Author: "Department of Digestive Surgery" - Searchworks@Jio Institute Digital Library Search Results

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4,909 results on '"Department of Digestive Surgery"'

1. Pancreatectomy for NET: External Evaluation of WHO 2017 Grading System (PanTEN)

Author: Department of digestive surgery, Carémeau Hospital, 30900, Nîmes, France, Department of oncology, Carémeau Hospital, 30900, Nîmes, France, Oncology - Institut du Cancer de Montpellier (ICM), Montpellier, France, and Digestive & Oncologic Surgery - Institut du Cancer de Montpellier (ICM), Montpellier, France
Published: 2019

2. EFFECT OF VITAMIN C SUPPLEMENTATION ON NEUTROPHIL FUNCTION IN MALE JUDOISTS DURING A TRAINING CAMP

Author: Department of Social Medicine, Hirosaki University Graduate School of Medicine, Department of Social Medicine, Hirosaki University Graduate School of Medicine / Department of Digestive Surgery, Hirosaki University Graduate School of Medicine, 山居, 聖典, 梅田, 孝, 松坂, 方士, 檀上, 和真, 高橋, 一平, 津谷, 亮佑, 長谷部, 達也, 中路, 重之, Yamai, Kiyonori, Umeda, Takashi, Matsuzaka, Masashi, Danjo, Kazuma, Takahashi, Ippei, Tsuya, Ryousuke, Hasebe, Tatsuya, Nakaji, Shigeyuki, Department of Social Medicine, Hirosaki University Graduate School of Medicine, Department of Social Medicine, Hirosaki University Graduate School of Medicine / Department of Digestive Surgery, Hirosaki University Graduate School of Medicine, 山居, 聖典, 梅田, 孝, 松坂, 方士, 檀上, 和真, 高橋, 一平, 津谷, 亮佑, 長谷部, 達也, 中路, 重之, Yamai, Kiyonori, Umeda, Takashi, Matsuzaka, Masashi, Danjo, Kazuma, Takahashi, Ippei, Tsuya, Ryousuke, Hasebe, Tatsuya, and Nakaji, Shigeyuki
Abstract: We examined the effects of vitamin C supplementation on neutrophil function during exercise loading. Neutrophil functions, namely the reactive oxygen species （ROS） production capability, neutrophil phagocytic activity （PA） and serum opsonic activity （SOA） were measured before and after a 2-hour unified loading exercise （ULE） both before and after a 7-day intensified training camp for 22 male judoists. The parameters were assessed neutrophil count, myogenic enzymes, vitamin C in serum, SOA, PA, ROS production capability, body composition, and so on. Subjects were randomly assigned to two groups; the VC group （daily diet supplementation of 1,500 mg vitamin C） and the Control group （no vitamin C supplementation）. The post-camp pre-ULE vitamin C level was higher in the VC group than in the Control group, though no such difference was seen at pre-camp. As for neutrophil function, although the typical changes seen following a single bout of normal exercise, namely an increase in SOA and ROS, and a decrease in PA, were recorded following the pre- and post-camp ULEs in both groups, significant difference in change rates were not seen between both groups. In conclusion, vitamin C supplementation had no significant influence on changes in neutrophil function.
Published: 2011

3. Effects of Hyaluronan Synthase Inhibitors, 4-Methylumbelliferone and 4-Methylesculetin on Human Pleural Malignant Mesothelioma Cells (NCI-H2052)

Author: 中井, 款, 吉原, 秀一, 諸橋, 一, 石戸, 圭之輔, 佐々木, 睦男, Department of Digestive Surgery, Hirosaki University Graduate School of Medicine, 弘前大学大学院医学研究科消化器外科学講座, Nakai, Makoto, Yoshihara, Shuichi, Morohashi, Hajime, Ishido, Keinosuke, Sasaki, Mutsuo, 中井, 款, 吉原, 秀一, 諸橋, 一, 石戸, 圭之輔, 佐々木, 睦男, Department of Digestive Surgery, Hirosaki University Graduate School of Medicine, 弘前大学大学院医学研究科消化器外科学講座, Nakai, Makoto, Yoshihara, Shuichi, Morohashi, Hajime, Ishido, Keinosuke, and Sasaki, Mutsuo
Abstract: Hyaluronan (HA) is a major component of the pericellular matrix, and is implicated in cell adhesion, invasion. and tumor metastasis. We have reported that 4-methylumbelliferone (MU) inhibits HA synthesis by cultured skin fibroblasts, melanoma cells, and pancreatic cancer cells. We focused in the present study, on mesothelioma which has an extremely poor prognosis, and in which no effective therapy has yet been established. We investigated dealing with this neoplasm whether MU and 4-methylesculetin (ME), a MU derivative, are able to inhibit HA synthesis by the mesothelioma cell line NCI-H2052. MU inhibited HA synthesis by about 20%, and ME by about 40%, in comparison with the control group. MU inhibited the adhesion of NCI-H2052 cells by about 30%, and ME by about 50%, compared with the untreated control. MU inhibited cell locomotion by about 30%. and ME by about 40%. It is suggested through these results suggest that MU and ME inhibit HA synthesis. adhesion, and locomotion by human mesothelioma cells and weaken their pericellular matrix, and that the inhibitory effect of ME on HA synthesis is stronger than that of MU. It is presumed that both MU and ME may have potential as new therapeutic or prophylactic medicines against mesothelioma.
Published: 2008

4. Fluorescence Image-Guided Lymphadenectomy in Robotic Gastrectomy (IG-MIG)

Author: Amilcare Parisi, Director of the Department of Digestive Surgery - St. Mary's Hospital of Terni
Published: 2019

5. Value of early repeated abdominal CT in selective non-operative management for blunt bowel and mesenteric injury

Author: Marc Leone, Ugo Scemama, A Maignan, Kathia Chaumoitre, Laurent Boyer, S. Berdah, Thierry Bege, Laura Beyer-Berjot, F Lannes, Assistance Publique - Hôpitaux de Marseille (APHM), Aix Marseille Université (AMU), Laboratoire de cristallographie et sciences des matériaux (CRISMAT), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-École Nationale Supérieure d'Ingénieurs de Caen (ENSICAEN), Normandie Université (NU)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche sur les Matériaux Avancés (IRMA), Normandie Université (NU)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Institut national des sciences appliquées Rouen Normandie (INSA Rouen Normandie), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université de Rouen Normandie (UNIROUEN), Institut National des Sciences Appliquées (INSA)-Normandie Université (NU)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS), Laboratoire de Biomécanique Appliquée (LBA UMR T24), Aix Marseille Université (AMU)-Université Gustave Eiffel, Hôpital Nord [CHU - APHM], Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), École Nationale Supérieure d'Ingénieurs de Caen (ENSICAEN), Normandie Université (NU)-Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Institut de Chimie du CNRS (INC), Department of Digestive Surgery. Hôpital Nord, Centre de résonance magnétique biologique et médicale (CRMBM), Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Assistance Publique-Hôpitaux de Marseille (AP-HM), Anthropologie bio-culturelle, Droit, Ethique et Santé (ADES), and Aix Marseille Université (AMU)-EFS ALPES MEDITERRANEE-Centre National de la Recherche Scientifique (CNRS)
Subjects: Male, medicine.medical_treatment, Abdominal Injuries, Wounds, Nonpenetrating, 030218 nuclear medicine & medical imaging, law.invention, Injury Severity Score, 0302 clinical medicine, Randomized controlled trial, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, law, Laparotomy, Medicine, Mesentery, Child, Tomography, ComputingMilieux_MISCELLANEOUS, Neuroradiology, Aged, 80 and over, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, medicine.diagnostic_test, Ultrasound, Interventional radiology, General Medicine, Middle Aged, 3. Good health, Intestines, Research Design, 030220 oncology & carcinogenesis, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Female, Radiology, Adult, medicine.medical_specialty, Adolescent, X-ray computed, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, Young Adult, 03 medical and health sciences, Blunt, McNemar's test, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, Humans, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, Radiology, Nuclear Medicine and imaging, Aged, Retrospective Studies, business.industry, Patient Selection, Wounds and injuries, Retrospective cohort study, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, Tomography, X-Ray Computed, business, Conservative treatment
Abstract: To evaluate the performance of an early repeated computed tomography (rCT) in initially non-operated patients with blunt bowel and mesenteric injuries (BBMI). This was a monocentric retrospective observational study from 2009 to 2017 of patients with a BBMI on initial CT (iCT). Patients initially non-operated on were scheduled for a rCT within 48 h. Initial CT and rCT diagnostic performance were compared based on a surgical injury prediction score previously described. For statistical analysis, we used the chi-square analyses for paired data (McNemar test). Eighty-four patients (1.9% of trauma) had suspected BBMI on iCT. Among these patients, 22 (26.2%) were initially operated on, 18 (21.4%) were later operated on, and 44 (52.4%) were not operated on. The therapeutic laparotomy rate was 85%. Thirty-four patients initially non-operated on had a rCT. The absolute value of the CT scan score increased for 15 patients (44.1%). The early rCT diagnostic performance, compared with iCT, showed an increase in sensitivity (from 63.6 to 91.7%), in negative predictive value (from 77.4 to 94.7%), and in AUC (from 0.77 to 0.94). In initially non-operated patients with BBMI lesions, the performance of an early rCT improved the sensitivity of lesion detection requiring surgical repair and the security of patient selection for non-operative treatment. • Selective non-operative treatment for hemodynamically stable patients with blunt bowel and/or mesenteric injuries on CT is developing but remains controversial. • An early repeated CT improved the sensitivity of lesion detection requiring surgical repair and the security of patient selection for conservative treatment.
Published: 2019

6. Autophagy of Intestinal Epithelial Cells Inhibits Colorectal Carcinogenesis Induced by Colibactin-Producing Escherichia coli in Apc Mice

Author: Laurène Salesse, Mathilde Bonnet, Catherine Godfraind, Denis Pezet, Cécily Lucas, Nicolas Barnich, Anaïs Larabi, Hang Thi Thu Nguyen, My Hanh Thi Hoang, Pierre Sauvanet, Guillaume Dalmasso, Johan Gagnière, Philip Rosenstiel, Richard Bonnet, Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre de Recherche en Nutrition Humaine d'Auvergne (CRNH d'Auvergne)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Laboratoire de Neuropathologie, Université Catholique de Louvain = Catholic University of Louvain (UCL)-Clinique Saint-Luc, CHU Clermont-Ferrand, Department of Digestive Surgery, University Medical Hospital, Institute of Clinical Molecular Biology, Kiel University, CCSD, Accord Elsevier, and ANR-16-IDEX-0001,CAP 20-25,CAP 20-25(2016)
Subjects: 0301 basic medicine, Carcinogenesis, Colon, DNA repair, DNA damage, Adenomatous Polyposis Coli Protein, ATG5, Autophagy-Related Proteins, Mice, Transgenic, Biology, [SDV.BBM.BM] Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, Mice, 03 medical and health sciences, 0302 clinical medicine, Autophagy, Escherichia coli, Animals, Humans, Intestinal Mucosa, RNA, Small Interfering, ATG16L1, ComputingMilieux_MISCELLANEOUS, Cell Proliferation, Hepatology, Gastroenterology, Epithelial Cells, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, HCT116 Cells, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, 3. Good health, Gene Expression Regulation, Neoplastic, Reverse transcription polymerase chain reaction, Disease Models, Animal, 030104 developmental biology, Real-time polymerase chain reaction, Gene Knockdown Techniques, Polyketides, Colonic Neoplasms, Host-Pathogen Interactions, Cancer research, 030211 gastroenterology & hepatology, Tumor necrosis factor alpha, [SDV.MP.BAC] Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, Peptides, HeLa Cells
Abstract: Background & Aims Colibactin-producing Escherichia coli (CoPEC) colonize the colonic mucosa of a higher proportion of patients with vs without colorectal cancer (CRC) and promote colorectal carcinogenesis in susceptible mouse models of CRC. Autophagy degrades cytoplasmic contents, including intracellular pathogens, via lysosomes and regulates intestinal homeostasis. We investigated whether inhibiting autophagy affects colorectal carcinogenesis in susceptible mice infected with CoPEC. Methods Human intestinal epithelial cells (IECs) (HCT-116) were infected with a strain of CoPEC (11G5 strain) isolated from a patient or a mutant strain that does not produce colibactin (11G5ΔclbQ). Levels of ATG5, ATG16L1, and SQSTM1 (also called p62) were knocked down in HCT-116 cells using small interfering RNAs. ApcMin/+ mice and ApcMin/+ mice with IEC-specific disruption of Atg16l1 (ApcMin/+/Atg16l1ΔIEC) were infected with 11G5 or 11G5ΔclbQ. Colonic tissues were collected from mice and analyzed for tumor size and number and by immunohistochemical staining, immunoblot, and quantitative reverse transcription polymerase chain reaction for markers of autophagy, DNA damage, cell proliferation, and inflammation. We analyzed levels of messenger RNAs (mRNAs) encoding proteins involved in autophagy in colonic mucosal tissues from patients with sporadic CRC colonized with vs without CoPEC by quantitative reverse-transcription polymerase chain reaction. Results Patient colonic mucosa with CoPEC colonization had higher levels of mRNAs encoding proteins involved in autophagy than colonic mucosa without these bacteria. Infection of cultured IECs with 11G5 induced autophagy and DNA damage repair, whereas infection with 11G5ΔclbQ did not. Knockdown of ATG5 in HCT-116 cells increased numbers of intracellular 11G5, secretion of interleukin (IL) 6 and IL8, and markers of DNA double-strand breaks but reduced markers of DNA repair, indicating that autophagy is required for bacteria-induced DNA damage repair. Knockdown of ATG5 in HCT-116 cells increased 11G5-induced senescence, promoting proliferation of uninfected cells. Under uninfected condition, ApcMin/+/Atg16l1ΔIEC mice developed fewer and smaller colon tumors than ApcMin/+ mice. However, after infection with 11G5, ApcMin/+/Atg16l1ΔIEC mice developed more and larger tumors, with a significant increase in mean histologic score, than infected ApcMin/+ mice. Increased levels of Il6, Tnf, and Cxcl1 mRNAs, decreased level of Il10 mRNA, and increased markers of DNA double-strand breaks and proliferation were observed in the colonic mucosa of 11G5-infected ApcMin/+/Atg16l1ΔIEC mice vs 11G5-infected ApcMin/+ mice. Conclusion Infection of IECs and susceptible mice with CoPEC promotes autophagy, which is required to prevent colorectal tumorigenesis. Loss of ATG16L1 from IECs increases markers of inflammation, DNA damage, and cell proliferation and increases colorectal tumorigenesis in 11G5-infected ApcMin/+ mice. These findings indicate the importance of autophagy in response to CoPEC infection, and strategies to induce autophagy might be developed for patients with CRC and CoPEC colonization.
Published: 2020

7. Adenocarcinoma of the oesophagogastric junction Siewert II: An oesophageal cancer better cured with total gastrectomy

Author: Benjamin Mathieu, Renaud Flamein, Fédérique Peschaud, Kevin Kraft, Diane Goéré, Sylvain Fabre, Basile Tsilividis, Frederic Borie, Florence Vandois, Jean Pierre Arnaud, Damien Louis, Virginie Pichot-Delahaye, Manuel Fernandez, Frank Bonnetain, Marie Guilbert, Sophie Michalak, Marc Pocard, Denis Pezet, Bertrand Millat, Thibault Voron, Brigitte Gillet, Jeremie Thereaux, Jean Yves Mabrut, Emmanuelle Leteurtre, Xavier B. D’Journo, Nicolas Carrere, Michel Prudhomme, Olivier Glehen, Gil Lebreton, Jean-Marc Regimbeau, Arnaud Pasquer, Pascal Thomas, Jean Robert Delpero, Johan Gagnière, Timothée Thiébot, Denis Collet, Aude Glaise, N. Huten, Guillaume Piessen, Ariane Poisson, Cécile Brigand, Mohamed Hebbar, Bernard Meunier, Pierre Dechelotte, Caroline Gronnier, Dorothée Brachet, Jérôme Guiramand, Abdenaceur Dhari, Francis Michot, François Paye, Jean Michel Balon, Jérémie H. Lefevre, Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), Hôpital Claude Huriez [Lille], CHU Lille, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO)-Université de Brest (UBO), 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), Laboratoire de chimie de coordination (LCC), 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), Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), 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)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Centre National de la Recherche Scientifique (CNRS), Service de chirurgie digestive, CHU Bordeaux [Bordeaux], Université de Lille, 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), Service de Chirurgie Digestive et Endocrinienne [CHU Angers], Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Service Chirurgie Digestive et Endocrinienne [CHU Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Service Biostatistiques et Informatique Médicale (CHU de Dijon) (DIM), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Département de chirurgie générale et digestive [CHU Strasbourg], Centre Hospitalier Universitaire de Strasbourg (CHU de Strasbourg ), Département de chirurgie digestive, [CHU Toulouse], Unité de Recherche sur les Maladies Infectieuses Tropicales Emergentes (URMITE), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, INSB-INSB-Centre National de la Recherche Scientifique (CNRS), Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Chirurgie digestive [CHU Amiens], CHU Amiens-Picardie, Éducation et scolarisation (ESCOL), Centre interdisciplinaire de recherche, culture, éducation, formation, travail (CIRCEFT), Université Paris 8 Vincennes-Saint-Denis (UP8)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Université Paris 8 Vincennes-Saint-Denis (UP8)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut de Recherche juridique de la Sorbonne André Tunc (IRJS), Université Paris 1 Panthéon-Sorbonne (UP1), Département de chirurgie digestive, CHU Clermont-Ferrand, Institut de Chimie des Substances Naturelles (ICSN), Centre National de la Recherche Scientifique (CNRS)-Institut de Chimie du CNRS (INC), Département de chirurgie digestive, [CHU Montpellier], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Département de chirurgie générale [Gustave Roussy], Institut Gustave Roussy (IGR), Service de Chirurgie Générale et Digestive[Lille], Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre de Recherche en Cancérologie de Marseille (CRCM), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Aix Marseille Université (AMU), Inserm UMR837 Team 5, Service d'oncologie médicale, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-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-Université Lille Nord de France (COMUE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Service de Chirurgie Digestive et Endocrinienne, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre de Biologie-Pathologie, Département de chirurgie digestive, [CHU Tours], Université d'Orléans (UO), Hémodynamique, Interaction Fibrose et Invasivité tumorales Hépatiques (HIFIH), Université d'Angers (UA), Department of Digestive Surgery, Rouen University Hospital, CHU de Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), 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), Service de chirurgie générale, digestive et oncologique [CHU Ambroise-Paré], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Ambroise Paré [AP-HP], Centre Hospitalier Lyon Sud, Service de Chirurgie Digestive, Hôpital Lariboisière, 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 Hépatobiliaire et Digestive [Rennes] = Hepatobiliary and Digestive Surgery [Rennes], CHU Pontchaillou [Rennes], AP-HM, Department of General and Digestive Surgery, North Hospital, Marseille, France, parent, Service de chirurgie digestive [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), 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), Institut de Chimie de Toulouse (ICT), 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), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service Chirurgie viscérale et digestive [CHU Toulouse], Pôle Maladies de l'appareil digestif [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), Aix Marseille Université (AMU)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837 (JPArc), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Institut de Chimie de Toulouse (ICT-FR 2599), 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), Centre Hospitalier Universitaire Estaing, Centre National de la Recherche Scientifique (CNRS)-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, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Sorbonne Université, Centre National de la Recherche Scientifique (CNRS), 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)-Université Lille Nord de France (COMUE)-Université de Lille, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université, 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), Service de Chirurgie Hépatobiliaire et Digestive [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), 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), and CCSD, Accord Elsevier
Subjects: Male, medicine.medical_specialty, Esophageal Neoplasms, medicine.medical_treatment, 030230 surgery, Adenocarcinoma, [SDV.BBM.BM] Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, 03 medical and health sciences, 0302 clinical medicine, Oesophagogastric junction, Gastrectomy, Medicine, Humans, In patient, ComputingMilieux_MISCELLANEOUS, Neoplasm Staging, Retrospective Studies, Surgical approach, business.industry, Cancer, Retrospective cohort study, Cardia, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, General Medicine, Middle Aged, medicine.disease, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, Neoadjuvant Therapy, 3. Good health, Surgery, Survival Rate, Oncology, 030220 oncology & carcinogenesis, Female, Esophagogastric Junction, France, [SDV.MP.BAC] Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, business, Median survival
Abstract: Introduction Type II AEG is now considered as oesophageal cancer in the seventh and eighth edition of TNM classification but optimal surgical approach for these tumors remains debated. The objective of the study is to assess and compare surgical and oncological outcomes of two surgical approaches: superior polar oesogastrectomy (SPO) or total gastrectomy (TG) in patients with type II adenocarcinoma of the oesophagogastric junction (AEG). Material and methods 183 patients with type II AEG treated from 1997 to 2010 in 21 French centers by SPO or TG were included in a multicenter retrospective study. The surgical and oncological outcomes were compared between these two surgical approaches. Results A TG was performed in 64 (35%) patients whereas 119 (65%) patients were treated by SPO with transthoracic approach in 100 of them (83.2%) and transhiatal approach with cervicotomy in 19 (16.8%). Surgical outcomes were comparable between the two approaches with a postoperative mortality rate of 4.9% and a severe operative morbidity rate within 30 days of 15.3%. Median survival in patients operated on by TG was of 46 months compared to 27 months in patients treated by SPO (p = 0.118). At multivariate analysis, TG appears to be an independent good prognostic factor compared to SPO (HR = 1.847; p = 0.008). However, TG was also associated with a higher rate of incomplete resection, (12.5% vs 5.9%; p = 0.120). Conclusion When TG allows obtaining tumor-free resection margins, this approach should be preferred to SPO.
Published: 2019

