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1. Suprapubic versus transurethral catheterization for bladder drainage in male rectal cancer surgery (GRECCAR10), a randomized clinical trial

Author

Trilling, B., Tidadini, F., Lakkis, Z., Jafari, M., Germain, A., Rullier, E., Lefevre, J., Tuech, J. J., Kartheuser, A., Leonard, D., Prudhomme, M., Piessen, G., Regimbeau, J. M., Cotte, E., Duprez, D., Badic, B., Panis, Y., Rivoire, M., Meunier, B., Portier, G., Bosson, J. L., Vilotitch, A., Foote, A., Caspar, Y., Rouanet, P., and Faucheron, J. L.

Published
2024
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3. Hypermethylation of the 5′ CpG island of the p14ARF flanking exon 1β in human colorectal cancer displaying a restricted pattern of p53 overexpression concomitant with increased MDM2 expression

Author

Nyiraneza Christine, Sempoux Christine, Detry Roger, Kartheuser Alex, and Dahan Karin

Subjects
Medicine, Genetics, QH426-470
Abstract

Abstract Background It has been suggested that inactivation of p14ARF, a tumor suppressor central to regulating p53 protein stability through interaction with the MDM2 oncoprotein, abrogates p53 activity in human tumors retaining the wild-type TP53 gene. Differences in expression of tumor suppressor genes are frequently associated with cancer. We previously reported on a pattern of restricted p53 immunohistochemical overexpression significantly associated with microsatellite instability (MSI), low TP53 mutation frequency, and MDM2 overexpression in colorectal cancers (CRCs). In this study, we investigated whether p14ARF alterations could be a mechanism for disabling the p53 pathway in this subgroup of CRCs. Results Detailed maps of the alterations in the p14ARF gene were determined in a cohort of 98 CRCs to detect both nucleotide and copy-number changes. Methylation-specific PCR combined with bisulfite sequencing was used to evaluate the prevalence and distribution of p14ARF methylation. p14ARF alterations were then correlated with MSI status, TP53 mutations, and immunohistochemical expression of p53 and MDM2. The frequency of p14ARF mutations was extremely low (1/98; 1%), whereas coexistence of methylated and unmethylated alleles in both tumors and normal colon mucosa was common (91/98; 93%). Only seven of ninety-eight tumors (7%) had a distinct pattern of methylation compared with normal colon mucosa. Evaluation of the prevalence and distribution of p14ARF promoter methylation in a region containing 27 CpG sites in 35 patients showed a range of methylated CpG sites in tumors (0 to 25 (95% CI 1 to 13) versus 0 to 17 (95% CI 0 to 2)) in adjacent colon mucosa (P = 0.004). Hypermethylation of the p14ARF promoter was significantly correlated with the restricted p53 overexpression pattern (P = 0.03), and MDM2 overexpression (P = 0.02), independently of MSI phenotype. Although no significant correlation between p14ARF methylation and TP53 mutational status was seen (P = 0.23), methylation involving the proximal CpG sites within the 5′ CpG flanking exon 1β was present more frequently in tumors with restricted p53 overexpression than in those with diffuse p53 overexpression (range of methylated clones 17 to 36% (95% CI 24 to 36%) versus range 0 to 3% (95% CI 0 to 3%), P = 0. 0003). Conclusion p14ARF epigenetic silencing may represent an important deregulating mechanism of the p53-MDM2-p14ARF pathway in CRCs exhibiting a restricted p53 overexpression pattern.

Published
2012
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4. The ladies trial: laparoscopic peritoneal lavage or resection for purulent peritonitisA and Hartmann's procedure or resection with primary anastomosis for purulent or faecal peritonitisB in perforated diverticulitis (NTR2037)

Author

Bruin Sjoerd C, Mannaerts Guido HH, Cense Huib A, Blanken-Peeters Charlotte FJM, Neijenhuis Peter A, Karsten Thomas M, Hoofwijk Anton GM, Gerhards Michael F, van Duijn Eino B, Consten Esther CJ, Slooter Gerrit D, Coene Peter-Paul LO, van Wagensveld Bart A, Tollenaar Rob AEM, Stockmann Hein BAC, Prins Hubert A, Pierik Robert EGJM, Weidema Wibo F, de Graaf Eelco JR, Steup Willem H, Swank Dingeman J, Kruyt Philip M, Boom Maarten J, Bosker Robbert JI, Nienhuijs Simon W, Sosef Meindert N, Crolla Rogier MPH, Stassen Laurents PS, van der Hoeven Joost AB, Mulder Irene M, Lange Johan F, Vermeulen Jefrey, Swank Hilko A, Eijsbouts Quirijn AJ, Wiezer Marinus J, Hazebroek Eric J, van Geloven Anna AW, Maring John K, D'Hoore André JL, Kartheuser Alex, Remue Christophe, van Grevenstein Helma MU, Konsten Joop LM, van der Peet Donald L, Govaert Marc JPM, Engel Alexander F, Reitsma Johannes B, and Bemelman Willem A

Subjects
Surgery, RD1-811
Abstract

Abstract Background Recently, excellent results are reported on laparoscopic lavage in patients with purulent perforated diverticulitis as an alternative for sigmoidectomy and ostomy. The objective of this study is to determine whether LaparOscopic LAvage and drainage is a safe and effective treatment for patients with purulent peritonitis (LOLA-arm) and to determine the optimal resectional strategy in patients with a purulent or faecal peritonitis (DIVA-arm: perforated DIVerticulitis: sigmoidresection with or without Anastomosis). Methods/Design In this multicentre randomised trial all patients with perforated diverticulitis are included. Upon laparoscopy, patients with purulent peritonitis are treated with laparoscopic lavage and drainage, Hartmann's procedure or sigmoidectomy with primary anastomosis in a ratio of 2:1:1 (LOLA-arm). Patients with faecal peritonitis will be randomised 1:1 between Hartmann's procedure and resection with primary anastomosis (DIVA-arm). The primary combined endpoint of the LOLA-arm is major morbidity and mortality. A sample size of 132:66:66 patients will be able to detect a difference in the primary endpoint from 25% in resectional groups compared to 10% in the laparoscopic lavage group (two sided alpha = 5%, power = 90%). Endpoint of the DIVA-arm is stoma free survival one year after initial surgery. In this arm 212 patients are needed to significantly demonstrate a difference of 30% (log rank test two sided alpha = 5% and power = 90%) in favour of the patients with resection with primary anastomosis. Secondary endpoints for both arms are the number of days alive and outside the hospital, health related quality of life, health care utilisation and associated costs. Discussion The Ladies trial is a nationwide multicentre randomised trial on perforated diverticulitis that will provide evidence on the merits of laparoscopic lavage and drainage for purulent generalised peritonitis and on the optimal resectional strategy for both purulent and faecal generalised peritonitis. Trial registration Nederlands Trial Register NTR2037

Published
2010
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9. Combined liver resection and cytoreductive surgery with HIPEC for metastatic colorectal cancer: Results of a worldwide analysis of 565 patients from the Peritoneal Surface Oncology Group International (PSOGI)

Author

Abba, J., Abboud, K., Arvieux, C., Carrere, S., Facy, O., Ferron, G., Lorimier, G., Marchal, F., Rat, P., Tuech, J.-J., Villeneuve, Laurent, Ortega-Deballon, P., Lo Dico, R., Faron, M., Yonemura, Y., Glehen, O., Pocard, M., Sardi, A., Hübner, M., Baratti, D., Liberale, G., Kartheuser, A., de Hingh, I., Sugarbaker, P., Ceelen, W., Moran, B., Robella, M., Quenet, F., Sideris, L., Goere, D., Limbert, M., Sammartino, P., and Morris, D.

