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1. 18F-FDG PET/CT-Based Prognostic Survival Model After Surgery for Head and Neck Cancer

Author: Gwenaelle Creff, Franck Jegoux, Xavier Palard, Adrien Depeursinge, Ronan Abgral, Remi Marianowski, Jean-Christophe Leclere, Thomas Eugene, Olivier Malard, Renaud De Crevoisier, Anne Devillers, Joel Castelli, Jonchère, Laurent, CHU Pontchaillou [Rennes], Département de médecine nucléaire [Rennes], CRLCC Eugène Marquis (CRLCC), Centre Eugène Marquis (CRLCC), Haute Ecole Spécialisée de Suisse Occidentale (HES-SO), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Centre hospitalier universitaire de Nantes (CHU Nantes), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), LTSI, INSERM, U1099 (Rennes, France), and Cancer Institute (Rennes, France)
Subjects: [SDV.IB] Life Sciences [q-bio]/Bioengineering, overall sur-vival, 030218 nuclear medicine & medical imaging, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, PET, distant metastasis, 030220 oncology & carcinogenesis, Radiology, Nuclear Medicine and imaging, head and neck cancer, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Clinical Investigation, prognosis, CT
Abstract: International audience; The aims of this multicenter study were to identify clinical and preop-erative PET/CT parameters predicting overall survival (OS) and distant metastasis???free survival (DMFS) in a cohort of head and neck squa-mous cell carcinoma patients treated with surgery, to generate a prog-nostic model of OS and DMFS, and to validate this prognostic model with an independent cohort. Methods: A total of 382 consecutive patients with head and neck squamous cell carcinoma, divided into training (n = 318) and validation (n = 64) cohorts, were retrospectively included. The following PET/CT parameters were analyzed: clinical parameters, SUVmax, SUVmean, metabolic tumor volume (MTV), total lesion glycolysis, and distance parameters for the primary tumor and lymph nodes defined by 2 segmentation methods (relative SUVmax threshold and absolute SUV threshold). Cox analyses were performed for OS and DMFS in the training cohort. The concordance index (c-index) was used to identify highly prognostic parameters. These prognostic parameters were externally tested in the validation cohort. Results: In multivariable analysis, the significant parameters for OS were T stage and nodal MTV, with a c-index of 0.64 (P < 0.001). For DMFS, the significant parameters were T stage, nodal MTV, and maxi-mal tumor???node distance, with a c-index of 0.76 (P < 0.001). These combinations of parameters were externally validated, with c-indices of 0.63 (P < 0.001) and 0.71 (P < 0.001) for OS and DMFS, respec-tively. Conclusion: The nodal MTV associated with the maximal tumor???node distance was significantly correlated with the risk of DMFS. Moreover, this parameter, in addition to clinical parameters, was associated with a higher risk of death. These prognostic factors may be used to tailor individualized treatment. Superscript/Subscript Available
Published: 2022
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2. Effectiveness of Geriatric Assessment-Driven Interventions on Survival and Functional and Nutritional Status in Older Patients with Head and Neck Cancer: A Randomized Controlled Trial (EGeSOR)

Author: Elena Paillaud, Lydia Brugel, Chloe Bertolus, Melany Baron, Emilie Bequignon, Philippe Caillet, Thomas Schouman, Jean Lacau Saint Guily, Sophie Périé, Eric Bouvard, Marie Laurent, Didier Salvan, Laurence Chaumette, Laure de Decker, Benoit Piot, Beatrix Barry, Agathe Raynaud-Simon, Elisabeth Sauvaget, Christine Bach, Antoine Bizard, Abderrahmane Bounar, Aurelien Minard, Bechara Aziz, Eric Chevalier, Dominique Chevalier, Cedric Gaxatte, Olivier Malard, Evelyne Liuu, Sandrine Lacour, Laetitia Gregoire, Charlotte Lafont, Florence Canouï-Poitrine, Tapia, Claudia, Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Cancer Research and Personalized Medicine - CARPEM [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), IMRB - CEPIA/'Clinical Epidemiology And Ageing : Geriatrics, Primary Care and Public Health' [Créteil] (U955 Inserm - UPEC), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service d'ORL [Créteil], Centre Hospitalier Intercommunal de Créteil (CHIC), Centre Léon Bérard [Lyon], Service de Stomatologie et Chirurgie Maxillo-facial [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), Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), IMRB - 'Biomechanics and Respiratory Apparatus' [Créteil] (U955 Inserm - UPEC), Biomécanique & Appareil Respiratoire (BAR), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Centre National de la Recherche Scientifique (CNRS), Institut de Biomécanique Humaine Georges Charpak (IBHGC), Université Sorbonne Paris Nord-Arts et Métiers Sciences et Technologies, HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), Oto-Rhino-Laryngologie Chirurgie cervico-faciale [CHU Tenon], CHU Tenon [AP-HP], Fondation Ophtalmologique Adolphe de Rothschild [Paris], Clinique Hartmann [Neuilly-sur-Seine], Hôpital Henri Mondor, Centre Hospitalier Sud Francilien, Centre hospitalier universitaire de Nantes (CHU Nantes), Pôle hospitalo-universitaire de gérontologie clinique [Nantes], Département de Stomatologie et chirurgie maxillo-faciale [CHU Nantes], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Centre hospitalier Saint-Joseph [Paris], Hôpital Foch [Suresnes], Centre Hospitalier Intercommunal Villeneuve-Saint-Georges (CHIV), Hôpital Léopold Bellan [Paris] (HLB), Hôpital Claude Huriez [Lille], CHU Lille, Centre hospitalier universitaire de Poitiers (CHU Poitiers), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)
Subjects: Cancer Research, function, geriatric assessment, head and neck cancer, elderly, survival, nutrition, [SDV.MHEP.GEG] Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, [SDV.MHEP.GEG]Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.AEN] Life Sciences [q-bio]/Food and Nutrition, Oncology, [SDV.CAN] Life Sciences [q-bio]/Cancer, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition
Abstract: International audience; This study assesses the efficacy of Geriatric Assessment (GA)-driven interventions and follow-up on six-month mortality, functional, and nutritional status in older patients with head and neck cancer (HNC). HNC patients aged 65 years or over were included between November 2013 and September 2018 by 15 Ear, Nose, and Throat (ENT) and maxillofacial surgery departments at 13 centers in France. The study was of an open-label, multicenter, randomized, controlled, and parallel-group design, with independent outcome assessments. The patients were randomized 1:1 to benefit from GA-driven interventions and follow-up versus standard of care. The interventions consisted in a pre-therapeutic GA, a standardized geriatric intervention, and follow-up, tailored to the cancer-treatment plan for 24 months. The primary outcome was a composite criterion including six-month mortality, functional impairment (fall in the Activities of Daily Living (ADL) score ≥2), and weight loss ≥10%. Among the patients included (n = 499), 475 were randomized to the experimental (n = 238) or control arm (n = 237). The median age was 75.3 years [70.4–81.9]; 69.5% were men, and the principal tumor site was oral cavity (43.9%). There were no statistically significant differences regarding the primary endpoint (n = 98 events; 41.0% in the experimental arm versus 90 (38.0%); p = 0.53), or for each criterion (i.e., death (31 (13%) versus 27 (11.4%); p = 0.48), weight loss of ≥10% (69 (29%) versus 65 (27.4%); p = 0.73) and fall in ADL score ≥2 (9 (3.8%) versus 13 (5.5%); p = 0.35)). In older patients with HNC, GA-driven interventions and follow-up failed to improve six-month overall survival, functional, and nutritional status.
Published: 2022
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3. History of tonsillectomy and risk of oropharyngeal cancer

