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1. La tumeur de Buschke Lowenstein chez la femme enceinte

Author

S. Valmary-Degano, Pascale Hoffmann, C. Thong Vanh, A. Buisson, F. Istasse, T. Michy, and Didier Riethmuller

Subjects
Gynecology, medicine.medical_specialty, Pregnancy, Fetus, Giant condyloma acuminatum, Sexual transmission, business.industry, Obstetrics and Gynecology, Disease, medicine.disease, Sex education, Reproductive Medicine, medicine, Clinical case, business, After treatment
Abstract

Buschke Lownestein's tumour is a giant acuminate condyloma characterised by its degenerative potential, its invasive nature and its recurrence after treatment. It is a rare condition, transmitted mainly by sexual transmission and induced by to the human papillomavirus (HPV). The discussion will be illustrated by a clinical case The treatment is still under discussion but surgery seems to be the best option. Management during pregnancy is more complex since it must take into account the mother and her fetus. The delivery route is still debated. The post-treatment evolution was satisfactory and without recurrence until the delivery which, due to the antecedent of 3 caesarean sections, was carried out by cesarean section. HPV vaccination, sex education and early treatment of condyloma lesions should prevent and in any case improve the prognosis of this disease.

Published
2022
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2. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for pseudomyxoma peritonei of appendicular and extra-appendicular origin

Author

J-B Delhorme, F Severac, G Averous, O Glehen, G Passot, N Bakrin, F Marchal, M Pocard, R Lo Dico, C Eveno, S Carrere, O Sgarbura, F Quenet, G Ferron, D Goéré, C Brigand, J Abba, K Abboud, M Alyami, C Arvieux, G Balagué, V Barrau, H Ben Rejeb, J-M Bereder, I Berton-Rigaud, F Bibeau, I Bonnefoy, D Bouzard, I Bricault, S Carrère, C de Chaisemartin, M Chassang, A Chevallier, T Courvoisier, P Dartigues, A Dohan, J Dubreuil, F Dumont, M Faruch-Bilfeld, J Fontaine, L Fournier, J Gagniere, D Geffroy, L Ghouti, F-N Gilly, L Gladieff, A Guibal, J-M Guilloit, F Guyon, B Heyd, C Hoeffel, C Hordonneau, S Isaac, P Jourdan-Enfer, R Kaci, R Kianmanesh, C Labbé-Devilliers, J Lacroix, B Lelong, A Leroux-Broussier, Y Lherm, G Lorimier, C Malhaire, P Mariani, E Mathiotte, P Meeus, E Mery, S Msika, C Nadeau, P Ortega-Deballon, O Pellet, P Peyrat, D Pezet, N Pirro, F Poizat, J Porcheron, A Poulet, P Rat, P Rousselot, P Rousset, H Senellart, M Serrano, V Servois, O Sgabura, A Skanjeti, M Svrcek, R Tetreau, E Thibaudeau, Y Touchefeu, J-J Tuech, S Valmary-Degano, D Vaudoyer, S Velasco, V Verriele-Beurrier, L Villeneuve, R Wernert, F Zinzindohoue, CHU Strasbourg, Les Hôptaux universitaires de Strasbourg (HUS), Department of Oncologic Surgery, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Department of oncologic surgery, Laboratoire de recherche en Hydrodynamique, Énergétique et Environnement Atmosphérique (LHEEA), École Centrale de Nantes (ECN)-Centre National de la Recherche Scientifique (CNRS), 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), CRLC Val d'Aurelle-Paul Lamarque, CRLCC Val d'Aurelle - Paul Lamarque, Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Department of Surgical Oncology Institut Claudius Regaud, Department of Surgical Oncology, Université Paris-Sud - Paris 11 (UP11), and Département de chirurgie digestive

Subjects
Male, medicine.medical_specialty, [SDV]Life Sciences [q-bio], Gastroenterology, Disease-Free Survival, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Pseudomyxoma peritonei, Survival rate, Peritoneal Neoplasms, Survival analysis, Urachus, Retrospective Studies, business.industry, Retrospective cohort study, Cytoreduction Surgical Procedures, Hyperthermia, Induced, Middle Aged, Prognosis, Pseudomyxoma Peritonei, medicine.disease, Debulking, Survival Analysis, 3. Good health, medicine.anatomical_structure, Appendiceal Neoplasms, 030220 oncology & carcinogenesis, Peritoneal Cancer Index, Female, 030211 gastroenterology & hepatology, Surgery, Hyperthermic intraperitoneal chemotherapy, business
Abstract

