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17 results on '"Groupe de Recherche Francogyn"'

1. Patients with stage IV epithelial ovarian cancer: understanding the determinants of survival

Author

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

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

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

Published
2020
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2. Therapeutic value of surgical paraaortic staging in locally advanced cervical cancer: a multicenter cohort analysis from the FRANCOGYN study group

Author

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

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

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

Published
2018
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3. Identification of a low risk population for parametrial invasion in patients with early-stage cervical cancer

Author

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

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

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

Published
2018
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5. Therapeutic value of surgical paraaortic staging in locally advanced cervical cancer: a multicenter cohort analysis from the FRANCOGYN study group

Author

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

Published
2018
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6. Identification of a low risk population for parametrial invasion in patients with early-stage cervical cancer

Author

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

Published
2018
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7. Signification pronostique du ratio d’atteinte ganglionnaire inguinale dans le carcinome épidermoide vulvaire

Author

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

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

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

Published
2020
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8. Prognostic factors of overall survival for patients with FIGO stage IIIc or IVa ovarian cancer treated with neo-adjuvant chemotherapy followed by interval debulking surgery: A multicenter cohort analysis from the FRANCOGYN study group

Author

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

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

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

Published
2020
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9. Recurrence Pattern of Cervical Cancer Based on the Platinum Sensitivity Concept: A Multi‐Institutional Study from the FRANCOGYN Group

Author

Geoffroy Canlorbe, Xavier Carcopino, Emilie Raimond, Lobna Ouldamer, Alexandre Bricou, Cyrille Huchon, Lise Lecointre, Ludivine Dion, Pierre Collinet, Marcos Ballester, Vincent Lavoué, Tiphaine de Foucher de Careil, François Golfier, Clémentine Owen, Yohan Kerbage, Cecile Hennebert, Groupe de Recherche Francogyn, Pierre Adrien Bolze, Sofiane Bendifallah, Cherif Akladios, Emile Daraï, Olivier Graesslin, Cyril Touboul, and Y. Dabi

Subjects
Oncology, Cervical cancer, medicine.medical_specialty, Chemotherapy, Prognostic factor, Standard of care, Multivariate analysis, business.industry, Platinum sensitivity, medicine.medical_treatment, Ethics committee, medicine.disease, Internal medicine, Medicine, business, Ovarian cancer
Abstract

Background: The standard of care for patients with advanced cervical cancer (ACC) includes platinum-based chemotherapy. The concept of platinum sensitivity is a major prognostic factor for patients with ovarian cancer. The aim of this study was to validate the applicability of the platinum sensitivity concept to ACC patients, and to estimate its prognostic interest in term of Overall Survival (OS) and pattern of recurrence (location, timing). Methods: Data of women with histologically proven FIGO 2019 stages IB3-IV ACC treated between May 2000 and November 2017 with platinum based regimens were retrospectively abstracted from 12 institutions from the FRANCOGYN Group. Findings: Respective 3-year OS were 52% (95% CI: 40·8-66·8), 21·6% (95% CI: 12·6-37·2) and 14·6% (95% CI: 4·2-50·2), in case of recurrence 18 months (p

Published
2020
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10. Inguino-femoral radiotherapy in vulvar squamous cell carcinoma: clues to revised indications in patients with only one intracapsular lymph node metastasis

Author

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

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

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

Published
2019

11. Incidence, patterns and prognosis of first distant recurrence after surgically treated early stage endometrial cancer: Results from the multicentre FRANCOGYN study group

Author

Jean Lévêque, Charles Coutant, Emile Daraï, Lobna Ouldamer, Vincent Lavoué, Sofiane Bendifallah, Gilles Body, Marcos Ballester, Pierre Collinet, Alexandre Bricou, Cyril Touboul, Olivier Graesslin, Groupe de Recherche Francogyn, Emilie Raimond, Nutrition, croissance et cancer (U 1069) (N2C), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, Service de Gynécologie et Obstétrique [Rennes] = Gynaecology [Rennes], CHU Pontchaillou [Rennes], and Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Oncology, medicine.medical_specialty, Lung Neoplasms, [SDV]Life Sciences [q-bio], Diaphragm, Bone Neoplasms, Disease, 030204 cardiovascular system & hematology, Malignancy, Disease-Free Survival, Metastasis, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Medicine, Humans, Stage (cooking), Aged, Neoplasm Staging, Aged, 80 and over, Lung, business.industry, Brain Neoplasms, Incidence (epidemiology), Endometrial cancer, Liver Neoplasms, Cancer, General Medicine, Middle Aged, medicine.disease, 3. Good health, Endometrial Neoplasms, Survival Rate, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Lymphatic Metastasis, Surgery, Female, France, Lymph Nodes, Neoplasm Recurrence, Local, business
Abstract