Author: Sophie Périé, Christian Righini, Sébastien Vergez, Nicolas Fakhry, Justine Lerat, Pierre Philouze, Nicolas Saroul, Jean-Damien Combes, Haitham Mirghani, Philippe Ceruse, Olivier Malard, Guillaume Buiret, Nicolas Voisin, Jean Lacau St Guily, Ritoungarte Nadjingar, Franck Jegoux, Emmanuel Bartaire, Gary M. Clifford, Renaud Garrel, Benjamin Verillaud, Silvia Franceschi, Centre International de Recherche contre le Cancer - International Agency for Research on Cancer (CIRC - IARC), Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Hospices Civils de Lyon (HCL), Clinique Hartmann [Neuilly-sur-Seine], Centre hospitalier universitaire de Nantes (CHU Nantes), CHU Pontchaillou [Rennes], Chemistry, Oncogenesis, Stress and Signaling (COSS), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire [Grenoble] (CHU), Institut Gustave Roussy (IGR), Département de cancérologie cervico-faciale [Gustave Roussy] (CCF), CHU Lille, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Hôpital Rothschild [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Ligue nationale contre le cancerLigue nationale contre le cancer [LNCC CD69 2014], Institut National Du Cancer (INCa) Institut National du Cancer (INCA) France [2014/122], Italian Ministry of Health (Ricerca Corrente) Ministry of Health, Italy, Association pour la Recherche sur le Cancer (ARC)Fondation ARC pour la Recherche sur le Cancer [20111204169], Université de Rennes (UR)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre hospitalier de Valence, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université de Montpellier (UM), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), Université Toulouse III - Paul Sabatier (UT3), 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), Assistance Publique - Hôpitaux de Marseille (APHM), CHU Limoges, CHU Clermont-Ferrand, Hôpital Lariboisière-Fernand-Widal [APHP], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Rothschild [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: Cancer Research, medicine.medical_specialty, Tonsillar cancer, Adolescent, medicine.medical_treatment, Palatine Tonsil, Oropharyngeal Tumor, [SDV.CAN]Life Sciences [q-bio]/Cancer, 03 medical and health sciences, 0302 clinical medicine, Tongue, Internal medicine, Base of the tongue cancer, medicine, Humans, 030223 otorhinolaryngology, Head and neck cancer, Tonsillectomy, Oropharyngeal cancer, business.industry, Cancer, Odds ratio, medicine.disease, 3. Good health, Oropharyngeal Neoplasms, medicine.anatomical_structure, Tonsil, Oncology, 030220 oncology & carcinogenesis, Oral Surgery, business
Abstract: International audience; Objective: To investigate whether palatine tonsillectomy in youth influences the risk of oropharyngeal cancers (OPC) by assessing the association between history of tonsillectomy and risk of tonsillar, base of tongue (BOT) cancer, and other head and neck cancers (HNC). Materials and Methods: RACKAM was a case-case study comparing frequency of tonsillectomy history in individuals diagnosed with HNC from 2013 to 2018 in 15 centers across France. History of tonsillectomy was defined using combined assessment of patients and rsquo; recollections and surgeons and rsquo; visualizations of tonsil area. OPC subsite-specific odds ratios (OR) of tonsillectomy were calculated using multinomial logistic regression with nonoropharyngeal HNC as reference. Results: 1045 patients were included in the study. Frequency of tonsillectomy was 19.5% in patients with tonsillar cancer (N = 85), 49.3% in BOT (N = 76), 33.8% in other oropharyngeal cancers (N = 202) and 38.0% in non-oropharyngeal HNC (N = 682). History of tonsillectomy was inversely associated with tonsillar cancer (adjusted OR 0.4; 95% CI 0.2 and ndash;0.8), and positively associated with BOT cancer (adjusted OR 1.8; 95% CI 1.1 and ndash;3.1), but was not associated with all OPC combined (adjusted OR 1.1; 95% CI 0.8 and ndash;1.4). Sensitivity analyses considering only patients and rsquo; or surgeons and rsquo; assessments of tonsillectomy provided comparable results. Conclusion: We confirm the long-term protective effect of tonsillectomy performed in youth on future risk of tonsillar cancer, and our study is the second to report a concurrent increased risk of BOT cancer. Our data suggest that tonsillectomy in youth shifts the site of the first diagnosed oropharyngeal tumor and has a limited impact on overall risk of OPC.
Published: 2021
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4. Guidelines of the French Society of Otorhinolaryngology–Head and Neck Surgery (SFORL), part I: Primary treatment of pleomorphic adenoma

Author: Olivier Malard, C.-A. Righini, Emmanuelle Uro-Coste, T. Kennel, Sébastien Vergez, M. Courtade-Saidi, Renaud Garrel, Dominique Chevalier, A. Varoquaux, C. Cartier, P. Mogultay, Nicolas Fakhry, S. Tronche, Juliette Thariat, CHU Toulouse [Toulouse], Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), CHU Toulouse [Toulouse]-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Laboratoire Parole et Langage (LPL), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre de Recherches en Cancérologie de Toulouse (CRCT), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), 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), CHU Grenoble, Centre hospitalier universitaire de Nantes (CHU Nantes), Laboratoire de physique corpusculaire de Caen (LPCC), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-École Nationale Supérieure d'Ingénieurs de Caen (ENSICAEN), Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3), Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU), Université de Montpellier (UM), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), 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), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Normandie Université (NU)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS), and Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)
Subjects: medicine.medical_specialty, [SDV]Life Sciences [q-bio], Biopsy, Fine-Needle, Enucleation, Adenoma, Pleomorphic, Salivary glands, Malignancy, Pleomorphic adenoma, Otolaryngology, 03 medical and health sciences, 0302 clinical medicine, Humans, Medicine, 030223 otorhinolaryngology, Lymph node, Parotid, Frozen section procedure, Submandibular gland, Salivary gland, business.industry, Salivary Gland Neoplasms, medicine.disease, Facial nerve, 3. Good health, medicine.anatomical_structure, Otorhinolaryngology, 030220 oncology & carcinogenesis, Surgery, Radiology, business
Abstract: International audience; Introduction: The authors present the guidelines of the French Society of Otorhinolaryngology-Head and Neck Surgery (SFORL) for the diagnosis and treatment of pleomorphic adenoma (PA) of the salivary glands.Method: A review of the literature was performed by a multidisciplinary task force. Guidelines were drafted based on the articles retrieved and the workgroup members' individual experience. Guidelines were graded A, B, C or expert opinion by decreasing level of evidence.Results: In clinically suspected salivary gland PA, MRI should be performed, including head and neck lymph node levels. Fine needle aspiration cytology is particularly recommended for tumours difficult to characterise by MRI. Frozen section biopsy should be performed to confirm diagnosis and adapt the surgical procedure in case of intraoperative findings of malignancy. Complete resection of the parotid PA should be performed en bloc, including margins, when feasible according to tumour location, while respecting the facial nerve. Enucleation (resection only in contact with the tumour) is not recommended. For the accessory salivary and submandibular glands, complete en bloc resection should be performed.
Published: 2021
Full Text: View/download PDF

5. Guidelines of the French Society of Otorhinolaryngology–Head and Neck Surgery (SFORL), part II: Management of recurrent pleomorphic adenoma of the parotid gland

Author: C.-A. Righini, C. Cartier, P. Mogultay, Renaud Garrel, Nicolas Fakhry, Emmanuelle Uro-Coste, Dominique Chevalier, A. Varoquaux, M. Courtade-Saidi, Sébastien Vergez, T. Kennel, Olivier Malard, S. Tronche, Juliette Thariat, Laboratoire de physique corpusculaire de Caen (LPCC), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-École Nationale Supérieure d'Ingénieurs de Caen (ENSICAEN), Normandie Université (NU)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Centre National de la Recherche Scientifique (CNRS), Hôtel-Dieu de Nantes, Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), CHU Lille, 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), Centre de Recherches en Cancérologie de Toulouse (CRCT), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Société française d'ORL et chirurgie cervico-faciale (SFORL), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Centre Hospitalier Universitaire [Grenoble] (CHU), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), and Michel-Avella, Amandine
Subjects: medicine.medical_specialty, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Adenoma, Pleomorphic, Salivary glands, Complete resection, complex mixtures, MESH: Salivary Gland Neoplasms, Pleomorphic adenoma, Otolaryngology, 03 medical and health sciences, 0302 clinical medicine, Recurrence, Humans, Parotid Gland, Medicine, MESH: Parotid Gland, MESH: Parotid Neoplasms, 030223 otorhinolaryngology, Parotid, Subclinical infection, [PHYS]Physics [physics], MESH: Humans, business.industry, General surgery, Evidence-based medicine, MESH: Adenoma, Pleomorphic, Salivary Gland Neoplasms, medicine.disease, MESH: Otolaryngology, Parotid Neoplasms, 3. Good health, Parotid gland, Radiation therapy, [SDV] Life Sciences [q-bio], medicine.anatomical_structure, Otorhinolaryngology, 030220 oncology & carcinogenesis, Head and neck surgery, Surgery, Neoplasm Recurrence, Local, business, MESH: Neoplasm Recurrence, Local
Abstract: International audience; Introduction: The authors present the guidelines of the French Society of Otorhinolaryngology-Head and Neck Surgery (SFORL) for the management of recurrent pleomorphic adenoma (RPA) of the parotid gland.Method: A review of the literature was performed by a multidisciplinary task force. Guidelines were drafted, based on the articles retrieved and the work group members' individual experience. There were then read and re-edited by an independent reading group. The proposed recommendations were graded A, B or C on decreasing levels of evidence.Results: Complete resection under neuromonitoring is recommended in case of RPA. The risks of progression and malignant transformation, which are higher the younger the patient, have to be taken into consideration. The risk of functional sequelae must be explained to the patient. MRI is recommended ahead of any surgery for parotid RPA, to determine extension and detect subclinical lesions. Radiotherapy should be considered in case of multi-recurrent pleomorphic adenoma after macroscopically complete revision surgery at high risk of new recurrence (microscopic residual disease), in case of RPA after incomplete resection, and in non-operable RPA.
Published: 2021
Full Text: View/download PDF

6. Effect of the Use of Intranasal Spray of Essential Oils in Patients with Perennial Allergic Rhinitis: A Prospective Study

Author: Pascal Demoly, Davide Caimmi, Olivier Malard, Gabriel Thabut, Renaud Louis, Catherine Neukirch, Département pneumologie et addictologie [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Physiopathologie et Epidémiologie des Maladies Respiratoires (PHERE (UMR_S_1152 / U1152)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Universitaire de Liège (CHU-Liège), Université de Liège, Centre hospitalier universitaire de Nantes (CHU Nantes), Université de Montpellier (UM), Herrada, Anthony, Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Institut Desbrest de santé publique (IDESP), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)
Subjects: Adult, Male, medicine.medical_specialty, Rhinitis, Allergic, Perennial, Perennial plant, medicine.medical_treatment, Immunology, Gastroenterology, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Allergic rhinitis, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Anti-Allergic Agents, Control, Oils, Volatile, medicine, Humans, Immunology and Allergy, In patient, Prospective Studies, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, 030223 otorhinolaryngology, Prospective cohort study, business.industry, Nasal Sprays, General Medicine, Middle Aged, 3. Good health, Management, Treatment Outcome, 030228 respiratory system, Nasal spray, Control test, Essential oils, [SDV.SP.PHARMA] Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, Experimental Allergy − Research Article, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Female, Nasal administration, Symptom Assessment, business, [SDV.IMM.ALL] Life Sciences [q-bio]/Immunology/Allergology, After treatment, Nasal symptoms
Abstract: Introduction: Among allergic rhinitis (AR) symptoms, nasal obstruction particularly affects the quality of life. Antihistamines and intranasal corticosteroids are the most frequently prescribed symptomatic drugs, but their efficacy is often incomplete. Essential oils (EO) have shown an anti-inflammatory effect and potential in treating patients with AR. The aim of this study was to evaluate the effectiveness of a hypertonic EO-based nasal spray on perennial AR (PAR) symptoms. Methods: This prospective, open-label, non-randomized, multicentric trial included 43 patients with PAR sensitized to mites, not controlled for more than a year. All were treated with Puressentiel® Respiratory-Decongestant Nasal Spray for 30 days. Their usual treatment remained unchanged during the study period. Before and after treatment, each participant filled out a rhinitis questionnaire, the Allergic Rhinitis Control Test (ARCT). A nasal inspiratory peak flow (NIPF) was performed. Results: The mean ARCT was 16.4 and 20.5 at D0 and D30, respectively (p < 0.001); the mean increase between D0 and D30 was 4.1 (p < 0.001). The proportion of patients with controlled rhinitis after 30 days of treatment was 69.8 versus 14% before treatment (p < 0.001). The mean NIPF was 86.5 L/min and 105.1 L/min at D0 and D30, respectively (p < 0.001); the mean increase between D0 and D30 was 18.5 L/min. Conclusion: A hypertonic EO-based nasal spray could be a new and natural option in the management of PAR. It could also be used as an add-on therapy when nasal symptoms are not fully controlled.
Published: 2021
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7. Management of cN0 low‐grade mucoepidermoid carcinomas of salivary glands: Prospective multicentre study of 152 cases of the French Network of Rare Head and Neck Tumors (REFCOR)