BackgroundThe prognostic value of the primary neoplasm responsible for pseudomyxoma peritonei (PMP) remains poorly studied. The aim of this study was to determine the prognosis for patients with extra-appendicular PMP (EA-PMP) treated optimally with complete cytoreductive surgery (CCRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).MethodsAll patients treated for PMP with CCRS and HIPEC between 1994 and 2016 were selected retrospectively from a French multicentre database. Patients with EA-PMP had pathologically confirmed non-neoplastic appendices and were matched in a 1 : 4 ratio with patients treated for appendicular PMP (A-PMP), based on a propensity score.ResultsSome 726 patients were identified, of which 61 (EA-PMP group) were matched with 244 patients (A-PMP group). The origins of primary tumours in the EA-PMP group included the ovary (45 patients), colon (4), urachus (4), small bowel (1), pancreas (1) and unknown (6). The median peritoneal carcinomatosis index was comparable in EA-PMP and A-PMP groups (15·5 versus 18 respectively; P = 0·315). In-hospital mortality (3 versus 2·9 per cent; P = 1·000) and major morbidity 26 versus 25·0 per cent; P = 0·869) were also similar between the two groups. Median follow-up was 66·9 months. The 5-year overall survival rate was 87·8 (95 per cent c.i. 83·2 to 92·5) per cent in the A-PMP group and 87 (77 to 96) per cent in the EA-PMP group. The 5-year disease-free survival rate was 66·0 (58·7 to 73·4) per cent and 70 (53 to 83) per cent respectively.ConclusionOverall and disease-free survival following treatment with CCRS and HIPEC is similar in patients with pseudomyxoma peritonei of appendicular or extra-appendicular origin.

Published
2018
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3. Immunohistochemical evaluation of two antibodies against PD-L1 and prognostic significance of PD-L1 expression in epithelioid peritoneal malignant mesothelioma: A RENAPE study

