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1. Surgery in reference centers improves survival of sarcoma patients: a nationwide study

Author

A. Giraud, P. Soibinet, Sébastien Carrère, E. Stoeckle, G. Vaz, J. Guiramand, J.-C. Ruzic, A. Dufresne, Jean-Yves Blay, F. Gouin, A. Rochwerger, F. Duffaud, A. Le Cesne, Francis Guillemin, J.-P. Spano, M. Rios, P. Meeus, Isabelle Ray-Coquard, A. Di Marco, G. Ferron, François Bertucci, François Sirveaux, N. Firmin, F. Fiorenza, O. Collard, S. Bonvalot, Emmanuelle Bompas, S. Causeret, P. Anract, M. Jafari, D. Pérol, J.-C. Machiavello, O. Marco, F. Ducimetière, C. Honore, A. Italiano, A. Michot, M. Karanian-Philippe, Nicolas Penel, P. Gimbergues, Mickaël Ropars, M. Toulmonde, F. Marchal, M. Brahmi, C. Le Pechoux, L.R. Le Nail, C. Perrin, F. Le Loarer, C. Chevreau, A. Dupré, J.-M. Guilloit, L. Chaigneau, F. Dujardin, Department of Medical Oncology [Lyon], Centre Léon Bérard [Lyon], Institut de Cancérologie Lucien Neuwirth, Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E), Département de Chirurgie cancérologique, Institut Gustave Roussy (IGR), Département d'oncologie médicale, Institut Bergonié [Bordeaux], UNICANCER-UNICANCER, Centre Régional de Lutte contre le Cancer Oscar Lambret [Lille] (UNICANCER/Lille), Université de Lille-UNICANCER, Institut de Cancérologie de l'Ouest [Angers/Nantes] (UNICANCER/ICO), UNICANCER, CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d’Oncologie Médicale [Hôpital de la Timone - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), CHU Pontchaillou [Rennes], Centre Eugène Marquis (CRLCC), 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), Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] (UNICANCER/ICL), Centre Paul Strauss, CRLCC Paul Strauss, Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Centre de Lutte contre le Cancer Antoine Lacassagne [Nice] (UNICANCER/CAL), UNICANCER-Université Côte d'Azur (UCA), Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de chirurgie [Centre Georges-François Leclerc], Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), Department of Surgical Oncology, Centre Jean Perrin [Clermont-Ferrand] (UNICANCER/CJP), Service d'Oncologie médicale [CHU Limoges], CHU Limoges, Service d'Oncologie Médicale [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Institut Jean Godinot [Reims], Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN), Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Claudius Regaud, Oncogenesis Stress Signaling (OSS), Université de Rennes (UR)-CRLCC Eugène Marquis (CRLCC), Centre de Recherche en Cancérologie de Marseille (CRCM), 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), Département de radiothérapie [Gustave Roussy], Centre de Recherches sur les Macromolécules Végétales (CERMAV ), Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Laboratoire Interdisciplinaire de Recherche Impliquant la Géologie et la Mécanique, Université Joseph Fourier - Grenoble 1 (UJF), Institut Curie [Paris], NetSARC, INCa & DGOS, RREPS, RESOS (INCa & DGOS) and LYRICAN, Association DAM’s, Ensemble contre Le GIST, FP7-278742, Eurosarc, ANR-10-LABX-0061, la Fondation ARC, Infosarcome, Ligue de L’Ain contre le Cancer, La Ligue contre le Cancer, EC 739521, EURACAN, ANR-10-LABX-0061,DEVWECAN,Development Cancer and Targeted Therapies(2010), CHU Saint-Etienne, Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CRLCC Eugène Marquis (CRLCC), Laboratoire des Mécanismes et Transfert en Géologie (LMTG), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Observatoire Midi-Pyrénées (OMP), Institut de Recherche pour le Développement (IRD)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut national des sciences de l'Univers (INSU - CNRS)-Centre National d'Études Spatiales [Toulouse] (CNES)-Centre National de la Recherche Scientifique (CNRS)-Météo-France -Institut de Recherche pour le Développement (IRD)-Institut national des sciences de l'Univers (INSU - CNRS)-Centre National d'Études Spatiales [Toulouse] (CNES)-Centre National de la Recherche Scientifique (CNRS)-Météo-France -Centre National de la Recherche Scientifique (CNRS), Université Lille Nord de France (COMUE)-UNICANCER, Hôpital de la Timone [CHU - APHM] (TIMONE)-Assistance Publique - Hôpitaux de Marseille (APHM), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), 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), Météo France-Centre National d'Études Spatiales [Toulouse] (CNES)-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Météo France-Centre National d'Études Spatiales [Toulouse] (CNES)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Centre National de la Recherche Scientifique (CNRS), CHU Lille, Université de Lille, Université Claude Bernard Lyon 1 [UCBL], METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694, Institut Gustave Roussy [IGR], Centre Hospitalier Régional Universitaire [Lille] [CHRU Lille], Hôpital Cochin [AP-HP], Hôpital de la Timone [CHU - APHM] [TIMONE], Institut de Recherche en Cancérologie de Montpellier [IRCM - U1194 Inserm - UM], Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] [UNICANCER/ICL], CHU Strasbourg, Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] [UNICANCER/CRLCC-CGFL], Centre Jean Perrin [Clermont-Ferrand] [UNICANCER/CJP], Centre Hospitalier Régional Universitaire de Besançon [CHRU Besançon], CRLCC Jean Godinot, Centre Régional de Lutte contre le Cancer François Baclesse [Caen] [UNICANCER/CRLC], Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen [CLCC Henri Becquerel], Centre Hospitalier Universitaire de La Réunion [CHU La Réunion], and Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]

