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1. Plasma membrane SK2 channel activity regulates migration and chemosensitivity of high‐grade serous ovarian cancer cells

Author

Olivier Romito, Aude Lemettre, Aurélie Chantôme, Ophélie Champion, Noémie Couty, Lobna Ouldamer, Nadine Hempel, Mohamed Trebak, Caroline Goupille, and Marie Potier‐Cartereau

Subjects
cell migration, chemosensitivity, high‐grade serous ovarian cancer, LPA, SK2 channel, Taxol®, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

No data are currently available on the functional role of small conductance Ca2+‐activated K+ channels (SKCa) in ovarian cancer. Here, we characterized the role of SK2 (KCa2.2) in ovarian cancer cell migration and chemosensitivity. Using the selective non‐cell‐permeant SK2 inhibitor Lei‐Dab7, we identified functional SK2 channels at the plasma membrane, regulating store‐operated Ca2+ entry (SOCE) in both cell lines tested (COV504 and OVCAR3). Silencing KCNN2 with short interfering RNA (siRNA), or blocking SK2 activity with Lei‐Dab7, decreased cell migration. The more robust effect of KCNN2 knockdown compared to Lei‐Dab7 treatment suggested the involvement of functional intracellular SK2 channels in both cell lines. In cells treated with lysophosphatidic acid (LPA), an ovarian cancer biomarker of progression, SK2 channels are a key player of LPA pro‐migratory activity but their role in SOCE is abolished. Concerning chemotherapy, SK2 inhibition increased chemoresistance to Taxol® and low KCNN2 mRNA expression was associated with the worst prognosis for progression‐free survival in patients with serous ovarian cancer. The dual roles of SK2 mean that SK2 activators could be used as an adjuvant chemotherapy to potentiate treatment efficacy and SK2 inhibitors could be administrated as monotherapy to limit cancer cell dissemination.

Published
2024
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2. First external validity study of the Fagotti score in ovarian cancer

Author

Sarah Aida, Mathieu Levaillant, Henri Azaïs, Marcos Ballester, Geoffroy Canlorbe, Pauline Chauvet, Tristan Gauthier, Cyrille Huchon, Yohan Kerbage, Martin Koskas, Lise Lecointre, Lobna Ouldamer, Émilie Raimond, Vincent Lavoué, and Guillaume Legendre

Subjects
Medicine, Science
Abstract

Abstract Epithelial ovarian cancer is mostly discovered at the stage of peritoneal carcinosis. Complete cytoreductive surgery improves overall survival. The Fagotti score is a predictive score of resectability based on peritoneal laparoscopic exploratory. Our aim was to study the inter-observer concordance in an external validation of the Fagotti score. An observational, prospective, multicenter study was conducted using the Francogyn research network. The primary outcome was inter-observer concordance of the Fagotti score. 15 patients in which an ovarian mass was discovered were included. For each patient, the first exploratory laparoscopy before any treatment/chemotherapy was recorded. This bank of 15 videos was subject to blind review accompanied by a Fagotti score rating by 11 gynecological surgeons specializing in oncology. A total of 165 blind reviews were performed. Inter-observer concordance was very good for the Fagotti score with an intraclass correlation coefficient (ICC) of 0.83 [95% CI 0.71; 0.93]. Inter-observer concordance for the adjusted Fagotti score, which accounts for unexplorable areas with extensive carcinomatosis, resulted in an ICC of 0.64 [95% CI 0.46; 0.82]. According to the reviewers, the three least explorable parameters were mesentery involvement, stomach infiltration and liver damage. The ICC of the explorable Fagotti score, i.e. score with deletion of the parameters most often unexplored by laparoscopy, was 0.86 [0.75–0.94]. This study confirms the reproducibility of the Fagotti score during first assessment laparoscopies in cases of advanced ovarian cancer. The explorable Fagotti score has an equivalent or better inter-observer concordance than the Fagotti score.

Published
2024
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3. Endogenous ether lipids differentially promote tumor aggressiveness by regulating the SK3 channel

Author

Marion Papin, Delphine Fontaine, Caroline Goupille, Sandy Figiel, Isabelle Domingo, Michelle Pinault, Cyrille Guimaraes, Nina Guyon, Pierre François Cartron, Patrick Emond, Antoine Lefevre, Maxime Gueguinou, David Crottès, Paul-Alain Jaffrès, Lobna Ouldamer, Karine Maheo, Gaëlle Fromont, Marie Potier-Cartereau, Philippe Bougnoux, Aurélie Chantôme, and Christophe Vandier

Subjects
ether lipids, miRNA, potassium channels, SK3 channel, Biochemistry, QD415-436
Abstract

SK3 channels are potassium channels found to promote tumor aggressiveness. We have previously demonstrated that SK3 is regulated by synthetic ether lipids, but the role of endogenous ether lipids is unknown. Here, we have studied the role of endogenous alkyl- and alkenyl-ether lipids on SK3 channels and on the biology of cancer cells. Experiments revealed that the suppression of alkylglycerone phosphate synthase or plasmanylethanolamine desaturase 1, which are key enzymes for alkyl- and alkenyl-ether-lipid synthesis, respectively, decreased SK3 expression by increasing micro RNA (miR)-499 and miR-208 expression, leading to a decrease in SK3-dependent calcium entry, cell migration, and matrix metalloproteinase 9–dependent cell adhesion and invasion. We identified several ether lipids that promoted SK3 expression and found a differential role of alkyl- and alkenyl-ether lipids on SK3 activity. The expressions of alkylglycerone phosphate synthase, SK3, and miR were associated in clinical samples emphasizing the clinical consistency of our observations. To our knowledge, this is the first report showing that ether lipids differentially control tumor aggressiveness by regulating an ion channel. This insight provides new possibilities for therapeutic interventions, offering clinicians an opportunity to manipulate ion channel dysfunction by adjusting the composition of ether lipids.

Published
2024
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5. The neonatal Fc receptor in cancer FcRn in cancer

Author

Diana Cadena Castaneda, Guillaume Brachet, Caroline Goupille, Lobna Ouldamer, and Valérie Gouilleux‐Gruart

Subjects
antigen presentation, cancer, cancer prognosis, cross‐presentation, FCGRT, immune complexes, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

ABSTRACT Since the neonatal IgG Fc receptor (FcRn) was discovered, it was found to be involved in immunoglobulin recycling and biodistribution, immune complexes routing, antigen presentation, humoral immune response, and cancer immunosurveillance. The latest data show that FcRn plays a part in cancer pathophysiology. In various types of cancers, such as lung and colorectal cancer, FcRn has been described as an early marker for prognosis. Dysregulation of FcRn expression by cancer cells allows them to increase their metabolism, and this process could be exploited for passive targeting of cytotoxic drugs. However, the roles of this receptor depend on whether the studied cell population is the tumor tissue or the infiltrating cells, bringing forward the need for further studies.

Published
2020
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6. Patients with stage IV epithelial ovarian cancer: understanding the determinants of survival

Author

Yohann Dabi, Cyrille Huchon, Lobna Ouldamer, Sofiane Bendifallah, Pierre Collinet, Alexandre Bricou, Emile Daraï, Marcos Ballester, Vincent Lavoue, Bassam Haddad, Cyril Touboul, and For the Groupe de Recherche FRANCOGYN

Subjects
Ovarian cancer, Stage IV, Debulking surgery, Chemotherapy, Prognostic factors, Post-operative residual disease, Medicine
Abstract

Abstract Background The most appropriate management for patients with stage IV ovarian cancer remains unclear. Our objective was to understand the main determinants associated with survival and to discuss best surgical management. Methods Data of 1038 patients with confirmed ovarian cancer treated between 1996 and 2016 were extracted from maintained databases of 7 French referral gynecologic oncology institutions. Patients with stage IV diseases were selected for further analysis. The Kaplan–Meier method was used to estimate the survival distribution. A Cox proportional hazards model including all the parameters statistically significant in univariable analysis, was used to account for the influence of multiple variables. Results Two hundred and eight patients met our inclusion criteria: 65 (31.3%) never underwent debulking surgery, 52 (25%) underwent primary debulking surgery (PDS) and 91 (43.8%) neoadjuvant chemotherapy and interval debulking surgery (NACT-IDS). Patients not operated had a significantly worse overall survival than patients that underwent PDS or NACT–IDS (p

Published
2020
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7. Total Polyunsaturated Fatty Acid Level in Abdominal Adipose Tissue as an Independent Predictor of Recurrence-Free Survival in Women with Ovarian Cancer

Author

Helene Salaun, Mathilde Poisson, Adeline Dolly, Flavie Arbion, Stéphane Servais, Jean François Dumas, Caroline Goupille, and Lobna Ouldamer

Subjects
adipose tissue, ovarian cancer, polyunsaturated fatty acids, recurrence-free survival, fatty acid metabolism, Biology (General), QH301-705.5, Chemistry, QD1-999
Abstract

Prognostic factors for epithelial ovarian cancers (EOCs) are in particular clinical factors such as pathology staging at diagnosis (FIGO stages), genetic mutation, or histological phenotypes. In the present study, FIGO stage, tumor residue after surgery, and body mass index were clinical predictors of recurrence-free survival (RFS). Nonetheless, a number of studies support a lipid metabolism disorder in ovarian cancer patients. The objective of this pilot study was to explore whether fatty acid composition of adipose reflecting the qualitative dietary intake and fatty acids metabolism may be associated with RFS. Forty-six women with EOCs and six with borderline ovarian tumors between March 2017 and January 2020 were included in this prospective study at Tours university teaching hospital (central France). The patients involved in the present study are part of the METERMUS trial (clinicaltrials.gov NCT03027479). Adipose tissue specimens from four abdominal locations (superficial and deep subcutaneous, visceral (pericolic), and omental) were collected during surgery or exploratory laparoscopy. A fatty acid profile of adipose tissue triglycerides was established by gas chromatography. Fatty acids composition was compared among the four locations using nonparametric Friedman’s ANOVA test for repeated measures. Median follow-up of EOC patients was 15 months and patients’ RFS was analyzed using Kaplan–Meier survival curves and log-rank test by separating patients into two groups according to median fatty acid levels. The content of long-chain saturated fatty acids (SFAs) was increased and that of long-chain polyunsaturated fatty acids (PUFAs) decreased in deep versus superficial subcutaneous adipose tissue in EOC patients. Nevertheless, the content of total SFAs was ~28%, monounsaturated fatty acids (MUFAs) ~55%, PUFAs n-6 ~11.5%, and PUFAs n-3 about 1.3%, whatever the adipose tissue. When EOC patients were separated into two groups by median fatty acid content, total PUFAs (n-6+n-3) levels, whatever the adipose tissue, were positively and independently associated with RFS. RFS was about two times longer in EOC patients with high versus low total PUFA content (median survival: 12 vs. 27 months, p = 0.01 to

Published
2023
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8. Therapeutic value of surgical paraaortic staging in locally advanced cervical cancer: a multicenter cohort analysis from the FRANCOGYN study group

Author

Yohann Dabi, Vanille Simon, Xavier Carcopino, Sofiane Bendifallah, Lobna Ouldamer, Vincent Lavoue, Geoffroy Canlorbe, Emilie Raimond, Charles Coutant, Olivier Graesslin, Pierre Collinet, Alexandre Bricou, Emile Daraï, Cyrille Huchon, Marcos Ballester, Bassam Haddad, Cyril Touboul, and For the Groupe de Recherche FRANCOGYN

Subjects
Cervical cancer, Locally advanced cervical cancer, Nodal surgical staging, Paraaortic lymph nodes invasion, Medicine
Abstract

Abstract Background The prognostic impact of surgical paraaortic staging remains unclear in patients with locally advanced cervical cancer (LACC). The objective of our study was to evaluate the survival impact of surgical staging in patients with LACC and no evidence of paraaortic lymph node (PALN) metastasis on pre-operative imaging work-up. Methods Data of 1447 patients with cervical cancer treated between 1996 and 2016 were extracted from maintained databases of 10 French University hospitals. Patients with locally advanced disease (IB2 or more) treated by concurrent chemoradiation therapy (CRT) and no evidence of paraaortic metastasis on pre-operative imaging work-up were selected for further analysis. The Kaplan–Meier method was used to estimate the survival distribution. A Cox proportional hazards model was used to account for the influence of multiple variables. Results Six hundred and forty-seven patients were included, 377 (58.3%) with surgical staging and 270 (41.7%) without, with a mean follow up of 38.1 months (QI 13.0–56.0). Pathologic analysis revealed positive lymph nodes in 47 patients (12.5%). In multivariate model analysis, surgical staging remained an independent prognostic factor for DFS (OR 0.64, CI 95% 0.46–0.89, p = 0.008) and OS (OR 0.43, CI 95% 0.27–0.68, p

Published
2018
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9. Using a new diagnostic tool to predict lymph node metastasis in advanced epithelial ovarian cancer leads to simple lymphadenectomy decision rules: A multicentre study from the FRANCOGYN group.

Author

Camille Mimoun, Xavier Paoletti, Thomas Gaillard, Adrien Crestani, Jean-Louis Benifla, Matthieu Mezzadri, Sofiane Bendifallah, Cyril Touboul, Alexandre Bricou, Yohann Dabi, Geoffroy Canlorbe, Yohan Kerbage, Vincent Lavoué, Lobna Ouldamer, Lise Lecointre, Charles Coutant, Arnaud Fauconnier, Roman Rouzier, and Cyrille Huchon

Subjects
Medicine, Science
Abstract

ObjectiveThe aim of this study was to develop a new diagnostic tool to predict lymph node metastasis (LNM) in patients with advanced epithelial ovarian cancer undergoing primary cytoreductive surgery.Materials and methodThe FRANCOGYN group's multicenter retrospective ovarian cancer cohort furnished the patient population on which we developed a logistic regression model. The prediction model equation enabled us to create LNM risk groups with simple lymphadenectomy decision rules associated with a user-friendly free interactive web application called shinyLNM.Results277 patients from the FRANCOGYN cohort were included; 115 with no LNM and 162 with LNM. Three variables were independently and significantly (pConclusionThis new tool may prove useful for improving surgical planning and provide useful information for patients.

Published
2021
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10. Accumulation of Arachidonic Acid, Precursor of Pro-Inflammatory Eicosanoids, in Adipose Tissue of Obese Women: Association with Breast Cancer Aggressiveness Indicators

Author

Lobna Ouldamer, Marie-Lise Jourdan, Michelle Pinault, Flavie Arbion, and Caroline Goupille

Subjects
obesity, breast cancer, body mass index, long-chain polyunsaturated fatty acid n-6, arachidonic acid, fatty acids, Biology (General), QH301-705.5
Abstract

While obesity is linked to cancer risk, no studies have explored the consequences of body mass index (BMI) on fatty acid profiles in breast adipose tissue and on breast tumor aggressiveness indicators. Because of this, 261 breast adipose tissue samples of women with invasive breast carcinoma were analyzed. Fatty acid profile was established by gas chromatography. For normal-weight women, major changes in fatty acid profile occurs after menopause, with the enrichment of long-chain polyunsaturated fatty acids (LC-PUFAs) of both n-6 and n-3 series enrichment, but a stable LC-PUFAs n-6/n-3 ratio across age. BMI impact was analyzed by age subgroups to overcome the age effect. BMI increase is associated with LC-PUFAs n-6 accumulation, including arachidonic acid. Positive correlations between BMI and several LC-PUFAs n-6 were observed, as well as a strong imbalance in the LC-PUFAs n-6/n-3 ratio. Regarding cancer, axillary lymph nodes (p = 0.02) and inflammatory breast cancer (p = 0.08) are more frequently involved in obese women. Increased BMI induces an LC-PUFAs n-6 accumulation, including arachidonic acid, in adipose tissue. This may participate in the development of low-grade inflammation in obese women and breast tumor progression. These results suggest the value of lifestyle and LC-PUFAs n-3 potential, in the context of obesity and breast cancer secondary/tertiary prevention.

