3 results on '"Julia Villeret"'
Search Results
2. Treatment failure following excision therapy of CIN: the impact of ă direct colposcopic vision during procedure
- Author
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Julien Mancini, Xavier Carcopino, Mellie Heineman, Aubert Agostini, Julia Villeret, Gilles Houvenaeghel, Léon Boubli, Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD), Institut de Recherche pour le Développement (IRD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Biostatistique et technologies de l'information et de la communication (BioSTIC) - [Hôpital de la Timone - APHM] (BiosTIC ), Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Département de chirurgie Paoli Calmette (Paoli Calmette), Aix-Marseille Université - Faculté de médecine (AMU MED), Aix Marseille Université (AMU), Service de gynécologie-obstétrique [Hôpital Nord - APHM], Hôpital Nord [CHU - APHM]-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), Institut méditerranéen de biodiversité et d'écologie marine et continentale (IMBE), Avignon Université (AU)-Aix Marseille Université (AMU)-Institut de recherche pour le développement [IRD] : UMR237-Centre National de la Recherche Scientifique (CNRS), Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], Centre National de la Recherche Scientifique (CNRS)-Institut de recherche pour le développement [IRD] : UMR237-Aix Marseille Université (AMU)-Avignon Université (AU), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Auquier, Pascal
- Subjects
Adult ,Risk ,medicine.medical_specialty ,[SDV.MHEP.PSM] Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,Uterine Cervical Neoplasms ,[SHS.PSY]Humanities and Social Sciences/Psychology ,Cervix Uteri ,Surgical specimen ,Cervical intraepithelial neoplasia ,Treatment failure ,[SHS.PSY] Humanities and Social Sciences/Psychology ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Histological diagnosis ,Clinical endpoint ,medicine ,Humans ,Treatment Failure ,030212 general & internal medicine ,[SHS.ECO] Humanities and Social Sciences/Economics and Finance ,Colposcopy ,030219 obstetrics & reproductive medicine ,medicine.diagnostic_test ,business.industry ,Obstetrics and Gynecology ,General Medicine ,During procedure ,Middle Aged ,Uterine Cervical Dysplasia ,medicine.disease ,[SHS.ECO]Humanities and Social Sciences/Economics and Finance ,Quality ,3. Good health ,Surgery ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,[SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,Female ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,business - Abstract
International audience; To assess whether the use of direct colposcopic vision during excision ă therapy of cervical intraepithelial neoplasia (CIN) has an impact on the ă risk of treatment failure. ă Data from 285 patients who had had excision therapy with proven CIN at ă specimen histological analysis were reviewed. Primary endpoint was the ă occurrence of post-treatment failure defined by the histological ă diagnosis of CIN 2-3 during follow-up. Data were analysed according to ă the use of colposcopy at the time of initial therapy of CIN. ă The use of direct colposcopic vision (DCV) resulted in a significant ă reduction in the mean height (p = 0.008) and diameter (p < 0.001) of the ă excised specimen. Patients' median follow-up was 28.4 (+/- 1.3) months. ă A total of 43 (15.2 %) patients were diagnosed with treatment failure. ă Compared to excisions performed without any use of colposcopy, DCV was ă not found to have any significant impact on the risk of treatment ă failure (HR: 0.58; 95 % CI 0.16-2.13, p = 0.412), neither when compared ă to excisions performed immediately after colposcopy (HR: 0.91; 95 % CI ă 0.47-1.79; p = 0.794). The only factors found to have a significant ă impact on the risk of treatment failure was the identification of clear ă margins (HR: 0.36; 95 %CI 0.19-0.69; p = 0.002) and the diameter of the ă surgical specimen (HR: 0.94; 95 %CI 0.89-0.99; p = 0.040). ă Although the use of DCV during excision therapy of CIN was associated ă with a significant reduction in the dimensions of the excised cervical ă specimen, it did not result in a significant change in the risk of ă treatment failure.
