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1. Does advanced age affect treatment of early glottic carcinoma?

Author

Frédéric Chabolle, I. Wagner, C.-A. Bach, S. Hans, F. Chatelet, A. Bizard, Service d'ORL et de Chirurgie cervico-faciale - Hôpital Foch, Hôpital Foch [Suresnes], Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), and The authors thank Dr Claude Fugain and Dr Jo?lle Otz for their contributions.

Subjects
Male, Early glottic cancer, Glottis, medicine.medical_specialty, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Laryngectomy, Anterior commissure, Affect (psychology), 03 medical and health sciences, 0302 clinical medicine, Overall survival, medicine, Humans, Endoscopic resection, 030223 otorhinolaryngology, Surgical treatment, Laryngeal Neoplasms, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Carcinoma, Mean age, 3. Good health, Surgery, Radiation therapy, Elderly patients, Otorhinolaryngology, Glottic cancer, 030220 oncology & carcinogenesis, Endoscopic cordectomy, Female, business
Abstract

International audience; Aims: Early glottic carcinoma is currently managed by radiation therapy or endoscopic surgery. Both are effective in elderly patients, but their respective indications are poorly determined. The present study assessed our management of very elderly patients with early glottic carcinoma. Material and methods: A retrospective single-center study included all patients aged 75 years and older at diagnosis, treated by radiation therapy or endoscopic surgery with curative intent for T1 or T2 glottic carcinoma between 2004 and 2018. Results: Records of 33 patients (27 men and 6 women; mean age, 82.2 years (range, 76.1-93.1 years)) were reviewed. 24 patients received radiation therapy and 9 endoscopic resection. The only factor for choice of treatment was anterior commissure involvement. Overall survival was 87% at 2 years and 62% at 5 years. 19% of patients relapsed within 5 years and had to undergo further treatment. There were no treatment-related deaths. Radiation therapy was associated with more acute local complications, with two temporary treatment interruptions and one uncompleted treatment. Surgical treatment was more likely to result in dysphonia, found in 80% of cases. Conclusion: Treatment of early glottic cancer in elderly subjects can consist in either radiotherapy or endoscopic surgery. Age should not affect management. Surgical treatment is shorter and better tolerated, although with poorer vocal outcome, and may be preferred in the most comorbid patients.

Published
2021
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2. Laryngopharyngeal reflux: The microbiota theory

Author

Sven Saussez, Nathalie De Vos, Amandine Everard, Jerome R. Lechien, Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service d'ORL et de Chirurgie cervico-faciale - Hôpital Foch, University of Mons [Belgium] (UMONS), CHU Saint-Pierre, Université libre de Bruxelles, Bruxelles, Université Catholique de Louvain = Catholic University of Louvain (UCL), Ecole de Santé Publique [Université Libre de Bruxelles], Université libre de Bruxelles (ULB), No., and UCL - SSS/LDRI - Louvain Drug Research Institute

Subjects
0301 basic medicine, medicine.medical_specialty, Etiology, Laryngopharyngeal, [SDV]Life Sciences [q-bio], Reflux, Disease, Pathogenesis, Gastroenterology, 03 medical and health sciences, Laryngopharyngeal reflux, 0302 clinical medicine, Internal medicine, Electric Impedance, Laryngopharyngeal Reflux, medicine, Humans, Microbiome, Retrospective Studies, Autonomic nerve, business.industry, Microbiota, General Medicine, Hypothesis, medicine.disease, 3. Good health, 030104 developmental biology, Food, Gastroesophageal, Oral Microbiome, business, 030217 neurology & neurosurgery
Abstract

International audience; Laryngopharyngeal reflux (LPR) is a prevalent disease associated with non-specific symptoms and findings. Many gray areas persist in the pathogenesis of LPR, the diagnosis and the treatment. Symptoms are poorly correlated with fiberoptic signs or hypopharyngeal-esophageal multichannel intraluminal impedance-pH monitoring findings. The therapeutic response remains uncertain with some resistant patients to medical or surgical treatment. The development of LPR-symptoms and findings may be related to the refluxate of a myriad of gastroduodenal enzymes, which may modify the laryngopharyngeal and oral microbiome leading to mucosa maintenance and recovery impairments. The diet of patient is important because it may impact the microbiome composition and some foods are known to increase the number of hypopharyngeal reflux events. The number of hypopharyngeal reflux events may be increased by autonomic nerve dysfunction that may have an important role in the persistence of LPR-symptoms.