Patterns of distant metastatic failure of endometrial cancer (EC) by specific anatomic site are not well described in the literature. In this manuscript, we evaluated the metastatic patterns of EC cancer and analysed the potential distribution of metastatic disease in this malignancy. Methods A total of 1444 women with EC were identified. Of which we extracted women with locoregional and distant recurrence or with distant recurrence alone. Women were scored based on first site of metastasis: multiple versus one site: bone, brain, lung, liver or sus diaphragmatic lymph nodes. Results 110 women developed distant metastatic disease with (n = 37(33.6%)) or without (n = 73(66.4%)) locoregional recurrence, including 39 women with exclusive first site of metastatic disease and 34 women with multiple sites of metastatic disease. When considering all women, the most common exclusive first site of metastasis was lung (42.8%). The median time to develop distant metastases was shorter after the completion of treatment for exclusive brain metastatic disease compared with other sites of metastatic− disease (7 months vs, 9 for lung, 10 for liver, 19 for bone and 27 months for sus-diaphragmatic LN; P = 0.004). The rate of 3-year overall survival was higher in the sus-diaphragmatic LN metastase group (83.3% vs 50.6% for lung, 37.3% for bone, 16.7% for brain and 0% for liver; P = 0.0059). Conclusion The present study has demonstrated the site-specific patterns of metastases. These data support current clinical practice of screening for site-specific metastatic disease after initial treatment of early stage EC based on concerning women-specific signs or symptoms.

Published
2019
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12. La chimiothérapie hyperthermique intra-péritonéale (CHIP) sauvée par les preuves : la carcinose ovarienne, cible privilégiée de la CHIP ?

Author

Martin Koskas, Cyrille Huchon, Olivier Graesslin, Pierre Collinet, Geoffroy Canlorbe, Groupe de Recherche Francogyn, Lobna Ouldamer, Xavier Carcopino, Cyril Touboul, Charles Coutant, Cherif Akladios, Alexandre Bricou, Pierre Adrien Bolze, Sofiane Bendifallah, Emile Daraï, Marcos Ballester, Vincent Lavoué, Service de Gynécologie et Obstétrique [Rennes] = Gynaecology [Rennes], CHU Pontchaillou [Rennes], Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Thérapies Laser Assistées par l'Image pour l'Oncologie - U 1189 (ONCO-THAI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-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), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Strasbourg, Service de gynécologie-obstétrique [Hôpital Nord - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], Institut méditerranéen de biodiversité et d'écologie marine et continentale (IMBE), Avignon Université (AU)-Aix Marseille Université (AMU)-Institut de recherche pour le développement [IRD] : UMR237-Centre National de la Recherche Scientifique (CNRS), Service de gynécologie-obstétrique [Hôpital Jean Verdier], Université Paris 13 (UP13)-Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CIC - CHU Bichat, Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, Service de Chirurgie Gynécologique Oncologique et Obstétrique [CHU Lyon Sud], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Nutrition, croissance et cancer (U 1069) (N2C), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Carcinose Angiogenèse et Recherche Translationnelle, Angiogenese et recherche translationnelle (CART U965), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de gynécologie et obstétrique [CHI Poissy-Saint Germain], CHI Poissy-Saint-Germain, Centre de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Gynécologie-obstétrique et médecine de la reproduction - Maternité [CHU Tenon], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Nord [CHU - APHM]-Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), Centre National de la Recherche Scientifique (CNRS)-Institut de recherche pour le développement [IRD] : UMR237-Aix Marseille Université (AMU)-Avignon Université (AU), Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris 13 (UP13), Service de Gynécologie et Obstétrique [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes]-hôpital Sud, CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Service de Gynécologie-Obstétrique [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université, Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CHU Pontchaillou [Rennes]-Hôpital Sud, Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Thérapies Laser Assistées par l'Image pour l'Oncologie (ONCO-THAI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Pierre et Marie Curie - Paris 6 (UPMC), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Tenon [APHP], Université Paris 13 (UP13)-Hôpital Jean Verdier [Bondy], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc (CRLCC - CGFL), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Tours, and Service de gynécologie et obstétrique [Poissy - Saint-Germain-en-Laye]]