Published
2021
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11. Akkermansia muciniphila Reduces Peritonitis and Improves Intestinal Tissue Wound Healing after a Colonic Transmural Defect by a MyD88-Dependent Mechanism

Author

Radu Bachmann, Matthias Van Hul, Pamela Baldin, Daniel Léonard, Nathalie M. Delzenne, Clara Belzer, Janneke P. Ouwerkerk, Dirk Repsilber, Ignacio Rangel, Alex Kartheuser, Robert Jan Brummer, Willem M. De Vos, and Patrice D. Cani

Subjects
Akkermansia muciniphila, wound healing, colonic leakage, peritonitis, Myd88, Cytology, QH573-671
Abstract

Anastomotic leakage is a major complication following colorectal surgery leading to peritonitis, complications, and mortality. Akkermansia muciniphila has shown beneficial effects on the gut barrier function. Whether A. muciniphila reduces peritonitis and mortality during colonic leakage is unknown. Whether A. muciniphila can directly modulate the expression of genes in the colonic mucosa in humans has never been studied. We investigated the effects of a pretreatment (14 days) with live A. muciniphila prior to surgical colonic perforation on peritonitis, mortality, and wound healing. We used mice with an inducible intestinal-epithelial-cell-specific deletion of MyD88 (IEC-MyD88 KO) to investigate the role of the innate immune system in this context. In a proof-of-concept pilot study, healthy humans were exposed to A. muciniphila for 2 h and colonic biopsies taken before and after colonic instillation for transcriptomic analysis. Seven days after colonic perforation, A.-muciniphila-treated mice had significantly lower mortality and severity of peritonitis. This effect was associated with significant improvements of wound histological healing scores, higher production of IL22, but no changes in the mucus layer thickness or genes involved in cell renewal, proliferation, or differentiation. All these effects were abolished in IEC-MyD88 KO mice. Finally, human subjects exposed to A. muciniphila exhibited an increased level of the bacterium at the mucus level 2 h after instillation and significant changes in the expression of different genes involved in the regulation of cell cycling, gene transcription, immunity, and inflammation in their colonic mucosa. A. muciniphila improves wound healing during transmural colonic wall defect through mechanisms possibly involving IL22 signaling and requiring MyD88 in the intestinal cells. In healthy humans, colonic administration of A. muciniphila is well tolerated and changes the expression of genes involved in the immune pathways.

Published
2022
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13. Gluteal Propeller Perforator Flaps: A Paradigm Shift in Abdominoperineal Amputation Reconstruction

Author

Bertheuil, Theodoros Chrelias, Yanis Berkane, Etienne Rousson, Korkut Uygun, Bernard Meunier, Alex Kartheuser, Eric Watier, Jérôme Duisit, and Nicolas

Subjects
abdominoperineal amputation, perineal reconstruction, pelvis, perforator flaps, propeller flaps
Abstract

Abdominoperineal amputation (AAP) is a gold standard procedure treating advanced abdominal and pelvic cancers. The defect resulting from this extensive surgery must be reconstructed to avoid complications, such as infection, dehiscence, delayed healing, or even death. Several approaches can be chosen depending on the patient. Muscle-based reconstructions are a reliable solution but are responsible for additional morbidity for these fragile patients. We present and discuss our experience in AAP reconstruction using gluteal-artery-based propeller perforator flaps (G-PPF) in a case series. Between January 2017 and March 2021, 20 patients received G-PPF reconstruction in two centers. Either superior gluteal artery (SGAP)- or inferior artery (IGAP)-based perforator flaps were performed depending on the best configuration. Preoperative, intraoperative, and postoperative data were collected. A total of 23 G-PPF were performed—12 SGAP and 11 IGAP flaps. Final defect coverage was achieved in 100% of cases. Eleven patients experienced at least one complication (55%), amongst whom six patients (30%) had delayed healing, and three patients (15%) had at least one flap complication. One patient underwent a new surgery at 4 months for a perineal abscess under the flap, and three patients died from disease recurrence. Gluteal-artery-based propeller perforator flaps are an effective and modern surgical procedure for AAP reconstruction. Their mechanic properties, in addition to their low morbidity, make them an optimal technique for this purpose; however, technical skills are needed, and closer surveillance with patient compliance is critical to ensure success. G-PPF should be widely used in specialized centers and considered a modern alternative to muscle-based reconstructions.

Published
2023
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14. Iatrogenic ureteral injury during colorectal surgery has a significant impact on patient outcomes: a French multicentric retrospective cohort study