8. French women's representations and experiences of the post‐treatment management of breast cancer and their perception of the general practitioner's role in follow‐up care: A qualitative study

Author: Anne Bottet, Catherine Laporte, Clémentine Raineau, Denis Pezet, Julie Vaure, Bénédicte Eschalier, Philippe Vorilhon, Neuro-Psycho Pharmacologie des Systèmes Dopimanégiques sous-corticaux (NPsy-Sydo), CHU Clermont-Ferrand-Université d'Auvergne - Clermont-Ferrand I (UdA), Department of Digestive Surgery, University Medical Hospital, 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), CHU Gabriel Montpied (CHU), CHU Clermont-Ferrand, Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), Institut National de la Recherche Agronomique (INRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre de Recherche en Nutrition Humaine d'Auvergne (CRNH d'Auvergne), and CHU Gabriel Montpied [Clermont-Ferrand]
Subjects: Adult, breast cancer survivors, media_common.quotation_subject, Psychology of self, Aftercare, post‐treatment follow‐up, Breast Neoplasms, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Nursing, General Practitioners, Perception, medicine, Humans, 030212 general & internal medicine, Survivors, ComputingMilieux_MISCELLANEOUS, Qualitative Research, media_common, Aged, Aged, 80 and over, Physician-Patient Relations, business.industry, Public Health, Environmental and Occupational Health, Cancer, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, Middle Aged, medicine.disease, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, Follow up care, 3. Good health, Original Research Paper, 030220 oncology & carcinogenesis, general practitioner, Female, France, Post treatment, Thematic analysis, business, Original Research Papers, Qualitative research
Abstract: Background In France, the Cancer Plan II 2009-2013 was launched to improve post-cancer management and promote greater involvement of general practitioners (GPs) in follow-up care. Objectives We investigated how women experienced the post-treatment management of breast cancer and perceived the role of the GP in follow-up care. Design We conducted a qualitative study based on semi-structured interviews with women with breast cancer in remission. The interviews were transcribed and analysed in accordance with the principles of thematic analysis. Setting and participants We interviewed 21 patients aged between 30 and 86. Eighteen breast cancer survivors were recruited from GP practices and five from a patients’ association. Results Four themes emerged from the thematic analysis: that breast cancer is a life-changing event; how patients managed the effects of treatment; how patients viewed the future; and patients’ expectations of their GP. Discussion and conclusion French survivors of breast cancer perceived the physical changes caused by their illness to impact their womanhood, leading to difficulties with sexual relations, a diminished sense of self and fears for the future. They felt abandoned at the end of treatment and desired support. They appreciated the ease of contacting their GP but considered follow-up care outside their remit. They agreed to be followed up by their GP, provided that they co-operated closely with a cancer specialist. This is in accordance with the French Cancer Plan II 2009-2013, which recommends greater involvement of GPs in a monitoring protocol shared with cancer specialists.
Published: 2016

9. Effectiveness assessment of riluzole in the prevention of oxaliplatin-induced peripheral neuropathy: RILUZOX-01: protocol of a randomised, parallel, controlled, double-blind and multicentre study by the UNICANCER-AFSOS Supportive Care intergroup

Author: Denis Pezet, Trevor Stanbury, Bruno Pereira, David Balayssac, Alain Eschalier, Franck Bonnetain, Ivan Krakowski, Valérie Plence, Jérôme Busserolles, Nicolas Kerckhove, CLEMENCON, EMILIE, Neuro-Dol (Neuro-Dol), Université d'Auvergne - Clermont-Ferrand I (UdA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Pharmacologie fondamentale et clinique de la douleur, Université d'Auvergne - Clermont-Ferrand I (UdA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université d'Auvergne - Clermont-Ferrand I (UdA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université d'Auvergne - Clermont-Ferrand I (UdA)-Institut National de la Santé et de la Recherche Médicale (INSERM), UNICANCER - Institut régional du Cancer Montpellier Val d'Aurelle (ICM), CRLCC Val d'Aurelle - Paul Lamarque, Unité de Biostatistiques [CHU Clermont-Ferrand], Direction de la recherche clinique et de l’innovation [CHU Clermont-Ferrand] (DRCI), CHU Clermont-Ferrand-CHU Clermont-Ferrand, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] (UNICANCER/ICL), UNICANCER, Department of Digestive Surgery, University Medical Hospital, and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])
Subjects: medicine.medical_specialty, [SDV]Life Sciences [q-bio], Antineoplastic Agents, colorectal cancer, Placebo, 03 medical and health sciences, 0302 clinical medicine, Double-Blind Method, Internal medicine, medicine, Clinical endpoint, Protocol, Humans, Multicenter Studies as Topic, Amyotrophic lateral sclerosis, ComputingMilieux_MISCELLANEOUS, Randomized Controlled Trials as Topic, Riluzole, business.industry, oxaliplatin, Peripheral Nervous System Diseases, General Medicine, medicine.disease, 3. Good health, Oxaliplatin, [SDV] Life Sciences [q-bio], Peripheral neuropathy, Neuroprotective Agents, Treatment Outcome, Chemotherapy-induced peripheral neuropathy, Oncology, 030220 oncology & carcinogenesis, Neuropathic pain, Medicine, Neurotoxicity Syndromes, business, 030217 neurology & neurosurgery, medicine.drug, chemotherapy-induced peripheral neuropathy
Abstract: IntroductionMost patients (>70%) experience acute neuropathic symptoms shortly after oxaliplatin infusions. These symptoms are not always resolved between infusions. Overall, 30%–50% of patients suffer from chronic oxaliplatin-induced peripheral neuropathy (OIPN). This cumulative and dose-dependent sensory neuropathy limits compliance or results in oxaliplatin-based chemotherapies to be substituted with less neurotoxic agents. These treatment changes impair clinical outcomes, and may be associated with comorbidities, such as distress, depression and anxiety. Currently, no drug used to prevent or treat OIPN is sufficiently effective to be used routinely in clinical practice. There is, thus, an unmet therapeutic need to reduce the intensity of and/or prevent OIPN. We hypothesised that riluzole would be an excellent candidate to address this public health issue. Riluzole is approved for treating amyotrophic lateral sclerosis. In animals, there is a beneficial effect on sensorimotor and pain disorders, as well as related comorbidities, after repeated administration of oxaliplatin. In humans, riluzole has shown neuroprotective, anxiolytic and antidepressive effects.Methods and analysisRILUZOX-01 trial was designed as a randomised, controlled, double-blind study to evaluate the efficacy of riluzole to prevent OIPN. Patients with colorectal cancer and initiating adjuvant oxaliplatin-based chemotherapy are eligible. Patients (n=210) will be randomly assigned to either riluzole or placebo, concomitantly with chemotherapy. The primary endpoint is the change in OIPN intensity, assessed by the sensory scale of the QLQ-CIPN20, after six 2-week cycles of chemotherapy. Secondary endpoints include incidence and severity of neuropathy, grade of sensory neuropathy, intensity and features of neuropathic pain, health-related quality of life, disease-free survival, overall survival and safety.Ethics and dessiminationThe study was approved by a French ethics committee (ref:39/18_1, ‘Comité de Protection des Personnes’ Ouest-IV, France) and plans to start enroling patients in September 2019. The trial is registered in EudraCT and clinicaltrials.gov.Trial registration numberN°2017-002320-25;NCT03722680
Published: 2019

10. In Vivo Feasibility of Arterial Embolization with Permanent and Absorbable Suture: The FAIR-Embo Concept

Author: Vincent Vidal, Pauline Brige, Jean-François Hak, Benjamin Guillet, Mickaël Bobot, A Haffner, Jean-Michel Bartoli, Guy Moulin, A Jacquier, Gilles Soulez, Farouk Tradi, P. Gach, Sophie Chopinet, Département de Radiologie [Hôpital de la Timone - APHM], Hôpital de la Timone [CHU - APHM] (TIMONE), Centre Européen de Recherche en Imagerie médicale (CERIMED), Centre National de la Recherche Scientifique (CNRS)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-École Centrale de Marseille (ECM)-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), Laboratoire d'Imagerie Interventionnelle Expérimentale (LIIE), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de chirurgie générale et viscérale [Hôpital de la Timone - APHM], Centre recherche en CardioVasculaire et Nutrition (C2VN), Institut National de la Recherche Agronomique (INRA)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), Service d'Anatomie Pathologique et de Neuropathologie [Hôpital de la Timone - CHU - APHM], Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM), Dpt Radiologie [Montréal], Université de Montréal [Montréal], Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), HOPITAL NORD MARSEILLE - APHM - SERV RADIOPHARM, Départment de Radiologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-École Centrale de Marseille (ECM)-Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Fédération nationale des Centres de lutte contre le Cancer (FNCLCC)-Centre National de la Recherche Scientifique (CNRS), Department of Digestive Surgery University Hospital Timone, AP-HM, Département de Néphrologie et transplantation [Hôpital Saint Louis - APHP], Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Laboratoire d'Anatomie Pathologique-Neuropathologique [AP-HM Hôpital La Timone], Department of Radiology, Centre Hospitalier de l’Universite´ de Montre´al, Department of Radiopharmacy, AP-HM, Brige, Pauline, Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), and Université de Montréal (UdeM)
Subjects: medicine.medical_specialty, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, Swine, medicine.medical_treatment, Life-threatening bleeding, [SDV]Life Sciences [q-bio], Absorbable suture, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, Embolization, 0302 clinical medicine, Life-threatening bleeding Emerging countries, In vivo, Absorbable Implants, medicine, Animals, Radiology, Nuclear Medicine and imaging, Polyglactin 910, ComputingMilieux_MISCELLANEOUS, Kidney, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, medicine.diagnostic_test, Sutures, business.industry, Embolization Agent, Polyethylene Terephthalates, Arterial Embolization, Angiography, Digital Subtraction, Digital subtraction angiography, Arteries, Embolization, Therapeutic, 3. Good health, Surgery, Emerging countries, [SDV] Life Sciences [q-bio], Non-absorbable suture, medicine.anatomical_structure, [SDV.IB.IMA] Life Sciences [q-bio]/Bioengineering/Imaging, Treatment Outcome, Models, Animal, Feasibility Studies, Cardiology and Cardiovascular Medicine, business, Tomography, X-Ray Computed, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Follow-Up Studies
Abstract: International audience; Purpose Arterial embolization has been shown to be effective and safe for the management of bleeding, especially for postpartum and pelvic traumatic bleeding. We propose to evaluate the proof of concept of feasibility and effectiveness of arterial embolization with absorbable and non-absorbable sutures in a porcine model. Materials and Methods In the acute setting (n = 1), several different arteries (mesenteric, splenic, pharyngeal, kidney) were embolized using non-absorbable sutures (NAS): Mersutures braided sutures (polyethylene terephthalate). In the chronic setting (n = 3), only lower pole renal arteries were embolized. On the right side, NAS was used, whereas on the left side embolization was realized with absorbable suture (AS): Vicryl((R)) braided suture (polyglactin 910). The chronic group was followed for 3 months. The pigs received contrast-enhanced CT the day before embolization (D-1), after the embolization (D0), at 1 month and 3 months after embolization (M1 and M3); digital subtraction angiography (DSA) was done at D0 and M3 and histological analysis at M3. Results All vascular targets were effectively embolized without any pre- or postoperative complications. Both DSAs and CTs at M3 showed a 100% recanalization rate for the AS embolization and a partial reversal rate for the NAS embolization. A renal hypotrophy in the embolized region was observed during both the M1 and M3 scans for both sutures (AS and NAS) with a clear hypotrophy for the NAS embolized kidney. Conclusion Embolization by AS and NAS (FAIR-Embo) is a feasible and effective treatment which opens up the possibility of global use of this inexpensive and widely available embolization agent.
Published: 2018

11. Prognostic value of a combination of innovative factors (gut microbiota, sarcopenia, obesity, metabolic syndrome) to predict surgical/oncologic outcomes following surgery for sporadic colorectal cancer: a prospective cohort study protocol (METABIOTE)

Author: Karine Poirot, Bruno Pereira, Lucie Cassagnes, Denis Pezet, Mathilde Bonnet, Caroline Chevarin, Pierre Sauvanet, Benoit Chassaing, Frédéric Robin, Catherine Godfraind, Johan Gagnière, Nicolas Barnich, Julie Veziant, CHU Clermont-Ferrand, Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre de Recherche en Nutrition Humaine d'Auvergne (CRNH d'Auvergne)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Service de Chirurgie Digestive et Hépatobiliaire [CHU Clermont-Ferrand], CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-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), Georgia State University, University System of Georgia (USG), Télécom ParisTech, Laboratoire de Neuropathologie, Université Catholique de Louvain = Catholic University of Louvain (UCL)-Clinique Saint-Luc, Department of Digestive Surgery, University Medical Hospital, Unité de biostatistiques, ANR-16-IDEX-0001,CAP 20-25,CAP 20-25(2016), Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte - Clermont Auvergne (M2iSH), 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)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), OUERTANI, jeannette, and CAP 20-25 - - CAP 20-252016 - ANR-16-IDEX-0001 - IDEX - VALID
Subjects: obesity, medicine.medical_specialty, postoperative outcomes, Colorectal cancer, colorectal cancer, Gut flora, [SDV.BBM.BM] Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, metabolic syndrome, sarcopenia, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Informed consent, medicine, Humans, Prospective Studies, Prospective cohort study, ComputingMilieux_MISCELLANEOUS, gut microbiota, biology, business.industry, prognostic factors, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, General Medicine, Length of Stay, medicine.disease, biology.organism_classification, Survival Analysis, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, Obesity, Gastrointestinal Microbiome, 3. Good health, Surgery, Clinical trial, Treatment Outcome, pathogenicE, coli, Oncology, pathogenicE. coli, 030220 oncology & carcinogenesis, Sarcopenia, Body Composition, 030211 gastroenterology & hepatology, [SDV.MP.BAC] Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, Metabolic syndrome, Colorectal Neoplasms, business
Abstract: IntroductionColorectal cancer (CRC) is still associated with poor prognosis, especially in patients with advanced disease. Development of new prognostic tools replacing or supplementing those routinely used is definitely needed, with the aim to optimise and personalise treatment strategies. Gut microbiota composition and body composition profile (obesity, sarcopenia and metabolic syndrome) have recently been reported separately as new relevant prognostic factors for postoperative surgical and oncologic outcomes following CRC surgery. However interactions that exist between these factors have been poorly studied. The purpose of this translational prospective cohort study (METABIOTE) is to investigate potential interactions between gut microbiota, body composition profile and postoperative outcomes and recurrence in patients undergoing surgery for non-metastatic sporadic CRC.Methods and analysisThis single-centre project aims to prospectively enrol 300 consecutive patients undergoing surgery for non-metastatic sporadic CRC at the University Hospital of Clermont-Ferrand, France for the identification of specific microbial signatures (from tumour, colonic mucosa and stools samples) associated with particular metabolic profiles that could impact postoperative morbidity and oncologic outcomes, using microbiological, molecular and imaging approaches. The primary outcome is the 5-year overall survival (OS). Other outcomes are 5-year CRC-related OS, 5-year disease-free survival, 30-day postoperative morbidity, 90-day postoperative mortality and length of hospital stay.Ethics and disseminationThis study protocol was reviewed and approved by an independent French regional review board (n°2018-A00352-53, ‘Comité de Protection des Personnes Ile de France VII’ on 4 July 2018, declared to the competent French authority (‘Agence Nationale de Sécurité du Médicament et des produits de santé’, France), and registered on the Clinical Trials web-based platform (NCT 03843905). Oral and written informed consent will be obtained from each included patient. Study results will be reported to the scientific community at conferences and in peer-reviewed scientific journals.Trial registration numberNCT03843905..
Published: 2020

12. Anti-TNF Therapy Is Associated With an Increased Risk of Postoperative Morbidity After Surgery for Ileocolonic Crohn Disease

