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1. Diagnostic Accuracy of Lipase as Early Predictor of Postoperative Pancreatic Fistula: Results from the LIPADRAIN study

Author: Béranger Doussot, MD, Alexandre Doussot, MD, PhD, Ahmet Ayav, MD, PhD, Nicolas Santucci, MD, Sophie Deguelte, MD, Amadou Khalilou Sow, MD, Mehdi El Amrani, MD, PhD, Laurence Duvillard, MD, PhD, Guillaume Piessen, MD, PhD, Edouard Girard, MD, PhD, Jean-Yves Mabrut, MD, PhD, Jonathan Garnier, MD, PhD, Pablo Ortega-Deballon, MD, PhD, Isabelle Fournel, MD, PhD, and Olivier Facy, MD, PhD
Subjects: Surgery, RD1-811
Abstract: Objective:. To evaluate the diagnostic accuracy of drain fluid lipase as an early predictor of postoperative pancreatic fistula and establish the most appropriate day for their measure. Background:. Clinically relevant postoperative pancreatic fistula remains a potentially life-threatening complication after pancreatic surgery. Early detection strategies remain key to reduce both the incidence and the burden of pancreatic fistula. Methods:. The LIPAse DRAIN (LIPADRAIN) study is a multicenter, prospective diagnostic study conducted in 7 tertiary university hospitals. Drain fluid values to detect clinically relevant postoperative pancreatic fistula from postoperative day 1 to postoperative day 6 were evaluated using receiver operating characteristic curve analysis. A biomarker was considered to be relevant for clinical use if its area under the curve (AUC) was greater than 0.75. Results:. Of the 625 patients included in the analysis, clinically relevant postoperative pancreatic fistula occurred in 203 (32%) patients. On postoperative days 3 and 4, drain fluid lipase was a reliable biomarker to detect clinically relevant postoperative pancreatic fistula (AUC: 0.761; 95% confidence interval [CI]: 0.761–0.799 and AUC: 0.784; 95% CI: 0.743–0.821, respectively). On postoperative day 3, with a threshold of 299 units/L, drain fluid lipase yielded a negative predictive value of 51%, sensitivity of 78%, and specificity of 63% for the detection of clinically relevant postoperative pancreatic fistula. Conclusions:. In this multicenter prospective study, drain fluid lipase is a reliable biomarker at postoperative days 3 and 4 for the diagnosis of clinically relevant postoperative pancreatic fistula after pancreatic surgery and should be systematically measured on postoperative day 3.
Published: 2024
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2. Benefit of a flash dose of corticosteroids in digestive surgical oncology: a multicenter, randomized, double blind, placebo-controlled trial (CORTIFRENCH)

Author: Joséphine Magnin, Isabelle Fournel, Alexandre Doussot, Jean-Marc Régimbeau, Philippe Zerbib, Guillaume Piessen, Laura Beyer-Berjot, Sophie Deguelte, Zaher Lakkis, Lilian Schwarz, David Orry, Ahmet Ayav, Fabrice Muscari, François Mauvais, Guillaume Passot, Nelson Trelles, Aurélien Venara, Stéphane Benoist, Mathieu Messager, David Fuks, Baptiste Borraccino, Christophe Trésallet, Alain Valverde, François-Régis Souche, Astrid Herrero, Sébastien Gaujoux, Jérémie Lefevre, Abderrahmane Bourredjem, Amélie Cransac, and Pablo Ortega-Deballon
Subjects: Perioperative corticosteroids, Digestive surgical oncology, Randomized placebo-controlled trial, Postoperative morbidity, cancer-related outcomes, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract: Abstract Background The modulation of perioperative inflammation seems crucial to improve postoperative morbidity and cancer-related outcomes in patients undergoing oncological surgery. Data from the literature suggest that perioperative corticosteroids decrease inflammatory markers and might be associated with fewer complications in esophageal, liver, pancreatic and colorectal surgery. Their benefit on cancer-related outcomes has not been assessed. Methods The CORTIFRENCH trial is a phase III multicenter randomized double-blind placebo-controlled trial to assess the impact of a flash dose of preoperative corticosteroids versus placebo on postoperative morbidity and cancer-related outcomes after elective curative-intent surgery for digestive cancer. The primary endpoint is the frequency of patients with postoperative major complications occurring within 30 days after surgery (defined as all complications with Clavien-Dindo grade > 2). The secondary endpoints are the overall survival at 3 years, the disease-free survival at 3 years, the frequency of patients with intraabdominal infections and postoperative infections within 30 days after surgery and the hospital length of stay. We hypothesize a reduced risk of major complications and a better disease-survival at 3 years in the experimental group. Allowing for 5% of drop-out, 1 200 patients (600 per arm) should be included. Discussion This will be the first trial focusing on the impact of perioperative corticosteroids on cancer related outcomes. If significant, it might be a strong improvement on oncological outcomes for patients undergoing surgery for digestive cancers. Trial registration ClinicalTrials.gov, NCT03875690, Registered on March 15, 2019, URL: https://clinicaltrials.gov/ct2/show/NCT03875690 .
Published: 2022
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3. Selective Internal Radiation Combined with Chemotherapy Maintains the Quality of Life in Intrahepatic Cholangiocarcinomas

Author: Camille Goislard de Monsabert, Yann Touchefeu, Boris Guiu, Boris Campillo-Gimenez, Olivier Farges, David Tougeron, Isabelle Baumgaertner, Ahmet Ayav, Luc Beuzit, Marc Pracht, Astrid Lièvre, Samuel Le Sourd, Karim Boudjema, Yan Rolland, Etienne Garin, Eveline Boucher, and Julien Edeline
Subjects: biliary tract cancer, radioembolization, Yttrium-90, chemotherapy, patient-reported outcomes, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract: Background: In the Yttrium-90 Microspheres in Cholangiocarcinoma (MISPHEC) single-arm phase 2 trial, concomitant chemotherapy and selective internal radiotherapy (SIRT) showed antitumor activity as a first-line treatment of unresectable intrahepatic cholangiocarcinomas (ICCs). In this sub-analysis, we aimed to evaluate one of the secondary endpoints, the health-related quality of life (QoL), evaluated with an EORTC QLQ-C30 instrument at the baseline and during treatment. Methods: The MISPHEC trial included treatment-naïve patients with an unresectable ICC between November 2013 and June 2016. Patients received concomitant first-line chemotherapy with cisplatin and gemcitabine for 8 cycles; SIRT was administered during cycle 1 (for patients with unilobar disease) or cycles 1 and 3 (for patients with bilobar disease) using glass Yttrium-90 microspheres. We evaluated the QoL—measured by the QLQ-C30 questionnaire—at the baseline, every 8 weeks during chemotherapy and follow-up, between 12 and 15 weeks after embolization and every 12 weeks after a liver resection if applicable. Results: A total of 41 patients were included, of which 34 completed questionnaires at the baseline. No clinically significant changes in the global health score or the sub-scales of the QLQ-C30 were observed during follow-up. The physical, social and role function mean score worsened during treatment and fatigue, nausea and pain scores increased although the differences were not clinically significant. In patients undergoing subsequent surgery, the QoL was not impaired. Conclusions: A combination of SIRT and chemotherapy with gemcitabine and cisplatin as the first-line treatment of unresectable ICCs was found to maintain the QoL.
Published: 2021
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4. Plasma mSEPT9: A Novel Circulating Cell-free DNA-Based Epigenetic Biomarker to Diagnose Hepatocellular Carcinoma

Author: Abderrahim Oussalah, Susann Rischer, Mouni Bensenane, Guillaume Conroy, Pierre Filhine-Tresarrieu, Renée Debard, Denise Forest-Tramoy, Thomas Josse, Dana Reinicke, Matthieu Garcia, Amandine Luc, Cédric Baumann, Ahmet Ayav, Valérie Laurent, Marcus Hollenbach, Cristina Ripoll, Rosa-Maria Guéant-Rodriguez, Fares Namour, Alexander Zipprich, Michael Fleischhacker, Jean-Pierre Bronowicki, and Jean-Louis Guéant
Subjects: Medicine, Medicine (General), R5-920
Abstract: Summary: Background: Patients with cirrhosis are at high risk of hepatocellular carcinoma (HCC). The SEPT9 gene is a key regulator of cell division and tumor suppressor whose hypermethylation is associated with liver carcinogenesis. The primary aim of this study was to evaluate the diagnostic accuracy of a PCR-based assay for the analysis of SEPT9 promoter methylation in circulating cell-free DNA (mSEPT9) for diagnosing HCC among cirrhotic patients. Methods: We report two phase II biomarker studies that included cirrhotic patients with or without HCC from France (initial study) and Germany (replication study). All patients received clinical and biological evaluations, and liver imaging according to current recommendations. The primary outcome was defined as the presence of HCC according to guidelines from the American Association for the Study of Liver Diseases. The diagnosis of HCC was confirmed by abdominal contrast-enhanced computed tomography scan and systematically discussed in a multidisciplinary consultation meeting. HCC-free cirrhotic patients were recruited if the screening abdominal ultrasound showed no evidence of HCC at the time of blood sampling for the mSEPT9 test and on the next visit six months later. The adjudicating physicians were blinded to patient results associated with the mSEPT9 test. Findings: We included 289 patients with cirrhosis (initial: 186; replication: 103), among whom 98 had HCC (initial: 51; replication: 47). The mSEPT9 test exhibited high diagnostic accuracy for HCC diagnosis, with an area under the receiver operating characteristic curve (AUROC) of 0.944 (0.900–0.970, p
Published: 2018
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5. Resection of Locally Advanced Pancreatic Neoplasms after Neoadjuvant Chemotherapy with Nab-Paclitaxel and Gemcitabine following FOLFIRINOX Failure

Author: Sarah Hahn, Ahmet Ayav, and Anthony Lopez
Subjects: Pancreas, Drug therapy, Surgery, Tumor, Diseases of the digestive system. Gastroenterology, RC799-869
Abstract: The incidence of pancreatic cancer has dramatically increased over the past years, but the prognosis has not improved. Between 30 and 40% of tumors are considered locally advanced, essentially due to vascular involvement. In recent years, new chemotherapy protocols with high response rates have been developed. FOLFIRINOX seems to be an interesting option in this situation, but hematologic toxicity could be an obstacle to its prescription. Nab-paclitaxel and gemcitabine offer significant response rates with a reasonable safety profile. We report here a single-center experience of 2 cases with a locally advanced pancreatic cancer initially considered unresectable, progressive after first-line neoadjuvant FOLFIRINOX chemotherapy, and then treated with second-line nab-paclitaxel/gemcitabine chemotherapy.
Published: 2017
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6. Is pancreatic head surgery safe in the elderly?

Author: Estelle Vigneron, Julie Leclerc, Hervé Chanty, Adeline Germain, and Ahmet Ayav
Subjects: Hepatology, Gastroenterology
Published: 2023
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7. Advanced nonmetastatic hepatocellular carcinoma: curative surgery may be an option

Author: Julie Leclerc and Ahmet Ayav
Subjects: General Earth and Planetary Sciences, General Environmental Science
Published: 2022
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8. Selective Internal Radiation Combined with Chemotherapy Maintains the Quality of Life in Intrahepatic Cholangiocarcinomas

Author: Etienne Garin, Yan Rolland, Luc Beuzit, Camille Goislard de Monsabert, Eveline Boucher, Astrid Lièvre, Yann Touchefeu, Samuel Le Sourd, David Tougeron, Karim Boudjema, Boris Campillo-Gimenez, Isabelle Baumgaertner, Olivier Farges, Ahmet Ayav, Marc Pracht, Julien Edeline, Boris Guiu, CRLCC Eugène Marquis (CRLCC), Centre hospitalier universitaire de Nantes (CHU Nantes), CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre hospitalier universitaire de Poitiers (CHU Poitiers), CRHU Nancy, 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), Service de Chirurgie Hépatobiliaire et Digestive [Rennes] = Hepatobiliary and Digestive Surgery [Rennes], Nutrition, Métabolismes et Cancer (NuMeCan), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), BTG, Ligue Contre le Cancer, Université de Montpellier (UM), Université de Rennes (UR)-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), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Jonchère, Laurent, and Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)
Subjects: vomiting, Yttrium-90, medicine.medical_treatment, insomnia, Brachytherapy, diarrhea, cisplatin, thrombocytopenia, chemotherapy, Gastroenterology, 030218 nuclear medicine & medical imaging, chemoradiotherapy, Cholangiocarcinoma, 0302 clinical medicine, Quality of life, dose response, pain, Embolization, RC254-282, clinical article, adult, gemcitabine, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, yttrium 90, nausea, humanities, 3. Good health, sirtuin, aged, female, anorexia, patient-reported outcomes, 030220 oncology & carcinogenesis, liver resection, [SDV.IB]Life Sciences [q-bio]/Bioengineering, medicine.symptom, medicine.drug, radioembolization, medicine.medical_specialty, Nausea, patient-reported outcome, Article, multiple cycle treatment, 03 medical and health sciences, male, Internal medicine, biliary tract cancer, medicine, follow up, neutropenia, Humans, human, [SDV.IB] Life Sciences [q-bio]/Bioengineering, Cisplatin, loss of appetite, Chemotherapy, business.industry, questionnaire, constipation, dyspnea, Gemcitabine, Radiation therapy, phase 2 clinical trial, multicenter study, Bile Ducts, Intrahepatic, Bile Duct Neoplasms, Concomitant, microsphere, Quality of Life, fatigue, asthenia, bile duct carcinoma, business
Abstract: Background: In the Yttrium-90 Microspheres in Cholangiocarcinoma (MISPHEC) single-arm phase 2 trial, concomitant chemotherapy and selective internal radiotherapy (SIRT) showed antitumor activity as a first-line treatment of unresectable intrahepatic cholangiocarcinomas (ICCs). In this sub-analysis, we aimed to evaluate one of the secondary endpoints, the health-related quality of life (QoL), evaluated with an EORTC QLQ-C30 instrument at the baseline and during treatment. Methods: The MISPHEC trial included treatment-naïve patients with an unresectable ICC between November 2013 and June 2016. Patients received concomitant first-line chemotherapy with cisplatin and gemcitabine for 8 cycles, SIRT was administered during cycle 1 (for patients with unilobar disease) or cycles 1 and 3 (for patients with bilobar disease) using glass Yttrium-90 microspheres. We evaluated the QoL—measured by the QLQ-C30 questionnaire—at the baseline, every 8 weeks during chemotherapy and follow-up, between 12 and 15 weeks after embolization and every 12 weeks after a liver resection if applicable. Results: A total of 41 patients were included, of which 34 completed questionnaires at the baseline. No clinically significant changes in the global health score or the sub-scales of the QLQ-C30 were observed during follow-up. The physical, social and role function mean score worsened during treatment and fatigue, nausea and pain scores increased although the differences were not clinically significant. In patients undergoing subsequent surgery, the QoL was not impaired. Conclusions: A combination of SIRT and chemotherapy with gemcitabine and cisplatin as the first-line treatment of unresectable ICCs was found to maintain the QoL.
Published: 2021
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9. Impact of the COVID-19 pandemic on disease stage and treatment for patients with pancreatic adenocarcinoma: A French comprehensive multicentre ambispective observational cohort study (CAPANCOVID)

Author: Mathias Brugel, Léa Letrillart, Camille Evrard, Aurore Thierry, David Tougeron, Mehdi El Amrani, Guillaume Piessen, Stéphanie Truant, Anthony Turpin, Christelle d'Engremont, Gaël Roth, Vincent Hautefeuille, Jean M. Regimbeau, Nicolas Williet, Lilian Schwarz, Frédéric Di Fiore, Christophe Borg, Alexandre Doussot, Aurélien Lambert, Valérie Moulin, Hélène Trelohan, Marion Bolliet, Amalia Topolscki, Ahmet Ayav, Anthony Lopez, Damien Botsen, Tulio Piardi, Claire Carlier, Olivier Bouché, Centre Hospitalier Universitaire de Reims (CHU Reims), Université de Reims Champagne-Ardenne (URCA), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277 (CANTHER), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire [Grenoble] (CHU), Université Grenoble Alpes (UGA), CHU Amiens-Picardie, Chirurgie digestive [CHU Amiens], Simplification des soins chez les patients complexes - UR UPJV 7518 (SSPC), Université de Picardie Jules Verne (UPJV), Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Service de chirurgie digestive [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Génomique et Médecine Personnalisée du Cancer et des Maladies Neuropsychiatriques (GPMCND), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Etablissement Français du Sang de Bourgogne Franche-Comté (site de Dijon) (EFS BFC (site de Dijon)), Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté]), Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (RIGHT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] (UNICANCER/ICL), UNICANCER, Groupe hospitalier de La Rochelle, CH Colmar, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Université de Lorraine (UL), Institut Jean Godinot [Reims], Vieillissement, Fragilité (VIEFRA - EA 3797), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Etablissement français du sang [Bourgogne-Franche-Comté] (EFS BFC), Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS BFC)-Université de Franche-Comté (UFC), Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre Hospitalier Universitaire de Reims [CHU Reims], Institut des Mondes Africains [IMAF], Centre hospitalier universitaire de Poitiers [CHU Poitiers], Miniaturisation pour la Synthèse, l’Analyse et la Protéomique - UAR 3290 [MSAP], Hôpital Claude Huriez [Lille], Centre Hospitalier Régional Universitaire [Lille] [CHRU Lille], Cooperator Multidisciplinary Oncology Group [GERCOR], Service de Gastro-Entérologie [CHRU Besançon], Institute for Advanced Biosciences / Institut pour l'Avancée des Biosciences (Grenoble) [IAB], Simplification des soins chez les patients complexes - UR UPJV 7518 [SSPC], Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] [CHU ST-E], Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen [CLCC Henri Becquerel], CHU Dijon, and Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] [UNICANCER/ICL]
Subjects: Cancer Research, Care pathway, Pancreatic neoplasms, Pandemic, SARS-CoV-2, COVID-19, Adenocarcinoma, Cohort Studies, Oncology, Communicable Disease Control, Humans, Pandemics, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Cancer
Abstract: International audience; Background: The COVID-19 pandemic caused major oncology care pathway disruption. The CAPANCOVID study aimed to evaluate the impact on pancreatic adenocarcinoma (PA) - from diagnosis to treatment - of the reorganisation of the health care system during the first lockdown.Methods: This multicentre ambispective observational study included 833 patients diagnosed with PA between September 1, 2019 and October 31, 2020 from 13 French centres. Data were compared over three periods defined as before the outbreak of COVID-19, during the first lockdown (March 1 to May 11, 2020) and after lockdown.Results: During the lockdown, mean weekly number of new cases decreased compared with that of pre-pandemic levels (13.2 vs. 10.8, -18.2%; p = 0.63) without rebound in the post-lockdown period (13.2 vs. 12.9, -1.7%; p = 0.97). The number of borderline tumours increased (13.6%-21.7%), whereas the rate of metastatic diseases rate dropped (47.1%-40.3%) (p = 0.046). Time-to-diagnosis and -treatment were not different over periods. Waiting neoadjuvant chemotherapy in resectable tumours was significantly favoured (24.7%-32.6%) compared with upfront surgery (13%-7.8%) (p = 0.013). The use of mFOLFIRINOX preoperative chemotherapy regimen decreased (84.9%-69%; p = 0.044). After lockdown, the number of borderline tumours decreased (21.7%-9.6%) and advanced diseases increased (59.7%-69.8%) (p = 0.046). SARS-CoV-2 infected 39 patients (4.7%) causing 5 deaths (12.8%).Conclusion: This cohort study suggests the existence of missing diagnoses and of a shift in disease stage at diagnosis from resectable to advanced diseases with related therapeutic modifications whose prognostic consequences will be known after the planned follow-up.Trial registration: Clinicaltrials.gov NCT04406571.
Published: 2022
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10. Development of a Clinical–Biological Model to Assess Tumor Progression in Metastatic Pancreatic Cancer: Post Hoc Analysis of the PRODIGE4/ACCORD11 Trial