Subjects
0301 basic medicine, Male, Multivariate analysis, sarcoma, medicine.medical_treatment, [SDV]Life Sciences [q-bio], surgery, 0302 clinical medicine, Prospective Studies, Registries, resection, Referral and Consultation, Aged, 80 and over, relapse, Hazard ratio, Hematology, Middle Aged, Prognosis, Corrigenda, 3. Good health, Survival Rate, Oncology, 030220 oncology & carcinogenesis, Surgical Procedures, Operative, Female, Sarcoma, France, Adult, medicine.medical_specialty, Adolescent, [SDV.CAN]Life Sciences [q-bio]/Cancer, reference center, Relapse free survival, survival, 03 medical and health sciences, Young Adult, medicine, Humans, Neurofibromatosis, Pathological, Aged, business.industry, Cancer, Original Articles, medicine.disease, Surgery, Radiation therapy, Editor's Choice, 030104 developmental biology, Neoplasm Recurrence, Local, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Follow-Up Studies
Abstract

International audience; BackgroundNETSARC (netsarc.org) is a network of 26 sarcoma reference centers with specialized multidisciplinary tumor boards (MDTB) aiming to improve the outcome of sarcoma patients. Since 2010, presentation to an MDTB and expert pathological review are mandatory for sarcoma patients nationwide. In the present work, the impact of surgery in a reference center on the survival of sarcoma patients investigated using this national NETSARC registry.Patients and methodsPatients’ characteristics and follow-up are prospectively collected and data monitored. Descriptive, uni- and multivariate analysis of prognostic factors were conducted in the entire series (N = 35 784) and in the subgroup of incident patient population (N = 29 497).ResultsAmong the 35 784 patients, 155 different histological subtypes were reported. 4310 (11.6%) patients were metastatic at diagnosis. Previous cancer, previous radiotherapy, neurofibromatosis type 1 (NF1), and Li–Fraumeni syndrome were reported in 12.5%, 3.6%, 0.7%, and 0.1% of patients respectively. Among the 29 497 incident patients, 25 851 (87.6%) patients had surgical removal of the sarcoma, including 9949 (33.7%) operated in a NETSARC center. Location, grade, age, size, depth, histotypes, gender, NF1, and surgery outside a NETSARC center all correlated to overall survival (OS), local relapse free survival (LRFS), and event-free survival (EFS) in the incident patient population. NF1 history was one of the strongest adverse prognostic factors for LRFS, EFS, and OS. Presentation to an MDTB was associated with an improved LRFS and EFS, but was an adverse prognostic factor for OS if surgery was not carried out in a reference center. In multivariate analysis, surgery in a NETSARC center was positively correlated with LRFS, EFS, and OS [P

Published
2019

2. Intraoperative radiological margin assessment in breast-conserving surgery

Author

B. Flipo, Jean-Marc Ferrero, C. Maestro, Y. Fouche, J.-C. Machiavello, D. Quaranta, C. Chapellier, I. Raoust, T. Ihrai, and M. Marcy

