9 results on '"Jaffre I"'
Search Results
2. Abstract P2-01-33: Non-sentinel lymph nodes involvement in early breast cancer patients: Performance of two predictive nomograms integrating the analysis of sentinel nodes by one step nucleic acid amplification in a cohort of 299 patients
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Bordes, V, primary, Campion, L, additional, Jezequel, P, additional, Lefrancois, A, additional, Boiffard, F, additional, Brillaud-Meflah, V, additional, Dravet, F, additional, Jaffre, I, additional, and Classe, J-M, additional
- Published
- 2017
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3. Laparoscopic hysterectomy after concurrent radiochemotherapy in locally advanced cervical cancer compared to laparotomy: A multi institutional prospective pilot study of cost, surgical outcome and quality of life
- Author
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Baffert, S., primary, Alran, S., additional, Fourchotte, V., additional, Traore, M.A., additional, Simondi, C., additional, Mathevet, P., additional, Loustalot, C., additional, Binelli, C., additional, Jaffre, I., additional, Barranger, E., additional, Dupre, P.F., additional, Ferron, G., additional, Houvenaeghel, G., additional, Leveque, J., additional, Descamps, P., additional, Body, G., additional, Raudrant, D., additional, and Classe, J.M., additional
- Published
- 2016
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4. Prospective Assessment of First-Year Quality of Life After Pelvic Exenteration for Gynecologic Malignancy: A French Multicentric Study.
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Martinez, A., Filleron, T., Rouanet, P., Méeus, P., Lambaudie, E., Classe, J. M., Foucher, F., Narducci, F., Gouy, S., Guyon, F., Marchal, F., Jouve, E., Colombo, P. E., Mourregot, A., Rivoire, M., Chopin, N., Houvenaeghel, G., Jaffre, I., Leveque, J., and Lavoue, V.
- Abstract
Background: Pelvic exenteration remains one of the most mutilating procedures, with important postoperative morbidity, an altered body image, and long-term physical and psychosocial concerns. This study aimed to assess quality of life (QOL) during the first year after pelvic exenteration for gynecologic malignancy performed with curative intent. Methods: A French multicentric prospective study was performed by including patients who underwent pelvic exenteration. Quality of life by measurement of functional and symptom scales was assessed using the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 (version 3.0) and the EORTC QLQ-OV28 questionnaires before surgery, at baseline, and 1, 3, 6, and 12 months after the procedure. Results: The study enrolled 97 patients. Quality of life including physical, personal, fatigue, and anorexia reported in the QLQ-C30 was significantly reduced 1 month postoperatively and improved at least to baseline level 1 year after the procedure. Body image also was significantly reduced 1 month postoperatively. Global health, emotional, dyspnea, and anorexia items were significantly improved 1 year after surgery compared with baseline values. Unlike younger patients, elderly patients did not regain physical and social activities after pelvic exenteration. Conclusions: Therapeutic decision on performing a pelvic exenteration can have a severe and permanent impact on all aspects of patients' QOL. Deterioration of QOL was most significant during the first 3 months after surgery. Elderly patients were the only group of patients with permanent decreased physical and social function. Preoperative evaluation and postoperative follow-up evaluation should include health-related QOL instruments, counseling by a multidisciplinary team to cover all aspects concerning stoma care, sexual function, and long-term concerns after surgery. [ABSTRACT FROM AUTHOR]
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- 2018
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5. Preoperative Breast Magnetic Resonance Imaging in Women With Local Ductal Carcinoma in Situ to Optimize Surgical Outcomes: Results From the Randomized Phase III Trial IRCIS.