Author: Julie Egea, Julia Salleron, Sophie Gourgou, Ahmet Ayav, Valérie Laurent, Béata Juzyna, Alexandre Harlé, Thierry Conroy, and Aurélien Lambert
Subjects: Cancer Research, Oncology, pancreatic cancer, tumor progression, quality of life, CA 19-9, patient-reported outcomes
Abstract: Background: The follow-up of pancreatic cancer (PC) is based on computed tomography (CT) assessment; however, there is no consensus on the use of clinical and biological criteria in tumor progression. We aimed to establish a clinical–biological model to highlight the progression of metastatic PC during first-line treatment. Methods: The patients treated with first-line chemotherapy in the phase 2/3 PRODIGE4/ACCORD11 clinical trial were evaluated retrospectively. Clinical and biological markers were evaluated at the time of CT scans and during treatment to determine tumor progression. Results: In total, 196 patients were analyzed, with 355 available tumor assessments. The clinical and biological factors associated with tumor progression in multivariate analysis included gemcitabine, global health status ≤ 33 (OR = 3.38, 95%CI [1.15; 9.91], p = 0.028), quality of life score between 34 and 66 (OR = 2.65, 95%CI [1.06; 6.59], p = 0.037), carcinoembryonic antigen (CEA) ≥ 3 times the standard value without any increase in the CEA level from inclusion (OR = 2.22, 95%CI [1.01; 4.89], p = 0.048) and with an increase in the CEA level from inclusion (OR = 6.56, 95%CI [2.73; 15.78], p < 0.001), and an increase in the carbohydrate antigen 19-9 level from inclusion (OR = 2.59, 95%CI [1.25; 5.36], p = 0.016). Conclusions: The self-assessment of patients’ general health status alongside tumor markers is an interesting approach to the diagnosis of the tumor progression of metastatic pancreatic cancer patients during first-line treatment.
Published: 2022
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11. Liver Venous Deprivation or Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy?: A Retrospective Multicentric Study

Author: Stéphanie Truant, Alexandre Chebaro, Alexandre Didier, François-René Pruvot, Fabrice Muscari, Mehdi El Amrani, Ercin Sonmez, Emmanuel Buc, Marie Bougard, Yuki Kitano, Christophe Laurent, Ahmet Ayav, Laurence Chiche, Katia Lecolle, René Adam, Laurent Sulpice, C. Maulat, Raffaele Brustia, Thibault Durin, Daniele Sommacale, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand, CHU Bordeaux [Bordeaux], CHU Henri Mondor, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Hôpital Paul Brousse, Université Paris-Saclay, Kumamoto University, Hôpital de Rangueil, CHU Toulouse [Toulouse], CHU Pontchaillou [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES), Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277 (CANTHER), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre National de la Recherche Scientifique (CNRS), CHU Henri Mondor [Créteil], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université de Rennes (UR), CHU Lille, Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre Hépato-Biliaire [Hôpital Paul Brousse] (CHB), and Hôpital Paul Brousse-Assistance Publique - Hôpitaux de Paris
Subjects: Adult, Male, medicine.medical_specialty, Carcinoma, Hepatocellular, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Portal vein ligation, 030230 surgery, Hepatic Veins, Muscle hypertrophy, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Medicine, Hepatectomy, Humans, Embolization, Vein, Prospective cohort study, Ligation, Aged, Retrospective Studies, Aged, 80 and over, Chemotherapy, business.industry, Portal Vein, Liver Neoplasms, Middle Aged, French Editorial from the ACHBPT, Embolization, Therapeutic, Surgery, Intention to Treat Analysis, medicine.anatomical_structure, Treatment Outcome, 030220 oncology & carcinogenesis, Cohort, Partition (politics), Feasibility Studies, Female, business
Abstract: International audience; OBJECTIVE: To compare two techniques of remnant liver hypertrophy in candidates for extended hepatectomy: radiological simultaneous portal vein (PVE) and hepatic vein embolization (HVE); namely liver venous deprivation (LVD), and ALPPS. SUMMARY BACKGROUND DATA: Recent advances in chemotherapy and surgical techniques have widened indications for extended hepatectomy, before which remnant liver augmentation is mandatory. ALPPS and LVD typically show higher hypertrophy rates than PVE, but their respective places in patient management remain unclear. METHODS: All consecutive ALPPS and LVD procedures performed in eight French centers between 2011 and 2020 were included. The main endpoint was the successful resection rate (resection rate without 90-day mortality) analyzed according to an intention-to-treat principle. Secondary endpoints were hypertrophy rates, intra- and post-operative outcomes. RESULTS: Among 209 patients, 124 had LVD 37 [13,1015] days before surgery, while 85 underwent ALPPS with an inter-stages period of 10 [6, 69] days. ALPPS was mostly-performed for colorectal liver metastases (CRLM), LVD for CRLM and perihilar cholangiocarcinoma. Hypertrophy was faster for ALPPS. Successful resection rates were 72.6% for LVD ± rescue ALPPS (n=6) versus 90.6% for ALPPS (p
Published: 2021
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12. Is Hartmann’s Pouch an Option in the Management of Acute Severe Ulcerative Colitis?

Author: Myriam Renaud, Ahmet Ayav, Bénédicte Caron, Laurent Peyrin-Biroulet, and Adeline Germain
Subjects: colectomy, surgical stomas, morbidity, digestive-system surgical procedures, ulcerative colitis, General Medicine
Abstract: Background: The surgical management of remnant rectosigmoid after subtotal colectomy with end ileostomy for acute severe ulcerative colitis remains controversial with respect to the need to perform sigmoidostomy or Hartmann’s pouch. The aim of this retrospective study was to investigate whether Hartmann’s pouch may be a safe option. Methods: Thirty-eight Hartmann’s pouches were performed between January 2003 and December 2015. We looked at morbidity (with a focus on the occurrence of pelvic sepsis and leakage of the rectal stump) and the rate of restored intestinal continuity. Results: Nineteen patients had surgical complications. Seven had an intra-abdominal collection, only one of which was in the pelvis, and the patient had to be reoperated. Only one patient had a reopening of the rectal stump, which was revealed by rectal bleeding. Twenty-six patients (68.4%) underwent further proctectomy with ileal J-pouch anal anastomosis with no difficulty in localizing or mobilizing the rectal stump and no major surgical complications. Conclusions: Hartmann’s pouch may be considered in patients with acute severe ulcerative colitis, with low rates of morbidity and pelvic sepsis. The restoration of intestinal continuity is possible after this procedure without any special difficulty.
Published: 2022
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13. Plasma mSEPT9: A Novel Circulating Cell-free DNA-Based Epigenetic Biomarker to Diagnose Hepatocellular Carcinoma

Author: Matthieu Garcia, Jean-Pierre Bronowicki, Pierre Filhine-Tresarrieu, M. Bensenane, Dana Reinicke, Marcus Hollenbach, Cristina Ripoll, Alexander Zipprich, Amandine Luc, Susann Rischer, Valérie Laurent, Ahmet Ayav, Jean-Louis Guéant, Denise Forest-Tramoy, Thomas Josse, Farès Namour, Cédric Baumann, Rosa-Maria Guéant-Rodriguez, Renée Debard, Guillaume Conroy, Abderrahim Oussalah, Michael Fleischhacker, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Martin-Luther-University Halle-Wittenberg, Service d'Hépato-gastro-entérologie [CHRU Nancy], ESPRI-Biobase [CHRU Nancy] (Unité fonctionnelle de la plateforme d’aide à la recherche clinique), Service de Chirurgie Digestive Hépatobiliaire et Endocrine [CHRU Nancy], Leipzig University, and Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: 0301 basic medicine, Oncology, Male, Cirrhosis, Hepatocellular carcinoma, [SDV]Life Sciences [q-bio], lcsh:Medicine, Epigenesis, Genetic, 0302 clinical medicine, Prospective cohort study, lcsh:R5-920, 0303 health sciences, DNA methylation, Liver Neoplasms, [SDV.BBM.MN]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular Networks [q-bio.MN], General Medicine, Middle Aged, 3. Good health, Biomarker (medicine), 030211 gastroenterology & hepatology, Female, alpha-Fetoproteins, lcsh:Medicine (General), Cell-Free Nucleic Acids, Research Paper, medicine.medical_specialty, Carcinoma, Hepatocellular, [SDV.CAN]Life Sciences [q-bio]/Cancer, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, Internal medicine, [SDV.BBM.GTP]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN], mSEPT9, medicine, Biomarkers, Tumor, Humans, [SDV.BBM]Life Sciences [q-bio]/Biochemistry, Molecular Biology, Epigenetics, Circulating cell-free DNA-based epigenetic biomarker, 030304 developmental biology, Aged, Receiver operating characteristic, Hepatology, business.industry, lcsh:R, medicine.disease, digestive system diseases, Circulating Cell-Free DNA, 030104 developmental biology, Cancer research, business, Septins, Blood sampling
Abstract: Summary Background Patients with cirrhosis are at high risk of hepatocellular carcinoma (HCC). The SEPT9 gene is a key regulator of cell division and tumor suppressor whose hypermethylation is associated with liver carcinogenesis. The primary aim of this study was to evaluate the diagnostic accuracy of a PCR-based assay for the analysis of SEPT9 promoter methylation in circulating cell-free DNA (mSEPT9) for diagnosing HCC among cirrhotic patients. Methods We report two phase II biomarker studies that included cirrhotic patients with or without HCC from France (initial study) and Germany (replication study). All patients received clinical and biological evaluations, and liver imaging according to current recommendations. The primary outcome was defined as the presence of HCC according to guidelines from the American Association for the Study of Liver Diseases. The diagnosis of HCC was confirmed by abdominal contrast-enhanced computed tomography scan and systematically discussed in a multidisciplinary consultation meeting. HCC-free cirrhotic patients were recruited if the screening abdominal ultrasound showed no evidence of HCC at the time of blood sampling for the mSEPT9 test and on the next visit six months later. The adjudicating physicians were blinded to patient results associated with the mSEPT9 test. Findings We included 289 patients with cirrhosis (initial: 186; replication: 103), among whom 98 had HCC (initial: 51; replication: 47). The mSEPT9 test exhibited high diagnostic accuracy for HCC diagnosis, with an area under the receiver operating characteristic curve (AUROC) of 0.944 (0.900–0.970, p, Highlights • Patients with cirrhosis are at high risk of hepatocellular carcinoma (HCC). • Accurate tumor biomarkers for the diagnosis and early detection of HCC need to be developed. • The circulating, cell-free, epigenetic biomarker mSEPT9 is a promising biomarker for diagnosing HCC in patients with cirrhosis. Patients with cirrhosis are at high risk of hepatocellular carcinoma (HCC). Several circulating epigenetic markers are under evaluation in HCC, notably those identified through “omics” approaches. However, to date, no circulating epigenetic biomarker has been shown to be useful for HCC diagnosis at the individual patient level. Through initial and replication phase II biomarker studies, we showed that the circulating, cell-free, DNA-based epigenetic biomarker mSEPT9 is a promising biomarker for diagnosing HCC in patients with cirrhosis. Future prospective studies should assess the mSEPT9 test in a screening algorithm for patients with cirrhosis to improve risk prediction and the personalized therapeutic management of HCC.
Published: 2018
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14. The prognostic value of inflammation-based scores in advanced hepatocellular carcinoma patients prior to treatment with sorafenib

Author: Julia Salleron, M. Bensenane, Guillaume Conroy, Jean-Pierre Bronowicki, Anthony Lopez, Cédric Baumann, Hélène Barraud, Arthur Belle, Didier Peiffert, Abdelbasset Nani, and Ahmet Ayav
Subjects: 0301 basic medicine, Oncology, Sorafenib, medicine.medical_specialty, Multivariate analysis, medicine.medical_treatment, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, HCC, Stage (cooking), prognostic factor, Adverse effect, business.industry, Cancer, medicine.disease, digestive system diseases, Surgery, Radiation therapy, 030104 developmental biology, inflammation-based scores, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, sorafenib, business, Body mass index, Research Paper, medicine.drug
Abstract: // Guillaume Conroy 1 , Julia Salleron 2 , Arthur Belle 1 , Mouni Bensenane 1 , Abdelbasset Nani 1 , Ahmet Ayav 3 , Didier Peiffert 4 , Anthony Lopez 1 , Cedric Baumann 5 , Helene Barraud 1 and Jean-Pierre Bronowicki 1 1 INSERM U954, Department of Hepato-gastroenterology, Lorraine University, Nancy University Hospital, Vandœuvre-les-Nancy, France 2 Department of Biostatistics, Lorraine Comprehensive Cancer Center, Vandœuvre-les-Nancy, France 3 Department of Digestive, Hepatobiliary and Endocrine Surgery, Lorraine University, Nancy University Hospital, Nancy, France 4 Department of Radiotherapy, Lorraine University, Lorraine Comprehensive Cancer Center, Vandœuvre-les-Nancy, France 5 ESPRI-BioBase Unit, Platform of PARC, Nancy University Hospital, Vandœuvre-les-Nancy, France Correspondence to: Jean-Pierre Bronowicki, email: Jp.bronowicki@chru-nancy.fr Keywords: HCC; inflammation-based scores; sorafenib; prognostic factor Received: June 20, 2017 Accepted: July 25, 2017 Published: September 30, 2017 ABSTRACT Background and Aims: The multikinase inhibitor sorafenib is the only currently approved drug for the indication of advanced hepatocellular carcinoma (HCC). It provides a limited gain in survival time but is frequently associated with adverse events. We currently lack simple prognostic factors in sorafenib-treated HCC patients. Various inflammation-based scores (IBSs) have been evaluated as predictors of tumor recurrence and survival in various malignancies (including HCC). The objective of the present study was to determine the prognostic value of IBSs for overall survival (OS) in advanced HCC patients prior to the initiation of sorafenib therapy. Methods: Patients with Barcelona Clinic Liver Cancer stage C HCC were enrolled retrospectively between October 2007 and September 2015. To identify prognostic factors for OS, bivariate and multivariate analysis were performed using a Cox proportional hazards regression model. Results: 161 patients (87.0% males; median age: 67; median OS: 9.1 months) were enrolled. A multivariate analysis identified a body mass index 38 U/L (HR=2.65, p
Published: 2017
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15. Resection of Locally Advanced Pancreatic Neoplasms after Neoadjuvant Chemotherapy with Nab-Paclitaxel and Gemcitabine following FOLFIRINOX Failure

Author: Ahmet Ayav, Sarah Hahn, and Anthony Lopez
Subjects: Oncology, medicine.medical_specialty, FOLFIRINOX, medicine.medical_treatment, Locally advanced, Resection, 03 medical and health sciences, 0302 clinical medicine, Pharmacotherapy, Pancreatic cancer, Internal medicine, medicine, Case Series, 030212 general & internal medicine, lcsh:RC799-869, Pancreas, Chemotherapy, Tumor, business.industry, Gastroenterology, medicine.disease, Gemcitabine, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Surgery, lcsh:Diseases of the digestive system. Gastroenterology, Drug therapy, business, medicine.drug
Abstract: The incidence of pancreatic cancer has dramatically increased over the past years, but the prognosis has not improved. Between 30 and 40% of tumors are considered locally advanced, essentially due to vascular involvement. In recent years, new chemotherapy protocols with high response rates have been developed. FOLFIRINOX seems to be an interesting option in this situation, but hematologic toxicity could be an obstacle to its prescription. Nab-paclitaxel and gemcitabine offer significant response rates with a reasonable safety profile. We report here a single-center experience of 2 cases with a locally advanced pancreatic cancer initially considered unresectable, progressive after first-line neoadjuvant FOLFIRINOX chemotherapy, and then treated with second-line nab-paclitaxel/gemcitabine chemotherapy.
Published: 2017

16. Extensive lymph node dissection during pancreaticoduodenectomy: a risk factor for hepatic steatosis?

Author: A. Mignot, Ahmet Ayav, D. Quillot, I. Petit, Phi-Linh Nguyen-Thi, A. Malgras, S. Zuily, and Valérie Laurent
Subjects: Adult, Male, medicine.medical_specialty, Urology, medicine.medical_treatment, Gastroenterology, Pancreaticoduodenectomy, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Risk Factors, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, Risk factor, Lymph node, Aged, Retrospective Studies, Aged, 80 and over, Radiological and Ultrasound Technology, business.industry, Fatty liver, Odds ratio, Middle Aged, Hepatology, medicine.disease, Fatty Liver, Pancreatic Neoplasms, Dissection, medicine.anatomical_structure, Lymphatic Metastasis, 030220 oncology & carcinogenesis, Lymph Node Excision, Female, 030211 gastroenterology & hepatology, Steatosis, Tomography, X-Ray Computed, business
Abstract: The first reports of hepatic steatosis following pancreaticoduodenectomy (PD) were published several years ago; however, clear risk factors remain to be identified. Therefore, the aim of this study was to identify the risk factors for hepatic steatosis post-PD. We studied 90 patients who had undergone PD between September 2005 and January 2015. The inclusion criteria were as follows: available unenhanced CT within one month before PD and at least one unenhanced CT acquisition between PD and chemotherapy initiation. Using scanners, we studied the liver and spleen density as well as the surface areas of visceral (VF) and subcutaneous fat (SCF). These variables were previously identified by univariate and multivariate analyses. Hepatic steatosis occurred in 25.6% of patients at 45.2 days, on average, post-PD. Among the patients with hepatic steatosis, the average liver density was 52 HU before PD and 15.1 HU post-PD (p
Published: 2017
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17. Radioembolization Plus Chemotherapy for First-line Treatment of Locally Advanced Intrahepatic Cholangiocarcinoma: A Phase 2 Clinical Trial