Published
2021
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3. Guidelines of clinical practice for the management of swallowing disorders and recent dysphonia in the context of the COVID-19 pandemic

Author

Camille Galant, B. Amy De La Breteque, Virginie Woisard, A. Julien-Laferrière, Lise Crevier-Buchman, Aude Lagier, Antoine Giovanni, S. Crestani, D Robert, Alexia Mattei, F. Marmouset, C. Lobryeau, S. Hans, Laboratoire Parole et Langage (LPL), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Service Oto-Rhino-Laryngologie (ORL) et chirurgie cervico-faciale [CHU Toulouse], Pôle Clinique des Voies respiratoires [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Service d'ORL et de Chirurgie cervico-faciale - Hôpital Foch, Service d'ORL et Chirurgie Cervico-Facial, Hôpital de la Timone [CHU - APHM] (TIMONE), Hopital de Clocheville, Unité de la voix et de la déglutition (Toulouse, France), CHU Toulouse [Toulouse], LPP - Laboratoire de Phonétique et Phonologie - UMR 7018 (LPP), and Université Sorbonne Nouvelle - Paris 3-Centre National de la Recherche Scientifique (CNRS)

Subjects
medicine.medical_specialty, Rehabilitation, Laryngology, business.industry, medicine.medical_treatment, Swallowing Disorders, Context (language use), [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Otorhinolaryngology, Swallowing, 030220 oncology & carcinogenesis, Health care, medicine, Infection control, Surgery, [SHS.LANGUE]Humanities and Social Sciences/Linguistics, [SDV.MHEP.OS]Life Sciences [q-bio]/Human health and pathology/Sensory Organs, 030223 otorhinolaryngology, Intensive care medicine, business, ComputingMilieux_MISCELLANEOUS
Abstract

International audience; Procedures putting healthcare workers in close contact with the airway are particularly at risk of contamination by the SARS-Cov-2 virus, especially when exposed to sputum, coughing, or a tracheostomy. In the current pandemic phase, all patients should be considered as potentially infected. Thus, the level of precaution recommended for the caregivers depends more on the type of procedure than on the patient's proved or suspected COVID-19 status. Procedures that are particularly at high risk of contamination are clinical and flexible endoscopic pharyngo-laryngological evaluation, and probably also video fluoroscopic swallowing exams. Voice rehabilitation should not be considered urgent at this time. Therefore , recommendations presented here mainly concern the management of swallowing disorders, which can sometimes be dangerous for the patient, and recent dysphonia. In cases where they are considered possible and useful, teleconsultations should be preferred to face-to-face assessments or rehabilitation sessions. The latter must be maintained only in few selected situations, after team discussions or in accordance with the guidelines provided by health authorities.

Published
2020
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4. Induction therapy with cetuximab plus docetaxel, cisplatin, and 5-fluorouracil (ETPF) in patients with resectable nonmetastatic stage III or IV squamous cell carcinoma of the oropharynx. A GERCOR phase II ECHO-07 study

Author

Martin Housset, Sophie Périé, Marine Lefevre, Martine Antoine, Patrick Soussan, Roger Lacave, Magdalena Benetkiewicz, Sébastien Albert, Jean Lacau St Guily, Frédéric Chabolle, Philippe Baril, Aimery de Gramont, Michel Gatineau, Rachel Moukoko, Franck Bonnetain, Jean-Baptiste Belloc, Alain Banal, Benoist Chibaudel, Philippe Céruse, Division of Medical Oncology - Franco-British Hospital Institute, Groupe Coopérateur Multidisciplinaire en Oncologie-Innovative Research Consortium ( GERCOR-IRC ), Cooperator Multidisciplinary Oncology Group ( GERCOR ), CHU Tenon [APHP], Laboratoire d'histologie et de biologie tumorale, Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Tenon [APHP], Clinical Research Group ( GRC ), Service d’Anatomie et cytologie pathologiques [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Tenon [APHP], Service de virologie, Service d'Oto-Rhino-Laryngologie et de Chirurgie Cervico- Faciale, Service d'Oto-Rhino-Laryngologie Chirurgie cervico-faciale -Hôpital Simone Veil, Service d'ORL et de Chirurgie cervico-faciale - Centre René Huguenin, Service d'ORL et de Chirurgie Cervico-Faciale ( PARIS - BICHAT - ORL et CCF ), Assistance publique - Hôpitaux de Paris (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Service d'ORL et de Chirurgie cervico-faciale - Hôpital Foch, Service d'ORL et de Chirurgie cervico-faciale - Hôpital Lyon-Sud, Hôpital Delafontaine, Centre Hospitalier de Saint-Denis, Groupe Hospitalier Paris Saint Joseph, Hôpital Européen Georges Pompidou [APHP] ( HEGP ), 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 ), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Cooperator Multidisciplinary Oncology Group (GERCOR), CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), 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), Service d'ORL et de Chirurgie Cervico-Faciale (PARIS - BICHAT - ORL et CCF), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier de Saint-Denis [Ile-de-France], Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) ( CEF2P / CARCINO ), and Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté [COMUE] ( UBFC ) -Université de Franche-Comté ( UFC )