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Balleyguier C, Dunant A, Ceugnart L, Kandel M, Chauvet MP, Chérel P, Mazouni C, Henrot P, Rauch P, Chopier J, Zilberman S, Doutriaux-Dumoulin I, Jaffre I, Jalaguier A, Houvenaeghel G, Guérin N, Callonnec F, Chapellier C, Raoust I, Mathieu MC, Rimareix F, Bonastre J, and Garbay JR
- Subjects
- Adult, Aged, Aged, 80 and over, Breast Neoplasms pathology, Carcinoma, Intraductal, Noninfiltrating pathology, Female, France, Humans, Middle Aged, Neoplasm Staging, Neoplasm, Residual, Predictive Value of Tests, Prospective Studies, Reoperation, Reproducibility of Results, Treatment Outcome, Tumor Burden, Breast Neoplasms diagnostic imaging, Breast Neoplasms surgery, Carcinoma, Intraductal, Noninfiltrating diagnostic imaging, Carcinoma, Intraductal, Noninfiltrating surgery, Magnetic Resonance Imaging, Margins of Excision, Mastectomy, Segmental adverse effects
- Abstract
Purpose: We evaluated the addition of breast magnetic resonance imaging (MRI) to standard radiologic evaluation on the re-intervention rate in women with ductal carcinoma in situ (DCIS) undergoing breast-conserving surgery., Patients and Methods: Women with biopsy-proven DCIS corresponding to a unifocal microcalcification cluster or a mass less than 30 mm were randomly assigned to undergo MRI or standard evaluation. The primary end point was the re-intervention rate for positive or close margins (< 2 mm) in the 6 months after randomization ( ClinicalTrials.gov identifier: NCT01112254)., Results: A total of 360 patients from 10 hospitals in France were included in the study. Of the 352 analyzable patients, 178 were randomly assigned to the MRI arm, and 174 were assigned to the control arm. In the intent-to-treat analysis, 82 of 345 patients with the assessable end point were reoperated for positive or close margins within 6 months, resulting in a re-intervention rate of 20% (35 of 173) in the MRI arm and 27% (47 of 172) in the control arm. The absolute difference of 7% (95% CI, -2% to 16%) corresponded to a relative reduction of 26% (stratified odds ratio, 0.68; 95% CI, 0.41 to 1.1; P = .13). When considering only the per-protocol population with an assessable end point, the difference was 9% (stratified odds ratio, 0.59; 95% CI, 0.35 to 1.0; P = .05). Total mastectomy rates were 18% (31 of 176) in the MRI arm and 17% (30 of 173) in the control arm (stratified P = .93). For 100 lesions seen on MRI, nonmass-like enhancement was more predominant (82%) than mass enhancement (20%). Nevertheless, no specific morphologic and kinetic parameters for DCIS were identified., Conclusion: The study did not show sufficient surgical improvement with the use of preoperative MRI to be clinically relevant in DCIS staging. However, this could be reconsidered with the improvement of new MRI sequences and new modalities in magnetic resonance techniques.
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- 2019
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6. [Clinical practice for morbidly obese endometrial cancer patients: A french multicentric study].
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Loaec C, Vaucel E, Darnis E, Lopes P, Selmes G, Jaffre I, and Classe JM
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- Adult, Aged, Aged, 80 and over, Body Weight, Chemotherapy, Adjuvant, Endometrial Neoplasms drug therapy, Endometrial Neoplasms pathology, Endometrial Neoplasms radiotherapy, Endometrium pathology, Female, Humans, Laparoscopy methods, Laparotomy, Middle Aged, Preoperative Care, Radiotherapy, Adjuvant, Retrospective Studies, Endometrial Neoplasms surgery, Obesity, Morbid complications
- Abstract
Introduction: Morbid obesity may lead to difficulties for management of endometrial cancer. The aim of this study was the assessment of management of endometrial cancer for morbidly obese women and the implementation of recommendations., Methods: this is retrospective study including women with BMI =40kg/m
2 treated for endometrial cancer between November 2010 and April 2017 in the university hospital in Nantes and the Cancer Center René Gauducheau in Nantes. Patients' demographics, pre-operative intra operative, post-operative data and survival were analyzed., Results: Twenty patients met the inclusion criteria with a median age of 65.5 (28-86) and a median BMI of 47kg/m2 (40-60). Type I histologic was identified in 90% and of a stage I FIGO I in 75% of the cases. All the patients have benefited from a biopsy of endometrium before surgery. 70% of the patients have benefited from a MRI before surgery (14/20). The surgery was realized by laparotomy in 40%, by mini invasive surgery in 50% and by vaginal procedure in 10% of. Mini invasive surgery was converted in laparotomy in 40% (4/10). A discrepancy of the ESMO's recommandation was observed in 40% of the cases (8/20). Two patients did not benefit from the adjuvant radiotherapy recommended because of delay of healing., Discussion: Although good prognosis, the endometrial cancer of morbidly obese women seem to be under treat. These patients do not seem benefited an optimal pre-operative assessment. The surgery is mainly realized by laparotomy with a not complete surgical stadification for one more than a third of the patients., (Copyright © 2018 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)- Published
- 2018
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7. Clinical and Survival Impact of FDG PET in Patients with Suspicion of Recurrent Ovarian Cancer: A 6-Year Follow-Up.