Author: Boris Guiu, Eveline Boucher, Samuel Le Sourd, Olivier Farge, David Tougeron, Astrid Lièvre, Karim Boudjema, Yann Touchefeu, Isabelle Baumgaertner, Ahmet Ayav, Etienne Garin, Luc Beuzit, Marc Pracht, Julien Edeline, Yan Rolland, Boris Campillo-Gimenez, Jonchère, Laurent, Centre Eugène Marquis (CRLCC), Nutrition, Métabolismes et Cancer (NuMeCan), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service d’Anatomie Pathologique [CHU Beaujon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Service d'Oncologie médicale [CHU Henri Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Henri Mondor, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-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), This study was partially funded by BTG Corporation and the Ligue Contre le Cancer., Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-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 Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Henri Mondor [Créteil]
Subjects: Male, Cancer Research, medicine.medical_specialty, Phases of clinical research, Gastroenterology, Cholangiocarcinoma, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, 030212 general & internal medicine, Progression-free survival, Prospective cohort study, Aged, [SDV.IB] Life Sciences [q-bio]/Bioengineering, business.industry, Combination chemotherapy, Middle Aged, Chemotherapy regimen, Gemcitabine, 3. Good health, Bile Ducts, Intrahepatic, Treatment Outcome, Bile Duct Neoplasms, Oncology, Response Evaluation Criteria in Solid Tumors, 030220 oncology & carcinogenesis, Concomitant, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Neoplasm Recurrence, Local, business, medicine.drug
Abstract: International audience; Importance - Patients with unresectable intrahepatic cholangiocarcinoma (ICC) have a poor prognosis. Selective internal radiotherapy (SIRT) is a promising treatment option for hepatic tumors, but no prospective studies of combination SIRT with chemotherapy have been published to our knowledge. Objective - To determine the response rate after SIRT combined with chemotherapy in patients with unresectable ICC. Design, setting, and participants - This phase 2 clinical trial, the Yttrium-90 Microspheres in Cholangiocarcinoma (MISPHEC) trial, included patients with unresectable ICC who have never received chemotherapy or intra-arterial therapy and were treated at 7 centers which had experience with SIRT between November 12, 2013, and June 21, 2016. Statistical analysis was performed from March 31, 2017, to June 17, 2019. Interventions - Concomitant first-line chemotherapy with cisplatin, 25 mg/m2, and gemcitabine, 1000 mg/m2 (gemcitabine reduced to 300 mg/m2 for the cycles just before and after SIRT), on days 1 and 8 of a 21-day cycle for 8 cycles. Selective internal radiotherapy was administered during cycle 1 (1 hemiliver disease) or cycles 1 and 3 (disease involving both hemilivers) using glass Y90 microspheres. Main outcomes and measures - Response rate at 3 months according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1. Secondary end points were toxic effects, progression-free survival, overall survival, disease control rate, and response rate according to Choi criteria. Results - Of 41 patients included in the study, 26 (63%) were male, with a mean (SD) age of 64.0 (10.7) years. Response rate according to RECIST was 39% (90% CI, 26%-53%) at 3 months according to local review and was confirmed at 41% as best response by central review; disease control rate was 98%. According to Choi criteria, the response rate was 93%. After a median follow-up of 36 months (95% CI, 26-52 months), median progression-free survival was 14 months (95% CI, 8-17 months), with progression-free survival rates of 55% at 12 months and 30% at 24 months. Median overall survival was 22 months (95% CI, 14-52 months), with overall survival rates of 75% at 12 months and 45% at 24 months. Of 41 patients, 29 (71%) had grades 3 to 4 toxic effects; 9 patients (22%) could be downstaged to surgical intervention, with 8 (20%) achieving R0 (microscopic-free margins) surgical resection. After a median of 46 months (95% CI, 31 months to not reached) after surgery, median relapse-free survival was not reached among patients who underwent resection. Conclusions and relevance - Combination chemotherapy and SIRT had antitumor activity as first-line treatment of unresectable ICC, and a significant proportion of patients were downstaged to surgical intervention. A phase 3 trial is ongoing.
Published: 2020
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18. Todani Type II Congenital Bile Duct Cyst

Author: François Paye, François-René Pruvot, Ahmet Ayav, Emilia Ragot, Laurent Dugué, Nicolas Demartines, Mustapha Adham, Gilles Mentha, Jacques Belghiti, Jean Yves Mabrut, Mehdi Ouaissi, Jean-François Gigot, Gennaro Nuzzo, Massimo Falconi, Reza Kianmanesh, Roberto Troisi, Ouaissi, M., Kianmanesh, R., Belghiti, J., Ragot, E., Mentha, G., Adham, M., Troisi, Roberto., Pruvot, F. -R., Dugue, L., Paye, F., Ayav, A., Nuzzo, G., Falconi, M., Demartines, N., Mabrut, J. -Y., Gigot, J. -F., Ouaissi, Mehdi, Kianmanesh, Reza, Belghiti, Jacque, Ragot, Emilia, Mentha, Gille, Adham, Mustapha, Troisi Roberto, Ivan, Pruvot Francois, Rene, Dugue, Laurent, Paye, Francoi, Ayav, Ahmet, Nuzzo, Gennaro, Falconi, Massimo, Demartines, Nicola, Mabrut Jean, Yve, and Gigot Jean, Francois
Subjects: Adult, Male, medicine.medical_specialty, Treatment outcome, digestive system, medicine, Carcinoma, Humans, Cyst, Child, Aged, Retrospective Studies, ddc:617, Bile duct, business.industry, Retrospective cohort study, Congenital biliary disease, Middle Aged, medicine.disease, Surgery, Europe, Treatment Outcome, medicine.anatomical_structure, Multicenter study, Todani type II bile duct cyst, Child, Preschool, Choledochal Cyst, Managment, Female, Long term outcome, Presentation (obstetrics), business, Diverticulum
Abstract: Objective: The purpose of the study was to analyze clinical presentation, surgical management, and long-term outcome of patients suffering from biliary diverticulum, namely Todani type II congenital bile duct cyst (BDC). Background: The disease incidence ranges between 0.8% and 5% of all reported BDC cases with a lack of information about clinical presentation, management, and outcome. Methods: A multicenter European retrospective study was conducted by the French Surgical Association. The patients' medical records were included in a Web site database. Diagnostic imaging studies, operative and pathology reports underwent central revision. Results: Among 350 patients with congenital BDC, 19 type II were identified (5.4%), 17 in adults (89.5%) and 2 in children. The biliary diverticulum was located at the upper, middle, and lower part of the extrahepatic biliary tree in 11, 4, and 4 patients (58%, 21%, and 21%, respectively). Complicated presentation occurred in 6 patients (31.6%), including one case of synchronous carcinoma. Surgical techniques included diverticulum excision in all patients. Associated resection of the extrahepatic biliary tree was required in 11 cases (58%) and could be predicted by the presence of complicated clinical presentation. There was no mortality. Long-term outcome was excellent in 89.5% of patients (median follow-uptime: 52 months). Conclusions: According to the present largest Western series of Todani type II BDC, the type of clinical presentation rather than BDC location, was able to guide the extent of biliary resection. Excellent long-term outcome can be achieved in expert centers.
Published: 2015
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19. Tumour size over 3 cm predicts poor short-term outcomes after major liver resection for hilar cholangiocarcinoma. By the HC-AFC-2009 group

Author: Laurence Chiche, Mustapha Adham, Jeanâ€Robert Delpero, Patrick Pessaux, Emmanuel Boleslawski, Daniel Azoulay, Denis Chatelain, Michel Scotté, Karim Boudjema, Alexis Laurent, Jean-Marc Regimbeau, Philippe Bachellier, Gérard Pascal, Jeanâ€Yves Mabrut, Momar Diouf, Olivier Farges, Gennaro Nuzzo, Christian Letoublon, Georges Mantion, Jeanâ€Francois Gigot, Yvesâ€Patrice Le Treut, Artigas Raventos, Francis Navarro, Michel Rivoire, Ahmet Ayav, David Fuks, CHU Amiens-Picardie, CHU Strasbourg, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Service de Chirurgie Viscérale et Digestive [CHU Caen], CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Hôpital Paul Brousse, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse, Hôpital Henri Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Département de chirurgie digestive et de l'urgence, CHU Grenoble-Hôpital Michallon, Hôpital Claude Huriez [Lille], CHU Lille, Centre Léon Bérard [Lyon], Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), Hôpital Edouard Herriot [CHU - HCL], Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service de Chirurgie Digestive Hépatobiliaire et Endocrine [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), CHU Pontchaillou [Rennes], Service de chirurgie digestive [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Hôpital Beaujon, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), and Herrada, Anthony
Subjects: Male, Curative resection, Time Factors, [SDV.MHEP.CHI] Life Sciences [q-bio]/Human health and pathology/Surgery, medicine.medical_treatment, Kaplan-Meier Estimate, 030230 surgery, Cholangiocarcinoma, 0302 clinical medicine, Risk Factors, Odds Ratio, Registries, Young adult, Aged, 80 and over, Gastroenterology, Middle Aged, Tumor Burden, 3. Good health, Treatment Outcome, 030220 oncology & carcinogenesis, Female, France, Adult, medicine.medical_specialty, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, Resection, Young Adult, 03 medical and health sciences, medicine, Hepatectomy, Humans, Aged, Retrospective Studies, Chi-Square Distribution, Hepatology, business.industry, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Retrospective cohort study, Original Articles, Odds ratio, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Surgery, Bile Ducts, Intrahepatic, Logistic Models, Bile Duct Neoplasms, Tumour size, Multivariate Analysis, Lymph Node Excision, business, Chi-squared distribution
Abstract: International audience; INTRODUCTION:As mortality and morbidity after a curative resection remains high, it is essential to identify pre-operative factors associated with an early death after a major resection.METHODS:Between 1998 and 2008, we selected a population of 331 patients having undergone a major hepatectomy including segment I with a lymphadenectomy and a common bile duct resection for a proven hilar cholangiocarcinoma in 21 tertiary centres. The study's objective was to identify pre-operative predictors of early death (30 mm [odds ratio (OR) 2.471 (95% confidence interval (CI) 1.136-7.339), P = 0.001] and major post-operative complication [OR 3.369 (95% CI 1.038-10.938), P = 0.004] were independently associated with death 30 mm was independently associated with death
Published: 2015
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20. Surgically treated oesophageal cancer developed in a radiated field: Impact on peri-operative and long-term outcomes

Author: Sheraz R. Markar, Caroline Gronnier, Arnaud Pasquer, Alain Duhamel, Hélène Behal, Jérémie Théreaux, Johan Gagnière, Gil Lebreton, Cécile Brigand, Bernard Meunier, Denis Collet, Christophe Mariette, Guillaume Luc, Magalie Cabau, Jacques Jougon, Bogdan Badic, Patrick Lozach, Serge Cappeliez, Arnaud Alves, Renaud Flamein, Denis Pezet, Federica Pipitone, Bogdan Stan Iuga, Nicolas Contival, Eric Pappalardo, Styliani Mantziari, Flora Hec, Marguerite Vanderbeken, Williams Tessier, Nicolas Briez, Fabien Fredon, Alain Gainant, Muriel Mathonnet, Jean-Marc Bigourdan, Salim Mezoughi, Christian Ducerf, Jacques Baulieux, Oussama Baraket, Gilles Poncet, Delphine Vaudoyer, Peggy Jourdan Enfer, Laurent Villeneuve, Olivier Glehen, Thibault Coste, Jean Michel Fabre, Frédéric Marchal, Romain Frisoni, Ahmet Ayav, Laurent Brunaud, Laurent Bresler, Charlotte Cohen, Olivier Aze, Nicolas Venissac, Daniel Pop, Jérôme Mouroux, Ion Donici, Michel Prudhomme, Emanuele Felli, Stéphanie Lisunfui, Marie Seman, Gaelle Godiris Petit, Mehdi Karoui, Christophe Tresallet, Fabrice Ménégaux, Laurent Hannoun, Brice Malgras, Denis Lantuas, Karine Pautrat, Marc Pocard, Patrice Valleur, Imperial College London, Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 (JPArc), Université Lille Nord de France (COMUE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Evaluation des technologies de santé et des pratiques médicales - ULR 2694 (METRICS), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Site de Recherche Intégrée en Cancérologie (SIRIC-ONCOLille), Université de Lille, Sciences et Technologies-Université de Lille, Sciences Humaines et Sociales-Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille), Université de Lille-UNICANCER-Université de Lille-UNICANCER-Cancéropole Nord-Ouest-Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Chirurgie digestive et hépatobiliaire, CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Hôpital de Hautepierre [Strasbourg], Laboratoire de chimie de coordination (LCC), Institut de Chimie de Toulouse (ICT), Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université de Toulouse (UT)-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Centre National de la Recherche Scientifique (CNRS), Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], CIC-IT Bordeaux, Université de Bordeaux (UB)-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Chirurgie Générale et Viscérale (CGV - BREST), Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Peuplements végétaux et bioagresseurs en milieu tropical (UMR PVBMT), Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Institut de Recherche pour le Développement (IRD)-Institut National de la Recherche Agronomique (INRA)-Université de La Réunion (UR), Département de chirurgie digestive, CHU Clermont-Ferrand, CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Hôpital Claude Huriez [Lille], CHU Lille, Service de Chirurgie Générale et Digestive[Lille], Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de Chirurgie digestive, endocrinienne et générale [CHU Limoges], CHU Limoges, Homéostasie Cellulaire et Pathologies (HCP), Université de Limoges (UNILIM)-CHU Limoges-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503), Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie (UPMC), Université Pierre et Marie Curie - Paris 6 (UPMC), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Ciblage thérapeutique en Oncologie (EA3738), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service Médico-Chirurgical des Maladies de l'Appareil Digestif et de Transplantation Hépatique, Hôpital Saint Eloi (CHRU Montpellier), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre de Recherche en Automatique de Nancy (CRAN), Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] (UNICANCER/ICL), UNICANCER, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre Hospitalier Universitaire de Nice (CHU Nice), Department of Thoracic Surgery, Louis Pasteur Hospital, Groupe de Recherche Angevin en Economie et Management (GRANEM), Université d'Angers (UA)-AGROCAMPUS OUEST-Institut National de l'Horticulture et du Paysage, Service de Chirurgie thoracique, Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Service d'hépato-gastro-entérologie [APHP Henri Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Department of Gastroenterological Surgery, Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Chirurgie Digestive, 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 Diderot - Paris 7 (UPD7), Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U1172 Inserm - U837 (JPArc), Institut de Chimie de Toulouse (ICT-FR 2599), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS), Service de Chirurgie Digestive, Hépato-Bilio-pancréatique et Transplantation Hépatique [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), 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), Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer (JPArc - U837 Inserm), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Université Lille 2 - Faculté de Médecine, Santé publique : épidémiologie et qualité des soins-EA 2694 (CERIM), Université de Lille, Sciences et Technologies-Université de Lille, Sciences Humaines et Sociales-CRLCC Oscar Lambret-Cancéropole Nord-Ouest-Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO), Centre Hospitalier Universitaire Estaing, Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie de Toulouse (ICT-FR 2599), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées-Institut de Recherche pour le Développement (IRD)-Centre National de la Recherche Scientifique (CNRS)-Centre National de la Recherche Scientifique (CNRS), CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bordeaux (UB), UMR Peuplement Végétaux et Bioagresseurs en Milieu Tropical (UMR PVBMT - INRA), Institut National de la Recherche Agronomique (INRA), Hôpital Claude Huriez, Université de Limoges (UNILIM)-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503)-CHU Limoges, CHU Saint-Eloi, Université de Lorraine (UL), Faculté de Médecine [Nancy], Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Chirurgie Digestive Hépatobiliaire et Endocrine [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nîmes (CHRU Nîmes), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHU Pitié-Salpêtrière [APHP], Service de chirurgie générale, Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Service de chirurgie digestive et hépato-bilio-pancréatique [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Hôpital Lariboisière, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Lariboisière-Université Paris Diderot - Paris 7 (UPD7), Centre de recherche Jean-Pierre Aubert-Neurosciences et Cancer, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé, Centre d'Etude et Recherche en Informatique Médicale, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte - Clermont Auvergne (M2iSH), Institut National de la Recherche Agronomique (INRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne (UCA)-Centre de Recherche en Nutrition Humaine d'Auvergne (CRNH d'Auvergne), Service de Chirurgie Hépatobiliaire et Digestive, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Service de chirurgie digestive, Service de Médecine Interne, PRES Université Lille Nord de France-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Department of Digestive Surgery, University Medical Hospital, Unité de Chirurgie Colorectale, CHU Grenoble, Unité de Méthodologie en Recherche Clinique, Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Centre de recherche en éducation de Nantes (CREN), Le Mans Université (UM)-Université de Nantes - UFR Lettres et Langages (UFRLL), Université de Nantes (UN)-Université de Nantes (UN), Chelsea and Westminster Hospital, Service de Chirurgie Thoracique (NICE - Chirurgie Thoracique), West University of Timisoara [Roumanie] (UVT), Service d'endocrinologie-métabolisme [CHU Pitié-Salpêtrière], Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Hôpital Henri Mondor-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Université Paris Diderot - Paris 7 (UPD7)-Hôpital Lariboisière-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Lille Nord de France (COMUE)-Université de Lille, Université Lille Nord de France (COMUE)-UNICANCER-Université Lille Nord de France (COMUE)-UNICANCER-Cancéropole Nord-Ouest-Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), Institut National de l'Horticulture et du Paysage-AGROCAMPUS OUEST, Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Université d'Angers (UA), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Hôpital Henri Mondor-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Université de Lille, Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-Université de Brest (UBO), Centre National de la Recherche Scientifique (CNRS)-Université de Lorraine (UL), Université d'Angers (UA)-AGROCAMPUS OUEST, and Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut National de l'Horticulture et du Paysage
Subjects: Male, Cancer Research, medicine.medical_specialty, Neoplasms, Radiation-Induced, Esophageal Neoplasms, medicine.medical_treatment, [SDV]Life Sciences [q-bio], [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, Adenocarcinoma, Eighty Nine, Radiated field, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Breast cancer, medicine, Humans, Hospital Mortality, 030212 general & internal medicine, ComputingMilieux_MISCELLANEOUS, Aged, Radiotherapy, business.industry, Incidence (epidemiology), Cancer, Neoplasms, Second Primary, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, Chemoradiotherapy, Perioperative, Middle Aged, medicine.disease, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, 3. Good health, Surgery, Radiation therapy, Treatment Outcome, Editorial, Oncology, 030220 oncology & carcinogenesis, Propensity score matching, Carcinoma, Squamous Cell, Female, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: The objectives of this study were to compare peri-operative and long-term outcomes from oesophageal cancer (EC) (i) that arose in a previously radiated field (ECRF) versus primary (PEC) and among ECRF patients and (ii) radiotherapy-induced (RIEC) versus non-radiotherapy-induced EC (NRIEC).Data were collected from 30 European centres from 2000 to 2010. Two thousand four hundred eighty nine EC patients surgically treated were included in the PEC group and 136 in the ECRF group, NRIEC group (n = 61) and RIEC group (n = 75). Propensity score matching analyses were used to compensate for differences in baseline characteristics.Compared to the PEC group, the ECRF group was characterised by less use of neoadjuvant chemoradiotherapy (0% versus 29.5%; P 0.001), less pathological stage III/IV (31.6% versus 39.2%, P = 0.036), greater incidence of R1/2 margins (21.3% versus 10.9%; P 0.001), increased in-hospital mortality (14.0% versus 7.1%; P = 0.003) and overall morbidity (68.4% versus 56.4%, P = 0.006). After matching, 5-year overall (28.8% versus 50.5%; hazard ratio [HR] = 1.53, 95% confidence interval [CI]: 1.15-2.04; P = 0.003) and event-free (32.2% versus 42.5%; HR = 1.56, 95% CI: 1.18-2.05; P = 0.002) survivals were significantly reduced in the ECRF group. There were no significant differences in incidence or pattern of tumour recurrence. Comparing RIEC and NRIEC groups, there were no significant differences in short- or long-term outcomes before and after matching.ECRF is associated with poorer long-term survival related to a reduced utilisation of neoadjuvant chemoradiotherapy and an increased incidence of tumour margin involvement at surgery. Outcomes appear to be dictated by the limitations related to previous radiotherapy administration more than the radiotherapy-induced carcinogenesis.
Published: 2017
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21. Effect of portal vein ligation on tumor growth and liver regeneration in rat cirrhotic liver lobes