Subjects
Gynecology, [SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health, Cancer Research, medicine.medical_specialty, business.industry, [SDV.CAN]Life Sciences [q-bio]/Cancer, Hematology, General Medicine, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, medicine.disease, 3. Good health, Peritoneal carcinomatosis, 03 medical and health sciences, 0302 clinical medicine, Oncology, 030220 oncology & carcinogenesis, medicine, Carcinoma, Radiology, Nuclear Medicine and imaging, 030212 general & internal medicine, Ovarian cancer, business, ComputingMilieux_MISCELLANEOUS
Abstract

International audience

Published
2019
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13. Comparison of pelvic and para-aortic lymphadenectomy versus para-aortic lymphadenectomy alone for locally advanced FIGO stage IB2 to IIB cervical cancer using a propensity score matching analysis: Results from the FRANCOGYN study group

Author

Emile Daraï, Florence Huguet, Marcos Ballester, Pierre Collinet, Vincent Lavoué, Geoffroy Canlorbe, Emilie Raimond, J. Varinot, Xavier Carcopino, Cyrille Huchon, Groupe de Recherche Francogyn, Lobna Ouldamer, Sofiane Bendifallah, Tiphaine de Foucher, Cyril Touboul, Alexandre Bricou, Olivier Graesslin, CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Pierre et Marie Curie - Paris 6 (UPMC), Institut Universitaire de Cancérologie [Sorbonne Université] (IUC), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Department of Obstetrics and Gynaecology, Centre Hospitalier Régional Universitaire de Tours, Hôpital Bretonneau, Tours, France., Department of Obstetrics, Gynecology and Reproductive Medicine, Hôpitaux Universitaires Paris Seine Saint-Denis, Assistance Publique-Hôpitaux de Paris, France., CRLCC Eugène Marquis (CRLCC), Institut méditerranéen de biodiversité et d'écologie marine et continentale (IMBE), Avignon Université (AU)-Aix Marseille Université (AMU)-Institut de recherche pour le développement [IRD] : UMR237-Centre National de la Recherche Scientifique (CNRS), Service de gynécologie-obstétrique [Hôpital Nord - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital Nord [CHU - APHM], Department of Obstetrics and Gynaecology, Institute Alix de Champagne University Hospital, Reims, France., Department of Obstetrics and Gynecology, Centre Hospitalier Intercommunal, Créteil, France., Department of Gynecologic Surgery, Jeanne de Flandre Hospital, CHU de Lille, Lille, France., Department of Obstetrics and Gynecology, Poissy-St Germain Hospital, Poissy, France., Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Universitaire de Cancérologie [Paris] (IUC), and Department of Obstetrics and Gynaecology, Hôpital Nord, APHM, Aix-Marseille University (AMU), CNRS, IRD, Marseille, France.

Subjects
Adult, medicine.medical_specialty, Survival, medicine.medical_treatment, Locally advanced, Urology, Uterine Cervical Neoplasms, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Pelvis, 03 medical and health sciences, 0302 clinical medicine, Nodal status, medicine, Para aortic lymphadenectomy, Humans, Aorta, Abdominal, Stage (cooking), Propensity Score, Lymph node, Aged, Neoplasm Staging, Cervical cancer, Locally advanced cervical cancer, [SDV.EE.SANT]Life Sciences [q-bio]/Ecology, environment/Health, 030219 obstetrics & reproductive medicine, business.industry, Lymphadenectomy, General Medicine, Middle Aged, medicine.disease, Prognosis, humanities, 3. Good health, Survival Rate, MESH: Locally advanced cervical cancer, medicine.anatomical_structure, Oncology, 030220 oncology & carcinogenesis, Lymphatic Metastasis, Propensity score matching, Lymph Node Excision, Surgery, Female, Neoplasm Recurrence, Local, business
Abstract

