Descriptor: "MESH : Proportional Hazards Models" - Searchworks@Jio Institute Digital Library Search Results

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35 results on '"MESH : Proportional Hazards Models"'

1. Long-Term Clinical Outcomes According to Previous Manifestations of Atherosclerotic Disease (from the FAST-MI 2010 Registry)

Author: Etienne Puymirat, Nicolas Danchin, Yves Cottin, Nadia Aissaoui, Tabassome Simon, Jean Ferrières, Gilles Lemesle, Francois Schiele, Pierre Coste, Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Université Paris Descartes - Paris 5 (UPD5)-Hôpital Européen Georges Pompidou [APHP] (HEGP), 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)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Descartes - Paris 5 (UPD5), Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Université Lille 2 - Faculté de Médecine, Lipides - Nutrition - Cancer [Dijon - U1231] (LNC), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement, Service de Cardiologie [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Hôpital cardiologique du Haut Leveque, Université de Bordeaux Ségalen [Bordeaux 2], Département de Cardiologie (Dep Cardio - BESANCON), Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon), Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de cardiologie [Toulouse], Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], CHU Saint-Antoine [APHP], 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)-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), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Service de cardiologie [CHRU de Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Paris-Centre de Recherche Cardiovasculaire ( PARCC - U970 ), Hôpital Européen Georges Pompidou [APHP] ( HEGP ) -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 ), Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Lipides - Nutrition - Cancer [Dijon - U1231] ( LNC ), Université de Bourgogne ( UB ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Département de Cardiologie ( Dep Cardio - BESANCON ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Épidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps, Université Toulouse III - Paul Sabatier ( UPS ), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Plateforme de recherche clinique de l'est parisien ( URCEST-CRCEST ), Service de pharmacologie clinique [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Saint-Antoine [APHP], Université Pierre et Marie Curie - Paris 6 ( UPMC ), Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps [Toulouse], Université Paul Sabatier - Toulouse 3 ( UPS ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Paul Sabatier - Toulouse 3 ( UPS ) -CHU Toulouse [Toulouse]-Hôpital de Rangueil, 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 Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Faculté de Médecine Henri Warembourg - Université de Lille, Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)
Subjects: Male, MESH : Atherosclerosis, medicine.medical_treatment, MESH : Mortality, Myocardial Infarction, MESH : Aged, MESH : Prospective Studies, Angiotensin-Converting Enzyme Inhibitors, Coronary Artery Disease, Disease, MESH : Cerebrovascular Disorders, 0302 clinical medicine, Medicine, Longitudinal Studies, Prospective Studies, MESH: Coronary Artery Disease, Myocardial infarction, Coronary Artery Bypass, MESH: Treatment Outcome, Cause of death, Aged, 80 and over, education.field_of_study, MESH: Middle Aged, Hazard ratio, MESH : Platelet Aggregation Inhibitors, Prognosis, MESH: Case-Control Studies, 3. Good health, MESH: Myocardial Infarction, MESH: Angiotensin Receptor Antagonists, MESH : Angiotensin-Converting Enzyme Inhibitors, Cardiology and Cardiovascular Medicine, MESH: Percutaneous Coronary Intervention, MESH : Case-Control Studies, medicine.medical_specialty, MESH : Angiotensin Receptor Antagonists, MESH: Prognosis, 03 medical and health sciences, Percutaneous Coronary Intervention, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Humans, MESH : Middle Aged, MESH : Coronary Artery Disease, MESH : Aged, 80 and over, MESH: Hydroxymethylglutaryl-CoA Reductase Inhibitors, education, MESH: Age Distribution, Aged, MESH: Humans, MESH: Mortality, Proportional hazards model, MESH: Coronary Artery Bypass, MESH : Humans, Case-control study, MESH : Proportional Hazards Models, medicine.disease, MESH : Coronary Artery Bypass, Case-Control Studies, MESH: Female, MESH: Registries, MESH : Age Distribution, 030204 cardiovascular system & hematology, MESH: Atherosclerosis, MESH: Proportional Hazards Models, MESH: Cause of Death, MESH: Aged, 80 and over, MESH : Percutaneous Coronary Intervention, Risk Factors, MESH: Risk Factors, Cause of Death, MESH : Female, Registries, 030212 general & internal medicine, MESH: Longitudinal Studies, MESH : Longitudinal Studies, MESH: Aged, MESH : Prognosis, MESH: Angiotensin-Converting Enzyme Inhibitors, MESH: Adrenergic beta-Antagonists, Middle Aged, [ SDV.MHEP.CSC ] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, MESH : Risk Factors, Treatment Outcome, MESH: Platelet Aggregation Inhibitors, Cardiology, Female, MESH: Cerebrovascular Disorders, France, MESH : Male, Adrenergic beta-Antagonists, MESH : Adrenergic beta-Antagonists, Population, MESH : Treatment Outcome, MESH: Multivariate Analysis, Angiotensin Receptor Antagonists, Age Distribution, Internal medicine, Mortality, MESH : France, Proportional Hazards Models, MESH : Cause of Death, business.industry, MESH : Hydroxymethylglutaryl-CoA Reductase Inhibitors, MESH : Multivariate Analysis, Percutaneous coronary intervention, Atherosclerosis, MESH: Male, MESH: Prospective Studies, MESH: France, Cerebrovascular Disorders, Multivariate Analysis, Hydroxymethylglutaryl-CoA Reductase Inhibitors, MESH : Myocardial Infarction, business, Platelet Aggregation Inhibitors, MESH : Registries
Abstract: IF 3.398; International audience; The prognosis of patients with acute myocardial infarction (AMI) has notably improved in the past 20 years. Using the French Registry of ST-Elevation and Non-ST-elevation Myocardial Infarction (FAST-MI) 2010 registry, we investigated whether previous manifestations of atherosclerotic disease (i.e., previous MI, or a history of any form of atherosclerotic disease) are at truly increased risk compared with those in whom AMI is the first manifestation of the disease. FAST-MI 2010 is a nationwide French registry including 3,079 patients with AMI, among whom 1,062 patients had a history of cardiovascular atherosclerotic disease and 498 patients had a history of MI. Overall, patients with a history of atherosclerotic disease (or MI) were older compared with patients without known cardiovascular disease (71 ± 13 vs 63 ± 14 years) and had higher cardiovascular risk profiles and co-morbidities. Using fully adjusted Cox multivariate analysis, previous manifestations of atherosclerotic disease were associated with higher 3-year mortality (hazard ratio 1.80, 95% confidence interval 1.40 to 2.31; p
Published: 2017

2. Incremental predictive value of mean platelet volume/platelet count ratio in in-hospital stroke after acute myocardial infarction

Author: Yves Cottin, Fabien Garnier, Karim Stamboul, Yannick Béjot, Thibault Leclercq, Olivier Hachet, Nobila Valentin Yaméogo, Charles Guenancia, Emmanuel De Maistre, Luc Lorgis, Lipides - Nutrition - Cancer [Dijon - U1231] ( LNC ), Université de Bourgogne ( UB ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de Cardiologie [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Registre Dijonnais des Accidents Vasculaires Cérébraux (AVC) - Dijon Stroke Registry, Centre d'épidémiologie des populations ( CEP ), Université de Bourgogne ( UB ) -Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc ( CRLCC - CGFL ) -Université de Bourgogne ( UB ) -Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc ( CRLCC - CGFL ) -Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Service d'Hématologie Clinique (CHU de Dijon), Lipides - Nutrition - Cancer (U866) ( LNC ), Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon ( ENSBANA ), Lipides - Nutrition - Cancer [Dijon - U1231] (LNC), Université de Bourgogne (UB)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre d'épidémiologie des populations (CEP), Université de Bourgogne (UB)-Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER-Université de Bourgogne (UB)-Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Lipides - Nutrition - Cancer (U866) (LNC), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon (ENSBANA), and Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement
Subjects: Male, Time Factors, MESH : Stroke, Myocardial Infarction, MESH : Aged, MESH: Comorbidity, Comorbidity, MESH: Hospitalization, 030204 cardiovascular system & hematology, MESH : Platelet Count, law.invention, MESH: Proportional Hazards Models, 0302 clinical medicine, MESH: Aged, 80 and over, Risk Factors, law, MESH: Risk Factors, Odds Ratio, [ SDV.MHEP.HEM ] Life Sciences [q-bio]/Human health and pathology/Hematology, MESH : Female, Myocardial infarction, MESH : Biomarkers, Stroke, MESH: Blood Platelets, Aged, 80 and over, MESH: Aged, Ejection fraction, MESH: Middle Aged, MESH : Prognosis, biology, MESH : Mean Platelet Volume, [SDV.MHEP.HEM]Life Sciences [q-bio]/Human health and pathology/Hematology, Hematology, General Medicine, Middle Aged, Prognosis, Intensive care unit, stroke, MESH : Risk Factors, 3. Good health, Hospitalization, MESH: Myocardial Infarction, risk factor, platelets, MESH : Comorbidity, Cardiology, MESH : Hospitalization, Female, Mean Platelet Volume, MESH : Time Factors, Blood Platelets, medicine.medical_specialty, MESH : Male, [SDV.BC]Life Sciences [q-bio]/Cellular Biology, Acute myocardial infarction, MESH: Prognosis, MESH: Stroke, C-reactive protein, 03 medical and health sciences, Internal medicine, medicine, Humans, MESH : Middle Aged, MESH: Platelet Count, cardiovascular diseases, Risk factor, Mean platelet volume, MESH : Aged, 80 and over, Survival analysis, Aged, Proportional Hazards Models, MESH: Humans, Platelet Count, business.industry, [ SDV.BC ] Life Sciences [q-bio]/Cellular Biology, MESH: Time Factors, MESH : Humans, MESH : Blood Platelets, medicine.disease, MESH : Proportional Hazards Models, MESH: Odds Ratio, MESH: Male, MESH: Mean Platelet Volume, biology.protein, MESH: Biomarkers, MESH : Odds Ratio, MESH : Myocardial Infarction, business, MESH: Female, Biomarkers, 030217 neurology & neurosurgery
Abstract: IF 2.558; International audience; Stroke is a serious complication after acute myocardial infarction (AMI) and is associated with an increased risk of death. Though the pathophysiological mechanisms are not exactly known, increased inflammation and platelet reactivity could play an important role in the occurrence of stroke during AMI. We aimed to investigate the relationship between both mean platelet volume (MPV), a parameter of platelet function, and C-reactive protein (CRP) and the occurrence of in-hospital ischemic stroke (IHS) after AMI. Data were obtained from a French regional survey for AMI that included 5976 patients admitted to an intensive care unit (ICU) between 2001 and 2010. Patients were divided into two groups according to the occurrence of IHS. MPV, platelet count (PC), and CRP were routinely measured at admission to the ICU; 99 (1.6%) IHSs were recorded during hospitalization after admission for AMI. In multivariate analysis, IHS was independently associated with a history of stroke (OR: 1.99%, CI: 1.1-3.49, p = 0.01), impaired left ventricular ejection fraction 10 mg/l (OR: 2.19, 95% CI: 1.44-3.33, p < 0.001), and MPV/PC ratio (OR: 1.04, 95% CI: 1.01-1.08, p = 0.023). Compared with the first to fourth quintiles, the last quintile of the MPV/PC ratio was associated with higher rates of IHS on survival curve analysis (p = 0.014). At hospital admission, a high MPV/PC ratio and a high level of CRP might help to identify patients at increased risk of IHS. Moreover, these results provide new insights into the potential role played by increased inflammation and platelet reactivity in the occurrence of stroke after AMI.
Published: 2017

3. The health and economic burden of bloodstream infections caused by antimicrobial-susceptible and non-susceptible Enterobacteriaceae and Staphylococcus aureus in European hospitals, 2010 and 2011: a multicentre retrospective cohort study

Author: Hos , Andrew J, Allignol , Arthur, Beyersmann , Jan, Graves , Nicholas, Schumacher , Martin, Hos , Rodolphe, Hos , Evelina, Hos , Giulia, Hos , Claudio, Hos , Fabio, Bertrand , Xavier, Gbaguidi-Haore , Houssein, Edgeworth , Jonathan, Tosas , Olga, Hos , Jose A, Hos , M Pilar, Pan , Angelo, Zoncada , Alessia, Hos , Charis A, Hos , Dilip, Seifert , Harald, Hos , Nina, Hagel , Stefan, Pletz , Mathias, Harbarth , Stephan, Meyer , Rodolphe, Tacconelli , Evelina, De Angelis , Giulia, Farina , Claudio, Pezzoli , Fabio, Martinez , Jose A, Ayala-Blanco , M Pilar, Marwick , Charis A, Nathwani , Dilip, Freiburg Center for Data Analysis and Modeling, University of Freiburg [Freiburg], Laboratoire de Biologie Moléculaire et Cellulaire du Cancer, Hôpital Kirchberg, Fondation de Recherche Cancer et Sang - Hôpital Kirchberg, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Divisione di Malattie Infettive, Istituti Ospitalieri di Cremona, Department of Ophthalmology, Friedrich-Alexander-University of Erlangen-Nuremberg, Feinberg School of Medicine, Northwestern University, Department of Pulmonary Medicine, Hannover Medical School [Hannover] ( MHH ), Infection Control Programme and WHO Collaborating Centre on Patient Safety, Department of Infectious Diseases, Università Cattolica del Sacro Cuore, INFN Laboratori Nazionali di Legnaro, Unità di Microbiologia, AO 'Ospedale San Carlo Borromeo', Hospital Papa Giovanni XXIII ( Hosp P Giovanni XXIII ), Groupe d'histoire et diffusion des sciences d'Orsay ( GHDSO ), Université Paris-Sud - Paris 11 ( UP11 ), Laboratoire Interdisciplinaire de Recherche en Didactique, Éducation et Formation ( LIRDEF ), and Université Paul-Valéry - Montpellier 3 ( UM3 ) -Université de Montpellier ( UM )
Subjects: Staphylococcus aureus, MESH : Retrospective Studies, MESH : Male, MESH : Europe, MESH : Aged, bloodstream infection, MESH : Treatment Outcome, Antimicrobial resistance, MESH : Hospital Mortality, multidrug resistance, [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology, MESH : Enterobacteriaceae Infections, Escherichia coli, MESH : Methicillin-Resistant Staphylococcus aureus, MESH : Female, MESH : Middle Aged, MESH : Anti-Bacterial Agents, MESH : Cephalosporin Resistance, MESH : Staphylococcus aureus, MESH : Humans, MESH : Enterobacteriaceae, MESH : Proportional Hazards Models, MESH : Hospitals, MESH : Length of Stay, bacterial infections, MESH : Staphylococcal Infections, Meticillin-resistant Staphylococcus aureus (MRSA) in humans, MESH : Health Care Costs
Abstract: International audience; We performed a multicentre retrospective cohort study including 606,649 acute inpatient episodes at 10 European hospitals in 2010 and 2011 to estimate the impact of antimicrobial resistance on hospital mortality, excess length of stay (LOS) and cost. Bloodstream infections (BSI) caused by third-generation cephalosporin-resistant Enterobacteriaceae (3GCRE), meticillin-susceptible (MSSA) and -resistant Staphylococcus aureus (MRSA) increased the daily risk of hospital death (adjusted hazard ratio (HR) = 1.80; 95% confidence interval (CI): 1.34-2.42, HR = 1.81; 95% CI: 1.49-2.20 and HR = 2.42; 95% CI: 1.66-3.51, respectively) and prolonged LOS (9.3 days; 95% CI: 9.2-9.4, 11.5 days; 95% CI: 11.5-11.6 and 13.3 days; 95% CI: 13.2-13.4, respectively). BSI with third-generation cephalosporin-susceptible Enterobacteriaceae (3GCSE) significantly increased LOS (5.9 days; 95% CI: 5.8-5.9) but not hazard of death (1.16; 95% CI: 0.98-1.36). 3GCRE significantly increased the hazard of death (1.63; 95% CI: 1.13-2.35), excess LOS (4.9 days; 95% CI: 1.1-8.7) and cost compared with susceptible strains, whereas meticillin resistance did not. The annual cost of 3GCRE BSI was higher than of MRSA BSI. While BSI with S. aureus had greater impact on mortality, excess LOS and cost than Enterobacteriaceae per infection, the impact of antimicrobial resistance was greater for Enterobacteriaceae.
Published: 2016