Author: Rui Xu, Nguyen Tran, Laurent Bresler, Zhi‑Su Liu, Yu‑Feng Yuan, Chong‑Qing Jiang, and Ahmet Ayav
Subjects: Cancer Research, Pathology, medicine.medical_specialty, Cirrhosis, Muscle hypertrophy, Immunology and Microbiology (miscellaneous), Fibrosis, medicine, liver regeneration, skin and connective tissue diseases, Oncogene, biology, business.industry, cirrhosis, portal vein ligation, Articles, General Medicine, respiratory system, biochemical phenomena, metabolism, and nutrition, bacterial infections and mycoses, medicine.disease, Molecular medicine, Liver regeneration, tumor growth, Alanine transaminase, Apoptosis, biology.protein, bacteria, business
Abstract: The aim of the present study was to investigate the effect of portal vein ligation (PVL) on the tumor growth rate and liver regeneration in rat cirrhotic liver lobes. A total of 45 male Wistar rats were randomly divided into PVL, hepatic tumor (HT) and HT + PVL groups (n=15 per group). Liver regeneration and tumor growth in ligated and non-ligated lobes were evaluated prior to and following PVL. In addition, serum alanine transaminase, total bilirubin levels and liver tissue samples were evaluated. The results indicated that PVL induced apparent hypertrophy in normal and HT rats. However, the ratio of non-ligated lobes to total liver weight or body weight in the HT + PVL group was significantly lower when compared with the PVL group (P
Published: 2014
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22. European experience of 573 liver resections for hepatocellular adenoma: a cross-sectional study by the AFC-HCA-2013 study group

Author: Daniel Sommacale, Emilie Bollon, Bernard Pol, François-René Pruvot, Marie Castagnet, Yves Patrice Le Treut, Alexandre Filippello, Jacques Belghiti, Frédéric Borie, Lorenzo Capussotti, Pierre Allemann, Guido Torzilli, Alexis Laurent, Daniel Cherqui, Philippe Bachellier, Gilles Mentha, Olivier Scatton, Mustapha Adham, Bertrand Suc, Olivier Turrini, Reza Kiamanesh, Jean Hardwigsen, Marco Montorsi, Romain Riboud, Fabrice Muscari, Benjamin Darnis, Patrice Pessaux, Olivier Farges, Olivier Soubrane, Mathieu Gonot-Gachard, Jean Yves Mabrut, Safi Dokmak, Jean-Charles Nault, Manuela Cesaretti, Pietro Addeo, Laura Ornella Perotto, Jean Marc Régimbaud, Nicolas Demartines, Alexandra Dili, Irinel Popescu, Jean Robert Delpero, Ahmet Ayav, Mikael Chetboun, Emmanuel Boleslawski, Jean luc Porcheron, Jean Michel Fabre, Christian Letoublon, Ricardo Gauzolino, Service de chirurgie digestive, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, Service de chirurgie hepato-pancreato-biliaire, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Jean Verdier [AP-HP], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Département d'hépato-gastroentérologie, CHU Grenoble-Université Grenoble Alpes (UGA), CHU Strasbourg, Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), Hôpital de la Timone [CHU - APHM] (TIMONE), Service de Chirurgie Digestive Hépatobiliaire et Endocrine [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Chirurgie Générale et Digestive [Rangueil], CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Centre Hospitalier Universitaire Vaudois [Lausanne] (CHUV), Centre hépato-biliaire (CHB), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor, Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon, Hôpital Jean Verdier [Bondy], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), UCL - SSS/IREC/GAEN - Pôle d'Hépato-gastro-entérologie, and UCL - (MGD) Service de chirurgie
Subjects: Adult, Male, Oncology, medicine.medical_specialty, Time Factors, Adenoma, Cross-sectional study, Hemorrhage, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, Liver resections, Gastroenterology, Adenoma, Liver Cell, Malignant transformation, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, Hepatectomy, Humans, Medicine, Retrospective Studies, Hepatology, business.industry, Incidence, Incidence (epidemiology), Liver Neoplasms, Large series, Retrospective cohort study, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Middle Aged, Hepatocellular adenoma, medicine.disease, digestive system diseases, Tumor Burden, 3. Good health, Europe, Cell Transformation, Neoplastic, Cross-Sectional Studies, Treatment Outcome, 030220 oncology & carcinogenesis, Original Article, Female, Laparoscopy, 030211 gastroenterology & hepatology, business
Abstract: International audience; BACKGROUND:Hepatocellular adenoma (HCA) is a benign hepatic lesion that may be complicated by bleeding and malignant transformation. The aim of the present study is to report on large series of liver resections for HCA and assess the incidence of hemorrhage and malignant transformation.METHODS:A retrospective cross-sectional study, from 27 European high-volume HPB units.RESULTS:573 patients were analyzed. The female: male gender ratio was 8:2, mean age: 37 ± 10 years. Of the 84 (14%) patients whose initial presentation was hemorrhagic shock (Hemorrhagic HCAs), hemostatic intervention was urgently required in 25 (30%) patients. No patients died after intervention. Tumor size was >5 cm in 74% in hemorrhagic HCAs and 64% in non-hemorrhagic HCAs (p < 0.001). In non-hemorrhagic HCAs (n = 489), 5% presented with malignant transformation. Male status and tumor size >10 cm were the two predictive factors. Liver resections included major hepatectomy in 25% and a laparoscopic approach in 37% of the patients. In non-hemorrhagic HCAs, there was no mortality and major complications occurred in 9% of patients.DISCUSSION:Liver resection for HCA is safe. Presentation with hemorrhage was associated with larger tumor size. In males with a HCA >10 cm, a HCC should be suspected. In such situation, a preoperative biopsy is preferable and an oncological liver resection should be considered.
Published: 2016
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23. Robotic transperitoneal left adrenalectomy for a 10cm pheochromocytoma (with video)

Author: Laurent Brunaud, Claire Nomine-Criqui, Luca Sessa, Laurent Bresler, Adeline Germain, and Ahmet Ayav
Subjects: Adult, Male, medicine.medical_specialty, medicine.medical_treatment, Adrenal Gland Neoplasm, Tumor burden, Adrenal Gland Neoplasms, 030209 endocrinology & metabolism, Pheochromocytoma, 03 medical and health sciences, 0302 clinical medicine, Robotic Surgical Procedures, Medicine, Humans, Robotic surgery, Laparoscopy, medicine.diagnostic_test, business.industry, Adrenalectomy, General surgery, Left adrenalectomy, General Medicine, medicine.disease, Surgery, Tumor Burden, 030220 oncology & carcinogenesis, Peritoneum, business
Published: 2016

24. Parenchymal-sparing hepatectomies (PSH) for bilobar colorectal liver metastases are associated with a lower morbidity and similar oncological results: a propensity score matching analysis

Author: Riccardo Memeo, Vito de Blasi, René Adam, Diane Goéré, Daniel Azoulay, Ahmet Ayav, Emilie Gregoire, Reza Kianmanesh, Francis Navarro, Antonio Sa Cunha, Patrick Pessaux, Cyril Cosse, Delphine Lignier, Jean Marc Regimbeau, Julien Barbieux, Emilie Lermite, Antoine Hamy, François Mauvais, Christophe Laurent, Irchid Al Naasan, Alexis Laurent, Philippe Compagnon, Mohammed Sbai Idrissi, Frédéric Martin, Jérôme Atger, Jacques Baulieux, Benjamin Darnis, Jean Yves Mabrut, Vahan Kepenekian, Julie Perinel, Mustapha Adham, Olivier Glehen, Michel Rivoire, Jean Hardwigsen, Anaïs Palen, Yves Patrice Le Treut, Jean Robert Delpero, Olivier Turrini, Astrid Herrero, Fabrizio Panaro, Laurent Bresler, Philippe Rauch, François Guillemin, Frédéric Marchal, Jean Gugenheim, Antonio Iannelli, Stéphane Benoist, Antoine Brouquet, Marc Pocard, Rea Lo Dico, David Fuks, Olivier Scatton, Olivier Soubrane, Jean-Christophe Vaillant, Tullio Piardi, Daniel Sommacale, Michel Comy, Philippe Bachellier, Elie Oussoultzoglou, Pietro Addeo, Dimitrios Ntourakis, Didier Mutter, Jacques Marescaux, Loïc Raoux, Bertrand Suc, Fabrice Muscari, Georges Elhomsy, Maximiliano Gelli, Denis Castaing, Daniel Cherqui, Gabriella PIttau, Oriana Ciacio, Eric Vibert, Dominique Elias, Fabrizio Vittadello, 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, Institut de Recherche Contre les Cancers de l'Appareil Digestif-European Institute of Telesurgery (IRCAD/EITS), CHU Strasbourg, Hôpital Paul Brousse, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse, Département de chirurgie générale [Gustave Roussy], Institut Gustave Roussy (IGR), Hôpital Henri Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Hôpital de la Timone [CHU - APHM] (TIMONE), AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), and Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)
Subjects: Male, Time Factors, Hepatocellular carcinoma, medicine.medical_treatment, Treatment outcome, Kaplan-Meier Estimate, Remnant liver, Gastroenterology, Wedge resection, 0302 clinical medicine, Risk Factors, Cancer, Aged, 80 and over, education.field_of_study, Liver Neoplasms, Middle Aged, 3. Good health, Treatment Outcome, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Female, Original Article, France, Colorectal Neoplasms, Adult, medicine.medical_specialty, Disease free survival, Population, Risk Assessment, Disease-Free Survival, 03 medical and health sciences, Internal medicine, medicine, 2 stage hepatectomy, Hepatectomy, Humans, Laparoscopic resection, Systemic chemotherapy, Mortality, education, Propensity Score, Aged, Retrospective Studies, Chi-Square Distribution, Hepatology, business.industry, Liver failure, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Retrospective cohort study, Length of Stay, Hepatic resection, Surgery, Logistic Models, Dysfunction, Propensity score matching, business, Chi-squared distribution, Liver Failure
Abstract: International audience; OBJECTIVE:The aim of this study is to evaluate whether a parenchymal-sparing strategy provides similar results in terms of morbidity, mortality, and oncological outcome of non-PSH hepatectomies in a propensity score matched population (PSMP) in case of multiple (>3) bilobar colorectal liver metastases (CLM).BACKGROUND:The surgical treatment of bilobar liver metastasis is challenging due to the necessity to achieve complete resection margins and a sufficient future remnant liver. Two approaches are adaptable as follows: parenchymal-sparing hepatectomies (PSH) and extended hepatectomies (NON-PSH).METHODS:A total of 3036 hepatectomies were analyzed from a multicentric retrospective cohort of hepatectomies. Patients were matched in a 1:1 propensity score analysis in order to compare PSH versus NON-PSH resections.RESULTS:PSH was associated with a lower number of complications (≥1) (25% vs. 34%, p = 0.04) and a lower grade of Dindo-Clavien III and IV (10 vs. 16%, p = 0.03). Liver failure was less present in PSH (2 vs. 7%, p = 0.006), with a shorter ICU stay (0 day vs. 1 day, p = 0.004). No differences were demonstrated in overall and disease-free survival.CONCLUSION:In conclusion, PSH resection for bilobar multiple CLMs represents a valid alternative to NON-PSH resection in selected patients with a reduced morbidity and comparable oncological results.
Published: 2016
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25. Major hepatectomy for colorectal liver metastases in patients aged over 80: A propensity score matching analysis

Author: Rosalyn M. Adam, Daniel Azoulay, Ahmet Ayav, Reza Kianmanesh, Patrick Pessaux, Francis Navarro, Emilie Gregoire, A. Sa Cunha, Riccardo Memeo, and Diane Goéré
Subjects: Oncology, medicine.medical_specialty, Hepatology, business.industry, Internal medicine, Propensity score matching, medicine, Gastroenterology, In patient, business, Major hepatectomy
Published: 2016
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26. Minimally invasive compared to open re-hepatectomy for colorectal liver metastases: A multi-institutional propensity-matched analysis of short and long-term outcomes

Author: Julie Hallet, Brice Gayet, Diane Goéré, Ahmet Ayav, Rosalyn M. Adam, A. Sa Cunha, J.-Y. Mabrut, Daniel Azoulay, Patrick Pessaux, and Francis Navarro
Subjects: medicine.medical_specialty, Hepatology, business.industry, medicine.medical_treatment, Propensity score matching, medicine, Long term outcomes, Gastroenterology, Hepatectomy, business, skin and connective tissue diseases, Surgery
Published: 2016
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27. Role of neoadjuvant treatment in clinical T2N0M0 oesophageal cancer: results from a retrospective multi-center European study

