undetermined patients of LN metastasis. In the univariate analysis and after adjusting for the LN metastasis probability provided by the nomogram, LVSI-positive tumors were associated with an increased risk for LN metastasis compared with LVSI-negative tumors (RR = 7.29 [3.87-13.7] and 5.04 [2.30-11.08], respectively). In contrast, the univariate analysis and after adjusting for the LN metastasis probability provided by the nomogram showed that LVSI-undetermined tumors were not associated with an increased risk for LN metastasis compared with LVSI-negative tumors (RR = 0.73 [0.32-1.69] and 1.26 [0.47-3.37], respectively). Conclusions: Our results suggested that LVSI should be considered to be an independent risk factor for LN metastasis. In this multicenter study, the risk for LN metastasis is similar when the LVSI is negative or is not detailed in the pathological report.
Published: 2013

48. Management and Survival of Elderly and Very Elderly Patients with Endometrial Cancer: An Age-Stratified Study of 1228 Women from the FRANCOGYN Group

Author: Geoffroy Canlorbe, Charles Coutant, Marcos Ballester, Alexandre Bricou, Nina Hudry, Clothilde Poupon, Emile Daraï, Cyrille Huchon, Lobna Ouldamer, Sofiane Bendifallah, Jean Levêque, Vincent Lavoué, Cyril Touboul, Emilie Raimond, Olivier Graesslin, Pierre Collinet, Service de Gynécologie et Obstétrique [Rennes] = Gynaecology [Rennes], CHU Pontchaillou [Rennes], Chemistry, Oncogenesis, Stress and Signaling (COSS), Institut National de la Santé et de la Recherche Médicale (INSERM)-CRLCC Eugène Marquis (CRLCC)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], CHU Tenon [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), ESIM - Déterminants Sociaux de la Santé et du Recours aux Soins (DS3), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), Nutrition, croissance et cancer (U 1069) (N2C), Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Imagerie et cerveau (iBrain - Inserm U1253 - UNIV Tours ), Service de Gynécologie-Obstétrique, Centre Hospitalier Universitaire de Reims (CHU Reims)-Hôpital Maison Blanche-Institut Mère Enfant, Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, Centre Hospitalier Intercommunal Créteil, CHI Créteil-CHI Créteil, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de gynécologie-obstétrique [Hôpital Jean Verdier], Université Paris 13 (UP13)-Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, Centre de Recherche Saint-Antoine (UMRS893), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris 13 (UP13), Université de Rennes (UR)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: medicine.medical_specialty, medicine.medical_treatment, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Surgical oncology, Internal medicine, medicine, Humans, Survival rate, Aged, Gynecology, Aged, 80 and over, 030219 obstetrics & reproductive medicine, business.industry, Endometrial cancer, Age Factors, Middle Aged, medicine.disease, Prognosis, Confidence interval, 3. Good health, Cystadenocarcinoma, Serous, Endometrial Neoplasms, Radiation therapy, Survival Rate, Oncology, 030220 oncology & carcinogenesis, Cohort, Adenocarcinoma, Lymph Node Excision, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Surgery, Female, Neoplasm Recurrence, Local, business, Cohort study, Adenocarcinoma, Clear Cell, Follow-Up Studies
Abstract: International audience; Background - Little data exist about the clinical management and survival of elderly patients with endometrial cancer. This study aimed to evaluate the management of elderly and very elderly patients with endometrial cancer as well as the overall survival (OS) rate, disease-free survival (DFS) rate, and cancer-specific survival (CSS) rate in a multicenter cohort. Methods - Data from 1228 patients with endometrial cancer who received primary treatment between January 2001 and December 2012 were collected from a multicenter database. Clinical management, DFS, CSS, and OS were analyzed. Results - Based on the international endometrial cancer risk classification, 36% (212/582) of women age 65 years or younger, 42% (220/526) of women ages 65-80 years, and 48% (58/120) of women older than 80 years showed high-risk endometrial cancer (p
Published: 2016

49. Patterns of recurrence and outcomes in surgically treated women with endometrial cancer according to ESMO-ESGO-ESTRO Consensus Conference risk groups: Results from the FRANCOGYN study Group

Author: Sofiane Bendifallah, Emile Daraï, Olivier Graesslin, Pierre Collinet, Cyril Touboul, Marcos Ballester, Emilie Raimond, Geoffroy Canlorbe, Vincent Lavoué, Lobna Ouldamer, and Charles Coutant
Subjects: 0301 basic medicine, Adult, medicine.medical_specialty, Time Factors, Databases, Factual, Specific time, Risk Assessment, Disease-Free Survival, 03 medical and health sciences, 0302 clinical medicine, Risk groups, Risk Factors, Internal medicine, Recurrence free survival, medicine, Humans, Cumulative incidence, First Recurrence, Peritoneal Neoplasms, Aged, Retrospective Studies, Gynecology, Aged, 80 and over, business.industry, Endometrial cancer, Incidence, Consensus conference, Obstetrics and Gynecology, Middle Aged, medicine.disease, Endometrial Neoplasms, Survival Rate, 030104 developmental biology, Oncology, Time to recurrence, 030220 oncology & carcinogenesis, Lymphatic Metastasis, Practice Guidelines as Topic, Female, France, Neoplasm Recurrence, Local, business
Abstract: The purpose of this study was to analyse the endometrial cancer (EC) patterns of recurrence based on a large French multicentre database according to ESMO-ESGO-ESTRO classification.Data of women with histologically proven EC who received primary surgical treatment between January 2001 and December 2012 were retrospectively abstracted from seven institutions with prospectively maintained databases. The endpoints were recurrence, recurrence free survival (RFS) and overall survival (OS). Time to the first EC recurrence in a specific site was evaluated by using cumulative incidence analysis (Gray's test).Data from 829 women were analysed in whom recurrences were observed in 176 (21%) with a median and mean time to recurrence of 13 and 19.5months, respectively. High (35%) and high-intermediate risk groups (16%) were associated with higher recurrence rates compared with low (9%) and intermediate (9%) risk patients (p0.0001). Women with high risk EC had a higher 5-year cumulative incidence of distant recurrence (20.7%) than women with high-intermediate, intermediate and low risk EC (5.6%, 3.5%, 3.3%), (p0.001), respectively. Women with high risk and high-intermediate risk EC had a higher 5-year cumulative incidence of loco-regional recurrence (24.3% and 16.6%, respectively) than women with intermediate and low risk EC (6.6% and 6.5%, respectively), (p0.001).We report specific time and site patterns of first recurrence according to the ESMO/ESGO/ESTRO classification. Sites and hazard rates for recurrence differ widely between subgroups over time. Defining patterns of EC recurrence may provide useful information for developing follow-up recommendations and designing therapeutic approaches.
Published: 2016

50. Disseminated intravascular coagulation syndrome two months after conservative management of placenta accreta. About two patients

Author: L. Duminil, Y. Bersot, Emilie Raimond, S. Bonneau, L. Bourrellier, R. Bensalem, A. Bertrand, J.-M. Malinovsky, and Olivier Graesslin
Subjects: Disseminated intravascular coagulation, medicine.medical_specialty, Pregnancy, 030219 obstetrics & reproductive medicine, Hysterectomy, Conservative management, business.industry, Placenta accreta, medicine.medical_treatment, Treatment outcome, Obstetrics and Gynecology, medicine.disease, Surgery, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, Reproductive Medicine, Placenta, medicine, 030212 general & internal medicine, Ultrasonography, business
Published: 2017

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