Author

Sérénon, Victor, Rouanet, Philippe, Charleux-Muller, Diane, Eveno, Clarisse, Poirot, Karine, Trilling, Bertrand, Benoist, Stéphane, Manceau, Gilles, Panis, Yves, Alves, Arnaud, Kartheuser, Alex, Venara, Aurélien, Pocard, Marc, Sabbagh, Charles, Laforest, Anaïs, Lakkis, Zaher, Badic, Bogdan, Chau, Amélie, Christou, Niki, Beyer-Berjot, Laura, Dumont, Frederic, Germain, Adeline, Valverde, Alain, Duchalais, Emilie, Ouaissi, Mehdi, Benhaim, Leonor, Collard, Maxime, Tuech, Jean‐jacques, Buscail, Etienne, Mege, Diane, Régimbeau, Jean-Marc, Aix-Marseille Université - École de médecine (AMU SMPM MED), Aix-Marseille Université - Faculté des sciences médicales et paramédicales (AMU SMPM), Aix Marseille Université (AMU)-Aix Marseille Université (AMU), CRLC Val d'Aurelle-Paul Lamarque, CRLCC Val d'Aurelle - Paul Lamarque, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), Institut National de la Recherche Agronomique (INRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre de Recherche en Nutrition Humaine d'Auvergne (CRNH d'Auvergne), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications Grenoble - UMR 5525 (TIMC-IMAG), 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 Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA), CHU Grenoble, AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Aix-Marseille Université - Faculté de médecine (AMU MED), Aix Marseille Université (AMU), Service de Chirurgie Viscérale et Digestive [CHU Caen], CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers (ANTICIPE), 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)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Caen Normandie - UFR Santé (UNICAEN Santé), Normandie Université (NU)-Normandie Université (NU), Université Catholique de Louvain = Catholic University of Louvain (UCL), Hémodynamique, Interaction Fibrose et Invasivité tumorales Hépatiques (HIFIH), Université d'Angers (UA), CArcinose Péritoine Paris-Technologies (ex-CART) (CAP Paris-Tech (UMR_S_1275)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Chirurgie digestive [CHU Amiens], CHU Amiens-Picardie, Simplification des soins chez les patients complexes - UR UPJV 7518 (SSPC), Université de Picardie Jules Verne (UPJV), Sorbonne Université (SU), CHU Saint-Antoine [AP-HP], Service d'Oncologie Médicale [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Laboratoire de Traitement de l'Information Medicale (LaTIM), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-IMT Atlantique (IMT Atlantique), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO), Contrôle de l’Activation Cellulaire, Progression Tumorale et Résistance thérapeutique (CAPTuR), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Service de Chirurgie digestive, endocrinienne et générale [CHU Limoges], CHU Limoges, and The French Research Group of Rectal Cancer Surgery = Groupe de Recherche en Chirurgie du Rectum (GRECCAR)

Subjects
ureteral injury, colorectal surgery, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, chemotherapy, ureteral stent
Abstract

International audience; Aim: The long-term urological sequelae after iatrogenic ureteral injury (IUI) during colorectal surgery are not clearly known. The aims of this work were to report the incidence of IUI and to analyse the long-term consequences of urological late complications and their impact on oncological results of IUI occurring during colorectal surgery through a French multicentric experience (GRECCAR group).Method: All the patients who presented with IUI during colorectal surgery between 2010 and 2019 were retrospectively included. Patients with ureteral involvement needing en bloc resection, delayed ureteral stricture or noncolorectal surgery were not considered.Results: A total of 202 patients (93 men, mean age 63 ± 14 years) were identified in 29 centres, corresponding to 0.32% of colorectal surgeries (n = 63 562). Index colorectal surgery was mainly oncological (n = 130, 64%). IUI was diagnosed postoperatively in 112 patients (55%) after a mean delay of 11 ± 9 days. Intraoperative diagnosis of IUI was significantly associated with shorter length of stay (21 ± 22 days vs. 34 ± 22 days, p < 0.0001), lower rates of postoperative hydronephrosis (2% vs. 10%, p = 0.04), anastomotic complication (7% vs. 22.5%, p = 0.002) and thromboembolic event (0% vs. 6%, p = 0.02) than postoperative diagnosis of IUI. Delayed chemotherapy because of IUI was reported in 27% of patients. At the end of the follow-up [3 ± 2.6 years (1 month-13 years)], 72 patients presented with urological sequalae (36%). Six patients (3%) required a nephrectomy.Conclusion: IUI during colorectal surgery has few consequences for the patients if recognized early. Long-term urological sequelae can occur in a third of patients. IUI may affect oncological outcomes in colorectal surgery by delaying adjuvant chemotherapy, especially when the ureteral injury is not diagnosed peroperatively.

Published
2023

16. Gluteal Propeller Perforator Flaps: A Paradigm Shift in Abdominoperineal Amputation Reconstruction

Author

Chrelias, Théodoros, Berkane, Yanis, Rousson, Etienne, Uygun, Korkut, Meunier, Bernard, Kartheuser, Alex, Watier, Eric, Duisit, Jerome, Bertheuil, Nicolas, CHU Pontchaillou [Rennes], Microenvironment and B-cells: Immunopathology,Cell Differentiation, and Cancer (MOBIDIC), Université de Rennes (UR)-Etablissement français du sang [Rennes] (EFS Bretagne)-Institut National de la Santé et de la Recherche Médicale (INSERM), Harvard Medical School [Boston] (HMS), Massachusetts General Hospital [Boston, MA, USA], Cliniques Universitaires Saint-Luc [Bruxelles], and None

Subjects
perforator flaps, perineal reconstruction, propeller flaps, [SDV.CAN]Life Sciences [q-bio]/Cancer, pelvis, abdominoperineal amputation
Abstract

International audience; Abdominoperineal amputation (AAP) is a gold standard procedure treating advanced abdominal and pelvic cancers. The defect resulting from this extensive surgery must be reconstructed to avoid complications, such as infection, dehiscence, delayed healing, or even death. Several approaches can be chosen depending on the patient. Muscle-based reconstructions are a reliable solution but are responsible for additional morbidity for these fragile patients. We present and discuss our experience in AAP reconstruction using gluteal-artery-based propeller perforator flaps (G-PPF) in a case series. Between January 2017 and March 2021, 20 patients received G-PPF reconstruction in two centers. Either superior gluteal artery (SGAP)- or inferior artery (IGAP)-based perforator flaps were performed depending on the best configuration. Preoperative, intraoperative, and postoperative data were collected. A total of 23 G-PPF were performed—12 SGAP and 11 IGAP flaps. Final defect coverage was achieved in 100% of cases. Eleven patients experienced at least one complication (55%), amongst whom six patients (30%) had delayed healing, and three patients (15%) had at least one flap complication. One patient underwent a new surgery at 4 months for a perineal abscess under the flap, and three patients died from disease recurrence. Gluteal-artery-based propeller perforator flaps are an effective and modern surgical procedure for AAP reconstruction. Their mechanic properties, in addition to their low morbidity, make them an optimal technique for this purpose; however, technical skills are needed, and closer surveillance with patient compliance is critical to ensure success. G-PPF should be widely used in specialized centers and considered a modern alternative to muscle-based reconstructions. © 2023 by the authors.