Author: Brouquet, Antoine, Maggiori, Léon, Zerbib, Philippe, Lefèvre, Jérémie, Denost, Quentin, Germain, Adeline, Cotte, Eddy, BEYER-BERJOT, Laura, Munoz-Bongrand, Nicolas, Desfourneaux, Véronique, Rahili, Amine, Duffas, Jean-Pierre, Pautrat, Karine, Denet, Christine, Bridoux, Valérie, Meurette, Guillaume, Faucheron, Jean-Luc, Loriau, Jérôme, Guillon, Françoise, Vicaut, Eric, Benoist, Stéphane, PANIS, Yves, Service de Chirurgie générale et digestive [CHU Le Kremlin-Bicêtre], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Service de Gastroentérologie [Hôpital Beaujon], Hôpital Beaujon, Service de Chirurgie Générale et Digestive[Lille], Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), 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), Bioingénierie tissulaire (BIOTIS), Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Chirurgie digestive [Bordeaux], CHU Bordeaux [Bordeaux], Service de Chirurgie Digestive Hépatobiliaire et Endocrine [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre Hospitalier Lyon Sud, Service de Chirurgie Digestive, Hospices Civils de Lyon (HCL), Laboratoire de Biomécanique Appliquée (LBA UMR T24), Aix Marseille Université (AMU)-Institut Français des Sciences et Technologies des Transports, de l'Aménagement et des Réseaux (IFSTTAR), Department of Gastroenterological Surgery, Hop St Louis, CHU Pontchaillou [Rennes], Centre Hospitalier Universitaire de Nice (CHU Nice), Chirurgie Générale et Digestive [Rangueil], CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Hôpital Lariboisière, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Lariboisière-Université Paris Diderot - Paris 7 (UPD7), Service de chirurgie digestive [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau (ADEN), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institute for Research and Innovation in Biomedicine (IRIB), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Normandie Université (NU)-Normandie Université (NU), Centre hospitalier universitaire de Nantes (CHU Nantes), Unité de Chirurgie Colorectale, CHU Grenoble-Hôpital Michallon, Groupe Hospitalier Paris Saint-Joseph, Hépato-gastro-entérologie, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Hospitalier Universitaire de Montpellier (CHU Montpellier ), Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Bordeaux (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM), Aix Marseille Université (AMU)-Université Gustave Eiffel, Hôpital Lariboisière-Fernand-Widal [APHP], Université Paris Diderot - Paris 7 (UPD7)-Hôpital Lariboisière-Fernand-Widal [APHP], Service de chirurgie digestive [CHU Rouen], Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), 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)-Université Paris Diderot - Paris 7 (UPD7), Hôpital Beaujon [AP-HP]-Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hémostase et pathologie cardiovasculaire, EA2693-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé, Service de Chirurgie Générale (A), CHU Bordeaux [Bordeaux]-Hôpital Saint-André, Service de chirurgie oncologique, 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], Institut Mutualiste de Montsouris (IMM), Department of Digestive Surgery, Rouen University Hospital, Clinique de Chirurgie Digestive et Endocrinienne [CHU Nantes], Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-GMCAO ), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC), 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]), Service de Chirurgie digestive [GH Paris Saint-Joseph], Groupe hospitalier Paris Saint-Joseph - Hôpital, Université Paris Diderot - Paris 7 (UPD7)-Hôpital Lariboisière-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Histoire Archéologie Littérature des Mondes Anciens - UMR 8164 (HALMA), Ministère de la Culture (MC)-Université de Lille-Centre National de la Recherche Scientifique (CNRS), Department Colorectal Surgery, Université Paris Diderot - Paris 7 (UPD7), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), 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), Groupe Hospitalier Paris Saint-Joseph (hpsj), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon [AP-HP], 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), Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), Histoire Archéologie Littérature des Mondes Anciens (HALMA) - UMR 8164 (HALMA), and Ministère de la Culture et de la Communication (MCC)-Université de Lille-Centre National de la Recherche Scientifique (CNRS)
Subjects: [SDV]Life Sciences [q-bio], [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, ComputingMilieux_MISCELLANEOUS
Abstract: International audience; Objective: To determine the risk factors of morbidity after surgery for ileocolonic Crohn disease (CD).Summary Background Data: The risk factors of morbidity after surgery for CD, particularly the role of anti-TNF therapy, remain controversial and have not been evaluated in a large prospective cohort study. Methods: From 2013 to 2015, data on 592 consecutive patients who underwent surgery for CD in 19 French specialty centers were collected prospectively. Possible relationships between anti-TNF and postoperative overall morbidity were tested by univariate and multivariate analyses. Because treatment by anti-TNF is possibly dependent on the characteristics of the patients and disease, a propensity score was calculated and introduced in the analyses using adjustment of the inverse probability of treatment-weighted method.Results: Postoperative mortality, overall and intra-abdominal septic morbidity rates in the entire cohort were 0%, 29.7%, and 8.4%, respectively; 143 (24.1%) patients had received anti-TNF 180 min (OR = 2.71; CI 95% = 1.54–4.78, P < 0.001) and recurrent CD (OR = 1.99; CI 95% = 1.13–3.36, P = 0.017). After calculating the propensity score and adjustment according to the inverse probability of treatment-weighted method, anti-TNF Conclusions: Preoperative anti-TNF therapy is associated with a higher risk of morbidity after surgery for ileocolonic CD. This information should be considered in the surgical management of these patients, particularly with regard to the preoperative preparation and indication of temporary defunctioning stoma.
Published: 2018

13. An anatomic and morphometric analysis of splenic variability using 3D reconstruction and spatial orientation from computed tomography

Author: Lionel Thollon, Thierry Bege, Christian Brunet, Anne-Sophie Studer, Kathia Chaumoitre, S. Coze, Cyril J.F. Kahn, Anderson Loundou, S. Berdah, Laboratoire de Biomécanique Appliquée (LBA UMR T24), Aix Marseille Université (AMU)-Université Gustave Eiffel, Hôpital Nord [CHU - APHM], Santé Publique et maladies Chroniques : Qualité de vie Concepts, Usages et Limites, Déterminants (SPMC), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM), Centre de résonance magnétique biologique et médicale (CRMBM), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Centre National de la Recherche Scientifique (CNRS), Service de radiothérapie - [Hôpital de la Timone - Hôpital Nord - APHM], Hôpital de la Timone [CHU - APHM] (TIMONE)- Hôpital Nord [CHU - APHM], and Department of Digestive Surgery. Hôpital Nord
Subjects: Adult, Male, Aging, Waist, Adolescent, Population, Young Adult, Imaging, Three-Dimensional, Abdomen, Image Processing, Computer-Assisted, [SDV.MHEP.AHA]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO], medicine, Humans, Obesity, education, ComputingMilieux_MISCELLANEOUS, Aged, Retrospective Studies, Sex Characteristics, Rib cage, education.field_of_study, Anthropometry, Orientation (computer vision), business.industry, [SPI.MECA.BIOM]Engineering Sciences [physics]/Mechanics [physics.med-ph]/Biomechanics [physics.med-ph], General Medicine, Anatomy, Middle Aged, Thorax, medicine.disease, Circumference, medicine.anatomical_structure, Liver, Abdominal trauma, Thoracic vertebrae, Female, Waist Circumference, Tomography, X-Ray Computed, business, Spleen, Developmental Biology
Abstract: In terms of frequency, the spleen is the first organ affected in abdominal trauma, resulting even today in a high rate of mortality (10%). Nevertheless, very few studies have investigated splenic quantitative morphometry as to shape and spatial orientation. Therefore, we analysed healthy spleen variability in order to integrate it in its environment and to correlate its morphometric parameters to anthropometric characteristics.Ninety abdominopelvic CT-scans performed on patients over 16 years with no splenic pathology were retrospectively selected among a Mediterranean population. Three age groups ([16-30], [30-60] and [over 60 years]), equally distributed among genders, were created. Parameters, such as volume, characteristic checkpoints, orientation, and morphology, were measured on the spleen, the 11th thoracic vertebra and the 10th ribs in three-dimensional reconstructions. Anthropometric parameters were characterised by waist circumference, costo-xiphoid angle, abdominal height and chest depth.Observed variations in splenic morphology were divided into three groups: cupped (66.7%), coiled (17.8%), and flat (15.5%). Splenic morphometry tends to be abdominal-shaped (54.5%) or dorsal-shaped (45.5%). The mean of the angle between the main axis of the spleen and the CT-scan horizontal axis was 40±14°. Correlations were highlighted between volume and gender (p0.05), splenic morphology and liver morphometry (p0.05) as well as between orientation of hilar surface and splenic morphometry (p0.01). Moreover, the spleen is more horizontal in women (p0.05), in the elderly (p0.05) and in the obese (p0.01).This study defines three groups based on shape and highlights correlations between parameters describing healthy splenic variability and its anthropometric characteristics, which are of great importance for numerical modelling in splenic studies.
Published: 2015

14. Endoscopic ultrasound-guided biliary drainage after failed ERCP: cumulative experience of 101 procedures at a single center

Author: Gilles Bommelaer, J Privat, Michel Dapoigny, Laurent Poincloux, Denis Pezet, Armando Abergel, Emmanuel Buc, Olivier Rouquette, CHU Estaing [Clermont-Ferrand], Centre Hospitalier Universitaire Clermont Ferrand, CHU Clermont-Ferrand, 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), Department of Digestive Surgery, University Medical Hospital, Département d'Hépato-Gastroentérologie, Hôtel-Dieu-CHU Clermont-Ferrand-Université de Clermont-Ferrand, Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Digestive and Hepatobiliary Medecine, University Medical Hospital, Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), and Institut National de la Recherche Agronomique (INRA)-Université d'Auvergne - Clermont-Ferrand I (UdA)
Subjects: Adult, Male, Endoscopic ultrasound, medicine.medical_specialty, Percutaneous, medicine.medical_treatment, Fistula, Percutaneous transhepatic cholangiography, Endosonography, Cohort Studies, Pneumoperitoneum, medicine, Humans, Ultrasonography, Interventional, ComputingMilieux_MISCELLANEOUS, Aged, Aged, 80 and over, Cholangiopancreatography, Endoscopic Retrograde, Endoscopic retrograde cholangiopancreatography, medicine.diagnostic_test, business.industry, Gastroenterology, Stent, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, Middle Aged, Jaundice, medicine.disease, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, digestive system diseases, 3. Good health, Surgery, Jaundice, Obstructive, Treatment Outcome, Choledochostomy, Drainage, Female, Stents, Radiology, medicine.symptom, business
Abstract: Background and study aim: Endoscopic ultrasound (EUS)-guided biliary access is an alternative to percutaneous access after failed endoscopic retrograde cholangiopancreatography (ERCP). This report presents 7 years’ cumulative experience of EUS-guided biliary drainage for obstructive jaundice in patients with failed ERCP. Patients and methods: Between February 2006 and February 2013, 101 patients (malignant = 98, benign = 3) with previous failed ERCP underwent an EUS intra- or extrahepatic approach with transluminal stenting or an EUS-guided rendezvous procedure with transpapillary stent placement. A single endoscopist performed all procedures. Results: A total of 71 patients underwent the intrahepatic approach (66 hepatogastrostomies and 5 EUS-guided rendezvous), and 30 underwent the extrahepatic approach (26 choledochoduodenostomies, 1 choledochojejunostomy, 1 choledochoantrostomy, and 2 EUS-guided cholangiographies). Technical and clinical success rates were 98.0 % and 92.1 %, respectively. There was no difference in efficacy between hepatogastrostomies and choledochoduodenostomies (94 % vs. 90 %; P = 0.69) or in major complications (10.6 % vs. 6.7 %; P = 1). Adverse events occurred in 12 patients (11.9 %): 10 in the hepatogastrostomy group (2 limited pneumoperitoneum, 1 hepatic hematoma, 5 bile leakage, 2 sepsis), and 2 in the choledochoduodenostomy group (1 arteriobiliary fistula and 1 sepsis). There were six procedure-related deaths, five among the first 50 patients and one among the last 51 patients. Hepatogastrostomy vs. choledochoduodenostomy, plastic vs. metal stenting, stent-in-stent vs. 1 stent, nasobiliary drain, or postoperative octreotide infusion were not prognostic of bile leakage. Conclusion: EUS-guided biliary drainage is an efficient technique, but is associated with significant morbidity that seems to decrease with the learning curve. It should be performed in tertiary care centers in selected patients. Prospective randomized studies are needed to compare EUS-guided biliary drainage with percutaneous transhepatic cholangiography drainage.
Published: 2015

15. Organ preservation for rectal cancer (GRECCAR 2): a prospective, randomised, open-label, multicentre, phase 3 trial

Author: Michel Prudhomme, Igor Sileznieff, Frédéric Marchal, Anne Rullier, Julien Asselineau, Alain Valverde, Denis Pezet, G. Portier, Jean-Jacques Tuech, Bernard Lelong, Eric Rullier, Véronique Vendrely, Bernard Meunier, Jean-Luc Faucheron, Adélaïde Doussau, Michel Rivoire, Quentin Denost, Mehrdad Jafari, Marc Pocard, Philippe Rouanet, Centre d'investigation clinique et d'épidémiologie clinique 7 (CIC-EC7), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut Bergonié - CRLCC Bordeaux-Institut National de la Santé et de la Recherche Médicale (INSERM)-Cancéropôle du Grand Sud-Ouest, Department of Surgical Oncology, Centre Val d'Aurelle, Laboratoire d'éthique médicale et médecine légale (LEM), Université Paris Descartes - Paris 5 (UPD5), 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], Applications des ultrasons à la thérapie, Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de Gastroentérologie et hépatologie, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon, Chirurgie Générale et Digestive [Purpan], CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], Service de Chirurgie Hépatobiliaire et Digestive, Département de chirurgie digestive, Centre Hospitalier Régional Universitaire de Nîmes (CHRU Nîmes), Hôpital Lariboisière, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Lariboisière-Université Paris Diderot - Paris 7 (UPD7), Department of Digestive Surgery, University Medical Hospital, 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 pathologie [Bordeaux], Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Groupe Hospitalier Saint-André, Groupe hospitalier Saint-André, Bioingénierie tissulaire (BIOTIS), Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de Soutien Méthodologique à la Recherche Clinique (USMR), CHU Bordeaux [Bordeaux], Pôle de Santé publique, Institut Bergonié [Bordeaux], UNICANCER-UNICANCER-Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Cancéropôle du Grand Sud-Ouest, Service de Chirurgie Hépatobiliaire et Digestive [Rennes], Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), 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), Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre de Recherche en Nutrition Humaine d'Auvergne (CRNH d'Auvergne)-Institut National de la Recherche Agronomique (INRA), Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], CHU Pontchaillou [Rennes], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Service de Chirurgie Hépatobiliaire et Digestive [Rennes] = Hepatobiliary and Digestive Surgery [Rennes], Institut National de la Recherche Agronomique (INRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre de Recherche en Nutrition Humaine d'Auvergne (CRNH d'Auvergne), Université de Bordeaux (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut Bergonié [Bordeaux], UNICANCER-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM)-Cancéropôle du Grand Sud-Ouest, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Lariboisière-Fernand-Widal [APHP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)
Subjects: medicine.medical_specialty, Population, 030230 surgery, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Clinical endpoint, medicine, Stage (cooking), Prospective cohort study, education, ComputingMilieux_MISCELLANEOUS, education.field_of_study, business.industry, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, General Medicine, Total mesorectal excision, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, 3. Good health, Surgery, Clinical trial, 030220 oncology & carcinogenesis, business, Chemoradiotherapy
Abstract: Summary Background Organ preservation is a concept proposed for patients with rectal cancer after a good clinical response to neoadjuvant chemotherapy, to potentially avoid morbidity and side-effects of rectal excision. The objective of this study was to compare local excision and total mesorectal excision in patients with a good response after chemoradiotherapy for lower rectal cancer. Methods We did a prospective, randomised, open-label, multicentre, phase 3 trial at 15 tertiary centres in France that were experts in the treatment of rectal cancer. Patients aged 18 years and older with stage T2T3 lower rectal carcinoma, of maximum size 4 cm, who had a good clinical response to neoadjuvant chemoradiotherapy (residual tumour ≤2 cm) were centrally randomly assigned by the surgeon before surgery to either local excision or total mesorectal excision surgery. Randomisation, which was done via the internet, was not stratified and used permuted blocks of size eight. In the local excision group, a completion total mesorectal excision was required if tumour stage was ypT2–3. The primary endpoint was a composite outcome of death, recurrence, morbidity, and side-effects at 2 years after surgery, to show superiority of local excision over total mesorectal excision in the modified intention-to-treat (ITT) population (expected proportions of patients having at least one event were 25% vs 60% for superiority). This trial was registered with ClinicalTrials.gov, number NCT00427375. Findings From March 1, 2007, to Sept 24, 2012, 186 patients received chemoradiotherapy and were enrolled in the study. 148 good clinical responders were randomly assigned to treatment, three were excluded (because they had metastatic disease, tumour >8 cm from anal verge, and withdrew consent), and 145 were analysed: 74 in the local excision group and 71 in the total mesorectal excision group. In the local excision group, 26 patients had a completion total mesorectal excision. At 2 years in the modified ITT population, one or more events from the composite primary outcome occurred in 41 (56%) of 73 patients in the local excision group and 33 (48%) of 69 in the total mesorectal excision group (odds ratio 1·33, 95% CI 0·62–2·86; p=0·43). In the modified ITT analysis, there was no difference between the groups in all components of the composite outcome, and superiority was not shown for local excision over total mesorectal excision. Interpretation We failed to show superiority of local excision over total mesorectal excision, because many patients in the local excision group received a completion total mesorectal excision that probably increased morbidity and side-effects, and compromised the potential advantages of local excision. Better patient selection to avoid unnecessary completion total mesorectal excision could improve the strategy. Funding National Cancer Institute of France, Sanofi, Roche Pharma.
Published: 2017

16. Multicentric initial experience with the use of the pressurized intraperitoneal aerosol chemotherapy (PIPAC) in the management of unresectable peritoneal carcinomatosis

Author: Denis Pezet, Olivier Glehen, Naoual Bakrin, Mohammad Alyami, Guillaume Passot, Delphine Cabelguenne, Johan Gagnière, Laurent Villeneuve, Olivia Sgarbura, François Quenet, Chirurgie digestive et hépatobiliaire, CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), Institut National de la Recherche Agronomique (INRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre de Recherche en Nutrition Humaine d'Auvergne (CRNH d'Auvergne), 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), Service de pharmacie - Centre Hospitalier Lyon Sud, Hospices Civils de Lyon (HCL), Unité de Méthodologie en Recherche Clinique, Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL), Department of Digestive Surgery, University Medical Hospital, Center Val d'Aurel, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Department of Obstetrics and Gynaecology, Ciblage thérapeutique en Oncologie (EA3738), Université de Lyon-Université de Lyon, Centre Hospitalier Universitaire Estaing, 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), and CRLCC Val d'Aurelle - Paul Lamarque-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Adult, Male, medicine.medical_specialty, Constipation, medicine.medical_treatment, Antineoplastic Agents, 03 medical and health sciences, 0302 clinical medicine, Ascites, medicine, Pressure, Pseudomyxoma peritonei, Humans, Mesothelioma, Prospective Studies, Prospective cohort study, ComputingMilieux_MISCELLANEOUS, Peritoneal Neoplasms, Aged, Aerosols, Chemotherapy, business.industry, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, General Medicine, Middle Aged, medicine.disease, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, 3. Good health, Surgery, Oxaliplatin, Treatment Outcome, Oncology, 030220 oncology & carcinogenesis, Conventional PCI, 030211 gastroenterology & hepatology, Female, France, medicine.symptom, business, Injections, Intraperitoneal, medicine.drug
Abstract: Background PIPAC is a recent approach for intraperitoneal chemotherapy with promising results for patients with peritoneal carcinomatosis (PC). We aimed to evaluate the postoperative outcome of PIPAC in patients with non-resectable PC during our initial experience of the technique. Methods All patients who underwent PIPAC for non-resectable PC in three centers were analyzed regarding postoperative outcomes. Results Seventy-three patients underwent 164 PIPAC. PC was from colorectal, gastric, ovarian, malignant mesothelioma, pseudomyxoma peritonei or other origins in 20, 26, 13, 8, 1 and 5 patients respectively. Forty-five (62%), 31 (42%), 8 (11%), 6 (8%), 1 (1%) patients underwent a second, third, fourth, fifth, and sixth PIPAC respectively. At the time of the first PIPAC, the median PCI was 17 (1–39), 57 patients presented with symptomatic PC (pain: 33; ascites: 35; transit disorder like diarrhea and constipation: 11). PCI improved in 64.5% of patients, 63.5% of patients presented with complete disappearance of symptoms. Major complications occurred as the outcome of 16 PIPAC (9.7%) and 5 (6.8%) patients died within 30 days of the PIPAC procedure. Rate of mortality and major complications 40% and 62% respectively occurred in first 20 treated patients. For 64 (88%) patients, systemic chemotherapy was associated with PIPAC and could be administered after PIPAC with a median delay of 14 days (2–28). Conclusions Implementing a PIPAC program in association with systemic chemotherapy is feasible and is associated with a risk of postoperative morbidity, even in teams highly experienced in PC management and requires a learning curve in patient selection.
Published: 2017

