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1. First-line treatment of exudative vocal fold-lesions by in-office local corticosteroid injection: A literature review

Author

R. Dassé and E. De Monès del Pujol

Subjects
medicine.medical_specialty, Triamcinolone acetonide, medicine.drug_class, business.industry, Submucosal injection, Vocal Cords, Laryngeal Edema, medicine.disease, Surgery, First line treatment, Polyps, Otorhinolaryngology, Adrenal Cortex Hormones, Reinke's edema, Fibrosis, Edema, otorhinolaryngologic diseases, medicine, Humans, Corticosteroid, Flexible endoscope, medicine.symptom, business, medicine.drug
Abstract

Objectives There are emerging reports of the effectiveness of in-office awake vocal-fold corticosteroid injection in the treatment of exudative vocal-fold lesions. The aim of this study was to review this therapy and specify indications, practical modalities and outcomes. Study design Systematic review of the literature without meta-analysis. Methods A systematic review by PubMed search for the period January 2000 to December 2018 was carried out. Results Nine articles were included, for a total of 502 lesions: nodules (46.4%), polyps (31.7%), and Reinke's edema (21.9%). Submucosal injection of low-dose triamcinolone acetonide (0.1 to 0.3 mL) was transoral, transcutaneous or transnasal via flexible endoscope with operating channel. Lesion volume was significantly reduced in more than 90% of cases, with significant vocal improvement in all studies. Relapse rates ranged between 4% and 31%, with time to relapse of 1 to 40 months. Conclusions First-line treatment of exudative glottic lesions by submucosal corticosteroid injection provides at least transient significant reduction in lesion volume and vocal improvement. It is consensually reserved to moderate-sized mainly exudative lesions without fibrosis. In-office injection provides an immediate therapeutic response in case of vocal impairment, enabling surgery under general anesthesia to be postponed.

Published
2021

2. Cystic form of cervical lymphadenopathy. Guidelines of the French Society of Otorhinolaryngology - Head and Neck Surgery (SFORL). Part 1: Diagnostic procedures for lymphadenopathy in case of cervical mass with cystic aspect

Author

S. Zerdoud, F. Benoudiba, G. Russ, E. de Monès, B. Rysman, S. Pondaven, Renaud Garrel, R. Abgral, G. Garcia, Francois Mouawad, and S. Tronche

Subjects
Adult, Image-Guided Biopsy, medicine.medical_specialty, Biopsy, Fine-Needle, Lymphadenopathy, Malignancy, Sensitivity and Specificity, Diagnosis, Differential, 03 medical and health sciences, 0302 clinical medicine, Fluorodeoxyglucose F18, Cervical lymphadenopathy, Positron Emission Tomography Computed Tomography, Biopsy, medicine, Humans, Thyroid Neoplasms, 030223 otorhinolaryngology, Ultrasonography, medicine.diagnostic_test, business.industry, Thyroid, Nasopharyngeal Neoplasms, medicine.disease, Magnetic Resonance Imaging, Head and neck squamous-cell carcinoma, Oropharyngeal Neoplasms, Fine-needle aspiration, medicine.anatomical_structure, Otorhinolaryngology, Nasopharyngeal carcinoma, Head and Neck Neoplasms, Thyroid Cancer, Papillary, 030220 oncology & carcinogenesis, Surgery, Radiology, medicine.symptom, Tomography, X-Ray Computed, business
Abstract

Objectives The authors present the guidelines of the French Society of Otorhinolaryngology - Head and Neck Surgery Society on diagnostic procedures for lymphadenopathy in case of a cervical mass with cystic aspect. Methods A multidisciplinary work-group was entrusted with a review of the scientific literature on the topic. Guidelines were drawn up, then read over by an editorial group independent of the work-group, and the final version was drawn up. Guidelines were graded as A, B, C or expert opinion, by decreasing level of evidence. Results In adults presenting a cystic cervical mass, it is recommended to suspect cervical lymphadenopathy: in order of decreasing frequency, cystic metastasis of head and neck squamous cell carcinoma, of undifferentiated nasopharyngeal carcinoma, and of thyroid papillary carcinoma (Grade C). On discovery of a cystic cervical mass on ultrasound, architectural elements indicating a lymph node and a thyroid nodule with signs of malignancy should be screened for, especially if the mass is located in levels III, IV or VI (Grade A). Malignant lymphadenopathy should be suspected in case of cervical mass with cystic component on CT (Grade B), but benign or malignant status cannot be diagnosed only on radiological data (CT or MRI) (Grade A), and 18-FDG PET-CT should be performed, particularly in case of inconclusive ultrasound-guided fine needle aspiration biopsy (Grade C).

Published
2019

3. Mucoepidermoid carcinoma of salivary glands: A French Network of Rare Head and Neck Tumors (REFCOR) prospective study of 292 cases