4. Cardiac rehabilitation and 5-year mortality after acute coronary syndromes: The 2005 French FAST-MI study

Author: Didier Carrié, Jean-Bernard Ruidavets, Marion Pouche, Luc Lorgis, Nicolas Danchin, Hervé Douard, Tabassome Simon, Philippe Brunel, Vincent Bataille, Jean Ferrières, Marie-Christine Iliou, Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Service de cardiologie [Toulouse], Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Réadaptation Cardiaque et Prévention Secondaire [Hôpital Corentin-Celton], Hôpital Corentin Celton [Issy-les-Moulineaux], 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)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), hôpital cardiologique (CHU de Bordeaux), CHU Bordeaux [Bordeaux], Laboratoire de Physiopathologie et Pharmacologie Cardio-Métaboliques (U866, Lipides et nutrition, équipe 5) (LPPCM), Lipides - Nutrition - Cancer (U866) (LNC), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon (ENSBANA)-Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon (ENSBANA), Service de Cardiologie [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Nouvelles Cliniques Nantaises, CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Paris-Centre de Recherche Cardiovasculaire (PARCC - UMR-S U970), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-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), Pfizer, Servier, Caisse nationale d'assurance maladie des travailleurs salariés, Épidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps, Université Toulouse III - Paul Sabatier ( UPS ), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Hôpitaux Universitaires Paris Ouest - Hôpital Corentin Celton [Issy-les-Moulineaux], Laboratoire de Physiopathologie et Pharmacologie Cardio-Métaboliques (U866, Lipides et nutrition, équipe 5) ( LPPCM ), Lipides - Nutrition - Cancer (U866) ( LNC ), Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon ( ENSBANA ) -Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon ( ENSBANA ), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Plateforme de recherche clinique de l'est parisien ( URCEST-CRCEST ), CHU Saint-Antoine [APHP], Paris-Centre de Recherche Cardiovasculaire ( PARCC - U970 ), Hôpital Européen Georges Pompidou [APHP] ( HEGP ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service Cardiologie [CHU Toulouse], Pôle Cardiovasculaire et Métabolique [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), 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 Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), 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)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université Paris Descartes - Paris 5 (UPD5)-Hôpital Européen Georges Pompidou [APHP] (HEGP), 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)-Institut National de la Santé et de la Recherche Médicale (INSERM), Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps [Toulouse], Université Paul Sabatier - Toulouse 3 ( UPS ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Paul Sabatier - Toulouse 3 ( UPS ) -CHU Toulouse [Toulouse]-Hôpital de Rangueil, and Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Hôpital Européen Georges Pompidou [APHP] ( HEGP )
Subjects: Male, MESH: Chi-Square Distribution, medicine.medical_treatment, MESH : Acute Coronary Syndrome, Myocardial Infarction, MESH : Aged, MESH : Prospective Studies, Cardiac rehabilitation, MESH: Risk Assessment, 0302 clinical medicine, Myocardial infarction, Prospective Studies, Referral and Consultation, MESH: Treatment Outcome, Rehabilitation, MESH: Middle Aged, General Medicine, MESH: Follow-Up Studies, 3. Good health, MESH: Myocardial Infarction, MESH : Patient Discharge, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Acute myocardial infarction, Mortalité, Risk Assessment, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Humans, MESH : Middle Aged, Acute Coronary Syndrome, MESH: Kaplan-Meier Estimate, Aged, Chi-Square Distribution, MESH: Humans, MESH : Chi-Square Distribution, Proportional hazards model, MESH: Patient Discharge, MESH : Humans, Patient survival, MESH : Follow-Up Studies, medicine.disease, MESH : Proportional Hazards Models, MESH: Acute Coronary Syndrome, ST-segment elevation myocardial infarction, MESH: Female, Time Factors, MESH: Registries, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, MESH : Referral and Consultation, MESH: Proportional Hazards Models, Older patients, Risk Factors, MESH: Risk Factors, MESH : Female, 030212 general & internal medicine, Registries, MESH : Risk Assessment, MESH: Aged, Ejection fraction, Non–ST-segment elevation myocardial infarction, Middle Aged, [ SDV.MHEP.CSC ] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, MESH : Risk Factors, Patient Discharge, Treatment Outcome, Female, France, MESH : Time Factors, MESH : Male, MESH : Treatment Outcome, MESH: Multivariate Analysis, MESH : Kaplan-Meier Estimate, MESH: Referral and Consultation, Internal medicine, Infarctus du myocarde sans sus-décalage du segment ST, medicine, In patient, cardiovascular diseases, Medical prescription, Mortality, Réadaptation cardiaque, MESH : France, Proportional Hazards Models, business.industry, Infarctus du myocarde avec sus-décalage du segment ST, MESH: Time Factors, MESH : Multivariate Analysis, MESH: Male, MESH: Prospective Studies, Surgery, MESH: France, Infarctus du myocarde aigu, Multivariate Analysis, MESH : Myocardial Infarction, business, MESH : Registries, Follow-Up Studies
Abstract: IF 2.271; International audience; Background. - Clinical studies have shown a beneficial effect of cardiac rehabilitation (CR) on mortality.Objective. - To study the effect of CR prescription at discharge on 5-year mortality in patients with acute myocardial infarction (AMI).Methods. - Participants, from the 2005 French FAST-MI hospital registry, were 2894 survivors at discharge, divided according to AMI type: ST-segment elevation myocardial infarction (STEMI; n=1523) and non-STEMI (NSTEMI; n=1371). The effect of CR prescription on mortality was analysed using a Cox proportional hazards model.Results. - At discharge, 22.1% of patients had a CR prescription. Patients referred to CR were younger (62.4 vs. 67.5 years), were more frequently men and more had presented with STEMI (67.8% vs. 48.3%) than non-referred patients. Ninety-four (14.7%) deaths occurred among patients referred to CR and 585 (25.9%) among non-referred patients (P= 60 years) and AMI type showed that the inverse association was stronger in men (HR 0.64, 95% CI 0.48-0.87) than in women (HR 0.95, 95% CI 0.64-1.39), in younger (HR 0.34, 95% CI 0.15-0.77) than in older patients (HR 0.84, 95% CI 0.65-1.07) and in NSTEMI (HR 0.63, 95% CI 0.46-0.88) than in STEMI (HR 0.99, 95% CI 0.69-1.40).Conclusion. - After hospitalization for AMI, referral to CR remains a significant predictor of improved patient survival; some subgroups seem to gain greater benefit. (C) 2015 Elsevier Masson SAS. All rights reserved.
Published: 2016

5. Incidence, Medical and Socio-Behavioural Predictors of Psychiatric Events in An 11-Year Follow-Up of HIV-Infected Patients on Antiretroviral Therapy

Author: Protopopescu, Camelia, Raffi, François, Brunet-François, Cécile, Salmon, Dominique, Verdon, Renaud, Reboud, Philippe, Carrieri, Maria Patrizia, Leport, Catherine, Spire, Bruno, Michel, Laurent, Michelet, Christian, Aix Marseille Université (AMU), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD), Institut de Recherche pour le Développement (IRD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Maladies infectieuses et tropicales, Service de médecine interne et centre de référence des maladies rares [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Unité de Maladies Infectieuses et Tropicales [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Epidémiologie et Biostatistique [Bordeaux], Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques (U738 / UMR_S738), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Troubles du comportement alimentaire de l'adolescent (UMR_S 669), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Sud - Paris 11 (UP11), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), APROCO-COPILOTE (ANRS CO8) Study Group, Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris-Sud - Paris 11 (UP11)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), CHU Cochin [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques, Aix Marseille Université ( AMU ), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale ( SESSTIM - U912 INSERM - AMU - IRD ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut de Recherche pour le Développement ( IRD ) -Aix Marseille Université ( AMU ), Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Cochin [AP-HP], Service des maladies infectieuses et tropicales, CHU Caen, Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Troubles du comportement alimentaire de l'adolescent ( UMR_S 669 ), Université Paris-Sud - Paris 11 ( UP11 ) -Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Institut de recherche, santé, environnement et travail ( Irset ), Université d'Angers ( UA ) -Université de Rennes 1 ( UR1 ), and Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -École des Hautes Études en Santé Publique [EHESP] ( EHESP ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ) -Université des Antilles ( UA )
Subjects: Male, MESH: CD4 Lymphocyte Count, Epidemiology, HIV Infections, MESH : Viral Load, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Surveys and Questionnaires, Immunopathology, Hiv infected patients, Pharmacology (medical), Longitudinal Studies, MESH: Incidence, MESH: Treatment Outcome, MESH: Middle Aged, Depression, MESH: HIV, Incidence, MESH : HIV Protease Inhibitors, MESH: Follow-Up Studies, MESH: HIV Infections, MESH : Incidence, 3. Good health, Suicide, [ SDV.MHEP.MI ] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Drug Therapy, Combination, Viral disease, Infection, 0305 other medical science, MESH: Social Behavior, medicine.medical_specialty, 03 medical and health sciences, MESH : HIV Infections, Humans, MESH : Middle Aged, Antiviral, Social Behavior, Pharmacology, MESH: Humans, MESH: Questionnaires, MESH : Humans, MESH : Follow-Up Studies, MESH: Adult, MESH : Proportional Hazards Models, medicine.disease, Antiretroviral agent, MESH: Female, Immune deficiency, MESH : Social Behavior, MESH : HIV, MESH: Proportional Hazards Models, Risk Factors, MESH : Depression, MESH: Risk Factors, MESH : Female, 030212 general & internal medicine, MESH: Longitudinal Studies, MESH : Longitudinal Studies, MESH : Suicide, Incidence (epidemiology), MESH : Questionnaires, Middle Aged, Viral Load, MESH : Adult, MESH : Risk Factors, AIDS, Treatment Outcome, Infectious Diseases, Female, France, MESH: Viral Load, Adult, MESH: Depression, MESH : Male, MESH : Treatment Outcome, Acquired immunodeficiency syndrome (AIDS), MESH : CD4 Lymphocyte Count, medicine, Chemotherapy, MESH : France, Psychiatry, Proportional Hazards Models, MESH: HIV Protease Inhibitors, 030505 public health, Potential risk, business.industry, MESH : Drug Therapy, Combination, HIV, HIV Protease Inhibitors, Antiretroviral therapy, MESH: Male, CD4 Lymphocyte Count, Treatment, MESH: France, MESH: Drug Therapy, Combination, MESH: Suicide, Predictive factor, business, Follow-Up Studies
Abstract: Background Psychiatric disorders are relatively common among HIV-infected patients. However, there are few studies about their potential risk factors. This analysis aimed to measure the incidence of severe psychiatric events (PE) among patients receiving combination antiretroviral therapy (cART) of the French APROCO-COPILOTE (ANRS CO8) cohort, and to identify the medical and socio-behavioural correlates of their first episode of depression, suicide or suicide attempt (D/S/SA). Methods APROCO-COPILOTE is a cohort of patients started on a protease inhibitor regimen between 1997 and 1999, with prospective medical standardized records and self-administered questionnaires collecting socio-demographic and socio-behavioural data. This analysis included all 11-year follow-up visits for 1,095 patients having completed baseline self-administered questionnaires. A proportional hazard Cox model was used to identify the correlates of a first D/S/SA event. Results The overall prevalence of severe PE remained low: 50 patients experienced 67 events (incidence rate [95% CI] =1.04 [0.82, 1.32] per 100 person-years). Depression ( n=16), suicides ( n=5) and suicide attempts ( n=14) were the most frequently diagnosed PE (0.54 [0.39, 0.76] per 100 person-years) among 25 patients. Multivariate results showed that unemployment, unstable housing, detectable viral load and smoking more than 20 cigarettes/day were independently associated with D/S/SA. Conclusions Although the incidence of severe PE remained relatively low among the patients of APROCO-COPILOTE cohort, this study's results underline a clinically important problem in HIV-infected patients receiving cART. Furthermore, our findings not only emphasize the importance of comprehensive care, especially for socially vulnerable patients, but may also help future studies designed to assess the effectiveness of interventions in reducing the risk of PE during cART.
Published: 2012

6. Therapeutic vaccination with TG4010 and first-line chemotherapy in advanced non-small-cell lung cancer: a controlled phase 2B trial

Author: Didier Debieuvre, Jean-Marc Limacher, Elisabeth Quoix, A. Madroszyk, Marc Buyse, Jean-Yves Bonnefoy, Z. Papai, Erich Stoelben, Gisèle Lacoste, Piotr Koralewski, Hervé Lena, Denis Braun, Alain Rivière, Marie-Pierre Chenard, Bérangère Bastien, Jean-Luc Breton, Annette Tavernaro, Rodryg Ramlau, Bruce Acres, Nadine Bizouarne, Virginie Westeel, Service de pneumologie, CHU Strasbourg-Hopital Civil, 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 ), Laboratoire d'Ingénierie des Systèmes Mécaniques et des MAtériaux ( LISMMA ), Université Paris 8 Vincennes-Saint-Denis ( UP8 ) -SUPMECA - Institut supérieur de mécanique de Paris, Centre Hospitalier de Belfort-Montbéliard, Service de Pneumologie, CHI de la Haute-Saône, International Drug Development Institute ( IDDI ), Service d'Anatomie Pathologique Générale, CHU Strasbourg-Hôpital de Hautepierre [Strasbourg], Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Laboratoire d'Ingénierie des Systèmes Mécaniques et des MAtériaux (LISMMA), Université Paris 8 Vincennes-Saint-Denis (UP8)-SUPMECA - Institut supérieur de mécanique de Paris (SUPMECA), CH Belfort-Montbéliard, and International Drug Development Institute (IDDI)
Subjects: Male, Lung Neoplasms, MESH: Chi-Square Distribution, MESH : Antineoplastic Combined Chemotherapy Protocols, medicine.medical_treatment, MESH: Membrane Glycoproteins, MESH : Aged, MESH: Risk Assessment, Deoxycytidine, Gastroenterology, MESH: Cancer Vaccines, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, 0302 clinical medicine, Antineoplastic Combined Chemotherapy Protocols, MESH: Vaccinia virus, Clinical endpoint, MESH : Neoplasm Staging, MESH: Treatment Outcome, Vaccines, Synthetic, 0303 health sciences, Membrane Glycoproteins, MESH: Middle Aged, MESH : Vaccinia virus, MESH : Antimetabolites, Antineoplastic, MESH : Chemotherapy, Adjuvant, 3. Good health, MESH: Antineoplastic Combined Chemotherapy Protocols, Oncology, 030220 oncology & carcinogenesis, Antimetabolites, Antineoplastic, medicine.medical_specialty, MESH: Vaccines, Synthetic, Risk Assessment, Disease-Free Survival, MESH : Cisplatin, 03 medical and health sciences, Humans, MESH : Middle Aged, MESH : Lung Neoplasms, MESH : Vaccines, Synthetic, Adverse effect, MESH: Kaplan-Meier Estimate, Aged, Chi-Square Distribution, MESH: Humans, MESH : Carcinoma, Non-Small-Cell Lung, MESH : Chi-Square Distribution, MESH: Deoxycytidine, MESH : Humans, MESH: Adult, MESH: Interleukin-2, MESH : Proportional Hazards Models, medicine.disease, MESH: Lung Neoplasms, MESH: Disease-Free Survival, Cisplatin, MESH: Female, MESH: Mucin-1, Time Factors, MESH : Membrane Glycoproteins, Kaplan-Meier Estimate, MESH: Proportional Hazards Models, Risk Factors, MESH: Risk Factors, Carcinoma, Non-Small-Cell Lung, MESH : Female, MESH : Risk Assessment, MESH: Aged, MESH: Antimetabolites, Antineoplastic, MESH : Cancer Vaccines, MESH: Neoplasm Staging, Middle Aged, MESH : Adult, MESH : Risk Factors, Europe, Treatment Outcome, Chemotherapy, Adjuvant, MESH: Chemotherapy, Adjuvant, MESH : Mucin-1, MESH : Disease-Free Survival, Female, MESH : Time Factors, medicine.drug, Adult, Combination therapy, MESH : Male, MESH : Europe, Vaccinia virus, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH : Treatment Outcome, Neutropenia, Cancer Vaccines, MESH : Interleukin-2, MESH : Kaplan-Meier Estimate, MESH : Deoxycytidine, Internal medicine, medicine, Lung cancer, Neoplasm Staging, Proportional Hazards Models, 030304 developmental biology, Chemotherapy, Performance status, business.industry, Mucin-1, MESH: Time Factors, Gemcitabine, MESH: Male, Surgery, MESH: Cisplatin, Interleukin-2, MESH: Europe, business, MESH: Carcinoma, Non-Small-Cell Lung
Abstract: International audience; BACKGROUND: Chemotherapy is the standard of care for advanced stages of non-small-cell lung cancer (NSCLC). TG4010 is a targeted immunotherapy based on a poxvirus (modified vaccinia virus Ankara) that codes for MUC1 tumour-associated antigen and interleukin 2. This study assessed TG4010 in combination with first-line chemotherapy in advanced NSCLC. METHODS: 148 patients with advanced (stage IIIB [wet] or IV) NSCLC expressing MUC1 by immunohistochemistry, and with performance status 0 or 1, were enrolled in parallel groups in this open-label, phase 2B study. 74 patients were allocated to the combination therapy group, and received TG4010 (10(8) plaque forming units) plus cisplatin (75 mg/m(2) on day 1) and gemcitabine (1250 mg/m(2) on days 1 and 8) repeated every 3 weeks for up to six cycles. 74 patients allocated to the control group received the same chemotherapy alone. Patients were allocated using a dynamic minimisation procedure stratified by centre, performance status, and disease stage. The primary endpoint was 6-month progression-free survival (PFS), with a target rate of 40% or higher in the experimental group. Analyses were done on an intention-to-treat basis. This study is completed and is registered with ClinicalTrials.gov, number NCT00415818. FINDINGS: 6-month PFS was 43*2% (32 of 74; 95% CI 33*4-53*5) in the TG4010 plus chemotherapy group, and 35*1% (26 of 74; 25*9-45*3) in the chemotherapy alone group. Fever, abdominal pain, and injection-site pain of any grade according to National Cancer Institute Common Toxicity Criteria were more common in the TG4010 group than in the chemotherapy alone group: 17 of 73 patients (23*3%) versus six of 72 (8*3%), 12 (16*4%) versus two (2*8%), and four (5*5%) versus zero (0%), respectively. The most common grade 3-4 adverse events were neutropenia (33 [45*2%] of patients in the TG4010 plus chemotherapy group vs 31 [43*1%] in the chemotherapy alone group) and fatigue (18 [24*7%] vs 13 [18*1%]); the only grade 3-4 events that differed significantly between groups were anorexia (three [4*1%] vs 10 [13*9%]) and pleural effusion (none vs four [5*6%]). 38 of 73 patients (52*1%) in the TG4010 plus chemotherapy group and 34 of 72 (47*2%) in the chemotherapy alone group had at least one serious adverse event. INTERPRETATION: This phase 2B study suggests that TG4010 enhances the effect of chemotherapy in advanced NSCLC. A confirmatory phase 2B-3 trial has been initiated. FUNDING: Transgene SA, Advanced Diagnostics for New Therapeutic Approaches (ADNA)/OSEO.
Published: 2011

7. Early surgery for failure after chemoradiation in operable thoracic oesophageal cancer. Analysis of the non-randomised patients in FFCD 9102 phase III trial: Chemoradiation followed by surgery versus chemoradiation alone