Subjects
Adult, medicine.medical_specialty, Neoplasm, Residual, medicine.medical_treatment, Breast Neoplasms, Mastectomy, Segmental, Intraoperative Period, Breast cancer, Predictive Value of Tests, Margin (machine learning), Breast-conserving surgery, Positive Margins, Humans, Medicine, Prospective Studies, Prospective cohort study, Aged, Histological examination, business.industry, Carcinoma, Ductal, Breast, Lumpectomy, General Medicine, Middle Aged, medicine.disease, Radiography, Carcinoma, Lobular, Oncology, Radiological weapon, Female, Surgery, Radiology, business
Abstract

A prospective study was lead in order to analyze the accuracy of an X-ray device settled in the operating room for margin assessment, when performing breast-conserving surgery. Patients and methods One hundred and seventy patients were included. All lesions were visible on the preoperative mammograms. An intraoperative X-ray of the lumpectomy specimen was systematically performed for margins assessment. Final histological data were collected and the accuracy of intraoperative specimen radiography (IOSR) for margin assessment was analyzed. Results IOSR allowed an evaluation of margins status in 155 cases (91.2%). After final histological examination, the positive margins rate would have been 6.5% if margin assessment had relied only on IOSR. Conclusion Margin assessment with a two-dimensional X-ray device would have allowed the achievement of negative margins in 93.5% of the cases. Moreover, this procedure allows important time-saving and could have a substantial economical impact.

Published
2014

3. Correction to: Surgery in reference centers improves survival of sarcoma patients: a nationwide study

Author

M. Karanian-Philippe, Isabelle Ray-Coquard, A. Di Marco, J.-M. Guilloit, C. Perrin, M. Toulmonde, J.-P. Spano, G. Ferron, C. Le Pechoux, O. Collard, M. Rios, François Sirveaux, J. Guiramand, A. Dufresne, L. Chaigneau, C. Chevreau, S. Causeret, P. Gimbergues, L.R. Le Nail, M. Jafari, J.-C. Ruzic, O. Marco, F. Gouin, G. Vaz, A. Dupré, P. Anract, E. Stoeckle, A. Michot, F. Dujardin, Jean-Yves Blay, Emmanuelle Bompas, F. Guillemin, C. Honore, F. Duffaud, P. Meeus, A. Rochwerger, Nicolas Penel, F. Fiorenza, F. Le Loarer, S. Bonvalot, Mickaël Ropars, A. Le Cesne, F. Ducimetière, D. Pérol, A. Italiano, F. Marchal, P. Soibinet, Sébastien Carrère, J.-C. Machiavello, A. Giraud, François Bertucci, N. Firmin, M. Brahmi, AIRPARIF - Surveillance de la qualité de l'air en Île-de-France, Institut Bergonié - CRLCC Bordeaux, Centre Léon Bérard [Lyon], Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire de recherche en Hydrodynamique, Énergétique et Environnement Atmosphérique (LHEEA), École Centrale de Nantes (ECN)-Centre National de la Recherche Scientifique (CNRS), Centre chirurgical Émile-Gallé, Institut des Biomolécules Max Mousseron [Pôle Chimie Balard] (IBMM), Ecole Nationale Supérieure de Chimie de Montpellier (ENSCM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), 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), Department of Surgical Oncology, Jean Perrin Comprehensive Cancer Centre, Service de Chirurgie orthopédique et traumatologique [CHU Limoges], CHU Limoges, Service d'oncologie Médicale, Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Hôpital Jean Minjoz, Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université de Lorraine (UL), Laboratoire de Chimie et Physique - Approche Multi-échelle des Milieux Complexes (LCP-A2MC), CHU Pitié-Salpêtrière [APHP], Institut Claudius Regaud, CRLCC Institut Claudius Regaud, Oncogenesis Stress Signaling (OSS), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-CRLCC Eugène Marquis (CRLCC), Département de radiothérapie [Gustave Roussy], Institut Gustave Roussy (IGR), Centre de Recherches sur les Macromolécules Végétales (CERMAV), Université Joseph Fourier - Grenoble 1 (UJF)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), Laboratoire Interdisciplinaire de Recherche Impliquant la Géologie et la Mécanique, Université Joseph Fourier - Grenoble 1 (UJF), Centre Oscar Lambret, Laboratoire des Mécanismes et Transfert en Géologie (LMTG), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Observatoire Midi-Pyrénées (OMP), Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Aix Marseille Université (AMU)-Institut Paoli-Calmettes, and 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)