17. One-month apparent diffusion coefficient correlates with response to radiofrequency ablation of hepatocellular carcinoma

Author: Barat, M, Fohlen, A, Cassinotto, C, Jannot, As, Dautry, R, Pelage, J-P, Boudiaf, M, Pocard, M, Eveno, C, Taouli, B, Soyer, P, Dohan, A, Department of Body and Interventional Imaging, Hôpital Lariboisière, Paris, France., Hôpital Lariboisière-Fernand-Widal [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hypoxie, physiopathologies cérébrovasculaire et tumorale (CERVOxy), Imagerie et Stratégies Thérapeutiques des pathologies Cérébrales et Tumorales (ISTCT), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Centre National de la Recherche Scientifique (CNRS)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Centre National de la Recherche Scientifique (CNRS), Service de Radiologie [CHU Caen], Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Department of Diagnostic and Interventional Imaging, Hôpîtal Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, Pessac, France., CHU Bordeaux [Bordeaux], INSERM U1053, Université Bordeaux, Bordeaux, France., Institut National de la Santé et de la Recherche Médicale (INSERM), Sciences de l’information au service de la médecine personnalisée (CRC - Inserm U1138), Centre de Recherche des Cordeliers (CRC), Université Paris Diderot - Paris 7 (UPD7)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Diderot - Paris 7 (UPD7)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Descartes - Paris 5 (UPD5), Department of Medical Informatics and Public Health, European George Pompidou Hospital, Paris, France., 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), Université Paris Diderot, Sorbonne Paris Cité, Paris, France, Université Paris Diderot - Paris 7 (UPD7), 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 Digestive Surgery, Hôpital Lariboisière, Paris, France., Department of Radiology and Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA., Icahn School of Medicine at Mount Sinai [New York] (MSSM), McGill University Health Center [Montreal] (MUHC), Hôpital Lariboisière, Hypoxie, physiopathologies cérébrovasculaire et tumorale ( CERVOxy ), Imagerie et Stratégies Thérapeutiques des pathologies Cérébrales et Tumorales ( ISTCT ), Commissariat à l'énergie atomique et aux énergies alternatives ( CEA ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Caen Normandie ( UNICAEN ), Normandie Université ( NU ) -Normandie Université ( NU ) -Commissariat à l'énergie atomique et aux énergies alternatives ( CEA ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Caen Normandie ( UNICAEN ), Normandie Université ( NU ) -Normandie Université ( NU ), Département de Radiologie [Caen], CHU Caen-Université de Caen Normandie ( UNICAEN ), Institut National de la Santé et de la Recherche Médicale ( INSERM ), Sciences de l’information au service de la médecine personnalisée ( CRC - Inserm U1138 ), Centre de Recherche des Cordeliers ( CRC ), Université Paris Diderot - Paris 7 ( UPD7 ) -École pratique des hautes études ( EPHE ) -Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Paris Diderot - Paris 7 ( UPD7 ) -École pratique des hautes études ( EPHE ) -Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Paris Descartes - Paris 5 ( UPD5 ), Hôpital Européen Georges Pompidou [APHP] ( HEGP ), Université Paris Diderot - Paris 7 ( UPD7 ), UMR CART - INSERM 965, Hôpital Lariboisière, Paris, France., Icahn School of Medicine at Mount Sinai [New York], McGill University Health Center [Montreal, Canada] ( MUHC ), Centre National de la Recherche Scientifique (CNRS)-Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Université Paris Diderot - Paris 7 (UPD7)-École pratique des hautes études (EPHE)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Diderot - Paris 7 (UPD7)-École pratique des hautes études (EPHE)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Université Pierre et Marie Curie - Paris 6 (UPMC)-École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC)-École Pratique des Hautes Études (EPHE), and Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: [ SDV ] Life Sciences [q-bio], [SDV]Life Sciences [q-bio], radiofrequency ablation, hepatocellular carcinoma, liver metastases, diffusion-weighted MRI
Abstract: International audience; PURPOSE:To assess whether apparent diffusion coefficient (ADC) values at 1 and 3 months after radiofrequency ablation (RFA) may be associated with a favorable response to therapy for hepatocellular carcinoma (HCC) and liver metastases.MATERIALS AND METHODS:Fifty-nine patients with HCC (n = 35) or liver metastases (n = 24) who underwent 1.5T diffusion-weighted magnetic resonance imaging (DWMRI) at 1 and 3 months post-RFA were included. ADC values of patients with local tumor recurrence were compared to those without local recurrence. A subgroup analysis was performed for HCC and metastases.RESULTS:Thirty-eight HCC and 27 metastases were evaluated. The ADC value of HCC at 1 month after RFA was lower in recurrent tumors (0.957 ± 0.229 [SD] × 10-3 mm2 ) compared to tumors with complete response (1.414 ± 0.322 [SD] × 10-3 mm2 /s, P = 0.006). At multivariate analysis, ADC at 1 month was the single independent variable associated with recurrence for HCC (area under the receiver operating characteristic curve = 0.860). No significant association was observed for liver metastases (P = 0.089).CONCLUSION:A low ADC value at 1 month after RFA is associated with an early local recurrence of HCC. This study does not confirm that such association exists for hepatic metastases.
Published: 2017

18. 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

19. Long-Term Effects, Pathophysiological Mechanisms, and Risk Factors of Chemotherapy-Induced Peripheral Neuropathies: A Comprehensive Literature Review

Author: Aurore Collin, Sakahlé Condé, David Balayssac, Nicolas Kerckhove, Carine Chaleteix, Denis Pezet, Neuro-Dol (Neuro-Dol), Université d'Auvergne - Clermont-Ferrand I (UdA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Unité de Nutrition Humaine - Clermont Auvergne (UNH), Institut National de la Recherche Agronomique (INRA)-Université Clermont Auvergne (UCA), CIC - Clermont Ferrand, Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Digestive Surgery, University Medical Hospital, 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), Université Clermont Auvergne (UCA), Unité de Nutrition Humaine (UNH), Institut National de la Recherche Agronomique (INRA)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Centre d'Investigation Clinique [CHU Clermont-Ferrand] (CIC 1405), Institut National de la Santé et de la Recherche Médicale (INSERM)-Direction de la recherche clinique et de l’innovation [CHU Clermont-Ferrand] (DRCI), CHU Clermont-Ferrand-CHU Clermont-Ferrand, Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), Institut National de la Recherche Agronomique (INRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre de Recherche en Nutrition Humaine d'Auvergne (CRNH d'Auvergne), and Université Clermont Auvergne [2017-2020] (UCA [2017-2020])
Subjects: Oncology, medicine.medical_specialty, Review, Pharmacology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, pathophysiological mechanisms, medicine, risk factors, Pharmacology (medical), long-term effects, Depression (differential diagnoses), ComputingMilieux_MISCELLANEOUS, Dysesthesia, business.industry, Bortezomib, Cancer, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, medicine.disease, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, 3. Good health, Oxaliplatin, anticancer drugs, Peripheral neuropathy, Chemotherapy-induced peripheral neuropathy, 030220 oncology & carcinogenesis, Neuropathic pain, medicine.symptom, business, 030217 neurology & neurosurgery, medicine.drug, chemotherapy-induced peripheral neuropathy
Abstract: Neurotoxic anticancer drugs, such as platinum-based anticancer drugs, taxanes, vinca alkaloids, and proteasome/angiogenesis inhibitors are responsible for chemotherapy-induced peripheral neuropathy (CIPN). The health consequences of CIPN remain worrying as it is associated with several comorbidities and affects a specific population of patients already impacted by cancer, a strong driver for declines in older adults. The purpose of this review is to present a comprehensive overview of the long-term effects of CIPN in cancer patients and survivors. Pathophysiological mechanisms and risk factors are also presented. Neurotoxic mechanisms leading to CIPNs are not yet fully understood but involve neuronopathy and/or axonopathy, mainly associated with DNA damage, oxidative stress, mitochondria toxicity, and ion channel remodeling in the neurons of the peripheral nervous system. Classical symptoms of CIPNs are peripheral neuropathy with a “stocking and glove” distribution characterized by sensory loss, paresthesia, dysesthesia and numbness, sometimes associated with neuropathic pain in the most serious cases. Several risk factors can promote CIPN as a function of the anticancer drug considered, such as cumulative dose, treatment duration, history of neuropathy, combination of therapies and genetic polymorphisms. CIPNs are frequent in cancer patients with an overall incidence of approximately 38% (possibly up to 90% of patients treated with oxaliplatin). Finally, the long-term reversibility of these CIPNs remain questionable, notably in the case of platinum-based anticancer drugs and taxanes, for which CIPN may last several years after the end of anticancer chemotherapies. These long-term effects are associated with comorbidities such as depression, insomnia, falls and decreases of health-related quality of life in cancer patients and survivors. However, it is noteworthy that these long-term effects remain poorly studied, and only limited data are available such as in the case of bortezomib and thalidomide-induced peripheral neuropathy.
Published: 2017
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20. Tailored Treatment Strategy for Locally Advanced Rectal Carcinoma Based on the Tumor Response to Induction Chemotherapy

Author: Rouanet, Philippe, Rullier, Eric, Lelong, Bernard, Maingon, Philippe, Tuech, Jean-Jacques, Pezet, Denis, Castan, Florence, Nougaret, Stéphanie, Department of Surgical Oncology, Centre Val d'Aurelle, Centre d'investigation clinique et d'épidémiologie clinique 7 (CIC-EC7), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut Bergonié - CRLCC Bordeaux-Institut National de la Santé et de la Recherche Médicale (INSERM)-Cancéropôle du Grand Sud-Ouest, 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], Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc (CRLCC - CGFL), Laboratoire d'éthique médicale et médecine légale (LEM), Université Paris Descartes - Paris 5 (UPD5), Department of Digestive Surgery, University Medical Hospital, 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), 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), Service d'imagerie abdominale, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-CHU Saint-Eloi, Institut Bergonié [Bordeaux], UNICANCER-UNICANCER-Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Cancéropôle du Grand Sud-Ouest, Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes], CHU Pontchaillou [Rennes], Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), Institut National de la Recherche Agronomique (INRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre de Recherche en Nutrition Humaine d'Auvergne (CRNH d'Auvergne), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Saint Eloi (CHRU Montpellier), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Institut Bergonié [Bordeaux], UNICANCER-UNICANCER-Institut National de la Santé et de la Recherche Médicale (INSERM)-Cancéropôle du Grand Sud-Ouest, Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre de Recherche en Nutrition Humaine d'Auvergne (CRNH d'Auvergne)-Institut National de la Recherche Agronomique (INRA), and CRLCC Val d'Aurelle - Paul Lamarque-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2017

21. Erratum to: Warmed and humidified carbon dioxide for abdominal laparoscopic surgery: meta-analysis of the current literature

Author: Bruno Pereira, David Balayssac, Bertrand Le Roy, Johan Gagnière, Jean-Etienne Bazin, Denis Pezet, Université Clermont Auvergne (UCA), Department of Clinical Research & Innovation, University Medical Hospital, Unité de soins intensifs [Clermont Ferrand], CHU Clermont-Ferrand-Hôpital Gabriel Montpied, Chirurgie digestive et hépatobiliaire, Centre Hospitalier Universitaire Estaing, Department of Digestive Surgery, University Medical Hospital, 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), Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), and Institut National de la Recherche Agronomique (INRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre de Recherche en Nutrition Humaine d'Auvergne (CRNH d'Auvergne)
Subjects: Insufflation, Laparoscopic surgery, medicine.medical_specialty, medicine.medical_treatment, media_common.quotation_subject, 03 medical and health sciences, 0302 clinical medicine, Pneumoperitoneum, Medicine, Laparoscopy, ComputingMilieux_MISCELLANEOUS, 030304 developmental biology, media_common, 0303 health sciences, medicine.diagnostic_test, business.industry, Convalescence, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, Hypothermia, medicine.disease, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, 3. Good health, Surgery, 030220 oncology & carcinogenesis, Anesthesia, medicine.symptom, business, Surgical endoscopy, Abdominal surgery
Abstract: The creation of a pneumoperitoneum for laparoscopic surgery is performed by the insufflation of carbon dioxide (CO2). The insufflated CO2 is generally at room temperature (20–25 °C) and dry (0–5 % relative humidity). However, these physical characteristics could lead to alterations of the peritoneal cavity, leading to operative and postoperative complications. Warming and humidifying the insufflated gas has been proposed to reduce the iatrogenic effects of laparoscopic surgery, such as pain, hypothermia and peritoneal alterations. Two medical devices are currently available for laparoscopic surgery with warm and humidified CO2. Clinical studies were identified by searching PubMed with keywords relating to humidified and warmed CO2 for laparoscopic procedures. Analysis of the literature focused on postoperative pain, analgesic consumption, duration of hospital stay and convalescence, surgical techniques and hypothermia. Bibliographic analyses reported 114 publications from 1977 to 2015, with only 17 publications of clinical interest. The main disciplines focused on were gynaecological and digestive surgery ). Analysis of the studies selected reported only a small beneficial effect of warmed and humidified laparoscopy compared to standard laparoscopy on immediate postoperative pain and per procedure hypothermia. No difference was observed for later postoperative shoulder pain, morphine equivalent daily doses, postoperative body core temperature, recovery room and hospital length of stay, lens fogging and procedure duration. Only few beneficial effects on immediate postoperative pain and core temperature have been identified in this meta-analysis. Although more studies are probably needed to close the debate on the real impact of warmed and humidified CO2 for laparoscopic procedures.
Published: 2017

22. Laparoscopy could be the best approach to treat colorectal cancer in selected patients aged over 80 years: Outcomes from a multicenter study

Author: Brice Gayet, Jean-Marc Phelip, Xavier Roblin, David Fuks, Léa Clavel, Jack Porcheron, Leslie Rinaldi, Mehdi Ouaissi, Nicolas Williet, Anderson Loundou, Igor Sielezneff, Gabriele Barabino, Centre de Recherches en Oncologie biologique et Oncopharmacologie (CRO2), Aix Marseille Université (AMU)- Hôpital de la Timone [CHU - APHM] (TIMONE)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut d'oncologie/développement Albert Bonniot de Grenoble (INSERM U823), Institut National de la Santé et de la Recherche Médicale (INSERM)-EFS-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF), Unité d'Aide Méthodologique, Assistance Publique - Hôpitaux de Marseille (APHM)-CHU Marseille, Service d'oncologie digestive et hépato-gastro-entérologie [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Vascular research center of Marseille (VRCM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Department of Digestive Surgery, University Medical Hospital, Service d'Hépato-gastroentérologie [CHU Saint-Etienne], CHU Amiens-Picardie, Departement medico-chirurgical de pathologie digestive, Institut Mutualiste de Montsouris (IMM), Laboratoire Interdisciplinaire d'Etude des Nanoparticules Aérosolisées (LINA-ENSMSE), École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-CIS, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-EFS-Institut National de la Santé et de la Recherche Médicale (INSERM), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E)
Subjects: Male, medicine.medical_specialty, Colorectal cancer, medicine.medical_treatment, [SDV]Life Sciences [q-bio], 030230 surgery, Metastasis, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, medicine, Humans, 10. No inequality, Laparoscopy, Survival rate, Colectomy, Survival analysis, ComputingMilieux_MISCELLANEOUS, Retrospective Studies, Aged, 80 and over, Hepatology, medicine.diagnostic_test, business.industry, Age Factors, Gastroenterology, Retrospective cohort study, Length of Stay, medicine.disease, Survival Analysis, 3. Good health, Surgery, Survival Rate, Treatment Outcome, Elective Surgical Procedures, 030220 oncology & carcinogenesis, Multivariate Analysis, Female, France, Colorectal Neoplasms, Elective Surgical Procedure, business
Abstract: The efficacy and safety of treating elderly patients with colorectal cancer (CRC) is of concern. This study aimed to compare the short- and long-term outcomes of elective laparoscopic vs. open surgery to treat CRC in very elderly patients.All patients aged80 years and who had undergone a colectomy for CRC without metastasis between July 2005 and April 2012 were considered for inclusion. Demographic, clinical, operative, and postoperative data, plus overall and disease-free survival rates, were retrospectively collected and compared between two groups of patients that underwent an open procedure (OP group) or laparoscopy (LG).123 patients were enrolled (55 OPG, 68 LG). Median age was similar between the groups (84 vs. 83 years, respectively; NS). Duration of surgery was significantly lower in OPG (170 vs. 200min; p=0.030). Overall mortality at 3 months was 8.3%: it tended to be greater in the OPG (16.5% vs. 1.5%, NS). Morbidity was significantly greater in the OPG compared to the LG (52.7% vs. 27.5%; p=0.021), resulting in significantly longer hospital stay (12 vs. 8 days, respectively; p0.001). Pathological findings were similar between the two groups. Cumulative overall survival rates at 3 and 5 years were significantly greater after laparoscopy (85% and 72%) compared to open surgery (58.2% and 48%, respectively; p0.001).Our study suggests that laparoscopy is safe and could increase overall survival compared to open surgery in elderly patients suffering from CRC.This retrospective study compared the short- and longer-term outcomes of patients aged80 years and undergoing elective laparoscopic or open surgery for CRC between 2005 and 2012.
Published: 2017

23. Protocols for staining of bile canalicular and sinusoidal networks of human, mouse and pig livers, three-dimensional reconstruction and quantification of tissue microarchitecture by image processing and analysis