Published
2023

18. Benchmarks in colorectal surgery: multinational study to define quality thresholds in high and low anterior resection

Author

Staiger, Roxane D, Rössler, Fabian, Kim, Min Jung, Brown, Carl, Trenti, Loris, Sasaki, Takeshi, Uluk, Deniz, Campana, Juan P, Giacca, Massimo, Schiltz, Boris, Bahadoer, Renu R, Lee, Kai-Yin, Kupper, Bruna E C, Hu, Katherine Y, Corcione, Francesco, Paredes, Steven R, Spampati, Sebastiano, Ukegjini, Kristjan, Jedrzejczak, Bartlomiej, Langer, Daniel, Stakelum, Aine, Park, Ji Won, Phang, P Terry, Biondo, Sebastiano, Ito, Masaaki, Aigner, Felix, Vaccaro, Carlos A, Panis, Yves, Kartheuser, Alex, Peeters, K C M J, Puhan, Milo Alan, et al, and University of Zurich

Subjects
610 Medicine & health, 10060 Epidemiology, Biostatistics and Prevention Institute (EBPI), 2700 General Medicine
Published
2022

20. Contemporary snapshot of tumor regression grade (TRG) distribution in locally advanced rectal cancer: a cross sectional multicentric experience

Author

Germani P., Di Candido F., Leonard D., Cuicchi D., Elmore U., Allaix M. E., Barbieri V. P., D'Allens L., Faes S., Milani M., Caputo D., Martinez C., Grosek J., Caracino V., Christou N., Roodbeen S. X., Bracale U., Wildeboer A., Usai A., Benedetti M., Balani A., Piccinni G., Catarci M., Millo P., Bouvy N., Corcione F., Hompes R., Ris F., Basti M., Tomazic A., Targarona E., Coppola A., Pietrabissa A., Hahnloser D., Adamina M., Viola M., Morino M., Rosati R., Poggioli G., Kartheuser A., Spinelli A., de Manzini N., Bellio G., Iacuzzo C., Zucca A., Corleone P., Giudici F., Palmisano S., Carvello M., Remue C., Bachmann R., Lombard N., Pirlet C., Ryckx A., Massaron S., Pugliese L., Coppola R., Ferrari C., Castiglioni S., Ponte E., Concina S., Piveteau A., An Y., Cagnazzo E., Troian M., Germani, Paola, Di Candido, Francesca, Léonard, Daniel, Cuicchi, Dajana, Elmore, Ugo, Allaix, Marco Ettore, Barbieri, Vittoria Pia, D'Allens, Laura, Faes, Seraina, Milani, Marika, Caputo, Damiano, Martinez, Carmen, Grosek, Jan, Caracino, Valerio, Christou, Niki, Roodbeen, Sapho X, Bracale, Umberto, Wildeboer, Aurelia, Usai, Antonella, Benedetti, Michele, Balani, Alessandro, Piccinni, Giuseppe, Catarci, Marco, Millo, Paolo, Bouvy, Nicole, Corcione, Francesco, Hompes, Roel, Ris, Frédéric, Basti, Massimo, Tomazic, Ale, Targarona, Eduardo, Coppola, Alessandro, Pietrabissa, Andrea, Hahnloser, Dieter, Adamina, Michel, Viola, Massimo, Morino, Mario, Rosati, Riccardo, Poggioli, Gilberto, Kartheuser, Alex, Spinelli, Antonino, de Manzini, Nicolò, Palmisano, Silvia, TRG Snapshot Study Group, Bellio, G., Iacuzzo, C., Zucca, A., Corleone, P., Giudici, F., Palmisano, S., Carvello, M., Remue, C., Bachmann, R., Lombard, N., Pirlet, C., Ryckx, A., Massaron, S., Pugliese, L., Coppola, R., Ferrari, C., Castiglioni, S., Ponte, E., Concina, S., Piveteau, A., An, Y., Cagnazzo, E., Troian, M., Surgery, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, MUMC+: MA Heelkunde (9), RS: NUTRIM - R2 - Liver and digestive health, Germani P., Di Candido F., Leonard D., Cuicchi D., Elmore U., Allaix M.E., Barbieri V.P., D'Allens L., Faes S., Milani M., Caputo D., Martinez C., Grosek J., Caracino V., Christou N., Roodbeen S.X., Bracale U., Wildeboer A., Usai A., Benedetti M., Balani A., Piccinni G., Catarci M., Millo P., Bouvy N., Corcione F., Hompes R., Ris F., Basti M., Tomazic A., Targarona E., Coppola A., Pietrabissa A., Hahnloser D., Adamina M., Viola M., Morino M., Rosati R., Poggioli G., Kartheuser A., Spinelli A., de Manzini N., Bellio G., Iacuzzo C., Zucca A., Corleone P., Giudici F., Palmisano S., Carvello M., Remue C., Bachmann R., Lombard N., Pirlet C., Ryckx A., Massaron S., Pugliese L., Coppola R., Ferrari C., Castiglioni S., Ponte E., Concina S., Piveteau A., An Y., Cagnazzo E., Troian M., UCL - SSS/IREC/CHEX - Pôle de chirgurgie expérimentale et transplantation, and UCL - (SLuc) Service de chirurgie et transplantation abdominale

Subjects
medicine.medical_specialty, Colorectal cancer, medicine.medical_treatment, THERAPY, CHEMORADIOTHERAPY, Neoadjuvant therapy, Pathologic complete response, Rectal cancer, Tumor regression grade, Chemoradiotherapy, Cross-Sectional Studies, Humans, Neoadjuvant Therapy, Neoplasm Staging, Rectal Neoplasms/diagnostic imaging, Rectal Neoplasms/surgery, Rectum/pathology, Treatment Outcome, EXCISION, 03 medical and health sciences, 0302 clinical medicine, NEOADJUVANT CHEMORADIATION, medicine, PREOPERATIVE RADIOTHERAPY, Cross-Sectional Studie, Tumor Regression Grade, ddc:617, medicine.diagnostic_test, Rectal Neoplasms, business.industry, Standard treatment, Rectum, Cancer, Magnetic resonance imaging, medicine.disease, Surgery, Exact test, 030220 oncology & carcinogenesis, Original Article, 030211 gastroenterology & hepatology, Radiology, FOLLOW-UP, business, Human, MRI
Abstract

Pre-operative chemoradiotherapy (CRT) followed by surgical resection is still the standard treatment for locally advanced low rectal cancer. Nowadays new strategies are emerging to treat patients with a complete response to pre-operative treatment, rendering the optimal management still controversial and under debate. The primary aim of this study was to obtain a snapshot of tumor regression grade (TRG) distribution after standard CRT. Second, we aimed to identify a correlation between clinical tumor stage (cT) and TRG, and to define the accuracy of magnetic resonance imaging (MRI) in the restaging setting. Between January 2017 and June 2019, a cross sectional multicentric study was performed in 22 referral centers of colon-rectal surgery including all patients with cT3-4Nx/cTxN1-2 rectal cancer who underwent pre-operative CRT. Shapiro–Wilk test was used for continuous data. Categorical variables were compared with Chi-squared test or Fisher’s exact test, where appropriate. Accuracy of restaging MRI in the identification of pathologic complete response (pCR) was determined evaluating the correspondence with the histopathological examination of surgical specimens.In the present study, 689 patients were enrolled. Complete tumor regression rate was 16.9%. The “watch and wait” strategy was applied in 4.3% of TRG4 patients. A clinical correlation between more advanced tumors and moderate to absent tumor regression was found (p = 0.03). Post-neoadjuvant MRI had low sensibility (55%) and high specificity (83%) with accuracy of 82.8% in identifying TRG4 and pCR.Our data provided a contemporary description of the effects of pre-operative CRT on a large pool of locally advanced low rectal cancer patients treated in different colon-rectal surgical centers.