Subjects
0301 basic medicine, medicine.medical_specialty, Multivariate analysis, [SDV]Life Sciences [q-bio], medicine.medical_treatment, [SDV.CAN]Life Sciences [q-bio]/Cancer, Relapse free survival, 03 medical and health sciences, 0302 clinical medicine, medicine, Neurofibromatosis, Pathological, ComputingMilieux_MISCELLANEOUS, business.industry, Hazard ratio, Cancer, Hematology, medicine.disease, 3. Good health, Surgery, Radiation therapy, 030104 developmental biology, Oncology, 030220 oncology & carcinogenesis, Sarcoma, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Background NETSARC (netsarc.org) is a network of 26 sarcoma reference centers with specialized multidisciplinary tumor boards (MDTB) aiming to improve the outcome of sarcoma patients. Since 2010, presentation to an MDTB and expert pathological review are mandatory for sarcoma patients nationwide. In the present work, the impact of surgery in a reference center on the survival of sarcoma patients investigated using this national NETSARC registry. Patients and methods Patients’ characteristics and follow-up are prospectively collected and data monitored. Descriptive, uni- and multivariate analysis of prognostic factors were conducted in the entire series (N = 35 784) and in the subgroup of incident patient population (N = 29 497). Results Among the 35 784 patients, 155 different histological subtypes were reported. 4310 (11.6%) patients were metastatic at diagnosis. Previous cancer, previous radiotherapy, neurofibromatosis type 1 (NF1), and Li–Fraumeni syndrome were reported in 12.5%, 3.6%, 0.7%, and 0.1% of patients respectively. Among the 29 497 incident patients, 25 851 (87.6%) patients had surgical removal of the sarcoma, including 9949 (33.7%) operated in a NETSARC center. Location, grade, age, size, depth, histotypes, gender, NF1, and surgery outside a NETSARC center all correlated to overall survival (OS), local relapse free survival (LRFS), and event-free survival (EFS) in the incident patient population. NF1 history was one of the strongest adverse prognostic factors for LRFS, EFS, and OS. Presentation to an MDTB was associated with an improved LRFS and EFS, but was an adverse prognostic factor for OS if surgery was not carried out in a reference center. In multivariate analysis, surgery in a NETSARC center was positively correlated with LRFS, EFS, and OS [P

Published
2019

4. Le muscle sternalis : derrière quel sein se cache-t-il ?

Author

M. Lallement, I. Raoust, C. Trastour, C. Chapellier, J.-C. Machiavello, A. Bongain, and P. Baque

Subjects
Sternum, medicine.diagnostic_test, business.industry, medicine.medical_treatment, Pectoralis major muscle, Computed tomography, Magnetic resonance imaging, Anatomy, Anatomic variant, Sternalis, Medicine, Surgery, medicine.symptom, business, Mastectomy, Confusion
Abstract

The sternalis muscle is a normal anatomic variant, which exists in about 5 to 8% of people. It runs longitudinally superficial to pectoralis major, alongside the sternum. Although the sternalis seems common in cadaveric studies, physicians are not familiar with it, which may lead to confusion in diagnosis. Occasionally, the sternalis may be misinterpreted as a breast mass on mammogramm. In that case, computed tomography and magnetic resonance imaging are useful. We report herein two cases of sternalis muscles encountered during mastectomy.

Published
2006

5. Étude des berges radiologiques au bloc opératoire dans le traitement conservateur du cancer du sein : évaluation carcinologique et médico-économique

Author

Y. Fouche, C. Chapellier, I. Raoust, C. Maestro, J.-C. Machiavello, T. Ihrai, B. Flipo, and D. Quaranta

Abstract

L’obtention de marges saines dans le traitement conservateur du cancer du sein est connue comme facteur pronostic fondamental. Mais obtenir ces marges saines des la primochirurgie permettant d’eviter les reinterventions est un challenge quotidien qui necessite souvent une logistique importante (transport des pieces en radio ou au laboratoire ; ou deplacement du pathologiste immobilise sur place). Il s’agit de la premiere etude prospective, continue, monocentrique dont le but est d’envisager une alternative a l’examen extemporane (BE) des pieces. Nous avons evalue le benefice d’une procedure radio de piece operatoire instantanee au moyen de materiel dedie, positionne en salle d’operation, dans la prise en charge des patientes presentant un cancer du sein, tant sur le plan oncologique que sur le plan organisationnel et medico-economique.