Author

S. Velasco, M. Chassang, Laurence Gladieff, Jean-Marc Guilloit, Frédéric Dumont, Thomas Courvoisier, Magali Svrcek, E. Mery, Jack Porcheron, Pablo Ortega-Deballon, V. Barrau, M. Serrano, Pierre Meeus, H. Senellart, Cécile Brigand, R. Kianmanesh, I. Bricault, M. Capovilla, O. Pellet, I. Bonnefoy, B. Lelong, A. Poulet, A. Chevallier, Delphine Vaudoyer, Frédéric Guyon, Julien Dubreuil, G. Ferron, S. Valmary-Degano, D. Geffroy, Franck Zinzindohoué, François-Noël Gilly, Laure Fournier, G. Lang Averous, Jean-Jacques Tuech, Catherine Arvieux, Karine Abboud, P. Rousselot, Y. Touchefeu, Guillaume Passot, R. Tetreau, Christine Hoeffel, Peggy Dartigues, Julio Abba, A. Dohan, Frédéric Bibeau, P. Peyrat, Naoual Bakrin, O. Sgabura, J.M. Bereder, Bruno Heyd, J. Lacroix, Frédéric Marchal, Johan Gagnière, Clarisse Eveno, J. Hommell-Fontaine, P. Rat, P. Jourdan-Enfer, C. Labbé-Devilliers, C. de Chaisemartin, Prudence Colpart, L. M'Hamdi, S. Carrere, Denis Pezet, D. Bouzard, R. Lo Dico, Marc Pocard, Gérard Lorimier, A. Leroux-Broussier, Cédric Nadeau, V. Verriele-Beurrier, François Quenet, Caroline Malhaire, S. Isaac, Nicolas Pirro, C. Hordonneau, Olivier Glehen, Clarisse Dromain, R. Kaci, L. Ghouti, E. Mathiotte, Vincent Servois, Mohammad Alyami, Pascale Mariani, H. Ben Rejeb, A. Guibal, S. Msika, Laurent Villeneuve, Romuald Wernert, F. Monnien, Diane Goéré, Emilie Thibaudeau, M. H. Laverrière, G. Balague, F. Poizat, M. Faruch-Bilfeld, Andrea Skanjeti, I. Berton-Rigaud, Yoann Lherm, Université Bourgogne Franche-Comté [COMUE] (UBFC), Pathology Department, CHU Besançon, Besançon, Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon), Hospices Civils de Lyon, Departement de Neurologie (HCL), Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital de Hautepierre [Strasbourg], Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU), Centre Hospitalier Universitaire [Grenoble] (CHU), Centre Paul Papin(Angers), Institut Bergonié [Bordeaux], UNICANCER, Department of Oncologic Surgery, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Departement of pathology, CHU Pontchaillou [Rennes], Service central de radiologie et d'imagerie médicale, CHU Grenoble-Hôpital Michallon, Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-IMAG-GMCAO), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Département de chirurgie digestive, CHU Strasbourg, CRLC Val d'Aurelle-Paul Lamarque, CRLCC Val d'Aurelle - Paul Lamarque, Département de chirurgie digestive [Institut Paoli Calmettes], Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Department of Radiology, Université Paris-Sud - Paris 11 (UP11), Laboratoire de Mécanique des Systèmes et des Procédés (LMSP), Université d'Orléans (UO)-Centre National de la Recherche Scientifique (CNRS), 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), Department of Surgical Oncology Institut Claudius Regaud, Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Ciblage thérapeutique en Oncologie (EA3738), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Department of Surgical Oncology, Dept. of Nucl. Med., Jean Minjoz Univ. Hosp., Besancon, Centre Hospitalier Universitaire de Reims (CHU Reims), CRLCC René Gauducheau, Service de chirurgie thoracique cardiaque et vasculaire [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Center Paul Papin, Laboratoire de physique de la matière (LPM), 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)-Centre National de la Recherche Scientifique (CNRS), Laboratoire de recherche en Hydrodynamique, Énergétique et Environnement Atmosphérique (LHEEA), École Centrale de Nantes (ECN)-Centre National de la Recherche Scientifique (CNRS), Institut Curie [Paris], Université de Lyon, Hôpital Louis Mourier - AP-HP [Colombes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Chirurgie Digestive, Cancérologique, Générale, Endocrinienne et Urgences (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Department of oncologic surgery, Department of nuclear Imaging, CHU Clermont-Ferrand, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Service d'hépato-gastro-entérologie, CHU Saint-Etienne, Equipe Avenir. University of Burgundy, Univers, Transport, Interfaces, Nanostructures, Atmosphère et environnement, Molécules (UMR 6213) (UTINAM), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS)-Institut national des sciences de l'Univers (INSU - CNRS), Service de Pathologie [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-Sorbonne Université, Service d'Oncologie Médicale Thoracique et Digestive [CHU Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Service de Médecine nucléaire, biophysique, isotopes [CHRU Besançon], Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Institut national des sciences de l'Univers (INSU - CNRS)-Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), and Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)

Subjects
Male, Mesothelioma, PD-L1, Pathology, medicine.medical_specialty, Survival, Antibodies, Neoplasm, [SDV]Life Sciences [q-bio], B7-H1 Antigen, Epithelioid subtype, 03 medical and health sciences, 0302 clinical medicine, Immune system, Biomarkers, Tumor, medicine, Humans, Lymphocytes, 030212 general & internal medicine, Peritoneal Neoplasms, Retrospective Studies, Immunity, Cellular, biology, business.industry, General Medicine, Middle Aged, Prognosis, medicine.disease, Immunohistochemistry, Peritoneal Malignant Mesothelioma, 3. Good health, Survival Rate, Oncology, 030220 oncology & carcinogenesis, biology.protein, Peritoneal mesothelioma, Biomarker (medicine), Female, Surgery, Hyperthermic intraperitoneal chemotherapy, France, Antibody, business, Follow-Up Studies
Abstract