Author: Petru Bucur, Seddik Hammad, Iryna Ilkavets, Dirk Drasdo, Jan G. Hengstler, Stefan Hoehme, Iris von Recklinghausen, Rosemarie Marchan, Klaus Golka, Amnah Othman, Tim Johann, Christoph Meyer, Bruno Christ, Patricio Godoy, Brigitte Begher-Tibbe, Rolf Gebhardt, Eric Vibert, Raymond Reif, Amruta Vartak, Uta Dahmen, Steven Dooley, Olaf Dirsch, Adrian Friebel, J Böttger, Leibniz Research Centre for Working Environment and Human Factors [Dortmund] (IFADO), Technische Universität Dortmund [Dortmund] (TU), Department of Forensic Medicine and Veterinary Toxicology [Qena], Faculty of Veterinary Medicine [Qena], South Valley University [Qena]-South Valley University [Qena], Interdisciplinary Centre for Bioinformatics [Leipzig] (IZBI), Universität Leipzig, Centre Hépato-Biliaire, Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Digestive Surgery and Liver Transplantation, CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Department of Visceral, Transplantation, Thoracic and Vascular Surgery, University Hospital Leipzig, University Hospital Leipzig, Molecular Hepatology - Alcohol Associated Diseases, Department of Medicine II, University of Heidelberg, Medical Faculty of Mannheim-University of Heidelberg, Medical Faculty of Mannheim, Scientific Databases and Visualization, HITS gGmbH, Experimental Transplantation Surgery, Department of General, Visceral and Vascular Surgery [Jena], Friedrich-Schiller-Universität = Friedrich Schiller University Jena [Jena, Germany]-Friedrich-Schiller-Universität = Friedrich Schiller University Jena [Jena, Germany], Friedrich-Schiller-Universität = Friedrich Schiller University Jena [Jena, Germany], Institut für Biochemie [Leipzig], Modelling and Analysis for Medical and Biological Applications (MAMBA), Laboratoire Jacques-Louis Lions (LJLL), Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS)-Inria Paris-Rocquencourt, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), BMBF (German Federal Ministry of Educationand Research) project Virtual Liver Network (VLN), French National Research Agency (ANR-13-TECS-0006—ProjectIntraoperative Fluorescent Liver Optimization Work-up—iFLOW)., ANR-13-TECS-0006,iFLOW,Estimation intraopératoire de la fonction hépatique par caméra fluorescente proche-infrarouge lors de chirurgies du foie(2013), and Universität Leipzig [Leipzig]
Subjects: Male, Quality Control, Swine, Health, Toxicology and Mutagenesis, Dipeptidyl Peptidase 4, Quantitative imaging, Biology, Bone canaliculus, Toxicology, Microcirculation, Antibody Specificity, medicine, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, Image Processing, Computer-Assisted, Animals, Humans, Hepatocyte polarity, Confocal microscopy, Liver microarchitecture, Systems biology, Image analysis, Paraffin Embedding, Staining and Labeling, Bile Canaliculi, Reproducibility of Results, Histology, General Medicine, Anatomy, [INFO.INFO-MO]Computer Science [cs]/Modeling and Simulation, [SDV.BIBS]Life Sciences [q-bio]/Quantitative Methods [q-bio.QM], Staining, Mice, Inbred C57BL, Vibratome, medicine.anatomical_structure, Liver, Hepatocyte, [INFO.INFO-TI]Computer Science [cs]/Image Processing [eess.IV], Hepatocytes, [INFO.INFO-BI]Computer Science [cs]/Bioinformatics [q-bio.QM], Immunostaining, Protocols
Abstract: Histological alterations often constitute a fingerprint of toxicity and diseases. The extent to which these alterations are cause or consequence of compromised organ function, and the underlying mechanisms involved is a matter of intensive research. In particular, liver disease is often associated with altered tissue microarchitecture, which in turn may compromise perfusion and functionality. Research in this field requires the development and orchestration of new techniques into standardized processing pipelines that can be used to reproducibly quantify tissue architecture. Major bottlenecks include the lack of robust staining, and adequate reconstruction and quantification techniques. To bridge this gap, we established protocols employing specific antibody combinations for immunostaining, confocal imaging, three-dimensional reconstruction of approximately 100-μm-thick tissue blocks and quantification of key architectural features. We describe a standard procedure termed ‘liver architectural staining’ for the simultaneous visualization of bile canaliculi, sinusoidal endothelial cells, glutamine synthetase (GS) for the identification of central veins, and DAPI as a nuclear marker. Additionally, we present a second standard procedure entitled ‘S-phase staining’, where S-phase-positive and S-phase-negative nuclei (stained with BrdU and DAPI, respectively), sinusoidal endothelial cells and GS are stained. The techniques include three-dimensional reconstruction of the sinusoidal and bile canalicular networks from the same tissue block, and robust capture of position, size and shape of individual hepatocytes, as well as entire lobules from the same tissue specimen. In addition to the protocols, we have also established image analysis software that allows relational and hierarchical quantifications of different liver substructures (e.g. cells and vascular branches) and events (e.g. cell proliferation and death). Typical results acquired for routinely quantified parameters in adult mice (C57Bl6/N) include the hepatocyte volume (5,128.3 ± 837.8 μm3) and the fraction of the hepatocyte surface in contact with the neighbouring hepatocytes (67.4 ± 6.7 %), sinusoids (22.1 ± 4.8 %) and bile canaliculi (9.9 ± 3.8 %). Parameters of the sinusoidal network that we also routinely quantify include the radius of the sinusoids (4.8 ± 2.25 μm), the branching angle (32.5 ± 11.2°), the length of intersection branches (23.93 ± 5.9 μm), the number of intersection nodes per mm3 (120.3 × 103 ± 42.1 × 103), the average length of sinusoidal vessel per mm3 (5.4 × 103 ± 1.4 × 103mm) and the percentage of vessel volume in relation to the whole liver volume (15.3 ± 3.9) (mean ± standard deviation). Moreover, the provided parameters of the bile canalicular network are: length of the first-order branches (7.5 ± 0.6 μm), length of the second-order branches (10.9 ± 1.8 μm), length of the dead-end branches (5.9 ± 0.7 μm), the number of intersection nodes per mm3 (819.1 × 103 ± 180.7 × 103), the number of dead-end branches per mm3 (409.9 × 103 ± 95.6 × 103), the length of the bile canalicular network per mm3 (9.4 × 103 ± 0.7 × 103 mm) and the percentage of the bile canalicular volume with respect to the total liver volume (3.4 ± 0.005). A particular strength of our technique is that quantitative parameters of hepatocytes and bile canalicular as well as sinusoidal networks can be extracted from the same tissue block. Reconstructions and quantifications performed as described in the current protocols can be used for quantitative mathematical modelling of the underlying mechanisms. Furthermore, protocols are presented for both human and pig livers. The technique is also applicable for both vibratome blocks and conventional paraffin slices. Electronic supplementary material The online version of this article (doi:10.1007/s00204-014-1243-5) contains supplementary material, which is available to authorized users.
Published: 2014

24. Medical Therapies for Stricturing Crohn's Disease: Efficacy and Cross-Sectional Imaging Predictors of Therapeutic Failure

Author: Cecile Campos, Anne Dubois, Gilles Bommelaer, Constance Hordonneau, Céline Lambert, Bruno Pereira, Marion Goutte, Anthony Buisson, Michel Dapoigny, Antoine Perrey, Felix Goutorbe, Service Hépato-Gastro-Entérologie, Centre Hospitalier Universitaire de Clermont-Ferrand, Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Radiologie, Hospices Civils de Lyon (HCL), Unité Biostatistique, 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 Chirurgie Digestive, MSD, Abbvie, Ferring, Takeda, Vifor Pharma, Hospira, CHU Clermont-Ferrand, Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), Institut National de la Recherche Agronomique (INRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre de Recherche en Nutrition Humaine d'Auvergne (CRNH d'Auvergne), Département Gastroentérologie, CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Département de Radiologie (LYON - Radio), CHU Lyon, Délégation à la Recherche Clinique et à l'Innovation (DRCI), Department of Digestive surgery, Centre Hospitalier de la Côte Basque, and Centre Hospitalier de la Côte Basque (CHCB)
Subjects: Male, Physiology, Fistula, Anti-Inflammatory Agents, Constriction, Pathologic, Anti-TNF, 0302 clinical medicine, Crohn Disease, Risk Factors, Treatment Failure, Crohn's disease, medicine.diagnostic_test, retrecissement, Hazard ratio, Gastroenterology, stenosis, Age Factors, Middle Aged, Magnetic Resonance Imaging, 3. Good health, crohn’s disease, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Drug Therapy, Combination, Female, Radiology, Immunosuppressive Agents, MRI, imagerie par résonance magnétique, Adult, medicine.medical_specialty, Abdominal Abscess, 03 medical and health sciences, Young Adult, Gastrointestinal Agents, Internal medicine, medicine, Intestinal Fistula, Humans, Cross-sectional imaging, Retrospective Studies, business.industry, Predictors, Tumor Necrosis Factor-alpha, Magnetic resonance imaging, Retrospective cohort study, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Odds ratio, maladie de crohn, Protective Factors, medicine.disease, Infliximab, Discontinuation, Stenosis, business, Tomography, X-Ray Computed, Stricture, thérapie, Follow-Up Studies
Abstract: International audience; BACKGROUND: Medical therapy efficacy remains controversial in stricturing Crohn's disease. Cross-sectional imaging, especially magnetic resonance imaging, has been suggested as very helpful to guide therapeutic decision making. AIM: To assess efficacy and predictors of therapeutic failure in patients receiving medical treatments for stricturing Crohn's disease. METHODS: In this retrospective study, therapeutic failure was defined as symptomatic stricture leading to surgical or endoscopic therapeutics, hospitalization, treatment discontinuation or additional therapy and short-term clinical response as clinical improvement assessed by two physicians. The 55 cross-sectional imaging examinations (33 magnetic resonance imaging and 22 CT scan) before starting medical therapy were analyzed independently by two radiologists. Results were expressed as hazard ratio (HR) or odds ratio (OR) with 95% confidence intervals (95% CI). RESULTS: Among 84 patients, therapeutic failure rate within 60 months was 66.6%. In multivariate analysis, Crohn's disease diagnosis after 40 years old (HR 3.9, 95% CI [1.37-11.2], p = 0.011), small stricture luminal diameter (HR 1.34, 95% CI [1.01-1.80], p = 0.046), increased stricture wall thickness (HR 1.23, 95% CI [1.04-1.46], p = 0.013) and fistula with abscess (HR 5.63, 95% CI [1.64-19.35], p = 0.006) were associated with therapeutic failure, while anti-TNF combotherapy (HR 0.17, 95% CI [0.40-0.71], p = 0.015) prevented it. Considering 108 therapeutic sequences, the short-term clinical response rate was 65.7%. In multivariate analysis, male gender (OR 0.15, 95% CI [0.03-0.64], p = 0.011), fistula with abscess (OR 0.09, 95% CI [0.01-0.77], p = 0.028) and comb sign (OR 0.23, 95% CI [0.005-0.97], p = 0.047) were associated with short-term clinical failure. CONCLUSION: Anti-TNF combotherapy seemed to prevent therapeutic failure, and cross-sectional imaging should be systematically performed to help medical management in stricturing Crohn's disease.
Published: 2016

25. Myenteric plexitis is a risk factor for endoscopic and clinical postoperative recurrence after ileocolonic resection in Crohn's disease

Author: Decousus, S., Boucher, A-L, Joubert, J., Goutte, Marion, Goutorbe, F., Dubois, A., Pereira, B., Dechelotte, P., Bommelaer, Emmanuel, Buisson, Anthony, Pathology Department, Ippokration Hospital, Gastroenterology Department, Hospital de Valme. CIBERehd, Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), Institut National de la Recherche Agronomique (INRA)-Université d'Auvergne - Clermont-Ferrand I (UdA), Department of Digestive surgery, CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Unité de Biostatistiques [CHU Clermont-Ferrand], Direction de la recherche clinique et de l’innovation [CHU Clermont-Ferrand] (DRCI), Institut National de la Santé et de la Recherche Médicale (INSERM), Université d'Auvergne - Clermont-Ferrand I (UdA), European Crohn´s and Colitis Organisation (ECCO). INT., Centre Hospitalier Universitaire Estaing, Biostatistics Unit - Medical Centre, Université Clermont Auvergne (UCA), 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), Université d'Auvergne (Clermont Ferrand 1) (UdA), and ProdInra, Archive Ouverte
Subjects: [SDV] Life Sciences [q-bio], [SDV]Life Sciences [q-bio], digestive system diseases
Abstract: Myenteric plexitis is a risk factor for endoscopic and clinical postoperative recurrence after ileocolonic resection in Crohn's disease. 11. Congress of ECCO - European Crohn's and Colitis Organisation
Published: 2016

26. Endoscopy-based management decreases the risk of postoperative recurrences in Crohn's disease

Author: Anne Dubois, Anthony Buisson, Marion Goutte, Juliette Joubert, Anne-Laure Boucher, Stéphanie Decousus, Michel Dapoigny, Denis Pezet, Felix Goutorbe, Johan Gagnière, Pierre Déchelotte, Corinne Borderon, Gilles Bommelaer, Bruno Pereira, Département Gastroentérologie, CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Université d'Auvergne - Clermont-Ferrand I (UdA), CHU Clermont-Ferrand, Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte (M2iSH), Institut National de la Recherche Agronomique (INRA)-Université d'Auvergne - Clermont-Ferrand I (UdA), Department of Digestive surgery, and ProdInra, Migration
Subjects: endoscopie, Male, Time Factors, crohn's disease, Disease, Kaplan-Meier Estimate, 0302 clinical medicine, Crohn Disease, Recurrence, postoperative recurrence, risk factors, Colectomy, Crohn's disease, medicine.diagnostic_test, Gastroenterology, General Medicine, Colonoscopy, Middle Aged, 3. Good health, facteur de risque, Treatment Outcome, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Female, France, Adult, Reoperation, medicine.medical_specialty, prevalence, Disease-Free Survival, 03 medical and health sciences, Young Adult, Predictive Value of Tests, medicine, Humans, Retrospective Cohort Study, endoscopy, Proportional Hazards Models, Retrospective Studies, prévalence, Chi-Square Distribution, business.industry, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, maladie de crohn, medicine.disease, digestive system diseases, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Endoscopy, Surgery, Hépatologie et Gastroentérologie, Multivariate Analysis, Hépatology and Gastroenterology, business
Abstract: International audience; AIM: to investigate whether an endoscopy-based management could prevent the long-term risk of postoperative recurrence. METHODS: From the pathology department database, we retrospectively retrieved the data of all the patients operated on for Crohn's disease (CD) in our center (1986-2015). Endoscopy-based management was defined as systematic postoperative colonoscopy (median time after surgery = 9.5 mo) in patients with no clinical postoperative recurrence at the time of endoscopy. RESULTS: From 205 patients who underwent surgery, 161 patients (follow-up > 6 mo) were included. Endoscopic postoperative recurrence occurred in 67.6%, 79.7%, and 95.5% of the patients, respectively 5, 10 and 20 years after surgery. The rate of clinical postoperative recurrence was 61.4%, 75.9%, and 92.5% at 5, 10 and 20 years, respectively. The rate of surgical postoperative recurrence was 19.0%, 38.9% and 64.7%, respectively, 5, 10 and 20 years after surgery. In multivariate analysis, previous intestinal resection, prior exposure to anti-TNF therapy before surgery, and fistulizing phenotype (B3) were postoperative risk factors. Previous perianal abscess/fistula (other perianal lesions excluded), were predictive of only symptomatic recurrence. In multivariate analysis, an endoscopy-based management (n = 49/161) prevented clinical (HR = 0.4, 95% CI: 0.25-0.66, p < 0.001) and surgical postoperative recurrence (HR = 0.30, 95% CI: 0.13-0.70, p = 0.006). CONCLUSION: Endoscopy-based management should be recommended in all CD patients within the first year after surgery as it highly decreases the long-term risk of clinical recurrence and reoperation.
Published: 2016

27. KRAS and BRAF Mutational Status in Primary Colorectal Tumors and Related Metastatic Sites: Biological and Clinical Implications

Author: Antoine Italiano, Thibault Fabas, René Brunet, Isabelle Soubeyran, Florence Pedeutour, Eric Francois, Jean Gugenheim, Marie-Christine Saint-Paul, Isabelle Hostein, Marianne Fonck, Yves Becouarn, Serge Evrard, Daniel Benchimol, Laboratory of Solid Tumors Genetics, Nice University Hospital, Institut de signalisation, biologie du développement et cancer (ISBDC), Centre National de la Recherche Scientifique (CNRS)-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 Côte d'Azur (UCA), Plateforme de génétique moléculaire des cancers d'Aquitaine, Institut Bergonié [Bordeaux], UNICANCER-UNICANCER, Department of Digestive Surgery, Centre Hospitalier Universitaire de Nice (CHU Nice), Service de Chirurgie Digestive et Transplantation Hépatique, Hôpital Archet II, Service d'Anatomie et Cytologie Pathologiques, and Hôpital Pasteur [Nice] (CHU)
Subjects: Male, Oncology, endocrine system diseases, Colorectal cancer, medicine.disease_cause, Polymerase Chain Reaction, 0302 clinical medicine, Surgical oncology, Epidermal growth factor receptor, Neoplasm Metastasis, [SDV.BDD]Life Sciences [q-bio]/Development Biology, Aged, 80 and over, 0303 health sciences, Cetuximab, biology, DNA, Neoplasm, Middle Aged, Prognosis, 3. Good health, ErbB Receptors, 030220 oncology & carcinogenesis, Female, KRAS, Colorectal Neoplasms, medicine.drug, Adult, Proto-Oncogene Proteins B-raf, medicine.medical_specialty, Antineoplastic Agents, Adenocarcinoma, Proto-Oncogene Proteins p21(ras), 03 medical and health sciences, Growth factor receptor, Proto-Oncogene Proteins, Internal medicine, Biomarkers, Tumor, medicine, Humans, Panitumumab, neoplasms, Aged, Neoplasm Staging, 030304 developmental biology, business.industry, Wild type, medicine.disease, digestive system diseases, Mutation, ras Proteins, Cancer research, biology.protein, Surgery, business
Abstract: International audience; BACKGROUND: KRAS and BRAF mutations in primary colorectal tumors (PT) are predictive of nonresponse to anti-epidermal growth factor receptor (EGFR) antibodies in patients with metastatic colorectal cancer (mCRC). The question of primary resistance to anti-EGFR treatment as a result of the presence of KRAS or BRAF mutations only in metastases has been raised but not resolved. METHODS: We analyzed the mutational status of KRAS and BRAF in 64 new patients with mCRC and performed a systematic review of published data from 285 patients. RESULTS: A total of 285 and 95 matched PT/metastases were available for the analysis of the KRAS and the BRAF status, respectively. An identical mutational pattern of KRAS in PT and the matching metastases were reported in all the cases but 14 (5%). In six cases (2%), KRAS was mutated in the PT and wild type in the metastatic site, whereas in eight cases (3%), KRAS was wild type in the PT and mutated in the metastatic site. An identical mutational pattern of BRAF in PT and the matching metastases was reported in all but two cases (3%). In one case (1.5%), BRAF was mutated in the PT and wild type in the metastatic site, whereas in one case (1.5%), BRAF was wild type in the PT and mutated in the metastatic site. CONCLUSIONS: The acquisition by metastases of a KRAS or a BRAF mutation that was not present in the PT is a rare event, occurring in 5% of cases of mCRC. This is not a frequent mechanism of primary resistance to anti-EGFR treatments in mCRC.
Published: 2010