Author: Julie, Vincent, Christophe, Mariette, Denis, Pezet, Emmanuel, Huet, Franck, Bonnetain, Olivier, Bouché, Thierry, Conroy, Bernard, Roullet, Jean-François, Seitz, Jean-Philippe, Herr, Frédéric, Di Fiore, Jean-Louis, Jouve, Laurent, Bedenne, M, Ducreux, CHU Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Hôpital Claude Huriez [Lille], CHU Lille, CHU Clermont-Ferrand, 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), Normandie Université (NU), Institute for Research and Innovation in Biomedicine (IRIB), Normandie Université (NU)-Normandie Université (NU)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de chirurgie digestive [CHU Rouen], Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Fédération Francophone de la Cancérologie Digestive, FFCD, Hôpital Robert Debré, Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims (CHU Reims), Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université Paris Descartes - Paris 5 (UPD5)-Université de Lorraine (UL), Institut de Cancérologie de Lorraine - Alexis Vautrin [Nancy] (UNICANCER/ICL), UNICANCER, Hôpital de la Milétrie, Centre hospitalier universitaire de Poitiers (CHU Poitiers), Hôpital de la Timone [CHU - APHM] (TIMONE), Hôpital privé Sainte-Marie - Ramsay Générale de Santé, Hôpital Charles Nicolle [Rouen], Butel J, Desselle P, Brice JC, Tissot B, Votte-Lambert A, Joly J, Burtin P, Arnaud JP, Cellier P, Estermann F, Chauvet B, Maringe E, Ozanne F, Varlet F, Becouarn Y, Avril A, Rougier P, Nordlinger B, Vincendet M, Charneau J, Pillon D, Stremsdoerfer N, Pelletier M, Clavero-Fabri MC, Leduc B, Segol P, Argouach LP, Roussel A, Maurel J, Salame R, Lacourt J, Janoray P, Ruget O, Baudet-Klepping D, Dupont G, Bommelaer G, Ruszniewski P, Hammel P, Chaussade S, Dousset B, Denis B, Wagner JD, Tamby E, Petit T, Weiss AM, Barbare JC, Jouve JL, Phelip JM, Senesse P, Michiels C, Maingon P, Coudert B, Fraisse J, Queuniet A, Gasnault L, Gstach JH, Guichard B, Howaizi M, Geoffroy P, Picot C, Fournet J, Mousseau M, Stampfli C, Michel P, Doll J, Durand S, Buffet C, Triboulet JP, Denimal F, Hebbar M, Quandalle P, Mirabel X, Lledo G, Giovannini M, Souillac P, Untereiner M, Leroy-Terquem E, Lacroix H, Francois E, Lagasse JP, Breteau N, Legoux JL, Etienne JC, Delattre JF, Lubrano D, Levy-Chazal N, Palot JP, Nasca S, Demange L, Nguyen TD, Seng S, Michel P, Teniere P, Thevenet P, Le Brise H, Fleury J, Kammerer J, Cosme H, Novello P, Avignon JP, Berton C, Legueul, Parisot P, Aunis G, Vetter D, Platini C, Cals L, Rouhier D, Robin B, Champetier T, Cartalat A, Marchal C, Guillemin F, Flamenbaum M, Cassan D, Ducreux M., Hôpital Claude Huriez, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU - HÔTEL-DIEU Clermont-Ferrand, Service de chirurgie digestive [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Institut de Cancérologie de Lorraine - Alexis Vautrin (ICL), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims ( CHU Reims ), Maladies chroniques, santé perçue, et processus d'adaptation. Approches épidémiologiques et psychologiques. ( APEMAC - EA 4360 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Université de Lorraine ( UL ), Institut de Cancérologie de Lorraine - Alexis Vautrin ( ICL ), CHU de Poitiers, and Hôpital de la Timone [CHU - APHM] ( TIMONE )
Subjects: Male, Cancer Research, Time Factors, Esophageal Neoplasms, Kaplan-Meier Estimate, MESH: Esophagectomy, law.invention, MESH: Proportional Hazards Models, MESH : Adenocarcinoma, 0302 clinical medicine, Randomized controlled trial, law, Risk Factors, MESH : Esophagectomy, MESH: Risk Factors, MESH : Neoplasm Staging, MESH : Female, MESH : Carcinoma, Squamous Cell, MESH: Treatment Outcome, MESH: Chemoradiotherapy, Randomised controlled trial, education.field_of_study, Hazard ratio, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Carcinoma, Squamous Cell, Chemoradiotherapy, MESH : Chemoradiotherapy, MESH: Neoplasm Staging, MESH : Risk Factors, Neoadjuvant Therapy, 3. Good health, Oesophageal neoplasms, Treatment Outcome, Oncology, Chemoradiation, 030220 oncology & carcinogenesis, MESH: Esophageal Neoplasms, Carcinoma, Squamous Cell, 030211 gastroenterology & hepatology, Female, Esophageal Squamous Cell Carcinoma, France, MESH : Time Factors, medicine.medical_specialty, MESH: Radiotherapy, Adjuvant, MESH : Male, Population, MESH: Neoadjuvant Therapy, Locally advanced, MESH : Treatment Outcome, Adenocarcinoma, MESH : Radiotherapy, Adjuvant, MESH : Kaplan-Meier Estimate, 03 medical and health sciences, Early surgery, medicine, Humans, Basal cell, Salvage surgery, education, MESH : France, Contraindication, MESH: Kaplan-Meier Estimate, Neoplasm Staging, Proportional Hazards Models, MESH: Humans, business.industry, MESH : Humans, MESH: Adenocarcinoma, MESH: Time Factors, Cancer, medicine.disease, MESH : Proportional Hazards Models, MESH: Male, Surgery, Esophagectomy, MESH: France, Radiotherapy, Adjuvant, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH : Esophageal Neoplasms, business, MESH : Neoadjuvant Therapy, MESH: Female
Abstract: International audience; BACKGROUND:Two randomised trials concerning thoracic oesophageal cancer concluded that for squamous cell carcinoma, chemoradiation alone leads to the same overall survival (OS) as chemoradiation followed by surgery. One of these trials, FFCD 9102, randomised only fit, compliant and operable responders to induction chemoradiation between continuation of chemoradiation and surgery. In the present analysis, the outcome in the patients not eligible for randomisation was calculated to determine if attempt of surgery should be recommended.METHODS:Eligible patients had operable T3-N0/N1-M0 thoracic oesophageal cancer. After initial chemoradiation, patients with no clinical response, or with contraindication to follow any attributed treatment, were not randomised. OS was studied first in the whole population of not randomised patients, and then specifically in clinical non-responders. The impact of surgery on OS was studied in these two populations.FINDINGS:Of the 451 registered patients in the trial, 192 were not randomised. Among them, 111 were clinical non-responders. Median OS was significantly shorter for non-randomised patients (11.5 months) than for randomised patients (18.9 months; p=0.0024). However, for the 112 non-randomised patients who underwent surgery, median OS was not different from that in randomised patients: 17.3 versus 18.9 months (p=0.58). Concerning clinical non-responders, median OS was longer for those who underwent surgery compared to non-operated patients: 17.0 versus 5.5 months (hazard ratio (HR)=0.39 [0.25-0.61]; p
Published: 2015

8. Relationships between sex, early valve surgery and mortality in patients with left-sided infective endocarditis analysed in a population-based cohort study

Author: Xavier Duval, François Alla, Christine Selton-Suty, Bruno Hoen, Laetitia Minary, Lucile Schubel, Thanh Doco-Lecompte, Catherine Chirouze, Elodie Curlier, Marie-Line Erpelding, CHU Pointe-à-Pitre/Abymes [Guadeloupe], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université Paris Descartes - Paris 5 (UPD5)-Université de Lorraine (UL), Centre d'Investigation Clinique - Epidemiologie Clinique/essais Cliniques Nancy, Cancéropôle du Grand Est-Institut National de la Santé et de la Recherche Médicale (INSERM), Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), INSERA CIC, Hôpital Bichat - Claude Bernard, Laboratoire Chrono-environnement - UFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service des maladies infectieuses et tropicales, Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Hôpital Saint-Jacques, Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Maladies chroniques, santé perçue, et processus d'adaptation ( APEMAC ), Université Paris Descartes - Paris 5 ( UPD5 ) -Université de Lorraine ( UL ), Cancéropôle du Grand Est-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Laboratoire Chrono-environnement - UFC (UMR 6249) ( LCE ), Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ) -Université Bourgogne Franche-Comté [COMUE] ( UBFC ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques, Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques (U738 / UMR_S738), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Diderot - Paris 7 (UPD7), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, Maladies chroniques, santé perçue, et processus d'adaptation. Approches épidémiologiques et psychologiques. ( APEMAC - EA 4360 ), Université de Lorraine ( UL ) -Université Paris Descartes - Paris 5 ( UPD5 ), Laboratoire Chrono-environnement ( LCE ), and Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC )
Subjects: Male, Time Factors, MESH : Retrospective Studies, Heart Valve Diseases, Logistic regression, MESH: Risk Assessment, MESH: Proportional Hazards Models, [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology, Epidemiology, MESH : Population Surveillance, Medicine, MESH : Female, Hospital Mortality, MESH : Heart Valve Prosthesis Implantation, MESH : Endocarditis, Bacterial, MESH : Risk Assessment, MESH : Sex Distribution, Heart Valve Prosthesis Implantation, education.field_of_study, MESH : Prognosis, MESH: Middle Aged, MESH: Sex Distribution, MESH: Follow-Up Studies, Middle Aged, Prognosis, MESH : Survival Rate, MESH : Heart Valve Diseases, Survival Rate, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, Aortic Valve, Population Surveillance, Infective endocarditis, MESH : Aortic Valve, Population study, Female, France, Cardiology and Cardiovascular Medicine, MESH : Time Factors, MESH: Heart Valve Prosthesis Implantation, medicine.medical_specialty, MESH: Survival Rate, MESH : Sex Factors, MESH : Male, Population, Risk Assessment, MESH: Prognosis, MESH: Population Surveillance, MESH : Hospital Mortality, Sex Factors, MESH: Sex Factors, Internal medicine, [ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology, Humans, Endocarditis, MESH : Middle Aged, MESH: Endocarditis, Bacterial, MESH: Hospital Mortality, Sex Distribution, education, MESH : France, Proportional Hazards Models, Retrospective Studies, MESH: Humans, business.industry, Proportional hazards model, MESH : Humans, MESH: Time Factors, Retrospective cohort study, MESH : Follow-Up Studies, MESH: Retrospective Studies, Endocarditis, Bacterial, MESH: Heart Valve Diseases, medicine.disease, MESH : Proportional Hazards Models, MESH: Male, Surgery, MESH: France, business, MESH: Aortic Valve, MESH: Female, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Follow-Up Studies
Abstract: Objective Whether sex-related differences in the prognosis of infective endocarditis (IE) are due to differences in disease severity or comorbid patterns, physiological specificities or a treatment indication bias is unclear. We conducted an analysis of the pooled database of two population-based cohorts of IE to reassess the relationships between sex, early valve surgery (EVS) and outcome in patients with IE. Methods Demographic and baseline characteristics, complications and outcome were compared in men and women with Duke-definite left-sided IE. A propensity model for EVS was constructed using multivariate logistic regression. Factors associated with 1-year mortality were identified using multivariate Cox models adjusted for EVS factors. Results The study population included 466 (75%) men and 154 (25%) women. Compared with men, women were older (p=0.005), were more often on haemodialysis (p=0.04), more often had a mitral valve IE (50.0% vs 35.8%, p=0.02), less often developed a septic shock (p=0.05), less often underwent EVS (p=0.001) yet had comparable inhospital mortality rates (20.1% vs 20.0%, p=0.96) and similar 1-year survival probability (logrank p=0.68). Female sex was neither associated with EVS (OR 0.76 (95% CI 0.49 to 1.16)) nor mortality (HR 1.17 (95% CI 0.80 to 1.69)). However EVS was associated with an increased risk of death in women in the early postoperative period (HR 8.72 (95% CI 3.42 to 22.24), p= Conclusions Women underwent EVS less often than men. However female sex was independently associated with neither EVS nor 1-year mortality. The reasons for a higher risk of early postoperative mortality in women must still be elucidated.
Published: 2014

9. Toward a NOTCH1/FBXW7/RAS/PTEN-based oncogenetic risk classification of adult T-cell acute lymphoblastic leukemia: a Group for Research in Adult Acute Lymphoblastic Leukemia study

Author: Raouf Ben Abdelali, Véronique Lhéritier, Jean-Yves Cahn, Françoise Huguet, Norbert Ifrah, Agnès Buzyn, Noémie de Gunzburg, Elizabeth Macintyre, Vahid Asnafi, Dominique Payet-Bornet, Sébastien Maury, Jonathan Bond, Thibaud Leguay, Amélie Trinquand, Bertrand Nadel, André Delannoy, Kheira Beldjord, Hervé Dombret, Xavier Thomas, Jérôme Lambert, Ludovic Lhermitte, Hossein Mossafa, Etienne Lengliné, Yves Chalandon, Caroline Bonmati, Aline Tanguy-Schmidt, Centre d'Immunologie de Marseille - Luminy ( CIML ), Aix Marseille Université ( AMU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Laboratoire de Cytogénétique - Pasteur-Cerba, Laboratoire Pasteur-Cerba, Laboratoire d'Hématologie [Purpan], Université Toulouse III - Paul Sabatier ( UPS ), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], Institut Cochin ( UMR_S567 / UMR 8104 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), TheREx, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications [Grenoble] ( 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 ), Centre de Recherche en Cancérologie de Lyon ( CRCL ), Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Centre Léon Bérard [Lyon]-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon ( HCL ), Hôpital de Jolimont, Haine-Saint-Paul and Cliniques Universitaires St Luc, Service hématologie, Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Service d'hématologie clinique [Avicenne], Université Paris 13 ( UP13 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Avicenne, Lymphocyte et cancer, IFR105-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Imagine - Institut des maladies génétiques ( IMAGINE - U1163 ), Centre d'Immunologie de Marseille - Luminy (CIML), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service Hématologie - IUCT-Oncopole [CHU Toulouse], Pôle Biologie [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Pôle IUCT [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Institut Cochin (UMR_S567 / UMR 8104), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), 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 )-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 Joseph Fourier - Grenoble 1 (UJF)-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), Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hospices Civils de Lyon (HCL), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris 13 (UP13)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Avicenne [AP-HP], IFR105-Institut National de la Santé et de la Recherche Médicale (INSERM), Imagine - Institut des maladies génétiques (IMAGINE - U1163), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU), Université Toulouse III - Paul Sabatier (UT3), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5), 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), Centre de Recherche en Cancérologie de Lyon (CRCL), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Necker - Enfants Malades [AP-HP], Université Paris 13 (UP13)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Avicenne, Centre National de la Recherche Scientifique (CNRS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, Ras Proteins/genetics, Oncology, Pathology, MESH : F-Box Proteins, DNA Mutational Analysis, Cell Cycle Proteins, MESH : Gene Deletion, MESH: Receptor, Notch1, 0302 clinical medicine, MESH : Cell Cycle Proteins, Receptor, Notch1, MESH: DNA Mutational Analysis, Young adult, ddc:616, 0303 health sciences, Hazard ratio, PTEN Phosphohydrolase/genetics, hemic and immune systems, 3. Good health, MESH : Phenotype, MESH: Young Adult, 030220 oncology & carcinogenesis, Predictive value of tests, Cohort, F-Box Proteins/genetics, MESH : Proto-Oncogene Proteins, MESH: Membrane Proteins, MESH: ras Proteins, medicine.medical_specialty, MESH : Young Adult, MESH : DNA Mutational Analysis, MESH: Phenotype, MESH: PTEN Phosphohydrolase, Disease-Free Survival, Proto-Oncogene Proteins p21(ras), 03 medical and health sciences, MESH: Cell Cycle Proteins, Humans, PTEN, Ubiquitin-Protein Ligases/genetics, MESH : Predictive Value of Tests, MESH: Kaplan-Meier Estimate, Cell Cycle Proteins/genetics, Receptor, Notch1/genetics, [ SDV.IMM.II ] Life Sciences [q-bio]/Immunology/Innate immunity, MESH: Humans, Proportional hazards model, F-Box Proteins, MESH : Humans, MESH: Adult, MESH : Proportional Hazards Models, MESH: Ubiquitin-Protein Ligases, MESH : Membrane Proteins, MESH: Disease-Free Survival, Mutation, ras Proteins, Adult Acute Lymphoblastic Leukemia, MESH : Genetic Predisposition to Disease, MESH : Ubiquitin-Protein Ligases, MESH : GTP Phosphohydrolases, MESH: Female, Gene Deletion, Cancer Research, F-Box-WD Repeat-Containing Protein 7, Time Factors, MESH : Precursor T-Cell Lymphoblastic Leukemia-Lymphoma, Kaplan-Meier Estimate, MESH : PTEN Phosphohydrolase, Precursor T-Cell Lymphoblastic Leukemia-Lymphoma, [SDV.IMM.II]Life Sciences [q-bio]/Immunology/Innate immunity, GTP Phosphohydrolases, MESH: Proportional Hazards Models, MESH: Risk Factors, Risk Factors, hemic and lymphatic diseases, MESH : Female, biology, MESH : Receptor, Notch1, MESH: Genetic Predisposition to Disease, MESH : Adult, MESH : Risk Factors, MESH: Predictive Value of Tests, MESH: Precursor T-Cell Lymphoblastic Leukemia-Lymphoma, Phenotype, MESH : Disease-Free Survival, Female, MESH : Mutation, MESH : Time Factors, Adult, MESH: Mutation, MESH: GTP Phosphohydrolases, Ubiquitin-Protein Ligases, MESH : Male, MESH: F-Box Proteins, MESH: Multivariate Analysis, MESH : Kaplan-Meier Estimate, Young Adult, Predictive Value of Tests, Proto-Oncogene Proteins, Internal medicine, medicine, Genetic Predisposition to Disease, Membrane Proteins/genetics, Precursor T-Cell Lymphoblastic Leukemia-Lymphoma/classification/genetics/mortality/therapy, Proportional Hazards Models, 030304 developmental biology, business.industry, MESH: Time Factors, PTEN Phosphohydrolase, Membrane Proteins, MESH : Multivariate Analysis, GTP Phosphohydrolases/genetics, MESH: Male, MESH: Proto-Oncogene Proteins, Proto-Oncogene Proteins/genetics, MESH: Gene Deletion, Multivariate Analysis, biology.protein, MESH : ras Proteins, business
Abstract: Purpose The Group for Research in Adult Acute Lymphoblastic Leukemia (GRAALL) recently reported a significantly better outcome in T-cell acute lymphoblastic leukemia (T-ALL) harboring NOTCH1 and/or FBXW7 (N/F) mutations compared with unmutated T-ALL. Despite this, one third of patients with N/F-mutated T-ALL experienced relapse. Patients and Methods In a series of 212 adult T-ALLs included in the multicenter randomized GRAALL-2003 and -2005 trials, we searched for additional N/K-RAS mutations and PTEN defects (mutations and gene deletion). Results N/F mutations were identified in 143 (67%) of 212 patients, and lack of N/F mutation was confirmed to be associated with a poor prognosis. K-RAS, N-RAS, and PTEN mutations/deletions were identified in three (1.6%) of 191, 17 (8.9%) of 191, and 21 (12%) of 175 patients, respectively. The favorable prognostic significance of N/F mutations was restricted to patients without RAS/PTEN abnormalities. These observations led us to propose a new T-ALL oncogenetic classifier defining low-risk patients as those with N/F mutation but no RAS/PTEN mutation (97 of 189 patients; 51%) and all other patients (49%; including 13% with N/F and RAS/PTEN mutations) as high-risk patients. In multivariable analysis, this oncogenetic classifier remained the only significant prognostic covariate (event-free survival: hazard ratio [HR], 3.2; 95% CI, 1.9 to 5.15; P < .001; and overall survival: HR, 3.2; 95% CI, 1.9 to 5.6; P < .001). Conclusion These data demonstrate that the presence of N/F mutations in the absence of RAS or PTEN abnormalities predicts good outcome in almost 50% of adult T-ALL. Conversely, the absence of N/F or presence of RAS/PTEN alterations identifies the remaining cohort of patients with poor prognosis.
Published: 2013