Author: Francois Mouawad, Béatrix Barry, Philippe Herman, Nicolas Fakhry, Bertrand Baujat, Ludovic de Gabory, Sébastien Vergez, Vianney Bastit, Juliette Thariat, Laurie Saloner Dahan, Olivier Mauvais, Gilles Poissonnet, J.-C. Merol, Laurent Gilain, Thomas Radulesco, Justin Michel, Renaud Garrel, Caroline Even, Emmanuelle Uro-Coste, Dominique Chevalier, C.-A. Bach, Roch Giorgi, C.-A. Righini, Olivier Malard, Xavier Dufour, Valérie Costes-Martineau, Patrick Dessi, Pathologies Pulmonaires et Plasticité Cellulaire - UMR-S 1250 (P3CELL), Université de Reims Champagne-Ardenne (URCA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Aix Marseille Université (AMU), CHU Marseille, 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), 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), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), CHU Bordeaux [Bordeaux], Pathogénèse et contrôle des infections chroniques (PCCI), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), 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 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), Hôpital Foch [Suresnes], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Chirurgie ORL et cervico-faciale [Centre François Baclesse], Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN), 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), dormoy, valerian, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre Hospitalier Universitaire de Montpellier (CHU Montpellier ), and 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)
Subjects: Adult, Male, medicine.medical_specialty, Adolescent, [SDV]Life Sciences [q-bio], MEDLINE, 03 medical and health sciences, 0302 clinical medicine, Mucoepidermoid carcinoma, medicine, Humans, Prospective Studies, [SDV.MHEP.OS]Life Sciences [q-bio]/Human health and pathology/Sensory Organs, 030223 otorhinolaryngology, ComputingMilieux_MISCELLANEOUS, Aged, Neoplasm Staging, Aged, 80 and over, business.industry, Head and neck tumors, Cancer, Middle Aged, medicine.disease, Salivary Gland Neoplasms, Combined Modality Therapy, 3. Good health, Parotid gland, Survival Rate, medicine.anatomical_structure, Otorhinolaryngology, [SDV.MHEP.OS] Life Sciences [q-bio]/Human health and pathology/Sensory Organs, 030220 oncology & carcinogenesis, Lymphatic Metastasis, Lymph Node Excision, Carcinoma, Mucoepidermoid, Female, Radiology, France, Neoplasm Grading, business
Abstract: International audience
Published: 2020
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8. 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
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9. Development of a rat model of mandibular irradiation sequelae for preclinical studies of bone repair

Author: Marine Dréno, Pierre Weiss, Pauline Bléry, Jérôme Guicheux, Olivier Malard, Florent Espitalier, Centre hospitalier universitaire de Nantes (CHU Nantes), Regenerative Medicine and Skeleton (RMeS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-École nationale vétérinaire, agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS), Ostéo-articulaire - Tête et cou - Odontologie - Neurochirurgie - Neurotraumatologie [CHU Nantes] (Pôle hospitalo-universitaire PHU4 - OTONN), Laboratoire d'ingénierie osteo-articulaire et dentaire (LIOAD), Université de Nantes (UN)-IFR26-Institut National de la Santé et de la Recherche Médicale (INSERM), Jehan, Frederic, Regenerative Medicine and Skeleton research lab (RMeS), Ecole Nationale Vétérinaire, Agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), and Université de Nantes (UN)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, medicine.medical_specialty, [SDV.MHEP.AHA] Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Bone Regeneration, medicine.medical_treatment, Rat model, Biomedical Engineering, Medicine (miscellaneous), Neovascularization, Physiologic, Bioengineering, Bone healing, Mandible, Bone tissue engineering, Osteogenesis, medicine, [SDV.MHEP.AHA]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], Animals, [SDV.MHEP.RSOA] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, [SDV.MHEP.GEG] Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, business.industry, [SDV.MHEP.GEG]Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, Irradiated bone, X-Ray Microtomography, Radiation therapy, Disease Models, Animal, Upper aerodigestive tract, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Rats, Inbred Lew, Radiology, business
Abstract: Repairing mandibular bone defects after radiotherapy of the upper aerodigestive tract is clinically challenging. Although bone tissue engineering has recently generated a number of innovative treatment approaches for osteoradionecrosis (ORN), these modalities must be evaluated preclinically in a relevant, reproducible, animal model. The objective of this study was to evaluate a novel rat model of mandibular irradiation sequelae, with a focus on the adverse effects of radiotherapy on bone structure, intraosseous vascularization, and bone regeneration. Rats were irradiated with a single 80 Gy dose to the jaws. Three weeks after irradiation, mandibular bone defects of different sizes (0, 1, 3, or 5 mm) were produced in each hemimandible. Five weeks after the surgical procedure, the animals were euthanized. Explanted mandibular samples were qualitatively and quantitatively assessed for bone formation, bone structure, and intraosseous vascular volume by using micro-computed tomography, scanning electron microscopy, and histology. Twenty irradiated hemimandibles and 20 nonirradiated hemimandibles were included in the study. The bone and vessel volumes were significantly lower in the irradiated group. The extent of bone remodeling was inversely related to the defect size. In the irradiated group, scanning electron microscopy revealed a large number of polycyclic gaps consistent with periosteocytic lysis (described as being pathognomonic for ORN). This feature was correlated with elevated osteoclastic activity in a histological assessment. In the irradiated areas, the critical-sized defect was 3 mm. Hence, our rat model of mandibular irradiation sequelae showed hypovascularization and osteopenia. Impact statement Repairing mandibular bone defects after radiotherapy of the upper aerodigestive tract is clinically challenging. Novel tissue engineering approaches for healing irradiated bone must first be assessed in animal models. The current rat model of mandibular irradiation sequelae is based on tooth extraction after radiotherapy. However, the mucosal sequelae of radiotherapy often prevent the retention of tissue-engineered biomaterials within the bone defect. We used a submandibular approach to create a new rat model of mandibular irradiation sequelae, which enables the stable retention of biomaterials within the bone defect and should thus facilitate the assessment of bone regeneration.
Published: 2020
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10. Good clinical practice recommendations for the use of PET/CT in oncology

Author: Arnaud Philip, Olivier Casasnovas, G. Quere, Caroline Bodet-Milin, Emmanuel Itti, David Groheux, Caroline Rousseau, Antoine Girard, Désirée Deandreis, Ronan Abgral, Philippe Moreau, Corinne Balleyguier, Pierre-Yves Salaun, Jean-Louis Alberini, Myriam Wartski, Solène Querellou-Lefranc, Florent Cachin, Isabelle Brenot-Rossi, Romain Coriat, Françoise Kraeber-Bodéré, David Taïeb, Antoine Tabarin, Jean-François Grellier, Olivier Malard, Alain Luciani, Elif Hindié, COLO, Mouniati, CHRU Brest - Service de médecine nucléaire (CHU - BREST - Med Nucléaire), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Laboratoire d'ingénierie osteo-articulaire et dentaire (LIOAD), Université de Nantes (UN)-IFR26-Institut National de la Santé et de la Recherche Médicale (INSERM), University Hospital of Brest, Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Gastro-entérologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Département de Médecine Nucléaire [AP-HM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE)- Hôpital Nord [CHU - APHM], Département d'endocrinologie - Bordeaux 2, Université Bordeaux Segalen - Bordeaux 2, Laboratoire des signaux et systèmes (L2S), Université Paris-Sud - Paris 11 (UP11)-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS), Foch Hospital, Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Hopital Saint-Louis [AP-HP] (AP-HP), University Hospital of Nantes, Médecine nucléaire, Département d'imagerie médicale [Gustave Roussy], Institut Gustave Roussy (IGR)-Institut Gustave Roussy (IGR), Institut Gustave Roussy (IGR), Laboratoire d'Imagerie Moléculaire Expérimentale (LIME), Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Service de médecine nucléaire [Créteil], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital du Bocage, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre hospitalier universitaire de Nantes (CHU Nantes), Service de Radiologie Adultes, CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre Jean Perrin [Clermont-Ferrand] (UNICANCER/CJP), UNICANCER, Imagerie Moléculaire et Stratégies Théranostiques (IMoST), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), 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), and Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Oncology, Positron emission tomography, medicine.medical_specialty, Referral, [SDV]Life Sciences [q-bio], Computed tomography, [SDV.CAN]Life Sciences [q-bio]/Cancer, Methodological approval, Medical Oncology, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, [SDV.CAN] Life Sciences [q-bio]/Cancer, Neoplasms, Positron Emission Tomography Computed Tomography, Internal medicine, Humans, Medicine, Radiology, Nuclear Medicine and imaging, ComputingMilieux_MISCELLANEOUS, PET-CT, medicine.diagnostic_test, business.industry, General Medicine, Focus group, 3. Good health, 030220 oncology & carcinogenesis, Good clinical practice, Clinical value, Nuclear Medicine, business
Abstract: Positron emission tomography/computed tomography (PET/CT) is a nuclear medicine functional imaging technique with proven clinical value in oncology. PET/CT indications are continually evolving with fresh advances made through research. French practice on the use of PET in oncology was framed in recommendations based on Standards-Options-Recommendations methodology and coordinated by the French federation of Comprehensive Cancer Centres (FNLCC). The recommendations were originally issued in 2002 followed by an update in 2003, but since then, a huge number of scientific papers have been published and new tracers have been licenced for market release. The aim of this work is to bring the 2003 version recommendations up to date. For this purpose, a focus group was set up in collaboration with the French Society for Nuclear Medicine (SFMN) to work on developing good clinical practice recommendations. These good clinical practice recommendations have been awarded joint French National Heath Authority (HAS) and French Cancer Institute (INCa) label status-the stamp of methodological approval. The present document is the outcome of comprehensive literature review and rigorous appraisal by a panel of experts, organ specialists, clinical oncologists, surgeons and imaging specialists. These data were also used for the EANM referral guidelines.
Published: 2020
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11. Utilisation d’un système de navigation en chirurgie endonasale : impact sur la stratégie chirurgicale et la satisfaction du chirurgien. Une étude prospective multicentrique