Author

A. Varoquaux, L. Castillo, M. Tassart, R. Jankowski, Emmanuelle Uro-Coste, F. Massip, L. Brugel, S Testelin, René-Jean Bensadoun, Olivier Mauvais, C. Bach, P. Herman, Christian-Adrien Righini, Laurent Gilain, Xavier Dufour, T. Mom, L. Laccoureye, E. Baudin, Justin Michel, Ludovic Le Taillandier de Gabory, G. Moulin, D. de Raucourt, C. Ferron, Juliette Thariat, R. Breheret, J.-M. Badet, V. Darrouzet, Bruno Devauchelle, T. Radulesco, Bertrand Baujat, V. Strunski, G. Poissonnet, Thomas Radulesco, Jean-Claude Merol, Renaud Garrel, C. Borel, A. Cosmidis, Odile Casiraghi, Dominique Chevalier, E. Serrano, Caroline Even, J.-C. Merol, P. Demez, L. Geoffrois, N. Fakhry, J.-P. Lavieille, A. Banal, J. Lacau St Guily, S. Duflo, J.-P. Bessède, B. Baujat, Marie Christine Kaminsky, F. Chabolle, Sebastien Albert, Roch Giorgi, O. Sterkers, N. Sarroul, Vianney Bastit, D. Blanchard, P. Lang, E. de Monès, P. Breton, G. Dolivet, R. Garrel, Sébastien Vergez, B. Toussaint, Anne Sudaka, A. Giovanni, G. Noel, P. Hofman, A. Bozorg-Grayeli, O. Malard, M. Housset, E. Lartigau, P. Ceruse, Valérie Costes-Martineau, C. Bertolus, Cécile Badoual, G. Andry, T. Van den Abbeele, F. Kolb, S. Faivre, F. Floret, P. Dessi, M. Juliéron, Nicolas Fakhry, J. Michel, Louis Crampette, Francois Mouawad, O. Choussy, Philippe Schultz, S. Hans, Marine Lefevre, L. Gilain, Emile Reyt, Sylvain Morinière, Philippe Herman, G. Valette, Béatrix Barry, A. Timochenko, Gilles Poissonnet, Antoine Moya-Plana, F. Veillon, S. Vergez, A. Coste, Franck Jegoux, E. Cassagnau, Christine Bach, Y. Marie Robin, B. Guerrier, E. Uro Coste, X. Leroy, Valérie Costes, Olivier Malard, F. Rolland, F. Dubrulle, A.C. Baglin, L. de Gabory, B. Ruhin, A. Girod, G. Calais, Laurie Saloner Dahan, Emmanuel Babin, J.C. Chobaut, Michel Wassef, Benjamin Lallemant, Jean-Michel Prades, C.-A. Righini, Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Aix Marseille Université (AMU), 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), Hôpital de la Timone [CHU - APHM] (TIMONE), 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), CHU Toulouse [Toulouse], CHU Bordeaux [Bordeaux], CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Lutte contre le Cancer Antoine Lacassagne [Nice] (UNICANCER/CAL), UNICANCER-Université Côte d'Azur (UCA), Institut Universitaire de la Face et du Cou [Nice], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Centre hospitalier universitaire de Nantes (CHU Nantes), Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Hôpital Foch [Suresnes], CHU Lille, Centre Hospitalier Universitaire de Reims (CHU Reims), Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU), CHU Clermont-Ferrand, Centre hospitalier universitaire de Poitiers (CHU Poitiers), Centre Hospitalier Universitaire [Grenoble] (CHU), Institut Gustave Roussy (IGR), Département de cancérologie cervico-faciale [Gustave Roussy] (CCF), CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université (SU), REFCOR members: S Albert, G Andry, E Babin, C Bach, J-M Badet, C Badoual, A C Baglin, A Banal, B Barry, E Baudin, B Baujat, R J Bensadoun, C Bertolus, J-P Bessède, D Blanchard, C Borel, A Bozorg-Grayeli, R Breheret, P Breton, L Brugel, G Calais, O Casiraghi, E Cassagnau, L Castillo, P Ceruse, F Chabolle, D Chevalier, J C Chobaut, O Choussy, A Cosmidis, A Coste, V Costes, L Crampette, V Darrouzet, P Demez, P Dessi, B Devauchelle, G Dolivet, F Dubrulle, S Duflo, X Dufour, S Faivre, N Fakhry, C Ferron, F Floret, L de Gabory, R Garrel, L Geoffrois, L Gilain, A Giovanni, A Girod, B Guerrier, S Hans, P Herman, P Hofman, M Housset, R Jankowski, F Jegoux, M Juliéron, M-C Kaminsky, F Kolb, J Lacau St Guily, L Laccoureye, B Lallemant, P Lang, E Lartigau, J-P Lavieille, M Lefevre, X Leroy, O Malard, F Massip, O Mauvais, J-C Merol, J Michel, T Mom, S Morinière, E de Monès, G Moulin, G Noel, G Poissonnet, J-M Prades, T Radulesco, D de Raucourt, E Reyt, C Righini, Y Marie Robin, F Rolland, B Ruhin, N Sarroul, P Schultz, E Serrano, O Sterkers, V Strunski, A Sudaka, M Tassart, S Testelin, J Thariat, A Timochenko, B Toussaint, E Uro Coste, G Valette, T Van den Abbeele, A Varoquaux, F Veillon, S Vergez, M Wassef, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université de Toulouse (UT)-Université de Toulouse (UT)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Institut National de la Santé et de la Recherche Médicale (INSERM), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Equipe IFTIM [ImViA - EA7535], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon)-Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER-Imagerie et Vision Artificielle [Dijon] (ImViA), Université de Bourgogne (UB)-Université de Bourgogne (UB), Laboratoire Parole et Langage (LPL), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Institut National de la Santé et de la Recherche Médicale (INSERM), dormoy, valerian, Pathogénèse et contrôle des infections chroniques (PCCI), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre Hospitalier Universitaire de Montpellier (CHU Montpellier )

Subjects
medicine.medical_specialty, Multivariate analysis, [SDV]Life Sciences [q-bio], Salivary glands, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Mucoepidermoid carcinoma, Internal medicine, Diabetes mellitus, Medicine, Stage (cooking), Intermediate Grade, 030223 otorhinolaryngology, Prospective cohort study, ComputingMilieux_MISCELLANEOUS, Cancer, [PHYS]Physics [physics], business.industry, General Medicine, medicine.disease, 3. Good health, Parotid gland, [SDV] Life Sciences [q-bio], medicine.anatomical_structure, Oncology, 030220 oncology & carcinogenesis, Surgery, business
Abstract

International audience; Background: To describe the characteristics of the largest European study of MEC of salivary glands and to determine the prognostic factors for overall and disease free survival.Patients and methods: Patients with MEC were prospectively included in the Réseau d'Expertise Français sur les Cancers ORL Rares (REFCOR, French Network of Rare Head and Neck Tumors) database between 2009 and 2015.Results: A total of 292 patients were included. Tumors were classified as low grade in 175 cases (60%), intermediate in 39 (13%) and high grade in 78 (27%). Median follow-up was 26 months. The 5-year OS and DFS rates were respectively 83% and 69%. In multivariate analysis, age (p = 0.004), diabetes (p = 0.02) and advanced stage (p = 0.03) were found to have a significant negative impact on OS. Diabetes (p = 0.001), alcohol consumption (p = 0.003) and advanced stage (p = 0.001) were found to have a significant negative impact on DFS. Compare to low grade, high grade tended to have a negative impact on OS (p = 0.05) and had a significant effect on DFS (0.002) while intermediate grade had no significant influence on survival. The surgical treatment had a positive impact on both OS (p = 0.00005) and DFS (p = 0.0005). Postoperative radiotherapy had no impact in multivariate analysis.Conclusion: Advanced clinical stage, high grade tumor, high age, the impossibility of carrying out a complete surgical resection, and diabetes are the main prognostic factors in this prospective series of patients with MEC. Such findings open new research perspectives on the influence of these components on initial patient care.

Published
2020

4. Cystic form of cervical lymphadenopathy in adults. Guidelines of the French Society of Otorhinolaryngology (short version). Part 2-etiological diagnosis procedure: Clinical and imaging assessment

Author

S. Zerdoud, V. Favier, Laure Santini, R. Abgral, G. Garcia, S. Tronche, Renaud Garrel, F. Benoudiba, A. Bozec, G. Russ, S. Pondaven, E. de Monès, Salvy-Córdoba, Nathalie, Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Institut Gustave Roussy (IGR), Département d'imagerie médicale [Gustave Roussy], Hôpital Augustin Morvan, Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Endocrinologie, Métabolisme et Prévention des Maladies Cardio-vasculaires [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [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 Universitaire de la Face et du Cou [Nice], Société française d'ORL et chirurgie cervico-faciale (SFORL), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Hôpital Pellegrin, and CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin

Subjects
medicine.medical_specialty, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, HPV (human papilloma virus), [SDV]Life Sciences [q-bio], Lymphadenopathy, Physical examination, Thyroid carcinoma, Metastasis of unknown primary, 03 medical and health sciences, 0302 clinical medicine, Cervical lymphadenopathy, MESH: Lymphadenopathy, Medicine, Humans, 030223 otorhinolaryngology, MESH: Humans, medicine.diagnostic_test, business.industry, Cysts, Head and neck squamous cell carcinoma, medicine.disease, Primary tumor, Head and neck squamous-cell carcinoma, [SDV] Life Sciences [q-bio], [SDV.IB.IMA] Life Sciences [q-bio]/Bioengineering/Imaging, Otorhinolaryngology, Nasopharyngeal carcinoma, 030220 oncology & carcinogenesis, Panendoscopy, Surgery, Radiology, medicine.symptom, MESH: Neck, business, MESH: Cysts, Neck
Abstract

Introduction The authors present the guidelines of the French Society of Otorhinolaryngology (SFORL) for clinical and radiological assessment of cystic neck lymphadenopathy of unknown primary in adults. Most cases concern head and neck carcinoma metastasis, often in the oropharyngeal area, or less frequently differentiated thyroid carcinoma or non-keratinizing nasopharyngeal carcinoma. Methods A multidisciplinary task force was commissioned to carry out a review of the literature on the etiological work-up in cystic neck lymphadenopathy in adults: clinical examination, conventional imaging (ultrasound, CT, MRI) and metabolic imaging. Guidelines were drafted based on the articles retrieved, and graded A, B, C or expert opinion according to decreasing level of evidence. Results Oriented clinical examination, cervical and thyroid ultrasound scan and contrast-enhanced neck and chest CT scan are recommended in the assessment of cystic neck lymphadenopathy of unknown primary in adult patients. PET-CT is recommended prior to panendoscopy, to identify the primary tumor. Conclusion Clinical and radiological assessment is fundamental for etiologic diagnosis of cystic neck lymphadenopathy in adult patients, and should be completed by cytological examination before in initiating treatment.