Published
2021

22. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis from colorectal cancer: a 13 years-retrospective monocentric study

Author

Livin, M, Leonard, D, Bachmann, R, Remue, C, Barbois, S, Van den Eynde, M, Cotte, E, De Cuyper, A, Sinapi, I, Van Maanen, A, Kartheuser, A, UCL - SSS/IREC/CHEX - Pôle de chirgurgie expérimentale et transplantation, UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (SLuc) Service d'oncologie médicale, UCL - (SLuc) Service de chirurgie cardiovasculaire et thoracique, UCL - (SLuc) Service d'hépato-gastro-entérologie, UCL - (SLuc) Service de chirurgie et transplantation abdominale, and UCL - (SLuc) Centre du cancer

Subjects
Liver Neoplasms, peritoneal carcinomatosis, Hyperthermic Intraperitoneal Chemotherapy, Cytoreduction Surgical Procedures, Hyperthermia, Induced, Combined Modality Therapy, Survival Rate, Percutaneous Coronary Intervention, Antineoplastic Combined Chemotherapy Protocols, Humans, cytoreductive surgery, Colorectal Neoplasms, Peritoneal Neoplasms, Retrospective Studies
Abstract

Background and study aim: Over the last 20 years, cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) has progressively become a therapeutic option for peritoneal carcinomatosis thanks to its favourable oncologic results. The aim of this study is to analyse the overall survival and recurrence-free survival, after complete CRS and closed abdomen technique HIPEC for peritoneal carcinomatosis from colorectal cancer. Patients and methods: This retrospective study collected the data from all patients who underwent a CRS with HIPEC for colorectal cancer at “Cliniques universitaires Saint Luc” from October 2007 to December 2020. Ninety-nine patients were included. Results: The median follow-up was 34 months. Post-operative mortality and Clavien-Dindo grade III/IV morbidity rates were 2.0% and 28.3%. The overall 2-year and 5-year survival rates were 80.1% and 54.4%. Using the multivariate analysis, age at surgery, liver metastases and PCI score >13 showed a statistically significant negative impact on overall survival. The 2-year and 5-year recurrence-free survival rates were 33.9% and 22%. Using the multivariate analysis, it was found that liver metastases, the extent of carcinomatosis with PCI>7 have a statistically significant negative impact on recurrence-free survival. Conclusions: Despite a high recurrence rate, CRS followed by HIPEC to treat peritoneal carcinomatosis from colorectal origin offer encouraging oncologic results with a satisfying survival rate. When PCI>13, CRS and HIPEC does not seem to offer any survival benefit and to efficiently limit recurrence, our data are in favor of a maximum PCI of 7.

Published
2022

24. Multicenter International Study of the Consensus Immunoscore for the Prediction of Relapse and Survival in Early-Stage Colon Cancer.

Author

Mlecnik, Bernhard, Lugli, Alessandro, Bindea, Gabriela, Marliot, Florence, Bifulco, Carlo, Lee, Jiun-Kae Jack, Zlobec, Inti, Rau, Tilman T., Berger, Martin D., Nagtegaal, Iris D., Vink-Börger, Elisa, Hartmann, Arndt, Geppert, Carol I., Kolwelter, Julie, Merkel, Susanne, Grützmann, Robert, Van den Eynde, Marc, Jouret-Mourin, Anne, Kartheuser, Alex, and Léonard, Daniel

Subjects
COLON tumors, RESEARCH, PREDICTIVE tests, CONFIDENCE intervals, CANCER relapse, TUMOR classification, IMMUNOASSAY, RESEARCH funding, DESCRIPTIVE statistics, CHI-squared test, PROGRESSION-free survival, OVERALL survival
Abstract

Simple Summary: This work determines the predictive value of the consensus Immunoscore in 1885 patients with AJCC/UICC-TNM stage I-II Colon Cancer (CC) from North American, European, and Asian care centers. Herein, we demonstrate that the immunity of early-stage CC patients, more than cancer cell-associated parameters, predicts outcome for stage I/II patients. Similar results were found for high-risk patients defined based on parameters such as the grade of differentiation, T4 stage, venous emboli, lymphatic invasion or perineural invasion (VELIPI). Within these pathological risk subgroups, the consensus Immunoscore accurately identifies early-stage CC patients with different clinical outcome, without treatment bias. Thus, the Immunoscore reliably diagnoses low immune cell infiltrated patients at risk of relapse, that would benefit from a more frequent and detailed medical monitoring. The Immunoscore is a patient classification method that can guide treatment decisions, through the quantification of CD3+ and cytotoxic CD8+ T-lymphocytes densities within the tumor and its invasive margin. Background: The prognostic value of Immunoscore was evaluated in Stage II/III colon cancer (CC) patients, but it remains unclear in Stage I/II, and in early-stage subgroups at risk. An international Society for Immunotherapy of Cancer (SITC) study evaluated the pre-defined consensus Immunoscore in tumors from 1885 AJCC/UICC-TNM Stage I/II CC patients from Canada/USA (Cohort 1) and Europe/Asia (Cohort 2). METHODS: Digital-pathology is used to quantify the densities of CD3+ and CD8+ T-lymphocyte in the center of tumor (CT) and the invasive margin (IM). The time to recurrence (TTR) was the primary endpoint. Secondary endpoints were disease-free survival (DFS), overall survival (OS), prognosis in Stage I, Stage II, Stage II-high-risk, and microsatellite-stable (MSS) patients. RESULTS: High-Immunoscore presented with the lowest risk of recurrence in both cohorts. In Stage I/II, recurrence-free rates at 5 years were 78.4% (95%-CI, 74.4–82.6), 88.1% (95%-CI, 85.7–90.4), 93.4% (95%-CI, 91.1–95.8) in low, intermediate and high Immunoscore, respectively (HR (Hi vs. Lo) = 0.27 (95%-CI, 0.18–0.41); p < 0.0001). In Cox multivariable analysis, the association of Immunoscore to outcome was independent (TTR: HR (Hi vs. Lo) = 0.29, (95%-CI, 0.17–0.50); p < 0.0001) of the patient's gender, T-stage, sidedness, and microsatellite instability-status (MSI). A significant association of Immunoscore with survival was found for Stage II, high-risk Stage II, T4N0 and MSS patients. The Immunoscore also showed significant association with TTR in Stage-I (HR (Hi vs. Lo) = 0.07 (95%-CI, 0.01–0.61); P = 0.016). The Immunoscore had the strongest (69.5%) contribution χ2 for influencing survival. Patients with a high Immunoscore had prolonged TTR in T4N0 tumors even for patients not receiving chemotherapy, and the Immunoscore remained the only significant parameter in multivariable analysis. CONCLUSION: In early CC, low Immunoscore reliably identifies patients at risk of relapse for whom a more intensive surveillance program or adjuvant treatment should be considered. [ABSTRACT FROM AUTHOR]