10. In-hospital and 1-year mortality in patients undergoing early surgery for prosthetic valve endocarditis

Author: David Gordon, Emilio Bouza, Víctor José González Ramallo, Christine Selton-Suty, PAOLO GROSSI, Eugene Athan, Emanuele Durante-Mangoni, Ru San Tan, Nuria Fernández-Hidalgo, Adina Ionac, Carlos Cervera, Jorge Solis, Corentine ALAUZET, Daniel J Sexton, François Alla, Sarah Israel, Hussien Rizk, Patricia Carmen Muñoz García, Andrew Wang, Juan M Pericas, Souha Kanj, Carlos Falces, Pierre-Edouard Fournier, Asunción Moreno Camacho, Martin Stryjewski, Antonio Toniolo, Didier Raoult, Monaldi Hospital, Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service des maladies infectieuses et tropicales, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, Clinical Microbiology and Infectious Diseases Department, Universidad Complutense de Madrid = Complutense University of Madrid [Madrid] (UCM), Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques, and Universidad Complutense de Madrid [Madrid] ( UCM )
Subjects: Male, MESH: Registries, medicine.medical_treatment, MESH : Prospective Studies, MESH : Mitral Valve, 030204 cardiovascular system & hematology, MESH: Proportional Hazards Models, 0302 clinical medicine, Valve replacement, MESH : Time-to-Treatment, MESH : Female, Hospital Mortality, Prospective Studies, Registries, 030212 general & internal medicine, MESH : Heart Valve Prosthesis Implantation, MESH : Endocarditis, Bacterial, Prospective cohort study, MESH : Propensity Score, Heart Valve Prosthesis Implantation, MESH: Middle Aged, Mortality rate, Hazard ratio, MESH: Follow-Up Studies, Middle Aged, 3. Good health, Aortic Valve, Heart Valve Prosthesis, Cohort, MESH : Aortic Valve, Mitral Valve, Female, Cohort study, MESH: Heart Valve Prosthesis Implantation, Endocarditis, Prosthetic valve, Surgery, medicine.medical_specialty, Prosthesis-Related Infections, MESH: Heart Valve Prosthesis, MESH : Male, Time-to-Treatment, MESH : Prosthesis-Related Infections, MESH : Heart Valve Prosthesis, MESH : Hospital Mortality, 03 medical and health sciences, [ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology, Internal Medicine, medicine, Humans, MESH : Middle Aged, MESH: Endocarditis, Bacterial, MESH: Time-to-Treatment, MESH: Hospital Mortality, Propensity Score, Proportional Hazards Models, MESH: Humans, Proportional hazards model, business.industry, MESH: Prosthesis-Related Infections, MESH : Humans, MESH : Follow-Up Studies, Endocarditis, Bacterial, MESH: Mitral Valve, MESH: Propensity Score, MESH : Proportional Hazards Models, MESH: Prospective Studies, MESH: Male, Propensity score matching, business, MESH: Aortic Valve, MESH: Female, MESH : Registries, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Follow-Up Studies
Abstract: International audience; IMPORTANCE: There are limited prospective, controlled data evaluating survival in patients receiving early surgery vs medical therapy for prosthetic valve endocarditis (PVE). OBJECTIVE: To determine the in-hospital and 1-year mortality in patients with PVE who undergo valve replacement during index hospitalization compared with patients who receive medical therapy alone, after controlling for survival and treatment selection bias. DESIGN, SETTING, AND PARTICIPANTS: Participants were enrolled between June 2000 and December 2006 in the International Collaboration on Endocarditis-Prospective Cohort Study (ICE-PCS), a prospective, multinational, observational cohort of patients with infective endocarditis. Patients hospitalized with definite right- or left-sided PVE were included in the analysis. We evaluated the effect of treatment assignment on mortality, after adjusting for biases using a Cox proportional hazards model that included inverse probability of treatment weighting and surgery as a time-dependent covariate. The cohort was stratified by probability (propensity) for surgery, and outcomes were compared between the treatment groups within each stratum. INTERVENTIONS: Valve replacement during index hospitalization (early surgery) vs medical therapy. MAIN OUTCOMES AND MEASURES: In-hospital and 1-year mortality. RESULTS: Of the 1025 patients with PVE, 490 patients (47.8%) underwent early surgery and 535 individuals (52.2%) received medical therapy alone. Compared with medical therapy, early surgery was associated with lower in-hospital mortality in the unadjusted analysis and after controlling for treatment selection bias (in-hospital mortality: hazard ratio [HR], 0.44 [95% CI, 0.38-0.52] and lower 1-year mortality: HR, 0.57 [95% CI, 0.49-0.67]). The lower mortality associated with surgery did not persist after adjustment for survivor bias (in-hospital mortality: HR, 0.90 [95% CI, 0.76-1.07] and 1-year mortality: HR, 1.04 [95% CI, 0.89-1.23]). Subgroup analysis indicated a lower in-hospital mortality with early surgery in the highest surgical propensity quintile (21.2% vs 37.5%; P = .03). At 1-year follow-up, the reduced mortality with surgery was observed in the fourth (24.8% vs 42.9%; P = .007) and fifth (27.9% vs 50.0%; P = .007) quintiles of surgical propensity. CONCLUSIONS AND RELEVANCE: Prosthetic valve endocarditis remains associated with a high 1-year mortality rate. After adjustment for differences in clinical characteristics and survival bias, early valve replacement was not associated with lower mortality compared with medical therapy in the overall cohort. Further studies are needed to define the effect and timing of surgery in patients with PVE who have indications for surgery.
Published: 2013

11. Usefulness of a single-item measure of depression to predict mortality: the GAZEL prospective cohort study. : single-item of depression and mortality

Author: Thomas Lefèvre, Aline Dugravot, Hermann Nabi, Marie Zins, Silvia Stringhini, Cédric Lemogne, Silla M. Consoli, Marcel Goldberg, Archana Singh-Manoux, Laboratoire de Traitement de l'Information Medicale ( LaTIM ), Université européenne de Bretagne ( UEB ) -Télécom Bretagne-Centre Hospitalier Régional Universitaire de Brest ( CHRU Brest ) -Université de Brest ( UBO ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut Mines-Télécom [Paris], Centre de recherche en épidémiologie et santé des populations ( CESP ), Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Université Paris-Sud - Paris 11 ( UP11 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Department of Epidemiology and Public Health, University College of London [London] ( UCL ), Centre de Gérontologie, Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Sainte-Périne-Rossini-Chardon Lagache, Université Paris Descartes - Paris 5 ( UPD5 ), Service Universitaire de Psychiatrie de l'Adulte et du sujet âgé, Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpitaux Universitaires Paris-Ouest (HUPO), Centre Emotion, Centre National de la Recherche Scientifique ( CNRS ) -CHU Pitié-Salpêtrière [APHP]-Université Pierre et Marie Curie - Paris 6 ( UPMC ), The GAZEL cohort study was funded by EDF-GDF and INSERM, and received grants from the Cohortes Santé TGIR Program. ASM is supported by a EUYRI award from the European Science Foundation and the National Institute on Aging, NIH (R01AG013196, and R01AG034454).
Subjects: Male, Gerontology, Health Behavior, MESH : Prospective Studies, France/epidemiology, 0302 clinical medicine, Risk Factors, MESH : Depression, Cause of Death, Surveys and Questionnaires, Epidemiology, MESH : Socioeconomic Factors, MESH : Female, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, Depression (differential diagnoses), Cause of death, MESH : Questionnaires, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, Middle Aged, MESH : Adult, MESH : Risk Factors, 3. Good health, Mental Health, Predictive value of tests, Cohort, depression, single-item, Female, France, MESH : Psychiatric Status Rating Scales, Adult, medicine.medical_specialty, MESH : Male, 03 medical and health sciences, Predictive Value of Tests, Internal medicine, medicine, Humans, MESH : Middle Aged, MESH : Predictive Value of Tests, Risk factor, MESH : Health Behavior, MESH : France, Proportional Hazards Models, MESH : Cause of Death, Psychiatric Status Rating Scales, Proportional hazards model, business.industry, Depression/complications/diagnosis/mortality, MESH : Humans, Public Health, Environmental and Occupational Health, MESH : Follow-Up Studies, MESH : Proportional Hazards Models, mortality, 030227 psychiatry, Socioeconomic Factors, business, Follow-Up Studies
Abstract: International audience; BACKGROUND: It remains unknown whether short measures of depression perform as well as long measures in predicting adverse outcomes such as mortality. The present study aims to examine the predictive value of a single-item measure of depression for mortality. METHODS: A total of 14,185 participants of the GAZEL cohort completed the 20-item Center-for-Epidemiologic-Studies-Depression (CES-D) scale in 1996. One of these items (I felt depressed) was used as a single-item measure of depression. All-cause mortality data were available until 30 September 2009, a mean follow-up period of 12.7 years with a total of 650 deaths. RESULTS: In Cox regression model adjusted for baseline socio-demographic characteristics, a one-unit increase in the single-item score (range 0-3) was associated with a 25% higher risk of all-cause mortality (95% CI: 13-37%, P
Published: 2012

12. Ten-year diabetes incidence in 1046 HIV-infected patients started on a combination antiretroviral treatment

Author: Capeau , Jacqueline, Bouteloup , Vincent, Katlama , Christine, Bastard , Jean-Philippe, Guiyedi , Vincent, Salmon-Ceron , Dominique, Protopopescu , Camelia, Leport , Catherine, Raffi , Francois, Chêne , Geneviève, Michelet , Christian, Centre de Recherche Saint-Antoine ( CR Saint-Antoine ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Pierre et Marie Curie - Paris 6 ( UPMC ), Epidémiologie et Biostatistique [Bordeaux], Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Epidémiologie, stratégies thérapeutiques et virologie cliniques dans l'infection à VIH, Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques, Université Paris Diderot - Paris 7 ( UPD7 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de médecine interne et centre de référence des maladies rares [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Cochin [AP-HP], Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale ( SESSTIM - U912 INSERM - AMU - IRD ), Institut de Recherche pour le Développement ( IRD ) -Aix Marseille Université ( AMU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Maladies infectieuses et tropicales, Institut de recherche, santé, environnement et travail ( Irset ), Université d'Angers ( UA ) -Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -École des Hautes Études en Santé Publique [EHESP] ( EHESP ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ) -Université des Antilles ( UA ), Agence Nationale de Recherches sur le Sida et les Hépatites Virales (ANRS), Inserm, Collège des Universitaires de Maladies Infectieuses et Tropicales (CMIT ex APPIT), Sidaction Ensemble contre le Sida, associated pharmaceutical companies: Abbott, Boehringer-Ingelheim, Bristol-Myers Squibb, GlaxoSmithKline, Gilead Sciences, Pfizer and Roche., ANRS CO8 APROCO-COPILOTE Cohort Study Group, 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), Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques (U738 / UMR_S738), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Institut de Recherche pour le Développement (IRD)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Aix Marseille Université (AMU), Université d'Angers (UA)-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )
Subjects: Male, MESH : Prospective Studies, MESH: Antiretroviral Therapy, Highly Active, Body Mass Index, Cohort Studies, MESH: Proportional Hazards Models, 0302 clinical medicine, Risk Factors, MESH: Risk Factors, MESH : Stavudine, Antiretroviral Therapy, Highly Active, Odds Ratio, Immunology and Allergy, Medicine, MESH : Female, Prospective Studies, 030212 general & internal medicine, MESH: Incidence, MESH: Anti-HIV Agents, Prospective cohort study, Lipoatrophy, Didanosine, MESH: Cohort Studies, Adiposity, MESH : Didanosine, 0303 health sciences, MESH: Middle Aged, Incidence, Incidence (epidemiology), MESH: Waist-Hip Ratio, Hazard ratio, MESH: HIV Infections, MESH: Follow-Up Studies, Middle Aged, MESH : Adult, MESH : Risk Factors, MESH : Incidence, 3. Good health, MESH : Diabetes Mellitus, Infectious Diseases, MESH: Didanosine, Cohort, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, diabetes mellitus, Female, medicine.drug, HIV infections, Adult, medicine.medical_specialty, MESH: Diabetes Mellitus, lipodystrophy, stavudine, Anti-HIV Agents, MESH : Male, Immunology, MESH: Stavudine, MESH : Cohort Studies, MESH : Waist-Hip Ratio, [ SDV.MP.VIR ] Life Sciences [q-bio]/Microbiology and Parasitology/Virology, MESH: Body Mass Index, 03 medical and health sciences, MESH : Adiposity, Internal medicine, MESH : HIV Infections, Humans, MESH : Indinavir, MESH : Middle Aged, Proportional Hazards Models, MESH: Adiposity, MESH: Humans, Waist-Hip Ratio, 030306 microbiology, business.industry, Proportional hazards model, MESH: Indinavir, MESH : Anti-HIV Agents, MESH : Humans, indinavir, MESH: Adult, MESH : Follow-Up Studies, Odds ratio, medicine.disease, MESH : Proportional Hazards Models, MESH : Antiretroviral Therapy, Highly Active, MESH: Male, MESH: Odds Ratio, MESH: Prospective Studies, MESH : Body Mass Index, MESH : Odds Ratio, business, MESH: Female, Follow-Up Studies
Abstract: International audience; OBJECTIVE: To evaluate the incidence and determinants of diabetes in a cohort of HIV-infected adults initiated with combination antiretroviral treatment (cART) in 1997-1999 and followed up to 2009. DESIGN: Prospective study of 1046 patients at 47 French clinical sites. METHODS: Potential determinants of diabetes occurrence, defined by confirmed increased glycemia and/or initiation of antidiabetic treatment, were assessed by a proportional hazards model, including time-updated metabolic parameters and ART exposure. RESULTS: Among the cohort, representing 7846 person-years of follow-up (PYFU), 54% received indinavir, 75% stavudine and 52% didanosine. Overall, 111 patients developed diabetes, with an incidence of 14.1/1000 PYFU (14.6 in men, 12.6 in women). Incidence peaked in 1999-2000 (23.2/1000 PYFU) and decreased thereafter. The incidence of diabetes was associated [adjusted hazard ratio (aHR), all P30 kg/m(2)), waist-to-hip ratio (hazard ratio = 3.87 for ≥0.97 male/0.92 female), time-updated lipoatrophy (hazard ratio = 2.14) and short-term exposure to indinavir (0-1 year: hazard ratio = 2.53), stavudine (0-1 year: hazard ratio = 2.56, 1-2 years: hazard ratio = 2.65) or didanosine (2-3 years: hazard ratio = 3.16). Occurrence of diabetes was not associated with HIV-related markers, hepatitis C, hypertension or family history of diabetes. Insulin resistance was predictive for incident diabetes. CONCLUSIONS: In this nationwide cohort, followed for 10 years after cART initiation, diabetes incidence peaked in 1990-2000, was markedly higher than that reported for European uninfected or other HIV-infected populations (4-6/1000 PYFU) and linked with age and adiposity. Adiposity and glycemic markers should be monitored in aging HIV-infected patients.
Published: 2012

13. Renal cell carcinoma (RCC) in patients with end-stage renal disease exhibits many favourable clinical, pathologic, and outcome features compared with RCC in the general population