Published
2020

5. Oncologic outcomes, prognostic factor analysis and therapeutic algorithm evaluation of head and neck mucosal melanomas in France

Author

A. Moya-Plana, A. Aupérin, R. Obongo, A. Baglin, F.R. Ferrand, B. Baujat, N. Saroul, O. Casiraghi, S. Vergez, P. Herman, F. Janot, J. Thariat, B. Vérillaud, L. de Gabory, S. Albert, G. Andry, E. Babin, C. Bach, J.-M. Badet, C. Badoual, A.C. Baglin, A. Banal, B. Barry, E. Baudin, R.J. Bensadoun, C. Bertolus, J.-P. Bessède, D. Blanchard, C. Borel, A. Bozorg-Grayeli, R. Breheret, P. Breton, L. Brugel, G. Calais, E. Cassagnau, L. Castillo, P. Ceruse, F. Chabolle, D. Chevalier, J.C. Chobaut, O. Choussy, A. Cosmidis, A. Coste, V. Costes, L. Crampette, V. Darrouzet, P. Demez, P. Dessi, B. Devauchelle, L. Digue, G. Dolivet, F. Dubrulle, S. Duflo, X. Dufour, C. Even, S. Faivre, N. Fakhry, C. Ferron, F. Floret, R. Garrel, L. Geoffrois, L. Gilain, A. Giovanni, A. Girod, B. Guerrier, S. Hans, P. Hofman, M. Housset, R. Jankowski, F. Jegoux, M. Juliéron, M.-C. Kaminsky, F. Kolb, J. Lacau St Guily, L. Laccoureye, B. Lallemant, P. Lang, E. Lartigau, J.-P. Lavieille, M. Lefevre, X. Leroy, O. Malard, F. Massip, O. Mauvais, J.-C. Merol, J. Michel, T. Mom, S. Morinière, E. de Monès, G. Moulin, G. Noel, G. Poissonnet, J.-M. Prades, D. de Raucourt, E. Reyt, C. Righini, Y. Marie Robin, F. Rolland, B. Ruhin, N. Sarroul, P. Schultz, E. Serrano, O. Sterkers, V. Strunski, A. Sudaka, M. Tassart, S. Testelin, A. Timochenko, B. Toussaint, E. Uro Coste, G. Valette, T. Van den Abbeele, A. Varoquaux, F. Veillon, M. Wassef, Institut Gustave Roussy (IGR), Service de biostatistique et d'épidémiologie (SBE), Direction de la recherche clinique [Gustave Roussy], Institut Gustave Roussy (IGR)-Institut Gustave Roussy (IGR), Département de cancérologie cervico-faciale [Gustave Roussy] (CCF), Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Clermont-Ferrand, Laboratorium für Physikalische Chemie (ETH-LPC), Eidgenössische Technische Hochschule - Swiss Federal Institute of Technology [Zürich] (ETH Zürich), French Rare Head and Neck Cancer Expert Network (REFCOR), Service d'Oto-Rhino-Laryngologie (O.R.L.) et de Chirurgie Cervico-Faciale [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), French Rare Head and Neck Cancer Expert Network. (REFCOR), Laboratoire d'études spatiales et d'instrumentation en astrophysique (LESIA), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut national des sciences de l'Univers (INSU - CNRS)-Observatoire de Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), 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], Médecine nucléaire, Département d'imagerie médicale [Gustave Roussy], Service d’ORL et de chirurgie cervico-faciale [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Paul Strauss de Lutte contre le Cancer (Strasbourg), Génétique, immunothérapie, chimie et cancer (GICC), UMR 6239 CNRS [2008-2011] (GICC UMR 6239 CNRS), Université de Tours (UT)-Centre National de la Recherche Scientifique (CNRS), Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), Chambre Régionale d'Agriculture des Pays de la Loire, Service de chirurgie, Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Normandie Université (NU), Service d’Otorhinolaryngologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université de Montpellier (UM), Service d'ORL, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Anthropologie bio-culturelle, Droit, Ethique et Santé (ADES), Aix Marseille Université (AMU)-EFS ALPES MEDITERRANEE-Centre National de la Recherche Scientifique (CNRS), Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie], CHU Amiens-Picardie, Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] (UNICANCER/ICL), UNICANCER, Service de Radiologie (LILLE - Radio), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de médecine gériatrique, CHU de Saint-Etienne, Université Paris 13 (UP13), Hôpital Pellegrin, Service d'ORL et chirurgie cervico-faciale, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service d'ORL et Chirurgie Cervico-Facial, Hôpital de la Timone [CHU - APHM] (TIMONE), Fluides, automatique, systèmes thermiques (FAST), Université Paris-Sud - Paris 11 (UP11)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), Laboratoire Géomatériaux (DGCB-LGM), École Nationale des Travaux Publics de l'État (ENTPE)-Centre National de la Recherche Scientifique (CNRS), Neurobiologie des réseaux sensorimoteurs (NRS (U7060)), Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Centre National de la Recherche Scientifique (CNRS), Centre méditérannéen de médecine moléculaire (C3M), Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Oto-Rhino-Laryngologie et de Chirurgie Cervico-Faciale [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), CHU Pontchaillou [Rennes], Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), University of St Andrews [Scotland], Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille), Université Lille Nord de France (COMUE)-UNICANCER, Centre hospitalier universitaire de Nantes (CHU Nantes), Statistique en grande dimension pour la génomique, Département PEGASE [LBBE] (PEGASE), Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Reims (CHU Reims), Institut d'Electronique du Solide et des Systèmes (InESS), Centre National de la Recherche Scientifique (CNRS), Service d'ORL et de Chirurgie Cervico-Faciale (TOURS - ORL et CCF), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Université de Rennes (UNIV-RENNES), Service de chirurgie oncologique cervico-faciale [centre Antoine Lacassagne, Nice], Centre de Lutte contre le Cancer Antoine Lacassagne [Nice] (UNICANCER/CAL), UNICANCER-Université Côte d'Azur (UCA)-UNICANCER-Université Côte d'Azur (UCA), Department of Otolaryngology and Head and Neck Surgery, University Hospital of Grenoble, BP 217, 38043, Grenoble Cedex 09, France, Université Joseph Fourier - Grenoble 1 (UJF), Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Institut National de la Santé et de la Recherche Médicale (INSERM)-EFS-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF), CRLCC René Gauducheau, CHU Strasbourg-Hôpital de Hautepierre [Strasbourg], Réhabilitation Chirurgicale mini-Invasive et Robotisée de l'Audition, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU), Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), Laboratoire de cristallographie et sciences des matériaux (CRISMAT), École Nationale Supérieure d'Ingénieurs de Caen (ENSICAEN), Normandie Université (NU)-Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Institut de Chimie du CNRS (INC), Department of Head and Neck Surgery, Hôpital Larrey [Toulouse], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Service d'oto-rhino-laryngologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Biomécanique et génie biomédical (BIM), Réseau d’Expertise Français sur les Cancers ORL Rares - French Network of Rare Head and Neck Tumors (REFCOR), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Groupe innovation et ciblage cellulaire (GICC), EA 7501 [2018-...] (GICC EA 7501), Université de Tours (UT), Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Université Nice Sophia Antipolis (1965 - 2019) (UNS), Université de Lille-UNICANCER, Université de Rennes (UR), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN), Normandie Université (NU)-Normandie Université (NU)-École Nationale Supérieure d'Ingénieurs de Caen (ENSICAEN), Normandie Université (NU)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche sur les Matériaux Avancés (IRMA), Normandie Université (NU)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université de Rouen Normandie (UNIROUEN), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS), Les Hôpitaux Universitaires de Strasbourg (HUS), Service Chirurgie maxillo-faciale et plastique de la face [CHU Toulouse], Pôle Céphalique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université de Tours-Centre National de la Recherche Scientifique (CNRS), and Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS)