Author: Eric Vicaut, V. Prulière-Escabasse, L. Castillo, D. Briche, P.-J. Monteyrol, B. Lombard, P. Lindas, A. Bizon, R. Stringini, Olivier Malard, B. Navailles, T. Nasser, J.-L. Betton, J.-B. Lecanu, B. Bertrand, J.-C. Merol, Benjamin Verillaud, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Clinique du Pré, Université d'Angers (UA), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre hospitalier régional Metz-Thionville (CHR Metz-Thionville), Hôpital Lariboisière-Fernand-Widal [APHP], Université Paris Diderot - Paris 7 (UPD7), Clinique de l’Atlantique, Partenaires INRAE, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Institut Universitaire de la Face et du Cou [Nice], Institut Arthur Vernes, Centre Hospitalier Robert Schuman, Hôpital d'Instruction des Armées Desgenettes, Service de Santé des Armées, Centre hospitalier universitaire de Nantes (CHU Nantes), Hôpital Robert Debré, Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims (CHU Reims), Polyclinique de Courlancy, Centre hospitalier de Valence, CHU Henri Mondor, CHI Créteil, Maladies neurodéveloppementales et neurovasculaires (NeuroDiderot (UMR_S_1141 / U1141)), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)
Subjects: 03 medical and health sciences, [SPI]Engineering Sciences [physics], 0302 clinical medicine, Otorhinolaryngology, 030220 oncology & carcinogenesis, Surgery, 030223 otorhinolaryngology
Abstract: Resume Objectifs Les systemes de navigation chirurgicale (SNC) sont maintenant largement utilises en chirurgie endoscopique endonasale ; le benefice apporte par ces systemes n’a neanmoins ete que partiellement etudie. L’objectif de cette etude etait d’evaluer de facon prospective et multicentrique l’impact de l’utilisation d’un SNC sur le deroulement du geste chirurgical et sur la satisfaction du chirurgien. Materiels et methodes Etude prospective multicentrique portant sur les patients operes d’une chirurgie endoscopique endonasale avec le SNC electromagnetique DigiPointeur® (DGP) dans 16 centres hospitaliers francais. Le cahier d’observation etait rempli par le chirurgien immediatement apres la fin de l’intervention. Les donnees recueillies incluaient en particulier le type d’intervention, les eventuels changements dans la strategie ou dans l’etendue du geste chirurgical lies a l’utilisation du SNC, et le niveau de satisfaction du chirurgien, evalue a partir d’une echelle analogique et de l’autoevaluation du stress ressenti durant l’intervention. Resultats L’etude permettait d’inclure 311 patients operes par 36 chirurgiens dans 16 hopitaux et cliniques francais. L’ethmoidectomie etait le geste le plus souvent pratique, dans 90 % des cas. Une exerese tumorale etait realisee dans 5,1 % des cas. L’utilisation du SNC permettait d’effectuer un geste chirurgical plus complet dans 81 % des cas, en particulier en permettant d’identifier et d’ouvrir des cellules supplementaires dans 57 % des cas. Le niveau moyen de satisfaction evaluee sur une echelle analogique etait de 8,6/10 ; le chirurgien ressentait une diminution du stress chirurgical attribuee a l’utilisation du SNC dans 95 % des cas. Conclusion Dans cette etude observationnelle, le recours a un SNC permettait d’augmenter l’etendue du geste chirurgical dans 81 % des cas, et avait un impact positif sur le stress ressenti par le chirurgien dans 95 % des cas.
Published: 2019
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12. Peripheral neck nerve tumor: A 73-case study and literature review

Author: C. Salaud, Olivier Malard, Florent Espitalier, C. Bossard, Grégory Michel, K. Boumaza, Service d’ORL et de chirurgie cervico-faciale, and Centre Hospitalier Intercommunal de Créteil (CHIC)
Subjects: Adult, Male, medicine.medical_specialty, Adolescent, [SDV]Life Sciences [q-bio], Malignant peripheral nerve sheath tumor, Schwannoma, Malignant transformation, Diagnosis, Differential, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Peripheral Nervous System Neoplasms, medicine, Humans, Neurofibroma, Child, 030223 otorhinolaryngology, Aged, Retrospective Studies, Aged, 80 and over, medicine.diagnostic_test, business.industry, Infant, Retrospective cohort study, Magnetic resonance imaging, Middle Aged, medicine.disease, Combined Modality Therapy, Magnetic Resonance Imaging, Neuroblastic Tumor, 3. Good health, Peripheral, Otorhinolaryngology, Chemotherapy, Adjuvant, Head and Neck Neoplasms, Child, Preschool, 030220 oncology & carcinogenesis, Female, Surgery, Radiology, business
Abstract: Objectives Peripheral neck nerve tumors are rare and mostly benign neoplasms. The exceptional malignant forms are very aggressive, and diagnosis is difficult. The objective of this study was to evaluate diagnostic and therapeutic management and identify possible predictive factors. Material and methods A retrospective study was conducted of 73 patients treated for peripheral neck nerve tumor between 1995 and 2015. Results Mean age was 44 years. The main presenting symptom was a cervical mass, isolated or associated with signs related to the affected nerve structure. Diagnosis was suspected by slow progression of a firm mass, featuring T1 hyposignal and T2 hypersignal on magnetic resonance imaging. Surgery was performed in 99% of cases, completed by adjuvant chemotherapy in case of malignant neuroblastic tumor. Type 1 neurofibromatosis and sudden increase in mass with or without associated pain suggested malignant transformation. Age below 10 years suggested neuroblastic tumor. Conclusion Neck nerve tumors are very often benign with low degenerative potential. Surgery is the treatment of choice after risk/benefit analysis. However, there is no clearly defined consensus regarding the timing of surgery for these lesions.
Published: 2019
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13. Actualisation des recommandations de bonne pratique clinique pour l’utilisation de la TEP en cancérologie

Author: Pierre-Yves, Salaün, Ronan, Abgral, Olivier, Malard, Solène, Querellou-Lefranc, Gilles, Quere, Myriam, Wartski, Romain, Coriat, Elif, Hindie, David, Taieb, Antoine, Tabarin, Antoine, Girard, Jean-François, Grellier, Isabelle, Brenot-Rossi, David, Groheux, Caroline, Rousseau, Désirée, Deandreis, Jean-Louis, Alberini, Caroline, Bodet-Milin, Emmanuel, Itti, Olivier, Casasnovas, Françoise, Kraeber-Bodere, Philippe, Moreau, Arnaud, Philip, Corinne, Balleyguier, Alain, Lucian, Florent, Cachin, Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Department of Nuclear Medicine, Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Laboratoire d'ingénierie osteo-articulaire et dentaire (LIOAD), Université de Nantes (UN)-IFR26-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Oncologie Thoracique (BREST - ICH), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Gastro-entérologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Service de médecine nucléaire, CHU Bordeaux [Bordeaux], Service de médecine nucléaire [Marseille], Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Service d'Endocrinologie (BORDEAUX - Endocrino), Centre Eugène Marquis (CRLCC), Service de Médecine Nucléaire [Saint-Louis], Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de médecine nucléaire [Saint-Herblain], Centre René Gauducheau-Institut Régional du Cancer Nantes-Atlantique (IRCNA)-Institut de Cancérologie de l'Ouest [Angers/Nantes] (UNICANCER/ICO), UNICANCER-UNICANCER, Médecine nucléaire, Département d'imagerie médicale [Gustave Roussy], Institut Gustave Roussy (IGR)-Institut Gustave Roussy (IGR), Laboratoire d'Imagerie Moléculaire Expérimentale (LIME), Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Service de médecine nucléaire [Créteil], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital du Bocage, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre Jean Perrin [Clermont-Ferrand] (UNICANCER/CJP), UNICANCER, Imagerie Moléculaire et Stratégies Théranostiques (IMoST), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Institut Gustave Roussy (IGR), Hôtel-Dieu de Nantes, and Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM)
Subjects: Positron emission tomography, Recommandation, Oncologie, [SDV.CAN]Life Sciences [q-bio]/Cancer, Recommendation, Neoplasm Recurrence, Local, Oncology, Neoplasms, Positron-Emission Tomography, Medical, Humans, Tomographie par émission de positon, France, Neoplasm Recurrence, Local, Nuclear Medicine, Societies, Societies, Medical
Abstract: International audience; Positron Emission Tomography (PET) is a functional nuclear medicine imaging technique which clinical value in oncology has been demonstrated. PET indications are constantly evolving, thanks to the contribution of research. The use of PET in oncology has been the subject of recommendations according to the Standard-Options-Recommendations methodology from the Fédération Nationale des Centres de Lutte Contre le Cancer in 2002, updated in 2003. However, many scientific works have been published since 2003 and new tracers have also obtained a marketing authorization in France. The objective of this work was therefore to update the recommendations established in 2003. In this context, in collaboration with the Société française de médecine nucléaire, a working group was set up for the development of good clinical practice recommendations under the HAS-INCA methodological label. The present document is issued from a comprehensive review of the literature and rigorous appraisal by a panel of national experts, organ specialists, clinical oncologists, surgeons, and imaging specialists. It is intended to be used as a guide to decision-making for those oncology teams that are able to manage patients in various situations in which the AMM label is not sufficiently precise.
Published: 2019
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14. Salivary duct carcinoma: Prospective multicenter study of 61 cases of the Réseau d'Expertise Français des Cancers ORL Rares