28. Management of patients with carcinoma of the right colon invading the duodenum or pancreatic head

Author: Jean-Jacques Tuech, Jean-Paul Joly, Jean-Marc Regimbeau, Pierre Verhaeghe, Patrick Pessaux, Thierry Yzet, Olivier Brehant, Sushil Deshpande, Denis Chatelain, B. Lefebure, Frédéric Dumont, Jean-Pierre Arnaud, François Mauvais, David Fuks, CHU Amiens-Picardie, 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), Département de chirurgie [CHU Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service de chirurgie digestive (Centre Hospitalier de Beauvais), Centre Hospitalier de Beauvais, Procédés Alimentaires et Microbiologiques [Dijon] (PAM), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université de Bourgogne (UB)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, Service d'Hépato-Gastroentérologie, Service de chirurgie digestive [CHU Rouen], Hémodynamique, Interaction Fibrose et Invasivité tumorales Hépatiques (HIFIH), Université d'Angers (UA), and Department of Digestive Surgery. Hôpital Nord
Subjects: Male, Time Factors, [SDV]Life Sciences [q-bio], medicine.medical_treatment, 030230 surgery, 0302 clinical medicine, Registries, Neoplasm Metastasis, Colectomy, Aged, 80 and over, Bile duct, Anastomosis, Surgical, Gastroenterology, Middle Aged, Pancreaticoduodenectomy, 3. Good health, Treatment Outcome, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Colonic Neoplasms, Right Colectomy, Duodenal Fistula, En bloc resection, Female, France, Proctology, management, Adult, medicine.medical_specialty, Duodenum, Perforation (oil well), 03 medical and health sciences, Adjacent organ involvement, Internal Medicine, medicine, Carcinoma, Humans, Neoplasm Invasiveness, Pancreas, Aged, Retrospective Studies, Carcinoma right colon, Hepatology, business.industry, medicine.disease, Surgery, Neoplasm Recurrence, Local, business
Abstract: International audience; Background Only few case series have been published about locally advanced carcinoma of the right colon invading the duodenum or pancreas (CRCDP). We report results of a retrospective study about this rare entity focusing on management and prognosis. Methods We reviewed the complete data of patients operated for CRCDP between 1988 and 2005 in four French digestive-surgery departments. Results Fifteen patients were managed [12 men, 3 women, mean age 63 years (43–86)]. These patients underwent attempted curative en bloc resection including right colectomy: 12 were treated by partial duodenectomy (tumours involving only a part of the duodenum); 3 were treated by pancreaticoduodenectomy. All tumours resected had clear resection margins (R0). About 53% of patients had hepatic metastases, duodenocolic fistula, carcinomatosis, abscess or perforation at presentation. Surgery was performed in emergency in 26% of cases. About 20% of patients had serious postoperative complications (heart failure, bile duct necrosis, septic shock), and three other patients had postoperative anastomotic leaks. No patient experienced duodenal fistula after partial duodenectomy. The mean median survival in resected patients was 22 months (0–122). Overall 1 and 3 years survival were 68% (n = 7) and 56% (n = 4). Despite clear resection margins in all patients, 26% of patients developed recurrence (duodenal wall resection n = 3; pancreaticoduodenectomy n = 1). Conclusion Morbidity and mortality after colectomy and en bloc partial duodenectomy or pancreaticoduodenectomy are high but in selected cases could offer prolonged survival. Aggressive surgery including major resection should be performed to obtain clear resection margins even in case of complicated forms.
Published: 2008

29. Closed-loop cardiovascular system model and partial hepatectomy simulation

Author: Audebert, Chloé, Bucur, Petru, Vibert, Eric, Gerbeau, Jean-Frédéric, Vignon-Clementel, Irene, Numerical simulation of biological flows (REO), Laboratoire Jacques-Louis Lions (LJLL), Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS)-Inria Paris-Rocquencourt, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), Department of Digestive Surgery and Liver Transplantation, CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre Hépato-Biliaire, Institut National de la Santé et de la Recherche Médicale (INSERM), ANR-13-TECS-0006,iFLOW,Estimation intraopératoire de la fonction hépatique par caméra fluorescente proche-infrarouge lors de chirurgies du foie(2013), Audebert, Chloe, and Technologies pour la santé et l'autonomie - Estimation intraopératoire de la fonction hépatique par caméra fluorescente proche-infrarouge lors de chirurgies du foie - - iFLOW2013 - ANR-13-TECS-0006 - TecSan - VALID
Subjects: Reduced-order model, [SPI.MECA.BIOM] Engineering Sciences [physics]/Mechanics [physics.med-ph]/Biomechanics [physics.med-ph], Hemodynamics, Hepatectomy, [SPI.MECA.BIOM]Engineering Sciences [physics]/Mechanics [physics.med-ph]/Biomechanics [physics.med-ph], [INFO.INFO-MO] Computer Science [cs]/Modeling and Simulation, Closed-loop model, [INFO.INFO-MO]Computer Science [cs]/Modeling and Simulation
Abstract: International audience; The present work aims at developing a mathematical model in order to reproduce hemodynamics changes due to liver surgeries. First, a 0D closed-loop model is developed, to simulate hepatectomy and compute post-operative average values. Due to the closed loop, the surgery impact both on and from the whole circulation can be captured, including bleeding and infusion. Then, a one-dimensional artery model is implemented to improve the closed-loop model and simulate better the changes in arterial waveforms due to surgery.
Published: 2015

30. The French Advanced Course for Deployment Surgery (ACDS) called Cours Avancé de Chirurgie en Mission Extérieure (CACHIRMEX): history of its development and future prospects

Author: G. Boddaert, Laurent Mathieu, Frédéric Rongieras, E. Hornez, J.-P. Avaro, Sylvain Rigal, Paul Balandraud, S. Bonnet, Federico Gonzalez, François Pons, Xavier Durand, Antoine Bertani, Department of Visceral and General Surgery, Percy Military Teaching Hospital, French Military Health Service Academy, École du Val de Grâce (EVDG), Service de Santé des Armées-Service de Santé des Armées, Department of Traumatology and Orthopedics, Department of Thoracic and Vascular Surgery, parent, Desgenettes Military Teaching Hospital, Sainte-Anne Teaching Hospital, Department of Urology, Val-de-Grâce Military Teaching Hospital, Laboratoire de Biomécanique et Mécanique des Chocs (LBMC UMR T9406), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut Français des Sciences et Technologies des Transports, de l'Aménagement et des Réseaux (IFSTTAR), Department of Digestive Surgery, and Sainte-Anne Military Teaching Hospital
Subjects: medicine.medical_specialty, Service (systems architecture), education, 0211 other engineering and technologies, Traumatology, Context (language use), 02 engineering and technology, Modern warfare, Military medicine, 03 medical and health sciences, BIOMECANIQUE, 0302 clinical medicine, Humans, Medicine, Military Medicine, Curriculum, DEPLOYMENT SURGERY, 021110 strategic, defence & security studies, Surgical team, business.industry, [SPI.MECA.BIOM]Engineering Sciences [physics]/Mechanics [physics.med-ph]/Biomechanics [physics.med-ph], 030208 emergency & critical care medicine, General Medicine, Surgery, Orthopedics, Software deployment, General Surgery, Education, Medical, Continuing, Clinical Competence, France, business
Abstract: Introduction The composition of a French Forward Surgical Team (FST) has remained constant since its creation in the early 1950s: 12 personnel, including a general and an orthopaedic surgeon. The training of military surgeons, however, has had to evolve to adapt to the growing complexities of modern warfare injuries in the context of increasing subspecialisation within surgery. The Advanced Course for Deployment Surgery (ACDS)—called Cours Avance de Chirurgie en Mission Exterieure (CACHIRMEX)—has been designed to extend, reinforce and adapt the surgical skill set of the FST that will be deployed. Methods Created in 2007 by the French Military Health Service Academy (Ecole du Val-de-Grâce), this annual course is composed of five modules. The surgical knowledge and skills necessary to manage complex military trauma and give medical support to populations during deployment are provided through a combination of didactic lectures, deployment experience reports and hands-on workshops. Results The course is now a compulsory component of initial surgical training for junior military surgeons and part of the Continuous Medical Education programme for senior military surgeons. From 2012, the standardised content of the ACDS paved the way for the development of two more team-training courses: the FST and the Special Operation Surgical Team training. The content of this French military original war surgery course is described, emphasising its practical implications and future prospects. Conclusion The military surgical training needs to be regularly assessed to deliver the best quality of care in an context of evolving modern warfare casualties.
Published: 2015

31. Colorectal cancer in patients seen at the teaching hospitals of Guadeloupe and Martinique: discrepancies, similarities in clinicopathological features, and p53 status

Author: Marc Lubeth, Benoit Tressières, Anne-Marie Andrea, Jacqueline Deloumeaux, Juliette Smith-ravin, Monique Decastel, Jacqueline Veronique-Baudin, Marlene Ossondo, BMC, Ed., Biologie Intégrée du Globule Rouge (BIGR (UMR_S_1134 / U1134)), Institut National de la Transfusion Sanguine [Paris] (INTS)-Université Paris Diderot - Paris 7 (UPD7)-Université de La Réunion (UR)-Université des Antilles (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pointe-à-Pitre/Abymes [Guadeloupe], Department of Anatomopathology, Teaching Hospital of Zobda Quitman, Centre d'investigation clinique Antilles-Guyane (CIC - Antilles Guyane), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU de la Martinique [Fort de France]-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], Cancer Registry of Martinique (AMREC), Cancer Registry of Guadeloupe, Department of Digestive Surgery, Département Scientifique Interfacultaire (DSI), Université des Antilles (Pôle Martinique), Université des Antilles (UA)-Université des Antilles (UA), This work was supported by the clinical research program of the Guadeloupe and Martinique Hospitals and by the Regions of Guadeloupe and Martinique., Pôle de Cancérologie Hématologie Urologie, Registre des Cancers de la Martinique - UF 1441 Recherche & Registre-CHU de la Martinique [Fort de France], Epidémiologie Clinique et Médecine EA 4097 (ECM), UFR des sciences médicales de l'UAG, and Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pointe-à-Pitre/Abymes [Guadeloupe] -CHU de la Martinique [Fort de France]-Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]
Subjects: medicine.medical_specialty, Pathology, Histology, [SDV.BIO]Life Sciences [q-bio]/Biotechnology, Colorectal cancer, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.BC.BC]Life Sciences [q-bio]/Cellular Biology/Subcellular Processes [q-bio.SC], Pathology and Forensic Medicine, Internal medicine, [SDV.BBM.GTP]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Genomics [q-bio.GN], P53 status, [SDV.BC.IC]Life Sciences [q-bio]/Cellular Biology/Cell Behavior [q-bio.CB], medicine, In patient, Stage (cooking), [SDV.BBM.BC]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Biochemistry [q-bio.BM], Discrepancy, Guadeloupian patients, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, business.industry, Retrospective cohort study, [SDV.BBM.BM]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Molecular biology, medicine.disease, 3. Good health, Cancer registry, Martinican patients, [SDV.GEN.GH]Life Sciences [q-bio]/Genetics/Human genetics, p53 status, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Clinicopathological features, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, [SDE.BE]Environmental Sciences/Biodiversity and Ecology, Clinicopathology, business, Martinique, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Research Article
Abstract: International audience; BACKGROUND: In Guadeloupe and Martinique, two French Overseas Departments, colorectal cancer (CRC) has become an essential public health issue. However, little is known about CRC characteristics and the p53 status in these populations, particularly in Guadeloupe, whereas certification of a cancer registry has been recently validated. METHODS: This was a descriptive retrospective study of 201 patients who, between 1995 and 2000, underwent surgery for CRC in the Guadeloupe Teaching Hospital (GlpeTH; 83 patients) and in the Martinique Teaching Hospital (MqueTH; 118 patients). The clinicopathological features and the p53 expression, evaluated with immunohistochemistry, were compared at the time of diagnosis. A relationship between these parameters and the p53 expression was also studied. Data were analysed, using the SPSS computer software version 17.0. RESULTS: No statistical difference was found between the two groups of patients regarding age (p = 0.60), percentage of young patients (
Published: 2014

32. Post-traumatic transdiaphragmatic intercostal hernia: report of two cases

Author: Mathilde Severac, Amine Rahili, Emmanuel I. Benizri, Daniel Benchimol, Jean-Marc Bereder, Jérôme Delotte, Institut de Biologie Valrose (IBV), Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Côte d'Azur (UCA), Service de gynécologie-obstétrique, Hôpital Archet 2 [Nice] (CHU), Centre de Lutte contre le Cancer Antoine Lacassagne [Nice] (UNICANCER/CAL), UNICANCER-Université Côte d'Azur (UCA), Department of Digestive Surgery, and Centre Hospitalier Universitaire de Nice (CHU Nice)
Subjects: medicine.medical_specialty, Abdominal Hernia, Intercostal Muscles, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Ascending colon, Diaphragmatic hernia, Hernia, [SDV.BDD]Life Sciences [q-bio]/Development Biology, Aged, Aged, 80 and over, Rib cage, Mesh repair, business.industry, 030208 emergency & critical care medicine, General Medicine, Surgical Mesh, medicine.disease, Hernia, Diaphragmatic, Traumatic, 3. Good health, Surgery, Treatment Outcome, 030220 oncology & carcinogenesis, Accidental Falls, Female, Radiology, Presentation (obstetrics), Tomography, X-Ray Computed, business
Abstract: International audience; Transdiaphragmatic intercostal hernias (TIH) are rare. Less than 40 cases of TIH have so far been reported, with only 8 cases involving herniation of the liver. This report presents the case of 2 patients with a right-sided abdominal lump following a fall. Thoracoabdominal CT-scan showed a TIH between the 9th and 10th ribs with liver and right colonic herniation in both patients. Both patients were successfully treated with mesh repair. The presentation, physiopathology and management of this rare occurrence are discussed.
Published: 2013

33. Small bowel involvement is a prognostic factor in colorectal carcinomatosis treated with complete cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy

Author: Amine Rahili, Emmanuel Benizri, Jean-Marc Bereder, Jean-Louis Bernard, Daniel Benchimol, Institut de Biologie Valrose (IBV), Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Côte d'Azur (UCA), Registre des cancers de l'enfant de PACA-Corse, Assistance Publique - Hôpitaux de Marseille (APHM), Department of Digestive Surgery, Centre Hospitalier Universitaire de Nice (CHU Nice), Centre de Lutte contre le Cancer Antoine Lacassagne [Nice] (UNICANCER/CAL), and UNICANCER-Université Côte d'Azur (UCA)
Subjects: Oncology, Male, MESH: Chi-Square Distribution, MESH: Intestine, Small, Colorectal cancer, Statistics as Topic, 030230 surgery, Gastroenterology, Intraperitoneal chemotherapy, 0302 clinical medicine, Surgical oncology, Intestine, Small, Infusions, Parenteral, Cytoreductive surgery, [SDV.BDD]Life Sciences [q-bio]/Development Biology, Univariate analysis, MESH: Middle Aged, MESH: Confidence Intervals, Middle Aged, Prognosis, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, MESH: Ileal Neoplasms, 3. Good health, 030220 oncology & carcinogenesis, MESH: Survival Analysis, MESH: Jejunal Neoplasms, Disease Progression, Hyperthermic intraperitoneal chemotherapy, MESH: Disease Progression, Female, Colorectal Neoplasms, medicine.medical_specialty, Fever, lcsh:Surgery, Prognostic factors, lcsh:RC254-282, MESH: Prognosis, 03 medical and health sciences, Internal medicine, MESH: Fever, medicine, Confidence Intervals, Humans, Survival rate, Survival analysis, MESH: Statistics as Topic, MESH: Humans, Chi-Square Distribution, Jejunal Neoplasms, business.industry, Research, lcsh:RD1-811, medicine.disease, Survival Analysis, MESH: Male, MESH: Infusions, Parenteral, Ileal Neoplasms, Conventional PCI, Peritoneal Cancer Index, Surgery, business, MESH: Female, MESH: Colorectal Neoplasms, Peritoneal carcinomatosis
Abstract: Background Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) is a promising treatment for patients with peritoneal carcinomatosis (PC). Our objective was to identify new prognostic factors in patients with PC from colorectal cancer treated with this procedure. Methods All patients with PC from colorectal cancer treated by HIPEC from January 2000 to December 2007 were prospectively included. The tumor extension was assessed by the Peritoneal Cancer Index (PCI) and the residual disease was recorded using the completeness cytoreductive score (CCs). All clinical and treatment data were computed in univariate and multivariable analyses using survival as primary end point. Results We carried out 51 complete procedures in 49 consecutive patients. The mean PCI was 10. The allocation of CCs was: CC-0 = 37, CC-1 = 14. The five-year overall and progression-free survival rate were 40% and 20%, respectively. Several prognostic factors for survival were identified by univariate analysis: PCI < 9 (P < 0.001), CC-0 vs. CC-1 (P < 0.01) and involvement of area 4 (P = 0.06), area 5 (P = 0.031), area 7 (P = 0.014), area 8 (P = 0.022), area 10 (P < 0.0001), and area 11 (P = 0.02). Only the involvement of the distal jejunum (area 10) was significant in the multivariable analysis (P = 0.027). Conclusions We demonstrated that the involvement of area 10 (distal jejunum of the PCI score) was an independent factor associated with poor prognosis.
Published: 2012

34. The role of clips in preventing migration of fully covered metallic esophageal stents: a pilot comparative study

Author: Jérôme Mouroux, Daniel Pop, Albert Tran, Daniel Benchimol, Babou Soilihi Karimdjee, Geoffroy Vanbiervliet, Nicolas Venissac, Xavier Hébuterne, Emmanuel Benizri, Stéphane M. Schneider, Jérôme Filippi, Pascal Staccini, Jean Gugenheim, Antonio Iannelli, Amine Rahili, Endoscopie Digestive, Hôpital Archet 2 [Nice] (CHU), Hépato-Gastroentérologie, Centre Hospitalier Universitaire de Nice (CHU Nice), Immunite anti-tumorale et chimiotactisme. Adenocarcinomes et métastases, Université Nice Sophia Antipolis (... - 2019) (UNS), Université Côte d'Azur (UCA)-Université Côte d'Azur (UCA)-IFR50-Institut National de la Santé et de la Recherche Médicale (INSERM), Infection bactérienne, inflammation, et carcinogenèse digestive, Centre méditerranéen de médecine moléculaire (C3M), Université Côte d'Azur (UCA)-Université Côte d'Azur (UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Biologie Valrose (IBV), Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Nice Sophia Antipolis (... - 2019) (UNS), Université Côte d'Azur (UCA)-Université Côte d'Azur (UCA), Groupe de Recherche Angevin en Economie et Management (GRANEM), Institut National de l'Horticulture et du Paysage-AGROCAMPUS OUEST-Université d'Angers (UA), Centre Hospitalier Universitaire de Nice, Institut de l'information scientifique et technique (INIST), Centre National de la Recherche Scientifique (CNRS), Service de Chirurgie thoracique, Department of Digestive Surgery, Université Côte d'Azur (UCA), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-IFR50-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UCA), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UCA), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UCA)-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), and COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)
Subjects: Male, Pilot Projects, Esophageal Diseases, MESH: Stomach, Feces, 0302 clinical medicine, MESH: Aged, 80 and over, Esophageal stent, Foreign-Body Migration, Medicine, CLIPS, [SDV.BDD]Life Sciences [q-bio]/Development Biology, computer.programming_language, Aged, 80 and over, MESH: Aged, MESH: Middle Aged, Anastomosis, Surgical, Stomach, MESH: Feces, Middle Aged, Surgical Instruments, MESH: Case-Control Studies, MESH: Esophagoscopy, Prosthesis Failure, surgical procedures, operative, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Female, Stents, Radiology, Esophagoscopy, medicine.medical_specialty, MESH: Surgical Instruments, Duodenum, MESH: Foreign-Body Migration, MESH: Esophageal Diseases, 03 medical and health sciences, MESH: Intestinal Fistula, Intestinal Fistula, Humans, cardiovascular diseases, Aged, MESH: Humans, business.industry, MESH: Pilot Projects, MESH: Male, Surgery, MESH: Stents, Intestinal Perforation, Case-Control Studies, MESH: Prosthesis Failure, MESH: Duodenum, MESH: Intestinal Perforation, business, computer, MESH: Female, MESH: Anastomosis, Surgical
Abstract: International audience; BACKGROUND: Migration is the most common complication of the fully covered metallic self-expanding esophageal stent (SEMS). This study aimed to determine the potential preventive effect of proximal fixation on the mucosa by clips for patients treated with fully covered SEMS. METHODS: In this study, 44 patients (25 males, 57%) were treated with fully covered SEMS including 22 patients with esophageal stricture (4 malignant obstructions, 6 anastomotic strictures, and 12 peptic strictures) and 22 patients with fistulas or perforations (10 anastomotic leaks, 4 perforations, and 8 postbariatric surgery fistulas). The Hanarostent (n = 25), Bonastent (n = 5), Niti-S (n = 12), and HV-stent (n = 2) with diameters of 18 to 22 mm and lengths of 80 to 170 mm were used. Two to four clips (mean, 2.35 ± 0.75 clips) were used consecutively in 23 patients to fix the upper flared end of the stent with the esophageal mucosal layer. Stent migration and its consequences were collected in the follow-up assessment with statistical analysis to compare the patients with and without clip placement. RESULTS: No complication with clip placement was observed, and the retrieval of the stent was not unsettled by the persistence of at least one clip (12 cases). Stent migration was noted in 15 patients (34%) but in only in 3 of the 23 patients with clips (13%). The number of patients treated to prevent one stent migration was 2.23. The predictive positive value of nonmigration after placement of the clip was 87%. In the multivariate analysis, the fixation with clips was the unique independent factor for the prevention of stent migration (odds ratio, 2.3; 95% confidence interval, 0.10-0.01; p = 0.03). CONCLUSIONS: Anchoring of the upper flare of the fully covered SEMS with the endoscopic clip is feasible and significantly reduces stent migration.
Published: 2012