Subjects
0301 basic medicine, Oncology, Male, Cancer Research, Multivariate analysis, medicine.medical_treatment, 0302 clinical medicine, Paranasal Sinuses, Medicine, Prospective Studies, Stage (cooking), Head and neck, Lymph node, Melanoma, Aged, 80 and over, Mucosal melanoma, Middle Aged, Prognosis, Progression-Free Survival, 3. Good health, Tumor Burden, Survival Rate, medicine.anatomical_structure, Head and Neck Neoplasms, 030220 oncology & carcinogenesis, Female, Mouth Neoplasms, France, Algorithms, Paranasal Sinus Neoplasms, Adult, medicine.medical_specialty, Nose Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, 03 medical and health sciences, Young Adult, Internal medicine, Humans, Sinonasal, Aged, Neoplasm Staging, Radiotherapy, business.industry, Head and neck cancer, Mouth Mucosa, medicine.disease, Otorhinolaryngologic Surgical Procedures, Oral cavity, Radiation therapy, Nasal Mucosa, 030104 developmental biology, Oral Cavity Mucosal Melanoma, Radiotherapy, Adjuvant, business
Abstract

International audience; BACKGROUND:Head and neck mucosal melanoma (HNMM) is aggressive and rare, with a poor prognosis because of its high metastatic potential. The two main subtypes are sinonasal (sinonasal mucosal melanoma [SNMM]) and oral cavity (oral cavity mucosal melanoma [OCMM]). Consensual therapeutic guidelines considering the primary tumour site and tumour-node-metastasis (TNM) stage are not well established.MATERIAL & METHODS:Patients with HNMM from the prospective national French Rare Head and Neck Cancer Expert Network database between 2000 and 2017 were included. Clinical characteristics, treatment modalities, outcomes and prognostic factors were analysed.RESULTS:In total, 314 patients were included. The 5-year overall survival (OS) and progression-free survival (PFS) rates were 49.4% and 24.7%, respectively, in the surgery group; no long-term survivors were observed when surgery was not feasible. Moreover, even after surgery, a high recurrence rate was reported with a median PFS of 22 months. In multivariate analysis, Union for International Cancer Control (UICC) stage and tumour site correlated with PFS and OS. Postoperative radiotherapy (PORT) improved the PFS but not OS in patients with small (T3) SNMM and OCMM tumours. Nodal involvement was more frequent in patients with OCMM (p < 10-4), although, as in SNMM, it was not a significant prognostic predictor.CONCLUSION:Even early HNMM was associated with poor oncologic outcomes due to distant metastases despite surgical resection with clear margins. Lymph node metastases had no impact on the prognosis, suggesting treatment de-escalation in cervical node management. PORT might be useful for local control.

Published
2019

6. Initial staging for squamous cell carcinoma of the mouth, larynx and pharynx (except nasopharynx). Part 3: General assessment. 2012 SFORL recommendations

Author

B. Barry, G. Raoul, J.-F. Chassagne, Frederic Rolland, D. de Raucourt, Sylvain Morinière, M. Langeard, E. de Monès, Cécile Badoual, C.-A. Righini, and Sébastien Vergez

Subjects
Initial staging, medicine.medical_specialty, medicine.medical_treatment, MEDLINE, Pain, Comorbidity, Risk Assessment, Risk Factors, Squamous cell carcinoma, medicine, Humans, Intubation, Stage (cooking), Intensive care medicine, Laryngeal Neoplasms, Neoplasm Staging, Patient Care Team, business.industry, Malnutrition, Anemia, Pharyngeal Neoplasms, Evidence-based medicine, medicine.disease, Dental care, Oral cavity, Surgery, Radiation therapy, Otorhinolaryngology, Carcinoma, Squamous Cell, Pharynx, Interdisciplinary Communication, Mouth Neoplasms, Larynx, business, Risk assessment
Abstract

Summary Objectives The French Society of Otorhinolaryngology (SFORL) set up a work group to draw up guidelines for initial staging of head and neck squamous cell carcinoma. Locoregional and remote extension assessment are dealt with in two separate reports. The present part 3 deals with the assessment of frequent associated symptoms and pathologies, requiring early treatment and the collection of data on a certain number of clinical and paraclinical parameters for therapeutic decision-making in the multidisciplinary team meeting. Materials and methods A multidisciplinary critical analysis of the literature was conducted. General assessment here covers screening, assessment and initial management of the following: usual risk factors (smoking, alcohol, HPV), the most frequent medical comorbidities, nutritional status, social and psychological status, dental status, pain and possible anemia. As oncologic management frequently associates surgery, radiation therapy and chemotherapy, the underlying examinations should be early, as part of initial staging. The levels of evidence for the examinations were estimated so as to grade guidelines, failing which expert consensuses were established. Results The high rates of pain, malnutrition and anemia call for systematic screening and early management, especially as rapidly effective treatments exist. Assessing comorbidity and social and psychological status enables general health status to be assessed, along with possible contraindications to the usual treatments. Tracheal intubation problems may require intubation under flexible endoscopy or jet-ventilation by inter-cricothyroid catheterization from the diagnostic endoscopy stage. Assessment and adapted dental care should be conducted if radiation therapy is likely or certain. Conclusion Early management of symptoms and comorbidity and anticipation of subsequent treatment are intended to shorten initial staging time and to collate the data needed for therapeutic decision-making. This assessment should be performed at the same time as the locoregional and remote extension assessment, and is obviously to be adapted according to tumoral extension stage and the possible treatment options.