Published
2023
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25. Risk adjusted benchmarking of abdominoperineal excision for rectal adenocarcinoma in the context of the Belgian PROCARE improvement project

Author

Penninckx, Freddy, Fieuws, Steffen, Beirens, Koen, Demetter, Pieter, Ceelen, Wim, Kartheuser, Alex, Molle, Gaetan, Van de Stadt, Jean, Vindevoghel, Koen, Van Eycken, Elizabeth, Bertrand, C, De Coninck, D, Duinslaeger, M, Kartheuser, A, Penninckx, F, Van de Stadt, J, Vaneerdeweg, W, Claeys, D, Burnon, D, Haustermans, K, Scalliet, P, Spaas, Ph, Demetter, P, Jouret-Mourin, A, Sempoux, C, Demey, W, Humblet, Y, Van Cutsem, E, Laurent, S, Van Cutsem, E, Van Laethem, JL, Danse, E, de Beeck, B Op, Smeets, P, Melange, M, Rahier, J, Cabooter, M, Pattyn, P, Peeters, M, Buset, M, Haeck, L, Mansvelt, B, Vindevoghel, K, Van Eycken, E, Dercq, J-P, and Thijs, A

Published
2013
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29. Akkermansia muciniphila Reduces Peritonitis and Improves Intestinal Tissue Wound Healing after a Colonic Transmural Defect by a MyD88-Dependent Mechanism.

Author

Bachmann, Radu, Van Hul, Matthias, Baldin, Pamela, Léonard, Daniel, Delzenne, Nathalie M., Belzer, Clara, Ouwerkerk, Janneke P., Repsilber, Dirk, Rangel, Ignacio, Kartheuser, Alex, Brummer, Robert Jan, De Vos, Willem M., and Cani, Patrice D.

Subjects
TISSUES, COLON (Anatomy), HEALING, PERITONITIS, CELL cycle regulation, CELL proliferation, WOUND healing
Abstract

Anastomotic leakage is a major complication following colorectal surgery leading to peritonitis, complications, and mortality. Akkermansia muciniphila has shown beneficial effects on the gut barrier function. Whether A. muciniphila reduces peritonitis and mortality during colonic leakage is unknown. Whether A. muciniphila can directly modulate the expression of genes in the colonic mucosa in humans has never been studied. We investigated the effects of a pretreatment (14 days) with live A. muciniphila prior to surgical colonic perforation on peritonitis, mortality, and wound healing. We used mice with an inducible intestinal-epithelial-cell-specific deletion of MyD88 (IEC-MyD88 KO) to investigate the role of the innate immune system in this context. In a proof-of-concept pilot study, healthy humans were exposed to A. muciniphila for 2 h and colonic biopsies taken before and after colonic instillation for transcriptomic analysis. Seven days after colonic perforation, A.-muciniphila-treated mice had significantly lower mortality and severity of peritonitis. This effect was associated with significant improvements of wound histological healing scores, higher production of IL22, but no changes in the mucus layer thickness or genes involved in cell renewal, proliferation, or differentiation. All these effects were abolished in IEC-MyD88 KO mice. Finally, human subjects exposed to A. muciniphila exhibited an increased level of the bacterium at the mucus level 2 h after instillation and significant changes in the expression of different genes involved in the regulation of cell cycling, gene transcription, immunity, and inflammation in their colonic mucosa. A. muciniphila improves wound healing during transmural colonic wall defect through mechanisms possibly involving IL22 signaling and requiring MyD88 in the intestinal cells. In healthy humans, colonic administration of A. muciniphila is well tolerated and changes the expression of genes involved in the immune pathways. [ABSTRACT FROM AUTHOR]

Published
2022
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31. Combined liver resection and cytoreductive surgery with HIPEC for metastatic colorectal cancer: Results of a worldwide analysis of 565 patients from the Peritoneal Surface Oncology Group International (PSOGI)

Author

S. Carrere, Lucas Sideris, Paolo Sammartino, François Quenet, Catherine Arvieux, Alex Kartheuser, M. Faron, B. J. Moran, I.H.J.T. de Hingh, Pablo Ortega-Deballon, Laurent Villeneuve, Olivier Facy, G. Ferron, David L. Morris, Julio Abba, Diane Goéré, Armando Sardi, M. Limbert, Martin Hübner, Karine Abboud, Frédéric Marchal, R. Lo Dico, Paul H. Sugarbaker, Marc Pocard, Wim Ceelen, Y. Yonemura, Gabriel Liberale, M. Robella, Gérard Lorimier, D. Baratti, Jean-Jacques Tuech, Olivier Glehen, P. Rat, Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CArcinose Péritoine Paris-Technologies (ex-CART) (CAP Paris-Tech (UMR_S_1275)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Institut Gustave Roussy (IGR), Département de chirurgie viscérale [Gustave Roussy], Hospices Civils de Lyon (HCL), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Mercy Medical Center, University of Lausanne (UNIL), Fondazione IRCCS Istituto Nazionale dei Tumori, Université libre de Bruxelles (ULB), Université Catholique de Louvain = Catholic University of Louvain (UCL), Catharina Hospital, MedStar Washington Hospital Center, Ghent University Hospital, Hampshire Hospitals NHS Foundation Trust [Basingstoke, UK], Candiolo Cancer Institute [Candiolo, Italie], Università degli studi di Torino (UNITO), Institut du Cancer de Montpellier (ICM), Université du Québec à Montréal = University of Québec in Montréal (UQAM), Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome], St George’s University Hospitals, PSOGI Working Group, BIG RENAPE Working Group: J Abba, K Abboud, C Arvieux, S Carrere, O Facy, G Ferron, G Lorimier, F Marchal, P Rat, J-J Tuech, Laurent Villeneuve, P Ortega-Deballon, UCL - SSS/IREC/CHEX - Pôle de chirgurgie expérimentale et transplantation, UCL - (SLuc) Service de chirurgie et transplantation abdominale, PSOGI Working Group, BIG RENAPE Working Group, Abba, J., Abboud, K., Arvieux, C., Carrere, S., Facy, O., Ferron, G., Lorimier, G., Marchal, F., Rat, P., Tuech, J.J., Villeneuve, L., and Ortega-Deballon, P.