Published
2012

6. [Sternalis muscle in breast surgery]

Author

C, Trastour, J-C, Machiavello, C, Chapellier, I, Raoust, P, Baque, M, Lallement, and A, Bongain

Subjects
Carcinoma, Lobular, Sternum, Carcinoma, Ductal, Breast, Humans, Breast Neoplasms, Female, Middle Aged, Muscle, Skeletal, Magnetic Resonance Imaging, Mastectomy, Mammography, Pectoralis Muscles
Abstract

The sternalis muscle is a normal anatomic variant, which exists in about 5 to 8% of people. It runs longitudinally superficial to pectoralis major, alongside the sternum. Although the sternalis seems common in cadaveric studies, physicians are not familiar with it, which may lead to confusion in diagnosis. Occasionally, the sternalis may be misinterpreted as a breast mass on mammogramm. In that case, computed tomography and magnetic resonance imaging are useful. We report herein two cases of sternalis muscles encountered during mastectomy.

Published
2005

8. 218 Preventing reoperation in invasive lobular breast cancer

Author

I. Raoust, F. Ettore, A. Vazquez Guerrero, B. Flipo, C. Chapellier, A. Figl, Michel Lallement, I. Birtwistle-Peyrottes, J.-C. Machiavello, and C. Balu-Maestro

Subjects
Oncology, Cancer Research, medicine.medical_specialty, Breast cancer, business.industry, Internal medicine, medicine, Cancer, medicine.disease, business
Published
2010

9. Non-specifically labelled cells that simulate bone marrow metastases in patients with non-metastatic breast cancer

Author

J C Machiavello, C Bayle, A. Thyss, Marion Schneider, A Creisson, M. Namer, C Bourcier, J Monticelli, J. M. Ferrero, Jean-Léon Lagrange, J. Gioanni, and M Lagrange

Subjects
Adult, Pathology, medicine.medical_specialty, Stromal cell, Breast Neoplasms, Sensitivity and Specificity, Pathology and Forensic Medicine, Metastasis, Breast cancer, Bone Marrow, Biopsy, Carcinoma, Medicine, Humans, Aged, Aged, 80 and over, medicine.diagnostic_test, business.industry, Histological Techniques, Bone metastasis, General Medicine, Middle Aged, medicine.disease, Immunohistochemistry, medicine.anatomical_structure, Bone marrow neoplasm, Female, Bone marrow, Stromal Cells, business, Bone Marrow Neoplasms, Research Article, Follow-Up Studies
Abstract

AIMS: To determine whether the presence of disseminated bone marrow tumour cells at diagnosis is a prognostic factor for breast cancer patients at high risk of recurrence or bone metastasis, and to assess their presence as a criterion for evaluation of the potential benefits of adjuvant chemotherapy. METHODS: Multiple bone marrow aspirates from 72 breast cancer patients free from metastasis were obtained during surgery at the time of diagnosis and were tested immunologically by alkaline phosphatase antialkaline phosphatase technique with a panel of three antiepithelial monoclonal antibodies (MoAb) KL1, EMA, and HMFG2. RESULTS: In nine of 72 patients, with each MoAb tested, numerous strongly positive cells always isolated were observed. However, it was demonstrated that these cells were non-specifically labelled and could be found in normal controls. CONCLUSIONS: There was no evidence of marrow tumour cells in 72 operable breast cancer patients. It is suggested that published results may be greatly overestimated and that non-specific labelling may be undetected. More specific MoAb should be found and a correlation with molecular biology should be performed if this criterion is to be considered as a prognostic factor.