Published
2013
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7. Initial staging of squamous cell carcinoma of the oral cavity, larynx and pharynx (excluding nasopharynx). Part 2: Remote extension assessment and exploration for secondary synchronous locations outside of the upper aerodigestive tract. 2012 SFORL guidelines

Author

D. de Raucourt, P.-Y. Salaun, J.-C. Ferrié, Sébastien Vergez, F. Dubrulle, Dominique Chevalier, E. de Monès, Michel Lapeyre, Sylvain Morinière, B. Barry, Stéphane Temam, Philippe Schultz, F. Lagarde, C. Bertolus, S. Tronche, Service d'ORL, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Department of Maxillofacial Surgery, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Department of Nuclear Medicine, Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO)-Université de Brest (UBO), Service de Radiologie (LILLE - Radio), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de Radiologie (POITIERS - Radio), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Département de cancérologie cervico-faciale [Gustave Roussy] (CCF), Institut Gustave Roussy (IGR), Service d'ORL et de Chirurgie Cervico-Faciale (LILLE - ORL et CCF), Department of Head and Neck Surgery, Hôpital Larrey [Toulouse], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Service d'ORL et de Chirurgie Cervico-Faciale (ORLEANS - ORL et CCF), Centre Hospitalier Régional d'Orléans (CHRO), Service d'ORL et de Chirurgie Cervico-Faciale (STRASBOURG - ORL et CCF), CHU Strasbourg, Service de Radiothérapie (CLERMONT FERRAND - Radiothérapie), CHU Clermont-Ferrand, Service d'ORL et de Chirurgie Cervico-Faciale (PARIS - BICHAT - ORL et CCF), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), SFORL (SFORL), SFORL, Service d'Oto-Rhino-Laryngologie (O.R.L.) et de Chirurgie Cervico-Faciale [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Service d'ORL et de Chirurgie Cervico-Faciale (TOURS - ORL et CCF), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Service de Chirurgie Maxillo-Faciale ( PARIS - PSL - Chir Maxillo-Faciale ), Assistance publique - Hôpitaux de Paris (AP-HP), Centre Hospitalier Régional Universitaire de Brest ( CHRU Brest ), Groupe d'Etude de la Thrombose de Bretagne Occidentale ( GETBO ), Université de Brest ( UBO ), Service de Radiologie ( LILLE - Radio ), Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Service de Radiologie ( POITIERS - Radio ), CHU de Poitiers, Département de cancérologie cervico-faciale [Gustave Roussy] ( CCF ), Institut Gustave Roussy ( IGR ), Service d'ORL et de Chirurgie Cervico-Faciale ( LILLE - ORL et CCF ), University Hospital Rangueil-Larrey, Service d'ORL et de Chirurgie Cervico-Faciale ( ORLEANS - ORL et CCF ), Centre Hospitalier Régional d'Orléans ( CHR ), Service d'ORL et de Chirurgie Cervico-Faciale ( STRASBOURG - ORL et CCF ), Service de Radiothérapie ( CLERMONT FERRAND - Radiothérapie ), Service d'ORL et de Chirurgie Cervico-Faciale ( PARIS - BICHAT - ORL et CCF ), Assistance publique - Hôpitaux de Paris (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], SFORL ( SFORL ), Service d'ORL et de Chirurgie Cervico-Faciale ( CAEN - ORL et CCF ), CHU Caen, Service d'ORL et de Chirurgie Cervico-Faciale ( TOURS - ORL et CCF ), and CHRU Tours

Subjects
Larynx, Pathology, MESH: Thoracic Neoplasms, Lung Neoplasms, Esophageal Neoplasms, MESH : Pharyngeal Neoplasms, [SDV]Life Sciences [q-bio], MESH : Mouth Neoplasms, MESH: Laryngeal Neoplasms, Oral cavity, Metastasis, MESH: Magnetic Resonance Imaging, MESH: Mouth Neoplasms, 0302 clinical medicine, Risk Factors, MESH: Risk Factors, Squamous cell carcinoma, MESH : Tomography, X-Ray Computed, MESH : Neoplasm Staging, MESH : Neoplasms, Second Primary, MESH : Endoscopy, MESH : Carcinoma, Squamous Cell, Neoplasm Metastasis, 030223 otorhinolaryngology, Head and neck, MESH: Bronchial Neoplasms, MESH : Laryngeal Neoplasms, MESH : Bronchial Neoplasms, Bronchial Neoplasms, Smoking, Neoplasms, Second Primary, MESH: Carcinoma, Squamous Cell, MESH: Neoplasm Staging, MESH : Thoracic Neoplasms, MESH : Risk Factors, Magnetic Resonance Imaging, MESH: Positron-Emission Tomography, 3. Good health, MESH : Smoking, MESH: Pharyngeal Neoplasms, medicine.anatomical_structure, 030220 oncology & carcinogenesis, MESH : Neoplasm Metastasis, MESH: Esophageal Neoplasms, Carcinoma, Squamous Cell, Fdg pet ct, Mouth Neoplasms, Radiology, MESH: Tomography, X-Ray Computed, CT, MRI, Initial staging, medicine.medical_specialty, MESH: Neoplasms, Second Primary, MESH: Smoking, Alcohol Drinking, Synchronous secondary location, Flexible endoscopy of the esophagus, MESH: Endoscopy, 03 medical and health sciences, MESH : Magnetic Resonance Imaging, medicine, Humans, Basal cell, MESH : Lung Neoplasms, Laryngeal Neoplasms, Neoplasm Staging, MESH: Humans, [ SDV ] Life Sciences [q-bio], business.industry, MESH : Humans, Pharynx, MESH : Positron-Emission Tomography, Endoscopy, Pharyngeal Neoplasms, Thoracic Neoplasms, MESH: Neoplasm Metastasis, FDG-PET/CT, MESH: Lung Neoplasms, MESH : Alcohol Drinking, Upper aerodigestive tract, Otorhinolaryngology, Positron-Emission Tomography, Surgery, MESH : Esophageal Neoplasms, business, Tomography, X-Ray Computed, MESH: Alcohol Drinking
Abstract

International audience; OBJECTIVES: This report presents the French Society of ORL (SFORL) guidelines for exploration for remote metastasis and synchronous second cancer in initial staging of head and neck squamous cell carcinoma. MATERIALS AND METHODS: An exhaustive literature review was analyzed by a multidisciplinary work-group. RESULTS: The thorax is the most frequent location of remote metastases and synchronous second cancer outside of the upper aerodigestive tract. Thoracic CT is recommended as first-line examination in all cases (grade B). 18-FDG PET/CT is recommended when the thoracic CT image is doubtful or in case of high metastatic risk (grade B), for the detection of non-pulmonary remote metastasis. Esophageal exploration is recommended in case of significant risk of synchronous esophageal cancer (hypopharyngeal or oropharyngeal tumor, chronic alcohol intoxication) (grade B). The reference examination is flexible endoscopy of the upper digestive tract (grade B). CONCLUSION: The present grade B recommendations rationalize the roles of the various first-line radiological and endoscopic examinations for remote metastasis and synchronous second cancer, so as to limit the number of examinations performed, thereby reducing the time needed for initial staging.