35. Prognostic value of jaundice in patients with gallbladder cancer by the AFC-GBC-2009 study group

Author: Philippe Bachellier, Francis Navarro, Laurence Chiche, Olivier Farges, J.-M. Regimbeau, F.-R. Pruvot, David Fuks, Y.P. Le Treut, Department of Digestive Surgery. Hôpital Nord, Department of Hepatobiliary Surgery, Hôpital de Hautepierre [Strasbourg], Hôpital Conception, Hôpital Claude Huriez [Lille], CHU Lille-CHU Lille, Universitary hospital, 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)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Hôpital Beaujon [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
Subjects: Male, Time Factors, medicine.medical_treatment, 030230 surgery, Gastroenterology, 0302 clinical medicine, Risk Factors, Lymph node, Aged, 80 and over, Portal Vein, General Medicine, Jaundice, Middle Aged, Pancreaticoduodenectomy, Prognosis, medicine.anatomical_structure, Treatment Outcome, Oncology, Research Design, 030220 oncology & carcinogenesis, Predictive value of tests, PD, Female, Gallbladder Neoplasms, medicine.symptom, GBC, Gallbladder carcinoma, Adult, medicine.medical_specialty, education, Vena Cava, Inferior, 03 medical and health sciences, Long-term survival, Predictive Value of Tests, Internal medicine, medicine, Humans, In patient, Cholecystectomy, Gallbladder cancer, Mortality, Survival analysis, Aged, Retrospective Studies, Common Bile Duct, Extended Liver resection, business.industry, Contraindications, Retrospective cohort study, medicine.disease, Survival Analysis, PVE, Lymph Node Excision, Surgery, Morbidity, business
Abstract: Introduction Jaundice is frequent in patients with gallbladder cancer (GBC) and indicates advanced disease and, according to some teams, precludes routine operative exploration. The present study was designed to re-assess the prognostic value of jaundice in patients with GBC. Methods Patients with GBC operated from 1998 to 2008 were included in a retrospective multicenter study (AFC). The main outcome measured was the prognostic value of jaundice in patients with GBC focusing on morbidity, mortality and survival. Results A total of 110 of 429 patients with GBC presented with jaundice, with a median age of 66 years (range: 31–88). The resectability rate was 45% ( n =50) and the postoperative mortality and morbidity rates were 16% and 62%, respectively; 71% had R0 resection and 46% had lymph node involvement. Overall 1- and 3-year survivals of the 110 jaundiced patients were 41% and 15%, respectively. For the 50 resected patients, 1- and 3-year survivals were 48% and 19%, respectively (real 5-year survivors n =4) which were significantly higher than that of the 60 non-resected patients (31%, 0%, p =0.001). Among the resected jaundiced patients, T-stage, N and M status were found to have a significant impact on survival. R0 resection did not increase the overall survival in all resected patients, but R0 increased median survival in the subgroup of N0 patients (20 months versus 6 months, p =0.01). Conclusion This series confirms that jaundice is a poor prognostic factor. However, the presence of jaundice does not preclude resection, especially in highly selected patients (N0).
Published: 2010

36. NFIB rearrangement in superficial, retroperitoneal, and colonic lipomas with aberrations involving chromosome band 9p22

Author: Florence Pedeutour, Claire Mainguené, Antoine Italiano, Nathalie Ebran, Rita Attias, Daniel Benchimol, Isabelle Monticelli, Anne Chevallier, Laboratory of Solid Tumors Genetics, Nice University Hospital, Institut de signalisation, biologie du développement et cancer (ISBDC), Centre National de la Recherche Scientifique (CNRS)-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 Côte d'Azur (UCA), Laboratoire d'Anatomo-Pathologie, Hôpital Pasteur [Nice] (CHU), Department of Pathology, Monaco, Department of Digestive Surgery, and Centre Hospitalier Universitaire de Nice (CHU Nice)
Subjects: Adult, Male, Cancer Research, Adenoma, Molecular Sequence Data, [SDV.CAN]Life Sciences [q-bio]/Cancer, Biology, 03 medical and health sciences, Exon, 0302 clinical medicine, HMGA2, otorhinolaryngologic diseases, Genetics, medicine, Humans, Retroperitoneal Neoplasms, 030304 developmental biology, Colonic lipoma, Aged, Chromosome Aberrations, 0303 health sciences, medicine.diagnostic_test, Base Sequence, Lipoma, Middle Aged, medicine.disease, body regions, stomatognathic diseases, NFI Transcription Factors, Chromosome Band, [SDV.GEN.GH]Life Sciences [q-bio]/Genetics/Human genetics, NFIB, 030220 oncology & carcinogenesis, Karyotyping, Colonic Neoplasms, biology.protein, Cancer research, Female, Chromosomes, Human, Pair 9, Fluorescence in situ hybridization
Abstract: Lipomas are frequently characterized by rearrangements resulting in the fusion of the HMGA2 gene (12q14.3) with a variety of partners. Chromosome band 9p22 rearrangements occur in about 1% of lipomas. We report here the molecular cytogenetic analysis of five cases of lipoma with a 9p22 aberration, including the first cytogenetic analysis of a colonic lipoma. Three out of the five cases showed a rearrangement of NFIB at 9p22.3. The NFIB rearrangement involved a fusion with HMGA2 in two cases. We have identified an in-frame fusion of the first three exons of HMGA2 with exon 6 of MSRB3 (12q14.3) and exons 8 and 9 of NFIB by using 3'RACE-PCR in a case of superficial lipoma. In a case of retroperitoneal lipoma we found a fusion of HMGA2 with NFIB by fluorescence in situ hybridization analysis. The colonic lipoma was characterized by a t(9;16;19)(p22;q21;q13) with a rearrangement of NFIB and no rearrangement of HMGA2. NFIB belongs to the nuclear factor I transcription family. It has been previously shown to be fused with HMGA2 in one case of lipoma and to be a recurrent partner of HMGA2 in pleormorphic adenoma of salivary glands. We here demonstrate that NFIB can also be rearranged independently from HMGA2, indicating a potentially important role in lipoma pathobiology. Our findings suggest that the rearrangement of NFIB might be associated with deep-seated lipomas, such as retroperitoneal or gastro-intestinal lipomas. (c) 2008 Wiley-Liss, Inc.
Published: 2008

37. Cutaneous myxolipoma with apocrine glandular differentiation: description of a new clinicopathological variant with chromosome 6p21 rearrangement

Author: Rita Attias, Florence Pedeutour, C Perrin, N Cardot-Leccia, Antoine Italiano, D Amato, Juliette Haudebourg, Laboratory of Solid Tumors Genetics, Nice University Hospital, Institut de signalisation, biologie du développement et cancer (ISBDC), Centre National de la Recherche Scientifique (CNRS)-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 Côte d'Azur (UCA), Department of Digestive Surgery, and Centre Hospitalier Universitaire de Nice (CHU Nice)
Subjects: 0303 health sciences, Pathology, medicine.medical_specialty, Histology, Apocrine, Chromosome, [SDV.CAN]Life Sciences [q-bio]/Cancer, General Medicine, Biology, Glandular Differentiation, Pathology and Forensic Medicine, Myxolipoma, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, [SDV.GEN.GH]Life Sciences [q-bio]/Genetics/Human genetics, medicine, 030304 developmental biology
Published: 2008

38. Role of radiotherapy with surgery for T3 and resectable T4 rectal cancer: evidence from randomized trials

Author: Eric Francois, Jean Pierre Gerard, Jacques Baulieux, Cécile Ortholan, Jean François Bosset, Daniel Benchimol, Olivier P. Thomas, Laboratory of Clinical and Experimental Pathology, CHU Nice, Institut de signalisation, biologie du développement et cancer ( ISBDC ), Université Nice Sophia Antipolis ( UNS ), Université Côte d'Azur ( UCA ) -Université Côte d'Azur ( UCA ) -Centre National de la Recherche Scientifique ( CNRS ), Laboratoire de Mécanique des Structures et des Systèmes Couplés ( LMSSC ), Conservatoire National des Arts et Métiers [CNAM] : EA3196, Department of Digestive Surgery, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ) -Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Centre Hospitalier Universitaire de Nice (CHU Nice), Institut de signalisation, biologie du développement et cancer (ISBDC), Centre National de la Recherche Scientifique (CNRS)-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 Côte d'Azur (UCA), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université de Franche-Comté (UFC), and Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)
Subjects: MESH: Combined Modality Therapy, Colorectal cancer, medicine.medical_treatment, MESH : Randomized Controlled Trials as Topic, law.invention, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, 0302 clinical medicine, Randomized controlled trial, law, Surgical oncology, 030212 general & internal medicine, MESH: Radiotherapy Dosage, MESH : Rectal Neoplasms, Randomized Controlled Trials as Topic, MESH : Neoplasm Recurrence, Local, MESH : Radiotherapy Dosage, MESH: Clinical Trials, Gastroenterology, Radiotherapy Dosage, General Medicine, Combined Modality Therapy, Colorectal surgery, 3. Good health, medicine.anatomical_structure, MESH: Survival Analysis, 030220 oncology & carcinogenesis, medicine.medical_specialty, [SDV.CAN]Life Sciences [q-bio]/Cancer, 03 medical and health sciences, MESH: Neoplasm Recurrence, medicine, Humans, MESH : Clinical Trials, Phase III as Topic, MESH: Humans, Rectal Neoplasms, business.industry, MESH : Humans, MESH: Rectal Neoplasms, MESH: Randomized Controlled Trials, medicine.disease, Survival Analysis, Surgery, Clinical trial, Radiation therapy, Clinical Trials, Phase III as Topic, Sphincter, Neoplasm Recurrence, Local, MESH : Survival Analysis, business, MESH : Combined Modality Therapy
Abstract: International audience; PURPOSE: The main treatment for resectable rectal cancer T2-T4 N0-N2 M0 is surgery. The benefit of preoperative or postoperative radiation therapy can be analyzed in terms of improvement of local control, sphincter preservation, and survival weighted against increased toxicity. METHODS: Only randomized trials can provide strong evidence of a positive cost-benefit ratio of such combined approach. The most recent trials were reviewed. RESULTS: Three randomized trials, including the latest German CAO-ARO trial, have demonstrated the superiority of preoperative radiotherapy with or without chemotherapy (vs. postoperative) in terms of local control and toxicity. The Ducth TME trial showed that even with modern standard surgery, preoperative radiotherapy improved local control. Preoperative irradiation using a high dose in a small volume and a long interval before surgery may improve sphincter preservation (Lyon trials). Concurrent chemoradiation (FFCD 9203, EORTC 22921, did not significantly improve sphincter preservation or survival but significantly reduced the local recurrence rate. CONCLUSIONS: In 2005 examination of randomized trials provides evidence for the benefit of preoperative chemoradiation in improving local control and probably sphincter preservation in rectal cancer. Randomized trials should be designed to further demonstrate improved sphincter preservation and to increase survival using adjuvant medical treatments.
Published: 2006

39. Swallowing a safety pin: Report of a case

Author: Daniel Benchimol, Charlotte Cohen, Jean Marc Bereder, Amine Rahili, Emmanuel Benizri, Institut de Biologie Valrose (IBV), Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Côte d'Azur (UCA), Chelsea and Westminster Hospital, Department of Digestive Surgery, and Centre Hospitalier Universitaire de Nice (CHU Nice)
Subjects: medicine.medical_specialty, Abdominal pain, medicine.diagnostic_test, business.industry, Colonoscopy, Case Report, medicine.disease, Appendicitis, Appendix, Alimentary tract, 3. Good health, Surgery, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, Swallowing, 030220 oncology & carcinogenesis, medicine, 030211 gastroenterology & hepatology, Foreign body, medicine.symptom, business, Laparoscopy, [SDV.BDD]Life Sciences [q-bio]/Development Biology
Abstract: International audience; Ingestion of a foreign body is a frequent and well-known medical problem with several diagnostic and therapeutic approaches. Usually, ingested foreign bodies pass through the alimentary tract without incident. In some cases, they can be lodged in the appendix and may cause appendicitis. We report a case of a 29-year old woman, suffering from mental illness, with a safety pin lodged in the appendix. Initially, the patient consulted for abdominal pain. After a period of waiting, during which time the foreign body did not move, a colonoscopy was performed but failed to see the safety pin. Then, the patient underwent a laparoscopic appendectomy. Pathological examination showed an ulcerative appendicitis.
Published: 2012

40. Cancer classification using the Immunoscore: a worldwide task force

Author: Iris D. Nagtegaal, Paul Waring, Michael I. Nishimura, Richard Palmqvist, Carlo Bifulco, Yutaka Kawakami, Christian H. Ottensmeier, Alessandro Lugli, Christoph Huber, Réjean Lapointe, Lotfi Chouchane, Noriyuki Sato, Helen K. Angell, Scott Kopetz, Kyogo Itoh, Michele Maio, Yili Wang, Bernard A. Fox, Thomas F. Gajewski, Christine Lagorce, Franck Pagès, Cedrik M. Britten, Ena Wang, Giuseppe Masucci, Patricia Shaw, Frank A. Sinicrope, Jill O'Donnell-Tormey, Fabiana Tatangelo, Andreas Lundqvist, Heinz Zwierzina, James P. Allison, Toshihiko Torigoe, P. Patel, Inti Zlobec, Blaise Clarke, Martin Asslaber, Corrado D'Arrigo, Shoichi Hazama, Martin C. Mihm, Harpreet Singh-Jasuja, Luigi Laghi, Anne Berger, Jérôme Galon, Samir N. Khleif, Paolo Delrio, Shilin N. Shukla, Gerardo Botti, Hartmann Arndt, Francesco M. Marincola, Leif Håkansson, Paolo A. Ascierto, Robert E. Hawkins, Bradly G. Wouters, Sacha Gnjatic, Graham Pawelec, Fabio Grizzi, Fernando Vidal-Vanaclocha, Shuji Ogino, Sebastian Kreiter, Kiyotaka Okuno, Peter Gibbs, Magdalena Thurin, Giorgio Trinchieri, Pamela S. Ohashi, Radiotherapie, RS: GROW - School for Oncology and Reproduction, Centre de Recherche des Cordeliers ( CRC (UMR_S 872) ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Université Paris Descartes - Paris 5 ( UPD5 ), Assistance Publique-Hopitaux de Paris, Hôpital Européen Georges Pompidou [APHP] ( HEGP ), Society for Immunotherapy of Cancer, Milwaukee, Infectious Disease and Immunogenetics Section (IDIS), Clinical Center and trans-NIH Center for Human Immunology (CHI), Cancer Diagnosis Program, National Cancer Institute ( NIH ), Oncology - Pathology - Anatomy, Institute of Pathology-University of Bern, Department of Pathology, Providence Portland Medical Center, Istituto Nazionale per lo Studio e la Cura dei Tumori 'Fondazione G.Pascale', TRON - Translational Oncology at the University Medical Center of the Johannes Gutenberg University Mainz, Weill Medical College of Cornell University [New York], Colorectal Surgery Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, University of Erlangen, Institute of Pathology, Medical University Graz, Division of Medical Oncology and Immunotherapy, University Hospital of Siena, Department of Oncology-Pathology, Karolinska Institutet [Stockholm], Harvard Medical School and Massachusetts General Hospital, Boston, CEU-San Pablo University School of Medicine and HM-Hospital of Madrid Scientific Foundation, Institute of Applied Molecular Medicine (IMMA), Ludwig Institute for Cancer Research, Memorial Sloan-Kettering Cancer Center, University of Lund, Immatics Biotechnologies GmbH, Experimental Cancer Medicine Centre, University of Southampton Faculty of Medicine, Department Haematology and Oncology, Innsbruck Medical University [Austria] ( IMU ), Molecular Gastroenterology and Department of Gastroenterology, Istituto Clinico Humanitas [Milan] ( IRCCS Milan ), Humanitas University [Milan] ( Hunimed ) -Humanitas University [Milan] ( Hunimed ), Ontario Cancer Institute and Campbell Family Institute for Cancer Research, Princess Margaret Hospital, Departments of Laboratory Medicine, Pathobiology & Radiation Oncology, Division of Cellular Signaling, Institute for Advanced Medical Research, Department of Digestive Surgery and Surgical Oncology, Yamaguchi University [Yamaguchi], Department of Surgery, Kinki University, Cancer Research Institute, New York, Avicenne Hospital, Center for Medical Research, Eberhard Karls Universität Tübingen, Oncology Institute, Loyola University Medical Center ( LUMC ), School of Cancer and Imaging Sciences, University of Manchester [Manchester], Research Center, University Hospital, Department of Oncology-Pathology [Karolinska Institutet], Georgia Health Sciences University Cancer Center, Augusta University, Brigham and Women's Hospital [Boston], Department of Medical Oncology, Royal Melbourne Hospital, University of Melbourne, Sapporo Medical University School of Medicine, Department of Immunology and Immunotherapy, Kurume University School of Medicine, The Gujarat Cancer & Research Institute, Asarwa, Department of Medical Biosciences, Pathology, Pathology Department, Radboud University Medical Center [Nijmegen], Institute for Cancer Research, Center of Translational medicine, Department of Histopathology, Dorset County Hospital, MD Anderson Cancer Center, Houston, Mayo Clinic and Mayo College of Medicine, Rochester, Cancer Inflammation Program, Center for Cancer Research, Oncology and Hematology, University of Chicago, Medical Oncology and Innovative Therapies Unit, Fondazione Melanoma Onlus, Laboratory of Molecular and Tumor Immunology, Earle A. Chiles Research Institute-Robert W. Franz Cancer Center, Department of Molecular Microbiology and Immunology, Oregon Health and Science University, BMC, Ed., Centre de Recherche des Cordeliers (CRC (UMR_S 872)), Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université Paris Descartes - Paris 5 (UPD5), 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), National Cancer Institute [Bethesda] (NCI-NIH), National Institutes of Health [Bethesda] (NIH)-National Institutes of Health [Bethesda] (NIH), Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Harvard Medical School [Boston] (HMS), Memorial Sloane Kettering Cancer Center [New York], Lund University [Lund], Innsbruck Medical University = Medizinische Universität Innsbruck (IMU), Istituto Clinico Humanitas [Milan] (IRCCS Milan), Humanitas University [Milan] (Hunimed)-Humanitas University [Milan] (Hunimed), University of Toronto-University of Toronto, Eberhard Karls Universität Tübingen = Eberhard Karls University of Tuebingen, Loyola University Medical Center (LUMC), Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CR CHUM), Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal (UdeM)-Université de Montréal (UdeM), University System of Georgia (USG)-University System of Georgia (USG), Sapporo Medical University-Sapporo Medical University, Kurume University-Kurume University, Oregon Health and Science University [Portland] (OHSU), Université Paris Descartes - Paris 5 (UPD5)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Innsbruck Medical University [Austria] (IMU), and Johannes Gutenberg - Universität Mainz = Johannes Gutenberg University (JGU)
Subjects: Oncology, medicine.medical_specialty, Medicin och hälsovetenskap, Internationality, Colorectal cancer, Advisory Committees, lcsh:Medicine, Review, Medical and Health Sciences, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, 0302 clinical medicine, Neoplasms, Internal medicine, [ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology, Tumor Microenvironment, medicine, Humans, Stage (cooking), Biomarker discovery, 030304 developmental biology, Medicine(all), 0303 health sciences, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Merkel cell carcinoma, business.industry, Biochemistry, Genetics and Molecular Biology(all), lcsh:R, Cancer, General Medicine, Classification, medicine.disease, Primary tumor, 3. Good health, Treatment Outcome, Tumor progression, 030220 oncology & carcinogenesis, Immunology, Biomarker (medicine), business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; Prediction of clinical outcome in cancer is usually achieved by histopathological evaluation of tissue samples obtained during surgical resection of the primary tumor. Traditional tumor staging (AJCC/UICC-TNM classification) summarizes data on tumor burden (T), presence of cancer cells in draining and regional lymph nodes (N) and evidence for metastases (M). However, it is now recognized that clinical outcome can significantly vary among patients within the same stage. The current classification provides limited prognostic information, and does not predict response to therapy. Recent literature has alluded to the importance of the host immune system in controlling tumor progression. Thus, evidence supports the notion to include immunological biomarkers, implemented as a tool for the prediction of prognosis and response to therapy. Accumulating data, collected from large cohorts of human cancers, has demonstrated the impact of immune-classification, which has a prognostic value that may add to the significance of the AJCC/UICC TNM-classification. It is therefore imperative to begin to incorporate the 'Immunoscore' into traditional classification, thus providing an essential prognostic and potentially predictive tool. Introduction of this parameter as a biomarker to classify cancers, as part of routine diagnostic and prognostic assessment of tumors, will facilitate clinical decision-making including rational stratification of patient treatment. Equally, the inherent complexity of quantitative immunohistochemistry, in conjunction with protocol variation across laboratories, analysis of different immune cell types, inconsistent region selection criteria, and variable ways to quantify immune infiltration, all underline the urgent requirement to reach assay harmonization. In an effort to promote the Immunoscore in routine clinical settings, an international task force was initiated. This review represents a follow-up of the announcement of this initiative, and of the J Transl Med. editorial from January 2012. Immunophenotyping of tumors may provide crucial novel prognostic information. The results of this international validation may result in the implementation of the Immunoscore as a new component for the classification of cancer, designated TNM-I (TNM-Immune).
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41. Laparoscopic and thoracoscopic whole-stomach esophagectomy with preoperative pyloric balloon dilatation for esophageal cancer: a prospective multicenter case-series outcome.