Author: Bertrand Baujat, Chloé Bertolus, Olivier Malard, Aude Villepelet, Refcor members, Benjamin Verillaud, François Janot, Sébastien Vergez, Marine Lefevre, Ludovic de Gabory, Olivier Mauvais, Renaud Garrel, CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Pierre et Marie Curie - Paris 6 (UPMC), Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Gustave Roussy (IGR), Service d'ORL et chirurgie cervico-faciale, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), 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), CHU Pitié-Salpêtrière [AP-HP], Centre hospitalier universitaire de Nantes (CHU Nantes), CHU Bordeaux [Bordeaux], and Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)
Subjects: Adult, Male, medicine.medical_specialty, Gastroenterology, Disease-Free Survival, Salivary duct carcinoma, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Tumor stage, Medicine, Humans, Prospective Studies, 030223 otorhinolaryngology, Lymph node, salivary duct carcinoma, Aged, Neoplasm Staging, Aged, 80 and over, business.industry, Hazard ratio, Carcinoma, prognostic factors, human epidermal growth factor receptor 2 (HER2)/neu, Middle Aged, medicine.disease, Salivary Gland Neoplasms, Combined Modality Therapy, targeted therapies, 3. Good health, Parotid gland, Androgen receptor, Survival Rate, androgen receptors, medicine.anatomical_structure, Otorhinolaryngology, Multicenter study, 030220 oncology & carcinogenesis, Immunohistochemistry, Female, France, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; BACKGROUND:The purposes of this study were to describe the characteristics of a prospective multicenter series of patients with salivary duct carcinoma and to investigate prognostic factors.METHODS:Patients included for salivary duct carcinoma between 2009 and 2016 in the Réseau d'Expertise Français des Cancers ORL Rares (REFCOR) database were selected. Immunohistochemical analyses were performed.RESULTS:Sixty-one patients were included in this study. The primary site was the parotid gland in 90% of the cases. Fifty-seven percent of the tumors were stage IV, 65% of patients had lymph node involvement, and 10% had metastases. Tumors showed androgen receptor (89%) and human epidermal growth factor receptor 2 (HER2)/neu (36%). Ninety-four percent of patients underwent surgery and 86% had postoperative radiotherapy. Six patients were treated with targeted therapies. The 3-year overall survival (OS) was 74% and the 3-year disease-free survival (DFS) was 44%. Tumor stages III to IV reduced DFS (hazard ratio [HR] 4.3; P = .04). The N2/3 class reduced distant metastasis-free survival (HR 7.3; P = .007).CONCLUSION:Salivary duct carcinoma prognosis is poor and is correlated with tumor stage and lymph node classification. Androgen receptor and HER2/neu should be tested as they offer the possibility of targeted therapies.
Published: 2019
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15. PCR-based detection of Aspergillus fumigatus and absence of azole resistance due to TR 34 /L98H in a french multicenter cohort of 137 patients with fungal rhinosinusitis

Author: Florent Morio, Tamic Erwan, Olivier Malard, Taieb Chouaki, Claire Cottrel, Rose-Anne Lavergne, Cyril Page, Xavier Dufour, Patrice Le Pape, Estelle Cateau, Pierre Bonfils, Eric Dannaoui, Centre hospitalier universitaire de Nantes (CHU Nantes), Unité de Parasitologie-Mycologie [CHU HEGP], Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), CHU Amiens-Picardie, Microbiologie de l'Eau (MDE), Ecologie et biologie des interactions (EBI), Université de Poitiers-Centre National de la Recherche Scientifique (CNRS)-Université de Poitiers-Centre National de la Recherche Scientifique (CNRS), Université de Poitiers-Centre National de la Recherche Scientifique (CNRS), Laboratoire d'ingénierie osteo-articulaire et dentaire (LIOAD), Université de Nantes (UN)-IFR26-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de neurophysique, physiologie, pathologie (UMR 8119), Université Paris Descartes - Paris 5 (UPD5)-Centre National de la Recherche Scientifique (CNRS), Cognition and Action Group (COGNAC-G - UMR 8257), École normale supérieure - Cachan (ENS Cachan)-Université Paris Descartes - Paris 5 (UPD5)-Centre National de la Recherche Scientifique (CNRS), Centre de Physiopathologie Toulouse Purpan ex IFR 30 et IFR 150 (CPTP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS), Cibles et médicaments de l'infection, de l'immunité et du cancer (IICiMed), Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, Université de Nantes (UN)-Université de Nantes (UN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre de Physiopathologie Toulouse Purpan (CPTP), Université Toulouse III - Paul Sabatier (UT3), and Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
Subjects: 0301 basic medicine, Aspergillus, biology, Aspergillus fumigatus, 030106 microbiology, Pcr assay, Azole resistance, Clinical settings, Dermatology, General Medicine, biology.organism_classification, fungal rhinosinusitis, 3. Good health, Microbiology, 03 medical and health sciences, 030104 developmental biology, Infectious Diseases, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, azole resistance, Cohort, Etiology, PCR-based detection, Fungal hyphae, TR34/L98H
Abstract: SummaryBackground Fungal rhinosinusitis has a worldwide distribution, comprises distinct clinical entities but is mostly due to Aspergillus among which A. fumigatus plays a major role in European countries. Although, there is accumulating evidence for the emergence of environmentally acquired-azole resistance in A. fumigatus (such as TR34/L98H) in various clinical settings, there is few data for patients with fungal rhinosinusitis. Objectives To investigate the prevalence of A. fumigatus azole resistance due to TR34/L98H in a multicenter cohort of patients with fungal rhinosinusitis. Patients/methods 137 patients with fungal rhinosinusitis admitted between 2002 and 2016 at four French medical centers were retrospectively enrolled. Clinical and mycological findings were collected. Aspergillus fumigatus and the TR34/L98H alteration conferring azole resistance were investigated directly from clinical samples using the commercial CE-IVD marked MycoGENIE® Aspergillus fumigatus Real-Time PCR assay. Results/Conclusions Fungal ball was the more frequent clinical form (n=118). Despite the presence of fungal hyphae at direct microscopic examination, mycological cultures remained negative for 83 out of the 137 patients (60.6%). The PCR assay proved to be useful allowing the identification of A. fumigatus and etiological diagnosis in 106 patients (77.4%) compared with 44 patients (32.1%) when using culture as the reference method. Importantly, neither TR34 nor L98H alterations were evidenced. This article is protected by copyright. All rights reserved.
Published: 2018
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16. Oncological and functional outcomes of trans-oral robotic surgery for pyriform sinus carcinoma: A French GETTEC group study

Author: Pierre Philouze, Olivier Malard, P. Mazerolle, C. Ferron, Sébastien Vergez, Emilie Bérard, Franck Jegoux, Karine Aubry, Renaud Garrel, Sophie El Bedoui, Sylvain Morinière, Jean Ton Van, Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), CHU Toulouse [Toulouse]-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), Service d'ORL, Hôpital Gui de Chauliac (CHRU de Montpellier), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service d'Oto-rhino-laryngologie (ORL) et chirurgie cervico-faciale [CHU Limoges], CHU Limoges, Service ORL et chirurgie cervico-faciale [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau, 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), Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), 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), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, 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), Service ORL [Hôpital Gui de Chauliac] (CHRU de Montpellier), Hôpital Gui de Chauliac [CHU Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université de Lille-UNICANCER, and Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Larynx, Male, Cancer Research, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Conservative Treatment, Pyriform sinus cancer, 0302 clinical medicine, Tracheotomy, Pharyngectomy, Robotic Surgical Procedures, Medicine, 030223 otorhinolaryngology, Head and neck cancer, Robotic hypopharyngectomy, Aged, 80 and over, Age Factors, Middle Aged, 3. Good health, Pyriform Sinus, medicine.anatomical_structure, Oncology, 030220 oncology & carcinogenesis, Hypopharyngeal squamous cell carcinoma, Female, France, Oral Surgery, Adult, medicine.medical_specialty, Organ preservation, Disease-Free Survival, 03 medical and health sciences, Enteral Nutrition, Transoral robotic surgery, Adjuvant therapy, otorhinolaryngologic diseases, Humans, Robotic surgery, Aged, Retrospective Studies, Hypopharyngeal Neoplasms, business.industry, Squamous Cell Carcinoma of Head and Neck, Patient Selection, Cancer, Chemoradiotherapy, Adjuvant, medicine.disease, Surgery, Feasibility Studies, business, Organ Sparing Treatments, Follow-Up Studies
Abstract: Background Pyriform sinus carcinomas (SCC) present specific functional and oncological issues. The recent advent of trans-oral robotic surgery (TORS), as a conservative procedure, has opened up new perspectives. Objectives To present the oncological and functional outcomes of TORS for pyriform sinus SCC. Materials and methods We included, retrospectively, all TORS procedures for pyriform sinus SCC performed between 2009 and 2017 in eight French tertiary referral centers. We excluded lesions involving the pyriform sinus that had developed from the oropharynx, larynx, or other anatomic sub-sites of the hypopharynx. Results We included 57 TORS procedures. Median hospital stay was 10 days. A preventive tracheotomy was performed in seven cases (12%), and all were successfully decannulated. Oral re-feeding was possible for 93%, after a median of 5 days. The main surgical complications were hemorrhages (three cases), all successfully handled, although 2 patients with heavy comorbidities died from blood loss in the days after. Adjuvant therapy was proposed in 31 cases (54%), including two cases of salvage surgery (total pharyngolaryngectomy). After a median follow-up of 23 months, overall and disease-free survival were, respectively, 84% and 74% at 24 months, and 66% and 50% at 48 months. At the end of follow-up, organ preservation rate was 96%. None of the surviving patients needed a tracheotomy and oral diet was possible for 96%. Conclusion The functional and oncological outcomes of TORS for pyriform sinus cancer are encouraging, and this procedure can be considered safe for selected early or moderately advanced cases as a conservative treatment.
Published: 2018
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17. Oropharyngeal cancer prognosis by tumour HPV status in France: The multicentric Papillophar study