Background Epithelioid peritoneal malignant mesothelioma (EPMM) is the most common subtype of this aggressive tumor. We compared two antibodies against PD-L1, a recent theranostic biomarker, and evaluated the prognostic value of PD-L1 expression by mesothelial and immune cells in EPMM. Methods Immunohistochemistry was performed on 45 EPMM. Clinical and pathological data were extracted from the RENAPE database. Using E1L3N and SP142 clones, inter-observer agreement, PD-L1 expression by mesothelial and immune cells and inter-antibody agreement were evaluated. The prognostic relevance of PD-L1 expression was evaluated in 39 EPMM by univariate and multivariate analysis of overall survival (OS) and progression-free survival (PFS). Results Inter-observer agreement on E1L3N immunostaining was moderate for mesothelial and immune cells, and fair for mesothelial and poor for immune cells using SP142. Using E1L3N, 31.1% of mesothelial and 15.6% of immune cells expressed PD-L1, and 22.2% of mesothelial and 26.7% of immune cells using SP142. Inter-antibody agreement was moderate. In most positive cases, 1–5% of tumor cells were positive. Using E1L3N, PD-L1 expression by lymphocytes was associated with better OS and PFS by both univariate and multivariate analysis. Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy predicted better prognosis than other treatments. Solid subtype was an independent prognostic factor for worse OS. Conclusion E1L3N appeared easier to use than SP142 to evaluate PD-L1 expression. A minority of EPMM expressed PD-L1, and only a few cells were positive. PD-L1 expression by immune cells evaluated with E1L3N was an independent prognostic factor in EPMM.

Published
2017
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4. Transfer of the lateral antebrachial cutaneous nerve to the dorsal branch of the ulnar nerve without nerve graft in case of lower brachial plexus injuries: Anatomical and feasibility study

Author

U. Assouline, B. Constantinou, Laurent Obert, Julien Pauchot, S. Valmary-Degano, and D. Lepage

Subjects
Male, medicine.medical_specialty, Context (language use), Sural nerve, 03 medical and health sciences, 0302 clinical medicine, Cadaver, Humans, Medicine, Brachial Plexus, Orthopedics and Sports Medicine, Brachial Plexus Neuropathies, Ulnar nerve, Nerve Transfer, 030222 orthopedics, business.industry, Magnetic resonance neurography, Rehabilitation, Ulna, Anatomy, medicine.disease, Surgery, medicine.anatomical_structure, Brachial plexus injury, Feasibility Studies, Female, business, Brachial plexus, 030217 neurology & neurosurgery
Abstract

In the context of lower (C8–T1) brachial plexus injury, transfer of the lateral antebrachial cutaneous nerve (LABCN) to the dorsal branch of the ulnar nerve (DBUN) with an interposed sural nerve graft has been proposed to restore sensitivity on the ulnar side of the hand. The purpose of this study was to assess the feasibility of performing this transfer directly – without interposition of a nerve graft – by intraneural dissection of the DBUN. An anatomical study was performed with 20 upper limbs from adult human cadavers. The LABCN and the DBUN were dissected. The LABCN emerged from the lateral side of the biceps brachii muscle at an average of 2.6 ± 0.4 cm from the interepicondylar line and was 13.5 ± 2.6 cm long, on average. The DBUN arose from the ulnar nerve 8.2 ± 1.6 cm from the styloid process of the ulna. The maximum length of DBUN intraneural dissection relative to the ulnar nerve was 7.5 ± 2.1 cm, on average. The LABCN could be transferred to the DBUN in a tension-free manner with end-to-end suturing. Intraneural dissection of the DBUN allows LABCN nerve transfer without interposition of a graft.

Published
2017
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5. T1 Vertebra Pedicular Osteoid Osteoma: Minimally Invasive Surgical Resection Aided by New Integrated Navigation to 3D Imaging Device

Author

S. Valmary-Degano, Gael Kerschbaumer, Marc Prod’homme, Jérôme Tonetti, Mehdi Boudissa, and Guillaume Cavalié

Subjects
Surgical resection, Osteoid osteoma, 030222 orthopedics, medicine.medical_specialty, business.industry, Imaging guidance, Tumor resection, Case Report, General Medicine, medicine.disease, Resection, Vertebra, lcsh:RD701-811, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, lcsh:Orthopedic surgery, medicine, Operative time, Radiology, business, 030217 neurology & neurosurgery, Fixation (histology)
Abstract

We hereby describe a minimally invasive resection of a T1 pedicular osteoid osteoma next to the vertebral canal. The patient had an 18-month report of painful radiculopathy. We performed the surgery under 3D imaging guidance using navigation with an all-in-one device. Full procedure irradiation was 1.17 mSv for a 181-picture acquisition. Complete operative time incision to closure was 58 minutes. Despite sparing the vertebral stability without any fixation, the tumor resection was well-margined, thanks to the focused guidance. After surgery, the patient had complete relief of his symptoms at the 6-month follow-up. 3D imaging system coupled to navigation made the procedure safe without consuming time. The single Surgivisio® device allows comfortable 3D minimally invasive spine navigation surgery with the ergonomics of a C-arm.