Published
2022
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11. Identification of a low risk population for parametrial invasion in patients with early-stage cervical cancer

Author

Yohann Dabi, Claire Willecocq, Marcos Ballester, Xavier Carcopino, Sofiane Bendifallah, Lobna Ouldamer, Vincent Lavoue, Geoffroy Canlorbe, Emilie Raimond, Charles Coutant, Olivier Graesslin, Pierre Collinet, Alexandre Bricou, Cyrille Huchon, Emile Daraï, Bassam Haddad, Cyril Touboul, and For the Groupe de Recherche FRANCOGYN

Subjects
Cervical cancer, Early-stage, Radical surgery, Predicting, Parametrial invasion, Low-risk, Medicine
Abstract

Abstract Background Recent studies have challenged radical procedures for less extensive surgery in selected patients with early-stage cervical cancer at low risk of parametrial invasion. Our objective was to identify a subgroup of patients at low risk of parametrial invasion among women having undergone surgical treatment. Methods Data of 1447 patients with cervical cancer treated between 1996 and 2016 were extracted from maintained databases of 10 French University hospitals. Patients with early-stage (IA2–IIA) disease treated by radical surgery including hysterectomy and trachelectomy, were selected for further analysis. The Kaplan–Meier method was used to estimate the survival distribution. A Cox proportional hazards model including all the parameters statistically significant in univariate analysis, was used to account for the influence of multiple variables. Results Out of the 263 patients included for analysis, on final pathology analysis 28 (10.6%) had parametrial invasion and 235 (89.4%) did not. Factors significantly associated with parametrial invasion on multivariate analysis were: age > 65 years, tumor > 30 mm in diameter measured by MRI, lymphovascular space invasion (LVSI) on pathologic analysis. Among the 235 patients with negative pelvic lymph nodes, parametrial disease was seen in only 7.6% compared with 30.8% of those with positive pelvic nodes (p

Published
2018
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12. Lymphatic Drainage of Bartholin’s Gland in Fresh Adult Cadavers: Implications in Terms of Groin Surgery in Case of Bartholin’s Gland Carcinoma

Author

Lobna Ouldamer, Emilie Serre, Christophe Destrieux, and Gilles Body

Abstract

Objective: To investigate the lymphatic drainage of Bartholin’s gland and its therapeutic implications in Bartholin’s gland carcinoma. Materials and Methods: Data were obtained from the anatomical study of ten fresh female cadavers with groin and pelvic dissections after lymphatic channel and node staining by injection of Lipiodol dye solution into Bartholin’s gland. Results: We distinguished three different lymphatic pathways: i) the superficial inguinal pathway, identified in 61.5% of cases, ii) the internal pudendal pathway (towards the pararectal fossa), identified in 30.8% of cases, and iii) the pelvic pathway, identified in 15.4% of cases, one after an inguinal pathway and the other following the labiocrural fold. No evidence of stained lymphatic structures was found in 31.6% of cases. The principal pathway was always ipsilateral. Conclusion: Ipsilateral groin lymphadenectomy offers the most effective ratio between oncological safety and surgery-related complications.

Published
2022

13. Low Levels of Omega-3 Long-Chain Polyunsaturated Fatty Acids Are Associated with Bone Metastasis Formation in Premenopausal Women with Breast Cancer: A Retrospective Study

Author

Caroline Goupille, Philippe G. Frank, Flavie Arbion, Marie-Lise Jourdan, Cyrille Guimaraes, Michelle Pinault, Gilles Body, Stephan Chevalier, Philippe Bougnoux, and Lobna Ouldamer

Subjects
breast cancer, bone metastases, n-3 long-chain polyunsaturated fatty acids, adipose tissue, Nutrition. Foods and food supply, TX341-641
Abstract

In the present study, we investigated various biochemical, clinical, and histological factors associated with bone metastases in a large cohort of pre- and postmenopausal women with breast cancer. Two hundred and sixty-one consecutive women with breast cancer were included in this study. Breast adipose tissue specimens were collected during surgery. After having established the fatty acid profile of breast adipose tissue by gas chromatography, we determined whether there were differences associated with the occurrence of bone metastases in these patients. Regarding the clinical and histological criteria, a majority of the patients with bone metastases (around 70%) had tumors with a luminal phenotype and 59% of them showed axillary lymph node involvement. Moreover, we found a negative association between the levels of n-3 long-chain polyunsaturated fatty acids (LC-PUFA) in breast adipose tissue and the development of bone metastases in premenopausal women. No significant association was observed in postmenopausal women. In addition to a luminal phenotype and axillary lymph node involvement, low levels of n-3 LC-PUFA in breast adipose tissue may constitute a risk factor that contributes to breast cancer bone metastases formation in premenopausal women.

Published
2020
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14. A Suggested Modification to FIGO Stage IV Epithelial Ovarian Cancer

Author

Marie Métairie, Louise Benoit, Meriem Koual, Enrica Bentivegna, Henri Wohrer, Pierre-Adrien Bolze, Yohan Kerbage, Emilie Raimond, Cherif Akladios, Xavier Carcopino, Geoffroy Canlorbe, Jennifer Uzan, Vincent Lavoué, Camille Mimoun, Cyrille Huchon, Martin Koskas, Hélène Costaz, François Margueritte, Yohann Dabi, Cyril Touboul, Sofiane Bendifallah, Lobna Ouldamer, Nicolas Delanoy, Huyen-Thu Nguyen-Xuan, Anne-Sophie Bats, Henri Azaïs, 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), Toxicité environnementale, cibles thérapeutiques, signalisation cellulaire (T3S - UMR_S 1124), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, CHU Lille, Université de Lille, Centre Hospitalier Universitaire de Reims (CHU Reims), Les Hôpitaux Universitaires de Strasbourg (HUS), Institut méditerranéen de biodiversité et d'écologie marine et continentale (IMBE), Avignon Université (AU)-Aix Marseille Université (AMU)-Institut de recherche pour le développement [IRD] : UMR237-Centre National de la Recherche Scientifique (CNRS), Hôpital Nord [CHU - APHM], Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHI Créteil, Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), CHU Pontchaillou [Rennes], CRLCC Eugène Marquis (CRLCC), Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, Centre hospitalier intercommunal de Poissy/Saint-Germain-en-Laye - CHIPS [Poissy], CHU Tenon [AP-HP], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Médecine Personnalisée, Pharmacogénomique, Optimisation Thérapeutique (MEPPOT - U1147), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), 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], and None

Subjects
epithelial ovarian cancer, Cancer Research, FIGO stage IV, Oncology, pleural involvement, metastatic patterns, overall survival, [SDV.CAN]Life Sciences [q-bio]/Cancer, prognosis
Abstract

International audience; International Federation of Gynecology and Obstetrics (FIGO) staging classification for stage IV epithelial ovarian cancer (EOC) separates stages IVA (pleural effusion) and IVB (parenchymal and/or extra-abdominal lymph node metastases). We aimed to evaluate its prognostic impact and to compare survival according to the initial metastatic location. We conducted a multicenter study between 2000 and 2020, including patients with a FIGO stage IV EOC. Primary endpoint was overall survival (OS). The secondary endpoints were progression-free survival (PFS) and recurrence rates. We included 307 patients: 98 (32%) had FIGO stage IVA and 209 (68%) had FIGO stage IVB. The median OS and PFS of stage IVA patients were significantly lower than those of stage IVB patients (31 versus 45 months (p = 0.02) and 18 versus 25 months (p = 0.01), respectively). Recurrence rate was higher in stage IVA than IVB patients (65% versus 47% (p = 0.004)). Initial pleural involvement was a poor prognostic factor with a median OS of 35 months versus 49 months for patients without initial pleural involvement (p = 0.024). Patients with FIGO stage IVA had a worse prognosis than patients with FIGO stage IVB EOC. Pleural involvement appears to be relevant for predicting survival. We suggest a modification of the current FIGO staging classification.

Published
2023

15. Presentation and Prognosis of Primary Expansile and Infiltrative Mucinous Carcinomas of the Ovary

Author

Marine Huin, Jerome Lorenzini, Flavie Arbion, Xavier Carcopino, Cyril Touboul, Yohann Dabi, Yohan Kerbage, Hélène Costaz, Lise Lecointre, Vincent Lavoué, Pierre-Adrien Bolze, Cyrille Huchon, Alexandre Bricou, Geoffroy Canlorbe, Camille Mimoun, Sofiane Bendifallah, Tristan Gauthier, Gilles Body, Lobna Ouldamer, CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Nutrition, croissance et cancer (U 1069) (N2C), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Nord [CHU - APHM], Aix Marseille Université (AMU), Centre Hospitalier Intercommunal de Créteil (CHIC), CHU Lille, Hôpital Jeanne de Flandre [Lille], Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, CHU Strasbourg, CHU Pontchaillou [Rennes], Oncogenesis, Stress, Signaling (OSS), Université de Rennes (UR)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), CHI Poissy-Saint-Germain, Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], CHU Tenon [AP-HP], CHU Limoges, None, and Jonchère, Laurent

Subjects
expansile mucinous carcinomas, [SDV.CAN] Life Sciences [q-bio]/Cancer, lymphadenectomy, mucinous ovarian carcinoma, [SDV.CAN]Life Sciences [q-bio]/Cancer, General Medicine, prognosis
Abstract

International audience; Objective: The aim of the present study was to evaluate evolution and prognosis of mucinous ovarian carcinomas (mOC), with respect to the two invasive patterns: expansile and infiltrative invasion. Methods: This was a descriptive, retrospective, multicenter study conducted in 13 French centres from 1 January 2001 to 31 December 2019. All patients operated on for epithelial ovarian neoplasia of the mucinous type (infiltrative/ expansile) were included, whether the surgery was performed immediately or after neoadjuvant chemotherapy. Results: A total of 94 women with mucinous carcinomas were included in the present study. Mucinous tumours were divided into 35 expansile (37%) and 59 infiltrative (63%) mOC. There was a statistically significant difference in early and late stages at initial diagnosis between expansile and infiltrative mOC. None of the expansile mOC showed metastatic lymph nodes, whereas almost a quarter of the infiltrative mOC were metastatic to the pelvic /para-aortic region. There was a clear difference in RFS, in favour of expansile mOC, with 90% survival at 5 years, compared with 60% for infiltrative mOC. Conclusions: Although infiltrative and expansile mOC belong to the same histological family, they present many distinctions in clinical presentation, histological invasion, and disease course.

Published
2022

16. Identification of a Positive Association between Mammary Adipose Cholesterol Content and Indicators of Breast Cancer Aggressiveness in a French Population

Author

Caroline Goupille, Michelle Pinault, Flavie Arbion, Marie Lise Jourdan, Philippe G. Frank, Lobna Ouldamer, and Cyrille Guimares

Subjects
Adult, 0301 basic medicine, medicine.medical_specialty, Population, Medicine (miscellaneous), Adipose tissue, Breast Neoplasms, Gastroenterology, Inflammatory breast cancer, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Breast cancer, Internal medicine, Humans, Medicine, Neoplasm Invasiveness, Mammary Glands, Human, education, Aged, Aged, 80 and over, education.field_of_study, Nutrition and Dietetics, business.industry, Cholesterol, Cancer, Middle Aged, medicine.disease, University hospital, 030104 developmental biology, Adipose Tissue, chemistry, 030220 oncology & carcinogenesis, Female, France, Analysis of variance, business
Abstract

BACKGROUND Several studies have recently highlighted important roles for adipose tissue in cancer. However, few have examined adipose tissue cholesterol, and no study has been performed in breast adipose tissue associated with breast tumors. OBJECTIVES The present work was designed to determine if breast adipose tissue cholesterol from the tumor-surrounding area is associated with breast cancer aggressiveness. METHODS Between 2009 and 2011, 215 breast adipose tissue samples were collected at the Tours University Hospital (France) during surgery of women (aged 28-89 y) with invasive breast cancer. Associations of free cholesterol (FC), esterified cholesterol (EC), and total cholesterol (TC) amounts with clinical variables (age, BMI, and treated or untreated hypercholesterolemia) and tumor aggressiveness parameters [phenotype, grade, presence of inflammatory breast cancer (IBC), and multifocality] were tested using Student's t test and after ANOVA. RESULTS The predominant form of cholesterol in adipose tissue was FC, and 50% of patients had no detectable EC. The adipose tissue FC content (μg/mg total lipid) was 18% greater in patients >70 y old than in those 40-49 y old (P

Published
2021

17. Risk Factors for Recurrence of Borderline Ovarian Tumours after Conservative Surgery and Impact on Fertility: A Multicentre Study by the Francogyn Group

Author

Adele Ozenne, Marion De Berti, Gilles Body, Xavier Carcopino, Olivier Graesslin, Yohan Kerbage, Cherif Akladios, Cyrille Huchon, Alexandre Bricou, Camille Mimoun, Emilie Raimond, Lobna Ouldamer, Service de Gynécologie-Obstétrique [CHRU Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Nutrition, croissance et cancer (U 1069) (N2C), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut méditerranéen de biodiversité et d'écologie marine et continentale (IMBE), Avignon Université (AU)-Aix Marseille Université (AMU)-Institut de recherche pour le développement [IRD] : UMR237-Centre National de la Recherche Scientifique (CNRS), Service de gynécologie-obstétrique [Hôpital Nord - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], Université de Reims Champagne-Ardenne (URCA), Hôpital Jeanne de Flandres, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Strasbourg, Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, Service de gynécologie-obstétrique [Hôpital Jean Verdier, Bondy], Université Paris 13 (UP13)-Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de gynécologie et obstétrique [Hopital Lariboisière - Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), and HAL UVSQ, Équipe

Subjects
fertility, recurrence, [SDV.MHEP.CHI] Life Sciences [q-bio]/Human health and pathology/Surgery, ovarian tumours, conservative treatment, [SDV.CAN]Life Sciences [q-bio]/Cancer, General Medicine, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, peritoneal staging, [SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, [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
Abstract

Introduction: Borderline ovarian tumours (BOT) represent 10–20% of epithelial tumours of the ovary. Although their prognosis is excellent, the recurrence rate can be as high as 30%, and recurrence in the infiltrative form accounts for 3% to 5% of recurrences. Affecting, in one third of cases, women of childbearing age, the surgical strategy with ovarian conservation is now recommended despite a significant risk of recurrence. Few studies have focused exclusively on patients who have received ovarian conservative treatment in an attempt to identify factors predictive of recurrence and the impact on fertility. The objective of this study was to identify the risk factors for recurrence of BOT after conservative treatment and the impact on fertility. Material and methods: This was a retrospective, multicentre study of women who received conservative surgery for BOT between February 1997 and September 2020. We divided the patients into two groups, the “R group” with recurrence and the “NR group” without recurrence. Results: Of 175 patients included, 35 had a recurrence (R group, 20%) and 140 had no recurrence (NR group, 80%). With a mean follow-up of 30 months (IQ 8–62.5), the overall recurrence rate was 20%. Recurrence was BOT in 17.7% (31/175) and invasive in 2.3% (4/175). The mean time to recurrence was 29.5 months (IQ 16.5–52.5). Initial complete peritoneal staging (ICPS) was performed in 42.5% of patients (n = 75). In multivariate analysis, age at diagnosis, nulliparity, advanced FIGO stage, the presence of peritoneal implants, and the presence of a micropapillary component for serous tumours were factors influencing the occurrence of recurrence. The post-surgery fertility rate was 67%. Conclusion: This multicentre study is to date one of the largest studies analysing the risk factors for recurrence of BOT after conservative surgery. Five risk factors were found: age at diagnosis, nulliparity, advanced FIGO stage, the presence of implants, and a micropapillary component. Only 25% of the patients with recurrence underwent ICPS. These results reinforce the interest of initial peritoneal staging to avoid ignoring an advanced tumour stage.