Subjects
Male, medicine.medical_specialty, Bevacizumab, Peritoneal surface, Colorectal cancer, Mitomycin, [SDV]Life Sciences [q-bio], Hyperthermic Intraperitoneal Chemotherapy, 030230 surgery, Resection, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, medicine, Humans, Prospective Studies, Chirurgie, Contraindication, Peritoneal Neoplasms, ComputingMilieux_MISCELLANEOUS, Aged, Neoplasm Staging, business.industry, Cytoreduction Surgical Procedures, General Medicine, Middle Aged, medicine.disease, Combined Modality Therapy, 3. Good health, Surgery, Cancérologie, Oncology, Curative treatment, 030220 oncology & carcinogenesis, Female, Hyperthermic intraperitoneal chemotherapy, Cisplatin, Neoplasm Grading, Colorectal Neoplasms, business, Cytoreductive surgery, medicine.drug
Abstract

SCOPUS: ar.j, info:eu-repo/semantics/published

Published
2021

32. Are colorectal cancer patients at risk for COVID-19 infection during the postoperative period? The Covid-GRECCAR study

Author

Tuech, Jean-Jacques, Manceau, Gilles, Ouaissi, Mehdi, Denet, Christine, Chau, Amélie, Kartheuser, Alex, Desfourneaux, Véronique, Duchalais, Emilie, Bertrand, Martin, Badic, Bogdan, Alves, Arnaud, Ceribelli, Cecilia, Venara, Aurelien, Mege, Diane, Mauvais, François, Dumont, Fréderic, Mabrut, Jean-Yves, Lakkis, Zaher, Cotte, Eddy, Meillat, Helene, French Research Group of Rectal Cancer Surgery (GRECCAR), UCL - SSS/IREC/CHEX - Pôle de chirgurgie expérimentale et transplantation, UCL - (SLuc) Service de chirurgie et transplantation abdominale, Département de chirurgie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service de Chirurgie Digestive, Hépato-Bilio-pancréatique et Transplantation Hépatique [CHU Pitié-Salpétrière], 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), Sorbonne Université - Faculté de Médecine (SU FM), Sorbonne Université (SU), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Institut Mutualiste de Montsouris (IMM), Université Catholique de Louvain = Catholic University of Louvain (UCL), CHU Pontchaillou [Rennes], Institut des Maladies de l'Appareil Digestif, Université de Nantes (UN), Centre hospitalier universitaire de Nantes (CHU Nantes), Hôpital Universitaire Carémeau [Nîmes] (CHU Nîmes), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers (ANTICIPE), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER, Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] (UNICANCER/ICL), UNICANCER, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Hôpital de la Timone [CHU - APHM] (TIMONE), Institut de Cancérologie de l'Ouest [Angers/Nantes] (UNICANCER/ICO), Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Gestionnaire, Hal Sorbonne Université, 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)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM), Chirurgie digestive [CHU Amiens], CHU Amiens-Picardie, Simplification des soins chez les patients complexes - UR UPJV 7518 (SSPC), and Université de Picardie Jules Verne (UPJV)

Subjects
Adult, Male, medicine.medical_specialty, COVID-19 outbreak, Colorectal cancer, Short Communication, [SDV]Life Sciences [q-bio], Population, Comorbidity, Risk Assessment, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Colorectal surgery, Internal medicine, Humans, Medicine, Anal cancer, Postoperative Period, Elective surgery, education, Aged, Retrospective Studies, Cancer, Aged, 80 and over, education.field_of_study, Pandemic, business.industry, Gastroenterology, COVID-19, Retrospective cohort study, Middle Aged, medicine.disease, 3. Good health, [SDV] Life Sciences [q-bio], Oncology, Elective Surgical Procedures, 030220 oncology & carcinogenesis, Female, 030211 gastroenterology & hepatology, France, Colorectal Neoplasms, business, Cohort study
Abstract

International audience; Introduction: During the COVID-19 pandemic, cancer patients have been regarded as having a high risk of severe events if they are infected with SARS-CoV-2, particularly those under medical or surgical treatment. The aim of this study was to assess the posttreatment risk of infection by SARS-CoV-2 in a population of patients operated on for colorectal cancer 3 months before the COVID-19 outbreak and who after hospitalization returned to an environment where the virus was circulating.Materials and methods: This French, multicenter cohort study included consecutive patients undergoing elective surgery for colorectal cancer between January 1 and March 31, 2020, at 19 GRECCAR hospitals. The outcome was the rate of COVID-19 infection in this group of patients who were followed until June 15, 2020.Results: This study included 448 patients, 262 male (58.5%) and 186 female (41.5%), who underwent surgery for colon cancer (n = 290, 64.7%), rectal cancer (n = 155, 34.6%), or anal cancer (n = 3, 0.7%). The median age was 68 years (19-95). Comorbidities were present in nearly half of the patients, 52% were at least overweight, and the median BMI was 25 (12-42). At the end of the study, 448 were alive. Six patients (1.3%) developed COVID-19 infection; among them, 3 were hospitalized in the conventional ward, and none of them died.Conclusion: The results are reassuring, with only a 1.3% infection rate and no deaths related to COVID-19. We believe that we can operate on colorectal cancer patients without additional mortality from COVID-19, applying all measures aimed at reducing the risk of infection.

Published
2021

36. Effect of hospital volume on quality of care and outcome after rectal cancer surgery

Author

Leonard, D., Penninckx, F., Kartheuser, A., Laenen, A., Van Eycken, E., Bertrand, C., De Coninck, D., Duinslaeger, M., Van de Stadt, J., Vaneerdeweg, W., Claeys, D., Burnon, D., Haustermans, K., Scalliet, P., Spaas, P., Demetter, P., Jouret-Mourin, A., Sempoux, C., Demey, W., Humblet, Y., Van Cutsem, E., Laurent, S., Van Laethem, J. L., Op de Beeck, B., Smeets, P., Melange, M., Rahier, J., Cabooter, M., Pattyn, P., Peeters, M., Buset, M., Mansvelt, B., Vindevoghel, K., Daubie, M., and Thijs, A.

Published
2014
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40. Multicenter International Society for Immunotherapy of Cancer Study of the Consensus Immunoscore for the Prediction of Survival and Response to Chemotherapy in Stage III Colon Cancer