Published
2013
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8. Management of the Neck in the Setting of Definitive Chemoradiation: Is There a Consensus? A GETTEC Study

Author

C. Ferron, C.-A. Righini, René-Jean Bensadoun, Jean-Michel Prades, D. Salvan, Marc Poupart, Xavier Dufour, Franck Jegoux, G. Dollivet, O. Choussy, Benjamin Lallemant, Pierre-Olivier Vedrine, D. de Raucourt, C. Scavennec, Yann Mallet, J. Lacau-Saint-Guily, Bertrand Baujat, Olivier Dassonville, Nicolas Guevara, P. Lindas, Olivier Malard, Philippe Ceruse, Sébastien Vergez, Georges Lawson, Juliette Thariat, E. de Monès, Adil Benlyazid, Alain Cosmidis, J.-C. Merol, Renaud Garrel, Marc Hamoir, Janot, S. Duflo, and Sylvain Morinière

Subjects
medicine.medical_specialty, Consensus, medicine.medical_treatment, Context (language use), Surgical oncology, Carcinoma, Humans, Medicine, Practice Patterns, Physicians', medicine.diagnostic_test, business.industry, Induction chemotherapy, Radiotherapy Dosage, Neck dissection, Induction Chemotherapy, Prognosis, medicine.disease, Combined Modality Therapy, Head and neck squamous-cell carcinoma, Surgery, Oncology, Docetaxel, Head and Neck Neoplasms, Positron emission tomography, Positron-Emission Tomography, Carcinoma, Squamous Cell, Neck Dissection, Tomography, X-Ray Computed, business, medicine.drug
Abstract

Background. The management of the neck remains controversial in the definitive chemoradiation setting of advanced N2-3 head and neck squamous cell carcinoma. Most published data favor omission of neck dissection (ND) after complete response for N2-3 or selective ND for residual disease Methods. We studied the patterns of care in the French-Belgian Groupe d'Etude des Tumeurs de la Tete Et du Cou (GETTEC) through a questionnaire-based survey. Results. Eighteen percent of institutions never performed up-front ND, 20% rarely, 40% sometimes, 14% often, and 8% systematically. Induction chemotherapy was indicated in 30% of the cases, and most ND were performed either between induction and radiation or after chemoradiation for residual disease. Response to chemoradiation was assessed by computed tomographic scan and positron emission tomography in 72% of cases. Selective ND was more common than radical ND. Conclusions. Omission of ND based on computed tomographic scan and positron emission tomography-based complete response to chemoradiation is the most common strategy for advanced nodal disease among centers. However, neck management strategies vary among institutions, and some institutions continue advocating systematic ND before irradiation. The new treatment options and the changing epidemiology, namely docetaxel-based induction chemotherapy and human papilloma virus-related head and neck squamous cell carcinoma having better response profiles and prognosis, are adding to the nonconsensual approach. The best therapeutic index in terms of neck management remains to be defined in this evolving context. © 2012 Society of Surgical Oncology.

Published
2012

9. Dent et irradiation : denture et conséquences sur la denture de la radiothérapie des cancers de la tête et du cou

Author

J. Santini, A. Bozec, Olivier Dassonville, Gilles Poissonnet, Vincent Darcourt, P.-Y. Marcy, E. de Monès, Charles Savoldelli, G. Odin, René-Jean Bensadoun, Juliette Thariat, Nicolas Guevara, and Cécile Ortholan

Subjects
medicine.medical_specialty, business.industry, Osteoradionecrosis, medicine.medical_treatment, Head and neck cancer, Dentistry, 030206 dentistry, medicine.disease, Dental care, 3. Good health, Surgery, Cancer treatment, Radiation therapy, stomatognathic diseases, 03 medical and health sciences, 0302 clinical medicine, stomatognathic system, Oncology, 030220 oncology & carcinogenesis, Oral and maxillofacial pathology, medicine, Radiology, Nuclear Medicine and imaging, Major complication, business, Complication
Abstract

Pre-irradiation dental care depends on teeth health, fields and dose of irradiation, compliance to fluorides, cessation of tobacco and psychosocial cofactors. Dental care aims at preventing complications and preserving the quality of life (eating, speech and aesthetics). Approximately 11% of patients do not require any pre-irradiation dental care. Dental complications vary from slight colorations of the teeth to major complication such as osteoradionecrosis. Osteoradionecrosis rates vary from 1 to 9%, and may be decreased by using a 21-day delay between extractions and irradiation, provided that it does not postpone cancer treatment, with a dose-dependent risk ( or =20% if >60 Gy). Osteoradionecrosis occurs spontaneously (35%), mostly involves the mandibula (85%).

Published
2010

10. Dent et irradiation : prévention et traitement des complications dentaires de la radiothérapie y compris l’ostéoradionécrose

Author

P.-Y. Marcy, Vincent Darcourt, J. Santini, Nicolas Guevara, Cécile Ortholan, A. Bozec, René-Jean Bensadoun, Olivier Dassonville, Juliette Thariat, Gilles Poissonnet, and E. de Monès

Subjects
medicine.medical_specialty, Reconstructive surgery, Osteoradionecrosis, business.industry, medicine.medical_treatment, Head and neck cancer, Dentistry, medicine.disease, Surgery, Radiation therapy, stomatognathic diseases, Oncology, Quality of life, Oral and maxillofacial pathology, medicine, Radiology, Nuclear Medicine and imaging, Complication, business, Psychosocial
Abstract

Pre-irradiation dental care depends on teeth health, fields and dose of irradiation, compliance to fluorides, cessation of tobacco and psychosocial cofactors. Dental care aims at preventing complications and preserving the quality of life (eating, speech, and aesthetics). The role of hyperbaric oxygenotherapy for the prevention of osteoradionecrosis after teeth removal on the mandibula in areas receiving 50 Gy or more is still controversial. Medical treatments may be sufficient for early stages of osteoradionecrosis (antibiotics, pain killers, non-steroidal anti-inflammatory drugs as well as clodronate, vitamin E, pentoxifyllin). However, reconstructive surgery should not be delayed in advanced stages of osteoradionecrosis. New irradiation techniques are changing dose distributions and therefore require close collaboration between odonto-stomatologists and radiation oncologists to define the best dental care.

Published
2010

11. État des lieux sur les carcinomes basaloïdes ORL

Author

J. Klijanienko, Cécile Badoual, J. Lacau Saint-Guily, C.-A. Righini, J. Santini, E. de Monès, C. Faure, Juliette Thariat, Catherine Butori, Gilles Poissonnet, S. Faivre, and Philippe Maingon

Subjects
Oncology, Cancer Research, medicine.medical_specialty, Pathology, medicine.medical_treatment, Cell, Metastasis, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Radiology, Nuclear Medicine and imaging, 030304 developmental biology, 0303 health sciences, Chemotherapy, PET-CT, business.industry, Head and neck cancer, Cancer, Hematology, General Medicine, medicine.disease, Head and neck squamous-cell carcinoma, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Concomitant, business
Abstract

Basaloid squamous cell carcinomas (SCC) are a rare variant of SCC of the head and neck. Their histological characteristics have been described by Wain in 1986 and are reported in the 2005 WHO classification. A poorer prognosis of BSCC has been reported. Two recent case-control studies have shown a higher rate of distant metastases (15-40%, mean over 30%). Conversely, BSCC have similar or better locoregional control rates, a relatively good radiosensitivity and locoregional control. The role of chemotherapy in the neoadjuvant, concomitant or adjuvant setting needs to be redefined due to high metastatic failure rates; chest CT or PET CT are recommended at baseline and every 6-month during follow-up. Some subgroups of BSCC (oropharynx in particular) are more likely to be associated with oncogenic human papilloma virus HPV16. The determination of BSCC head and neck subgroups by HPV status is critical for the prognosis. The basaloid sub-type of squamous cell carcinomas owing to its particular behavior, should be taken into account while deciding the optimal therapeutic strategy.