Published
2022

18. Accumulation of Arachidonic Acid, Precursor of Pro-Inflammatory Eicosanoids, in Adipose Tissue of Obese Women: Association with Breast Cancer Aggressiveness Indicators

Author

Goupille, Lobna Ouldamer, Marie-Lise Jourdan, Michelle Pinault, Flavie Arbion, and Caroline

Subjects
obesity, breast cancer, body mass index, long-chain polyunsaturated fatty acid n-6, arachidonic acid, fatty acids, adipose tissue
Abstract

While obesity is linked to cancer risk, no studies have explored the consequences of body mass index (BMI) on fatty acid profiles in breast adipose tissue and on breast tumor aggressiveness indicators. Because of this, 261 breast adipose tissue samples of women with invasive breast carcinoma were analyzed. Fatty acid profile was established by gas chromatography. For normal-weight women, major changes in fatty acid profile occurs after menopause, with the enrichment of long-chain polyunsaturated fatty acids (LC-PUFAs) of both n-6 and n-3 series enrichment, but a stable LC-PUFAs n-6/n-3 ratio across age. BMI impact was analyzed by age subgroups to overcome the age effect. BMI increase is associated with LC-PUFAs n-6 accumulation, including arachidonic acid. Positive correlations between BMI and several LC-PUFAs n-6 were observed, as well as a strong imbalance in the LC-PUFAs n-6/n-3 ratio. Regarding cancer, axillary lymph nodes (p = 0.02) and inflammatory breast cancer (p = 0.08) are more frequently involved in obese women. Increased BMI induces an LC-PUFAs n-6 accumulation, including arachidonic acid, in adipose tissue. This may participate in the development of low-grade inflammation in obese women and breast tumor progression. These results suggest the value of lifestyle and LC-PUFAs n-3 potential, in the context of obesity and breast cancer secondary/tertiary prevention.

Published
2022
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19. Dead space closure with quilting suture versus conventional closure with drainage for the prevention of seroma after mastectomy for breast cancer (QUISERMAS): protocol for a multicentre randomised controlled trial

Author

Bruno Giraudeau, Solène Brunet-Houdard, Agnes Caille, Lobna Ouldamer, Julia Bonastre, and Gilles Body

Subjects
Medicine
Abstract

Introduction Postoperative wound seroma is common after mastectomy. This complication is associated with significant impact on patient outcomes and healthcare costs. The optimal closure approach for seroma prevention remains unknown but some evidence suggests that quilting suture of the dead space could lower the incidence of seroma. The aim of this trial is to compare seroma formation using quilting suture versus conventional closure with drainage in patients undergoing mastectomy.Methods and analysis This is a multicentre, superiority, randomised controlled trial in women undergoing mastectomy with or without axillary involvement. Exclusion criteria include indication of bilateral mastectomy or immediate reconstruction and any physical or psychiatric condition that could impair patient's ability to cooperate with postoperative data collection or that do not allow an informed consent. 320 participants will be randomised in a 1:1 ratio to receive either quilting suture or conventional wound closure with drain. The primary outcome is seroma requiring either aspiration or surgical intervention within 21 days following mastectomy. Secondary outcomes include seroma regardless of whether or not it requires an intervention, surgical site infection, pain score, cosmetic result, patient's quality of life, costs and cost-effectiveness. The primary analysis will be an intention-to treat analysis performed with a χ2 test (or Fisher's exact test).Ethics and dissemination Written informed consent will be obtained from all participants. This study was approved by Tours Research ethics committee (CPP TOURS—Region Centre—Ouest 1, 2014-R20, 16 December 2014). Study findings will be published in peer-reviewed journals and presented at relevant national and international breast cancer conferences.Trial registration number NCT02263651.

Published
2016
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20. N-3 Polyunsaturated Fatty Acids of Marine Origin and Multifocality in Human Breast Cancer.

Author

Lobna Ouldamer, Caroline Goupille, Anne Vildé, Flavie Arbion, Gilles Body, Stephan Chevalier, Jean Philippe Cottier, and Philippe Bougnoux

Subjects
Medicine, Science
Abstract

OBJECTIVE:The microenvironment of breast epithelial tissue may contribute to the clinical expression of breast cancer. Breast epithelial tissue, whether healthy or tumoral, is directly in contact with fat cells, which in turn could influence tumor multifocality. In this pilot study we investigated whether the fatty acid composition of breast adipose tissue differed according to breast cancer focality. METHODS:Twenty-three consecutive women presenting with non-metastatic breast cancer underwent breast-imaging procedures including Magnetic Resonance Imaging prior to treatment. Breast adipose tissue specimens were collected during breast surgery. We established a biochemical profile of adipose tissue fatty acids by gas chromatography. We assessed whether there were differences according to breast cancer focality. RESULTS:We found that decreased levels in breast adipose tissue of docosahexaenoic and eicosapentaenoic acids, the two main polyunsaturated n-3 fatty acids of marine origin, were associated with multifocality. DISCUSSION:These differences in lipid content may contribute to mechanisms through which peritumoral adipose tissue fuels breast cancer multifocality.

Published
2016
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21. Signification pronostique du ratio d’atteinte ganglionnaire inguinale dans le carcinome épidermoide vulvaire

Author

Chantal Touboul, Emile Daraï, Xavier Carcopino, E Serre, Olivier Graesslin, Lobna Ouldamer, Marcos Ballester, Groupe de Recherche Francogyn, Gilles Body, Emilie Raimond, Caroline Diguisto, and Sofiane Bendifallah

Subjects
Gynecology, 03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, Reproductive Medicine, business.industry, 030220 oncology & carcinogenesis, medicine, Obstetrics and Gynecology, Lymph node metastasis, 030204 cardiovascular system & hematology, business
Abstract

Resume Objectifs Le but de ce travail etait d’evaluer l’impact clinique du ratio de la dissemination metastatique ganglionnaire inguinale (LNR) chez les patientes prises en charge pour un cancer vulvaire de type epidermoide. Materiel et methodes La cohorte de l’etude etait representee par des patientes prises en charge pour un carcinome epidermoide vulvaire, entre janvier 2005 et decembre 2015, dans 5 institutions francaises avec bases de donnees prospectives. Population Au toal, 636 femmes, parmi lesquelles 508 (79,9 %) ont eu une chirurgie ganglionnaire inguinale. Le seuil significatif du LNR a ete determine par la methode du minimal valeur de p. Critere de jugement principal Comparaison de la survie globale et sans recidive selon le LNR. Resultats Au total, 176 femmes (34,6 %) avaient au moins un ganglion atteint. Il existait une difference significative de survie globale et de survie sans recidive selon que le LNR, soit > 0,2 ou non. Conclusion L’evaluation, dans notre etude, du ratio de ganglions positifs, semble demontrer que celui-ci pourrait etre considere comme un facteur pronostique a part entiere.

Published
2020

22. Prognostic factors of overall survival for patients with FIGO stage IIIc or IVa ovarian cancer treated with neo-adjuvant chemotherapy followed by interval debulking surgery: A multicenter cohort analysis from the FRANCOGYN study group

Author

Laura Vincent, L Bengrine, Lobna Ouldamer, C. Jankowski, Laurent Arnould, H. Costaz, Cherif Akladios, Marcos Ballester, Geoffroy Canlorbe, Vincent Lavoué, S. Dridi, Pierre Adrien Bolze, M M Padéano, Cyrille Huchon, Sofiane Bendifallah, Groupe de Recherche Francogyn, Alexandre Bricou, C Touboul, Pierre Collinet, Charles Coutant, Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, Nutrition, croissance et cancer (U 1069) (N2C), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Groupe Hospitalier Diaconesses Croix Saint-Simon, CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), CHU Strasbourg, CHU Pontchaillou [Rennes], Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Hôpital Jeanne de Flandres, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Intercommunal de Créteil (CHIC), CHI Poissy-Saint-Germain, Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Jonchère, Laurent, Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [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), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Tours

Subjects
Neoplasm, Residual, medicine.medical_treatment, Genes, BRCA2, FIGO Stage IIIC, Genes, BRCA1, Platinum Compounds, Carcinoma, Ovarian Epithelial, Cohort Studies, 0302 clinical medicine, Ascitic Fluid, Overall survival, Peritoneal Lavage, 030212 general & internal medicine, Ovarian Neoplasms, Univariate analysis, Cytoreduction Surgical Procedures, General Medicine, Middle Aged, Prognosis, Debulking, Neoadjuvant Therapy, 3. Good health, Survival Rate, Oncology, 030220 oncology & carcinogenesis, Female, Taxoids, France, Omentum, Cohort study, medicine.medical_specialty, [SDV.CAN]Life Sciences [q-bio]/Cancer, Antineoplastic Agents, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Interval debulking surgery, Neoadjuvant chemotherapy, Pelvis, 03 medical and health sciences, [SDV.CAN] Life Sciences [q-bio]/Cancer, Ovarian cancer, Median follow-up, medicine, Humans, Neoplasm Invasiveness, Aged, Neoplasm Staging, Proportional Hazards Models, business.industry, Retrospective cohort study, medicine.disease, Surgery, [SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Multivariate Analysis, Lymph Node Excision, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Lymphadenectomy, Lymph Nodes, business
Abstract

International audience; Introduction The aim of this study was to identify prognostic factors of overall survival in patients with FIGO stage IIIc or IVa ovarian cancer (OC) treated by neo-adjuvant chemotherapy (NAC) followed by interval debulking surgery.Materials and methods Data from 483 patients with ovarian cancer were retrospectively collected, from January 1, 2000 to December 31, 2016, from the FRANCOGYN database, regrouping data from 11 centers specialized in ovarian cancer treatment. Median overall survival was determined using the Kaplan-Meier method. Univariate and multivariate analysis were performed to define prognostic factors of overall survival.Results The median overall survival was 52 after a median follow up of 30 months. After univariate analysis, factors significantly associated with decreased overall survival were; no pelvic and/or para-aortic lymphadenectomy (p = 0.002), residual disease (CC1/CC2/CC3) after surgery (p < 0.001), positive cytology after NAC (p < 0.001), omental disease after NAC (p = 0.002), no pathologic complete response (pCR) (p = 0.002). In multivariate analysis, factors significantly associated with decreased overall survival were; residual disease after surgery (HR = 1.93; CI95% (1.16–3.21), p = 0.01) and positive cytology after NAC (HR = 1.59; CI95% (1.01–2.55), p = 0.05). Patients with no residual disease after surgery had a median overall survival of 64 months versus 35 months for patients with residual disease. Patients with negative cytology after NAC had a median overall survival of 71 months versus 43 months for patients with positive cytology after NAC.Conclusion In this first and largest French based retrospective study, complete cytoreductive surgery in ovarian cancer remains the main prognostic factor of overall survival.

Published
2020

23. Sodium Channel Na v 1.5 Controls Epithelial-to-Mesenchymal Transition and Invasiveness in Breast Cancer Cells Through its Regulation by the Salt-Inducible Kinase-1

Author

Frédéric Gradek, Osbaldo Lopez-Charcas, Stéphanie Chadet, Lucile Poisson, Lobna Ouldamer, Caroline Goupille, Marie-Lise Jourdan, Stéphan Chevalier, Driffa Moussata, Pierre Besson, and Sébastien Roger

Subjects
lcsh:R, lcsh:Medicine, lcsh:Q, lcsh:Science
Abstract

Loss of epithelial polarity and gain in invasiveness by carcinoma cells are critical events in the aggressive progression of cancers and depend on phenotypic transition programs such as the epithelial-to-mesenchymal transition (EMT). Many studies have reported the aberrant expression of voltage-gated sodium channels (NaV) in carcinomas and specifically the NaV1.5 isoform, encoded by the SCN5A gene, in breast cancer. NaV1.5 activity, through an entry of sodium ions, in breast cancer cells is associated with increased invasiveness, but its participation to the EMT has to be clarified. In this study, we show that reducing the expression of NaV1.5 in highly aggressive human MDA-MB-231 breast cancer cells reverted the mesenchymal phenotype, reduced cancer cell invasiveness and the expression of the EMT-promoting transcription factor SNAI1. The heterologous expression of NaV1.5 in weakly invasive MCF-7 breast cancer cells induced their expression of both SNAI1 and ZEB1 and increased their invasive capacities. In MCF-7 cells the stimulation with the EMT-activator signal TGF-β1 increased the expression of SCN5A. Moreover, the reduction of the salt-inducible kinase 1 (SIK1) expression promoted NaV1.5-dependent invasiveness and expression of EMT-associated transcription factor SNAI1. Altogether, these results indicated a prominent role of SIK1 in regulating NaV1.5-dependent EMT and invasiveness.

Published
2019

24. Lymphovascular invasion as a criterion for adjuvant chemotherapy for FIGO stage I-IIa clear cell carcinoma, mucinous,low grade serous and low grade endometrioid ovarian cancer

Author

Geoffroy Canlorbe, Julie Delvallée, Lobna Ouldamer, Charles Coutant, Alexandre Bricou, Pierre Collinet, Emile Daraï, Cyril Touboul, Sofiane Bendifallah, Gilles Body, Cherif Akladios, Mathilde Cancel, Camille Mimoun, Pierre-Adrien Bolze, Xavier Carcopino, Cyrille Huchon, Marcos Ballester, Yohann Dabi, Vincent Lavoué, Nutrition, croissance et cancer (U 1069) (N2C), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHI Créteil, CHU Lille, Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, CHU Strasbourg, Chemistry, Oncogenesis, Stress and Signaling (COSS), Université de Rennes (UR)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Gynécologie et Obstétrique [Rennes] = Gynaecology [Rennes], CHU Pontchaillou [Rennes], Hospices Civils de Lyon (HCL), Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Pitié-Salpêtrière [AP-HP], Groupe Hospitalier Diaconesses Croix Saint-Simon, Institut méditerranéen de biodiversité et d'écologie marine et continentale (IMBE), Avignon Université (AU)-Aix Marseille Université (AMU)-Institut de recherche pour le développement [IRD] : UMR237-Centre National de la Recherche Scientifique (CNRS), Hôpital Lariboisière-Fernand-Widal [APHP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), 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 National de la Recherche Scientifique (CNRS)-Institut de recherche pour le développement [IRD] : UMR237-Aix Marseille Université (AMU)-Avignon Université (AU), Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-CRLCC Eugène Marquis (CRLCC)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), and Jonchère, Laurent

Subjects
Oncology, endocrine system diseases, Lymphovascular invasion, Adjuvant chemotherapy, 0302 clinical medicine, Overall survival, Stage (cooking), Neoplasm Metastasis, Aged, 80 and over, Ovarian Neoplasms, education.field_of_study, 030219 obstetrics & reproductive medicine, Obstetrics and Gynecology, Middle Aged, Prognosis, Adenocarcinoma, Mucinous, Lymphovascular, female genital diseases and pregnancy complications, 3. Good health, Serous fluid, Chemotherapy, Adjuvant, 030220 oncology & carcinogenesis, Clear cell carcinoma, Female, France, Adult, medicine.medical_specialty, Adolescent, Lymphovascular space invasion, Population, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Decision Support Techniques, 03 medical and health sciences, [SDV.CAN] Life Sciences [q-bio]/Cancer, Ovarian cancer, Internal medicine, medicine, Humans, education, [SDV.BDLR] Life Sciences [q-bio]/Reproductive Biology, Aged, Neoplasm Staging, Retrospective Studies, business.industry, [SDV.BDLR]Life Sciences [q-bio]/Reproductive Biology, medicine.disease, Recurrence-free survival, Endometrial Neoplasms, [SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Reproductive Medicine, business, Adenocarcinoma, Clear Cell
Abstract

International audience; BACKGROUND: The aim of this study was to evaluate the impact of lymphovascular space invasion (LVSI) on overall survival (OS) and recurrence-free survival (RFS) in patients managed for stage I-IIa clear cell carcinoma, mucinous, low-grade serous and low-grade endometrioid ovarian cancer MATERIAL AND METHODS: Retrospective multicentre study of the research group FRANCOGYN between January 2001 and December 2018. All patients managed for stage I-IIa clear cell carcinoma, mucinous /low grade serous and endometrioid ovarian cancer and for whom the presence of histological slides for the review of LVSI was available, were included. Patient’s characteristics with LVSI (LVSI group) were compared to those without LVSI (No LVSI group). A cox analysis for OS and RFS analysis were performed in all population. RESULTS: Over the study period, 133 patients were included in the thirteen institutions. Among them, 12 patients had LVSI (9%). LVSI was an independent predictive factor for poorer Overall and recurrence free survivals. LVSI affected OS (p