Author: Laurent Salomon, Lionel Badet, Georges Karam, Jacques Tostain, Pierre Bigot, Nathalie Rioux-Leclercq, Sébastien Barbet, Jean-Etienne Terrier, Bernard Escudier, Michel Soulié, Hicham Elkentaoui, Abdel-Rahmène Azzouzi, Fabrice Dugardin, Yann Neuzillet, Jean-Christophe Bernhard, Jacques Hubert, Aurélien Descazeaux, Karim Fehri, Nicolas Brichart, Philippe Paparel, J.M. Boutin, Laurent Guy, Baptiste Tisserand, Arnaud Mejean, Ismaël Galliot, Marc-Olivier Timsit, Laurence Bastien, Jérôme Rigaud, Antoine Valeri, Jacques Petit, Laurent Zini, Benoit Barrou, Christian Pfister, Xavier Tillou, Franck Bruyère, Fabien Saint, Herve Lang, Jean-Jacques Patard, Marie-Dominique Azemar, Denis Chautard, Julien Branchereau, Hervé Wallerand, Pascal Rischmann, Laura Poissonnier, Charles Deruelle, Lucille Martin, Laurence Albiges, Jacques Irani, Arnauld Villers, Thierry Lebret, Hervé Baumert, François Kleinclauss, Nicolas Terrier, Jean-Alexandre Long, Pierre-Etienne Theveniaud, M. Gigante, Frédéric Staerman, Jean-Marie Ferriere, Romain Mathieu, Morgan Rouprêt, F. Sallusto, Benoit Feuillu, Service d'urologie, Hôpital Foch [Suresnes], CHU Amiens-Picardie, Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-CHU Pontchaillou [Rennes], CHU Grenoble-Hôpital Michallon, Service d'urologie-andrologie, CHU Saint-Etienne-Université Jean Monnet [Saint-Étienne] ( UJM ) -Hôpital nord, Service d'urologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] ( CHLS ), Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ), Hôpital Saint-Joseph, Département de médecine oncologique [Gustave Roussy], Institut Gustave Roussy ( IGR ), CHU Strasbourg, Service d'anatomie et cytologie pathologiques [Rennes], Université d'Angers ( UA ) -CHU Angers, Service d'urologie, andrologie et transplantation rénale, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Institut Mondor de recherche biomédicale ( IMRB ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Service d'urologie [Tours], Hôpital Bretonneau-CHRU Tours, Hôtel-Dieu, Service d'Urologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Hôpital Huriez-Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Service de Chirurgie urologique et andrologie [CHU Limoges], CHU Limoges, Service d'urologie et transplantation rénales [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Service de Néphrologie et Urologie, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques, Service d'urologie [Rouen], CHU Rouen-Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Normandie Université ( NU ), Université de Reims Champagne-Ardenne ( URCA ), Centre hospitalier universitaire de Poitiers ( CHU Poitiers ) -Hôpital La Milétrie, Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Descartes - Paris 5 ( UPD5 ) -CHU Necker - Enfants Malades [AP-HP], Service d'Urologie - Transplantation Rénale - Andrologie, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], CHU Clermont-Ferrand-Hôpital Gabriel Montpied, Université de Brest ( UBO ) -Centre Hospitalier Régional Universitaire de Brest ( CHRU Brest ), Service d'urologie [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Université Paris-Sud - Paris 11 ( UP11 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Bicêtre, members of the Comité de Transplantation de l'Association Française d'Urologie, the Comité de Cancérologie de l'Association Française d'Urologie, Service d'urologie [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], CHU Saint-Etienne-Université Jean Monnet [Saint-Étienne] (UJM)-Hôpital nord, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Institut Gustave Roussy (IGR), Université d'Angers (UA)-Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Institut Mondor de recherche biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Bretonneau-Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Hôpital Huriez-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service d'urologie et transplantation rénales [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Hôpital Saint-Jacques, CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Université de Reims Champagne-Ardenne (URCA), Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Hôpital La Milétrie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Bicêtre-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11), Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Service d'anatomie et cytologie pathologiques [Rennes] = Anatomy and Cytopathology [Rennes], CHU Pontchaillou [Rennes], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau, Service d'Urologie [CHU Pitié-Salpêtrière], 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 Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, De Villemeur, Hervé, CHU Saint-Etienne-Université Jean Monnet - Saint-Étienne (UJM)-Hôpital nord, Département d'Urologie-Andrologie et Transplantation Rénale [CHU Toulouse], Pôle Urologie - Néphrologie - Dialyse - Transplantations - Brûlés - Chirurgie plastique - Explorations fonctionnelles et physiologiques [CHU Toulouse], and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)
Subjects: Male, [ SDV.MHEP.UN ] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, MESH: Chi-Square Distribution, Time Factors, MESH : Retrospective Studies, 030232 urology & nephrology, MESH : Aged, Kaplan-Meier Estimate, MESH: Risk Assessment, urologic and male genital diseases, Gastroenterology, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, MESH: Proportional Hazards Models, MESH : Carcinoma, Renal Cell, 0302 clinical medicine, Renal cell carcinoma, MESH: Risk Factors, Risk Factors, MESH : Female, MESH : Neoplasm Staging, MESH : Risk Assessment, MESH: Treatment Outcome, MESH: Aged, education.field_of_study, Univariate analysis, MESH: Middle Aged, MESH: Carcinoma, Renal Cell, MESH: Neoplasm Staging, Middle Aged, MESH : Adult, MESH : Survival Rate, MESH : Risk Factors, Kidney Neoplasms, 3. Good health, Survival Rate, Treatment Outcome, MESH: Kidney Failure, Chronic, 030220 oncology & carcinogenesis, Female, France, MESH : Time Factors, Adult, medicine.medical_specialty, MESH: Survival Rate, Urology, MESH : Male, Population, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH : Treatment Outcome, Risk Assessment, MESH : Kidney Failure, Chronic, End stage renal disease, MESH : Kaplan-Meier Estimate, 03 medical and health sciences, [SDV.CAN] Life Sciences [q-bio]/Cancer, Internal medicine, medicine, Humans, MESH : Middle Aged, education, MESH : France, Survival rate, Carcinoma, Renal Cell, MESH: Kaplan-Meier Estimate, Aged, Neoplasm Staging, Proportional Hazards Models, Retrospective Studies, MESH: Humans, Chi-Square Distribution, MESH : Chi-Square Distribution, business.industry, MESH: Time Factors, MESH : Humans, MESH: Adult, MESH: Retrospective Studies, medicine.disease, MESH : Proportional Hazards Models, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, MESH: Male, MESH : Kidney Neoplasms, Surgery, Transplantation, MESH: France, Kidney Failure, Chronic, MESH: Kidney Neoplasms, business, Kidney cancer, MESH: Female, Kidney disease
Abstract: International audience; BACKGROUND: Patients with end-stage renal disease (ESRD) are at risk of developing renal tumours. OBJECTIVE: Compare clinical, pathologic, and outcome features of renal cell carcinomas (RCCs) in ESRD patients and in patients from the general population. DESIGN, SETTING, AND PARTICIPANTS: Twenty-four French university departments of urology participated in this retrospective study. INTERVENTION: All patients were treated according to current European Association of Urology guidelines. MEASUREMENTS: Age, sex, symptoms, tumour staging and grading, histologic subtype, and outcome were recorded in a unique database. Categoric and continuous variables were compared by using chi-square and student statistical analyses. Cancer-specific survival (CSS) was assessed by Kaplan-Meier and Cox methods. RESULTS AND LIMITATIONS: The study included 1250 RCC patients: 303 with ESRD and 947 from the general population. In the ESRD patients, age at diagnosis was younger (55 ± 12 yr vs 62 ± 12 yr); mean tumour size was smaller (3.7 ± 2.6 cm vs 7.3 ± 3.8 cm); asymptomatic (87% vs 44%), low-grade (68% vs 42%), and papillary tumours were more frequent (37% vs 7%); and poor performance status (PS; 24% vs 37%) and advanced T categories (≥ 3) were more rare (10% vs 42%). Consistently, nodal invasion (3% vs 12%) and distant metastases (2% vs 15%) occurred less frequently in ESRD patients. After a median follow-up of 33 mo (range: 1-299 mo), 13 ESRD patients (4.3%), and 261 general population patients (27.6%) had died from cancer. In univariate analysis, histologic subtype, symptoms at diagnosis, poor PS, advanced TNM stage, high Fuhrman grade, large tumour size, and non-ESRD diagnosis context were adverse predictors for survival. However, only PS, TNM stage, and Fuhrman grade remained independent CSS predictors in multivariate analysis. The limitation of this study is related to the retrospective design. CONCLUSIONS: RCC arising in native kidneys of ESRD patients seems to exhibit many favourable clinical, pathologic, and outcome features compared with those diagnosed in patients from the general population.
Published: 2011

14. Locally advanced unresectable pancreatic cancer: Induction chemoradiotherapy followed by maintenance gemcitabine versus gemcitabine alone: Definitive results of the 2000-2001 FFCD/SFRO phase III trial

Author: Barhoumi , M., Mornex , F., Bonnetain , Franck, Rougier , P., Mariette , C., Bouché , O., Bosset , J.-F., Aparicio , T., Mineur , L., Azzedine , A., Hammel , P., Butel , J., Stremsdoerfer , N., Maingon , P., Bedenne , L., Chauffert , B., Matrice extracellulaire et dynamique cellulaire - UMR 7369 (MEDyC), Université de Reims Champagne-Ardenne (URCA)-SFR CAP Santé (Champagne-Ardenne Picardie Santé), Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Université de Reims Champagne-Ardenne (URCA)-Université de Picardie Jules Verne (UPJV)-Centre National de la Recherche Scientifique (CNRS), Laboratoire d'Epidémiologie et d'Ecologie parasitaire, Institut Pasteur de Tunis, Institut Pasteur de Tunis, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP), Grand Accélérateur National d'Ions Lourds (GANIL), Centre National de la Recherche Scientifique (CNRS)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Institut Pasteur de Tunis-Réseau International des Instituts Pasteur ( RIIP ), Grand Accélérateur National d'Ions Lourds ( GANIL ), Commissariat à l'énergie atomique et aux énergies alternatives ( CEA ) -Institut National de Physique Nucléaire et de Physique des Particules du CNRS ( IN2P3 ) -Centre National de la Recherche Scientifique ( CNRS ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), and Maquart, François-Xavier
Subjects: Male, MESH : Hematologic Diseases, MESH: Remission Induction, MESH: Combined Modality Therapy, Gastrointestinal Diseases, MESH : Antineoplastic Combined Chemotherapy Protocols, MESH : Aged, Kaplan-Meier Estimate, MESH : Gastrointestinal Diseases, Deoxycytidine, MESH : Radiotherapy, Conformal, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, MESH: Proportional Hazards Models, MESH: Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols, MESH : Female, ComputingMilieux_MISCELLANEOUS, Aged, 80 and over, MESH: Aged, MESH : Carcinoma, Pancreatic Ductal, MESH: Antimetabolites, Antineoplastic, MESH: Middle Aged, MESH : Antimetabolites, Antineoplastic, Remission Induction, Middle Aged, MESH : Adult, MESH: Hematologic Diseases, Combined Modality Therapy, MESH: Antineoplastic Combined Chemotherapy Protocols, MESH: Radiotherapy, Conformal, Disease Progression, MESH : Fluorouracil, Female, MESH: Disease Progression, Fluorouracil, MESH: Pancreatic Neoplasms, Carcinoma, Pancreatic Ductal, Adult, Antimetabolites, Antineoplastic, MESH : Male, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH : Cisplatin, MESH : Kaplan-Meier Estimate, MESH : Deoxycytidine, Humans, MESH : Middle Aged, MESH : Aged, 80 and over, MESH: Gastrointestinal Diseases, MESH: Kaplan-Meier Estimate, Aged, Proportional Hazards Models, MESH : Remission Induction, MESH: Humans, MESH: Carcinoma, Pancreatic Ductal, MESH : Humans, MESH: Deoxycytidine, MESH: Adult, MESH : Disease Progression, MESH : Proportional Hazards Models, Hematologic Diseases, Gemcitabine, MESH: Male, Pancreatic Neoplasms, MESH: Cisplatin, Cisplatin, Radiotherapy, Conformal, MESH : Combined Modality Therapy, MESH: Female, MESH: Fluorouracil, MESH : Pancreatic Neoplasms
Abstract: International audience; PURPOSE: To compare chemoradiation with systemic chemotherapy to chemotherapy alone in locally advanced pancreatic cancer. PATIENTS AND METHODS: One hundred and nineteen patients with locally advanced pancreatic cancer, with World Health Organization performance status of zero to two were randomly assigned to either the induction chemoradiation group (60 Gy, 2 Gy/fraction; concomitant 5-fluoro-uracil infusion, 300 mg/m(2) per day, days 1-5 for 6 weeks; cisplatin, 20 mg/m(2) per day, days 1-5 during weeks 1 and 5) or the induction gemcitabine group (GEM: 1000 mg/m(2) weekly for 7 weeks). Maintenance gemcitabine (1000 mg/m(2) weekly, 3/4 weeks) was given in both arms until disease progression or toxicity. RESULTS: Overall survival was shorter in the chemoradiation than in the gemcitabine arm (median survival 8.6 [99% confidence interval 7.1-11.4] and 13 months [8,9,9-18], p=0.03). One-year survival was, respectively, 32 and 53%. These results were confirmed in a per-protocol analysis for patients who received 75% or more of the planned dose of radiotherapy. More overall grades 3-4 toxic effects were recorded in the chemoradiation arm, both during induction (36 versus 22%) and maintenance (32 versus 18%). CONCLUSION: This intensive induction schedule of chemoradiation was more toxic and less effective than gemcitabine alone.
Published: 2011

15. Alteration of nutritional status at diagnosis is a prognostic factor for survival of amyotrophic lateral sclerosis patients

Author: Jean-Claude Desport, Pierre-Marie Preux, Patrick Kajeu, Marie Nicol, Philippe Couratier, Pierre Jésus, B Nicolaud, Benoît Marin, Service de l'Information Médicale et de l'Évaluation [CHU Limoges] (SIME), CHU Limoges, Laboratoire de Biostatistique et d'Informatique Médicale, Université de Limoges (UNILIM), Neuroépidémiologie Tropicale et Comparée (NETEC), Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503)-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Université de Limoges (UNILIM), Service d'Hépato-Gastro-Entérologie et Nutrition [CHU Limoges], Service de Neurologie [CHU Limoges], Grelier, Elisabeth, Service de l'Information Médicale et de l'Évaluation [CHU Limoges] ( SIME ), Université de Limoges ( UNILIM ), Neuroépidémiologie Tropicale et Comparée ( NETEC ), Université de Limoges ( UNILIM ) -Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Génomique, Environnement, Immunité, Santé, Thérapeutique ( GEIST FR CNRS 3503 ), Neuroépidémiologie Tropicale ( NET ), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique ( GEIST ), Université de Limoges ( UNILIM ) -Université de Limoges ( UNILIM ) -CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Neuroépidémiologie Tropicale (NET), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), and Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, Vital capacity, [SDV]Life Sciences [q-bio], MESH : Aged, Disease, MESH : Nutritional Status, MESH: Proportional Hazards Models, 0302 clinical medicine, Electric Impedance, MESH : Female, 030212 general & internal medicine, Amyotrophic lateral sclerosis, ComputingMilieux_MISCELLANEOUS, MESH: Amyotrophic Lateral Sclerosis, 2. Zero hunger, MESH: Aged, MESH : Prognosis, MESH: Middle Aged, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, Middle Aged, Prognosis, MESH: Nutritional Status, [SDV] Life Sciences [q-bio], Psychiatry and Mental health, MESH: Survival Analysis, Body Composition, Disease Progression, Female, MESH: Disease Progression, medicine.medical_specialty, Neuromuscular disease, MESH : Male, MESH : Body Composition, Nutritional Status, MESH: Prognosis, Central nervous system disease, 03 medical and health sciences, MESH : Amyotrophic Lateral Sclerosis, Internal medicine, medicine, Humans, MESH : Middle Aged, MESH: Electric Impedance, Survival analysis, MESH : Electric Impedance, Aged, Proportional Hazards Models, MESH: Humans, [ SDV ] Life Sciences [q-bio], Proportional hazards model, business.industry, MESH : Humans, Amyotrophic Lateral Sclerosis, MESH : Disease Progression, MESH: Body Composition, MESH : Proportional Hazards Models, medicine.disease, Survival Analysis, MESH: Male, Surgery, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Neurology (clinical), MESH : Survival Analysis, business, Motor neurone disease, MESH: Female, 030217 neurology & neurosurgery
Abstract: International audience; OBJECTIVES: The aims were to analyse changes in nutritional parameters from diagnosis of amyotrophic lateral sclerosis (ALS) to death and to assess their relationships with survival at the time of diagnosis and during follow-up. METHODS: 92 ALS patients were included and clinically assessed every 3 months (ALS functional rating scale, manual muscular testing, forced vital capacity, weight, BMI, percentage weight loss). Bioimpedance was performed to evaluate body composition (fat-free mass, fat mass and hydration status) and phase angle. Survival analyses were performed from diagnosis to death or censoring date using a Cox model. RESULTS: The evolution of nutritional parameters in ALS patients was marked by significant decreases in weight, BMI, fat-free mass and phase angle, and increased fat mass. The authors identified an adjusted 30% increased risk of death for a 5% decrease from usual weight at time of diagnosis (RR 1.30; 95% CI 1.08 to 1.56). During follow-up, the authors identified adjusted 34% (95% CI 18% to 51%) and 24% (95% CI 13% to 36%) increased risks of death associated with each 5% decrease in usual weight and each unit decrease in usual BMI, respectively (p
Published: 2011

16. High levels of antibodies against merkel cell polyomavirus identify a subset of patients with merkel cell carcinoma with better clinical outcome