Author: Jean-Luc Pretet, Xavier Dufour, Jean Lacau St Guily, Béatrix Barry, Philippe Schultz, Philippe Birembaut, Bertrand Baujat, Olivier Malard, Alexandra Rousseau, Silvia Franceschi, Christine Clavel, Sophie Périé, Université Pierre et Marie Curie - Paris 6 (UPMC), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Biomatériaux et Bioingénierie (BB), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Matériaux et nanosciences d'Alsace (FMNGE), Institut de Chimie du CNRS (INC)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut de Chimie du CNRS (INC)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service d'Anatomie et cytologie pathologique, Université Paris Diderot - Paris 7 (UPD7)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Service d’ORL et de chirurgie cervico-faciale [CHU Hôtel Dieu, Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Plasticité de l'épithélium respiratoire dans les conditions normales et pathologiques - UMR-S 903 (PERPMP), Université de Reims Champagne-Ardenne (URCA)-Centre Hospitalier Universitaire de Reims (CHU Reims)-Institut National de la Santé et de la Recherche Médicale (INSERM)-SFR CAP Santé (Champagne-Ardenne Picardie Santé), Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV), Centre International de Recherche contre le Cancer - International Agency for Research on Cancer (CIRC - IARC), Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Matériaux et Nanosciences Grand-Est (MNGE), Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), 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)-Université Paris Diderot - Paris 7 (UPD7), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (UR 3181) (CEF2P / CARCINO), 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), Université de Reims Champagne-Ardenne (URCA)-Université de Reims Champagne-Ardenne (URCA), Littoral, Environnement : Méthodes et Outils Numériques (LEMON), Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), CHU Tenon [APHP], Université de Strasbourg (UNISTRA)-Matériaux et nanosciences d'Alsace, Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris]-Université Paris Diderot - Paris 7 (UPD7), and Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Université de Franche-Comté (UFC)
Subjects: Male, Oncology, Cancer Research, medicine.medical_specialty, Multivariate analysis, MESH: Surgical treatment, medicine.medical_treatment, [SDV]Life Sciences [q-bio], MESH: Oropharyngeal cancer, Alphapapillomavirus, 03 medical and health sciences, 0302 clinical medicine, MESH: Progression-free survival, MESH: Survival, Internal medicine, medicine, Humans, Progression-free survival, Stage (cooking), 030223 otorhinolaryngology, MESH: Tobacco, Gynecology, business.industry, Hazard ratio, Cancer, Induction chemotherapy, Prognosis, medicine.disease, Confidence interval, female genital diseases and pregnancy complications, 3. Good health, Radiation therapy, Oropharyngeal Neoplasms, 030220 oncology & carcinogenesis, MESH: Human papillomavirus, Female, France, Oral Surgery, business
Abstract: International audience; Aims :To evaluate the impact of human papillomavirus (HPV) status, tobacco smoking and initial treatment approach on progression-free survival (PFS) and overall survival (OS) for oropharyngeal cancer (OPC) in France, a country where smoking declines started late (1990s).Methods :340 OPC patients (median age: 60 years) from 14 French hospitals were followed up (median 26.7 months). PCR-based positivity for both HPV DNA and E6/E7 mRNA was used to distinguish HPV-positive OPC (27.1%). Hospital-stratified hazard ratios (HR) and corresponding 95% confidence intervals (CI) were used to compare PFS and OS according to HPV and other prognostic factors in hospital-stratified unadjusted and multivariate models. The combined effect of HPV status with either smoking, stage, or initial treatment on PFS was also evaluated.Results :PFS in multivariate analysis was better in HPV-positive patients (HR = 0.42; 95% CI: 0.24–0.73) and worse in older patients (HR for 5-year age increase = 1.12) and those having had firstly radiotherapy (HR = 1.86; 95% CI: 1.19–2.92) or induction chemotherapy (HR = 1.73; 95% CI: 1.08–2.79) instead of upfront surgery. Findings for OS were similar. Loco-regional recurrences were less frequent in HPV-positive (10.5%) than HPV-negative patients (26.0%) but distant recurrences were similarly frequent. HPV status did not modify the influence of smoking or stage on PFS but the impossibility to perform upfront surgery may be more relevant for HPV-negative patients.Conclusions :HPV-positive OPC patients fare better than HPV-negative OPC and may benefit from toxicity-sparing. Whether HPV-negative patients responded less well to radiation and chemotherapy because of more severe genomic damage or bulkier tumours is unclear.
Published: 2017
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18. Micro-CT Analysis of Radiation-Induced Osteopenia and Bone Hypovascularization in Rat

Author: Guillaume Michel, Jérôme Guicheux, Pierre Weiss, Pauline Bléry, P. Pilet, Olivier Malard, Florent Espitalier, Laboratoire d'ingénierie osteo-articulaire et dentaire (LIOAD), Université de Nantes (UN)-IFR26-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Oto-Rhino-Laryngologie et de Chirurgie Cervico-Faciale [CHU Nantes] (PHU4 - OTONN), Centre hospitalier universitaire de Nantes (CHU Nantes), Service d'Odontologie Restauratrice et Chirurgicale [CHU Nantes] (PHU4 - OTONN), Ostéo-articulaire - Tête et cou - Odontologie - Neurochirurgie - Neurotraumatologie [CHU Nantes] (Pôle hospitalo-universitaire PHU4 - OTONN), This work was supported by grants from the ‘‘Liguecontre le cancer’’ foundation., and Jehan, Frederic
Subjects: Blood supply, Bone tissue, Osteoradionecrosis, Endocrinology, Diabetes and Metabolism, Radiography, medicine.medical_treatment, Intracardiac injection, Bone and Bones, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Bone Density, X-ray micro-tomography, medicine, Animals, Orthopedics and Sports Medicine, Irradiation, [SDV.MHEP.RSOA] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, [SDV.MHEP.GEG] Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, Tibia, Radiotherapy, business.industry, [SDV.MHEP.GEG]Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, 030206 dentistry, Anatomy, X-Ray Microtomography, medicine.disease, 3. Good health, Rats, Osteopenia, Radiation therapy, Bone Diseases, Metabolic, Disease Models, Animal, Radiation Injuries, Experimental, medicine.anatomical_structure, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, 030220 oncology & carcinogenesis, Cortical bone, business, Nuclear medicine
Abstract: International audience; Treatment of carcinomas of the upper aerodigestive tract often requires external radiation therapy. However, radiation affects all the components of bone, with different degrees of sensitivity, and may produce severe side effects such as mandibular osteoradionecrosis (ORN). Intraosseous vascularization is thought to be decreased after irradiation, but its impact on total bone volume is still controversial. The aim of this study was to compare intraosseous vascularization, cortical bone thickness, and total bone volume in a rat model of ORN versus nonirradiated rats, using a micro-computed tomography (micro-CT) analysis after intracardiac injection of a contrast agent. The study was performed on 8-week-old Lewis 1A rats (n = 14). Eleven rats underwent external irradiation on the hind limbs by a single 80-Gy dose. Three rats did not receive irradiation and served as controls for statistical analysis. Eight weeks after the external irradiation, all the animals received a barium sulfate intracardiac injection under general anesthesia. All samples were analyzed with the micro-computed tomography system at a resolution of 5.5 µm. The images were later processed to create 3D reconstructions and study vascularization, bone volume, and cortical thickness. Data from irradiated and nonirradiated rats were compared using the Kruskal–Wallis test. No animal died after irradiation. Nineteen irradiatedtibias and six nonirradiated tibias were included for micro-CT analysis. The vessel percentage was significantly lower inirradiated bones (p = 0.0001). The distance between the vessels, a marker of vascular destruction, was higher after irradiation (p = 0.001). The vessels were also more altered distally after irradiation (p = 0.028). Cortical thickness wasseverely decreased after irradiation, sometimes even reduced to zero. Both trabecular and cortical structures were destroyed after irradiation, with wide bone gaps. Finally, both total bone volume (p = 0.0001) and cortical thickness (p = 0.0001) were significantly decreased in irradiated tibias compared to nonirradiated tibias. These results led to multiple spontaneous fractures in the irradiated group, and the destruction of intraosseous vessels observed macroscopically with the radiographic preview. This study revealed the impact of radiation on intraosseous vasculature and cortical bone with a micro-CT analysis in a rat ORN model. Hypovascularization and osteopenia are consistent with the literature, contributing amorphological scale with high resolution. Visualization of the vasculature by micro-CT is an innovative technique to see thechanges after radiation, and should help adjust bone tissue engineering in irradiated bone.
Published: 2015
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19. Evaluation of new bone formation in irradiated areas using association of mesenchymal stem cells and total fresh bone marrow mixed with calcium phosphate scaffold