Published
2021

25. Impact of severe obesity in the management of patients with high-risk endometrial cancer: A FRANCOGYN study

Author

Ombline Simon, Ludivine Dion, Krystel Nyangoh Timoh, Pierre François Dupré, Henri Azaïs, Sofiane Bendifallah, Cyril Touboul, Yohan Dabi, Olivier Graesslin, Emilie Raimond, Hélène Costaz, Yohan Kerbage, Cyrille Huchon, Camille Mimoun, Martin Koskas, Cherif Akladios, Lise Lecointre, Geoffroy Canlorbe, Pauline Chauvet, Lobna Ouldamer, Jean Levêque, Vincent Lavoué, CHU Pontchaillou [Rennes], Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), 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), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Universitaire de Reims (CHU Reims), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, CHU Lille, Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), AP-HP - Hôpital Bichat - Claude Bernard [Paris], CHU Strasbourg, CHU Pitié-Salpêtrière [AP-HP], CHU Clermont-Ferrand, CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Oncogenesis, Stress, Signaling (OSS), Université de Rennes (UR)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Jonchère, Laurent

Subjects
MESH: Humans, Clinical management, MESH: Lymph Node Excision, [SDV]Life Sciences [q-bio], Obstetrics and Gynecology, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, MESH: Obesity, Morbid, Endometrial Neoplasms, Obesity, Morbid, [SDV] Life Sciences [q-bio], [SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, [SDV.CAN] Life Sciences [q-bio]/Cancer, Endometrial cancer, Reproductive Medicine, Humans, Lymph Node Excision, MESH: Obesity, Female, Surgery, Obesity, MESH: Endometrial Neoplasms, Neoplasm Recurrence, Local, MESH: Female, MESH: Neoplasm Recurrence, Local
Abstract

International audience; Objective: To assess the surgical management and survival of severely obese patients with high-risk endometrial cancer.Materials and methods: Data from 269 patients with high-risk endometrial cancer who were treated between 2001 and 2018 were collected from a multicenter database (11 centers). We classified the patients according to their BMI and compared outcomes in two groups: a normal weight group of women with a BMI < 25 kg/m2, and a severe obesity group of women with a BMI ≥ 35 kg/m2. The groups were compared for epidemiologic, pathologic, management, relapse-free survival (RFS) and overall survival (OS) elements.Results: Patients in the severe obesity group were younger (64 years vs. 68 years, p < 0.05) and had more comorbidities (hypertension, diabetes). They also had more locally advanced tumors and pelvic lymph node involvement (47% vs 24%, p < 0.05). The severely obese patients were less likely to undergo recommended surgical staging, with fewer lumbar aortic dissections than women of normal weight (23% vs 36%, p < 0.05) and fewer pelvic sentinel lymph node biopsies (26.5% vs 12.1%, p < 0.05). No difference in RFS or OS were observed between the two groups.Conclusion: Patients with severe obesity and high-risk endometrial cancer have more locally advanced tumors, and are less likely to be managed according to surgical recommendations. However, RFS and OS do not seem to be affected.

Published
2022

26. Influence des facteurs hormonaux sur le pronostic des cancers du sein triple négatifs

Author

Marie Lise Jourdan, Marie Chas, Gilles Body, Lobna Ouldamer, Flavie Arbion, Agnès Caille, Victoire Weymuller, Caroline Diguisto, Nutrition, croissance et cancer (U 1069) (N2C), Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
0301 basic medicine, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, Reproductive Medicine, [SDV]Life Sciences [q-bio], 030220 oncology & carcinogenesis, Obstetrics and Gynecology, 3. Good health
Abstract

Resume Objectif Les cancers du sein triple negatifs, definis par l’absence d’expression des recepteurs hormonaux et de la proteine HER2, sont consideres comme des tumeurs agressives et de mauvais pronostic en comparaison aux tumeurs hormonosensibles. L’objectif de l’etude etait d’evaluer les associations entre les facteurs hormonaux et les facteurs influencant le pronostic chez les patientes prises en charge pour tumeurs triple negatives. Methodes Toutes les femmes operees d’un cancer du sein triple negatif entre janvier 2009 et decembre 2013 ont ete incluses. Pour chaque patiente, les facteurs recueillis ont ete les donnees cliniques, anatomopathologiques, la prise en charge therapeutique, ainsi que les donnees de survie. Resultats Sur la periode de l’etude, 1682 femmes ont ete operees d’un cancer du sein, dont 1444 presentaient au moins une tumeur infiltrante. Cent cinquante-cinq patientes (10,7 %) avaient une tumeur triple negative. L’âge moyen au diagnostic pour les tumeurs triple negatives etait de 56,4 ans, soit significativement plus jeune que pour les autres types de tumeurs, p = 0,0001. Chez les patientes avec une tumeur triple negative, la parite etait le seul facteur hormonal identifie comme un facteur independant d’atteinte ganglionnaire axillaire (OR = 1,53 ; IC95 % [1,10–2,25] p = 0,02) et l’antecedent de THM comme facteur independant protecteur de recidive locoregionale (OR = 0,13 [0,005–0,64] p = 0,001). Nous n’avons pas trouve de facteur hormonal identifie comme predictif de metastase a distance. Nous n’avons pas retrouve de difference de survie en fonction de la parite (p = 0,72), de la categorie d’IMC (p = 0,62), de la prise ou non de THM (p = 0,49). Conclusion Les facteurs hormonaux semblent egalement avoir une implication pronostique pour les tumeurs triples negatives malgre l’absence d’expression des recepteurs hormonaux.

Published
2019

27. Facteurs prédictifs de concordance (seuil 5 mm) entre les tailles mesurées à l’IRM mammaire et les tailles histologiques dans les cancers infiltrants du sein de type lobulaire

Author

Anne Vildé, Lobna Ouldamer, S. Cayet, Flavie Arbion, R. Gest, Gilles Body, Nutrition, croissance et cancer (U 1069) (N2C), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Tours

Subjects
03 medical and health sciences, 0302 clinical medicine, Reproductive Medicine, [SDV]Life Sciences [q-bio], 030220 oncology & carcinogenesis, Obstetrics and Gynecology, 030218 nuclear medicine & medical imaging, 3. Good health
Abstract

Resume Introduction L’objectif de ce travail est d’evaluer l’existence de facteurs predictifs de concordance entre les tailles mesurees a l’IRM mammaire et les tailles histologiques dans les cancers mammaires infiltrants de type lobulaire. Methodes Les patientes incluses dans l’etude ont ete traitees entre le 1er janvier 2007 et le 31 decembre 2016 pour un cancer mammaire lobulaire infiltrant isole ou associe a un contingent de carcinome canalaire infiltrant. Une analyse univariee puis multivariee a ete realisee pour determiner l’association entre differents facteurs clinico-histologiques et la discordance entre les tailles IRM et les tailles histologiques (seuil 5 mm). Resultats Durant la periode de l’etude, 384 patientes avec un cancer mammaire lobulaire infiltrant ont ete incluses. Nous disposions des donnees IRM de 246 patientes. Pour une discordance > 5 mm), en analyse univariee, les facteurs eligibles pour une analyse multivariee etaient le statut menopausique (OR 1,93[1,01–3,71], p = 0,04), la taille histologique (OR 0,97 [0,96–0,99], p Conclusion Ce travail nous a permis d’identifier des facteurs predictifs independants de discordance entre les tailles mesurees a l’IRM mammaire et la taille histologique de lesions de carcinome lobulaire infiltrant.

Published
2019

28. Assessment of Lymph Node Involvement with PET-CT in Advanced Epithelial Ovarian Cancer. A FRANCOGYN Group Study

Author

Guillaume Lades, Nicolas Bourdel, Camille Sallée, Lauranne Rossard, François Margueritte, Tristan Gauthier, Lobna Ouldamer, Jacques Monteil, Aymeline Lacorre, Antoine Tardieu, CHU Limoges, CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, Institut Pascal (IP), Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne (UCA)-Institut national polytechnique Clermont Auvergne (INP Clermont Auvergne), Université Clermont Auvergne (UCA)-Université Clermont Auvergne (UCA), Service Obstétrique [CHU Clermont-Ferrand], CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, and Service de médecine nucléaire [CHU Limoges]

Subjects
medicine.medical_specialty, medicine.medical_treatment, advanced epithelial ovarian cancer, lcsh:Medicine, positron emission tomography/computed tomography, Article, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Histological diagnosis, medicine, Epithelial ovarian cancer, Lymph node, ComputingMilieux_MISCELLANEOUS, PET-CT, Chemotherapy, medicine.diagnostic_test, Group study, business.industry, lcsh:R, General Medicine, female genital diseases and pregnancy complications, medicine.anatomical_structure, Positron emission tomography, 030220 oncology & carcinogenesis, lymphadenectomy, Lymphadenectomy, Radiology, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

The objective of our study is to evaluate the diagnostic performance of positron emission tomography/computed tomography (PET-CT) for the assessment of lymph node involvement in advanced epithelial ovarian, fallopian tubal or peritoneal cancer (EOC). This was a retrospective, bicentric study. We included all patients over 18 years of age with a histological diagnosis of advanced EOC who had undergone PET-CT at the time of diagnosis or prior to cytoreduction surgery with pelvic or para-aortic lymphadenectomy. We included 145 patients with primary advanced EOC. The performance of PET-CT was calculated from the data of 63 patients. The sensitivity of PET-CT for preoperative lymph node evaluation was 26.7%, specificity was 90.9%, PPV was 72.7%, and NPV was 57.7%. The accuracy rate was 60.3%, and the false-negative rate was 34.9%. In the case of primary cytoreduction (n = 16), the sensitivity of PET-CT was 50%, specificity was 87.5%, PPV was 80%, and NPV was 63.6%. The accuracy rate was 68.8%, and the false negative rate was 25%. After neoadjuvant chemotherapy (n = 47), the sensitivity of PET-CT was 18.2%, specificity was 92%, PPV was 66.7%, and NPV was 56.1%. The accuracy rate was 57.5%, and the false negative rate was 38.3%. Due to its high specificity, the performance of a preoperative PET-CT scan could contribute to the de-escalation and reduction of lymphadenectomy in the surgical management of advanced EOC in a significant number of patients free of lymph node metastases.

Published
2021

29. Does Time-to-Chemotherapy after Primary Complete Macroscopic Cytoreductive Surgery Influence Prognosis for Patients with Epithelial Ovarian Cancer? A Study of the FRANCOGYN Group

Author

Vincent Lavoué, Cyril Touboul, Catherine Uzan, Yohann Dabi, Geoffroy Canlorbe, Thomas Gaillard, Cyrille Huchon, Pierre Collinet, Alexandre Bricou, Cherif Akladios, Marcos Ballester, Henri Azaïs, Charles Coutant, Grégoire Rocher, Pierre-Adrien Bolze, Lobna Ouldamer, Sofiane Bendifallah, Emilie Raimond, Service de Chirurgie et Cancérologie Gynécologique et Mammaire [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), Centre de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [AP-HP], Sorbonne Université - Faculté de Médecine (SU FM), Sorbonne Université (SU), Institut Universitaire de Cancérologie [Paris] (IUC), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Hôpital Jeanne de Flandres, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Groupe Hospitalier Diaconesses Croix Saint-Simon, Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Bretonneau, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, CHU Pontchaillou [Rennes], Centre Hospitalier Intercommunal de Créteil (CHIC), CHU Strasbourg, Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, Centre Hospitalier Universitaire de Reims (CHU Reims), Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Gestionnaire, Hal Sorbonne Université, Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Service de Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], Service de chirurgie gynécologique et mammaire [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], and Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)

Subjects
epithelial ovarian cancer, medicine.medical_specialty, endocrine system diseases, Adjuvant chemotherapy, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Population, lcsh:Medicine, chemotherapy, Gastroenterology, Article, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Overall survival, Epithelial ovarian cancer, cardiovascular diseases, education, education.field_of_study, Chemotherapy, 030219 obstetrics & reproductive medicine, business.industry, lcsh:R, Advanced stage, Retrospective cohort study, General Medicine, female genital diseases and pregnancy complications, 3. Good health, [SDV] Life Sciences [q-bio], 030220 oncology & carcinogenesis, prognosis, business, Cytoreductive surgery
Abstract

To determine if the time-to-chemotherapy (TTC) after primary macroscopic complete cytoreductive surgery (CRS) influences recurrence-free survival (RFS) and overall survival (OS) in patients with epithelial ovarian cancer (EOC). We conducted an observational multicenter retrospective cohort analysis of women with EOC treated from September 2006 to November 2016 in nine institutions in France (FRANCOGYN research group) with maintained EOC databases. We included women with EOC (all FIGO stages) who underwent primary complete macroscopic CRS prior to platinum-based adjuvant chemotherapy. Two hundred thirty-three patients were included: 73 (31.3%) in the early-stage group (ESG) (FIGO I-II), and 160 (68.7%) in the advanced-stage group (ASG) (FIGO III-IV). Median TTC was 43 days (36–56). The median OS was 77.2 months (65.9–106.6). OS was lower in the ASG when TTC exceeded 8 weeks (70.5 vs. 59.3 months, p = 0.04). No impact on OS was found when TTC was below or above 6 weeks (78.5 and 66.8 months, respectively, p = 0.25). In the whole population, TTC had no impact on RFS or OS. None of the factors studied were associated with an increase in TTC. Chemotherapy should be initiated as soon as possible after CRS. A TTC greater than 8 weeks is associated with poorer OS in patients with advanced stage EOC.

Published
2021

30. Status of Surgical Management of Borderline Ovarian Tumors in France: are Recommendations Being Followed? Multicentric French Study by the FRANCOGYN Group

Author

Martin Koskas, Justine Gantzer, Pierre Collinet, Thomas Boisramé, Cyrille Huchon, Vincent Lavoué, Eva Sangnier, Emilie Faller, Lobna Ouldamer, Virginie Bund, Cherif Akladios, Geoffroy Canlorbe, Charles Coutant, Martin Demarchi, Cyril Touboul, Pierre-Adrien Bolze, Lise Lecointre, Sofiane Bendifallah, HAL-SU, Gestionnaire, Les Hôpitaux Universitaires de Strasbourg (HUS), Laboratoire des sciences de l'ingénieur, de l'informatique et de l'imagerie (ICube), École Nationale du Génie de l'Eau et de l'Environnement de Strasbourg (ENGEES)-Université de Strasbourg (UNISTRA)-Institut National des Sciences Appliquées - Strasbourg (INSA Strasbourg), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de Recherche en Informatique et en Automatique (Inria)-Les Hôpitaux Universitaires de Strasbourg (HUS)-Centre National de la Recherche Scientifique (CNRS)-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)-Réseau nanophotonique et optique, Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), L'Institut hospitalo-universitaire de Strasbourg (IHU Strasbourg), Institut National de Recherche en Informatique et en Automatique (Inria)-l'Institut de Recherche contre les Cancers de l'Appareil Digestif (IRCAD)-Les Hôpitaux Universitaires de Strasbourg (HUS)-La Fédération des Crédits Mutuels Centre Est (FCMCE)-L'Association pour la Recherche contre le Cancer (ARC)-La société Karl STORZ, Immuno-Rhumatologie Moléculaire, Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Reims (CHU Reims), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Service de Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], CHU Tenon [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), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Hôpital Jeanne de Flandres, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de Chirurgie et Cancérologie Gynécologique et Mammaire [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Centre Hospitalier Intercommunal de Créteil (CHIC), Centre hospitalier intercommunal de Poissy/Saint-Germain-en-Laye - CHIPS [Poissy], Département d'oncologie médicale [Centre Georges-François Leclerc], Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER, Centre Paul Strauss, CRLCC Paul Strauss, CHU Pontchaillou [Rennes], Institut National des Sciences Appliquées - Strasbourg (INSA Strasbourg), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS)-École Nationale du Génie de l'Eau et de l'Environnement de Strasbourg (ENGEES)-Réseau nanophotonique et optique, Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-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)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), centre hospitalier intercommunal de Poissy/Saint-Germain-en-Laye - CHIPS [Poissy], Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS)-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)-Réseau nanophotonique et optique, Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA), Service de chirurgie gynécologique et mammaire [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)

Subjects
medicine.medical_specialty, Referral, [SDV.MHEP.CHI] Life Sciences [q-bio]/Human health and pathology/Surgery, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, Carcinoma, Ovarian Epithelial, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, [SDV.CAN] Life Sciences [q-bio]/Cancer, Surgical oncology, Biopsy, Humans, Medicine, Laparoscopy, Neoplasm Staging, Retrospective Studies, Ovarian Neoplasms, 030219 obstetrics & reproductive medicine, medicine.diagnostic_test, business.industry, General surgery, Gynecologic Oncology, 3. Good health, Omentectomy, Serous fluid, [SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Oncology, 030220 oncology & carcinogenesis, Female, Surgery, France, Borderline ovarian tumors, Neoplasm Recurrence, Local, business, Cohort study
Abstract

Background Borderline ovarian tumors (BOTs) are tumors with a favorable prognosis but whose management by consensus is essential to limit the risk of invasive recurrence. This study aimed to conduct an inventory of surgical practices for BOT in France and to evaluate the conformity of the treatment according to the current French guidelines. Methods This retrospective, multicenter cohort study included nine referral centers of France between January 2001 and December 2018. It analyzed all patients with serous and mucinous BOT who had undergone surgery. A peritoneal staging in accordance with the recommendations was defined by performance of a peritoneal cytology, an omentectomy, and at least one peritoneal biopsy. Results The study included 332 patients. A laparoscopy was performed in 79.5% of the cases. Treatment was conservative in 31.9% of the cases. The recurrence rate was significantly increased after conservative treatment (17.3% vs 3.1%; p < 0.001). Peritoneal cytology was performed for 95.5%, omentectomy for 83.1%, and at least one biopsy for 82.2% of the patients. The overall recurrence rate was 7.8%, and the recurrence was invasive in 1.2% of the cases. No link was found between the recurrence rate and the conformity of peritoneal staging. The overall rate of staging noncompliance was 22.9%. Conclusion The current standards for BOT management seem to be well applied.

