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Resume Objectif Le cancer du sein associe a la grossesse est une entite complexe tant sur le plan diagnostique que therapeutique, une approche multidisciplinaire est donc essentielle. Un nomogramme predictif de la recidive a 36 mois des CSAG a recemment ete developpe, l’objectif etait de l’evaluer sur une cohorte independante. Methode Il s’agit d’une etude retrospective monocentrique incluant toutes les patientes atteintes d’un CSAG entre janvier 2004 et mars 2018. Une analyse de survie sans recidive a ete realisee par la methode de Kaplan–Meier. La performance du nomogramme a ete analysee sur 3 indicateurs : la discrimination par une courbe ROC (receiver operator characteristic), le calibrage et le benefice clinique net par une courbe d’analyse de decision. Resultat Quarante et une patientes ont ete incluses. La survie sans recidive a 3 ans etait de 83 %. La discrimination du nomogramme etait jugee acceptable avec un index de concordance de l’aire sous la courbe a 0,78. Le modele etait correctement calibre (p = 0,44). L’analyse de la courbe de decision revele un benefice net positif pour un seuil de probabilite de recidive compris entre 5 et 35 %. Conclusion La performance de ce modele de prediction est acceptable mais le benefice clinique net est faible. Predire le risque de recidive reste un challenge et des outils plus precis sont necessaires.

International audience; Non-tubal ectopic pregnancies can be located in the uterine portion of the tube (interstitial or cornual), in the cervix (cervical), in a cesarian scar, in the ovary, or intra-abdominally. Even though they are rare, they are associated with a high mortality. Invasive surgeries such as cornuectomy and hysterectomy were common to treat them in case of hemorrhage. Thanks to recent advances in imaging techniques, diagnosis of non-tubal ectopic pregnancy is made earlier and conservative management has been developed in order to respect fertility of patients. Beyond these treatments, systemic or local injection of Methotrexate shows very good success.In the article, we aimed to describe the technics of vaginal injection of in situ methotrexate with ultrasound guidance.

Introduction Mucosal melanomas (MM) of the female genital tract are rare a. We aimed to study the prognostic factors of vulvar and vaginal locations of MM. Material and method A multicenter, retrospective cohort study conducted between 01/01/2000 and 01/06/2019. Result Of the 33 patients included 25 (75.8 %) had vulvar (VuM) and eight (24.2 %) vaginal melanomas (VaM). VaMs were deeper: median Breslow index: 17.5 mm [3.5−22] versus 4.3 mm [0.35−18] (p = 0.013). Average follow-up was 24.0 ± 59.8 months. Twenty-six patients (78.8 %) experienced recurrence. Disease-free survival was 52.9 % at 1 year (64.7 % for VuM and 14.3 % for VaM) and 8.4 % at 3 years (11 % for VuM and 0% for VaM) (p = 0.002). Median time to the first recurrence was 9.01 months [CI95 %: 2.07–56.71]. VaM recurred earlier than VuM (3.12 months [CI95 %: 2.07–12.49] versus 17.72 [CI95 %: 3.58–56.71], p = 0.011). VaM had a higher risk of recurrence (HR = 5.64 [CI95 %: 2.01–15.82], p = 0.001) in multivariate analysis. Overall survival was 88.5 % at 1 year (100 % for VuM and 50 % for VaM), and 59.4 % at 3 years (69.3 % for VuM and 25 % for VaM). Women with VaM died earlier: median specific death occurrence of 8.76 months [CI95 %: 6.54–24.72] versus 39.61 [CI95 %: 21.89–209.21], p = 0.013 (HR = 5.08 [CI95 %: 1.39–18.60], p = 0.014). A lesion size ≥3 cm was associated with an increased risk of mortality (HR = 8.45 [CI95 %: 1.60–44.52], p = 0.012). In multivariate analysis, vaginal location remained an independent and predictive variable of a higher risk of specific death (HR = 8.56 [CI95 %: 1.95–37.64], p = 0.005). Conclusion A vaginal location of MM is associated with a poorer prognosis than a vulvar location.