Author: Sheraz R. Markar, Caroline Gronnier, Arnaud Pasquer, Alain Duhamel, Hélène Beal, Jérémie Théreaux, Johan Gagnière, Gil Lebreton, Cécile Brigand, Bernard Meunier, Denis Collet, Christophe Mariette, Abdennahceur Dhahri, Delphine Lignier, Cyril Cossé, Jean-Marc Regimbeau, Magalie Cabau, Jacques Jougon, Bogdan Badic, Patrick Lozach, Jean Pierre Bail, Serge Cappeliez, Issam El Nakadi, Arnaud Alves, Renaud Flamein, Denis Pezet, Federica Pipitone, Bogdan Stan-Iuga, Nicolas Contival, Eric Pappalardo, Simon Msika, Styliani Mantziari, Nicolas Demartines, Flora Hec, Marguerite Vanderbeken, Williams Tessier, Nicolas Briez, Fabien Fredon, Alain Gainant, Muriel Mathonnet, Jean Marc Bigourdan, Salim Mezoughi, Christian Ducerf, Jacques Baulieux, Jean-Yves Mabrut, Oussama Baraket, Gilles Poncet, Mustapha Adham, Delphine Vaudoyer, Peggy Jourdan Enfer, Laurent Villeneuve, Olivier Glehen, Thibault Coste, Jean-Michel Fabre, Frédéric Marchal, Romain Frisoni, Ahmet Ayav, Laurent Brunaud, Laurent Bresler, Charlotte Cohen, Olivier Aze, Nicolas Venissac, Daniel Pop, Jérôme Mouroux, Ion Donici, Michel Prudhomme, Emanuele Felli, Stéphanie Lisunfui, Marie Seman, Gaelle Godiris Petit, Mehdi Karoui, Christophe Tresallet, Fabrice Ménégaux, Jean-Christophe Vaillant, Laurent Hannoun, Brice Malgras, Denis Lantuas, Karine Pautrat, Marc Pocard, Patrice Valleur, Najim Chafai, Pierre Balladur, Magalie Lefrançois, Yann Parc, François Paye, Emmanuel Tiret, Marius Nedelcu, Letizia Laface, Thierry Perniceni, Brice Gayet, Alexandre Filipello, Jack Porcheron, Olivier Tiffet, Noémie Kamlet, Rodrigue Chemaly, Amandine Klipfel, Patrick Pessaux, Cecile Brigand, Serge Rohr, Nicolas Carrère, Chiara Da Re, Frédéric Dumont, Diane Goéré, Dominique Elias, Claude Bertrand, Imperial College London, Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U1172 Inserm - U837 (JPArc), Université Lille Nord de France (COMUE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Hôpital Claude Huriez [Lille], CHU Lille, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Site de Recherche Intégrée en Cancérologie (SIRIC-ONCOLille), Université de Lille, Sciences et Technologies-Université de Lille, Sciences Humaines et Sociales-Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille), Université de Lille-UNICANCER-Université de Lille-UNICANCER-Cancéropole Nord-Ouest-Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de Biostatistiques [CHRU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de Chirurgie Générale et Viscérale (CGV - BREST), Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Chirurgie digestive et hépatobiliaire, CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Peuplements végétaux et bioagresseurs en milieu tropical (UMR PVBMT), Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Institut de Recherche pour le Développement (IRD)-Institut National de la Recherche Agronomique (INRA)-Université de La Réunion (UR), Hôpital Côte de Nacre [CHU Caen], CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Hôpital de Hautepierre [Strasbourg], Service de Chirurgie Hépatobiliaire et Digestive [Rennes] = Hepatobiliary and Digestive Surgery [Rennes], CHU Pontchaillou [Rennes], Service de chirurgie digestive, CHU Bordeaux [Bordeaux], Ingénierie des Matériaux Polymères (IMP), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), CIC-IT Bordeaux, Université de Bordeaux (UB)-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Brest (UBO), Département de chirurgie digestive, CHU Clermont-Ferrand, Centre de recherche sur l'Inflammation (CRI (UMR_S_1149 / ERL_8252 / U1149)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Chirurgie Générale et Digestive[Lille], Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de Chirurgie digestive, endocrinienne et générale [CHU Limoges], CHU Limoges, Homéostasie Cellulaire et Pathologies (HCP), Université de Limoges (UNILIM)-CHU Limoges-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503), Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie (UPMC), Université Pierre et Marie Curie - Paris 6 (UPMC), Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Unité de Chirurgie Colorectale, CHU Grenoble, Environnement Ville Société (EVS), École normale supérieure - Lyon (ENS Lyon)-École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Université Lumière - Lyon 2 (UL2)-Université Jean Moulin - Lyon 3 (UJML), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet [Saint-Étienne] (UJM)-École Nationale des Travaux Publics de l'État (ENTPE)-École nationale supérieure d'architecture de Lyon (ENSAL)-Centre National de la Recherche Scientifique (CNRS), Unité de Méthodologie en Recherche Clinique, Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Centre de recherche en éducation de Nantes (CREN), Le Mans Université (UM)-Université de Nantes - UFR Lettres et Langages (UFRLL), Université de Nantes (UN)-Université de Nantes (UN), Centre de Recherche en Automatique de Nancy (CRAN), Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Chelsea and Westminster Hospital, Service de Chirurgie Thoracique (NICE - Chirurgie Thoracique), Centre Hospitalier Universitaire de Nice (CHU Nice), West University of Timișoara [Roumanie] (WUT), Service de Chirurgie thoracique, Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Lab-STICC_UBS_CID_DECIDE, Laboratoire des sciences et techniques de l'information, de la communication et de la connaissance (UMR 3192) (Lab-STICC), Université européenne de Bretagne - European University of Brittany (UEB)-Université de Bretagne Sud (UBS)-Université de Brest (UBO)-Télécom Bretagne-Institut Brestois du Numérique et des Mathématiques (IBNM), Université de Brest (UBO)-Institut Mines-Télécom [Paris] (IMT)-Centre National de la Recherche Scientifique (CNRS)-Université européenne de Bretagne - European University of Brittany (UEB)-Université de Bretagne Sud (UBS)-Université de Brest (UBO)-Télécom Bretagne-Institut Brestois du Numérique et des Mathématiques (IBNM), Université de Brest (UBO)-Institut Mines-Télécom [Paris] (IMT)-Centre National de la Recherche Scientifique (CNRS)-Laboratoire des sciences et techniques de l'information, de la communication et de la connaissance (Lab-STICC), Université européenne de Bretagne - European University of Brittany (UEB)-École Nationale d'Ingénieurs de Brest (ENIB)-Université de Bretagne Sud (UBS)-Université de Brest (UBO)-Télécom Bretagne-Institut Brestois du Numérique et des Mathématiques (IBNM), Université de Brest (UBO)-École Nationale Supérieure de Techniques Avancées Bretagne (ENSTA Bretagne)-Institut Mines-Télécom [Paris] (IMT)-Centre National de la Recherche Scientifique (CNRS)-École Nationale d'Ingénieurs de Brest (ENIB)-École Nationale Supérieure de Techniques Avancées Bretagne (ENSTA Bretagne)-Centre National de la Recherche Scientifique (CNRS), Service d'hépato-gastro-entérologie [APHP Henri Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service d'Endocrinologie, Métabolisme et Prévention des Maladies Cardio-vasculaires [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), Laboratoire de Mathématiques Informatique et Applications (LAMIA), Université des Antilles et de la Guyane (UAG), Service de Chirurgie Digestive, Hépato-Bilio-pancréatique et Transplantation Hépatique [CHU Pitié-Salpétrière], Department of Gastroenterological Surgery, Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), 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 Chirurgie Digestive, 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 Diderot - Paris 7 (UPD7), Service de chirurgie générale et digestive [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), 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), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut Mutualiste de Montsouris (IMM), Departement medico-chirurgical de pathologie digestive, Chirurgie digestive, Centre Hospitalier Universitaire de Saint-Etienne, Départment de Statistiques Bio-médicales, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Service de chirurgie digestive [Strasbourg-Hautepierre], Département de chirurgie générale [Gustave Roussy], Institut Gustave Roussy (IGR), R&D, centre de Fresnes, Pfizer, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Lille Nord de France (COMUE)-Université de Lille, Université Lille Nord de France (COMUE)-UNICANCER-Université Lille Nord de France (COMUE)-UNICANCER-Cancéropole Nord-Ouest-Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de biostatistiques [CHU Lille], Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Université européenne de Bretagne - European University of Brittany (UEB)-Université de Bretagne Sud (UBS)-Université de Brest (UBO)-Institut Brestois du Numérique et des Mathématiques (IBNM), Université de Brest (UBO)-Télécom Bretagne-Institut Mines-Télécom [Paris] (IMT)-Centre National de la Recherche Scientifique (CNRS)-Université européenne de Bretagne - European University of Brittany (UEB)-Université de Bretagne Sud (UBS)-Université de Brest (UBO)-Institut Brestois du Numérique et des Mathématiques (IBNM), Université de Brest (UBO)-Télécom Bretagne-Institut Mines-Télécom [Paris] (IMT)-Centre National de la Recherche Scientifique (CNRS)-Laboratoire des sciences et techniques de l'information, de la communication et de la connaissance (Lab-STICC), École Nationale d'Ingénieurs de Brest (ENIB)-Université de Bretagne Sud (UBS)-Université de Brest (UBO)-Télécom Bretagne-Institut Brestois du Numérique et des Mathématiques (IBNM), Université de Brest (UBO)-Université européenne de Bretagne - European University of Brittany (UEB)-École Nationale Supérieure de Techniques Avancées Bretagne (ENSTA Bretagne)-Institut Mines-Télécom [Paris] (IMT)-Centre National de la Recherche Scientifique (CNRS)-École Nationale d'Ingénieurs de Brest (ENIB)-École Nationale Supérieure de Techniques Avancées Bretagne (ENSTA Bretagne)-Centre National de la Recherche Scientifique (CNRS), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Hôpital Henri Mondor-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d’Endocrinologie, Métabolisme et Prévention des Risques Cardio-Vasculaires [CHU Pitié-Salpêtrière], ONERA - The French Aerospace Lab [Châtillon], ONERA-Université Paris Saclay (COmUE), Centre de recherche Jean-Pierre Aubert-Neurosciences et Cancer, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé, Hôpital Claude Huriez, Université de Lille, Sciences et Technologies-Université de Lille, Sciences Humaines et Sociales-CRLCC Oscar Lambret-Cancéropole Nord-Ouest-Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Universitaire Estaing, UMR Peuplement Végétaux et Bioagresseurs en Milieu Tropical (UMR PVBMT - INRA), Institut National de la Recherche Agronomique (INRA), Service de Chirurgie Hépatobiliaire et Digestive, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet [Saint-Étienne] (UJM)-Centre National de la Recherche Scientifique (CNRS), CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bordeaux (UB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Diderot - Paris 7 (UPD7), Hopital Louis Mourier - AP-HP [Colombes], École normale supérieure - Lyon (ENS Lyon)-Université Lumière - Lyon 2 (UL2)-Université Jean Moulin - Lyon 3 (UJML), Université de Lyon-Université de Lyon-Université Jean Monnet [Saint-Étienne] (UJM)-École Nationale des Travaux Publics de l'État (ENTPE)-École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-École nationale supérieure d'architecture de Lyon (ENSAL)-Centre National de la Recherche Scientifique (CNRS)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA), Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM), West University of Timisoara [Roumanie] (UVT), Centre Hospitalier Régional Universitaire de Nîmes (CHRU Nîmes), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service d'endocrinologie-métabolisme [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Service de chirurgie digestive et hépato-bilio-pancréatique [CHU Pitié-Salpétrière], Hôpital Lariboisière, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Lariboisière-Université Paris Diderot - Paris 7 (UPD7), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Saint-Antoine [APHP], Centre de Recherche Saint-Antoine (CR Saint-Antoine), ONERA, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), Université de Limoges (UNILIM)-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503)-CHU Limoges, Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 (JPArc), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), Environnement, Ville, Société (EVS), École normale supérieure de Lyon (ENS de Lyon)-École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Jean Monnet - Saint-Étienne (UJM)-École Nationale des Travaux Publics de l'État (ENTPE)-École nationale supérieure d'architecture de Lyon (ENSAL)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Saint-Antoine [AP-HP], Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Service de Chirurgie Hépatobiliaire et Digestive [Rennes], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Sorbonne Université, Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Lille, Droit et Santé, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Hospices Civils de Lyon ( HCL ), Site de Recherche Intégrée en Cancérologie ( SIRIC-ONCOLille ), Université de Lille, Sciences et Technologies-Université de Lille, Sciences Humaines et Sociales-CRLCC Oscar Lambret-Cancéropole Nord-Ouest-Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Service de Chirurgie Générale et Viscérale ( CGV - BREST ), Centre Hospitalier Régional Universitaire de Brest ( CHRU Brest ) -Université de Brest ( UBO ), UMR Peuplement Végétaux et Bioagresseurs en Milieu Tropical ( UMR PVBMT - INRA ), Institut National de la Recherche Agronomique ( INRA ), Hôpital de la Côte de Nacre, Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Ingénierie des Matériaux Polymères - Site Université Claude Bernard Lyon 1 ( IMP ), Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon ( INSA Lyon ), Université de Lyon-Institut National des Sciences Appliquées ( INSA ) -Institut National des Sciences Appliquées ( INSA ) -Université Jean Monnet [Saint-Étienne] ( UJM ) -Centre National de la Recherche Scientifique ( CNRS ), CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Bordeaux ( UB ), Université de Brest ( UBO ), Centre de recherche sur l'Inflammation ( CRI ), Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Homéostasie Cellulaire et Pathologies ( HCP ), Université de Limoges ( UNILIM ) -CHU Limoges-Génomique, Environnement, Immunité, Santé, Thérapeutique ( GEIST FR CNRS 3503 ), Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie ( UPMC ), Université Pierre et Marie Curie - Paris 6 ( UPMC ), Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ), Environnement Ville Société ( EVS ), École normale supérieure - Lyon ( ENS Lyon ) -Université Lumière - Lyon 2 ( UL2 ) -Université Jean Moulin - Lyon III-Institut National des Sciences Appliquées de Lyon ( INSA Lyon ), Université de Lyon-Institut National des Sciences Appliquées ( INSA ) -Université de Lyon-Institut National des Sciences Appliquées ( INSA ) -Université Jean Monnet [Saint-Étienne] ( UJM ) -École Nationale des Travaux Publics de l'État ( ENTPE ) -Ecole Nationale Supérieure des Mines de Saint-Etienne-École nationale supérieure d'architecture de Lyon ( ENSAL ) -Centre National de la Recherche Scientifique ( CNRS ), Université de Lyon-Université de Lyon-Hospices Civils de Lyon ( HCL ), Centre Hospitalier Lyon Sud [CHU - HCL] ( CHLS ), Centre de recherche en éducation de Nantes ( CREN ), Université de Nantes ( UN ), Centre de Recherche en Automatique de Nancy ( CRAN ), Université de Lorraine ( UL ) -Centre National de la Recherche Scientifique ( CNRS ), Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Nutrition-Génétique et Exposition aux Risques Environnementaux ( NGERE ), Université de Lorraine ( UL ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Chelsea and Westminster Hospital NHS Foundation Trust, Service de Chirurgie Thoracique ( NICE - Chirurgie Thoracique ), CHU Nice, West University of Timisoara [Roumanie], West University of Timisoara, Centre Hospitalier Régional Universitaire de Nîmes ( CHRU Nîmes ), Laboratoire des sciences et techniques de l'information, de la communication et de la connaissance (UMR 3192) ( Lab-STICC ), Université européenne de Bretagne ( UEB ) -Université de Bretagne Sud ( UBS ) -Université de Brest ( UBO ) -Télécom Bretagne-Institut Brestois du Numérique et des Mathématiques ( IBNM ), Université de Brest ( UBO ) -Institut Mines-Télécom [Paris]-Centre National de la Recherche Scientifique ( CNRS ) -Université européenne de Bretagne ( UEB ) -Université de Bretagne Sud ( UBS ) -Université de Brest ( UBO ) -Télécom Bretagne-Institut Brestois du Numérique et des Mathématiques ( IBNM ), Université de Brest ( UBO ) -Institut Mines-Télécom [Paris]-Centre National de la Recherche Scientifique ( CNRS ) -Laboratoire des sciences et techniques de l'information, de la communication et de la connaissance ( Lab-STICC ), École Nationale d'Ingénieurs de Brest ( ENIB ) -Université de Bretagne Sud ( UBS ) -Université de Brest ( UBO ) -Télécom Bretagne-Institut Brestois du Numérique et des Mathématiques ( IBNM ), Université de Brest ( UBO ) -Université européenne de Bretagne ( UEB ) -ENSTA Bretagne-Institut Mines-Télécom [Paris]-Centre National de la Recherche Scientifique ( CNRS ) -École Nationale d'Ingénieurs de Brest ( ENIB ) -ENSTA Bretagne-Centre National de la Recherche Scientifique ( CNRS ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Laboratoire de Mathématiques Informatique et Applications ( LAMIA ), Université des Antilles et de la Guyane ( UAG ), Angiogenese et recherche translationnelle ( CART U965 ), Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Lariboisière-Université Paris Diderot - Paris 7 ( UPD7 ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Saint-Antoine [APHP], Centre de Recherche Saint-Antoine ( CR Saint-Antoine ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ), Institut Mutualiste de Montsouris ( IMM ), CHU Angers, ONERA - The French Aerospace Lab ( Chatillon ), Procédés Alimentaires et Microbiologiques [Dijon] ( PAM ), Université de Bourgogne ( UB ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Université Bourgogne Franche-Comté ( UBFC ), and Institut Gustave Roussy ( IGR )
Subjects: Oncology, Subset Analysis, Cancer Research, medicine.medical_specialty, Neoadjuvant treatment, Survival, medicine.medical_treatment, [SDV]Life Sciences [q-bio], [SDV.CAN]Life Sciences [q-bio]/Cancer, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Neoadjuvant therapy, [ SDV ] Life Sciences [q-bio], business.industry, Oesophageal cancer, Carcinoma, Phase-III Trial, Cancer, Retrospective cohort study, Chemoradiotherapy, cT2N0M0, medicine.disease, Resection, 3. Good health, Postoperative Mortality, Esophagectomy, 030220 oncology & carcinogenesis, Propensity score matching, Adenocarcinoma, 030211 gastroenterology & hepatology, Surgery, Therapy, business
Abstract: International audience; Aims: The aims of this study were to compare short-and long-term outcomes for clinical T2N0 oesophageal cancer with analysis of (i) primary surgery (S) versus neoadjuvant therapy plus surgery (NS), (ii) squamous cell carcinoma and adenocarcinoma subsets; and (iii) neoadjuvant chemoradiotherapy versus neoadjuvant chemotherapy.Methods: Data were collected from 30 European centres from 2000 to 2010. Among 2944 included patients, 355 patients (12.1%) had cT2N0 disease; 285 (S) and 70 (NS), were compared in terms of short-and long-term outcomes. Propensity score matching analyses were used to compensate for differences in baseline characteristics.Results: No significant differences between the groups were shown in terms of in hospital morbidity and mortality. Nodal disease was observed in 50% of S-group at the time of surgery, with 20% pN2/N3. Utilisation of neoadjuvant therapy was associated with significant tumour downstaging as reflected by increases in pT0, pN0 and pTNM stage 0 disease, this effect was further enhanced with neoadjuvant chemoradiotherapy. After adjustment on propensity score and confounding factors, for all patients and subset analysis of squamous cell and adenocarcinoma, neoadjuvant therapy had no significant effect upon survival or recurrence (overall, loco-regional, distant or mixed) compared to surgery alone. There were no significant differences between neoadjuvant chemotherapy and chemoradiotherapy in short-or long-term outcomes.Conclusion: The results of this study suggest that a surgery alone treatment approach should be recommended as the primary treatment approach for cT2N0 oesophageal cancer despite 50% of patients having nodal disease at the time of surgery.
Published: 2016
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28. Long-term oncological outcomes of two-stage hepatectomy for unresectable colorectal liver metastases: results of a prospective study

Author: François Quenet, Jean-Robert Delpero, Frédéric Marchal, Michel Rivoire, Johan Gagnière, Aurélien Dupré, Ahmet Ayav, Serge Evrard, and Guillaume Passot
Subjects: medicine.medical_specialty, Hepatology, business.industry, Two stage hepatectomy, Gastroenterology, Medicine, business, Prospective cohort study, Term (time), Surgery
Published: 2018
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29. Laparoscopic Habib™ 4X: a bipolar radiofrequency device for bloodless laparoscopic liver resection

Author: Madhava Pai, Shirin Elizabeth Khorsandi, Ahmet Ayav, Giuseppe Navarra, Nagy A. Habib, O. Damrah, C.A.M. Sommerville, and Long R. Jiao
Subjects: medicine.medical_specialty, Hepatology, Vascular anatomy, business.industry, Gastroenterology, laparoscopic liver resection, Pringle manoeuvre, Review Article, Liver resections, Intraoperative bleeding, liver resection technique, Surgery, Resection, radiofrequency, Coagulative necrosis, Hepatic surgery, medicine, Bipolar radiofrequency, Habib 4X, business
Abstract: Background. In recent years the progress of laparoscopic procedures and the development of new and dedicated technologies have made laproscopic hepatic surgery feasible and safe. In spite of this laparoscopic liver resection remains a surgical procedure of great challenge because of the risk of massive bleeding during liver transection and the complicated biliary and vascular anatomy in the liver. A new laparoscopic device is reported here to assist liver resection laparoscopically. Methods. The laparoscopic Habib™ 4X is a bipolar radiofrequency device consisting of a 2x2 array of needles arranged in a rectangle. It is introduced perpendicularly into the liver, along the intended transection line. It produces coagulative necrosis of the liver parenchyma sealing biliary radicals and blood vessels and enables bloodless transection of the liver parenchyma. Results. Twenty-four Laparoscopic liver resections were performed with LH4X out of a total of 28 attempted resections over 12 months. Pringle manoeuvre was not used in any of the patients. None of the patients required intraoperative transfusion of red cells or blood products. Conclusion. Laparoscopic liver resection can be safely performed with laparoscopic Habib™ 4X with a significantly low risk of intraoperative bleeding or postoperative complications.
Published: 2008
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30. Incidence and Risk Factors Related to Symptomatic Venous Thromboembolic Events After Esophagectomy for Cancer