Published
2021

31. Prognosis impact of posttreatment pelvic MRI in patients treated for stage IB2-IIB cervical cancer with chemoradiation therapy

Author

Cyril Touboul, Olivier Graesslin, François Golfier, Marcos Ballester, Sophie Knight, Alexandre Bricou, Yohan Kerbage, Pierre Adrien Bolze, Sofiane Bendifallah, Cyrille Huchon, Ludivine Dion, Emilie Raimond, Yohann Dabi, Florence Rodriguez, Vincent Lavoué, Lobna Ouldamer, Geoffroy Atrous, Xavier Carcopino, Pierre Collinet, Myriam Mimouni, Tiphaine Moussilmani, Julien Mancini, Jonchère, Laurent, Institut méditerranéen de biodiversité et d'écologie marine et continentale (IMBE), Avignon Université (AU)-Aix Marseille Université (AMU)-Institut de recherche pour le développement [IRD] : UMR237-Centre National de la Recherche Scientifique (CNRS), Hôpital Nord [CHU - APHM], 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), 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), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance Publique - Hôpitaux de Marseille (APHM), Hospices Civils de Lyon (HCL), Groupe Hospitalier Diaconesses Croix Saint-Simon, Hôpital Jeanne de Flandre [Lille], Nutrition, croissance et cancer (U 1069) (N2C), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Chemistry, Oncogenesis, Stress and Signaling (COSS), Université de Rennes (UR)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHI Créteil, Institut Mère Enfant Alix de Champagne, Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), CHI Poissy-Saint-Germain, Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-CRLCC Eugène Marquis (CRLCC)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Centre National de la Recherche Scientifique (CNRS)-Institut de recherche pour le développement [IRD] : UMR237-Aix Marseille Université (AMU)-Avignon Université (AU), Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM), Université de Rennes 1 (UR1), and 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)

Subjects
medicine.medical_specialty, Survival, [SDV.MHEP.CHI] Life Sciences [q-bio]/Human health and pathology/Surgery, medicine.medical_treatment, Uterine Cervical Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, Disease, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, Hysterectomy, 030218 nuclear medicine & medical imaging, Lesion, 03 medical and health sciences, 0302 clinical medicine, [SDV.CAN] Life Sciences [q-bio]/Cancer, Predictive Value of Tests, Recurrence, medicine, Humans, In patient, Pelvic MRI, Stage (cooking), Neoplasm Staging, Retrospective Studies, Cervical cancer, medicine.diagnostic_test, business.industry, Magnetic resonance imaging, Chemoradiotherapy, General Medicine, Middle Aged, medicine.disease, Prognosis, Magnetic Resonance Imaging, 3. Good health, Survival Rate, Oncology, Chemoradiation, 030220 oncology & carcinogenesis, Female, Surgery, Radiology, Neoplasm Recurrence, Local, medicine.symptom, business
Abstract

International audience; OBJECTIVES: To evaluate the performances of systematic posttreatment pelvic magnetic resonance imaging (PPMRI) in predicting prognosis of patients treated with chemoradiation therapy (CRT) for locally advanced cervical cancer (LACC). MATERIALS AND METHODS: Multi-institutional data from 216 patients presenting FIGO IB2-IIB cervical cancer for which PPMRI was performed following CRT were retrospectively reviewed. Incomplete response was defined as the identification of persistent lesion on PPMRI. Primary endpoints were patients’ 5-year recurrence free (RFS) and overall (OS) survivals. Secondary endpoint was the identification of residual histologic disease on hysterectomy specimens when completion surgery was performed. RESULTS: PPMRI identified an incomplete response in 102 (47.2%) cases. A 70% or more reduction in tumor size on PPMRI was identified as the best predictive cut-off for recurrence (37.7% sensitivity and 78.7% specificity) and death (50% sensitivity and 77.9% specificity) with significant impact on those risks (HRa: 0.42; 95%CI: 0.23-0.77 and HRa: 0.18; 95%CI: 0.06-0.50, respectively). Completion hysterectomy was performed in 117 (54.4%) cases, with histologic residual disease in 55 (47.4%). PPMRI demonstrated 74.5% sensitivity and 50.8% specificity in predicting residual disease. Although survival of patients with complete response at PPMRI was not impacted by completion hysterectomy, it significantly increased 5-year RFS and OS of those with incomplete response: 38.7% vs. 65.3% (p

Published
2021

32. Recurrence Pattern of Cervical Cancer Based on the Platinum Sensitivity Concept: A Multi-Institutional Study from the FRANCOGYN Group

Author

Geoffroy Canlorbe, Emile Daraï, Cyrille Huchon, Cyril Touboul, Marcos Ballester, Olivier Graesslin, Tiphaine de Foucher, Xavier Carcopino, Pierre Adrien Bolze, Sofiane Bendifallah, Ludivine Dion, Emilie Raimond, François Golfier, Cherif Akladios, Vincent Lavoué, Pierre Collinet, Clémentine Owen, Yohan Kerbage, Lobna Ouldamer, Cecile Hennebert, Y. Dabi, Alexandre Bricou, Lise Lecointre, CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Intercommunal de Créteil (CHIC), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Pontchaillou [Rennes], CHU Pitié-Salpêtrière [AP-HP], Hospices Civils de Lyon (HCL), Les Hôpitaux Universitaires de Strasbourg (HUS), Hôpital Jeanne de Flandre [Lille], Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut méditerranéen de biodiversité et d'écologie marine et continentale (IMBE), Avignon Université (AU)-Aix Marseille Université (AMU)-Institut de recherche pour le développement [IRD] : UMR237-Centre National de la Recherche Scientifique (CNRS), Hôpital Nord [CHU - APHM], Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Institut Mère Enfant Alix de Champagne, Groupe Hospitalier Diaconesses Croix Saint-Simon, Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Service de Gynécologie-Obstétrique, Maternité, Chirurgie Gynécologique [CHU Pitié-Salpêtrière], and Centre National de la Recherche Scientifique (CNRS)-Institut de recherche pour le développement [IRD] : UMR237-Aix Marseille Université (AMU)-Avignon Université (AU)

Subjects
Oncology, medicine.medical_specialty, Prognostic factor, Multivariate analysis, Standard of care, endocrine system diseases, medicine.medical_treatment, lcsh:Medicine, Article, 03 medical and health sciences, platinum sensitivity, 0302 clinical medicine, Internal medicine, medicine, Lymph node, 030304 developmental biology, Cervical cancer, 0303 health sciences, Chemotherapy, Platinum sensitivity, business.industry, lcsh:R, General Medicine, recurrence pattern, medicine.disease, female genital diseases and pregnancy complications, 3. Good health, medicine.anatomical_structure, 030220 oncology & carcinogenesis, business, Ovarian cancer, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, advanced cervical cancer
Abstract

The standard of care for patients with advanced cervical cancer (ACC) includes platinum-based chemotherapy. The concept of platinum sensitivity is a major prognostic factor for patients with ovarian cancer. The aim of this study was to validate the applicability of the platinum sensitivity concept to ACC patients, and to estimate its prognostic interest in terms of overall survival (OS) and pattern of recurrence (location, timing). Data of women with histologically proven FIGO 2019 stages IB3&ndash, IV ACC, treated between May 2000 and November 2017 with platinum-based regimens, were retrospectively abstracted from 12 institutions from the FRANCOGYN Group. Respective 3-year OSs were 52% (95% CI: 40.8%&ndash, 66.8%), 21.6% (95% CI: 12.6%&ndash, 37.2%), and 14.6% (95% CI: 4.2%&ndash, 50.2%), in case of recurrence &lt, 6 months, between 6 and 17 months, and &ge, 18 months (p &lt, 0.001). Risk of metastatic or multisite recurrence was significantly higher in case of recurrence &lt, 6 months, and risk of local or isolated infradiaphragmatic nodal recurrence was significantly higher in case of recurrence &gt, 0.001). In multivariate analysis, platinum sensitivity status was a strong prognostic factor for OS after recurrence, independent of histological grade, lympho-vascular space involvement, final lymph node status, and treatment. Platinum sensitivity status may help to classify patients in three prognostic subgroups for OS after recurrence, and appears to be a strong prognostic factor correlated to the pattern of recurrence.

Published
2020

33. Fallopian tube prolapse after hysterectomy: a systematic review.

Author

Lobna Ouldamer, Agnès Caille, and Gilles Body

Subjects
Medicine, Science
Abstract

BACKGROUND:Prolapse of the fallopian tube into the vaginal vault is a rarely reported complication that may occur after hysterectomy. Clinicians can miss the diagnosis of this disregarded complication when dealing with post-hysterectomy vaginal bleeding. OBJECTIVES:We performed a systematic review in order to describe the clinical presentation, therapeutic management and outcome of fallopian tube prolapse occurring after hysterectomy. SEARCH STRATEGY:A systematic search of MEDLINE and EMBASE references from January 1980 to December 2010 was performed. We included articles that reported cases of fallopian tube prolapse after hysterectomy. Data from eligible studies were independently extracted onto standardized forms by two reviewers. RESULTS:Twenty-eight articles including 51 cases of fallopian tube prolapse after hysterectomy were included in this systematic review. Clinical presentations included abdominal pain, dyspareunia, post- coital bleeding, and/or vaginal discharge. Two cases were asymptomatic and diagnosed at routine checkup. The surgical management reported comprised partial or total salpingectomy, with vaginal repair in some cases combined with oophorectomy using different approaches (vaginal approach, combined vaginal-laparoscopic approach, laparoscopic approach, or laparotomy). Six patients were initially treated by silver nitrate application without success. CONCLUSIONS:This systematic review provided a precise summary of the clinical characteristics and treatment of patients presenting with fallopian tube prolapse following hysterectomy published in the past 30 years. We anticipate that these results will help inform current investigations and treatment.

Published
2013
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34. PROGNOSTIC VALUE OF POSTTREATMENT FEDG-PET IMAGING FOLLOWING COMBINED CHEMORADIATION THERAPY IN LOCALLY ADVANCED CERVICAL CANCER

Author

Julien Mancini, Emilie Raimond, Yohan Kerbage, Marcos Ballester, Cyril Touboul, Xavier Carcopino, Ludivine Dion, Vincent Lavoué, Myriam Mimouni, Yohann Dabi, Cyrille Huchon, Alexandre Bricou, Sophie Knight, Pierre Collinet, François Golfier, Olivier Graesslin, Geoffroy Atrous, Lobna Ouldamer, Pierre Adrien Bolze, Sofiane Bendifallah, Institut méditerranéen de biodiversité et d'écologie marine et continentale (IMBE), Centre National de la Recherche Scientifique (CNRS)-Institut de recherche pour le développement [IRD] : UMR237-Aix Marseille Université (AMU)-Avignon Université (AU), 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), Centre Hospitalier Intercommunal de Créteil (CHIC), Hospices Civils de Lyon (HCL), Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Groupe Hospitalier Diaconesses Croix Saint-Simon, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Nutrition, croissance et cancer (U 1069) (N2C), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), 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 de Reims (CHU Reims), Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Centre d’Études et de Conservation des Œufs et du Sperme [CHU Jean Verdier] (CECOS), Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Avignon Université (AU)-Aix Marseille Université (AMU)-Institut de recherche pour le développement [IRD] : UMR237-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université de Rennes (UR)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Jonchère, Laurent, Service de Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-CRLCC Eugène Marquis (CRLCC)-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)

Subjects
Adult, medicine.medical_specialty, Neoplasm, Residual, Locally advanced, Uterine Cervical Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, Disease, Completion surgery, Disease-Free Survival, 03 medical and health sciences, 0302 clinical medicine, [SDV.CAN] Life Sciences [q-bio]/Cancer, Humans, Medicine, In patient, chemoradiation, Neoplasm Staging, Retrospective Studies, Cervical cancer, 030219 obstetrics & reproductive medicine, business.industry, FEDG-PET, Medical record, Obstetrics and Gynecology, Chemoradiotherapy, Pet imaging, Middle Aged, medicine.disease, 3. Good health, Treatment Outcome, Reproductive Medicine, Positron-Emission Tomography, 030220 oncology & carcinogenesis, Vaginal brachytherapy, Female, France, Radiology, prognosis, Neoplasm Recurrence, Local, Radiopharmaceuticals, business
Abstract

International audience; Objectives - To evaluate the performances of posttreatment FEDG-PET to predict the prognosis of patients treated with concurrent chemoradiotherapy (CT/RT) for locally advanced cervical cancer. Materials and methods - The medical records of 131 patients treated in 9 French academic institutions for IB2-IIB cervical cancer and for which a posttherapy FEDG-PET was performed were reviewed. All patients received CT/RT, possibly completed with vaginal brachytherapy (VBT) and completion surgery. Posttreatment FEDG-PET was performed within 3 months after completion of CT/RT or VBT. Incomplete metabolic response (IMR) was defined as the persistence of FEDG uptake. Results - An IMR was identified in 44 (33.6 %) cases. IMR was associated with higher risk of recurrence (aHR = 2.8; 95 %CI: 1.3-5.7; p = 0.006) and death (aHR = 4.5 ;95 %CI: 1.4-13.8; p = 0.009). Completion surgery was performed in 61 (46.9 %) patients with histologic cervical residual disease identified in 31 (50.8 %). FEDG-PET sensitivity and specificity in predicting cervical residual disease following CT/RT was 48.4 % (95 %CI: 30.8-66) and 80 % (95 %CI: 65.7-94.3), respectively. Conclusions - In patients treated with CT/RT for locally advanced cervical cancer, despite limited performances to predict cervical residual disease, posttreatment FEDG-PET is predictive of patients' prognosis and long-term outcome.