Author: Gérard Lorette, Eve Maubec, Agnès Carlotti, Annabel Maruani, Marie-Françoise Avril, Maxime Fleury, Raphaël Cazal, Serge Guyétant, Mauro Tognon, Flore Rozenberg, Françoise Arnold, Antoine Touzé, Emmanuelle Le Bidre, François Aubin, Pierre Coursaget, Hélène Laude, Laboratoire Analyse, Géométrie et Applications (LAGA), Université Paris 8 Vincennes-Saint-Denis (UP8)-Centre National de la Recherche Scientifique (CNRS)-Institut Galilée-Université Paris 13 (UP13), Immunité et cancer (U932), Université Paris Descartes - Paris 5 (UPD5)-Institut Curie [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de dermatologie, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Service de Dermatologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire de Virologie, Hôpital Saint-Vincent de Paul, Laboratoire Analyse, Géométrie et Applications ( LAGA ), Université Paris 8 Vincennes-Saint-Denis ( UP8 ) -Université Paris 13 ( UP13 ) -Université Sorbonne Paris Cité ( USPC ) -Institut Galilée-Centre National de la Recherche Scientifique ( CNRS ), Immunité et cancer ( U932 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut Curie-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques-Université de Franche-Comté ( UFC ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Service de Dermatologie, Hôpital Cochin, AP-HP, Paris, Université Paris 8 Vincennes-Saint-Denis (UP8)-Université Paris 13 (UP13)-Institut Galilée-Université Sorbonne Paris Cité (USPC)-Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Curie-Université Paris Descartes - Paris 5 (UPD5), Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Hôpital Saint-Jacques-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Université de Franche-Comté (UFC), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP], Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté [COMUE] ( UBFC ) -Université de Franche-Comté ( UFC ), and Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Cochin [AP-HP]
Subjects: Pathology, MESH: Chi-Square Distribution, MESH: Lymphatic Metastasis, MESH: Polyomavirus, MESH : Aged, MESH : Prospective Studies, MESH: Risk Assessment, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, Merkel cell carcinoma, 0302 clinical medicine, MESH: Up-Regulation, MESH : Neoplasm Staging, MESH : Up-Regulation, MESH: Capsid Proteins, 0303 health sciences, MESH: Middle Aged, Antibody titer, food and beverages, MESH : Lymphatic Metastasis, MESH : Enzyme-Linked Immunosorbent Assay, MESH: Case-Control Studies, MESH : Polyomavirus, 3. Good health, Oncology, 030220 oncology & carcinogenesis, MESH: RNA, Viral, VIRUS, Antibody, MESH : Case-Control Studies, medicine.medical_specialty, MESH: Prognosis, 03 medical and health sciences, MESH : Middle Aged, MESH : Predictive Value of Tests, MESH : Aged, 80 and over, MESH: Kaplan-Meier Estimate, MESH: Humans, MESH : Chi-Square Distribution, MESH : Humans, MESH: Adult, MESH : Proportional Hazards Models, medicine.disease, MESH: Tumor Markers, Biological, MESH: Disease-Free Survival, MESH: Female, SKIN, MESH: Antibodies, Viral, Cancer Research, MESH : Capsid Proteins, Merkel cell polyomavirus, Human skin, antibody, immune system, outcome, MESH: Proportional Hazards Models, MESH: Aged, 80 and over, MESH: Risk Factors, MESH : Tumor Markers, Biological, INFECTION, EPIDEMIOLOGY, MESH : Female, MESH : Risk Assessment, MESH : Carcinoma, Merkel Cell, MESH: Aged, MESH : Prognosis, biology, MESH: Enzyme-Linked Immunosorbent Assay, MESH: Neoplasm Staging, MESH : Adult, MESH : Risk Factors, MESH: Predictive Value of Tests, ETIOLOGY, MESH : Disease-Free Survival, MESH : Time Factors, circulatory and respiratory physiology, MESH : Antibodies, Viral, EXPRESSION, TISSUES, MESH : Male, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH : Kaplan-Meier Estimate, medicine, MESH : RNA, Viral, MESH : France, 030304 developmental biology, Insect cell, business.industry, MESH: Skin Neoplasms, MESH : Skin Neoplasms, MESH: Time Factors, Cancer, MESH: Carcinoma, Merkel Cell, biology.organism_classification, MESH: Male, MESH: Prospective Studies, MESH: France, Geometric mean titer, MCV, biology.protein, business
Abstract: Purpose A new human polyomavirus, Merkel cell polyomavirus (MCV), was identified in 2008 in tumor tissue of patients with Merkel cell carcinoma (MCC), a relatively rare human skin cancer. In this study, we investigated patients with MCC and controls for the presence of antibodies against MCV and their association with clinical characteristics. Patients and Methods Antibodies against MCV were investigated by enzyme-linked immunosorbent assay in 68 patients with MCC and 82 controls using VP1 virus-like particles produced in insect cells. Results Antibodies against MCV were detected in all patients with MCC and in 85% of controls. However, high antibody titers (> 10,000) were rarely observed in controls (7.3%) and they were detected in 64.7% of patients with MCC (P < .001) in contrast to the absence of VP1 expression in tumor samples. In addition, the geometric mean titer of anti-MCV in patients with MCC was around 14 times higher than that observed in MCV-positive controls (P < .001) and was not correlated with tumor viral load. High antibody titers were not found to be associated with any subject or tumor characteristics, but better progression-free survival was observed in patients with high antibody titers (hazard ratio, 4.6; 95% CI, 1.7 to 12.2; P = .002). Conclusion High titers of MCV antibodies in a much higher proportion of patients with MCC than in controls confirmed the association between MCV infection and MCC. The findings also indicated that a better progression-free survival occurred in patients with high MCV antibody titers and suggested that there are at least two distinct etiologic causes of MCC.
Published: 2011

17. Analysis of an ordinal outcome in a multicentric randomized controlled trial: application to a 3-arm anti-malarial drug trial in Cameroon

Author: Henri Gwet, Solange Youdom Whegang, Leonardo K. Basco, Jean-Christophe Thalabard, Mathématiques Appliquées à Paris 5 ( MAP5 - UMR 8145 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National des Sciences Mathématiques et de leurs Interactions-Centre National de la Recherche Scientifique ( CNRS ), Mathématiques Appliquées Paris 5 (MAP5 - UMR 8145), and Université Paris Descartes - Paris 5 (UPD5)-Institut National des Sciences Mathématiques et de leurs Interactions (INSMI)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Epidemiology, MESH : Child, Preschool, MESH: Epidemiologic Methods, MESH : Randomized Controlled Trials as Topic, MESH: Regression Analysis, MESH : Multicenter Studies as Topic, MESH : Malaria, Falciparum, law.invention, MESH: Proportional Hazards Models, Randomized controlled trial, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, law, MESH : Regression Analysis, Multicenter Studies as Topic, Cameroon, Malaria, Falciparum, MESH: Treatment Outcome, Randomized Controlled Trials as Topic, lcsh:R5-920, [STAT.AP]Statistics [stat]/Applications [stat.AP], MESH: Malaria, Falciparum, Hazard ratio, MESH : Models, Statistical, MESH : Infant, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Infant, Drug Combinations, [ SDV.MHEP.MI ] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Pyrimethamine, Treatment Outcome, MESH : Drug Combinations, Child, Preschool, Regression Analysis, Drug Therapy, Combination, lcsh:Medicine (General), Research Article, medicine.drug, medicine.medical_specialty, MESH: Pyrimethamine, Coverage probability, Health Informatics, Amodiaquine, MESH : Treatment Outcome, Ordinal regression, MESH : Amodiaquine, MESH : Sulfadoxine, MESH : Epidemiologic Methods, Antimalarials, Internal medicine, Sulfadoxine, medicine, Humans, MESH : Pyrimethamine, MESH: Amodiaquine, Proportional Hazards Models, MESH: Drug Combinations, MESH: Humans, Models, Statistical, MESH : Cameroon, Proportional hazards model, business.industry, MESH : Drug Therapy, Combination, MESH: Child, Preschool, MESH : Humans, [ STAT.AP ] Statistics [stat]/Applications [stat.AP], Infant, Odds ratio, MESH: Cameroon, MESH : Proportional Hazards Models, MESH: Antimalarials, Confidence interval, Surgery, MESH: Drug Therapy, Combination, MESH: Randomized Controlled Trials as Topic, MESH: Multicenter Studies as Topic, MESH : Antimalarials, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Epidemiologic Methods, business, MESH: Models, Statistical, MESH: Sulfadoxine
Abstract: Background Malaria remains a burden in Sub-Saharan Countries. The strategy proposed by the World Health Organization (WHO) is to systematically compare the therapeutic efficacy of antimalarial drugs using as primary outcome for efficacy, a four-category ordered criterion. The objective of the present work was to analyze the treatment effects on this primary outcome taking into account both a center-effect and individual covariates. A three-arm, three-centre trial of Amodiaquine (AQ), sulfadoxine-pyrimethamine (SP) and their combination (AQ + SP), conducted by OCEAC-IRD in 2003, in 538 children with uncomplicated Plasmodium falciparum malaria, is used as an illustration. Methods Analyses were based on ordinal regression methods, assuming an underlying continuous latent variable, using either the proportional odds (PO) or the proportional hazards (PH) models. Different algorithms, corresponding to both frequentist- and bayesian-approaches, were implemented using the freely available softwares R and Winbugs, respectively. The performances of the different methods were evaluated on a simulated data set, and then they were applied on the trial data set. Results Good coverage probability and type-1 error for the treatment effect were achieved. When the methods were applied on the trial data set, results highlighted a significance decrease of SP efficacy when compared to AQ (PO, odds ratio [OR] 0.14, 95% confidence interval [CI] 0.04-0.57; hazard ratio [HR] 0.605, 95% CI 0.42-0.82), and an equal effectiveness between AQ + SP and AQ (PO, odds ratio [OR] 1.70, 95% confidence interval [CI] 0.25-11.44; hazard ratio [HR] 1.40, 95% CI 0.88-2.18). The body temperature was significantly related to the responses. The patient weights were marginally associated to the clinical response. Conclusion The proposed analyses, based on usual statistical packages, appeared adapted to take into account the full information contained in the four categorical outcome in malaria trials, as defined by WHO, with the possibility of adjusting on individual and global covariates.
Published: 2010

18. Immuno-fluorescence in situ hybridization index predicts survival in patients with diffuse large B-cell lymphoma treated with R-CHOP: a GELA study

Author: Copie-Bergman, Christiane, Gaulard, Philippe, Leroy, Karen, Briere, Josette, Baia, Maryse, Jais, Jean-Philippe, Salles, Gilles, Berger, Françoise, Haioun, Corinne, Tilly, Herve, Emile, Jean-François, Banham, Alison, Mounier, Nicolas, Gisselbrecht, Christian, Feugier, Pierre, Coiffier, Bertrand, Molina, Thierry, Groupe Henri Mondor-Albert Chenevier, Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Hôpital Albert Chenevier, Institut Mondor de Recherche Biomédicale ( IMRB ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Service d'anatomo-pathologie [Paris], Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Diderot - Paris 7 ( UPD7 ) -Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Service d'informatique médicale et biostatistiques [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Département de pathologie, Hospices Civils de Lyon ( HCL ), Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon, Service d'hématologie clinique, Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Service d'Hématologie, CRLCC Henri Becquerel, Service d'anatomie pathologique, Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Ambroise Paré, Laboratoire épidémiologie et oncogénèse des tumeurs digestives, Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ), Nuffield Department of Clinical Laboratory Sciences, University of Oxford [Oxford], Service d'onco-hématologie, CHU Nice-Hôpital l'Archet, Service d'hématologie-oncologie adultes, Service d'Hématologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Département de Pathologie, Assistance publique - Hôpitaux de Paris (AP-HP)-Hôtel-Dieu-Université Paris Descartes - Paris 5 ( UPD5 ), This study was supported by a grant from the Programme Hospitalier de Recherche Clinique AP-HP (AOM 03060), Dako A/S and ARTGIL (Association pour la Recherche Thérapeutique, Génétique et Immunologique dans les lymphomes). AHB was supported by Leukaemia Research, UK., Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Hôpital Albert Chenevier, Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hospices Civils de Lyon (HCL), Université Claude Bernard Lyon 1 (UCBL), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Service d'anatomie pathologique [CHU Ambroise-Paré], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Ambroise Paré [AP-HP], Biomarqueurs et essais cliniques en Cancérologie et Onco-Hématologie (BECCOH), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Université Paris-Saclay, Centre Hospitalier Universitaire de Nice (CHU Nice)-Hôpital l'Archet, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôtel-Dieu-Université Paris Descartes - Paris 5 (UPD5), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP]
Subjects: MESH : Antineoplastic Combined Chemotherapy Protocols, MESH : Aged, MESH : Dose-Response Relationship, Drug, MESH: Risk Assessment, MESH : Lymphoma, Large B-Cell, Diffuse, MESH: Antibodies, Monoclonal, MESH: Dose-Response Relationship, Drug, MESH : Proto-Oncogene Proteins c-bcl-2, MESH: Proportional Hazards Models, MESH: Aged, 80 and over, immune system diseases, hemic and lymphatic diseases, MESH : Female, MESH: In Situ Hybridization, Fluorescence, MESH : Risk Assessment, MESH : Cyclophosphamide, MESH: Treatment Outcome, MESH: Aged, MESH: Middle Aged, MESH : Prognosis, MESH: Enzyme-Linked Immunosorbent Assay, MESH : Enzyme-Linked Immunosorbent Assay, MESH: Predictive Value of Tests, MESH : In Situ Hybridization, Fluorescence, MESH: Antineoplastic Combined Chemotherapy Protocols, MESH : Genes, myc, MESH: Survival Analysis, MESH : Antibodies, Monoclonal, MESH : Severity of Illness Index, MESH : Vincristine, MESH: Probability, MESH : Probability, MESH : Male, MESH : Drug Administration Schedule, MESH: Vincristine, MESH : Treatment Outcome, MESH: Drug Administration Schedule, MESH: Multivariate Analysis, MESH: Prognosis, MESH: Doxorubicin, MESH: Severity of Illness Index, MESH : Doxorubicin, [SDV.BBM]Life Sciences [q-bio]/Biochemistry, Molecular Biology, MESH : Middle Aged, MESH : Predictive Value of Tests, MESH : Aged, 80 and over, [ SDV.BBM ] Life Sciences [q-bio]/Biochemistry, Molecular Biology, MESH: Genes, myc, MESH: Humans, MESH : Humans, MESH: Biological Markers, MESH: Cyclophosphamide, MESH : Multivariate Analysis, MESH : Prednisone, MESH : Proportional Hazards Models, MESH: Male, MESH : Antibodies, Monoclonal, Murine-Derived, MESH : Biological Markers, MESH: Proto-Oncogene Proteins c-bcl-2, MESH: Antibodies, Monoclonal, Murine-Derived, MESH: Lymphoma, Large B-Cell, Diffuse, MESH : Survival Analysis, MESH: Prednisone, MESH: Female
Abstract: International audience; PURPOSE: To evaluate the prognostic value of cell of origin immunohistochemical markers and BCL2, BCL6, and c-MYC translocations in a homogeneous cohort of patients with diffuse large B-cell lymphoma (DLBCL) treated with rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). PATIENTS AND METHODS: Patients with CD20+ DLBCL were enrolled in the randomized LNH98-5 and 01-5B Groupe d'Etude des Lymphomes de l'Adulte trials. Paraffin-embedded tumor samples of 119 patients treated with R-CHOP were analyzed by immunohistochemistry for CD10, BCL6, MUM1/IRF4, LMO2, and forkhead box protein P1 (FOXP1) expression and for BCL2, BCL6, and c-MYC breakpoints by fluorescence in situ hybridization (FISH) on tissue microarray. RESULTS: LMO2 expression and BCL2 breakpoint were associated with the germinal center (GC) subtype defined by Hans' algorithm, respectively (P < .0001; P = .0002) whereas FOXP1 expression and BCL6 breakpoint were associated with the non-germinal center (non-GC) subtype (P = .008 and P = .0001, respectively). The immunohistochemical markers analyzed independently, GC/non-GC phenotype and BCL2 breakpoint did not predict overall survival (OS). BCL6 breakpoint was significantly associated with an unfavorable impact on OS (P = .04). Interestingly, an immunoFISH index, defined by positivity for at least two of three non-GC markers (FOXP1, MUM1/IRF4, BCL6 breakpoint) was significantly associated with a shorter 5-year OS rate (44%; 95% CI, 28 to 60 v 78%; 95% CI, 59 to 89; P = .01) which was independent (P = .04) of the age-adjusted International Prognostic Index (P = .04) in multivariate analysis. CONCLUSION: Our study demonstrates that combining immunohistochemistry with FISH allows construction of an immunoFISH index that significantly predicts survival in elderly DLBCL patients treated with R-CHOP.
Published: 2009

19. Lymphoproliferative disorders in patients receiving thiopurines for inflammatory bowel disease: a prospective observational cohort study