Author: Jean-Michel Fabre, Delphine Lignier, Claude Bertrand, Xaviéra Coueffé, Brice Gayet, Marie Seman, Peggy Jourdan Enfer, Gainant A, Christophe Trésallet, Magalie Cabau, Jacques Jougon, Magalie Lefrançois, Gil Lebreton, Emmanuel Tiret, Nicolas Contival, Styliani Mantziari, Bernard Meunier, Nicolas Demartines, Flora Hec, Alexandre Filipello, Denis Lantuas, Federica Pipitone, Chiara Da Re, Renaud Flamein, François Paye, Denis Collet, Patrick Pessaux, Karine Pautrat, Jean-Marc Bigourdan, Simon Msika, Michel Prudhomme, Johan Gagnière, Jérémie Thereaux, Mehdi Karoui, Patrice Valleur, Diane Goéré, Yann Parc, Mael Chalret du Rieu, Jean-Pierre Bail, Jacques Baulieux, Denis Pezet, Stéphanie Lisunfui, Williams Tessier, Laurent Brunaud, Ion Donici, Marguerite Vanderbeken, Fabien Fredon, N. Chafai, Gilles Poncet, Charlotte Cohen, Jérémie H. Lefevre, Guillaume Luc, Letizia Laface, Serge Rohr, Frédéric Dumont, Jean-Marc Regimbeau, Oussama Baraket, R Frisoni, Serge Cappeliez, Issam El Nakadi, Eric Pappalardo, Marius Nedelcu, Thibault Coste, Marc Pocard, Cécile Brigand, N. Briez, Patrick Lozach, Amandine Klipfel, Gaelle Godiris Petit, Olivier Tiffet, Daniel Pop, Arnaud Alves, Jack Porcheron, Christophe Mariette, Delphine Vaudoyer, Arnaud Pasquer, Frédéric Marchal, Bogdan Stan-Iuga, Thierry Perniceni, Nicolas Carrere, Laurent Villeneuve, Jean-Christophe Vaillant, Caroline Gronnier, Olivier Glehen, B. Malgras, Muriel Mathonnet, Nicolas Venissac, Pierre Balladur, Markus Schäfer, Noémie Kamlet, Olivier Aze, Laurent Bresler, C. Ducerf, Jérôme Mouroux, Dominique Elias, Cyril Cosse, Bogdan Badic, Salim Mezoughi, Jean-Yves Mabrut, Emanuele Felli, Abdennahceur Dhahri, Fabrice Menegaux, Laurent Hannoun, Kathleen Turner, Ahmet Ayav, Mustapha Adam, Rodrigue Chemaly, Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 (JPArc), Université Lille Nord de France (COMUE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Chirurgie digestive et hépatobiliaire, CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Service de Chirurgie Générale et Viscérale (CGV - BREST), Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Service de Médecine Interne, PRES Université Lille Nord de France-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CIC-IT Bordeaux, Université de Bordeaux (UB)-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Brest (UBO), Peuplements végétaux et bioagresseurs en milieu tropical (UMR PVBMT), Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Institut de Recherche pour le Développement (IRD)-Institut National de la Recherche Agronomique (INRA)-Université de La Réunion (UR), Département de chirurgie digestive, CHU Clermont-Ferrand, Centre de recherche sur l'Inflammation (CRI (UMR_S_1149 / ERL_8252 / U1149)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université Sorbonne Paris Cité (USPC), Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Chirurgie Générale et Digestive[Lille], Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de Chirurgie digestive, endocrinienne et générale [CHU Limoges], CHU Limoges, Université Pierre et Marie Curie - Paris 6 - UFR de Médecine Pierre et Marie Curie (UPMC), Université Pierre et Marie Curie - Paris 6 (UPMC), Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Montreal Heart Institute, Ciblage thérapeutique en Oncologie (EA3738), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Centre de recherche en éducation de Nantes (CREN), Le Mans Université (UM)-Université de Nantes - UFR Lettres et Langages (UFRLL), Université de Nantes (UN)-Université de Nantes (UN), Université de Lorraine (UL), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Interactions, Corpus, Apprentissages, Représentations (ICAR), École normale supérieure de Lyon (ENS de Lyon)-Université Lumière - Lyon 2 (UL2)-INRP-Ecole Normale Supérieure Lettres et Sciences Humaines (ENS LSH)-Centre National de la Recherche Scientifique (CNRS), Service de Chirurgie Thoracique (NICE - Chirurgie Thoracique), Centre Hospitalier Universitaire de Nice (CHU Nice), Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU), Babes-Bolyai University [Cluj-Napoca] (UBB), Service de Chirurgie thoracique, Anthropologie bio-culturelle, Droit, Ethique et Santé (ADES), Aix Marseille Université (AMU)-EFS ALPES MEDITERRANEE-Centre National de la Recherche Scientifique (CNRS), Lab-STICC_UBS_CID_DECIDE, Laboratoire des sciences et techniques de l'information, de la communication et de la connaissance (UMR 3192) (Lab-STICC), Université européenne de Bretagne - European University of Brittany (UEB)-Université de Bretagne Sud (UBS)-Université de Brest (UBO)-Télécom Bretagne-Institut Brestois du Numérique et des Mathématiques (IBNM), Université de Brest (UBO)-Institut Mines-Télécom [Paris] (IMT)-Centre National de la Recherche Scientifique (CNRS)-Université européenne de Bretagne - European University of Brittany (UEB)-Université de Bretagne Sud (UBS)-Université de Brest (UBO)-Télécom Bretagne-Institut Brestois du Numérique et des Mathématiques (IBNM), Université de Brest (UBO)-Institut Mines-Télécom [Paris] (IMT)-Centre National de la Recherche Scientifique (CNRS)-Laboratoire des sciences et techniques de l'information, de la communication et de la connaissance (Lab-STICC), Université européenne de Bretagne - European University of Brittany (UEB)-École Nationale d'Ingénieurs de Brest (ENIB)-Université de Bretagne Sud (UBS)-Université de Brest (UBO)-Télécom Bretagne-Institut Brestois du Numérique et des Mathématiques (IBNM), Université de Brest (UBO)-École Nationale Supérieure de Techniques Avancées Bretagne (ENSTA Bretagne)-Institut Mines-Télécom [Paris] (IMT)-Centre National de la Recherche Scientifique (CNRS)-École Nationale d'Ingénieurs de Brest (ENIB)-École Nationale Supérieure de Techniques Avancées Bretagne (ENSTA Bretagne)-Centre National de la Recherche Scientifique (CNRS), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Laboratoire de Mathématiques Informatique et Applications (LAMIA), Université des Antilles et de la Guyane (UAG), Université des Antilles (Pôle Guadeloupe), Université des Antilles (UA), Service de Chirurgie Digestive, 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 Diderot - Paris 7 (UPD7), Association Pro Pictura Antiqua (APPA-CEPMR), Ville de Soissons, CHU Saint-Antoine [AP-HP], 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), Laboratoire Hubert Curien (LHC), Institut d'Optique Graduate School (IOGS)-Université Jean Monnet - Saint-Étienne (UJM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Institut Mutualiste de Montsouris (IMM), Departement medico-chirurgical de pathologie digestive, Service de Chirurgie Hépatobiliaire et Digestive [Rennes] = Hepatobiliary and Digestive Surgery [Rennes], CHU Pontchaillou [Rennes], Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), CHU Strasbourg, Laboratoire brestois de mécanique et des systèmes (LBMS), École Nationale d'Ingénieurs de Brest (ENIB)-Université de Brest (UBO)-École Nationale Supérieure de Techniques Avancées Bretagne (ENSTA Bretagne), Département de chirurgie générale [Gustave Roussy], Institut Gustave Roussy (IGR), Chercheur indépendant, Hospices Civils de Lyon (HCL), Centre de recherche Jean-Pierre Aubert-Neurosciences et Cancer, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé, Centre Hospitalier Universitaire Estaing, Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), UMR Peuplement Végétaux et Bioagresseurs en Milieu Tropical (UMR PVBMT - INRA), Institut National de la Recherche Agronomique (INRA), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), Hopital Louis Mourier - AP-HP [Colombes], Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), equipe 4, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL)-Centre de Recherche en Cancérologie de Lyon (CRCL), Université de Lyon-Université de Lyon-Centre Léon Bérard [Lyon]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre Léon Bérard [Lyon]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), École normale supérieure - Lyon (ENS Lyon)-Université Lumière - Lyon 2 (UL2)-INRP-Ecole Normale Supérieure Lettres et Sciences Humaines-Centre National de la Recherche Scientifique (CNRS), Normandie Université (NU)-Institut National des Sciences Appliquées (INSA), Université européenne de Bretagne - European University of Brittany (UEB)-Université de Bretagne Sud (UBS)-Université de Brest (UBO)-Institut Brestois du Numérique et des Mathématiques (IBNM), Université de Brest (UBO)-Télécom Bretagne-Institut Mines-Télécom [Paris] (IMT)-Centre National de la Recherche Scientifique (CNRS)-Université européenne de Bretagne - European University of Brittany (UEB)-Université de Bretagne Sud (UBS)-Université de Brest (UBO)-Institut Brestois du Numérique et des Mathématiques (IBNM), Université de Brest (UBO)-Télécom Bretagne-Institut Mines-Télécom [Paris] (IMT)-Centre National de la Recherche Scientifique (CNRS)-Laboratoire des sciences et techniques de l'information, de la communication et de la connaissance (Lab-STICC), École Nationale d'Ingénieurs de Brest (ENIB)-Université de Bretagne Sud (UBS)-Université de Brest (UBO)-Télécom Bretagne-Institut Brestois du Numérique et des Mathématiques (IBNM), Université de Brest (UBO)-Université européenne de Bretagne - European University of Brittany (UEB)-École Nationale Supérieure de Techniques Avancées Bretagne (ENSTA Bretagne)-Institut Mines-Télécom [Paris] (IMT)-Centre National de la Recherche Scientifique (CNRS)-École Nationale d'Ingénieurs de Brest (ENIB)-École Nationale Supérieure de Techniques Avancées Bretagne (ENSTA Bretagne)-Centre National de la Recherche Scientifique (CNRS), Service de gastroentérologie et cancérologie digestive [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Service de chirurgie générale viscérale et endocrinienne [CHU Pitié-Sapêtrière], Service de chirurgie digestive et hépato-bilio-pancréatique [CHU Pitié-Salpétrière], 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), Université Paris Diderot - Paris 7 (UPD7), Hôpital Lariboisière, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Lariboisière-Université Paris Diderot - Paris 7 (UPD7), Service de chirurgie générale et digestive [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Saint-Antoine [APHP], Centre de Recherche Saint-Antoine (CR Saint-Antoine), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), Laboratoire Hubert Curien [Saint Etienne] (LHC), Institut d'Optique Graduate School (IOGS)-Université Jean Monnet [Saint-Étienne] (UJM)-Centre National de la Recherche Scientifique (CNRS), Service de Chirurgie Hépatobiliaire et Digestive, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Centre Hospitalier Universitaire de Saint-Etienne, Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U1172 Inserm - U837 (JPArc), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Lille Nord de France (COMUE)-Université de Lille, Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Diderot - Paris 7 (UPD7), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Edouard Herriot [CHU - HCL], École normale supérieure - Lyon (ENS Lyon)-Université Lumière - Lyon 2 (UL2)-INRP-Ecole Normale Supérieure Lettres et Sciences Humaines (ENS LSH)-Centre National de la Recherche Scientifique (CNRS), Service d'Hépato-Gastro-Entérologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Chirurgie Générale, Viscérale et Endocrinienne [CHU Pitié-Sapêtrière], Service de Chirurgie Digestive, Hépato-Bilio-pancréatique et Transplantation Hépatique [CHU Pitié-Salpétrière], Université Paris Diderot - Paris 7 (UPD7)-Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO)-Université de Brest (UBO), Université de Nantes - UFR Lettres et Langages (UFRLL), Université de Nantes (UN)-Université de Nantes (UN)-Le Mans Université (UM), Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Sorbonne Université, Service de Chirurgie Hépatobiliaire et Digestive [Rennes], FREGAT Working Group-FRENCH-AFC, Dhahri, A., Lignier, D., Cossé, C., Regimbeau, J.M., Luc, G., Collet, D., Cabau, M., Jougon, J., Badic, B., Lozach, P., Bail, J.P., Cappeliez, S., El Nakadi, I., Lebreton, G., Alves, A., Flamein, R., Pezet, D., Pipitone, F., Stan-Iuga, B., Coueffé, X., Contival, N., Pappalardo, E., Msika, S., Hec, F., Vanderbeken, M., Tessier, W., Briez, N., Fredon, F., Gainant, A., Mathonnet, M., Bigourdan, J.M., Mezoughi, S., Ducerf, C., Baulieux, J., Mabrut, J.Y., Pasquer, A., Baraket, O., Poncet, G., Adam, M., Vaudoyer, D., Enfer, P.J., Villeneuve, L., Glehen, O., Coste, T., Fabre, J.M., Marchal, F., Frisoni, R., Ayav, A., Brunaud, L., Bresler, L., Cohen, C., Aze, O., Venissac, N., Pop, D., Mouroux, J., Donici, I., Prudhomme, M., Felli, E., Lisunfui, S., Seman, M., Petit, G.G., Karoui, M., Tresallet, C., Ménégaux, F., Vaillant, J.C., Hannoun, L., Malgras, B., Lantuas, D., Pautrat, K., Pocard, M., Valleur, P., Lefevre, J., Chafai, N., Balladur, P., Lefranéois, M., Parc, Y., Paye, F., Tiret, E., Nedelcu, M., Laface, L., Perniceni, T., Gayet, B., Turner, K., Meunier, B., Filipello, A., Porcheron, J., Tiffet, O., Kamlet, N., Chemaly, R., Klipfel, A., Pessaux, P., Brigand, C., Rohr, S., Chalret du Rieu, M., Carrére, N., Da Re, C., Dumont, F., Goéré, D., Elias, D., and Bertrand, C.
Subjects: Pulmonary and Respiratory Medicine, Adult, Male, ARDS, medicine.medical_specialty, Esophageal Neoplasms, medicine.drug_class, medicine.medical_treatment, Low molecular weight heparin, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, 030204 cardiovascular system & hematology, Aged, Aged, 80 and over, Esophageal Neoplasms/surgery, Esophagectomy/adverse effects, Female, Hospital Mortality, Humans, Incidence, Length of Stay, Middle Aged, Postoperative Complications/etiology, Risk Factors, Venous Thromboembolism/epidemiology, Venous Thromboembolism/etiology, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Internal medicine, Medicine, cardiovascular diseases, ComputingMilieux_MISCELLANEOUS, business.industry, Incidence (epidemiology), Cancer, Venous Thromboembolism, Esophageal cancer, equipment and supplies, medicine.disease, 3. Good health, Pulmonary embolism, Surgery, Esophagectomy, Venous thrombosis, 030220 oncology & carcinogenesis, Cardiology and Cardiovascular Medicine, business
Abstract: Background Major oncologic surgery is associated with a high incidence of venous thromboembolic events (VTE), including deep venous thrombosis (DVT) and pulmonary embolism (PE). However, the incidence and risk factors for symptomatic VTE during curative treatment for patients with esophageal cancer are poorly documented. Methods Data were collected from 30 European centers from 2000 to 2010. The incidence of in-hospital VTE was assessed in 2,944 patients with esophageal cancer having surgery with curative intent, and 50 clinically relevant parameters were assessed as potential risk factors for VTE. Patients received low molecular weight heparin prophylaxis during hospital stay and for 4 weeks after surgery. Results Eighty-four patients (2.9%) developed a symptomatic VTE; all of them had a DVT and 44 were also diagnosed with a PE. In the VTE group there were 19 postoperative deaths recorded, 5 of which (26.3%) were directly caused by PE at postoperative days 7, 10, 21, 45, and 48 despite VTE prophylaxis. In-hospital postoperative mortality was significantly higher in VTE patients (23% versus 7%, p 0.001) and mean hospital stay was also longer in this group (33 ± 24 versus 25 ± 21 days, p 0.001). Multivariable analysis showed that high American Society of Anesthesiologists (ASA) class ( p = 0.008), pneumopathy ( p = 0.002), or an acute respiratory distress syndrome (ARDS) ( p = 0.015) were significantly associated with VTE. Conclusions Patients with ASA class III or IV and those who present a postoperative pneumopathy or ARDS seem to be at higher risk for VTE. Thus, current VTE screening and thromboprophylaxis for these patients might be inadequate and needs further investigation.
Published: 2016
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31. Congenital bile duct cyst (BDC) is a more indolent disease in children compared to adults, except for Todani type IV-A BDC: results of the European multicenter study of the French Surgical Association

Author: Mehdi Ouaissi, Reza Kianmanesh, Emilia Ragot, Jacques Belghiti, Barbara Wildhaber, Gennaro Nuzzo, Remi Dubois, Yann Revillon, Daniel Cherqui, Daniel Azoulay, Chritian Letoublon, François-René Pruvot, Adeline Roux, Jean-Yves Mabrut, Jean-François Gigot, Jean De Ville de Goyet, Catherine Hubert, Jan Lerut, Jean-Bernard Otte, Raymond Reding, Olivier Farges, Alain Sauvanet, Oulhaci Wassila, Felice Giulante, Francesco Ardito, Maria De Rose Agostino, Thomas Gelas, Pierre-Yves Mure, Jacques Baulieux, Christian Gouillat, Christian Ducerf, Sabine Irtan, Sabine Sarnacki, Alexis Laurent, Philippe Compagnon, Chady Salloum, Roger Lebeau, Olivier Risse, Stéphanie Truant, Emmanuel Boleslawski, François Corfiotti, Patrick Rat, Alexandre Doussot, Pablo Ortega-Deballon, François Paye, Pierre Balladur, Mustapha Adham, Christian Partensky, Taore Alhassane, Karim Boudjema, Catelin Tiuca Dane, Yves-Patrice Le Treut, Mathieu Rinaudo, Jean Hardwigsen, Hélène Martelli, Frédéric Gauthier, Sophie Branchereau, Simon Msika, Daniel Sommacale, Jean-Pierre Palot, Ahmet Ayav, Charles-Alexandre Laurain, Massimo Falconi, Denis Castaing, Oriana Ciacio, René Adam, Eric Vibert, Roberto Troisi, Aude Vanlander, Stéphane Geiss, Gilles De Taffin, Denis Collet, Antonio Sa Cunha, Laurent Duguet, Bouzid Chafik, Kamal Bentabak, Abdelaziz Graba, Nicolas Meurisse, Jacques Pirenne, Lorenzo Capussotti, Serena Langelle, Nermin Halkic, Nicolas Demartines, Alessandra Cristaudi, Gaëtan Molle, Baudouin Mansvelt, Massimo Saviano, Gelmini Roberta, Ousema Baraket, Samy Bouchoucha, Bernard Sastre, Ouaissi, M., Kianmanesh, R., Ragot, E., Belghiti, J., Wildhaber, B., Nuzzo, G., Dubois, R., Revillon, Y., Cherqui, D., Azoulay, D., Letoublon, C., Pruvot, F. -R., Roux, A., Mabrut, J. -Y., Gigot, J. -F., De Goyet, J. D. V., Hubert, C., Lerut, J., Otte, J. -B., Reding, R., Farges, O., Sauvanet, A., Wassila, O., Giulante, F., Ardito, F., De Rose Agostino, M., Gelas, T., Mure, P. -Y., Baulieux, J., Gouillat, C., Ducerf, C., Irtan, S., Sarnacki, S., Laurent, A., Compagnon, P., Salloum, C., Lebeau, R., Risse, O., Truant, S., Boleslawski, E., Corfiotti, F., Rat, P., Doussot, A., Ortega-Deballon, P., Paye, F., Balladur, P., Adham, M., Partensky, C., Alhassane, T., Boudjema, K., Dane, C. T., Le Treut, Y. -P., Rinaudo, M., Hardwigsen, J., Martelli, H., Gauthier, F., Branchereau, S., Msika, S., Sommacale, D., Palot, J. -P., Ayav, A., Laurain, C. -A., Falconi, M., Castaing, D., Ciacio, O., Adam, R., Vibert, E., Troisi, R., Vanlander, A., Geiss, S., De Taffin, G., Collet, D., Sa Cunha, A., Duguet, L., Chafik, B., Bentabak, K., Graba, A., Meurisse, N., Pirenne, J., Capussotti, L., Langelle, S., Halkic, N., Demartines, N., Cristaudi, A., Molle, G., Mansvelt, B., Saviano, M., Roberta, G., Baraket, O., Bouchoucha, S., and Sastre, B.
Subjects: Male, Time Factors, Settore MED/18 - CHIRURGIA GENERALE, Comorbidity, Kaplan-Meier Estimate, Disease, 030230 surgery, Postoperative Complications, 0302 clinical medicine, Risk Factors, Medicine, Cyst, Young adult, Child, Aged, 80 and over, ddc:618, Bile duct, Age Factors, Gastroenterology, Middle Aged, Europe, Biliary Tract Surgical Procedures, Treatment Outcome, medicine.anatomical_structure, Child, Preschool, Choledochal Cyst, 030220 oncology & carcinogenesis, liver resection, Female, Original Article, Adult, medicine.medical_specialty, Adolescent, Young Adult, 03 medical and health sciences, Humans, Choledochal cysts, Aged, Retrospective Studies, Hepatology, business.industry, Infant, Newborn, Infant, Retrospective cohort study, medicine.disease, Surgery, Todani type IV, business, Congenital bile duct cyst
Abstract: Aim To compare clinical presentation, operative management and short- and long-term outcomes of congenital bile duct cysts (BDC) in adults with children. Methods Retrospective multi-institutional Association Francaise de Chirurgie study of Todani types I+IVB and IVA BDC. Results During the 37-year period to 2011, 33 centers included 314 patients (98 children; 216 adults). The adult population included more high-risk patients, with more active, more frequent prior treatment (47.7% vs 11.2%; p < 0.0001), more complicated presentation (50.5% vs 35.7%; p = 0.015), more synchronous biliary cancer (11.6% vs 0%; p = 0.0118) and more major surgery (23.6% vs 2%; p < 0.0001), but this latter feature was only true for type I+IVB BDC. Compared to children, the postoperative morbidity (48.1% vs 20.4%; p < 0.0001), the need for repeat procedures and the status at follow-up were worse in adults (27% vs 8.8%; p = 0.0009). However, severe postoperative morbidity and fair or poor status at follow-up were not statistically different for type IVA BDC, irrespective of patients' age. Synchronous cancer, prior HBP surgery and Todani type IVA BDC were independent predictive factors of poor or fair long-term outcome. Conclusion BDC is a more indolent disease in children compared to adults, except for Todani type IV-A BDC.
Published: 2016