Published
2020

35. Impact on Prognosis of the Surgical Route, Laparoscopy or Laparotomy, for the Surgical Staging of Early Stage Ovarian Cancer—A Study from the FRANCOGYN Group

Author

Lobna Ouldamer, Geoffroy Canlorbe, Yohan Kerbage, Margaux Merlier, Emilie Raimond, Pierre-Adrien Bolze, Marcos Ballester, Charles Coutant, Vincent Lavoué, Adeline Pierache, Pierre Collinet, Yohann Dabi, Jerome Phalippou, Nassima Ramdane, Alexandre Bricou, Sofiane Bendifallah, Cyrille Huchon, Cherik Akladios, Henri Azaïs, Cyril Touboul, Hôpital Jeanne de Flandre [Lille], Evaluation des technologies de santé et des pratiques médicales - ULR 2694 (METRICS), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Université de Lille, Service de Gynécologie-Obstétrique, Maternité, Chirurgie Gynécologique [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), Institut Universitaire de Cancérologie [Paris] (IUC), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Groupe Hospitalier Diaconesses Croix Saint-Simon, CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université - Faculté de Médecine (SU FM), Sorbonne Université (SU), Nutrition, croissance et cancer (U 1069) (N2C), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, CHU Pontchaillou [Rennes], Université Paris-Est Créteil Val-de-Marne - Faculté de médecine (UPEC Médecine), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHU Strasbourg, Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, Institut Mère Enfant Alix de Champagne, Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), 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)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), and Institut Universitaire de Cancérologie [Sorbonne Université] (IUC)

Subjects
medicine.medical_specialty, genetic structures, medicine.medical_treatment, overall survival, lcsh:Medicine, Article, 03 medical and health sciences, 0302 clinical medicine, Laparotomy, medicine, Overall survival, Stage (cooking), Laparoscopy, minimally invasive surgery, 030219 obstetrics & reproductive medicine, medicine.diagnostic_test, business.industry, lcsh:R, Retrospective cohort study, General Medicine, medicine.disease, early stage ovarian cancer, Laparoscopic staging, 3. Good health, Surgery, laparoscopic staging, Log-rank test, 030220 oncology & carcinogenesis, Ovarian cancer, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Background and objective: according to the latest ESMO&minus, ESGO recommendations, laparotomy is the standard surgical approach to treat and stage patients with presumed early stage epithelial ovarian cancer (EOC). A few studies have investigated the efficacy and the safety of laparoscopy for the staging of early stage EOC, and this question is still in the center of debates. Recurrence-free survival (RFS) and overall survival (OS) benefits of the minimally invasive surgery (MIS) have still to be specified. The aim of this multicenter and retrospective study is to assess the survival outcomes of laparoscopic staging in comparison with laparotomic staging for patients presenting with an early stage EOC. Methods: data of patients with early stage EOC (FIGO I-IIA) who underwent primary surgery between 2000 and 2018 were extracted from the FRANCOGYN database. OS and RFS of these two groups, constituted according to the surgical route, were compared using Log rank test. Results: of the 144 patients included, 107 patients underwent laparotomy and 37 underwent laparoscopy for a staging purpose. The median follow-up was 36.0 months (18.0 to 58.0). For the laparoscopy and the laparotomy group, the median follow-up period was 24 (11.0 to 50.0) and 42.0 (24.0 to 66.0) months, respectively, (p &lt, 0.001). Tumor recurrence occurred in 33 (23%) patients: 2 (5.4%) in the laparoscopy group and 31 (29%) in the laparotomy group (p = 0.08). The OS rate at 5 years was 97.3% after laparoscopy and 79.8% after laparotomy (p = 0.19). Conclusions: there is no difference associated with the laparoscopic approach for the staging of early stage EOC on RFS and OS in comparison with laparotomy. MIS may be proposed as a safe and adequate alternative to laparotomy when performed by well-trained surgeons.

Published
2020

36. Comparison of survival outcomes between laparoscopic and abdominal radical hysterectomy for early-stage cervical cancer: A French multicentric study

Author

Olivier Graesslin, Amélie Benbara, Vincent Lavoué, Emilie Raimond, Xavier Carcopino, François Zaccarini, Sofiane Bendifallah, Lobna Ouldamer, Cyrille Huchon, Pierre-Adrien Bolze, Emile Daraï, Cyril Touboul, Geoffroy Canlorbe, Anna Santy, Pierre Collinet, Yohann Dabi, François Golfier, CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), CHI Créteil, CHU Pontchaillou [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES), Assistance Publique - Hôpitaux de Marseille (APHM), Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Pitié-Salpêtrière [AP-HP], Centre Hospitalier Universitaire de Reims (CHU Reims), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHI Poissy-Saint-Germain, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Université de Rennes (UR)

Subjects
medicine.medical_specialty, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Matched-Pair Analysis, Uterine Cervical Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Open surgery, Hysterectomy, Disease-Free Survival, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Laparotomy, medicine, Radical hysterectomy, Humans, Survival outcomes, Stage (cooking), Radical Hysterectomy, Laparoscopy, Retrospective Studies, Cervical cancer, 030219 obstetrics & reproductive medicine, medicine.diagnostic_test, business.industry, Obstetrics and Gynecology, Postoperative complication, Length of Stay, Middle Aged, medicine.disease, Survival Analysis, 3. Good health, Surgery, Reproductive Medicine, 030220 oncology & carcinogenesis, Propensity score matching, Female, France, business
Abstract

International audience; OBJECTIVES: A recent randomized controlled trial has reconsidered the use of laparoscopy for treating patients with early-stage cervical cancer with radical hysterectomy (RH). We aimed to evaluate if surgical approach had an impact on surgical and oncological outcomes in these patients in a French setting. METHODS: Data of 1706 patients with cervical cancer treated between 1996 and 2017 were extracted from maintained databases of 9 French University hospitals. Patients, with FIGO stage IA2 to IIB tumors, treated by radical hysterectomy were selected for further analysis. A propensity score matching was used with a ratio of 2:1 in favor of laparoscopic approach was used. The Kaplan Meier method was used to estimate the survival distribution. RESULTS: 34 patients treated with laparotomy were matched with 61 patients treated by minimally invasive surgery (MIS). There was no difference regarding overall survival (91 % vs 81 %, p > 0.05) or disease-free survival (82 % vs 78 %, p > 0.05). There was no difference regarding surgical outcomes with no excess of postoperative complication in patients with MIS. Hospital stay was significantly longer in patients operated on laparotomy. CONCLUSION: In our study, there was no evidence of a difference in survival between minimally invasive surgery and laparotomy in patients treated with radical hysterectomy for early-stage cervical cancer.

Published
2020

37. Risk factors for recurrence of borderline ovarian tumors in France: A multicenter retrospective study by the FRANCOGYN group

Author

Cyrille Huchon, Sofiane Bendifallah, P. Collinet, Olivier Graesslin, Lobna Ouldamer, E. Sangnier, Camille Mimoun, Alexandre Bricou, Lise Lecointre, Emilie Raimond, Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Université de Paris (UP)

Subjects
Adult, medicine.medical_specialty, Multivariate analysis, Time Factors, Adolescent, [SDV]Life Sciences [q-bio], Conservative Treatment, 03 medical and health sciences, Ovarian tumor, Young Adult, 0302 clinical medicine, Surgical oncology, Risk Factors, Internal medicine, medicine, Humans, Stage (cooking), Survival rate, ComputingMilieux_MISCELLANEOUS, Aged, Neoplasm Staging, Retrospective Studies, Aged, 80 and over, Ovarian Neoplasms, Univariate analysis, Analysis of Variance, 030219 obstetrics & reproductive medicine, business.industry, Incidence (epidemiology), Age Factors, Obstetrics and Gynecology, Retrospective cohort study, Middle Aged, 3. Good health, Survival Rate, Reproductive Medicine, 030220 oncology & carcinogenesis, Female, France, Neoplasm Recurrence, Local, business, Follow-Up Studies
Abstract

Introduction Borderline ovarian tumors (BOTs) although rare, have shown an increase in the incidence worldwide. Although the survival rate is high, the recurrence rate is estimated to be between 5% and 34%. The objective of this study was to identify risk factors for recurrence of BOTs. Methods This retrospective multicenter study included 493 patients treated surgically for BOT between January 2001 and December 2018. Results Thirty-seven patients showed recurrence (group R, 7.5%), while 456 did not (group NR, 92.5%). With an average follow-up of 30.5 months (1-276), the overall recurrence rate was 7.5%. Recurrence rates for the BOT and invasive types were 5.7% (n = 28) and 1.4% (n = 7), respectively. The mean time to recurrence was 44.1 (3-251) months. Univariate analysis showed that age at diagnosis, type of surgical procedure, histological type, and FIGO stage were factors influencing recurrence. Multivariate analysis showed that the risk factors for recurrence of BOT were conservative treatment (OR = 7 [95% CI 3.01-16.23]; p Discussion To the best of our knowledge, this multicenter study was one of the largest studies on the risk factors for BOT recurrence. Conservative treatment and advanced FIGO stage were identified as risk factors for BOT recurrence. These results reinforce the need for restaging of patients who did not have an optimal initial surgical staging so as not to avoid missing a tumor in the advanced stage. Referral to a surgical oncology center is suggested to optimize overall patient management.

Published
2020

38. Ovarian Cancer in the Elderly Time to Move towards a More Logical Approach to Improve Prognosis-A Study from the FRANCOGYN Group

Author

Xavier Carcopino, Henri Azaïs, Cyril Touboul, Cherif Akladios, Geoffroy Canlorbe, Martin Koskas, Nicolas Bourdel, Pauline Chauvet, Mathieu Mezzadri, Tristan Gauthier, Hélène Costaz, Cyrille Huchon, Pierre Collinet, Frederik Kridelka, Yohann Dabi, Camille Mimoun, Lobna Ouldamer, Alexandre Bricou, Lise Lecointre, Sofiane Bendifallah, Krystel Nyangoh Timoh, Ludivine Dion, Pierre-Adrien Bolze, Olivier Graesslin, Vincent Lavoué, Emilie Raimond, Marcos Ballester, Jean Levêque, CHU Pontchaillou [Rennes], Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Pitié-Salpêtrière [AP-HP], Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA), Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Gynécologie-Obstétrique, Maternité, Chirurgie Gynécologique [CHU Pitié-Salpêtrière], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)

Subjects
medicine.medical_specialty, endocrine system diseases, health care facilities, manpower, and services, medicine.medical_treatment, [SDV]Life Sciences [q-bio], lcsh:Medicine, frailty, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, chemotherapy, elderly, Article, surgery, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, In patient, Survival rate, Chemotherapy, 030219 obstetrics & reproductive medicine, Surgical approach, business.industry, lcsh:R, Logical approach, social sciences, General Medicine, University hospital, medicine.disease, humanities, 3. Good health, ovarian cancer, Multicenter study, 030220 oncology & carcinogenesis, business, Ovarian cancer
Abstract

Background and objective: Elderly and/or frail women with ovarian cancer are often undertreated. The aim of the study is to compare the effects of age and frailty on surgical approaches, postoperative complications, and prognosis in elderly women with ovarian cancer. Methods: A retrospective multicenter study of women &ge, 70 years were treated for ovarian cancer at seven French university hospitals between 2007 and 2015. Results: Of the 1119 women treated for ovarian cancer during the study period, 147 were &ge, 70 years and had complete data. Of these women, 65 were aged 70&ndash, 74 years, and 82 were aged &ge, 75 years. Overall, 77% of the younger women (49/65) received optimal treatment compared with 51% (40/82) of the older women (p = 0.018). Women &ge, 75 years underwent fewer bowel resections (32% vs. 67%, p &lt, 0.001) and experienced fewer postoperative complications (22.6% vs. 38.9%, p &lt, 0.001), 53.2% of the women in this age group were treated by primary surgery or surgery only. These women also received more chemotherapy with platinum only (15% [9/56] vs. 2% [1/57], p = 0.007) and less bevacizumab (9% [5/56] vs. 32% [18/57], p = 0.003). Patients with greater frailty (a modified Charlson Comorbidity Index [mCCI] score &gt, 3) had a five-year survival rate of 30% versus 62% for those with a score &le, 3 (p &lt, 0.001). Conclusions: Surgeons modify their approach to treating ovarian cancer in women &ge, 75 years probably to reduce immediate postoperative complications. The prognosis is significantly worse in patients with greater frailty. Improvements to the sequence of treatments administered, with priority given to neoadjuvant chemotherapy in patients with greater frailty, could help increase the number of women who receive optimal treatment and improve their prognosis.

Published
2020

39. Management and Survival of Elderly and Very Elderly Patients with Ovarian Cancer: An Age-Stratified Study of 1123 Women from the FRANCOGYN Group

Author

Geoffroy Canlorbe, Hélène Costaz, Pierre-Adrien Bolze, Sofiane Bendifallah, Olivier Graesslin, Cyrille Huchon, Pierre Collinet, Marcos Ballester, Alexandre Bricou, Lise Lecointre, Yolaine Joueidi, Cherif Akladios, Emilie Raimond, Jean Levêque, Krystel Nyangoh Timoh, Nicolas Bourdel, Xavier Carcopino, Cyril Touboul, Frédéric Kridelka, Yohann Dabi, Camille Mimoun, Lobna Ouldamer, Henri Azaïs, Pauline Chauvet, Martin Koskas, Tristan Gauthier, Mathieu Mezzadri, Ludivine Dion, Vincent Lavoué, CHU Pontchaillou [Rennes], Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, and Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )

Subjects
Oncology, medicine.medical_specialty, health care facilities, manpower, and services, medicine.medical_treatment, [SDV]Life Sciences [q-bio], lcsh:Medicine, frailty, chemotherapy, elderly, Article, surgery, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Overall survival, 030212 general & internal medicine, Chemotherapy, business.industry, Endometrial cancer, lcsh:R, social sciences, General Medicine, medicine.disease, humanities, 3. Good health, ovarian cancer, 030220 oncology & carcinogenesis, Cohort, Ovarian cancer, business
Abstract

Elderly women with ovarian cancer are often undertreated due to a perception of frailty. We aimed to evaluate the management of young, elderly and very elderly patients and its impact on survival in a retrospective multicenter study of women with ovarian cancer between 2007 to 2015. We included 979 women: 615 women (62.8%) &lt, 65 years, 225 (22.6%) 65&ndash, 74 years, and 139 (14.2%) &ge, 75 years. Women in the 65&ndash, 74 years age group were more likely to have serous ovarian cancer (p = 0.048). Patients &gt, 65 years had more &gt, IIa FIGO stage: 76% for &lt, 65 years, 84% for 65&ndash, 74 years and 80% for &ge, 75 years (p = 0.033). Women &ge, 75 years had less standard procedures (40% (34/84) vs. 59% (104/177) for 65&ndash, 74 years and 72% (384/530) for &lt, 65 years (p &lt, 0.001). Only 9% (13/139) of women &ge, 75 years had an Aletti score &gt, 8 compared with 16% and 22% for the other groups (p &lt, 0.001). More residual disease was found in the two older groups (30%, respectively) than the younger group (20%) (p &lt, 0.05). Women &ge, 75 years had fewer neoadjuvant/adjuvant cycles than the young and elderly women: 23% &ge, 75 years received &lt, 6 cycles vs. 10% (p = 0.003). Univariate analysis for 3-year Overall Survival showed that age &gt, 65 years, FIGO III (HR = 3.702, 95%CI: 2.30&ndash, 5.95) and IV (HR = 6.318, 95%CI: 3.70&ndash, 10.77) (p &lt, 0.001), residual disease (HR = 3.226, 95%CI: 2.51&ndash, 4.15, p &lt, 0.001) and lymph node metastasis (HR = 2.81, 95%CI: 1.91&ndash, 4.12, 0.001) were associated with lower OS. Women &gt, 65 years are more likely to have incomplete surgery and more residual disease despite more advanced ovarian cancer. These elements are prognostic factors for women&rsquo, s survival regardless of age. Specific trials in the elderly would produce evidence-based medicine and guidelines for ovarian cancer management in this population.