Author: STEPHANE NANCEY, Francois MION, Nathalie Ganne-Carrié, Dany GARGOT, ANTOINE CORTOT, Laurent Siproudhis, Bernard FLOURIE, ROBERT BENAMOUZIG, Tabassome SIMON, Frederic Gottrand, Guillaume Savoye, Gerard Thiefin, Fabrice Carrat, Jean-Pierre Hugot, Pierre DESREUMAUX, Laurent Peyrin-biroulet, Laurent Michaud, Christos CHRISTIDIS, Olivier Hermine, Service de Gastroentérologie et nutrition [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Saint-Antoine [APHP], Service d'Anatomie et Cytologie Pathologique, Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Descartes - Paris 5 ( UPD5 ) -Hopital Necker-Enfants Malades, Registre Bourguignon des Cancers Digestifs, Lipides - Nutrition - Cancer (U866) ( LNC ), Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon ( ENSBANA ) -Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon ( ENSBANA ) -Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand ( CHU Dijon ), Service d'Hépato-gastroentérologie, Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Service de gastro-entérologie, Assistance publique - Hôpitaux de Paris (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Infection bactérienne, inflammation, et carcinogenèse digestive, Université Nice Sophia Antipolis ( UNS ), Université Côte d'Azur ( UCA ) -Université Côte d'Azur ( UCA ) -IFR50-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Immunité muqueuse et vaccination, Institut National de la Santé et de la Recherche Médicale ( INSERM ) -IFR50-Université Nice Sophia Antipolis ( UNS ), Université Côte d'Azur ( UCA ) -Université Côte d'Azur ( UCA ), Service de gastro-entérologie et assistance nutritive, Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Diderot - Paris 7 ( UPD7 ) -Hôpital Beaujon, Registre des hémopathies malignes de Côte d'Or, Service d'hématologie biologique [CHU Necker], CHU Necker - Enfants Malades [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP), Epidémiologie des maladies infectieuses et modélisation ( ESIM ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Agents pathogènes et inflammation - UFC (EA 4266) ( API ), Université de Franche-Comté ( UFC ), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Saint-Antoine [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Descartes - Paris 5 (UPD5)-CHU Necker - Enfants Malades [AP-HP], Lipides - Nutrition - Cancer (U866) (LNC), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon (ENSBANA)-Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Ecole Nationale Supérieure de Biologie Appliquée à la Nutrition et à l'Alimentation de Dijon (ENSBANA)-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), 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), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon, Service d'immuno-hématologie pédiatrique [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Necker - Enfants Malades [AP-HP], Epidémiologie des maladies infectieuses et modélisation (ESIM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Agents pathogènes et inflammation - UFC (EA 4266) (API), Université de Franche-Comté (UFC), 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), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], 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)-IFR50-Université Côte d'Azur (UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Beaujon [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), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Nice Sophia Antipolis (1965 - 2019) (UNS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Descartes - Paris 5 ( UPD5 ) -CHU Necker - Enfants Malades [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP]
Subjects: Male, Time Factors, MESH : Age Distribution, MESH : Prospective Studies, MESH : Aged, Inflammatory bowel disease, MESH: Proportional Hazards Models, 0302 clinical medicine, MESH: Lymphoproliferative Disorders, Crohn Disease, Risk Factors, MESH: Risk Factors, MESH : Purines, MESH : Female, Prospective Studies, MESH: Incidence, Prospective cohort study, MESH : Immunosuppressive Agents, MESH : Sex Distribution, MESH: Aged, MESH : Tumor Necrosis Factor-alpha, Crohn's disease, MESH: Middle Aged, Thiopurine methyltransferase, biology, MESH : Lymphoproliferative Disorders, Incidence, MESH: Sex Distribution, General Medicine, MESH: Purines, Middle Aged, MESH : Adult, MESH : Colitis, Ulcerative, Ulcerative colitis, MESH : Risk Factors, MESH : Incidence, 3. Good health, 030220 oncology & carcinogenesis, Cohort, Drug Therapy, Combination, Female, 030211 gastroenterology & hepatology, [ SDV.MHEP.HEG ] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, France, MESH: Immunosuppressive Agents, Immunosuppressive Agents, Cohort study, MESH : Time Factors, Adult, medicine.medical_specialty, MESH : Male, MESH: Colitis, Ulcerative, Lymphoproliferative disorders, MESH : Crohn Disease, MESH: Multivariate Analysis, 03 medical and health sciences, Age Distribution, Internal medicine, medicine, Humans, MESH : Middle Aged, Sex Distribution, MESH : France, MESH: Age Distribution, Aged, Proportional Hazards Models, MESH: Humans, MESH: Crohn Disease, Tumor Necrosis Factor-alpha, business.industry, MESH : Drug Therapy, Combination, MESH: Time Factors, MESH : Humans, MESH : Multivariate Analysis, MESH: Adult, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, medicine.disease, MESH : Proportional Hazards Models, Lymphoproliferative Disorders, MESH: Male, MESH: Prospective Studies, Surgery, MESH: France, MESH: Drug Therapy, Combination, Purines, MESH: Tumor Necrosis Factor-alpha, Multivariate Analysis, biology.protein, Colitis, Ulcerative, business, MESH: Female
Abstract: International audience; BACKGROUND: Reports of an increased risk of lymphoproliferative disorders in patients receiving thiopurines for inflammatory bowel disease are controversial. We assessed this risk in a prospective observational cohort study. METHODS: 19,486 patients with inflammatory bowel disease, of whom 11,759 (60.3%) had Crohn's disease and 7727 (39.7%) had ulcerative colitis or unclassified inflammatory bowel disease, were enrolled in a nationwide French cohort by 680 gastroenterologists, who reported details of immunosuppressive therapy during the observation period, cases of cancer, and deaths. The risk of lymphoproliferative disorder was assessed according to thiopurine exposure. Median follow-up was 35 months (IQR 29-40). FINDINGS: At baseline, 5867 (30.1%) of patients were receiving, 2809 (14.4%) had discontinued, and 10,810 (55.5%) had never received thiopurines. 23 new cases of lymphoproliferative disorder were diagnosed, consisting of one case of Hodgkin's lymphoma and 22 cases of non-Hodgkin lymphoproliferative disorder. The incidence rates of lymphoproliferative disorder were 0.90 per 1000 (95% CI 0.50-1.49) patient-years in those receiving, 0.20/1000 (0.02-0.72) patient-years in those who had discontinued, and 0.26/1000 (0.10-0.57) patient-years in those who had never received thiopurines (p=0.0054). The multivariate-adjusted hazard ratio of lymphoproliferative disorder between patients receiving thiopurines and those who had never received the drugs was 5.28 (2.01-13.9, p=0.0007). Most cases associated with thiopurine exposure matched the pathological range of post-transplant disease. INTERPRETATION: Patients receiving thiopurines for inflammatory bowel disease have an increased risk of developing lymphoproliferative disorders. FUNDING: Programme Hospitalier de Recherche Clinique National (AOM05157), Association François Aupetit, Délégation Inter-régionale de la Recherche clinique Ile de France-Assistance Publique Hôpitaux de Paris (AP-HP), Ligue contre le Cancer, and Fonds de Recherche de la Société Nationale Française de Gastro-entérologie.
Published: 2009

20. Duration of androgen suppression in the treatment of prostate cancer

Author: Bolla , Michel, De Reijke , Theodorus M, Van Tienhoven , Geertjan, Van Den Bergh , Alphonsus C M, Oddens , Jorg, Poortmans , Philip M P, Gez , Eliahu, Kil , Paul, Akdas , Atif, Soete , Guy, Kariakine , Oleg, Van Der Steen-Banasik , Elsbietha M, Musat , Elena, Piérart , Marianne, Mauer , Murielle E, Collette , Laurence, Renseigné , Non, Bosset , Jean-François, Département de cancérologie et radiothérapie, CHU Grenoble, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Faculteit Medische Wetenschappen/UMCG, Guided Treatment in Optimal Selected Cancer Patients (GUTS), Medical Imaging and Physical Sciences, Radiation Therapy, CCA -Cancer Center Amsterdam, Urology, and Radiotherapy
Subjects: Oncology, Male, MESH: Treatment Failure, medicine.medical_treatment, MESH : Aged, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, Tosyl Compounds, 0302 clinical medicine, MESH : Nitriles, MESH: Middle Aged, MESH: Heart Diseases, Hazard ratio, General Medicine, MESH: Follow-Up Studies, MESH: Nitriles, 3. Good health, 030220 oncology & carcinogenesis, Prostatic Neoplasms/drug therapy, MESH: Tosyl Compounds, MESH : Prostatic Neoplasms, medicine.medical_specialty, MESH : Androgen Antagonists, MESH : Drug Administration Schedule, MESH: Drug Administration Schedule, Disease-Free Survival, Drug Administration Schedule, MESH : Anilides, 03 medical and health sciences, MESH : Treatment Failure, Humans, MESH : Middle Aged, MESH : Aged, 80 and over, Anilides/adverse effects, Aged, MESH: Humans, Proportional hazards model, Heart Diseases/mortality, MESH : Humans, Androgen Antagonists, MESH: Adult, MESH : Follow-Up Studies, medicine.disease, Androgen, Interim analysis, MESH : Proportional Hazards Models, Flutamide, RANDOMIZED-TRIAL, Radiation therapy, MESH : Flutamide, MESH: Disease-Free Survival, aged, 80 and over, MESH: Combined Modality Therapy, 030232 urology & nephrology, ADJUVANT, Androgen suppression, MESH : Radiotherapy, Conformal, Gonadotropin-Releasing Hormone, MESH: Proportional Hazards Models, Prostate cancer, MESH: Aged, 80 and over, QUALITY-OF-LIFE, MESH: Gonadotropin-Releasing Hormone, Anilides, Treatment Failure, Quality Of Life, MESH: Aged, Radiotherapy, Conformal/adverse effects, Nitriles/adverse effects, PHASE-III TRIAL, Middle Aged, MESH : Adult, Combined Modality Therapy, EORTC, MESH: Androgen Antagonists, oncology, MESH: Radiotherapy, Conformal, MESH : Disease-Free Survival, RADIOTHERAPY, Adult, Heart Diseases, medicine.drug_class, MESH : Male, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH: Anilides, Internal medicine, RADIATION-THERAPY, Nitriles, medicine, MANAGEMENT, Androgen Antagonists/administration & dosage, Proportional Hazards Models, Tosyl Compounds/adverse effects, Flutamide/adverse effects, business.industry, Prostatic Neoplasms, Cancer, MESH: Quality of Life, MESH : Tosyl Compounds, MESH : Heart Diseases, Gonadotropin-Releasing Hormone/analogs & derivatives, MESH : Quality of Life, MESH: Flutamide, MESH: Male, Surgery, IRRADIATION, MESH: Prostatic Neoplasms, DEPRIVATION THERAPY, Radiotherapy, Conformal, MESH : Gonadotropin-Releasing Hormone, business, MESH : Combined Modality Therapy, Follow-Up Studies
Abstract: International audience; BACKGROUND: The combination of radiotherapy plus long-term medical suppression of androgens (> or = 2 years) improves overall survival in patients with locally advanced prostate cancer. We compared the use of radiotherapy plus short-term androgen suppression with the use of radiotherapy plus long-term androgen suppression in the treatment of locally advanced prostate cancer. METHODS: We randomly assigned patients with locally advanced prostate cancer who had received external-beam radiotherapy plus 6 months of androgen suppression to two groups, one to receive no further treatment (short-term suppression) and the other to receive 2.5 years of further treatment with a luteinizing hormone-releasing hormone agonist (long-term suppression). An outcome of noninferiority of short-term androgen suppression as compared with long-term suppression required a hazard ratio of more than 1.35 for overall survival, with a one-sided alpha level of 0.05. An interim analysis showed futility, and the results are presented with an adjusted one-sided alpha level of 0.0429. RESULTS: A total of 1113 men were registered, of whom 970 were randomly assigned, 483 to short-term suppression and 487 to long-term suppression. After a median follow-up of 6.4 years, 132 patients in the short-term group and 98 in the long-term group had died; the number of deaths due to prostate cancer was 47 in the short-term group and 29 in the long-term group. The 5-year overall mortality for short-term and long-term suppression was 19.0% and 15.2%, respectively; the observed hazard ratio was 1.42 (upper 95.71% confidence limit, 1.79; P=0.65 for noninferiority). Adverse events in both groups included fatigue, diminished sexual function, and hot flushes. CONCLUSIONS: The combination of radiotherapy plus 6 months of androgen suppression provides inferior survival as compared with radiotherapy plus 3 years of androgen suppression in the treatment of locally advanced prostate cancer. (ClinicalTrials.gov number, NCT00003026.)
Published: 2009

21. The abdominoperineal resection itself is associated with an adverse outcome: the European experience based on a pooled analysis of five European randomised clinical trials on rectal cancer

Author: Joakim Folkesson, Marcel den Dulk, Krzysztof Bujko, Claus Rödel, Cornelis J.H. van de Velde, Laurence Collette, Hein Putter, Jean-François Bosset, Lars Påhlman, Corrie A.M. Marijnen, Department of Medical Statistics, Leiden University Medical Center (LUMC), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), and Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC )
Subjects: Male, Oncology, Cancer Research, Time Factors, Colorectal cancer, MESH : Risk, MESH: Lymphatic Metastasis, MESH : Abdomen, MESH : Aged, Kaplan-Meier Estimate, Perineum, MESH : Randomized Controlled Trials as Topic, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, MESH: Proportional Hazards Models, MESH : Adenocarcinoma, 0302 clinical medicine, MESH: Rectum, Abdomen, Medicine, MESH : Female, MESH: Kaplan-Meiers Estimate, MESH : Rectal Neoplasms, Randomized Controlled Trials as Topic, MESH: Treatment Outcome, MESH: Aged, MESH: Middle Aged, MESH: Risk, MESH : Neoplasm Recurrence, Local, Abdominoperineal resection, Hazard ratio, MESH : Lymphatic Metastasis, MESH: Follow-Up Studies, Middle Aged, MESH : Survival Rate, 3. Good health, Europe, Survival Rate, Treatment Outcome, Lymphatic Metastasis, 030220 oncology & carcinogenesis, MESH : Rectum, Female, 030211 gastroenterology & hepatology, MESH: Neoplasm Recurrence, Local, MESH : Time Factors, Risk, medicine.medical_specialty, animal structures, MESH: Survival Rate, MESH : Male, MESH : Europe, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH : Treatment Outcome, Adenocarcinoma, MESH : Perineum, MESH: Abdomen, 03 medical and health sciences, Internal medicine, Humans, MESH : Middle Aged, MESH: Patient Selection, MESH: Perineum, Survival rate, Aged, Proportional Hazards Models, MESH: Humans, Rectal Neoplasms, business.industry, Proportional hazards model, Patient Selection, MESH : Humans, MESH: Adenocarcinoma, MESH: Time Factors, Rectum, Cancer, MESH: Rectal Neoplasms, MESH : Follow-Up Studies, MESH : Kaplan-Meiers Estimate, MESH : Patient Selection, MESH : Proportional Hazards Models, medicine.disease, MESH: Male, Surgery, Clinical trial, MESH: Randomized Controlled Trials as Topic, Propensity score matching, MESH: Europe, Neoplasm Recurrence, Local, business, MESH: Female, Follow-Up Studies
Abstract: International audience; PURPOSE: The aim of this study is to identify factors associated with the decision to perform an abdominoperineal resection (APR) and to assess if these factors or the surgical procedure itself is associated with circumferential resection margin (CRM) involvement, local recurrence (LR), overall survival (OS) and cancer-specific survival (CSS). PATIENTS AND METHODS: The Swedish Rectal Cancer Trial (SRCT), TME trial, CAO/ARO/AIO-94 trial, EORTC 22921 trial and Polish Rectal Cancer Trial (PRCT) were pooled. A propensity score was calculated, which indicated the predicted probability of undergoing an APR given gender, age and distance, and used in the multivariate analyses. RESULTS: An APR procedure was associated with an increased risk of CRM involvement [odd ratio (OR) 2.52, p
Published: 2009

22. Overall genomic pattern is a predictor of outcome in neuroblastoma

Author: Jérôme Couturier, Dominique Plantaz, Alexander Valent, Agnès Ribeiro, Dominique Valteau-Couanet, Michel Peuchmaur, Caroline Thomas, Evi Michels, Véronique Mosseri, Isabelle Janoueix-Lerosey, Jean Michon, Delphine Lequin, Gudrun Schleiermacher, Hervé Rubie, Olivier Delattre, Angelika Eggert, Raphael Rousseau, Frank Speleman, Joëlle Vermeulen, Valérie Combaret, Unité de génétique et biologie des cancers ( U830 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut Curie-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Département de Pédiatrie, INSTITUT CURIE, Center for Medical Genetics [Ghent], Ghent University Hospital, Service de biostatistique ( IC10213 ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -INSTITUT CURIE, Unité de génétique somatique, Unité de Cytogénétique, Service d'anatomie et de cytologie pathologique, Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Robert Debré-Université Paris Diderot - Paris 7 ( UPD7 ), Département de biologie et pathologie médicales [Gustave Roussy], Institut Gustave Roussy ( IGR ), Service Hématologie Infantile, CHU Grenoble, Laboratoire d'Hématologie [Purpan], Université Toulouse III - Paul Sabatier ( UPS ), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse], Service Hémato-Oncologie Infantile, Laboratoire d'Oncologie Moléculaire, Centre Léon Bérard [Lyon], Department of Paediatric Oncology and Haematology, University Children's Hospital of Essen, Département d'oncologie pédiatrique, Supported by grants from the Institut National de la Sante´ et de la Recherche Me´ dicale and the Ligue Nationale contre le Cancer (Equipe labellise´ e). Construction of the BAC/PAC array was supported by grants from the Carte d'Identite´ des Tumeurs/Program of the Ligue Nationale Contre le Cancer. Belgian array-CGH results were obtained by support of the Stichting tegen Kanker and Specific Targeted Research Project. E.M. is supported by the concerted research fund (GOA, No. 12051203). J.V. is supported by the Belgian Kids' Fund., Janoueix-Lerosey, Isabelle, Unité de génétique et biologie des cancers (U830), Université Paris Descartes - Paris 5 (UPD5)-Institut Curie [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Curie [Paris], Service de biostatistique (IC10213), Institut Curie [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Robert Debré-Université Paris Diderot - Paris 7 (UPD7), Institut Gustave Roussy (IGR), Service Hématologie - IUCT-Oncopole [CHU Toulouse], Pôle Biologie [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Pôle IUCT [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Institut Curie [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Descartes - Paris 5 (UPD5), Université Toulouse III - Paul Sabatier (UT3), Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Curie [Paris], and Université Paris Diderot - Paris 7 (UPD7)-Hôpital Robert Debré-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
Subjects: Oncology, Cancer Research, Pathology, Genes, myc, Medizin, MESH: Gene Amplification, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, MESH: Proportional Hazards Models, Neuroblastoma, 0302 clinical medicine, MESH : Tumor Markers, Biological, Copy-number variation, MESH : Comparative Genomic Hybridization, Oligonucleotide Array Sequence Analysis, 0303 health sciences, Comparative Genomic Hybridization, MESH : Prognosis, MESH: Genomic Instability, MESH : Gene Amplification, MESH : Infant, MESH: Follow-Up Studies, DNA, Neoplasm, Prognosis, MESH: Infant, MESH : Oligonucleotide Array Sequence Analysis, MESH : Genes, myc, 030220 oncology & carcinogenesis, MESH: Survival Analysis, MESH : DNA, Neoplasm, medicine.medical_specialty, Copy number analysis, MESH: DNA, Neoplasm, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH: Prognosis, MESH: Multivariate Analysis, Genomic Instability, 03 medical and health sciences, [SDV.CAN] Life Sciences [q-bio]/Cancer, Internal medicine, medicine, Biomarkers, Tumor, Humans, Clinical significance, Survival analysis, MESH: Genes, myc, 030304 developmental biology, Proportional Hazards Models, MESH: Humans, business.industry, Proportional hazards model, MESH : Humans, Gene Amplification, Cancer, MESH : Multivariate Analysis, Infant, MESH : Follow-Up Studies, medicine.disease, MESH : Proportional Hazards Models, MESH: Neuroblastoma, Survival Analysis, MESH: Comparative Genomic Hybridization, MESH: Oligonucleotide Array Sequence Analysis, MESH: Tumor Markers, Biological, Multivariate Analysis, MESH : Neuroblastoma, MESH : Survival Analysis, business, MESH : Genomic Instability, Comparative genomic hybridization, Follow-Up Studies
Abstract: Purpose For a comprehensive overview of the genetic alterations of neuroblastoma, their association and clinical significance, we conducted a whole-genome DNA copy number analysis. Patients and Methods A series of 493 neuroblastoma (NB) samples was investigated by array-based comparative genomic hybridization in two consecutive steps (224, then 269 patients). Results Genomic analysis identified several types of profiles. Tumors presenting exclusively whole-chromosome copy number variations were associated with excellent survival. No disease-related death was observed in this group. In contrast, tumors with any type of segmental chromosome alterations characterized patients with a high risk of relapse. Patients with both numerical and segmental abnormalities clearly shared the higher risk of relapse of segmental-only patients. In a multivariate analysis, taking into account the genomic profile, but also previously described individual genetic and clinical markers with prognostic significance, the presence of segmental alterations with (HR, 7.3; 95% CI, 3.7 to 14.5; P < .001) or without MYCN amplification (HR, 4.5; 95% CI, 2.4 to 8.4; P < .001) was the strongest predictor of relapse; the other significant variables were age older than 18 months (HR, 1.8; 95% CI, 1.2 to 2.8; P = .004) and stage 4 (HR, 1.8; 95% CI, 1.2 to 2.7; P = .005). Finally, within tumors showing segmental alterations, stage 4, age, MYCN amplification, 1p and 11q deletions, and 1q gain were independent predictors of decreased overall survival. Conclusion The analysis of the overall genomic pattern, which probably unravels particular genomic instability mechanisms rather than the analysis of individual markers, is essential to predict relapse in NB patients. It adds critical prognostic information to conventional markers and should be included in future treatment stratification.
Published: 2009