Subjects
Male, Oncology, Cancer Research, medicine.medical_specialty, oropharyngeal cancer, Perforation (oil well), Cetuximab, [SDV.CAN]Life Sciences [q-bio]/Cancer, Docetaxel, Neutropenia, chemotherapy, papillomavirus, Gastroenterology, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, TPF Regimen, medicine, Humans, Radiology, Nuclear Medicine and imaging, Neoplasm Metastasis, papillomavirus Correspondence Benoist Chibaudel, Neoplasm Staging, Original Research, business.industry, induction therapy, Induction chemotherapy, Induction Chemotherapy, Middle Aged, medicine.disease, Primary tumor, 3. Good health, Oropharyngeal Neoplasms, Treatment Outcome, Carcinoma, Squamous Cell, Female, Taxoids, Fluorouracil, Cisplatin, Neoplasm Grading, business, Febrile neutropenia, medicine.drug
Abstract

International audience; Induction TPF regimen is a standard treatment option for squamous cell carcinoma (SCC) of the oropharynx. The efficacy and safety of adding cetuximab to induction TPF (ETPF) therapy was evaluated. Patients with nonmetastatic resectable stage III/IV SCC of the oropharynx were treated with weekly cetuximab followed the same day by docetaxel and cisplatin and by a continuous infusion of 5-fluorouracil on days 1-5 (every 3 weeks, 3 cycles). The primary endpoint was clinical and radiological complete response (crCR) of primary tumor at 3 months. Secondary endpoints were crCR rates, overall response, pathological CR, progression-free survival, overall survival, and safety. Forty-two patients were enrolled, and 41 received ETPF. The all nine planned cetuximab doses and the full three doses of planned chemotherapy were completed in 31 (76%) and 36 (88%) patients, respectively. Twelve (29%) patients required dose reduction. The crCR of primary tumor at the completion of therapy was observed in nine (22%) patients. ETPF was associated with a tumor objective response rate (ORR) of 58%. The most frequent grade 3–4 toxicities were as follows: nonfebrile neutropenia (39%), febrile neutropenia (19%), diarrhea (10%), and stomatitis (12%). Eighteen (44%) patients experienced acne-like skin reactions of any grade. One toxic death occurred secondary to chemotherapy-induced colitis with colonic perforation. This phase II study reports an interesting response rate for ETPF in patients with moderately advanced SCC of the oropharynx. The schedule of ETPF evaluated in this study cannot be recommended at this dosage.

Published
2015
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5. Imaging work-up for screening of paraganglioma and pheochromocytoma in SDHx mutation carriers: a multicenter prospective study from the PGL.EVA Investigators