32. Right robotic adrenalectomy for a 8cm pheochromocytoma (with video)

Author: Luca Sessa, Claire Nominé, Adeline Germain, Ahmet Ayav, Laurent Brunaud, Laurent Bresler, Service de Chirurgie Digestive Hépatobiliaire et Endocrine [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)
Subjects: medicine.medical_specialty, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Adrenal Gland Neoplasms, Pheochromocytoma, Inferior vena cava, Young Adult, Robotic Surgical Procedures, Minimally invasive surgery, Medicine, Humans, Robotic surgery, Laparoscopy, ComputingMilieux_MISCELLANEOUS, medicine.diagnostic_test, business.industry, Adrenalectomy, Right triangular ligament, General Medicine, Robotics, medicine.disease, 3. Good health, Surgery, Retractor, Dissection, medicine.anatomical_structure, medicine.vein, Female, business
Abstract: Please cite this article in press as: Sessa L, et al. Right robotic adrenalectomy for a 8 cm pheochromocytoma (with video). Journal of Visceral Surgery (2015), http://dx.doi.org/10.1016/j.jviscsurg.2015.06.010 Pheochromocytoma; Robotic surgery; Minimally invasive surgery; Robotics CT scan showed a 10 cm right adrenal tumor compatible with a pheochromocytoma. MIBG scintigraphy confirmed a right adrenal tumor single uptake. Routine biomolecular evaluation (SDHx and VHL genes) was negative for a familial disease. A totally robotic lateral transperitoneal right adrenalectomy was performed. The patient was placed in left lateral strict decubitus and flexed at the waist. An ‘‘open’’ right subcostal access was used to introduce a 12 mm optical trocar. Under laparoscopic vision (0◦ scope), 4 other trocars were introduced: two 8 mm right subcostal trocars, one 12 mm and one 10 mm trocars for the first-assistant’s left and right (liver retractor) hand, respectively. The robotic cart (da Vinci® Si Surgical System, Intuitive Surgical) was placed above the patient’s right shoulder and was docked. Intra-abdominal exploration confirmed the presence of a large retroperitoneal mass that completely modified the right suprarenal region. The right triangular ligament was divided and the liver was medially retracted. The right aspect of the vena cava was not initially accessible because of the large adrenal mass volume. Consequently, the tumor was first dissected, en bloc with the periadrenal fat, from the upper pole of the kidney and from lateral attachments to obtain an adequate mobilization of the adrenal mass allowing its rotation to better approach the right lateral and posterior aspects of the vena cava. Then, dissection was carried out progressively upward along the inferior vena cava on the medial margin of the tumor. Four large adrenal veins were consecutively dissected, clipped using nonabsorbable self-locking clips (Hem-o-lok®, Weck-Telefex Europe Ltd.), and divided. The adrenal mass was completely dissected and mobilized from its posterior aspect (iliopsoas muscle). Overall operative time was 90 minutes. No post-operative complication was observed hospitalization duration was 3 days. Pathology confirmed an adrenal pheochromocytoma, 8 cm in diameter with a PASS score 1 with R0 resection without capsular effraction.
Published: 2015
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33. Characterization and Clinical Application of Human CD34 + Stem/Progenitor Cell Populations Mobilized into the Blood by Granulocyte Colony‐Stimulating Factor

Author: Federica M. Marelli-Berg, Francesco Dazzi, Stephen B. Marley, Paul Tait, Rikke Dodge, Steen Lindkaer Jensen, Nataša Levičar, Madhava Pai, Myrtle Y. Gordon, Ahmet Ayav, Malcolm Alison, Mahrokh Nohandani, Philippe Bachellier, Raymond J. Playford, Joanna Nicholls, Tamara Thalji, Faisal A. Al-Allaf, Nagy A. Habib, John Davies, Hanane M’Hamdi, Robert I. Lechler, Farzin Farzaneh, Joop Gaken, Jane F. Apperley, Long R. Jiao, Ioannis Dimarakis, and Jonathan P. Welsh
Subjects: Amniotic stem cells, Cell Biology, Biology, Molecular biology, Endothelial stem cell, Haematopoiesis, Amniotic epithelial cells, Immunology, Molecular Medicine, Stem cell, Progenitor cell, Developmental Biology, Adult stem cell, Interleukin 3
Abstract: A phase I study was performed to determine the safety and tolerability of injecting autologous CD34(+) cells into five patients with liver insufficiency. The study was based on the hypothesis that the CD34(+) cell population in granulocyte colony-stimulating factor (G-CSF)-mobilized blood contains a subpopulation of cells with the potential for regenerating damaged tissue. We separated a candidate CD34(+) stem cell population from the majority of the CD34(+) cells (99%) by adherence to tissue culture plastic. The adherent and nonadherent CD34(+) cells were distinct in morphology, immunophenotype, and gene expression profile. Reverse transcription-polymerase chain reaction-based gene expression analysis indicated that the adherent CD34(+) cells had the potential to express determinants consistent with liver, pancreas, heart, muscle, and nerve cell differentiation as well as hematopoiesis. Overall, the characteristics of the adherent CD34(+) cells identify them as a separate putative stem/progenitor cell population. In culture, they produced a population of cells exhibiting diverse morphologies and expressing genes corresponding to multiple tissue types. Encouraged by this evidence that the CD34(+) cell population contains cells with the potential to form hepatocyte-like cells, we gave G-CSF to five patients with liver insufficiency to mobilize their stem cells for collection by leukapheresis. Between 1 x 10(6) and 2 x 10(8) CD34(+) cells were injected into the portal vein (three patients) or hepatic artery (two patients). No complications or specific side effects related to the procedure were observed. Three of the five patients showed improvement in serum bilirubin and four of five in serum albumin. These observations warrant further clinical trials.
Published: 2006
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34. Defective remethylation of homocysteine is related to decreased synthesis of coenzymes B2 in thyroidectomized rats

Author: F Barbé, Laurent Brunaud, Jean-Marc Alberto, Jean-Louis Guéant, P. Gérard, Ahmet Ayav, and Marc Merten
Subjects: Male, medicine.medical_specialty, Erythrocytes, Homocysteine, Riboflavin, Clinical Biochemistry, Glutathione reductase, Cystathionine beta-Synthase, 5-Methyltetrahydrofolate-Homocysteine S-Methyltransferase, Methylation, Biochemistry, chemistry.chemical_compound, Hypothyroidism, Internal medicine, medicine, Animals, Choline, Methylenetetrahydrofolate Reductase (NADPH2), Methionine, biology, Kinase, Organic Chemistry, Vitamin B 12 Deficiency, Glutathione, Cystathionine beta synthase, Rats, Inbred F344, Diet, Enzymes, Rats, Glutathione Reductase, Endocrinology, chemistry, Thyroidectomy, biology.protein, Regression Analysis
Abstract: We investigated the influence of hypothyroidism on homocysteine metabolism in rats, focusing on a hypothetical deficient synthesis of FAD by riboflavin kinases. Animals were allocated in control group (n = 7), thyroidectomized rats (n = 6), rats with diet deficient in vitamin B2, B9, B12, choline and methionine (n = 7), thyroidectomized rats with deficient diet (n = 9). Homocysteine was decreased in operated rats (2.6 +/- 1.01 vs. 4.05 +/- 1.0 mumol/L, P = 0.02) and increased in deficient diet rats (29.56 +/- 4.52 vs. 4.05 +/- 1.0 micromol/L, P = 0.001), when compared to control group. Erythrocyte-Glutathione-Reductase-Activation-Coefficient (index of FAD deficiency) was increased in thyroidectomized or deficient diet rats (P = 0.004 for both). Methylenetetrahydrofolate-reductase and methionine-synthase activities were decreased in thyroidectomized rats but not in those subjected to deficient diet. Cystathionine-beta-synthase was increased only in operated rats. Taken together, these results showed a defective re-methylation in surgical hypothyroidism, which was due in part to a defective synthesis of vitamin B2 coenzymes. This defective pathway was overcompensated by the increased Cystathionine-beta-synthase activity.
Published: 2005
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35. Laparoscopic approach for solitary insulinoma: a multicentre study

Author: Afce, Ahmet Ayav, Laurent Bresler, Patrick Boissel, Sfcl, and Laurent Brunaud
Subjects: Adult, Male, medicine.medical_specialty, Fistula, medicine.medical_treatment, Enucleation, Pancreatectomy, medicine, Humans, Abscess, Laparoscopy, Insulinoma, Aged, Retrospective Studies, medicine.diagnostic_test, business.industry, Length of Stay, Middle Aged, medicine.disease, Surgery, Pancreatic Neoplasms, Treatment Outcome, Cardiothoracic surgery, Feasibility Studies, Female, Radiology, business, Follow-Up Studies, Abdominal surgery
Abstract: Surgical resection of insulinomas is the preferred treatment in order to avoid symptoms of hypoglycaemia. During the past years, advances in laparoscopic techniques have allowed surgeons to approach the pancreas and treat these lesions laparoscopically. We analysed the feasibility, safety, and outcome of patients undergoing laparoscopic resection of insulinomas in a large, retrospective, multicentre study. Thirty-six patients with pancreatic insulinomas were enrolled in this study. All patients were suspected of having solitary insulinomas after preoperative localisation tests and underwent a laparoscopic approach. Patients, operating characteristics and outcome were analysed. Mean patient age was 48 years (range 20–77 years). Insulinomas were localised in the head (n=7), isthmus (n=2), body (n=14) or tail (n=13) of the pancreas before laparoscopic approach. Mean size of the lesions was 15.5 mm (range 4–25 mm). The surgical procedure was enucleation in 19 cases (52%), spleen-preserving distal pancreatectomy in 12 cases (33%), spleno-pancreatectomy in three cases (8%), one duodenopancreatectomy and one central pancreatectomy. Conversion rate was 30%. The reason for conversion in seven patients (63%) was the inability to localise the tumour during the laparoscopic procedure. In six of these cases laparoscopic ultrasonography was not performed. Mean operating time was 156 min (range 50–420 min). Postoperative course was uneventful in 23 patients (64%). Eleven patients (30%) developed specific complications of pancreatic surgery: intra-abdominal abscess (n=6) or pancreatico-cutaneous fistula (n=5). Mean duration of fistulae was 55 days (range 5–130 days) and all the fistulae were dry at follow-up. After a mean follow-up period of 26 months (range 2–87 months), 33 patients (91%) are free of symptoms, and three patients have been lost to follow-up. The laparoscopic approach is safe to treat preoperatively localised insulinoma, with a morbidity rate comparable to that for the open approach. When the tumour is not found during laparoscopy, laparoscopic ultrasonography seems to be the most efficient tool to localise it and probably to prevent conversion.
Published: 2004
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36. Surgical management of combined rectal and genital prolapse in young patients: transabdominal approach

Author: Ahmet Ayav, Laurent Bresler, Rasa Zarnegar, Patrick Boissel, and Laurent Brunaud
Subjects: Adult, medicine.medical_specialty, Constipation, Rectum, Gynecologic Surgical Procedures, Patient satisfaction, Recurrence, Uterine Prolapse, Abdomen, Humans, Medicine, Sex organ, Digestive System Surgical Procedures, Retrospective Studies, business.industry, Gastroenterology, Retrospective cohort study, Rectal Prolapse, Middle Aged, Surgical Mesh, medicine.disease, Surgery, Rectal prolapse, Treatment Outcome, Surgical mesh, medicine.anatomical_structure, Patient Satisfaction, Female, medicine.symptom, business, Follow-Up Studies
Abstract: The aim of this study was to determine the anatomical and functional outcomes of the simultaneous treatment of combined rectal and genital prolapse in young patients. Between March 2001 and June 2002, eight female patients with symptomatic rectal and genital prolapse were enrolled in this study. The median age at the time of presentation was 44 years (range 34–53). All patients underwent simultaneous transabdominal treatment of their combined prolapse. Genital prolapse was treated by colpohysteropexy. Rectal prolapse was treated by mesh rectopexy or sutured rectopexy associated with sigmoid resection. The end evaluation to assess long-term results was performed after a median duration of follow-up of 17 months (range 10–24). Patients were asked about current problems with constipation, use of laxatives, incontinence and recurrence. The postoperative course was uneventful in 7 out of 8 cases. None of the patients had recurrence. Three patients out of 6 remained constipated postoperatively. One patient had a new onset of constipation postoperatively. None of the patients became faecally incontinent. Seven patients (87%) stated that they had improved overall after surgery. Combined rectal and genital prolapse in young women can be safely treated simultaneously using an abdominal approach. The genital prolapse should be treated by colpohysteropexy. The rectal prolapse should be treated by mesh rectopexy in patients who are not constipated, and by sutured rectopexy plus sigmoid resection in patients who are constipated preoperatively.
Published: 2004
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37. Totally Robotic Distal Pancreatectomy with Preservation of Spleen and Splenic Vessels

Author: Claire Nominé, Luca S, L Bresler, Laurent Brunaud, Adeline Germain, and Ahmet Ayav
Subjects: medicine.anatomical_structure, business.industry, General Engineering, medicine, General Earth and Planetary Sciences, Spleen, Anatomy, Distal pancreatectomy, business, General Environmental Science
Published: 2015
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38. Thoracoscopic treatment of a right Bochdalek hernia in an adult (with video)

Author: Adeline Germain, Ahmet Ayav, R Frisoni, Laurent Brunaud, Laurent Bresler, Service de Chirurgie Digestive Hépatobiliaire et Endocrine [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)
Subjects: Adult, medicine.medical_specialty, Hernia, [SDV]Life Sciences [q-bio], Diaphragmatic breathing, 03 medical and health sciences, 0302 clinical medicine, Thoracoscopy, medicine, Adults, Humans, ComputingMilieux_MISCELLANEOUS, Medicine(all), medicine.diagnostic_test, business.industry, Thoracic Surgery, Video-Assisted, General surgery, General Medicine, medicine.disease, Surgery, Bochdalek hernia, 030220 oncology & carcinogenesis, Female, business, Hernias, Diaphragmatic, Congenital, 030217 neurology & neurosurgery, Diaphragmatic
Abstract: International audience
Published: 2014
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39. Totally robotic Roux-en-Y gastric bypass (with video)

Author: Adeline Germain, Laurent Brunaud, Ahmet Ayav, Laurent Bresler, G. Fantola, and N. Reibel
Subjects: medicine.medical_specialty, Gastric bypass, Gastric Bypass, Video Recording, Body Mass Index, Robotic Surgical Procedures, Diabetes mellitus, Medicine, Humans, Minimally Invasive Surgical Procedures, Robotic surgery, Laparoscopy, Medicine(all), medicine.diagnostic_test, business.industry, Anastomosis, Roux-en-Y, General Medicine, Robotics, medicine.disease, Roux-en-Y anastomosis, Surgery, Obesity, Morbid, Obstructive sleep apnea, surgical procedures, operative, business, Dyslipidemia, New technologies
Abstract: Gastric bypass;Laparoscopy;Robotic surgery;Robotics;New technologiesThe prevalenceofmorbidlyobeseindividualsisrisingrapidly.Beingoverweightpredisposespatients to multiple serious medical comorbidities including type two diabetes, hyperten-sion, dyslipidemia, and obstructive sleep apnea. This video shows stepby a totallyrobotic Roux-en-Y gastric bypass in an obese patient(BMI42kg/m
Published: 2014

40. Acute mesenteric venous thrombosis: Case for nonoperative management

Author: Laurent Antunes, Stephan Collinet-Adler, Patrick Boissel, Laurent Bresler, Ahmet Ayav, Laurent Brunaud, and Frédéric Marchal
Subjects: Male, Reoperation, medicine.medical_specialty, medicine.drug_class, medicine.medical_treatment, Perforation (oil well), Comorbidity, Mesenteric Veins, Laparotomy, Hypertension, Portal, Mesenteric Vascular Occlusion, medicine, Humans, Aged, Proportional Hazards Models, Retrospective Studies, Venous Thrombosis, Bowel infarction, Vascular disease, business.industry, Patient Selection, Anticoagulant, Anticoagulants, Retrospective cohort study, Length of Stay, Middle Aged, medicine.disease, Thrombosis, Survival Analysis, Surgery, Causality, Treatment Outcome, Acute Disease, Portal hypertension, Female, Morbidity, business, Tomography, X-Ray Computed, Cardiology and Cardiovascular Medicine
Abstract: Objective: Initial treatment in the management of acute mesenteric vein thrombosis (MVT) is controversial. Some authors have proposed a surgical approach, whereas others have advocated medical therapy (anticoagulation). In this study, we analyzed and compared the results obtained with surgical and medical treatment to determine the best initial management for this disease. Methods: We retrospectively reviewed the records of patients treated for MVT in a secondary care surgical department from January 1987 to December 1999. Before January 1995, our departmental policy was to perform surgery in patients with suspected MVT. Since January 1995, we have preferred a medical approach when achievable. Each patient in this study was assessed for diagnosis, initial management (laparotomy or anticoagulation), morbidity, mortality, duration of hospitalization, the need for secondary operation, portal hypertension, and survival rates. Results: Twenty-six patients were treated, 14 before January 1995 (group 1) and 12 since January 1995 (group 2). Morbidity, mortality, secondary operation, portal hypertension, and 2-year survival rates were 34.6%, 19.2%, 15.3%, 19.2%, and 76.9%, respectively. No statistical difference was observed between the two groups. The mean duration of hospitalization was 51.6 days in group 1 and 23.2 days in group 2 (P
Published: 2001
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41. Is port-site resection necessary in the surgical management of gallbladder cancer?