Published
2009

12. Le lambeau musculomuqueux de buccinateur pédiculé sur l’artère faciale : technique de prélèvement et indications

Author

H.K. Tan, Frédéric Kolb, T. Ayad, Gérard Mamelle, Stéphane Temam, and E. De Monès

Subjects
Gynecology, Pedicle flap, medicine.medical_specialty, media_common.quotation_subject, medicine, Surgery, Art, media_common
Abstract

Resume Objectifs Decrire l’anatomie et la technique de prelevement du lambeau musculomuqueux de buccinateur de l’artere faciale (lambeau de FAMM), ainsi que ses indications dans la chirurgie reconstructrice cervicofaciale. Methodes Revue retrospective de notre experience et revue de la litterature. Resultats Decrit en 1992 par Pribaz et al. [Plast Reconstr Surg 90 (1992) 421–9], le lambeau de FAMM est pedicule sur l’artere faciale et la base peut etre superieure ou inferieure en fonction de la region a reconstruire. Le drainage veineux s’effectue generalement par les veinules du plexus buccal plutot que par la veine faciale. Dans notre experience, le lambeau de FAMM a ete utilise essentiellement pour des deficits muqueux au niveau de la cavite orale suite a l’exerese de cancers. D’autres indications ont ete le recouvrement de deficits localises dans l’oropharynx, la fosse nasale et l’orbite ainsi que pour recouvrir des zones d’osteoradionecrose mandibulaire. Conclusions La technique de prelevement du lambeau de FAMM est simple et fiable. Les possibilites de reconstruction sont variees dans la region cervicofaciale.

Published
2008

13. Morbidity and mortality revue of the French group of transoral robotic surgery: a multicentric study

Author

Philippe Ceruse, Gilles Dolivet, Karine Aubry, E. de Monès, Olivier Malard, Sébastien Vergez, Benjamin Lallemant, O. Choussy, Sylvain Morinière, Service d'Oto-rhino-laryngologie (ORL) et chirurgie cervico-faciale [CHU Limoges], CHU Limoges, CHU Toulouse [Toulouse], Service d'ORL, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Service ORL et chirurgie cervico-faciale [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau, Service d'ORL, chirurgie cervico-faciale [Rouen], Hôpital Charles Nicolle [Rouen]-CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Centre hospitalier universitaire de Nantes (CHU Nantes), Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] (UNICANCER/ICL), UNICANCER, Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Service d’Otorhinolaryngologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), and Hôpital Bretonneau-Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)

Subjects
Larynx, Male, medicine.medical_specialty, Fistula, medicine.medical_treatment, Health Informatics, Aspiration pneumonia, Head and neck cancers, 03 medical and health sciences, 0302 clinical medicine, Tracheotomy, Postoperative Complications, da Vinci robot, Robotic Surgical Procedures, Transoral robotic surgery, medicine, Humans, Mortality, Risk factor, Stage (cooking), 030223 otorhinolaryngology, Intraoperative Complications, Aged, Retrospective Studies, business.industry, Retrospective cohort study, Length of Stay, Middle Aged, medicine.disease, 3. Good health, Surgery, medicine.anatomical_structure, Head and Neck Neoplasms, 030220 oncology & carcinogenesis, Female, Morbidity, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; Transoral robotic assisted surgery (TORS) represents an innovative endoscopic therapeutic alternative in the treatment of head and neck tumors. Many publications favor this surgery, especially in terms of functional results. The aim of this study was to investigate the TORS morbidity and mortality and to identify the risk factors for complications. It is a multicenter retrospective study. All head and neck tumor patients treated by TORS were included in the study over a period of 5 years (2009-2014). The studied parameters were the intraoperative and post-operative complications including hemorrhage, fistula, tracheotomy, aspiration pneumonia and death. The parameters were correlated with age, tumor location, tumor stage, endoscopic exposure and patient's co-morbidities. 178 patients were included in the study. Malignant tumors classified as T1 were found in 169 cases (n = 51), T2 (n = 100), T3 (n = 16) and T4 (n = 2). The tumor locations were distributed as follows: larynx (n = 84), oropharynx (n = 51), and hypopharynx (n = 43). Fifty-three patients followed post-radiation therapy. We observed 12 intraoperative complications including 6 hemorrhage, 3 pharyngeal fistulas and 3 external surgical conversions. Postoperatively, we detected 33 hemorrhage, 27 aspiration pneumonia, 9 tracheostomy, 2 pharyngostomes, 2 cervical spondylitis and 2 deaths. The risk factors identified were (i) anticoagulant and/or antiplatelet therapy for hemorrhage, (ii) tumoral stage and the laryngeal location for aspiration pneumonia and (iii) laryngeal location for tracheostomy. Higher age over 65 years has been identified as a risk factor for all post-operative complications. TORS is a safe technique for the treatment of head and neck tumors. We identified some risk factors for complications which should systematically be studied in order to reduce its morbidity.

Published
2015

14. Study of the concordance between p16 immunohistochemistry and HPV-PCR genotyping for the viral diagnosis of oropharyngeal squamous cell carcinoma

Author

C. Majoufre-Lefebvre, V. Castetbon, H. Fleury, E. de Monès, S. Cherrière, D. Fonmarty, and S. Eimer

Subjects
Oncology, Male, HPV, medicine.medical_specialty, Pathology, Genotype, Concordance, Polymerase Chain Reaction, Sensitivity and Specificity, Human Papillomavirus DNA Tests, Cohen's kappa, Predictive Value of Tests, Risk Factors, Internal medicine, medicine, Biomarkers, Tumor, Prevalence, Humans, Prospective Studies, Prospective cohort study, Genotyping, Cyclin-Dependent Kinase Inhibitor p16, Neoplasm Staging, Oropharyngeal cancer, Human papillomavirus 16, business.industry, Papillomavirus Infections, P16, Cancer, Reproducibility of Results, Middle Aged, medicine.disease, Prognosis, Immunohistochemistry, Neoplasm Proteins, Clinical trial, Oropharyngeal Neoplasms, PCR, medicine.anatomical_structure, Otorhinolaryngology, Tonsil, DNA, Viral, Carcinoma, Squamous Cell, Surgery, Female, France, Neoplasm Grading, business
Abstract

Objective The diagnosis of HPV-related oropharyngeal cancer in clinical practice is based on p16 immunohistochemistry and PCR detection of viral DNA (HPV-PCR). The primary objective of this study was to evaluate the concordance between these 2 diagnostic tests. The secondary objective was to study the clinical characteristics of these patients. Materials and methods This single-centre prospective study was conducted between February 2010 and July 2012. Immunohistochemical analysis of p16 and HPV-PCR were performed on tumour biopsies. Concordance was evaluated according to Cohen's kappa coefficient and was interpreted according to the Landis and Koch scale. The patients’ clinical data were analysed as a function of the diagnostic test results. Results Seventy-one patients were included in this study. The prevalence of HPV was 43.7% according to p16 and 31% according to HPV-PCR. The concordance study revealed a kappa coefficient of 0.615. A tumour of the tonsil or base of the tongue was detected in 100% of p16+/HPV-PCR+ cases. Smoking and alcohol abuse were significantly less frequent among HPV+ patients regardless of the method of detection. These patients were older and presented tumours with a lower grade of histological differentiation. Conclusion p16 immunohistochemistry or HPV-PCR used alone appear to be insufficient. These results confirm the high prevalence of HPV-related oropharyngeal squamous cell carcinoma (OSCC) and the previously reported specific clinical and histological features, apart from age. It appears essential for future clinical trials to be stratified according to smoking and tumour HPV status, defined by means of reliable virological tests targeting E6/E7 mRNA and no longer a simple positive response to the p16 marker, as is frequently the case at the present time. New tests suitable for use in routine practice therefore need to be developed.