Author

Mirko Peitzsch, Pierre-François Plouin, Philippe Halimi, Anne-Paule Gimenez-Roqueplo, Patricia Niccoli, Anne Hernigou, Claire Houzard, Laurence Amar, Françoise Borson-Chazot, Brigitte Delemer, Florence Tenenbaum, Gilles Chatellier, Aurore Caumont-Prim, Isabelle Coupier, Séverine Peyrard, Chantal Hignette, Rossella Libé, Frédéric Chabolle, Sophie Leboulleux, Vincent Rohmer, Catherine Cardot-Bauters, Institut National du Cancer [Boulogne Billancourt] (INC), Angiogenesis Imaging UMR970, Institut National de la Santé et de la Recherche Médicale (INSERM), Unité d ’ Épidémiologie et de Recherche Clinique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital George Pompidou, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Service de radiologie cardio-vasculaire [CHU HEGP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Biochimie Endocrinienne et Métabolique [Marseille] (U38 Inserm - CHU Timone), Université de la Méditerranée - Aix-Marseille 2- Hôpital de la Timone [CHU - APHM] (TIMONE)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Gustave Roussy (IGR), Médecine nucléaire, Département d'imagerie médicale [Gustave Roussy], Institut Gustave Roussy (IGR)-Institut Gustave Roussy (IGR), Service d'hypertension artérielle et médecine vasculaire, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre de médecine nucléaire, Fédération d'endocrinologie-Groupement hospitalier Lyon-Est, Service d’endocrinologie, diabétologie et maladies métaboliques [CHRU LIlle], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service d'Endocrinologie - Diabète - Nutrition [Reims], Université de Reims Champagne-Ardenne (URCA)-Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims (CHU Reims), Service d'ORL et de Chirurgie cervico-faciale - Hôpital Foch, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'hypertension artérielle, Institut Cochin (IC UM3 (UMR 8104 / U1016)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP), Service de pathologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre d'Investigation Clinique - Epidemiologie Clinique/essais Cliniques [CHU HEGP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Stress Oxydant et Pathologies Métaboliques (SOPAM), Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Groupement Hospitalier Lyon-Est (GHE), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL)-Fédération d'endocrinologie, Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), CHU Pitié-Salpêtrière [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)

Subjects
Male, SDHB, Endocrinology, Diabetes and Metabolism, [SDV]Life Sciences [q-bio], Clinical Biochemistry, Adrenal Gland Neoplasms, Biochemistry, Magnetic resonance angiography, 0302 clinical medicine, Endocrinology, Paraganglioma, Protein Isoforms, Prospective Studies, Prospective cohort study, Early Detection of Cancer, medicine.diagnostic_test, Middle Aged, Research Personnel, 3. Good health, Succinate Dehydrogenase, Head and Neck Neoplasms, 030220 oncology & carcinogenesis, Female, Radiology, Algorithms, Adult, Diagnostic Imaging, medicine.medical_specialty, Heterozygote, 030209 endocrinology & metabolism, Context (language use), Pheochromocytoma, 03 medical and health sciences, Young Adult, Internal medicine, medicine, Humans, Genetic Testing, Radionuclide Imaging, business.industry, Biochemistry (medical), Gold standard (test), medicine.disease, Radiography, Mutation, SDHD, business
Abstract

International audience; CONTEXT: Recommendations have not been established concerning imaging to screen SDHx mutation carriers for paraganglioma and pheochromocytoma.OBJECTIVE: Our objective was to compare the performance of gadolinium-enhanced magnetic resonance angiography, contrast-enhanced computed tomography, and [(123)I]metaiodo-benzylguanidine and somatostatin receptor scintigraphies for detecting head and neck and thoracic-abdominal-pelvic paragangliomas in SDHx mutation carriers.DESIGN AND SETTING: We conducted a prospective, multicenter study from June 2005 to December 2009 at 23 French medical centers.PATIENTS: A total of 238 index cases or relatives carrying mutations in SDHD, SDHB, or SDHC genes were included.INTERVENTION: Images obtained by each technique were analyzed blind, without knowledge of results from other tests, first in each local center and then centrally.MAIN OUTCOME MEASURES: We evaluated sensitivity, specificity, and likelihood ratios for individual and combinations of tests, the gold standard being the consensus of an expert committee.RESULTS: Two hundred two tumors were diagnosed in 96 subjects. At local assessment, the sensitivity of anatomical imaging for detecting all tumors was higher (85.7%) than that of both scintigraphic techniques (42.7% for [(123)I]metaiodo-benzylguanidine and 69.5% for somatostatin receptor scintigraphy), except for thoracic localizations where somatostatin receptor scintigraphy was more sensitive (61.5 vs. 46.2% for anatomical imaging and 30.8% for [(123)I]metaiodo-benzylguanidine scintigraphy). The best diagnostic performance during local assessment was obtained by combining anatomical imaging tests and somatostatin receptor scintigraphy (sensitivity 91.7%). Central assessment significantly increased the sensitivity (98.6%) of tests in combination.CONCLUSIONS: In routine practice, the imaging work-up for screening SDHx mutation carriers should include thoraco-abdomino-pelvic computed tomography, head and neck magnetic angiography, and somatostatin receptor scintigraphy. Expert centralized image assessment is recommended.

Published
2013
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