Author

Toshihiko Torigoe, Tilman T. Rau, Gabriela Bindea, Yutaka Kawakami, Helena Skalova, Lucie Lafontaine, Arndt Hartmann, Sara Hafezi-Bakhtiari, Nikki Knijn, Fabio Grizzi, Giuseppe Masucci, Kiyotaka Okuno, Carol Geppert, Martin D. Berger, Anne Jouret-Mourin, Fabiana Tatangelo, Florence Marliot, Christine Lagorce, Julia Y. Wang, Bradly G. Wouters, Birva Shah, P. Patel, Eva Zavadova, Ichiro Takemasa, Nobuaki Suzuki, Daniel Léonard, Hiroaki Nagano, SeongJun Han, Heather L. MacGregor, J. Jack Lee, Mingli Xu, Anastasia Lanzi, Carmen Ballesteros-Merino, Alex Kartheuser, Christopher Paustian, Inti Zlobec, Guanjun Zhang, Julie Kolwelter, Bernhard Mlecnik, Emilia Andersson, Jan Spacek, Shannon van Lent–van Vliet, Elisa Vink-Börger, Tessa Fredriksen, Linh T. Nguyen, Carlijn van de Water, Boryana Popivanova, Bernard A. Fox, Carlo Bifulco, Christophe Remue, Franck Pagès, Marc Van den Eynde, Kruti N. Rajvik, Gennaro Ciliberto, Paolo Delrio, Shilin N. Shukla, Robert Grützmann, Hemangini H. Vora, Jeroen R. Dijkstra, Shoichi Hazama, Alessandro Lugli, Anne Berger, Iris D. Nagtegaal, Jérôme Galon, Nacilla Haicheur, Tomonobu Fujita, Daniela Bruni, Tomohisa Furuhata, Michal Vocka, Shashank J. Pandya, Noriyuki Sato, Yili Wang, Susanne Merkel, Bénédicte Buttard, Kristyna Nemejcova, Carine El Sissy, Bohuslav Konopasek, Ana-Maria Muşină, Luigi Laghi, Michele Maio, Michael H.A. Roehrl, Lubos Petruzelka, Jayendrakumar B. Patel, Prashant Bavi, Francesco M. Marincola, Paolo A. Ascierto, Pavel Dundr, Amos Kirilovsky, Dragos-Viorel Scripcariu, Gerardo Botti, Kyogo Itoh, Pamela S. Ohashi, UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - SSS/IREC/CHEX - Pôle de chirgurgie expérimentale et transplantation, UCL - (SLuc) Unité d'oncologie médicale, UCL - (SLuc) Service d'anatomie pathologique, and UCL - (SLuc) Service de chirurgie et transplantation abdominale

Subjects
0301 basic medicine, Oncology, Male, Cancer Research, medicine.medical_specialty, Time Factors, CD3 Complex, medicine.medical_treatment, Antineoplastic Agents, CD8-Positive T-Lymphocytes, Disease-Free Survival, 03 medical and health sciences, 0302 clinical medicine, Lymphocytes, Tumor-Infiltrating, All institutes and research themes of the Radboud University Medical Center, Predictive Value of Tests, Internal medicine, medicine, Tumours of the digestive tract Radboud Institute for Molecular Life Sciences [Radboudumc 14], Humans, Lymphocyte Count, 610 Medicine & health, Survival rate, Aged, Neoplasm Staging, Aged, 80 and over, Chemotherapy, business.industry, Microsatellite instability, Cancer, Immunotherapy, ORIGINAL REPORTS, Middle Aged, medicine.disease, Stage III Colon Cancer, Survival Rate, 030104 developmental biology, Chemotherapy, Adjuvant, 030220 oncology & carcinogenesis, Predictive value of tests, Colonic Neoplasms, Mutation, 570 Life sciences, biology, Female, Microsatellite Instability, Neoplasm Recurrence, Local, business, Adjuvant
Abstract

PURPOSE The purpose of this study was to evaluate the prognostic value of Immunoscore in patients with stage III colon cancer (CC) and to analyze its association with the effect of chemotherapy on time to recurrence (TTR). METHODS An international study led by the Society for Immunotherapy of Cancer evaluated the predefined consensus Immunoscore in 763 patients with American Joint Committee on Cancer/Union for International Cancer Control TNM stage III CC from cohort 1 (Canada/United States) and cohort 2 (Europe/Asia). CD3+ and cytotoxic CD8+ T lymphocyte densities were quantified in the tumor and invasive margin by digital pathology. The primary end point was TTR. Secondary end points were overall survival (OS), disease-free survival (DFS), prognosis in microsatellite stable (MSS) status, and predictive value of efficacy of chemotherapy. RESULTS Patients with a high Immunoscore presented with the lowest risk of recurrence, in both cohorts. Recurrence-free rates at 3 years were 56.9% (95% CI, 50.3% to 64.4%), 65.9% (95% CI, 60.8% to 71.4%), and 76.4% (95% CI, 69.3% to 84.3%) in patients with low, intermediate, and high immunoscores, respectively (hazard ratio [HR; high v low], 0.48; 95% CI, 0.32 to 0.71; P = .0003). Patients with high Immunoscore showed significant association with prolonged TTR, OS, and DFS (all P < .001). In Cox multivariable analysis stratified by participating center, Immunoscore association with TTR was independent (HR [high v low], 0.41; 95% CI, 0.25 to 0.67; P = .0003) of patient’s sex, T stage, N stage, sidedness, and microsatellite instability status. Significant association of a high Immunoscore with prolonged TTR was also found among MSS patients (HR [high v low], 0.36; 95% CI, 0.21 to 0.62; P = .0003). Immunoscore had the strongest contribution χ2 proportion for influencing survival (TTR and OS). Chemotherapy was significantly associated with survival in the high-Immunoscore group for both low-risk (HR [chemotherapy v no chemotherapy], 0.42; 95% CI, 0.25 to 0.71; P = .0011) and high-risk (HR [chemotherapy v no chemotherapy], 0.5; 95% CI, 0.33 to 0.77; P = .0015) patients, in contrast to the low-Immunoscore group ( P > .12). CONCLUSION This study shows that a high Immunoscore significantly associated with prolonged survival in stage III CC. Our findings suggest that patients with a high Immunoscore will benefit the most from chemotherapy in terms of recurrence risk.

Published
2020
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41. Rectal Tonsil as a Cause of Recurrent Rectal Prolapse

Author

Isabelle Scheers, Laurence Pratte, Aurore Pire, Alex Kartheuser, Alessandra Camboni, UCL - SSS/IREC/CHEX - Pôle de chirgurgie expérimentale et transplantation, UCL - SSS/IREC/MORF - Pôle de Morphologie, UCL - SSS/IREC/PEDI - Pôle de Pédiatrie, UCL - (SLuc) Service de chirurgie et transplantation abdominale, UCL - (SLuc) Service de gastro-entérologie et hépatologie pédiatrique, and UCL - (SLuc) Service d'anatomie pathologique

Subjects
medicine.medical_specialty, business.industry, General surgery, Rectum, Gastroenterology, MEDLINE, Rectal Prolapse, medicine.disease, Rectal prolapse, Polyps, Treatment Outcome, medicine.anatomical_structure, Recurrence, Tonsil, Pediatrics, Perinatology and Child Health, medicine, Humans, business, Digestive System Surgical Procedures
Abstract

A 9-year-old boy presenting with recurrent rectal bleeding and prolapse refractory to therapy for constipation was referred for colonoscopy. Initial work-up (magnesium, thyroid function, food allergies, celiac disease, and stool cultures) was negative. Five large rectal polyps were evidenced just above dental line. Due to the location of the lesions, a combined endoscopic/surgical submucosal resection of the lesions was performed. [...]

Published
2020

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