- Published
- 2016
3. Benefits of Direct Colposcopic Vision for Optimal LLETZ Procedure: A Prospective Multicenter Study
- Author
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Didier Riethmuller, Julien Mancini, Claire Caradec, Jean-Luc Brun, Xavier Carcopino, Sébastien Henno, Vincent Lavoué, Lise Preaubert, Julien Chevreau, Anne Mendel, Aubert Agostini, Gery Lamblin, Adelaide Jarniat, Julia Villeret, Jean Gondry, Angélique Bryand, Serge Douvier, Anthony Atallah, Jean-Jacques Baldauf, Hajanarina Rakotomahenina, Hôpital Nord [CHU - APHM], Transporteurs membranaires, chimioresistance et drug-design ( TMCD2 ), Aix Marseille Université ( AMU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale ( SESSTIM ), Institut de Recherche pour le Développement ( IRD ) -Aix Marseille Université ( AMU ) -ORS PACA-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Institut Paoli Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Biostatistique et technologies de l'information et de la communication (BioSTIC) - [Hôpital de la Timone - APHM] ( BiosTIC ), Institut de Recherche pour le Développement ( IRD ) -Aix Marseille Université ( AMU ) -ORS PACA-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut de Recherche pour le Développement ( IRD ) -Aix Marseille Université ( AMU ) -ORS PACA-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Aix Marseille Université ( AMU ) -Assistance Publique - Hôpitaux de Marseille ( APHM ) - Hôpital de la Timone [CHU - APHM] ( TIMONE ), Hôpital Femme Mère Enfant [CHU - HCL] ( HFME ), Hospices Civils de Lyon ( HCL ), Université Nice Sophia Antipolis - Faculté de Médecine ( UNS UFR Médecine ), Université Nice Sophia Antipolis ( UNS ), Université Côte d'Azur ( UCA ) -Université Côte d'Azur ( UCA ), Service de gynécologie–obstétrique, CHU Strasbourg-Hôpital de Hautepierre [Strasbourg], CHU Pontchaillou [Rennes], UFR des Sciences de Santé (Université de Bourgogne), Université de Bourgogne ( UB ), Service de Gynécologie Obstétrique, Médecine Foetale et Stérilité Conjugale - Chirurgie Gynécologie et Oncologique [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Service de gynécologie, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques, department of pathology, university hospital, parakou, Service de gynécologie-obstétrique [Hôpital Nord - APHM], Aix Marseille Université ( AMU ) -Assistance Publique - Hôpitaux de Marseille ( APHM ) - Hôpital Nord [CHU - APHM], Institut méditerranéen de biodiversité et d'écologie marine et continentale ( IMBE ), Université d'Avignon et des Pays de Vaucluse ( UAPV ) -Aix Marseille Université ( AMU ) -Institut de recherche pour le développement [IRD] : UMR237-Centre National de la Recherche Scientifique ( CNRS ), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Paoli-Calmettes, Biostatistique et technologies de l'information et de la communication (BioSTIC) - [Hôpital de la Timone - APHM] (BiosTIC ), Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Hôpital Femme Mère Enfant [CHU - HCL] (HFME), Hospices Civils de Lyon (HCL), Service de Gynécologie et Obstétrique [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes]-Hôpital Sud, Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Hôpital Saint-Jacques, Transporteurs membranaires, chimioresistance et drug-design (TMCD2), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Recherche pour le Développement (IRD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Université Nice Sophia Antipolis - Faculté de Médecine (UNS UFR Médecine), Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA), Université de Bourgogne (UB), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, Hôpital Nord [CHU - APHM]-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), Institut méditerranéen de biodiversité et d'écologie marine et continentale (IMBE), Avignon Université (AU)-Aix Marseille Université (AMU)-Institut de recherche pour le développement [IRD] : UMR237-Centre National de la Recherche Scientifique (CNRS), Université Nice Sophia Antipolis (1965 - 2019) (UNS), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM), and Auquier, Pascal
- Subjects
Adult ,medicine.medical_specialty ,Pathology ,Electrosurgery ,medicine.medical_treatment ,[SDV]Life Sciences [q-bio] ,[ SDV.MHEP.PSM ] Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,[SDV.MHEP.PSM] Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,[SHS.PSY]Humanities and Social Sciences/Psychology ,Cervical intraepithelial neoplasia ,[SHS.PSY] Humanities and Social Sciences/Psychology ,03 medical and health sciences ,[ SHS.PSY ] Humanities and Social Sciences/Psychology ,0302 clinical medicine ,Medicine ,[ SHS.ECO ] Humanities and Social Sciences/Economies and finances ,Humans ,030212 general & internal medicine ,Prospective Studies ,[SHS.ECO] Humanities and Social Sciences/Economics and Finance ,Prospective cohort study ,Cervix ,Fixation (histology) ,Colposcopy ,Intraepithelial neoplasia ,030219 obstetrics & reproductive medicine ,medicine.diagnostic_test ,business.industry ,Obstetrics and Gynecology ,[ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie ,General Medicine ,[SHS.ECO]Humanities and Social Sciences/Economics and Finance ,medicine.disease ,Uterine Cervical Dysplasia ,3. Good health ,Surgery ,medicine.anatomical_structure ,Treatment Outcome ,Multicenter study ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,[SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health ,Quality of Life ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Female ,business - Abstract
International audience; Objective The aim of the study was to assess whether direct colposcopic ă vision (DCV) of the cervix during large loop excision of the ă transformation zone (LLETZ) is associated with a decrease in the volume ă and dimensions of specimens or affects margin status at histology. ă Materials and Methods A prospective multicenter observational study of ă 216 women who underwent LLETZ for grades 2 and 3 cervical ă intraepithelial neoplasia was conducted. The volume and dimensions ă (circumference, length, and thickness) of the surgical specimens were ă measured before fixation. Data were compared according to the use of ă colposcopy during LLETZ. The following 3 groups were considered: LLETZ ă performed without colposcopy (n = 91), LLETZ performed immediately after ă colposcopy (n = 51), and LLETZ performed under DCV (n = 74). ă Results Patient characteristics were comparable with regard to age, ă parity, history of excision, indication of the procedure, and the size ă of the cervix. We found a significant decrease in all dimensions of the ă specimens obtained under DCV (p < .001). Margin status was not affected. ă After adjusting for confounders, the mean volumes were significantly ă lower in the DCV group (adjusted mean difference = -0.66 mL; 95% CI = ă -1.17 to -0.14). The probability that negative margins would be achieved ă together with the attainment of a volume less than 5 mL and a thickness ă less than 10 mm was the highest in the DCV group (adjusted OR = 2.80; ă 95% CI = 1.13 to 6.90). ă Conclusions Direct colposcopic vision is associated with a significant ă decrease in the volume and in all dimensions of LLETZ specimens with no ă compromise in the margin status.
- Published
- 2015
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