Published
2015

15. Initial staging of squamous cell carcinoma of the oral cavity, larynx and pharynx (excluding nasopharynx). Part I: Locoregional extension assessment: 2012 SFORL guidelines

Author

S. Tronche, Stéphane Temam, J.-C. Ferrié, D. de Raucourt, Michel Lapeyre, C.-A. Righini, E. de Monès, Pierre-Yves Salaun, Sylvain Morinière, F. Lagarde, Sébastien Vergez, F. Dubrulle, B. Barry, Dominique Chevalier, Cécile Badoual, Chloé Bertolus, Philippe Schultz, Department of Head and Neck Surgery, Hôpital Larrey [Toulouse], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Service d'ORL et de Chirurgie Cervico-Faciale (TOURS - ORL et CCF), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Service de Radiologie (LILLE - Radio), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Department of Nuclear Medicine, Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Department of Maxillofacial Surgery, CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Département de cancérologie cervico-faciale [Gustave Roussy] (CCF), Institut Gustave Roussy (IGR), Service d'ORL et de Chirurgie Cervico-Faciale (LILLE - ORL et CCF), Service d'ORL et de Chirurgie Cervico-Faciale (ORLEANS - ORL et CCF), Centre Hospitalier Régional d'Orléans (CHRO), Service d'ORL et de Chirurgie Cervico-Faciale (STRASBOURG - ORL et CCF), CHU Strasbourg, Service de Radiothérapie (CLERMONT FERRAND - Radiothérapie), CHU Clermont-Ferrand, Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Grenoble, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, Service d'ORL et de Chirurgie Cervico-Faciale (PARIS - BICHAT - ORL et CCF), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), SFORL (SFORL), SFORL, Service d'Oto-Rhino-Laryngologie (O.R.L.) et de Chirurgie Cervico-Faciale [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), University Hospital Rangueil-Larrey, Service d'ORL et de Chirurgie Cervico-Faciale ( TOURS - ORL et CCF ), CHRU Tours, Service de Radiologie ( LILLE - Radio ), Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Centre Hospitalier Régional Universitaire de Brest ( CHRU Brest ), Groupe d'Etude de la Thrombose de Bretagne Occidentale ( GETBO ), Université de Brest ( UBO ), Service de Chirurgie Maxillo-Faciale ( PARIS - PSL - Chir Maxillo-Faciale ), Assistance publique - Hôpitaux de Paris (AP-HP), Département de cancérologie cervico-faciale [Gustave Roussy] ( CCF ), Institut Gustave Roussy ( IGR ), Service d'ORL et de Chirurgie Cervico-Faciale ( LILLE - ORL et CCF ), Service d'ORL et de Chirurgie Cervico-Faciale ( ORLEANS - ORL et CCF ), Centre Hospitalier Régional d'Orléans ( CHR ), Service d'ORL et de Chirurgie Cervico-Faciale ( STRASBOURG - ORL et CCF ), Service de Radiothérapie ( CLERMONT FERRAND - Radiothérapie ), Institut d'oncologie/développement Albert Bonniot de Grenoble ( INSERM U823 ), Université Joseph Fourier - Grenoble 1 ( UJF ) -CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Joseph Fourier - Grenoble 1 ( UJF ) -CHU Grenoble, Service d'ORL et de Chirurgie Cervico-Faciale ( PARIS - BICHAT - ORL et CCF ), Assistance publique - Hôpitaux de Paris (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], SFORL ( SFORL ), Service d'ORL et de Chirurgie Cervico-Faciale ( CAEN - ORL et CCF ), CHU Caen, Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO)-Université de Brest (UBO), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Institut National de la Santé et de la Recherche Médicale (INSERM)-EFS-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF)

Subjects
Larynx, MESH : Pharyngeal Neoplasms, MESH: Lymphatic Metastasis, [SDV]Life Sciences [q-bio], MESH : Mouth Neoplasms, MESH: Laryngeal Neoplasms, MESH : Neoplasms, Multiple Primary, Oral cavity, MESH : Neoplasm Invasiveness, MESH : Narrow Band Imaging, MESH: Magnetic Resonance Imaging, Neoplasms, Multiple Primary, MESH: Mouth Neoplasms, Narrow Band Imaging, 0302 clinical medicine, Squamous cell carcinoma, MESH: Cooperative Behavior, MESH: Narrow Band Imaging, Medicine, MESH: Microscopy, Confocal, MESH: Neoplasms, Multiple Primary, MESH : Neoplasm Staging, MESH : Endoscopy, Cooperative Behavior, MESH : Carcinoma, Squamous Cell, 030223 otorhinolaryngology, MESH: Multidetector Computed Tomography, MESH : Laryngeal Neoplasms, MESH : Evidence-Based Medicine, Evidence-Based Medicine, Microscopy, Confocal, MESH : Prognosis, medicine.diagnostic_test, MESH : Lymphatic Metastasis, MESH: Carcinoma, Squamous Cell, MESH: Neoplasm Staging, MESH : Cooperative Behavior, Prognosis, Magnetic Resonance Imaging, MESH : Interdisciplinary Communication, 3. Good health, MESH: Pharyngeal Neoplasms, medicine.anatomical_structure, Lymphatic Metastasis, 030220 oncology & carcinogenesis, Carcinoma, Squamous Cell, Disease Progression, Mouth Neoplasms, MESH: Disease Progression, MESH: Interdisciplinary Communication, France, MESH : Multidetector Computed Tomography, medicine.medical_specialty, Tomodensitometry, MESH: Prognosis, MESH: Endoscopy, 03 medical and health sciences, MESH : Magnetic Resonance Imaging, Multidetector Computed Tomography, Carcinoma, Humans, Neoplasm Invasiveness, Basal cell, MESH : Microscopy, Confocal, MESH : France, Laryngeal Neoplasms, Neoplasm Staging, MESH: Humans, [ SDV ] Life Sciences [q-bio], business.industry, MESH : Humans, Head and neck cancer, Pharynx, Pharyngeal Neoplasms, Endoscopy, MESH : Disease Progression, Evidence-based medicine, MESH: Neoplasm Invasiveness, medicine.disease, Surgery, MESH: France, Otorhinolaryngology, Interdisciplinary Communication, business, MESH: Evidence-Based Medicine
Abstract

International audience; OBJECTIVES: To set out good practice guidelines for locoregional extension assessment of squamous cell carcinoma of the head and neck (excluding nasopharynx, nasal cavities and sinuses). MATERIALS AND METHODS: A critical multidisciplinary review of the literature on locoregional extension assessment of squamous cell carcinoma of the head and neck was conducted, applying levels of evidence in line with the French health authority's (HAS) literature analysis guide of January 2000. CONCLUSION: Based on the levels of evidence of the selected articles and on work-group consensus, graded guidelines are set out for clinical, endoscopic and imaging locoregional extension assessment of head and neck cancer.

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