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Rusu D, Carlier T, Colombié M, Goulon D, Fleury V, Rousseau N, Berton-Rigaud D, Jaffre I, Kraeber-Bodéré F, Campion L, and Rousseau C
- Abstract
Background: The aim of this retrospective study was to evaluate the contribution of fluorine-18-fluoro-deoxyglucose (FDG) positron emission tomography (PET) to the clinical management and survival outcome of patients (pts) suspected of recurrent ovarian carcinoma, with the hypothesis that early diagnosis of recurrent ovarian cancer may improve overall survival (OS)., Methods: Fifty-three FDG PET/CT scans were retrospectively analyzed for 42 pts. CT and PET/CT findings were confirmed by imaging and clinical follow-up, and/or pathology, which were considered as the gold standard diagnosis. The treatment plan based on CT staging was compared with that based on PET/CT findings. Medical records were reviewed for pts characteristics, progression-free survival (PFS), and OS. PFS and OS were analyzed using the Cox proportional hazards regression model., Results: The final diagnosis of recurrence was established pathologically (n = 16), or by a median clinical follow-up of 6.5 years (range 0.5-7.5) after the PET/CT (n = 37). PET/CT provided a higher detection sensitivity (92.2%, 47/51) than CT (60.8%, 31/51) (p < 0.001). Globally, PET/CT modified the treatment plan in 56.6% (30/53) and in 65.2% (15/23) when the CT was negative prior to PET/CT. In 30 cases, those benefited from a modified treatment plan, these changes led to the intensification of a previous treatment procedure in 83.3% (25/30), and to a reduction in the previous treatment procedure in 16.6% of cases (5/30). The Cox regression multivariate analysis showed that the number of lesions visualized by CT and presence of lung lesions detected by PET/CT were significantly associated with PFS (p = 0.002 and p = 0.035, respectively)., Conclusion: On account of its impact on treatment planning, and especially in predicting patient outcome, FDG PET is a valuable diagnostic tool for cases of suspected ovarian cancer recurrence.
- Published
- 2015
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8. Cost-Effectiveness of Conventional vs Robotic-Assisted Laparoscopy in Gynecologic Oncologic Indications.