Introduction Pre-treatment evaluation of nodal status is crucial in women presenting with locally advanced cervical cancer (LACC). However, the prognostic impact of surgical staging remains to be proved, as published results comparing surgical versus radiological staging are contradictory. The aim of this study was to compare the prognosis of women with FIGO stage IB2–IIB CC who underwent surgical nodal staging including either exclusive para-aortic lymphadenectomy (PAL) or comprehensive pelvic + para-aortic lymphadenectomy (P-PAL). Materials and methods Data of 314 women with FIGO stage IB2 to IIB CC treated between January 2000 and January 2015 were retrospectively abstracted from nine French institutions. The prognosis and outcomes were compared by Propensity score (PS) matching (PSM) analysis. Results The median follow-up was 33 months (2–114). When comparing women who underwent PAL vs P-PAL, the recurrence rates were 26% (37/144) and 28% (41/144), respectively (p = 0.595). The respective 3-year recurrence free survival (RFS) for P-PAL and PAL were 72.9% (95% CI, 65.7–81.0) and 70.7% (95% CI, 62.4–80.2), (p = 0.394). The respective 3-year overall survival (OS) rates for P-PAL and PAL were 86.8% (95% CI, 81.1–92.9) and 78.6% (95% CI, 70.4–87.7) (p = 0.592). In the sub-group of women with lymph node metastases, RFS was improved for women who underwent P-PAL compared to those with exclusive PAL (p = 0.027), with no difference in OS (p = 0.187). Conclusions Comprehensive P-PAL does not seem to be of significant therapeutic benefit compared to exclusive PAL.

Published
2018
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14. Lymphadenectomy in elderly patients with high-intermediate-risk, high-risk or advanced endometrial cancer: Time to move from personalized cancer medicine to personalized patient medicine!

Author

Jean Levêque, Geoffroy Canlorbe, Charles Coutant, Krystel Nyangoh Timoh, Martin Koskas, Cyril Touboul, Vincent Lavoué, Nina Hudry, Pierre Collinet, Adelaïde Racin, Marcos Ballester, Emile Daraï, Olivier Graesslin, Lobna Ouldamer, Alexandre Bricou, Sofiane Bendifallah, Emilie Raimond, Cyrille Huchon, Groupe de Recherche Francogyn, CHU Pontchaillou [Rennes], Chemistry, Oncogenesis, Stress and Signaling (COSS), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), ESIM - Déterminants Sociaux de la Santé et du Recours aux Soins (DS3), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Hôpital Bretonneau, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER, CHI Créteil, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris 13 (UP13), CHI Poissy-Saint-Germain, CIC - CHU Bichat, Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université de Rennes (UR)-CRLCC Eugène Marquis (CRLCC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Recherche Saint-Antoine (CRSA), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)

Subjects
Databases, Factual, medicine.medical_treatment, Logistic regression, Paraaortic lymphadenectomy, Cohort Studies, 0302 clinical medicine, Elderly, Precision Medicine, ComputingMilieux_MISCELLANEOUS, Aged, 80 and over, 030219 obstetrics & reproductive medicine, General Medicine, Prognosis, 3. Good health, Oncology, 030220 oncology & carcinogenesis, Lymphatic Metastasis, Female, France, Cancer-specific survival, medicine.medical_specialty, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, [SDV.MHEP.GEO]Life Sciences [q-bio]/Human health and pathology/Gynecology and obstetrics, Risk Assessment, Disease-Free Survival, 03 medical and health sciences, Cancer Medicine, Internal medicine, High-risk endometrial cancer, medicine, Humans, Neoplasm Invasiveness, Geriatric Assessment, Aged, Neoplasm Staging, Retrospective Studies, Proportional hazards model, business.industry, Endometrial cancer, High intermediate risk, Retrospective cohort study, Lymphadenectomy, medicine.disease, Survival Analysis, Endometrial Neoplasms, Logistic Models, Multivariate Analysis, Lymph Node Excision, Surgery, Lymph Nodes, business, Forecasting
Abstract