Author: Yves Amouriq, Pierre Corre, Paul Pilet, Olivier Malard, Pierre Weiss, Jérôme Guicheux, Sophie Sourice, Florent Espitalier, Pauline Bléry, Jehan, Frederic, Université de Nantes - UFR Odontologie, Université de Nantes (UN), Service d'Odontologie Restauratrice et Chirurgicale [CHU Nantes] (PHU4 - OTONN), Centre hospitalier universitaire de Nantes (CHU Nantes), Laboratoire d'ingénierie osteo-articulaire et dentaire (LIOAD), Université de Nantes (UN)-IFR26-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Chirurgie maxillo-faciale et stomatologie, and Service d’ORL et de chirurgie cervico-faciale [CHU Hôtel Dieu, Nantes]
Subjects: Calcium Phosphates, Male, Scaffold, Pathology, medicine.medical_specialty, Materials science, Bone pathology, Cell, Biomedical Engineering, Biophysics, chemistry.chemical_element, Bioengineering, Bone Marrow Cells, Calcium, Mesenchymal Stem Cell Transplantation, urologic and male genital diseases, Biomaterials, Fractures, Bone, Tissue engineering, Osteogenesis, medicine, Animals, Bone regeneration, Radiation Injuries, Cells, Cultured, Bone Marrow Transplantation, [SDV.MHEP.RSOA] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Tissue Scaffolds, [SDV.MHEP.GEG] Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, [SDV.MHEP.GEG]Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontology, Mesenchymal stem cell, Mesenchymal Stem Cells, Equipment Design, 3. Good health, Rats, Equipment Failure Analysis, medicine.anatomical_structure, Treatment Outcome, chemistry, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Rats, Inbred Lew, Bone Substitutes, Female, Bone marrow, Biomedical engineering
Abstract: International audience; The consequences of the treatment of the squamous cell carcinomas of the upper aerodigestive tract (bone removal and external radiation therapy) are constant. Tissue engineering using biphasic calcium phosphate (BCP) and mesenchymal stem cells (MSC) is considered as a promising alternative. We previously demonstrated the efficacy of BCP and total fresh bone marrow (TBM) in regenerating irradiated bone defect. The aim of this study was to know if adding MSC to BCP + TBM mixture could improve the bone formation in irradiated bone defects. Twenty-four Lewis 1A rats received a single dose of 20 Gy to the hind limbs. MSC were sampled from non-irradiated donors and amplified in proliferative, and a part in osteo-genic, medium. 3 weeks after, defects were created on femurs and tibias, which were filled with BCP alone, BCP + TBM, BCP + TBM + uncommitted MSC, or BCP + TBM + committed MSC. 3 weeks after, samples were removed and prepared for qualitative and quantitative analysis. The rate of bone ingrowth was significantly higher after implantation of BCP + TBM mixture. The adding of a high concentration of MSC, committed or not, didn't improve the bone regeneration. The association BCP + TBM remains the most efficient material for bone substitution in irradiated areas.
Published: 2014
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20. Assessment of disease control in allergic rhinitis

Author: Moises A. Calderon, Thierry Haddad, Bertrand Delaisi, Thomas B. Casale, Jean Jacques Braun, Isabella Annesi-Maesano, Elie Serrano, Olivier Malard, Pascal Demoly, Florence Trebuchon, Glenis Scadding, Pharmacoepidemiologie et évaluation de l'impact des produits de santé sur les populations, Université Bordeaux Segalen - Bordeaux 2-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Section of Allergy and Clinical Immunology, Imperial College London-Royal Brompton Hospital, Division of Allergy and Immunology, Department of Medicine-Creighton University, Rhinology Department, Royal National Throat, Nose and Ear Institute, Epidémiologie des maladies infectieuses et modélisation (ESIM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'ORL et chirurgie cervico-faciale, CHU Strasbourg-Hôpital de Hautepierre [Strasbourg], Service de gastro-entérologie, mucoviscidose, pneumologie et nutrition[Debré], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Robert Debré-Université Paris Diderot - Paris 7 (UPD7), Service de dermatologie et allergologie [CHU Tenon], Université Pierre et Marie Curie - Paris 6 (UPMC)-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), Service d'oto-rhino-laryngologie, Hôtel-Dieu-Centre hospitalier universitaire de Nantes (CHU Nantes), Allergologie, Cabinet d'Allergologie, Oto - Rhino - Laryngologie (O.R.L.) et chirurgie cervico-faciale [Toulouse], CHU Toulouse [Toulouse]-Hôpital Larrey [Toulouse], CHU Toulouse [Toulouse], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Service ORL, otoneurologie et ORL pédiatrique [CHU Toulouse], Pôle Céphalique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), BMC, Ed., CHU Tenon [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, Pediatrics, [SDV.IMM] Life Sciences [q-bio]/Immunology, Immunology, MEDLINE, Alternative medicine, Review, Allergic rhinitis, 03 medical and health sciences, 0302 clinical medicine, Disease severity, Disease control, medicine, Immunology and Allergy, Respiratory function, 030212 general & internal medicine, Psychiatry, Control (linguistics), Asthma, ARIA, business.industry, Questionnaire, medicine.disease, Rescue medication, Classification, GINA, 3. Good health, 030228 respiratory system, [SDV.IMM]Life Sciences [q-bio]/Immunology, business
Abstract: International audience; The Allergic Rhinitis and its Impact on Asthma (ARIA) initiative has had a significant impact, by raising awareness of allergic rhinitis (AR) and improving the diagnosis and treatment of AR sufferers. ARIA classifies the severity of AR as "mild" or "moderate/severe" on the basis of "yes"/"no" answers to four questions. This two-point classification has been criticized as providing little guidance on patient management; patients with "mild" AR are unlikely to consult a physician, whereas the group of patients with "moderate/severe" seen by specialists is heterogeneous. These perceived shortcomings have prompted attempts to improve the ARIA classification or, by analogy with the Global Initiative for Asthma (GINA), adopt approaches based on "disease control" in AR. Even though "disease severity", "disease control" and "responsiveness to treatment" are different (albeit related) metrics, they are not mutually exclusive. Currently, there is no single, accepted definition, but we propose that "disease control" in AR can combine (i) measurements of the severity and/or frequency of daily or nocturnal symptoms, (ii) impairments in social, physical, professional and educational activities, (iii) respiratory function monitoring and (iv) exacerbations (e.g. unscheduled medical consultations and rescue medication use). Although control-based classifications have a number of limitations (e.g. their dependence on treatment compliance and the patient's psychological status), these instruments could be used as an adjunct to the ARIA severity classification and regional practice parameters. Here, we assess the strengths and weaknesses of the current two-level ARIA classification, analyze published proposals for its modification and review the literature on instruments that measure AR control. We conclude that there is a need for research in which severity is compared with control in terms of their effects on patient management.
Published: 2013
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21. Microarchitecture of irradiated bone: comparison with healthy bone

Author: Paul Pilet, Pauline Bléry, Yves Amouriq, Jean-Pierre Guédon, Olivier Malard, Pierre Weiss, Florent Espitalier, Nicolas Normand, Aurore Arlicot, N. Durand, Laboratoire d'ingénierie osteo-articulaire et dentaire (LIOAD), Université de Nantes (UN)-IFR26-Institut National de la Santé et de la Recherche Médicale (INSERM), Equipe de recherche clinique en Odontologie (ERT1051), Université de Nantes (UN), Service d'Odontologie Conservatrice Endodontie, Institut de Recherche en Communications et en Cybernétique de Nantes (IRCCyN), Mines Nantes (Mines Nantes)-École Centrale de Nantes (ECN)-Ecole Polytechnique de l'Université de Nantes (EPUN), Université de Nantes (UN)-Université de Nantes (UN)-PRES Université Nantes Angers Le Mans (UNAM)-Centre National de la Recherche Scientifique (CNRS), irccyn-ivc, Université de Nantes (UN)-Université de Nantes (UN)-PRES Université Nantes Angers Le Mans (UNAM)-Centre National de la Recherche Scientifique (CNRS)-Mines Nantes (Mines Nantes)-École Centrale de Nantes (ECN)-Ecole Polytechnique de l'Université de Nantes (EPUN), and Service ORL
Subjects: business.industry, Experimental model, medicine.medical_treatment, External irradiation, Irradiated bone, 02 engineering and technology, 021001 nanoscience & nanotechnology, External Radiation Therapy, 01 natural sciences, 010309 optics, Implant placement, Radiation therapy, [INFO.INFO-TS]Computer Science [cs]/Signal and Image Processing, 0103 physical sciences, Medicine, 0210 nano-technology, business, Dental implant, Bone volume, [SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Biomedical engineering
Abstract: International audience; The squamous cell carcinomas of the upper aero-digestive tract represent about ten percent of cancers. External radiation therapy leads to esthetic and functional consequences, and to a decrease of the bone mechanical abilities. For these patients, the oral prosthetic rehabilitation, including possibilities of dental implant placement, is difficult. The effects of radiotherapy on bone microarchitecture parameters are not well known. Thus, the purpose of this study is to assess the effects of external radiation on bone micro architecture in an experimental model of 25 rats using micro CT. 15 rats were irradiated on the hind limbs by a single dose of 20 Grays, and 10 rats were non irradiated. Images of irradiated and healthy bone were compared. Bone microarchitecture parameters (including trabecular thickness, trabecular number, trabecular separation, connectivity density and tissue and bone volume) between irradiated and non-irradiated bones were calculated and compared using a Mann and Whitney test. After 7 and 12 weeks, images of irradiated and healthy bone are different. Differences on the irradiated and the healthy bone populations exhibit a statistical significance. Trabecular number, connectivity density and closed porosity are less important on irradiated bone. Trabecular thickness and separation increase for irradiated bone. These parameters indicate a decrease of irradiated bone properties. Finally, the external irradiation induces changes on the bone micro architecture. This knowledge is of prime importance for better oral prosthetic rehabilitation, including implant placement.
Published: 2012
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22. Radiation effects on bone healing and reconstruction: interpretation of the literature