Published
2019

6. Diffuse malignant peritoneal mesothelioma: Evaluation of systemic chemotherapy with comprehensive treatment through the RENAPE Database

Author

V. Kepenekian, D. Elias, G. Passot, E. Mery, D. Goere, D. Delroeux, F. Quenet, G. Ferron, D. Pezet, J.M. Guilloit, P. Meeus, M. Pocard, J.M. Bereder, K. Abboud, C. Arvieux, C. Brigand, F. Marchal, J.M. Classe, G. Lorimier, C. De Chaisemartin, F. Guyon, P. Mariani, P. Ortega-Deballon, S. Isaac, C. Maurice, F.N. Gilly, O. Glehen, G. Averous, F. Bibeau, D. Bouzard, A. Chevallier, S. Croce, P. Dartigues, S. Durand-Fontanier, L. Gouthi, B. Heyd, R. Kaci, R. Kianmanesh, M.H. Laverrière, E. Leblanc, B. Lelong, A. Leroux, V. Loi, C. Mariette, S. Msika, P. Peyrat, N. Pirro, J. Paineau, F. Poizat, J. Porcheron, P. Rat, J.M. Regimbeau, E. Thibaudeau, J.J. Tuech, S. Valmary-Degano, V. Verriele, P. Zerbib, and F. Zinzindohoue

Subjects
Oncology, Cancer Research, medicine.medical_specialty, medicine.medical_treatment, Population, computer.software_genre, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, education, Chemotherapy, education.field_of_study, Database, business.industry, Hazard ratio, Retrospective cohort study, Perioperative, medicine.disease, Confidence interval, 3. Good health, 030220 oncology & carcinogenesis, Peritoneal mesothelioma, 030211 gastroenterology & hepatology, Hyperthermic intraperitoneal chemotherapy, business, computer
Abstract

Purpose: Diffuse malignant peritoneal mesothelioma (DMPM) is a severe disease with mainly locoregional evolution. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is the reported treatment with the longest survival. The aim of this study was to evaluate the impact of perioperative systemic chemotherapy strategies on survival and postoperative outcomes in patients with DMPM treated with curative intent with CRS-HIPEC, using a multi-institutional database: the French RENAPE network. Patients and methods: From 1991 to 2014, 126 DMPM patients underwent CRS-HIPEC at 20 tertiary centres. The population was divided into four groups according to perioperative treatment: only neoadjuvant chemotherapy (NA), only adjuvant chemotherapy (ADJ), perioperative chemotherapy (PO) and no chemotherapy before or after CRS-HIPEC (NoC). Results: All groups (NA: n Z 42; ADJ: n Z 16; PO: n Z 16; NoC: n Z 48) were comparable regarding clinicopathological data and main DMPM prognostic factors. After a median follow-up of 61 months, the 5-year overall survival (OS) was 40%, 67%, 62% and 56% in NA, ADJ, PO and NoC groups, respectively (P Z 0.049). Major complications occurred for 41%, 45%, 35% and 41% of patients from NA, ADJ, PO and NoC groups, respectively (P Z 0.299). In multivariate analysis, NA was independently associated with worse OS (hazard ratio, 2.30; 95% confidence interval, 1.07e4.94; P Z 0.033). Conclusion: This retrospective study suggests that adjuvant chemotherapy may delay recurrence and improve survival and that NA may impact negatively the survival for patients with DMPM who underwent CRS-HIPEC with curative intent. Upfront CRS and HIPEC should be considered when achievable, waiting for stronger level of scientific evidence.