Published
1997

10. [A comparative study of 4 sequential first-line chemotherapy protocols in locally advanced breast cancer]

Author

J M, Ferrero, M, Namer, J F, Dufour, R, Largillier, A, Creisson, E, Teissier, J C, Machiavello, M, Lallement, J, Monticelli, and M, Abbes

Subjects
Adult, Antibiotics, Antineoplastic, Neutropenia, Dose-Response Relationship, Drug, Breast Neoplasms, Middle Aged, Antineoplastic Agents, Phytogenic, Drug Administration Schedule, Survival Rate, Treatment Outcome, Doxorubicin, Vincristine, Antineoplastic Combined Chemotherapy Protocols, Humans, Female, Fluorouracil, Neoplasm Metastasis, Neoplasm Recurrence, Local, Antineoplastic Agents, Alkylating, Cyclophosphamide, Aged, Neoplasm Staging
Abstract

Between 1977 and 1994, our center administered successively 4 different chemotherapy regimens to 242 evaluable patients with locally advanced breast cancer. Patients with inflammatory signs were excluded. Sixty-eight patients were treated by AVCF (A (adriamycine) + V (vincristine) + C (cytoxan) + F (5FU)), 47 by AECF (A + E (vindesine) + C + F), 81 by CAFP (C + A + F + P (prednisone)) and 46 by AN (A + N (vinorelbine)). The mean number of cycle was 3. One hundred and twenty-five patients (52.5%) responded to chemotherapy and we recorded 35 complete response (14.7%). The response rates at the different combinations were respectively: AVCF: 29.4%, AECF: 53.2%, CAFP: 64.9%, AN: 65.2%, and were independent of tumor size, grade and receptor status. The response rate at the AVCF regimen was significantly worse than the others (p = 0.0005). Breast conserving surgery was performed in 31 patients (14%) and 17 patients (8%) had a complete response. Among the 35 patients with complete response, 21 were treated by radiotherapy alone. Local recurrence occurred in 19 patients (7.9%) and 96 (40%) had advanced disease. The mean follow-up of AVCF regimen was 150 months, 115 months for AECF, 111 for CAFP and 42 months for AN. The disease-free survival and the overall survival were significantly better with AECF, CAFP and AN regimens (DFS p0.04, OS p0.02). Survival was better in those patients with an objective response (p = 0.002) or with non-affected axillary node at the time of surgery. Our study showed already that AVCF combination was significantly lower than AECF, CAFP, AN in terms of response rate, disease-free survival and overall survival. Waiting the results of randomized studies about the impact of neoadjuvant chemotherapy on survival, we look for chemotherapy regimen improving the rate of conservative surgery.

Published
1997

11. [Breast metastasis revealing cancer of the kidney. Apropos of a new case and review of the literature]

Author

J, Monticelli, J C, Machiavello, I, Birtwisle-Peyrottes, A, Goharin, and A C, Lange

Subjects
Humans, Breast Neoplasms, Female, Middle Aged, Neoplasm Recurrence, Local, Nephrectomy, Kidney Neoplasms, Adenocarcinoma, Clear Cell
Abstract

Metastases are rarely located in the breast. Generally, breast metastases appear during the course of a known primitive cancer and renal origin is very rare. It is even more exceptional that metastasis reveals renal cancer as observed in this case. Five similar cases have been reported in the literature.

Published
1994

12. [Conservative treatment of epidermoid cancer of the anal canal combining radiotherapy and curietherapy. Experience at the Antoine-Lacassagne Center]

Author

J L, Lagrange, P, Chauvel, E, François, J, Bourry, D, Benchimol, J M, Bereder, J C, Machiavello, and H, Richelme

Subjects
Aged, 80 and over, Male, Evaluation Studies as Topic, Lymphatic Metastasis, Carcinoma, Squamous Cell, Humans, Female, Middle Aged, Neoplasm Recurrence, Local, Anus Neoplasms, Combined Modality Therapy, Aged
Abstract

From 1973 to 1987, 33 patients aged from 46 to 86 years (25 female, 8 male) were treated for a tumour of the anal canal with radiotherapy and curietherapy. Tumour distribution was 7 T1, 19 T2, 7 T3, and 4 patients were N+. After treatment it was possible to assess 31 patients; 29 were in complete remission, remission was obtained in 2 others following surgery. Tolerance was comparable to other series but 4 patients developed necrosis of the anal canal; 2 patients died under general anesthesia and 1 patient had a radiation injury of the small intestine. The sphincter was conserved in 65 p. cent of cases. Relapse occurred in 8 patients within 6-92 months, and 6 patients developed metastases. Overall survival was 78 p. cent at 3 years and 74 p. cent at 5 and 10 years. Disease-free survival was 65 p. cent at 3 and 5 years and 52 p. cent at 10 years. Our results confirm those of other series using a similar treatment plan. This treatment is difficult to put into practice. Patients must be carefully selected preferably by a team including proctologist, surgeon and radiotherapist.

Published
1990

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