Author: Laurence Chiche, D Fuks, Gérard Pascal, J.-M. Regimbeau, Gennaro Nuzzo, Olivier Farges, Christian Letoublon, Alexis Laurent, Ahmet Ayav, Michel Rivoire, Emmanuel Boleslawski, Jean-François Gigot, J.R. Delpero, A. Raventos, Mustapha Adham, J.-Y. Mabrut, Philippe Bachellier, Y-P Le Treut, Michel Scotté, Georges Mantion, Daniel Azoulay, Patrick Pessaux, Karim Boudjema, and Francis Navarro
Subjects: Adult, Male, Reoperation, medicine.medical_specialty, Port site, Improved survival, Resection, Long term survival, polycyclic compounds, Medicine, Humans, In patient, Gallbladder cancer, Surgical treatment, Peritoneal Neoplasms, Aged, Retrospective Studies, Aged, 80 and over, Incidental Findings, business.industry, General surgery, General Medicine, biochemical phenomena, metabolism, and nutrition, Middle Aged, medicine.disease, Prognosis, Surgery, Survival Rate, Cholecystectomy, Laparoscopic, Female, Gallbladder Neoplasms, France, Neoplasm Recurrence, Local, business, Follow-Up Studies
Abstract: Gallbladder carcinoma is frequently discovered incidentally on pathologic examination of the specimen after laparoscopic cholecystectomy (LC) performed for presumed "benign" disease. The objective of the present study was to assess the role of excision of port-sites from the initial LC for patients with incidental gallbladder carcinoma (IGBC) in a French registry.Data on patients with IGBC identified after LC between 1998 and 2008 were retrospectively collated in a French multicenter database. Among those patients undergoing re-operation with curative intent, patients with port-site excision (PSE) were compared with patients without PSE and analyzed for differences in recurrence patterns and survival.Among 218 patients with IGBC after LC (68 men, 150 women, median age 64 years), 148 underwent re-resection with curative intent; 54 patients had PSE and 94 did not. Both groups were comparable with regard to demographic data (gender, age70, co-morbidities), surgical procedures (major resection, lymphadenectomy, main bile duct resection) and postoperative morbidity. In the PSE group, depth of tumor invasion was T1b in six, T2 in 24, T3 in 22, and T4 in two; this was not significantly different from patients without PSE (P = 0.69). Port-site metastasis was observed in only one (2%) patient with a T3 tumor who died with peritoneal metastases 15 months after resection. PSE did not improve the overall survival (77%, 58%, 21% at 1, 3, 5 years, respectively) compared to patients with no PSE (78%, 55%, 33% at 1, 3, 5 years, respectively, P = 0.37). Eight percent of patients developed incisional hernia at the port-site after excision.In patients with IGBC, PSE was not associated with improved survival and should not be considered mandatory during definitive surgical treatment.
Published: 2013

42. Major anatomical hepatectomy vs multiple wedge resection for multifocal colorectal liver metastasis: A propensity score match analysis

Author: Francis Navarro, Emilie Gregoire, A. Sa Cunha, Daniel Azoulay, Patrick Pessaux, Ahmet Ayav, Philippe Bachelier, Diane Goéré, Riccardo Memeo, and Rosalyn M. Adam
Subjects: Match analysis, medicine.medical_specialty, Hepatology, business.industry, Anatomical hepatectomy, Propensity score matching, Gastroenterology, medicine, medicine.disease, business, Wedge resection (lung), Metastasis, Surgery
Published: 2016
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43. Pancreatic, endocrine and bariatric surgery: the role of robot-assisted approaches

Author: Ahmet Ayav, N. Reibel, and Laurent Brunaud
Subjects: Laparoscopic surgery, medicine.medical_specialty, medicine.medical_treatment, Splenectomy, Endocrine Surgical Procedures, Bariatric Surgery, Context (language use), Endocrine System Diseases, Pancreatectomy, medicine, Humans, Robotic surgery, Obesity, Laparoscopy, Colectomy, Metabolic Syndrome, medicine.diagnostic_test, business.industry, General surgery, Pancreatic Diseases, General Medicine, Robotics, Surgery, Dissection, Cholecystectomy, business
Abstract: Please cite this article in press as: Brunaud L, et al. Pancreatic, endocrine and bariatric surgery: The role of robot-assisted approaches. Journal of Visceral Surgery (2011), doi:10.1016/j.jviscsurg.2011.05.006 surgery have also been carried by this groundswell. In 2010, surgery on all organs encompassed by the field of surgical endocrinology (pancreas and adrenal, parathyroid, and thyroid glands) is routinely performed by a minimally invasive laparoscopic approach, as is bariatric surgery [1—7]. For most surgeons, however, laparoscopy is still limited to procedures of relatively low (e.g., cholecystectomy or appendectomy) or intermediate (fundoplication, colectomy, splenectomy, or gastric bypass) complexity [8]. The causes of this limitation are mainly related to the technical difficulties encountered with laparoscopy, for which the surgeon uses long instruments without articulated ends, which thus provide only four degrees of freedom. Such instruments modify the performance of the surgical procedure as compared to open surgery, where surgeons can position their bodies and use their shoulders, elbows, wrists, and finger joints for optimal control of the surgical movements. In addition, the physician views laparoscopy on a two-dimensional screen, which has no depth of field; this makes some dissection and suturing procedures more difficult. The camera is not manipulated by the surgeon but by an assistant, which can also affect the quality of the field of vision. Finally, alignment of the visual field with the ends of the instruments is rarely achieved; this problem creates a significant fatigue factor that interferes with the precision of the surgeon’s hand movements [9]. In this context, the development of robotic surgery is part of a process intended to give patients the advantages of laparoscopy while endeavoring to overcome the aforesaid difficulties routinely encountered by laparoscopic surgeons. Robotic surgery consists of ‘‘simply’’ placing a computer interface between patient and surgeon to optimize the feasibility and quality of the surgical procedure. It is therefore actually laparoscopic surgery whose feasibility, indications, and results are ‘‘optimized’’ compared with conventional laparoscopic surgery [10].
Published: 2011

44. Robotic thyroid surgery using a gasless transaxillary approach: cosmetic improvement or improved quality of surgical dissection?

Author: Laurent Bresler, Rasa Zarnegar, Marc Klein, Laurent Brunaud, Adeline Germain, and Ahmet Ayav
Subjects: Total thyroidectomy, medicine.medical_specialty, business.industry, Goiter, medicine.medical_treatment, General surgery, Thyroid, Thyroidectomy, Recurrent nerve, General Medicine, Robotics, Middle Aged, Surgery, Endocrine surgery, Dissection, medicine.anatomical_structure, Axilla, medicine, Recurrent laryngeal nerve, Humans, Female, business, Transaxillary approach
Abstract: In head and neck surgery, minimally invasive approaches have been typically avoided due to concerns about visualization, possible damage to vital structures, and limited availability of effective instrumentation. The incorporation of robotic technology in surgery is now an accepted fact, and because of the complexities of certain laparoscopic procedures, the extended capabilities offered by robotic technology have gained wide acceptance. We report the case of a patient who underwent a robotic total thyroidectomy using a gasless right transaxillary approach. This technique provides a high quality image leading to improved visualization of vital structures during thyroidectomy with the added advantage of avoidance of a neck incision. Several issues regarding this technique remain to be clarified and evaluated in multicenter studies: patient selection, surgeon training and learning curve, postoperative morbidity due to recurrent nerve and parathyroid injury, long term oncologic and cosmetic results. However, we believe that robotic thyroid surgery using a gasless transaxillary approach will advance the frontiers of minimally invasive endocrine surgery.
Published: 2010

45. Totally endoscopic lateral parathyroidectomy: prospective evaluation of 200 patients. ESES 2010 Vienna presentation

Author: Laurent Bresler, Nicole De Talance, Rasa Zarnegar, Laurent Brunaud, Marc Klein, Adeline Germain, Ahmet Ayav, Jean Claude Mayer, and Thibaut Fouquet
Subjects: Parathyroidectomy, Adult, Male, medicine.medical_specialty, Time Factors, Adolescent, medicine.medical_treatment, Risk Assessment, Statistics, Nonparametric, Young Adult, medicine, Humans, Minimally Invasive Surgical Procedures, Prospective Studies, Prospective cohort study, Aged, Aged, 80 and over, Hyperparathyroidism, Pain, Postoperative, Chi-Square Distribution, medicine.diagnostic_test, business.industry, Endoscopy, Length of Stay, Middle Aged, medicine.disease, Dissection, Parathyroid Neoplasms, Treatment Outcome, Cardiothoracic surgery, Surgery, Female, Radiology, France, business, Primary hyperparathyroidism, Abdominal surgery, Follow-Up Studies
Abstract: Several new minimally invasive techniques (mini-open, video-assisted, and endoscopic procedures) for parathyroidectomy have been described. However, totally endoscopic lateral approach parathyroidectomy (Henry technique) is not routinely performed. This is a prospective study of 200 consecutive patients that underwent totally endoscopic lateral parathyroidectomy. Two hundred of 387 patients (52%) with primary hyperparathyroidism were included. Fifty-six patients (28%) were converted to open parathyroidectomy. Causes for conversion were lack of intraoperative localization (11%), difficult dissection (10%), bleeding (4%), failure of normalization of IOPTH results (2%), and other causes (1%). Gland localization (areas 1 to 2 versus area 3) and CaPTHus score (
Published: 2010

46. Bloodless liver resection using radiofrequency energy

Author: Nagy A. Habib, Long R. Jiao, and Ahmet Ayav
Subjects: Liver surgery, Male, medicine.medical_specialty, Treatment outcome, Blood Loss, Surgical, Intraoperative bleeding, Resection, Postoperative Complications, Blood loss, Parenchyma, Medicine, Hepatectomy, Humans, Blood Transfusion, Prospective Studies, Aged, business.industry, fungi, Liver Neoplasms, Gastroenterology, food and beverages, Length of Stay, Middle Aged, Hemostasis, Surgical, Surgery, Survival Rate, Treatment Outcome, Hemostasis, Catheter Ablation, Female, business, Radiofrequency energy
Abstract: Background: Liver surgery carries the risk of intraoperative bleeding. In order to avoid bleeding, transection of the liver can be performed after coagulating the parenchyma by using monoplolar or bipolar radiofrequency energy. Methods: 236 consecutive patients underwent liver resection with the radiofrequency-assisted technique using either a monopolar or a bipolar device. Data were collected prospectively to assess the outcome including, intraoperative blood loss, blood transfusion requirement, morbidity and mortality rates. Results: There were 41 major hepatectomies and 195 minor resections. Overall mean intraoperative blood loss was 157 ± 240 ml, while mean blood loss during liver transection was 90 ± 105 ml. 10 patients (4%) received blood transfusion. 50 patients (21%) developed postoperative complications including 5 bile leaks (2%). The mortality rate was 2.1%. No patient was reoperated for postoperative haemorrhage or bile leak. The mean postoperative stay was 11 ± 10 days. Conclusion: The radiofrequency-assisted liver resection technique offers hepatobiliary surgeons an additional method for performing liver resections with minimal blood loss, low transfusion requirement, and low morbidity and mortality rates.
Published: 2007

47. Mild neonatal hypoxia exacerbates the effects of vitamin-deficient diet on homocysteine metabolism in rats

Author: Jean-Pierre Bronowicki, Emmanuelle Nédélec, Jean-Marc Alberto, Sébastien Blaise, Jean-Louis Guéant, Grégory Pourié, Ahmet Ayav, Jean-Luc Daval, Centre des Sciences du Goût et de l'Alimentation [Dijon] ( CSGA ), Institut National de la Recherche Agronomique ( INRA ) -Université de Bourgogne ( UB ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Centre National de la Recherche Scientifique ( CNRS ), Service d'Hépato-gastro-entérologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Nutrition-Génétique et Exposition aux Risques Environnementaux ( NGERE ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Lorraine ( UL ), Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre des Sciences du Goût et de l'Alimentation [Dijon] (CSGA), Institut National de la Recherche Agronomique (INRA)-Université de Bourgogne (UB)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Centre National de la Recherche Scientifique (CNRS), and Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: MESH : RNA, Messenger, Homocysteine, [ SDV.AEN ] Life Sciences [q-bio]/Food and Nutrition, Messenger, Wistar, MESH: Maternal-Fetal Exchange, MESH: Anoxia, Transsulfuration, MESH: Base Sequence, 5-Methyltetrahydrofolate-Homocysteine S-Methyltransferase, MESH: Avitaminosis, MESH: Animals, Newborn, chemistry.chemical_compound, 0302 clinical medicine, MESH: Pregnancy, Anoxia, Pregnancy, MESH : Homocysteine, Choline, MESH: Animals, MESH : Female, Hypoxia, Maternal-Fetal Exchange, 2. Zero hunger, 0303 health sciences, MESH : 5-Methyltetrahydrofolate-Homocysteine S-Methyltransferase, MESH : Rats, MESH : Animals, Newborn, MESH: Methylenetetrahydrofolate Reductase (NADPH2), 3. Good health, MESH: Cystathionine beta-Synthase, MESH: Pregnancy Complications, MESH: 5-Methyltetrahydrofolate-Homocysteine S-Methyltransferase, Female, medicine.symptom, Vitamin, Hyperhomocysteinemia, medicine.medical_specialty, MESH: Rats, MESH : Anoxia, Offspring, MESH : Methylenetetrahydrofolate Reductase (NADPH2), MESH : Cystathionine beta-Synthase, Cystathionine beta-Synthase, Biology, MESH : Rats, Wistar, MESH : Pregnancy Complications, 03 medical and health sciences, Internal medicine, medicine, Animals, RNA, Messenger, MESH: Homocysteine, Rats, Wistar, Methylenetetrahydrofolate Reductase (NADPH2), 030304 developmental biology, MESH: RNA, Messenger, Base Sequence, MESH : Avitaminosis, MESH : Maternal-Fetal Exchange, Avitaminosis, MESH: Rats, Wistar, Hypoxia (medical), medicine.disease, Newborn, Cystathionine beta synthase, Rats, Pregnancy Complications, MESH : Pregnancy, Endocrinology, chemistry, Animals, Newborn, Pediatrics, Perinatology and Child Health, biology.protein, RNA, MESH : Base Sequence, MESH : Animals, MESH: Female, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition, 030217 neurology & neurosurgery
Abstract: International audience; Elevated plasma homocysteine has been linked to pregnancy complications and developmental diseases. Whereas hyperhomocysteinemia is frequently observed in populations at risk of malnutrition, hypoxia may alter the remethylation of homocysteine in hepatocytes. We aimed to investigate the combined influences of early deficiency in nutritional determinants of hyperhomocysteinemia and of neonatal hypoxia on homocysteine metabolic pathways in developing rats. Dams were fed a standard diet or a diet deficient in vitamins B12, B2, folate, month, and choline from 1 mo before pregnancy until weaning of the offspring. The pups were divided into four treatment groups corresponding to "no hypoxia/standard diet," "hypoxia (100% N2 for 5 min at postnatal d 1)/standard diet," "no hypoxia/deficiency," and "hypoxia/deficiency," and homocysteine metabolism was analyzed in their liver at postnatal d 21. Hypoxia increased plasma homocysteine in deficient pups (21.2 +/- 1.6 versus 13.3 +/- 1.2 microM, p < 0.05). Whereas mRNA levels of cystathionine beta-synthase remained unaltered, deficiency reduced the enzyme activity (48.7 +/- 2.9 versus 83.6 +/- 6.3 nmol/h/mg, p < 0.01), an effect potentiated by hypoxia (29.4 +/- 4.7 nmol/h/mg, p < 0.05). The decrease in methylene-tetrahydrofolate reductase activity measured in deficient pups was attenuated by hypoxia (p < 0.05), and methionine-adenosyltransferase activity was slightly reduced only in the "hypoxia/deficiency" group (p < 0.05). Finally, hypoxia enhanced the deficiency-induced drop of the S-adenosylmethionine/S-adenosylhomocysteine ratio, which is known to influence DNA methylation and gene expression. In conclusion, neonatal hypoxia may increase homocysteinemia mainly by decreasing homocysteine transsulfuration in developing rats under methyl-deficient regimen. It could therefore potentiate the well-known adverse effects of hyperhomocysteinemia.
Published: 2005
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48. Liver Resection With a New Multiprobe Bipolar Radiofrequency Device

Author: Philippe Bachellier, Ricardo Pellicci, Long R. Jiao, Miroslav Milicevic, Joanna Nicholls, Nagy A. Habib, Ahmet Ayav, and Robert Julian Dickinson
Subjects: Male, medicine.medical_specialty, Time Factors, Blood transfusion, medicine.medical_treatment, Blood Loss, Surgical, Catheter ablation, Postoperative Complications, medicine, Hepatectomy, Humans, Prospective Studies, Prospective cohort study, Square Centimeter, business.industry, Mortality rate, Liver Neoplasms, Cancer, Equipment Design, Length of Stay, Middle Aged, Intraoperative Hemorrhage, medicine.disease, Surgery, Treatment Outcome, Anesthesia, Catheter Ablation, Female, business
Abstract: Hypothesis Liver resection can be associated with marked blood loss. A novel multiprobe bipolar radiofrequency device (Habib 4X; RITA Medical Systems Inc, Fremont, California) has been developed to assist in liver resection and to reduce intraoperative blood loss. Design Prospective study. Setting Tertiary referral unit. Patients Sixty-two patients requiring liver resection between November 1, 2004, and February 28, 2006, primarily for metastatic cancer. Intervention Liver resection with the radiofrequency device. Main Outcome Measures Intraoperative blood loss, liver parenchyma transection time, and complications. Results There were 51 minor and 11 major hepatectomies. Mean (SD) transection time was 39 (27) seconds per square centimeter. Mean (SD) blood loss was 4.8 (5.6) mL per square centimeter. No patient required hepatic inflow occlusion. One patient required blood transfusion. There were no deaths, and the morbidity rate was 18%. Mean (SD) hospital stay was 8 (3) days. Conclusions This new bipolar radiofrequency device allows minor and major hepatectomies to be performed with minimal blood loss, low blood transfusion requirement, and reduced mortality and morbidity rates.
Published: 2008
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49. Is intraoperative ultrasound still useful for the detection of colorectal cancer liver metastases?

Author: Adeline Germain, Valérie Croise-Laurent, Ahmet Ayav, Laurent Brunaud, Guillaume Hoch, and Laurent Bresler
Subjects: Male, medicine.medical_specialty, Time Factors, Colorectal cancer, medicine.medical_treatment, Intraoperative ultrasonography, Intraoperative ultrasound, Time-to-Treatment, Tertiary Care Centers, Predictive Value of Tests, medicine, Hepatectomy, Humans, Aged, Retrospective Studies, Ultrasonography, Intraoperative Care, medicine.diagnostic_test, Hepatology, business.industry, Liver Neoplasms, Gastroenterology, Magnetic resonance imaging, Retrospective cohort study, Original Articles, Middle Aged, medicine.disease, Magnetic Resonance Imaging, Female, Radiology, France, business, Colorectal Neoplasms, Tomography, X-Ray Computed, Preoperative imaging
Abstract: BackgroundDebate on the optimal mode of preoperative imaging in the management of colorectal liver metastases (CRLM) is ongoing and, despite its longstanding use, the precise role of intraoperative ultrasonography (IOUS) is not well established. This study evaluates the impact of IOUS in the era of high-quality, cross-sectional imaging techniques.MethodsAll patients who underwent liver resection for CRLM in a tertiary care referral centre from January 2006 to December 2013 were included. All patients were submitted to computed tomography (CT) and/or liver magnetic resonance imaging (MRI) before surgery. Intraoperative US was performed mainly to detect previously non-diagnosed tumours that would change the surgical strategy.ResultsA total of 225 liver resections were performed. Liver MRI and CT scans were available for 202 patients (89.8%) and 225 patients (100%), respectively. Radiological reports recorded 632 liver tumours in 219 patients (i.e. 2.9 lesions per patient). The median time between preoperative liver MRI and surgical resection was 36 days. Intraoperative inspection, palpation and US found 20 additional lesions in 18 patients (8.0%), in three of whom lesions were diagnosed only on IOUS (1.4%). Overall, only 12 of the 20 lesions were malignant.ConclusionsAlthough CT and liver MRI are commonly used, IOUS alone allows the discovery of a few additional lesions that result in a change of surgical strategy in 1.4% of cases.
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50. Court-circuit gastrique totalement robotique (avec vidéo)

Author: Laurent Bresler, Adeline Germain, Ahmet Ayav, N. Reibel, Laurent Brunaud, and G. Fantola
Subjects: Chirurgie robotique, Gastric bypass, business.industry, Nouvelles technologies, Medicine, Surgery, Laparoscopy, Robotic surgery, Robotics, business, Laparoscopie, Bypass gastrique, New technologies
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