Published
2016
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7. In situ delivery of allogeneic natural killer cell (NK) combined with Cetuximab in liver metastases of gastrointestinal carcinoma: A phase I clinical trial

Author

Idir Idirene, S. Valmary-Degano, Eric Delabrousse, C. Barisien, Christophe Ferrand, Yann Godet, Romain Loyon, Olivier Adotevi, Fabienne Pouthier, Jeanne Galaine, Francine Fein, Christophe Borg, A. Dormoy, Pierre Tiberghien, P. Morel, Caroline Laheurte, Zaher Lakkis, Stefano Kim, Xavier Pivot, Jean-Marie Certoux, and Marine Jary

Subjects
lcsh:Immunologic diseases. Allergy, 0301 basic medicine, medicine.medical_specialty, Adoptive cell transfer, medicine.medical_treatment, Immunology, Phases of clinical research, lcsh:RC254-282, Gastroenterology, Natural killer cell, Metastasis, Cell therapy, 03 medical and health sciences, Internal medicine, cetuximab, medicine, Immunology and Allergy, adoptive cell transfer, Original Research, Chemotherapy, Cetuximab, business.industry, FOXP3, intrahepatic infusion, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, medicine.disease, 030104 developmental biology, medicine.anatomical_structure, Oncology, nk cell, lcsh:RC581-607, business, medicine.drug
Abstract

Despite successful introduction of NK-based cellular therapy in the treatment of myeloid leukemia, the potential use of NK alloreactivity in solid malignancies is still elusive. We performed a phase I clinical trial to assess the safety and efficacy of in situ delivery of allogeneic NK cells combined with cetuximab in liver metastasis of gastrointestinal origin. The conditioning chemotherapy was administrated before the allogeneic NK cells injection via hepatic artery. Three escalating doses were tested (3.10(6), 8.10(6) and 12.10(6) NK cells/kg) following by a high-dose interleukin-2 (IL-2). Cetuximab was administered intravenously every week for 7 weeks. Nine patients with liver metastases of colorectal or pancreatic cancers were included, three per dose level. Hepatic artery injection was successfully performed in all patients with no report of dose-limiting toxicity. Two patients had febrile aplasia requiring a short-term antibiotherapy. Grade 3/4 anemia and thrombopenia were also observed related to the chemotherapy. Objective clinical responses were documented in 3 patients and among them 2 occurred in patients injected with cell products harboring two KIR ligand mismatches and one in a patient with one KIR ligand mismatch. Immune monitoring revealed that most patients presented an increase but transient of IL-15 and IL-7 cytokines levels one week after chemotherapy. Furthermore, a high expansion of FoxP3(+)regulatory T cells and PD-1(+) T cells was observed in all patients, related to IL-2 administration. Our results demonstrated that combining allogeneic NK cells transfer via intra-hepatic artery, cetuximab and a high-dose IL-2 is feasible, well tolerated and may result in clinical responses.

Published
2017

8. Polymyalgia rheumatica and vagal paraganglioma

Author

O. Mauvais, V. L’Huillier, L. Tavernier, and S. Valmary-Degano

Subjects
musculoskeletal diseases, Male, Vagus Nerve Diseases, Pathology, medicine.medical_specialty, Gene mutation, Asymptomatic, Metastasis, Polymyalgia rheumatica, Diagnosis, Differential, 03 medical and health sciences, 0302 clinical medicine, immune system diseases, Paraganglioma, medicine, Humans, Cranial Nerve Neoplasms, skin and connective tissue diseases, 030223 otorhinolaryngology, Head and neck, Vagal paraganglioma, Histological examination, Paraganglioma, Extra-Adrenal, business.industry, Middle Aged, medicine.disease, Magnetic Resonance Imaging, Treatment Outcome, Otorhinolaryngology, Polymyalgia Rheumatica, 030220 oncology & carcinogenesis, Surgery, medicine.symptom, business
Abstract

Introduction Vagal paraganglioma are rare tumors that are mostly asymptomatic. We report a case of vagal paraganglioma associated with paraneoplastic polymyalgia rheumatica and review the literature on benign paragangliomas of the head and neck associated with paraneoplastic syndrome. Case report A 53-year-old man presented with atypical polymyalgia rheumatica. MRI revealed a tumor that was then surgically excised. Histological examination confirmed the diagnosis of benign vagal paraganglioma. Rapid, complete and permanent resolution of all rheumatological symptoms were observed postoperatively, confirming the diagnosis of paraneoplastic polymyalgia rheumatica. Conclusion Paraganglioma of the neck associated with paraneoplastic syndrome remains exceptional. A predisposing gene mutation must be systematically investigated. Long-term surveillance must be ensured due to the risk of local recurrence, second tumors or metastasis.

Published
2017

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