Published
2020

40. Clinical Medicine Impact of Lymphadenectomy on Survival of Patients with Serous Advanced Ovarian Cancer After Neoadjuvant Chemotherapy: A French National Multicenter Study (FRANCOGYN)

Author

Justine Gantzer, Lise Lecointre, Cherif Akladios, Martin Demarchi, Cyrille Huchon, Vincent Lavoué, Marcos Ballester, Thomas Boisramé, Pierre Collinet, Cyril Touboul, Pierre-Adrien Bolze, Martin Koskas, Geoffroy Canlorbe, Emilie Faller, Charles Coutant, Virginie Bund, Michel Velten, Lobna Ouldamer, Sofiane Bendifallah, Jean-Jacques Baldauf, Les Hôpitaux Universitaires de Strasbourg (HUS), Laboratoire des sciences de l'ingénieur, de l'informatique et de l'imagerie (ICube), École Nationale du Génie de l'Eau et de l'Environnement de Strasbourg (ENGEES)-Université de Strasbourg (UNISTRA)-Institut National des Sciences Appliquées - Strasbourg (INSA Strasbourg), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS)-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)-Réseau nanophotonique et optique, Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA), L'Institut hospitalo-universitaire de Strasbourg (IHU Strasbourg), Institut National de Recherche en Informatique et en Automatique (Inria)-l'Institut de Recherche contre les Cancers de l'Appareil Digestif (IRCAD)-Les Hôpitaux Universitaires de Strasbourg (HUS)-La Fédération des Crédits Mutuels Centre Est (FCMCE)-L'Association pour la Recherche contre le Cancer (ARC)-La société Karl STORZ, Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CIC Hôpital Bichat, Institut National de la Santé et de la Recherche Médicale (INSERM)-UFR de Médecine-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 Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Hôpital Jeanne de Flandres, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service d'Oncologie médicale [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Service de chirurgie gynécologique et mammaire [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Intercommunal de Créteil (CHIC), CHI Poissy-Saint-Germain, Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, Centre Paul Strauss, CRLCC Paul Strauss, Groupe Hospitalier Diaconesses Croix Saint-Simon, CHU Pontchaillou [Rennes], Institut National des Sciences Appliquées - Strasbourg (INSA Strasbourg), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS)-École Nationale du Génie de l'Eau et de l'Environnement de Strasbourg (ENGEES)-Réseau nanophotonique et optique, Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-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)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Service de Chirurgie et Cancérologie Gynécologique et Mammaire [CHU Pitié-Salpêtrière], Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de Recherche en Informatique et en Automatique (Inria)-Les Hôpitaux Universitaires de Strasbourg (HUS)-Centre National de la Recherche Scientifique (CNRS)-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)-Réseau nanophotonique et optique, Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), AP-HP - Hôpital Bichat - Claude Bernard [Paris], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-UFR de Médecine

Subjects
medicine.medical_specialty, medicine.medical_treatment, Population, lcsh:Medicine, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Sciences du Vivant [q-bio]/Cancer, Article, 03 medical and health sciences, 0302 clinical medicine, Ovarian carcinoma, Internal medicine, medicine, systematic lymphadenectomy, 030212 general & internal medicine, education, Chemotherapy, education.field_of_study, business.industry, Proportional hazards model, lcsh:R, General Medicine, Debulking, 3. Good health, ovarian carcinoma, Serous fluid, 030220 oncology & carcinogenesis, Lymphadenectomy, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Cohort study, neoadjuvant chemotherapy
Abstract

Background: The population of interest to this study comprised individuals with advanced-stage ovarian carcinoma who were exposed to neoadjuvant chemotherapy (NAC) followed by interval debulking surgery (IDS). Those who had not received systematic lymphadenectomy (SL, Group 1) were compared to those who had received SL (Group 2). Outcome measures included progression-free survival (PFS), overall survival (OS), and surgical complications. Methods: This was a retrospective, multicenter cohort study in nine referral centers of France between January 2000 and June 2017. OS analysis using the multivariate Cox regression model was performed. PFS and surgery-related morbidity were analyzed. Results: Of the 255 patients included, 100 were in Group 1 and 155 in Group 2. Patient majority was, on average, younger and less comorbid, with predominant R0 surgery in Group 2. Dindo&ndash, Clavien score was similar between the two groups (p = 0.15). Median OS was 26.8 months in Group 2 and 27.6 months in Group 1. SL was not statistically significant on OS (p = 0.7). Median PFS was 18.3 months in Group 2 and 16.6 months in Group 1. SL had positive impact on PFS (p = 0.005). Conclusions: patients who had received SL (Group 2) had significantly higher PFS regardless of node-positivity status when compared to those who had not received SL (Group 1).

Published
2020

41. All pure flat atypical atypia lesions of the breast diagnosed using percutaneous vacuum-assisted breast biopsy do not need surgical excision

Author

Elodie Poisson, Gilles Body, Carole Bonneau, Flavie Arbion, Lobna Ouldamer, Anne Vildé, and Patrick Michenet

Subjects
0301 basic medicine, Breast biopsy, medicine.medical_specialty, Percutaneous, Vacuum, Biopsy, Breast Neoplasms, Malignancy, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Carcinoma, medicine, Atypia, Humans, Breast, Retrospective Studies, Hyperplasia, medicine.diagnostic_test, business.industry, Carcinoma, Ductal, Breast, Calcinosis, Cancer, General Medicine, Middle Aged, medicine.disease, Carcinoma, Intraductal, Noninfiltrating, Logistic Models, 030104 developmental biology, 030220 oncology & carcinogenesis, Vacuum-assisted breast biopsy, Female, Surgery, Radiology, business, Mammography
Abstract

Background The purposes of this study were to evaluate the outcome of women with pure flat atypical atypia (FEA) diagnosed at vacuum-assisted breast biopsy (VABB) targeting microcalcifications and to determine whether clinical, radiological and pathologic parameters are able to predict which lesions will be upgraded to malignancy. Materials 2414 cases of consecutive VABB for microcalcifications using VA 8-, 10- or 11-Gauge stereotactically guided core biopsy performed between January 2005 and December 2011 from two french breast cancer centers were evaluated. Data of women with VABB-diagnosed pure FEA who underwent either excisional surgery or mammographic follow-up were analyzed. Cases with mass lesions or ipsilateral cancers were excluded. Two pathologists (FA,PM) reviewed the results of procedures performed. Clinical, radiological, as well as histological criteria have been studied in order to determine the correlation between these factors and carcinoma underestimation. Results and conclusion This study included 70 cases of pure FEA. Twenty women underwent surgical excision and 50 had clinical and mammographic surveillance only. In three women FEA was upgraded to breast cancer on excision. Clinical and mammographic follow-up for a mean of 56 months ± 27 in the group without excision showed two cancers in the same breast (Intermediate grade DCIS, and invasive ductal carcinoma 84 and 48 months respectively after VABB). Three factors were significantly predictive of underestimation or occurence of cancer for pure FEA when the radiologic lesions are calcifications: age≥ 57 years, radiologic size >10 mm and number of FEA foci ≥4.

Published
2018

42. Inguino-femoral radiotherapy in vulvar squamous cell carcinoma: clues to revised indications in patients with only one intracapsular lymph node metastasis

Author

Gilles Body, Xavier Carcopino, Lobna Ouldamer, Emile Daraï, Caroline Diguisto, Emilie Raimond, Emilie Serre, Cyril Touboul, Sofiane Bendifallah, Groupe de Recherche Francogyn, and Olivier Graesslin

Subjects
Adult, endocrine system, medicine.medical_specialty, Vulvar Squamous Cell Carcinoma, medicine.medical_treatment, Groin, Disease-Free Survival, Vulva, Young Adult, Risk Factors, medicine, Carcinoma, Humans, Radiology, Nuclear Medicine and imaging, In patient, Neoplasm Invasiveness, Prospective Studies, Prospective cohort study, Survival rate, Aged, Neoplasm Staging, Retrospective Studies, Aged, 80 and over, Vulvar Neoplasms, business.industry, Retrospective cohort study, Hematology, General Medicine, Middle Aged, medicine.disease, Prognosis, Radiation therapy, Survival Rate, medicine.anatomical_structure, Oncology, Lymphatic Metastasis, Carcinoma, Squamous Cell, Lymph Node Excision, Female, Radiotherapy, Adjuvant, Radiology, France, Lymph Nodes, Neoplasm Recurrence, Local, business, Follow-Up Studies
Abstract

Background and objectives: The aim was to review the clinical impact of groin metastatic nodal disease in women with vulvar squamous cell carcinoma (VSCC) and to evaluate the impact of adjuvant rad...

Published
2019

43. Identification of a low risk population for parametrial invasion in patients with early-stage cervical cancer

Author

Cyril Touboul, Marcos Ballester, Cyrille Huchon, Xavier Carcopino, Emilie Raimond, Olivier Graesslin, Vincent Lavoué, Alexandre Bricou, Emile Daraï, Geoffroy Canlorbe, Claire Willecocq, Pierre Collinet, Bassam Haddad, Yohann Dabi, Charles Coutant, Lobna Ouldamer, Sofiane Bendifallah, HAL UVSQ, Équipe, Université Paris-Est Créteil Val-de-Marne - Faculté de médecine (UPEC Médecine), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service de Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], CHU Tenon [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), Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie (UPMC), Université Pierre et Marie Curie - Paris 6 (UPMC), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Service de Gynécologie et Obstétrique [Rennes] = Gynaecology [Rennes], CHU Pontchaillou [Rennes], Département de Néonatologie [CHU de Rennes], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de gynécologie-obstétrique [Hôpital Jean Verdier], Université Paris 13 (UP13)-Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), CHI Créteil, Carcinose Angiogenèse et Recherche Translationnelle, Angiogenese et recherche translationnelle (CART U965), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Gynécologie-Obstétrique [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université, Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Service de Gynécologie et Obstétrique [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes]-hôpital Sud, Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris 13 (UP13)

Subjects
medicine.medical_specialty, Multivariate analysis, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Early-stage, Radical surgery, Urology, Uterine Cervical Neoplasms, lcsh:Medicine, Kaplan-Meier Estimate, General Biochemistry, Genetics and Molecular Biology, Low-risk, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Predicting, medicine, Humans, Neoplasm Invasiveness, Stage (cooking), Aged, Neoplasm Staging, Cervical cancer, Univariate analysis, 030219 obstetrics & reproductive medicine, Hysterectomy, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Parametrial, Proportional hazards model, business.industry, Research, Parametrial invasion, lcsh:R, General Medicine, Middle Aged, medicine.disease, 3. Good health, [SDV] Life Sciences [q-bio], 030220 oncology & carcinogenesis, Multivariate Analysis, Female, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Background Recent studies have challenged radical procedures for less extensive surgery in selected patients with early-stage cervical cancer at low risk of parametrial invasion. Our objective was to identify a subgroup of patients at low risk of parametrial invasion among women having undergone surgical treatment. Methods Data of 1447 patients with cervical cancer treated between 1996 and 2016 were extracted from maintained databases of 10 French University hospitals. Patients with early-stage (IA2–IIA) disease treated by radical surgery including hysterectomy and trachelectomy, were selected for further analysis. The Kaplan–Meier method was used to estimate the survival distribution. A Cox proportional hazards model including all the parameters statistically significant in univariate analysis, was used to account for the influence of multiple variables. Results Out of the 263 patients included for analysis, on final pathology analysis 28 (10.6%) had parametrial invasion and 235 (89.4%) did not. Factors significantly associated with parametrial invasion on multivariate analysis were: age > 65 years, tumor > 30 mm in diameter measured by MRI, lymphovascular space invasion (LVSI) on pathologic analysis. Among the 235 patients with negative pelvic lymph nodes, parametrial disease was seen in only 7.6% compared with 30.8% of those with positive pelvic nodes (p

Published
2018

44. Impact of the first lockdown for coronavirus 19 on breast cancer management in France: A multicentre survey

Author

Geoffroy Canlorbe, Floriane Murris, Cyrille Huchon, Guillaume Legendre, Carina Rua, Emile Daraï, Tristan Gauthier, Sandrine Avigdor, Yohann Dabi, Lobna Ouldamer, Julien Cirier, Marcos Ballester, Sonia Zilberman, Jerome Phalippou, Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), and Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)

Subjects
medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Mammaplasty, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Psychological intervention, Breast Neoplasms, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Conservative Treatment, Epidemic disease, Patient Isolation, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Surveys and Questionnaires, Pandemic, medicine, Humans, Survey, Early discharge, Mastectomy, Retrospective Studies, 030219 obstetrics & reproductive medicine, SARS-CoV-2, business.industry, COVID-19, Obstetrics and Gynecology, Retrospective cohort study, Containment, Length of Stay, medicine.disease, 3. Good health, Ambulatory Surgical Procedures, Reproductive Medicine, Surgical Procedures, Operative, 030220 oncology & carcinogenesis, Emergency medicine, Original Article, Female, France, business, Healthcare system
Abstract

International audience; Objective: This study examined the impact of lockdown for SARS-CoV-2 on breast cancer management via an online survey in a French multicentre setting. Material and methods: This is a multicentre retrospective study, over the strict lockdown period from March 16th to May 11th, 2020 in metropolitan France. 20 centres were solicited, of which 12 responded to the survey. Results: 50% of the centres increased their surgical activity, 33% decreased it and 17% did not change it during containment. Some centres had to cancel (17%) or postpone (33%) patient-requested interventions due to fear of SARS-CoV-2. Four and 6 centres (33% and 50%) respectively cancelled and postponed interventions for medical reasons. In the usual period, 83% of the centres perform their conservative surgeries on an outpatient basis, otherwise the length of hospital stay was 24 to 48 h. All the centres except one performed conservative surgery on an outpatient basis during the lockdown period, for which. 8% performed mastectomies on an outpatient basis during the usual period. During lockdown, 50% of the centres reduced their hospitalization duration (25% outpatient /25% early discharge on Day 1). Conclusion: This study explored possibilities for management during the first pandemic lockdown. The COVID-19 pandemic required a total reorganization of the healthcare system, including the care pathways for cancer patients.

Published
2021

45. Using a new diagnostic tool to predict lymph node metastasis in advanced epithelial ovarian cancer leads to simple lymphadenectomy decision rules: A multicentre study from the FRANCOGYN group

Author

Arnaud Fauconnier, Matthieu Mezzadri, Sofiane Bendifallah, Jean Louis Benifla, Roman Rouzier, Yohan Kerbage, Vincent Lavoué, Xavier Paoletti, Geoffroy Canlorbe, Camille Mimoun, Charles Coutant, Cyrille Huchon, Lobna Ouldamer, Adrien Crestani, Cyril Touboul, Thomas Gaillard, Yohann Dabi, Alexandre Bricou, Lise Lecointre, Risques cliniques et sécurité en santé des femmes et en santé périnatale (RISCQ), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Service de gynécologie et obstétrique [Hopital Lariboisière - Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université de Paris (UP), Département d'Oncologie Chirurgicale [Institut Curie], Institut Curie [Paris], Cancer et génome: Bioinformatique, biostatistiques et épidémiologie d'un système complexe, MINES ParisTech - École nationale supérieure des mines de Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut Curie [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de gynécologie-obstétrique [Hôpital Jean Verdier], Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Sorbonne Paris Nord, Service de gynécologie et obstétrique [Créteil], CHI Créteil, Service de Gynécologie-Obstétrique, Maternité, Chirurgie Gynécologique [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), Clinique de Gynécologie [Lille] (Hôpital Jeanne de Flandre), Hôpital Jeanne de Flandre [Lille]-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de Gynécologie et Obstétrique [Rennes] = Gynaecology [Rennes], CHU Pontchaillou [Rennes], Hôpital Bretonneau, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Département de Gynécologie-Obstétrique [CHU Strasbourg], CHU Strasbourg-Hôpital de Hautepierre [Strasbourg], Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, Institut Curie [Paris]-MINES ParisTech - École nationale supérieure des mines de Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), Mines Paris - PSL (École nationale supérieure des mines de Paris), Service de Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], and HAL UVSQ, Équipe

Subjects
Oncology, Epidemiology, medicine.medical_treatment, Cancer Treatment, Pelvic Lymphadenectomy, Lymph node metastasis, Carcinoma, Ovarian Epithelial, Logistic regression, Surgical planning, Metastasis, Mathematical and Statistical Techniques, 0302 clinical medicine, Positron Emission Tomography Computed Tomography, Basic Cancer Research, Medicine and Health Sciences, Blood and Lymphatic System Procedures, Medicine, Ovarian Neoplasms, 0303 health sciences, Multidisciplinary, Cancer Risk Factors, Statistics, Cytoreduction Surgical Procedures, Middle Aged, 3. Good health, Surgical Oncology, Lymphatic Metastasis, 030220 oncology & carcinogenesis, Physical Sciences, Cohort, Female, France, Anatomy, Research Article, Clinical Oncology, medicine.medical_specialty, Science, Clinical Decision-Making, Surgical and Invasive Medical Procedures, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Research and Analysis Methods, Lymphatic System, 03 medical and health sciences, [SDV.CAN] Life Sciences [q-bio]/Cancer, Internal medicine, Humans, Statistical Methods, Aged, Retrospective Studies, 030304 developmental biology, Internet, business.industry, Biology and Life Sciences, Lymphadenectomy, Decision rule, medicine.disease, [SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Logistic Models, Medical Risk Factors, Lymph Node Excision, Lymph Nodes, Clinical Medicine, business, Ovarian cancer, Mathematics, Forecasting
Abstract

Objective The aim of this study was to develop a new diagnostic tool to predict lymph node metastasis (LNM) in patients with advanced epithelial ovarian cancer undergoing primary cytoreductive surgery. Materials and method The FRANCOGYN group’s multicenter retrospective ovarian cancer cohort furnished the patient population on which we developed a logistic regression model. The prediction model equation enabled us to create LNM risk groups with simple lymphadenectomy decision rules associated with a user-friendly free interactive web application called shinyLNM. Results 277 patients from the FRANCOGYN cohort were included; 115 with no LNM and 162 with LNM. Three variables were independently and significantly (p Conclusion This new tool may prove useful for improving surgical planning and provide useful information for patients.