Author: Nguyen H, Pham DH, Luong TH, Nguyen XH, Nguyen DH, and Nguyen AK
Subjects: Humans, Male, Middle Aged, Prospective Studies, Aged, Treatment Outcome, Dilatation methods, Pylorus surgery, Feasibility Studies, Adult, Gastroparesis etiology, Gastroparesis prevention & control, Female, Esophagectomy methods, Esophageal Neoplasms surgery, Laparoscopy methods, Thoracoscopy methods, Postoperative Complications epidemiology, Postoperative Complications prevention & control, Postoperative Complications etiology, Preoperative Care methods
Abstract: Introduction: To mitigate gastroparesis as well as other post-operative complications, we undertook a prospective multicenter study to assess the feasibility, safety, and efficacy in the short-term outcomes of laparoscopic and thoracoscopic whole stomach esophagectomy with preoperative pyloric balloon dilatation., Methods: A prospective descriptive study on 37 patients with laparoscopic and thoracoscopic whole stomach esophagectomy with preoperative pyloric balloon dilatation from January 2019 to March 2023. The perioperative indications, clinical data, intra-operative index, pathological postoperative specimens, postoperative complications, and follow-up results were retrospectively evaluated., Results: In our study, all patients were male, with dysphagia as the predominant symptom (45.9%). Esophageal cancer incidence was similar between middle and lower thirds. Nodules were the primary finding on esophagoscopy (48.6%). Preoperative pyloric dilation averaged 31.2 min without complications. Surgical duration ranged from 225 to 400 min (mean 305). Gastric tube fluid volume averaged 148.9 ± 110.66 ml per day. Among 34 post-operative cases underwent gastric transit scans, most had non-dilated stomachs with efficient pyloric drug circulation. Three cases required prolonged ventilation, precluding pyloric circulation scans. Four patients developed chylous fistula, one requiring chest tube embolization. Recurrent laryngeal nerve damage occurred in 10.8% of cases., Conclusion: After evaluating esophageal cancer patients undergoing laparoscopic whole-stomach esophagectomy with preoperative pyloric balloon dilatation, it was found that this procedure is safe, effective, and significantly reduces postoperative gastroparesis and related complications., (© 2024. The Author(s).)
Published: 2024
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42. A novel scoring system for predicting disease severity without CT imaging in acute diverticulitis.

Author: Leena-Mari M, Juha G, Jukka K, and Mika U
Subjects: Humans, Male, Female, Middle Aged, Acute Disease, Risk Factors, Aged, Adult, Multivariate Analysis, Retrospective Studies, Severity of Illness Index, Tomography, X-Ray Computed, Diverticulitis diagnostic imaging, ROC Curve
Abstract: Purpose: Clinical scoring could help physicians identify patients with suspected acute diverticulitis who would benefit from further evaluation using computed tomography imaging. The aim of the study was to identify risk factors for complicated acute diverticulitis and create a risk score to predict disease severity in acute diverticulitis., Methods: Patients diagnosed with CT-verified acute diverticulitis between 2015 and 2017 were included. Data on patients' clinical and laboratory findings and medical histories were collected retrospectively. Risk factors for complicated acute diverticulitis were identified using univariate and multivariate analyses. Continuous laboratory values were categorised by cut-off points determined using receiver operating characteristic (ROC) analysis. The Acute Diverticulitis Severity Score was formulated using logistic regression analysis., Results: Of the total 513 patients included in the study, 449 (88%) had UAD, and 64 (12%) had CAD. Older age, significant comorbidities, C-reactive protein level, leucocyte count, vomiting, and body temperature were found to be independently associated with a higher risk for CAD. The novel Acute Diverticulitis Severity Score could reliably detect patients with CAD. The area under the ROC curve was 0.856 (p < 0.001) in discriminating disease severity. While higher scores indicate radiological studies, patients with low scores face an almost non-existent risk for complicated disease, making such studies possibly redundant., Conclusions: The Acute Diverticulitis Severity Score accurately separated patients with uncomplicated disease from those at risk for complicated disease. This score can be applied in daily clinical practice to select patients requiring further investigation, consequently reducing healthcare costs and burdens., (© 2024. The Author(s).)
Published: 2024
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43. Gastric tube-preserving pancreaticoduodenectomy for ampullary adenocarcinoma after Lewis-Santy esophagectomy: a case report and literature review.

Author: Nachtergaele S, Mattart L, Vindevogel C, Francart D, Herman D, and Brescia L
Abstract: Pancreaticoduodenectomy after esophagectomy is a challenging procedure given the need to preserve the vascularization of the gastric plasty. We describe a case of a modified Longmire III procedure in a 68-year-old patient who underwent an esophagectomy with gastric conduit reconstruction in 2019 for esophageal adenocarcinoma. Two years later, an adenocarcinoma of the ampulla of Vater was diagnosed, necessitating pancreaticoduodenectomy with preservation of the gastric conduit. The patient presented no postoperative complications. Hepatic recurrence was observed 13 months after surgical resection. At 24 months follow-up, new liver metastases were observed. Preservation of the gastroduodenal and right gastric arteries was achieved, enabling conservation of the gastric plasty. Given the limitations of lymphadenectomy, the indication for this surgery must always be carefully considered. In the context of complex surgery, a complete preoperative workup to precisely determine the vascular anatomy as well as any anatomical variations is essential to establish the best operative strategy., Competing Interests: None declared., (Published by Oxford University Press and JSCR Publishing Ltd. © The Author(s) 2024.)
Published: 2024
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44. A Case Report of Primary Neuroendocrine Carcinoma of the Anal Canal with Cancer Genome Profiling.

Author: Morita R, Sugeta S, Yoshida J, Ueda T, Hara T, Morimoto Y, Shibuya A, Ohno T, Nakajima T, Fuji N, Konishi E, and Yoshida N
Abstract: Primary neuroendocrine carcinoma (NEC) of the anal canal is a rare, highly malignant tumor with a poor prognosis. Despite the standard first-line treatment with etoposide or irinotecan combined with cisplatin, effective second-line therapies are lacking. In 2019, Japan approved cancer genome profiling (CGP) tests for solid tumors to enhance genomic understanding. We present the case of a 79-year-old woman with NEC of the anal canal, treated with etoposide, carboplatin, and amrubicin. Post-standard therapy, CGP suggested pemigatinib, a tyrosine kinase inhibitor; however, the patient died before receiving it. This case highlights the potential of personalized medicine to improve outcomes in such cases.
Published: 2024
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45. Impact of late-night liver transplantation on recipient outcome.

Author: Carton I, Le Pabic E, Thobie A, Jeddou H, Robin F, Sulpice L, and Boudjema K
Abstract: When liver graft procurements take place in the late afternoon or in the evening, transplantation is often performed at night when alertness and psychomotor abilities may be altered. Our objective was to determine whether liver transplantation performed at night increases severe 90-day postoperative complication rates. In this observational study, we analyzed all consecutive patients who were transplanted between January 1, 2012 and December 31, 2018. Outcomes were compared according to whether all or part of the liver transplantation was performed or not (control group) at late night, i.e., between midnight and 5 a.m. The main outcome was rate of Clavien-Dindo ≥ IIIb complications within 90 days post-transplantation. 790 liver transplantations were analyzed. In a multivariable analysis adjusted for cold ischemic time, late-night procedures required more blood transfusions (P = 0.010) and had higher odds of severe complication occurrence than controls (odds ratio 1.67; 95% CI, [1.10-2.54]). One-year graft and patient survival was similar. We conclude that the organization of liver transplant surgery should be reconsidered to avoid LN surgery as much as can be done. Except to create teams dedicated to night work (which represents a considerable cost), such organization may require safe extension of liver graft preservation times. The alternative could be to extend the use of oxygenated machine perfusion preservation with the unique purpose of safely extending the graft preservation time., (© 2024. Italian Society of Surgery (SIC).)
Published: 2024
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46. Comparison of the influence of postoperative oral nutritional supplementation between octogenarian and non-octogenarian patients undergoing gastrectomy for cancer.

Author: Maruyama S, Kawaguchi Y, Akaike H, Shoda K, Higuchi Y, Nakayama T, Saito R, Takiguchi K, Izumo W, Shiraishi K, Furuya S, Nakata Y, Amemiya H, Kawaida H, and Ichikawa D
Subjects: Humans, Female, Male, Aged, 80 and over, Aged, Follow-Up Studies, Prognosis, Weight Loss, Middle Aged, Postoperative Care methods, Retrospective Studies, Nutritional Status, Gastrectomy adverse effects, Gastrectomy methods, Stomach Neoplasms surgery, Stomach Neoplasms pathology, Postoperative Complications prevention & control, Dietary Supplements, Malnutrition etiology, Sarcopenia etiology, Sarcopenia prevention & control
Abstract: Background: Despite recent reports, the effectiveness of postoperative oral nutritional supplementation (ONS) on body weight loss and malnutrition after gastrectomy remains controversial. We aimed to elucidate the effectiveness of ONS especially in octogenarian patients undergoing oncological gastrectomy., Methods: A total of 286 consecutive patients who underwent gastrectomy for gastric cancer were eligible. Postoperative body weight loss, malnutrition, and sarcopenia were compared between patients with and without postoperative ONS among octogenarian patients aged ≥ 80 years and non-octogenarian patients aged < 80 years., Results: In this study, 36 (62.1%) octogenarian and 121 (53.1%) non-octogenarian patients continued postoperative ONS for three months. The clinicopathologic characteristics were not different between the ONS (-) and ONS (+) groups among the octogenarian and non-octogenarian patients. The changes in body weight and serum albumin levels at postoperative 1 year were different between the ONS (-) and ONS (+) groups (P = 0.03 and P = 0.04, respectively) among the octogenarian patients, but not between the two groups among the non-octogenarian patients (P = 0.99 and P = 0.29, respectively). Also, the decline in psoas muscle mass index at postoperative 6 months and 1 year was significantly lower in the ONS (+) group than in the ONS (-) group (P < 0.01 and P < 0.01, respectively). In addition, similar results were found in octogenarian patients who underwent distal gastrectomy., Conclusions: Postoperative ONS could prevent body weight loss, malnutrition, and sarcopenia especially in octogenarian patients who underwent gastrectomy for gastric cancer., (© 2024. The Author(s).)
Published: 2024
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47. Construction of J-shaped ileal reservoir and manual or stapled ileo-anal anastomosis.

Author: Collard MK, Lefèvre JH, and Parc Y
Published: 2024
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48. Invited Editorial About the Clinical Significance of "Predictive Value of C-Reactive Protein for Infectious Complications After Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy: A Single-Center Prospective Study" by Charbonneau et al. : Postoperative CRP to Predict Postoperative Complications: A Myth or Reality?

Author: Liberale G
Published: 2024
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49. The seven-day cumulative post-esophagectomy inflammatory response predicts cancer recurrence.

Author: Fujiwara Y, Endo S, Higashida M, Kubota H, Yoshimatsu K, and Ueno T
Subjects: Humans, Male, Female, Middle Aged, Aged, Prognosis, Retrospective Studies, Inflammation etiology, Postoperative Complications etiology, Postoperative Complications epidemiology, Esophageal Squamous Cell Carcinoma surgery, Esophageal Squamous Cell Carcinoma pathology, Time Factors, Predictive Value of Tests, Area Under Curve, Esophagectomy adverse effects, Esophageal Neoplasms surgery, Esophageal Neoplasms pathology, Esophageal Neoplasms mortality, C-Reactive Protein analysis, C-Reactive Protein metabolism, Neoplasm Recurrence, Local epidemiology, Carcinoma, Squamous Cell surgery, Carcinoma, Squamous Cell pathology
Abstract: Background: The relationship between postoperative cumulative systemic inflammation and cancer survival needs to be investigated. We developed an approach to the prognostication of postoperative esophageal cancer by establishing low and high cut-off values for the C-reactive protein (CRP) area under the curve (AUC) at 7 and 14 days after esophagectomy., Methods: One hundred and twenty-five consecutive patients with biopsy-proven invasive esophageal squamous cell carcinoma (SCC) who underwent esophagectomies were evaluated. Postoperative CRP levels were analyzed for the first 14 days after surgery. The AUC on days 7 and 14 were calculated and compared with clinicopathological features and survival. The cut-off values for CRP at 7 days (CRP 7 d) and 14 days (CRP 14 d) were 599 mg/L and 1153 mg/L, respectively., Results: The patients in the low CRP 7 d group had significantly better recurrence-free survival (RFS) and overall survival (OS), not that in the low CRP 14d group. The OS rates in the high CRP groups at PODs 1, 3, 10, and 14 were significantly lower than those in the low CRP groups. Postoperative complications were more common in the high CRP groups on PODs 3, 10, and 14. Univariate analyses revealed that pTNM stage, depth of tumor invasion, tumor location, lymph node involvement, and CRP 7 d were significant prognostic factors for both OS and RFS. The Cox proportional hazards model identified pTNM, tumor location, and CRP 7d as independent prognostic factors for the RFS and OS., Conclusions: Early prediction of patients with postoperative complications, and adequate management will suppress the elevation of CRP 7 d and further suppress the CRP value in the late postoperative period, which may improve the prognosis of esophageal cancer patients after esophagectomy., (© 2024. The Author(s).)
Published: 2024
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50. Difference between sentinel and non-sentinel lymph nodes in the distribution of dendritic cells and macrophages: An immunohistochemical and morphometric study using gastric regional nodes obtained in sentinel node navigation surgery for early gastric cancer.

Author: Sonoda T, Arigami T, Aoki M, Matsushita D, Shimonosono M, Tsuruda Y, Sasaki K, Ohtsuka T, and Murakami G
Abstract: The sentinel lymph node (SN) concept has a significant impact on cancer surgery. We aimed to examine which morphology of dendritic cells (DCs) and macrophages corresponds to "preconditioning" of the SN against cancer. Although macrophages are generally able to tolerate cancer metastasis, the CD169-positive subtype is believed to be a limited exception. Immunohistochemical and morphometric analyses were performed to examine DC-SIGN-, CD68-, and CD169-positive cells in SNs and non-SNs of 23 patients with gastric cancer with or without nodal metastasis. All patients survived for >5 years without recurrence. DCs were present in the subcapsular, paracortical, and medullary sinuses, the endothelia of which expressed DC-SIGN and smooth muscle actin (SMA). In the non-SNs of patients without metastasis, subcapsular DCs occupied a larger area than SNs, and this difference was statistically significant. Conversely, subcapsular DCs were likely to have migrated to the paracortical area of the SNs. DC clusters often overlapped with macrophage clusters; however, histiocytosis-like clusters of CD169-negative macrophages showed a smaller overlap. We found a significantly larger overlap between DC-SIGN and CD169-positive clusters in SNs than in non-SNs; the larger overlap seemed to correspond to a higher cross-presentation of cancer antigens between these cell populations. DC-SIGN-CD169-double positive cells might exist within this overlap. SNs in gastric cancers are usually preconditioned as a frontier of cancer immunity, but they may sometimes be suppressed earlier than non-SNs. DC-SIGN- and CD169-positive cells appeared to decrease owing to a long lag time from the primary lesion occurrence and a short distance from the metastasis., (© 2024 The Author(s). Journal of Anatomy published by John Wiley & Sons Ltd on behalf of Anatomical Society.)
Published: 2024
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