Author: Eric Goyenvalle, Olivier Malard, Guy Daculsi, Eric Aguado, Franck Jegoux, Groupe d'Études Remodelage Osseux et bioMatériaux (GEROM), and Université d'Angers (UA)
Subjects: medicine.medical_specialty, [SDV]Life Sciences [q-bio], Osteogenesis, Distraction, Bone healing, Mandible, Bone morphogenetic protein, Osseointegration, Bone and Bones, Bone remodeling, 03 medical and health sciences, 0302 clinical medicine, Tissue engineering, Medicine, Animals, Humans, General Dentistry, Bone Marrow Transplantation, Bone Development, Bone Transplantation, Tissue Engineering, business.industry, Regeneration (biology), Dose-Response Relationship, Radiation, 030206 dentistry, Plastic Surgery Procedures, Radiation effect, Jaw Neoplasms, Surgery, Mandibular Neoplasms, medicine.anatomical_structure, Otorhinolaryngology, Osteoradionecrosis, 030220 oncology & carcinogenesis, Bone Morphogenetic Proteins, Bone Substitutes, Guided Tissue Regeneration, Periodontal, Bone marrow, Bone Remodeling, Oral Surgery, Cranial Irradiation, business, Biomedical engineering
Abstract: International audience; ObjectiveReconstructing irradiated mandibles with biomaterials is still a challenge but little investigated. We collected data that could help us understand studies in the field of regeneration with biomaterials and irradiated bone.Study designSystematic review of the literature.ResultsDelay and duration of radiation delivery and total equivalent dose are the most variable parameters in the various studies, resulting in confusion when interpreting the literature. Most reproducible experiments show that radiation reduces osteogenic cell numbers, alters cytokine capacity, and delays and damages bone remodeling. Interindividual variations and how such changes become irreversible lesions are still uncertain. In the case of regeneration using biomaterials, most studies have addressed the question of reconstruction in previously irradiated bone. The results show that osseointegration is often possible, although the failure rate is higher. The sooner the implantation takes place after the end of the radiation, the higher the likelihood of failure. Few studies have focused on primary reconstruction followed by early irradiation, and most of the currently available engineering models would be altered by radiation. Good outcomes have been obtained with bone morphogenetic protein and with total bone marrow transplanation.ConclusionThis review points out the difficulties in achieving reproducible experiments and interpreting literature in this underinvestigated field.
Published: 2010
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23. Gene expression profiling in sinonasal adenocarcinoma

Author: Olivier Malard, Isabelle Guisle-Marsollier, Sylvia Quemener, Karine Renaudin, C. Ferron, Véronique Sébille-Rivain, Dominique Tripodi, Christian Verger, Christian Geraut, Catherine Gratas-Rabbia-Ré, Service de Médecine du Travail et des Risques Professionnels, Centre de Recherche en Cancérologie Nantes-Angers (CRCNA), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM)-Hôtel-Dieu de Nantes-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Laennec-Centre National de la Recherche Scientifique (CNRS)-Faculté de Médecine d'Angers-Centre hospitalier universitaire de Nantes (CHU Nantes), Service d'Anatomie Pathologique, EA Biométadys, Université de Nantes (UN), Service ORL, Plateforme Puces à ADN-OGP, Laboratoire de Biomathématiques-Biostatistiques, Consultation des Pathologies Professionnelles, CH Hôtel-Dieu, Service de Biochimie, Grant support: La Ligue Contre le Cancer, comité Pays de la LOIRE, La Direction de la Recherche Clinique du Centre Hospitalo-Universitaire de Nantes., and BMC, Ed.
Subjects: Male, MESH: Neoplasm Proteins, Microarray, Galectin 4, 0302 clinical medicine, Ethmoid Sinus, Gene expression, Genetics(clinical), MESH: Ethmoid Sinus, Genetics (clinical), MESH: Coenzyme A Ligases, Oligonucleotide Array Sequence Analysis, MESH: Aged, 0303 health sciences, MESH: Middle Aged, biology, Middle Aged, Immunohistochemistry, 3. Good health, Neoplasm Proteins, 030220 oncology & carcinogenesis, Adenocarcinoma, [SDV.BBM.GTP] Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN], Female, DNA microarray, Paranasal Sinus Neoplasms, lcsh:Internal medicine, lcsh:QH426-470, 03 medical and health sciences, MESH: Gene Expression Profiling, [SDV.BBM.GTP]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN], Research article, Coenzyme A Ligases, medicine, Genetics, Humans, lcsh:RC31-1245, Gene, 030304 developmental biology, Aged, MESH: Paranasal Sinus Neoplasms, MESH: Humans, Clusterin, Gene Expression Profiling, MESH: Adenocarcinoma, MESH: Immunohistochemistry, medicine.disease, Molecular biology, MESH: Male, MESH: Galectin 4, Gene expression profiling, lcsh:Genetics, MESH: Clusterin, MESH: Oligonucleotide Array Sequence Analysis, Cancer research, biology.protein, MESH: Female
Abstract: Background Sinonasal adenocarcinomas are uncommon tumors which develop in the ethmoid sinus after exposure to wood dust. Although the etiology of these tumors is well defined, very little is known about their molecular basis and no diagnostic tool exists for their early detection in high-risk workers. Methods To identify genes involved in this disease, we performed gene expression profiling using cancer-dedicated microarrays, on nine matched samples of sinonasal adenocarcinomas and non-tumor sinusal tissue. Microarray results were validated by quantitative RT-PCR and immunohistochemistry on two additional sets of tumors. Results Among the genes with significant differential expression we selected LGALS4, ACS5, CLU, SRI and CCT5 for further exploration. The overexpression of LGALS4, ACS5, SRI, CCT5 and the downregulation of CLU were confirmed by quantitative RT-PCR. Immunohistochemistry was performed for LGALS4 (Galectin 4), ACS5 (Acyl-CoA synthetase) and CLU (Clusterin) proteins: LGALS4 was highly up-regulated, particularly in the most differentiated tumors, while CLU was lost in all tumors. The expression of ACS5, was more heterogeneous and no correlation was observed with the tumor type. Conclusion Within our microarray study in sinonasal adenocarcinoma we identified two proteins, LGALS4 and CLU, that were significantly differentially expressed in tumors compared to normal tissue. A further evaluation on a new set of tissues, including precancerous stages and low grade tumors, is necessary to evaluate the possibility of using them as diagnostic markers.
Published: 2009
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24. Effects of high doses of ionising radiation on bone in rats: A new model for evaluation of bone engineering

Author: Guy Daculsi, Bernard Giumelli, Pierre Weiss, Olivier Malard, Jean-Michel Bouler, E. Lerouxel, Anne Moreau, Chimie Et Interdisciplinarité : Synthèse, Analyse, Modélisation (CEISAM), Université de Nantes - UFR des Sciences et des Techniques (UN UFR ST), and Université de Nantes (UN)-Université de Nantes (UN)-Centre National de la Recherche Scientifique (CNRS)-Institut de Chimie du CNRS (INC)
Subjects: Pathology, medicine.medical_specialty, Time Factors, Necrosis, Osteoradionecrosis, medicine.medical_treatment, Radiation Dosage, Bone and Bones, Ionizing radiation, Random Allocation, 03 medical and health sciences, 0302 clinical medicine, Bone Marrow, Fibrosis, Radiation, Ionizing, medicine, Animals, Edema, Femur, [SDV.IB.BIO]Life Sciences [q-bio]/Bioengineering/Biomaterials, Bone Marrow Diseases, Wound Healing, Tibia, Tissue Engineering, business.industry, Histology, 030206 dentistry, medicine.disease, Rats, Radiation therapy, Disease Models, Animal, medicine.anatomical_structure, Otorhinolaryngology, Rats, Inbred Lew, 030220 oncology & carcinogenesis, Female, Surgery, Bone marrow, Bone Diseases, Oral Surgery, medicine.symptom, business, Wound healing
Abstract: The purpose of this study was to assess the effects of high doses of ionising radiation on the histology and healing of bone in an experimental model of 12 inbred rats. Ten of the rats had external irradiation of a single dose of 30 or 45 Gy on the hind limbs, which is equivalent to 2 or 3 times the routine doses used for treatment in humans. Three weeks later, two bony defects were created on their left sides, and the animals were killed 12 or 18 weeks after irradiation. Decalcified bony specimens were studied with light microscopy for qualitative analysis. Thirty Gy irradiation induced medullar oedema or fibro-oedema and normal or fibrous healing of the defects. Forty-five Gy induced medullar oedema or fibro-oedema and depletion in bone marrow. In addition, pathological healing of the defects was obvious and characterised by oedema, fibrosis, and necrosis. In this study high doses of ionising radiation modified the histology of bone, particularly into fibro-oedema, and delayed healing. This new animal model could be used to evaluate the capacities of tissue-engineered materials to repair bony defects after irradiation and osteoradionecrosis. (C) 2009 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
Published: 2009
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24 results on '"Olivier Malard"'

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22. Radiation effects on bone healing and reconstruction: interpretation of the literature

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24. Effects of high doses of ionising radiation on bone in rats: A new model for evaluation of bone engineering

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