Pelvic and paraaortic lymphadenectomy are recommended for women with high-intermediate, high-risk and advanced endometrial cancer (EC). Lymphadenectomy is less frequently performed in elderly patients than in younger patients. We examined the survival of elderly women diagnosed with high-risk EC according to whether lymphadenectomy was performed or not.We selected women over 70 years with high-intermediate risk, high-risk or advanced EC from a multicenter retrospective cohort of women diagnosed between 2001 and 2013. Multivariate logistic regression models and Cox proportional hazards survival methods for overall survival (OS), disease-free survival (DFS) and cancer-specific survival (CSS) were used for analyses.71 women had lymphadenectomy and were compared with the 213 who did not. Recurrence was similar in both groups (42% vs 33%, respectively, p = 0.17) but more deaths were reported in the group without lymphadenectomy (38% vs 23%, respectively, p 0.001). There was no difference in adjuvant treatment in the two groups (17% vs 27%, respectively, p = 0.27). Elderly patients without lymphadenectomy had lower 3-year DFS (56% vs 71%, p = 0.076), CSS (67% vs 85%, p 0.001) and OS (50% vs 71% p 0.001). The Cox proportional hazard models showed independently poorer prognosis in women without lymphadenectomy (3.027, 95% CI 1.58-5.81, p 0.001), histology type 2 (3.46, 95% CI 1.51-7.97, p = 0.003) and lymphovascular space involvement (3.47, 95% CI 1.35-8.98, p = 0.01) on 3-year CSS.No lymphadenectomy in elderly patients with high-risk or advanced EC is independently associated with poorer prognosis. Elderly patients with EC should benefit from lymphadenectomy when indicated.

Published
2018
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15. Change in hazard rates of recurrence over time following diagnosis of endometrial cancer: An age stratified multicentre study from the FRANCOGYN group

Author

Jean Lévêque, Sofiane Bendifallah, Olivier Graesslin, Goeffroy Canlorbe, Groupe de Recherche Francogyn, Gilles Body, Pierre Collinet, Cyrille Huchon, Emilie Raimond, Cyril Touboul, Lobna Ouldamer, Charles Coutant, Emile Daraï, Marcos Ballester, Vincent Lavoué, and Alexandre Bricou

Subjects
0301 basic medicine, Adult, medicine.medical_specialty, Salpingo-oophorectomy, Hysterectomy, Metastasis, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, medicine, Advanced disease, Initial treatment, Humans, Prospective Studies, Stage (cooking), Aged, Neoplasm Staging, Aged, 80 and over, business.industry, Endometrial cancer, Hazard ratio, Age Factors, General Medicine, Middle Aged, medicine.disease, Endometrial Neoplasms, Survival Rate, 030104 developmental biology, Increased risk, Oncology, 030220 oncology & carcinogenesis, Lymphatic Metastasis, Surgery, Targeted surveillance, Female, France, Neoplasm Recurrence, Local, business
Abstract

Predicting the pattern of recurrence can aid in the development of targeted surveillance and treatment strategies. The objectives of this study were to identify patterns of recurrence in women with operable endometrial cancer (EC) and to identify high-risk periods for recurrence in function of age.The data of 1153 women who received primary surgical treatment for stage I-III EC between January 2001 and December 2013 were abstracted from a prospectively maintained multicentre database. The time to first recurrence was calculated from the date of diagnosis, and the associated hazard function was examined to determine the peak risk period of recurrence. We categorized age at diagnosis as65 and ≥ 65 years old and analysed the hazard rate (HR) by stratifying age groups.Women with EC aged ≥65 years maintain a significant recurrence rate during follow-up whatever the stratification (locoregional recurrence, distant recurrence, ESMO/ESGO/ESTRO subgroup). Multivariable Cox proportional hazard regression showed that the increased risk of recurrence of EC was associated with advanced age, advanced disease ESMO/ESGO/ESTRO subgroup but not with initial treatment received.The annual HR of recurrence is not uniformly distributed over time but is dynamic and markedly determined by prognostic factors at diagnosis.