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Marino P, Houvenaeghel G, Narducci F, Boyer-Chammard A, Ferron G, Uzan C, Bats AS, Mathevet P, Dessogne P, Guyon F, Rouanet P, Jaffre I, Carcopino X, Perez T, and Lambaudie E
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- Adult, Aged, Aged, 80 and over, Endometrial Neoplasms pathology, Endometrial Neoplasms surgery, Female, Follow-Up Studies, Humans, Length of Stay, Lymphatic Metastasis, Middle Aged, Neoplasm Staging, Pelvic Neoplasms secondary, Pelvic Neoplasms surgery, Prognosis, Prospective Studies, ROC Curve, Uterine Cervical Neoplasms pathology, Uterine Cervical Neoplasms surgery, Cost-Benefit Analysis, Endometrial Neoplasms economics, Laparoscopy economics, Pelvic Neoplasms economics, Postoperative Complications, Robotic Surgical Procedures economics, Uterine Cervical Neoplasms economics
- Abstract
Objective: Robotic surgical techniques are known to be expensive, but they can decrease the cost of hospitalization and improve patients' outcomes. The aim of this study was to compare the costs and clinical outcomes of conventional laparoscopy vs robotic-assisted laparoscopy in the gynecologic oncologic indications., Methods: Between 2007 and 2010, 312 patients referred for gynecologic oncologic indications (endometrial and cervical cancer), including 226 who underwent conventional laparoscopy and 80 who underwent robot-assisted laparoscopy, were included in this prospective multicenter study. The direct costs, operating theater costs, and hospital costs were calculated for both surgical strategies using the microcosting method., Results: Based on an average number of 165 surgical cases performed per year with the robot, the total extra cost of using the robot was €1456 per intervention. The robot-specific costs amounted to €2213 per intervention, and the cost of the robot-specific surgical supplies was €957 per intervention. The cost of the surgical supplies specifically required by conventional laparoscopy amounted to €1432, which is significantly higher than that of the robotic supplies (P < 0.001). Hospital costs were lower in the case of the robotic strategy (€2380 vs €2841, P < 0.001) because these patients spent less time in intensive care (0.38 vs 0.85 days). Operating theater costs were higher in the case of the robotic strategy (€1490 vs €1311, P = 0.0004) because the procedure takes longer to perform (4.98 hours vs 4.38 hours)., Conclusions: The main driver of additional costs is the fixed cost of the robot, which is not compensated by the lower hospital room costs. The robot would be more cost-effective if robotic interventions were performed on a larger number of patients per year or if the purchase price of the robot was reduced. A shorter learning curve would also no doubt decrease the operating theater costs, resulting in financial benefits to society.
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- 2015
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9. Survival benefit of hyperthermic intraperitoneal chemotherapy for recurrent ovarian cancer: a multi-institutional case control study.
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Le Brun JF, Campion L, Berton-Rigaud D, Lorimier G, Marchal F, Ferron G, Oger AS, Dravet F, Jaffre I, and Classe JM
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- Case-Control Studies, Combined Modality Therapy, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neoplasm Recurrence, Local pathology, Neoplasm Recurrence, Local therapy, Neoplasm Staging, Ovarian Neoplasms pathology, Ovarian Neoplasms therapy, Prognosis, Retrospective Studies, Survival Rate, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Chemotherapy, Cancer, Regional Perfusion, Hyperthermia, Induced, Neoplasm Recurrence, Local mortality, Ovarian Neoplasms mortality
- Abstract
Background: Hyperthermic intraperitoneal chemotherapy (HIPEC) and complete surgical removal of the tumor, in relapsing patients may provide a clinical benefit. There is no consensus considering the place of HIPEC for patients who had first ovarian cancer relapse. To assess for possible efficacy of HIPEC on overall survival (OS) rates in this situation, we performed a multi-institutional study., Methods: The current study was a retrospective case control multi-institutional study comparing a group of patients treated with HIPEC to a group of patients treated without HIPEC. Inclusion criteria were first relapse of a serous ovarian carcinoma and >6 months after the end of initial treatment. Exclusion criteria were another pathological subtype of ovarian cancer, a relapse at <6 months after initial treatment, and a second relapse or more. We aimed to assess OS, morbidity, and mortality rates and prognostic factors., Results: From June 1997-July 2011, 42 patients were included, 23 in the HIPEC group and 19 in the control group. Each patient from the two groups had a complete secondary surgery at the time of the first relapse. At 4 years OS was 75.6 % in the HIPEC group and 19.4 % in the control group (p = 0.013). In a multivariate analysis, HIPEC and interval-free before the end of initial treatment were both independent prognostic factors., Conclusion: When compared to the control group, complete secondary surgery and HIPEC appear to afford a better OS rate than complete secondary surgery alone, in case of first ovarian cancer relapse. Further randomized trials are warranted to confirm these results.
- Published
- 2014
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