Published
2021

46. The impact of the COVID-19 coronavirus pandemic on the surgical management of gynecological cancers: Analysis of the multicenter database of the French SCGP and the FRANCOGYN group

Author

Vincent Lavoué, Camille Mimoun, Théo Jouen, Aymeline Lacorre, Henri Azaïs, Stéphanie Seidler, Andrew Spiers, Anne-Lyse Vallin, Marc Siffert, Lobna Ouldamer, Guillaume Legendre, Pauline Chauvet, Hervé Fernandez, Lise Lecointre, Philippe Descamps, Tristan Gauthier, Sofiane Bendifallah, and Yohan Kerbage

Subjects
medicine.medical_specialty, Databases, Factual, Genital Neoplasms, Female, medicine.medical_treatment, History, 21st Century, Cohort Studies, Gynecologic, 03 medical and health sciences, Gynecologic Surgical Procedures, 0302 clinical medicine, Endometrial cancer, Ovarian cancer, Borderline tumor, Intensive care, Cancer of vulva, medicine, Humans, Women, Pandemics, Gynecological surgery, Aged, Pelvic, Cervical cancer, 030219 obstetrics & reproductive medicine, Pandemic, SARS-CoV-2, business.industry, General surgery, COVID-19, Obstetrics and Gynecology, Cancer, Middle Aged, medicine.disease, Reproductive Medicine, 030220 oncology & carcinogenesis, Communicable Disease Control, Quarantine, Cohort, VIRUS, Female, Original Article, Lymphadenectomy, France, Cancers, business, Cohort study
Abstract

Introduction The coronavirus SARS-CoV-2 (COVID-19) pandemic has put tremendous pressure on the French healthcare system. Almost all hospital departments have had to profoundly modify their activity to cope with the crisis. In this context, the surgical management of cancers has been a topic of debate as care strategies were tailored to avoid any delay in treatment that could be detrimental to patient wellbeing while being careful not to overload intensive care units. The primary objective of this study was to observe changes in the surgical management of pelvic cancers during the COVID-19 pandemic in France. Material and Methods This study analyzed data from the prospective multi-center cohort study conducted by the French Society for Pelvic and Gynecological Surgery (SCGP) with methodological support from the French (FRANCOGYN) Group. All members of the SCGP received by e-mail a link allowing them to include patients who were scheduled to undergo gynecological carcinologic surgery between March 16th 2020 and May 11th 2020. Demographic data, the characteristics of cancers and the impact of the crisis in terms of changes to the usual recommended coarse of care were collected. Results A total of 181 patients with a median age 63 years were included in the cohort. In total, 31 patients had cervical cancer, 76 patients had endometrial cancer, 52 patients had ovarian or tubal cancer, 5 patients had a borderline tumor of the ovary, and 17 patients had vulvar cancer. During the study period, the care strategy was changed for 49 (27%) patients with postponed for 35 (19.3%) patients, and canceled for 7 (3.9%) patients. Surgical treatment was maintained for 139 (76.8%) patients. Management with neoadjuvant chemotherapy was offered to 19 (10,5%) patients and a change in surgical choice was made for 5 (2,8%) patients. In total, 8 (4,4%) patients tested positive for COVID-19. Data also shows a greater number of therapeutic changes in cases of ovarian cancer as well as a cancelation of a lumbo-aortic lymphadenectomy in one patient with cervical cancer. Hospital consultants estimated a direct detrimental impact of the COVID-19 pandemic for 39 patients, representing 22% of gynecological cancers. Conclusion This study provided observational data of the impact of the COVID-19 health crisis on the surgical management of gynecological cancers.

Published
2021

47. Predicting poor prognosis recurrence in women with endometrial cancer: a nomogram developed by the FRANCOGYN study group

Author

Emile Daraï, Gilles Body, Vincent Lavoué, Sofiane Bendifallah, Marcos Ballester, Lobna Ouldamer, Pierre Collinet, Emilie Raimond, Jean Lévêque, Charles Coutant, Olivier Graesslin, Cyril Touboul, Nutrition, croissance et cancer (U 1069) (N2C), Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Epidemiologie, Systèmes d'information, Modélisation, Institut National de la Santé et de la Recherche Médicale (INSERM), Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Expert en Endométriose [CHU Tenon] (GRC6 C3E), Institut Mère Enfant Alix de Champagne, Hôpital Jeanne de Flandres, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, CHU Pontchaillou [Rennes], Oncogenesis Stress Signaling (OSS), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CRLCC Eugène Marquis (CRLCC), Centre de Recherche Saint-Antoine (UMRS893), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Groupe de recherche clinique Centre Expert en Endométriose (GRC 6 - C3E), Sorbonne Université (SU), and Université de Rennes (UR)-CRLCC Eugène Marquis (CRLCC)

Subjects
0301 basic medicine, Oncology, Risk, Cancer Research, medicine.medical_specialty, recurrence, medicine.medical_treatment, [SDV.CAN]Life Sciences [q-bio]/Cancer, nomogram, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Internal medicine, medicine, metastasis, Humans, 10. No inequality, Retrospective Studies, Receiver operating characteristic, Proportional hazards model, business.industry, Endometrial cancer, peritoneal carcinomatosis, Retrospective cohort study, Nomogram, medicine.disease, Prognosis, Confidence interval, Endometrial Neoplasms, Nomograms, 030104 developmental biology, 030220 oncology & carcinogenesis, endometrial cancer, Clinical Study, Lymphadenectomy, Female, business
Abstract

International audience; Background - The purpose of this study was to develop a nomogram to predict 'poor prognosis recurrence' (PPR) in women treated for endometrial cancer (EC). Methods - The data of 861 women who received primary surgical treatment between January 2001 and December 2013 were abstracted from a prospective multicenter database. Data were randomly split into two sets: training and validation with a predefined 2/3 ratio. A Cox proportional hazards multivariate model of selected prognostic features was performed in the training cohort (n=574) to develop a nomogram predicting PPRs. The nomogram was validated in the validation cohort of 287 patients. Results - In the training cohort, 82 (14.3%) developed subsequent PPR. Age, histologic type and grade, lymphovascular space invasion status, FIGO stage, and nodal staging (SLN±pelvic and/or para-aortic lymphadenectomy) were independently associated with subsequent PPR. The nomogram showed an area under the receiver operating characteristic curve (AUC) of 0.82 (95% confidence interval (CI), 0.73-0.89) in the training set. The validation set showed a good discrimination with an AUC of 0.75 (95% CI, 0.65-0.83). Conclusions - We have developed a robust tool that is able to predict subsequent PPRs in women with FIGO I-III EC.

Published
2016

48. Lipid metabolism and Calcium signaling in epithelial ovarian cancer

Author

Aurélie Chantôme, Marie Potier-Cartereau, Sana Kouba, Caroline Goupille, Christophe Vandier, Lobna Ouldamer, Céline Garcia, Delphine Fontaine, Nutrition, croissance et cancer (U 1069) (N2C), Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de gynécologie-obstétrique [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Gynécologie-Obstétrique [CHRU Tours], and CCSD, Accord Elsevier

Subjects
0301 basic medicine, endocrine system diseases, Physiology, Carcinogenesis, Disease, medicine.disease_cause, Pathogenesis, chemistry.chemical_compound, 0302 clinical medicine, Lysophosphatidic acid, Medicine, MESH: Animals, Calcium signaling, MESH: Lipid Metabolism, Ovarian Neoplasms, Arachidonic Acid, MESH: Risk, MESH: Carcinogenesis, female genital diseases and pregnancy complications, 3. Good health, MESH: Ovarian Neoplasms, MESH: Epithelial Cells, Female, Risk, MESH: Receptor Cross-Talk, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH: Calcium Signaling, MESH: Lysophospholipids, 03 medical and health sciences, [SDV.CAN] Life Sciences [q-bio]/Cancer, Animals, Humans, Calcium Signaling, Molecular Biology, MESH: Humans, business.industry, Lipid metabolism, Epithelial Cells, Cell Biology, Lipid signaling, Receptor Cross-Talk, Lipid Metabolism, MESH: Arachidonic Acid, 030104 developmental biology, chemistry, Cancer cell, Cancer research, Lysophospholipids, business, MESH: Female, 030217 neurology & neurosurgery
Abstract

International audience; Epithelial Ovarian cancer (EOC) is the deadliest gynecologic malignancy and represents the fifth leading cause of all cancer-related deaths in women. The majority of patients are diagnosed at an advanced stage of the disease that has spread beyond the ovaries to the peritoneum or to distant organs (stage FIGO III-IV) with a 5-year overall survival of about 29%. Consequently, it is necessary to understand the pathogenesis of this disease. Among the factors that contribute to cancer development, lipids and ion channels have been described to be associated to cancerous diseases particularly in breast, colorectal and prostate cancers. Here, we reviewed the literature data to determine how lipids or lipid metabolites may influence EOC risk or progression. We also highlighted the role and the expression of the calcium (Ca2+) and calcium-activated potassium (KCa) channels in EOC and how lipids might regulate them. Although lipids and some subclasses of nutritional lipids may be associated to EOC risk, lipid metabolism of LPA (lysophosphatidic acid) and AA (arachidonic acid) emerges as an important signaling network in EOC. Clinical data showed that they are found at high concentrations in EOC patients and in vitro and in vivo studies referred to them as triggers of the Ca2+entry in the cancer cells inducing their proliferation, migration or drug resistance. The cross-talk between lipid mediators and Ca2+ and/or KCa channels needs to be elucidated in EOC in order to facilitate the understanding of its outcomes and potentially suggest novel therapeutic strategies including treatment and prevention.

Published
2019

49. Impact of vaginal brachytherapy in intermediate and high-intermediate risk endometrial cancer: a multicenter study from the FRANCOGYN group

Author

Geoffroy Canlorbe, Emile Daraï, Charles Coutant, Pierre Alain Reboux, Marcos Ballester, Charles Henry Canova, Henri Azaïs, Olivier Graesslin, Pierre Collinet, Jean Levêque, Cyril Touboul, Sofiane Bendifallah, Alexandre Bricou, Lobna Ouldamer, Delphine Hudry, Cyrille Huchon, Martin Koskas, Vincent Lavoué, Catherine Uzan, Emilie Raimond, CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [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), Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Nutrition, croissance et cancer (U 1069) (N2C), Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Reims (CHU Reims), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, Service de gynécologie et obstétrique [Créteil], CHI Créteil, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de gynécologie-obstétrique [Hôpital Jean Verdier], Université Paris 13 (UP13)-Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Gynécologie et Obstétrique [Rennes] = Gynaecology [Rennes], CHU Pontchaillou [Rennes], Chemistry, Oncogenesis, Stress and Signaling (COSS), Institut National de la Santé et de la Recherche Médicale (INSERM)-CRLCC Eugène Marquis (CRLCC)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Jonchère, Laurent, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UR)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris 13 (UP13), Université de Rennes 1 (UR1), and 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)

Subjects
medicine.medical_specialty, medicine.medical_treatment, Brachytherapy, Urology, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Endometrial Cancer, 03 medical and health sciences, 0302 clinical medicine, Uterine Corpus, [SDV.CAN] Life Sciences [q-bio]/Cancer, Risk Factors, Adjuvant therapy, Humans, Medicine, Aged, Neoplasm Staging, Retrospective Studies, Local Neoplasm Recurrence, Aged, 80 and over, 030219 obstetrics & reproductive medicine, business.industry, Endometrial cancer, High intermediate risk, Obstetrics and Gynecology, General Medicine, Middle Aged, medicine.disease, Endometrial Neoplasms, 3. Good health, Radiation therapy, [SDV.MHEP.GEO] Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Oncology, Multicenter study, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Case-Control Studies, 030220 oncology & carcinogenesis, Practice Guidelines as Topic, Vaginal brachytherapy, Female, Radiotherapy, Adjuvant, Original Article, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, Neoplasm Recurrence, Local, business, Adjuvant
Abstract

International audience; Objective - According to recent European Society of Medical Oncology, European Society of Gynaecological Oncology and European Society of Radiotherapy and Oncology guidelines, adjuvant vaginal brachytherapy (VB) is optional in patients with intermediate risk (IR) and high-intermediate risk (HIR) endometrial cancer (EC). The aim of this French retrospective, multicenter study was to assess the impact of VB in these groups on local recurrence rate, local recurrence-free survival (RFS) and overall survival (OS).Methods - Data of 191 patients with IR and HIR EC who underwent primary surgery with or without VB and no other adjuvant treatment between 2000 and 2016 were extracted from the FRANCOGYN database. Rate of local recurrence, OS and local RFS in these two groups were compared using the Kaplan-Meier method. Results - The number of patients with IR and HIR EC were 118 and 73 respectively. VB was used in 92 patients in IR group and 43 in HIR group. Median follow-up was 22 months. In the HIR group, the local recurrence rate was significantly higher in the no adjuvant therapy group in comparison with the VB group (16.7% and 0% respectively, p=0.02). There was also a significant improvement in local RFS (p=0.01) in VB group. In IR EC, there is no significant difference on local recurrence rate (4.2% and 3.2%, respectively, p=1.00) or local RFS (p=0.54) between the two groups.Conclusions - VB is an efficient adjuvant treatment for patients with HIR EC. VB is not associated with an improvement of RFS or OS in IR EC patient.

Published
2019

50. Impact pronostique du délai d'induction de la radiothérapie adjuvante dans le cancer du sein

Author

Gilles Body, Joseph Pilloy, Lobna Ouldamer, Marie-Lise Jourdan, Claire Fleurier, M. Lesage, Julien Cirier, Flavie Arbion, Nutrition, croissance et cancer (U 1069) (N2C), Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Gynecology, medicine.medical_specialty, Adjuvant radiotherapy, business.industry, [SDV]Life Sciences [q-bio], Obstetrics and Gynecology, 030501 epidemiology, medicine.disease, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Reproductive Medicine, 030220 oncology & carcinogenesis, Medicine, 0305 other medical science, business
Abstract

Resume Objectif Evaluer les delais d’acces aux traitements de radiotherapie adjuvante du cancer du sein et etudier l’impact sur le pronostic des patientes. Methodes Etude descriptive retrospective au centre hospitalo-universitaire de Tours entre le 1er janvier 2007 et le 31 decembre 2013. L’ensemble des patientes operees pour un cancer du sein sur cette periode ont ete incluses. Les patientes avec chimiotherapie (neo-adjuvante, adjuvante) ont ete exclues. Les delais d’acces a la radiotherapie adjuvante ont ete releves. La survie globale, la survie sans rechute et la survie sans recidive (loco-regionale ou metastatique a distance) ont ete utilisees pour etudier l’impact sur le pronostic. Resultats Sur les 1855 patientes presentant un cancer du sein de type infiltrant, les patientes justifiant d’une radiotherapie adjuvante etaient au nombre de 904 (48,7 %). En population globale, on retrouvait un lien significatif entre la survie sans recidive et un delai chirurgie-radiotherapie superieur a 90 jours avec en analyse multivariee (HR = 2,12 [1,03–46] p = 0,04). Ainsi, la realisation de la radiotherapie a plus de 90 jours de la date de la chirurgie apparaissait donc comme un facteur independant impactant la survie sans rechute dans la population globale. Chez les patientes beneficiant d’un traitement conservateur, la radiotherapie realisee a plus de 65 jours du traitement chirurgical conservateur, etait un facteur independant impactant negativement la survie sans recidive : HR = 2,29 [1,16–4,54], p = 0,02. La radiotherapie realisee a plus de 70 jours du traitement chirurgical conservateur, etait un facteur independant impactant negativement la survie globale : HR = 3,41 [1,005–112], p = 0,04. Conclusion Le delai d’acces aux traitements adjuvants du cancer du sein impacte la survie des patientes, notamment en cas de cas de chirurgie mammaire conservatrice.

Published
2019

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