Published
2018

16. Prognostic value of local relapse for patients with endometrial cancer

Author

J. Uzan, Lobna Ouldamer, Sofiane Bendifallah, Alexandre Bricou, Groupe de Recherche Francogyn, Pierre Collinet, Vincent Lavoué, Olivier Graesslin, Charles Coutant, Y. Dabi, Emilie Raimond, C Touboul, Bassam Haddad, Geoffroy Canlorbe, Marcos Ballester, and Emile Daraï

Subjects
Oncology, Risk, medicine.medical_specialty, Multivariate analysis, medicine.medical_treatment, Brachytherapy, Disease, Stage ii, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Carcinoma, Medicine, Humans, Aged, 030219 obstetrics & reproductive medicine, business.industry, Sentinel Lymph Node Biopsy, Endometrial cancer, General Medicine, Middle Aged, medicine.disease, University hospital, Prognosis, Lymphovascular, Endometrial Neoplasms, Survival Rate, 030220 oncology & carcinogenesis, Surgery, Female, France, Neoplasm Recurrence, Local, business
Abstract

The objective of our study was to determine survival and prognostic factors associated with isolated local recurrence of endometrial cancer.Data of 1229 patients with endometrial carcinoma treated between 2000 and 2012 were extracted from maintained databases of nine French University Hospitals as well as from the Senti-Endo trial. Patients with isolated central pelvic and vaginal recurrence were selected for further analysis.Two hundreds and twenty five patients recurred during the inclusion period, 20 with isolated central pelvic recurrence and 23 with vaginal recurrence. Patients without recurrence had initially significantly less lymphovascular space invasion (p = 0.01), less advanced diseases (stage II) (p 0.001) and more often low or intermediate risk tumours than patients with local recurrence. Local recurrence was statistically associated with better overall survival than non-local recurrence (p = 0.028) but dramatically decreased overall survival when compared to patients without any recurrence (p 0.001). The site of recurrence, i.e. vaginal or central pelvic, was significantly associated with overall survival (p = 0.015). Patients without brachytherapy at initial management were more likely to have local recurrence of their disease when compared to those without recurrence (p = 0.03). None of the prognostics factors for survival in patients with local recurrence was statistically significant in multivariate analysis.Local recurrence is a key event in endometrial cancer evolution severely impacting overall survival. Better understanding of the factors associated with prolonged survival is mandatory to improve our management of these patients.

Published
2017

17. Patients with stage IV epithelial ovarian cancer: understanding the determinants of survival.

Author

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

Subjects
OVARIAN epithelial cancer, MULTIVARIABLE testing, PROGRESSION-free survival, PROPORTIONAL hazards models
Abstract

Background: The most appropriate management for patients with stage IV ovarian cancer remains unclear. Our objective was to understand the main determinants associated with survival and to discuss best surgical management.Methods: Data of 1038 patients with confirmed ovarian cancer treated between 1996 and 2016 were extracted from maintained databases of 7 French referral gynecologic oncology institutions. Patients with stage IV diseases were selected for further analysis. The Kaplan-Meier method was used to estimate the survival distribution. A Cox proportional hazards model including all the parameters statistically significant in univariable analysis, was used to account for the influence of multiple variables.Results: Two hundred and eight patients met our inclusion criteria: 65 (31.3%) never underwent debulking surgery, 52 (25%) underwent primary debulking surgery (PDS) and 91 (43.8%) neoadjuvant chemotherapy and interval debulking surgery (NACT-IDS). Patients not operated had a significantly worse overall survival than patients that underwent PDS or NACT-IDS (p < 0.001). In multivariable analysis, three factors were independent predictors of survival: upfront surgery (HR 0.32 95% CI 0.14-0.71, p = 0.005), postoperative residual disease = 0 (HR 0.37 95% CI 0.18-0.75, p = 0.006) and association of Carboplatin and Paclitaxel regimen (HR 0.45 95% CI 0.25-0.80, p = 0.007).Conclusions: Presence of distant metastases should not refrain surgeons from performing radical procedures, whenever the patient is able to tolerate. Maximal surgical efforts should be done to minimize residual disease as it is the main determinant of survival. [ABSTRACT FROM AUTHOR]

Published
2020
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