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IntroductionSarcomas are rare tumours of connective tissue. The exact overall incidence of sarcomas is unknown due to diagnostic difficulties and the various histological subtypes (over 80 subtypes). However, the apparent increasing incidence of sarcomas suggests environmental causes such as pesticides. Except for some specific factors (ie, ionising radiation, vinyl chloride, dioxin and genetic predispositions) the scientific knowledge on the aetiology of sarcomas is sparse and inconsistent. France is a particularly appropriate country to set up a study investigating the causes of sarcoma occurrence due to the French organisation in treatment and care of sarcoma patients, which is highly structured and revolved around national expert networks. The main objective of the ETIOlogy of SARcomas (ETIOSARC) project is to study the role of lifestyle, environmental and occupational factors in the occurrence of sarcomas among adults from a multicentric population-based case–control study.Methods and analysisCases will be all incident patients (older than 18 years) prospectively identified in 15 districts of France covered by a general population-based cancer registry and/or a reference centre in sarcoma’s patient care over a 3-year period with an inclusion start date ranging from February 2019 to January 2020 and histologically confirmed by a second review of the diagnosis. Two controls will be individually matched by sex, age (5 years group) and districts of residence and randomly selected from electoral rolls. A standardised questionnaire will be administered by a trained interviewer in order to gather information about occupational and residential history, demographic and socioeconomic characteristics and lifestyle factors. At the end of the interview, a saliva sample will be systematically proposed. This study will permit to validate or identify already suspected risk factors for sarcomas such as phenoxyherbicides, chlorophenol and to generate new hypothesis to increase our understanding about the genetic and environmental contributions in the carcinogenicity process.Ethics and disseminationThe present study is promoted by the French National Institute of Health and Medical Research (identification number C17-03). This study received National French Ethic committee (CPP Sud Méditerrannée I) approval (identification number 18-31) and French Data Protection Authority (CNIL) approval (identification number 918171). Results of this study will be published in international peer-reviewed journals. Technical appendix, statistical code and dataset will be available in the Dryad repository when collection data are completed.Trial registration numberNCT03670927.

La prise en charge du cancer colorectal a change ces quinze dernieres annees. Ces changements reposent en partie sur des evolutions dans le domaine de l’anatomie pathologique, tant morphologique que moleculaire. Elles se declinent aux plans pronostique et predictif. Le but de cet article est de souligner quelques changements majeurs ayant eu lieu dans le domaine de l’anatomie pathologique des cancers colorectaux depuis le dernier millenaire.

La valeur pronostique de l’activateur de type urokinase du plasminogene (uPA) et de son inhibiteur (PAI-1) dans les cancers du sein sans envahissement ganglionnaire a ete etablie avec un niveau de preuve maximum (level of evidence I) [1]. Il est, avec les recepteurs hormonaux et le statut HER2, le seul test decisionnel sur la mise en place des traitements adjuvants, recommande au niveau international et accessible en pratique clinique de routine en Europe. L’independance de l’information apportee par le test uPA-PAI-1 analyse prospectivement et la correlation avec les autres parametres clinicopathologiques a ete etudiee sur une population atteinte de cancers du sein operes au centre val d’Aurelle-Paul Lamarque entre janvier 2006 et decembre 2009.

To evaluate the best strategy for treatment of sarcoma that occurs after radiation therapy.Records were retrospectively reviewed for 80 patients with a confirmed histologic diagnosis of sarcoma that occurred after radiation therapy performed during 1975-1995. The patients were treated for breast cancer (n = 33, 42%), non-Hodgkin lymphoma (n = 9, 11%), cervical cancer (n = 9, 11%), benign lesions (n = 4, 5%), or other tumors (n = 25, 31%). Sarcoma occurred after a mean latency of 12 years (range, 3-64 years), with most (70%) developing in the soft tissue. Treatment included surgery (28 patients), surgery and chemotherapy (18 patients), chemotherapy only (15 patients), and radiation therapy (14 patients).By the end of the study, 51 patients were dead, including 46 due to sarcoma. Median survival was 23 months. Overall survival rates at 2 and 5 years, respectively, were 69% and 39% for patients treated with surgery, 10% and 0% for those treated with chemotherapy, and 52% and 35% for those treated with surgery and chemotherapy (P =.001). The 2- and 5-year rates for survival without recurrence were 54% and 32%, respectively.The results confirm the beneficial effect of surgery. Further study is needed to explore the roles of combined treatments.