23. The expression of Twist has an impact on survival in human bladder cancer and is influenced by the smoking status

Author: Jean P. Thiery, Hugues Bittard, Marie E. Fondrevelle, Franck Monnien, Hervé Wallerand, Robert E. Reiter, Dominique Chopin, Bernadette Kantelip, Laboratoire d'anatomie pathologique [Besancon], Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Jean Minjoz-Université de Franche-Comté ( UFC ), 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 ), Service de Néphrologie et Urologie, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques, Service d'urologie, andrologie et transplantation rénale, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Service d'Anatomie pathologique [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), 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), and Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques
Subjects: Oncology, Male, Pathology, MESH : Immunohistochemistry, MESH : Aged, Kaplan-Meier Estimate, MESH: Cadherins, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, MESH: Proportional Hazards Models, 0302 clinical medicine, MESH: Aged, 80 and over, MESH: Risk Factors, Risk Factors, MESH : Neoplasm Staging, MESH : Female, MESH: Kaplan-Meiers Estimate, Stage (cooking), MESH: Aged, Aged, 80 and over, 0303 health sciences, MESH: Middle Aged, MESH : Prognosis, Smoking, MESH: Twist Transcription Factor, Nuclear Proteins, Anatomical pathology, MESH: Neoplasm Staging, Middle Aged, Cadherins, Prognosis, Immunohistochemistry, MESH : Risk Factors, 3. Good health, MESH: Urinary Bladder Neoplasms, MESH : Smoking, MESH : Urinary Bladder Neoplasms, 030220 oncology & carcinogenesis, Disease Progression, MESH: Disease Progression, Female, MESH : Cadherins, medicine.medical_specialty, MESH: Smoking, Urology, MESH : Male, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH: Multivariate Analysis, MESH: Prognosis, 03 medical and health sciences, Internal medicine, medicine, Humans, MESH : Middle Aged, Epithelial–mesenchymal transition, Risk factor, MESH : Aged, 80 and over, 030304 developmental biology, Aged, Neoplasm Staging, Proportional Hazards Models, Bladder cancer, MESH: Humans, Proportional hazards model, business.industry, Twist-Related Protein 1, MESH : Twist Transcription Factor, MESH : Humans, Cancer, MESH : Multivariate Analysis, MESH : Nuclear Proteins, MESH: Immunohistochemistry, MESH : Kaplan-Meiers Estimate, MESH : Disease Progression, medicine.disease, MESH : Proportional Hazards Models, MESH: Male, Urinary Bladder Neoplasms, Multivariate Analysis, business, MESH: Nuclear Proteins, MESH: Female
Abstract: International audience; OBJECTIVES: Twist is considered as transcription factor that regulates epithelial mesenchymal transition (EMT) by at least inhibition of E-cadherin expression. EMT is a key event in the tumor invasion process. The purpose of this study is to investigate the expression of Twist but also those of E- and N-cadherin in human primary bladder tumor and to evaluate its prognostic value. As smoking cigarettes is a strong bladder cancer risk factor, we tried to evaluate the impact of the tobacco status on these molecular abnormalities. MATERIALS AND METHODS: To delineate on the oncogenic role for Twist in human bladder cancer, we evaluated the E- and N-cadherin but also Twist expression (n = 70) by immunohistochemistry. We evaluated the prognostic value of these expressions. Moreover, we tried to correlate these protein expressions to the smoking status of the patients. Overall survival (OS) and progression-free survival (PFS) were evaluated using the Kaplan-Meier method, and multivariate analysis was performed using the Cox proportional hazard analysis. RESULTS: Of the 70 bladder tumors, 28 (40%) cases were positive for Twist expression, 16 (23%) cases were negative for E-cadherin expression, and 12 (17%) were positive for N-cadherin expression. When categorized into negative vs. positive expression, Twist was associated with the stage (P = 0.001), the grade (P < 0.001), the progression (P = 0.02), and the E-cadherin expression (P = 0.01). Moreover, positive Twist expression clearly predicted poorer PFS (P = 0.02). In the multivariate analysis, both positive Twist expression and loss of E-cadherin expression were independent prognostic factors for PFS (P = 0.046 and P = 0.001, respectively) and only loss of E-cadherin expression for the OS (P < 0.001). We also demonstrated that almost 60% (16/28) of patients with Twist-positive expression were current smokers at the time of the diagnosis, corroborating the fact that smoking modulates the expression of EMT markers including Twist. CONCLUSION: Positive Twist expression may be a useful prognostic marker for patients with bladder cancer. Its expression seems to be correlated to the tobacco status of the patients.
Published: 2009

24. The performance of multiple imputation for missing covariate data within the context of regression relative survival analysis

Author: Giorgi, Roch, Belot, Aurélien, Gaudart, Jean, Launoy, Guy, Renseigné, Non, Danzon, Arlette, Chercheur indépendant, Service de Biostatistique, Hospices Civils de Lyon ( HCL ), Laboratoire de Biométrie et Biologie Evolutive ( LBBE ), Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique ( Inria ) -Centre National de la Recherche Scientifique ( CNRS ), Département des maladies chroniques et traumatismes, Institut de Veille Sanitaire (INVS), Laboratoire d'Enseignement et de Recherche sur le Traitement de l'Information Médicale ( LERTIM ), Université de la Méditerranée - Aix-Marseille 2, Cancers et Populations : Facteurs de Risque, Depistage, Pratiques Diagnostiques et Therapeutiques, Université de Caen Normandie ( UNICAEN ), Normandie Université ( NU ) -Normandie Université ( NU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Hospices Civils de Lyon (HCL), Biostatistiques santé, Département biostatistiques et modélisation pour la santé et l'environnement [LBBE], Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-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 Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-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)-Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-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), Laboratoire d'Enseignement et de Recherche sur le Traitement de l'Information Médicale (LERTIM), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (UR 3181) (CEF2P / CARCINO), 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), 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: Registries, MESH : Male, MESH : Aged, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH: Prognosis, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, MESH: Proportional Hazards Models, MESH: Computer Simulation, MESH : Female, MESH : Middle Aged, MESH : France, MESH: Aged, MESH: Middle Aged, MESH: Humans, MESH : Prognosis, MESH : Humans, MESH : Models, Statistical, MESH : Proportional Hazards Models, MESH: Male, MESH: France, MESH : Computer Simulation, MESH: Survival Analysis, MESH : Colorectal Neoplasms, MESH : Survival Analysis, MESH: Female, MESH: Colorectal Neoplasms, MESH: Models, Statistical, MESH : Registries
Abstract: International audience; Relative survival assesses the effects of prognostic factors on disease-specific mortality when the cause of death is uncertain or unavailable. It provides an estimate of patients' survival, allowing for the effects of other independent causes of death. Regression-based relative survival models are commonly used in population-based studies to model the effects of some prognostic factors and to estimate net survival. Most often, studies focus on routinely collected prognostic factors for which the proportion of missing values is usually low (around 5 per cent). However, in some cases, additional factors are collected with a greater proportion of missingness. In the present article, we systematically assess the performance of multiple imputation in regression analysis of relative survival through a series of simulation experiments. According to the assumptions concerning the missingness mechanism (completely at random, at random, and not at random) and the missingness pattern (monotone, non-monotone), several strategies were considered and compared: all cases analysis, complete cases analysis, missing data indicator analysis, and multiple imputation by chained equations (MICE) analysis. We showed that MICE performs well in estimating the hazard ratios and the baseline hazard function when the missing mechanism is missing at random (MAR) conditionally on the vital status. In the situations where the missing mechanism was not MAR conditionally on vital status, complete case behaves consistently. As illustration, we used data of the French Cancer Registries on relative survival of patients with colorectal cancer.
Published: 2008

25. Adjuvant therapy with pegylated interferon alfa-2b versus observation alone in resected stage III melanoma: final results of EORTC 18991, a randomised phase III trial

Author: Eggermont , Alexander M M, Suciu , Stefan, Santinami , Mario, Testori , Alessandro, Kruit , Wim H J, Marsden , Jeremy, Punt , Cornelis J A, Salès , François, Gore , Martin, Mackie , Rona, Kusic , Zvonko, Dummer , Reinhard, Hauschild , Axel, Musat , Elena, Spatz , Alain, Keilholz , Ulrich, Renseigné , Non, Aubin , François, Département de biologie et pathologie médicales [Gustave Roussy], Institut Gustave Roussy ( IGR ), Department of Medicine III, Charité, Campus Benjamin Franklin, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Institut Gustave Roussy (IGR), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Other departments, Surgery, Medical Oncology, and University of Zurich
Subjects: Male, MESH: Observation, MESH : Aged, Observation, 2700 General Medicine, MESH : Observation, Gastroenterology, Polyethylene Glycols, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, MESH: Proportional Hazards Models, 0302 clinical medicine, Immune Regulation [NCMLS 2], Pegylated interferon, Interferon, Medicine, MESH : Female, Neoplasm Metastasis, Melanoma, MESH: Aged, 0303 health sciences, MESH: Middle Aged, interferon alfa-2b, melanoma, EORTC 18991, Hazard ratio, MESH : Polyethylene Glycols, 10177 Dermatology Clinic, MESH : Chemotherapy, Adjuvant, General Medicine, Middle Aged, MESH : Adult, Recombinant Proteins, 3. Good health, MESH : Antiviral Agents, Tolerability, Chemotherapy, Adjuvant, MESH: Chemotherapy, Adjuvant, 030220 oncology & carcinogenesis, MESH : Neoplasm Metastasis, MESH : Disease-Free Survival, Female, medicine.drug, Adult, MESH: Antiviral Agents, MESH: Interferon Alfa-2b, medicine.medical_specialty, Adolescent, MESH: Melanoma, MESH : Male, MESH : Melanoma, Alpha interferon, 610 Medicine & health, [SDV.CAN]Life Sciences [q-bio]/Cancer, Interferon alpha-2, Antiviral Agents, Disease-Free Survival, 03 medical and health sciences, Translational research [ONCOL 3], Interventional oncology [UMCN 1.5], Internal medicine, MESH : Adolescent, Adjuvant therapy, Humans, MESH : Middle Aged, Interferon alfa, Aged, Proportional Hazards Models, 030304 developmental biology, MESH: Adolescent, MESH: Humans, Intention-to-treat analysis, Hereditary cancer and cancer-related syndromes [ONCOL 1], business.industry, MESH : Humans, Interferon-alpha, MESH: Adult, MESH : Proportional Hazards Models, MESH : Interferon Alfa-2b, MESH: Neoplasm Metastasis, MESH: Male, Surgery, MESH: Polyethylene Glycols, MESH: Disease-Free Survival, business, MESH: Female
Abstract: Contains fulltext : 69569.pdf (Publisher’s version ) (Closed access) BACKGROUND: Any benefit of adjuvant interferon alfa-2b for melanoma could depend on dose and duration of treatment. Our aim was to determine whether pegylated interferon alfa-2b can facilitate prolonged exposure while maintaining tolerability. METHODS: 1256 patients with resected stage III melanoma were randomly assigned to observation (n=629) or pegylated interferon alfa-2b (n=627) 6 mug/kg per week for 8 weeks (induction) then 3 mug/kg per week (maintenance) for an intended duration of 5 years. Randomisation was stratified for microscopic (N1) versus macroscopic (N2) nodal involvement, number of positive nodes, ulceration and tumour thickness, sex, and centre. Randomisation was done with a minimisation technique. The primary endpoint was recurrence-free survival. Analyses were done by intention to treat. This study is registered with ClinicalTrials.gov, number NCT00006249. FINDINGS: All randomised patients were included in the primary efficacy analysis. 608 patients in the interferon group and 613 patients in the observation group were included in safety analyses. The median length of treatment with pegylated interferon alfa-2b was 12 (IQR 3.8-33.4) months. At 3.8 (3.2-4.2) years median follow-up, 328 recurrence events had occurred in the interferon group compared with 368 in the observation group (hazard ratio 0.82, 95% CI 0.71-0.96; p=0.01); the 4-year rate of recurrence-free survival was 45.6% (SE 2.2) in the interferon group and 38.9% (2.2) in the observation group. There was no difference in overall survival between the groups. Grade 3 adverse events occurred in 246 (40%) patients in the interferon group and 60 (10%) in the observation group; grade 4 adverse events occurred in 32 (5%) patients in the interferon group and 14 (2%) in the observation group. In the interferon group, the most common grade 3 or 4 adverse events were fatigue (97 patients, 16%), hepatotoxicity (66, 11%), and depression (39, 6%). Treatment with pegylated interferon alfa-2b was discontinued because of toxicity in 191 (31%) patients. INTERPRETATION: Adjuvant pegylated interferon alfa-2b for stage III melanoma has a significant, sustained effect on recurrence-free survival.
Published: 2008

26. BAC array CGH distinguishes mutually exclusive alterations that define clinicogenetic subtypes of gliomas

Author: Gaëlle Pierron, Michèle Kujas, Emmanuel Barillot, Carlo Lucchesi, Elodie Manié, Marc Sanson, Isabel Brito, Ahmed Idbaih, Karima Mokhtari, Virginie Raynal, Yannick Marie, Olivier Delattre, Véronique Mosseri, Alain Aurias, Khê Hoang-Xuan, Jean-Yves Delattre, Unité de génétique et biologie des cancers ( U830 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut Curie-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Biologie des Interactions Neurones / Glie, Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Unité de Génétique Somatique, INSTITUT CURIE, Service de biostatistique ( IC10213 ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -INSTITUT CURIE, Service de neurologie 1 [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Laboratoire de Neuropathologie Raymond Escourolle, Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Service de Bioinformatique ( CURIE-BIOINFO ), Unité de génétique et biologie des cancers (U830), Université Paris Descartes - Paris 5 (UPD5)-Institut Curie [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Curie [Paris], Service de biostatistique (IC10213), Institut Curie [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Pitié-Salpêtrière [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)-Université Pierre et Marie Curie - Paris 6 (UPMC), Service de Bioinformatique (CURIE-BIOINFO), Idbaih, Ahmed, Service de Neurologie [CHU Pitié-Salpêtrière], IFR70-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), Laboratoire de Neuropathologie Raymond Escourolle [CHU Pitié-Salpétriêre], Université Pierre et Marie Curie - Paris 6 (UPMC)-CHU Pitié-Salpêtrière [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), Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: Male, Pathology, Chromosomes, Artificial, Bacterial, MESH: Chromosomes, Human, Pair 19, MESH : Aged, Loss of Heterozygosity, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, MESH: Nucleic Acid Hybridization, 0302 clinical medicine, MESH : Chromosomes, Human, Pair 10, MESH: Middle Aged, Clinical pathology, Brain Neoplasms, Nucleic Acid Hybridization, Prognosis, MESH : Nucleic Acid Hybridization, 3. Good health, MESH : Chromosomes, Human, Pair 19, ErbB Receptors, Oncology, Chromosomes, Human, Pair 1, 030220 oncology & carcinogenesis, Chromosome Deletion, Chromosomes, Human, Pair 9, Chromosomes, Human, Pair 7, MESH : Chromosomes, Artificial, Bacterial, medicine.medical_specialty, MESH: Chromosomes, Artificial, Bacterial, MESH: Chromosome Deletion, Oligodendroglioma, MESH: Receptor, Epidermal Growth Factor, World Health Organization, Disease-Free Survival, MESH: Prognosis, 03 medical and health sciences, [SDV.CAN] Life Sciences [q-bio]/Cancer, Humans, MESH : Middle Aged, [SDV.NEU] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], MESH : Predictive Value of Tests, Pathological, Aged, [SDV.GEN]Life Sciences [q-bio]/Genetics, MESH: Humans, Proportional hazards model, MESH : Humans, MESH: Adult, medicine.disease, MESH : Proportional Hazards Models, MESH : Chromosome Deletion, Survival Analysis, MESH: Astrocytoma, MESH: Disease-Free Survival, [ SDV.GEN ] Life Sciences [q-bio]/Genetics, MESH: Female, 030217 neurology & neurosurgery, Comparative genomic hybridization, Cancer Research, MESH : Oligodendroglioma, Oligonucleotides, [SDV.GEN] Life Sciences [q-bio]/Genetics, MESH: World Health Organization, MESH : Chromosomes, Human, Pair 1, MESH: Glioma, MESH: Proportional Hazards Models, MESH : Chromosomes, Human, Pair 7, MESH: Oligonucleotides, MESH : Receptor, Epidermal Growth Factor, MESH : Chromosomes, Human, Pair 9, MESH : Female, MESH: Aged, MESH : Prognosis, Glioma, Middle Aged, MESH : Adult, Phenotype, MESH: Predictive Value of Tests, MESH: Survival Analysis, MESH: Brain Neoplasms, MESH : Disease-Free Survival, Female, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Adult, MESH: Chromosomes, Human, Pair 7, MESH: Chromosomes, Human, Pair 1, MESH : Male, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH : Oligonucleotides, Biology, Astrocytoma, Malignancy, MESH: Multivariate Analysis, Predictive Value of Tests, medicine, MESH : Brain Neoplasms, MESH: Oligodendroglioma, Proportional Hazards Models, MESH: Loss of Heterozygosity, Chromosomes, Human, Pair 10, Breakpoint, Cancer, MESH : Multivariate Analysis, MESH : Astrocytoma, MESH: Male, MESH: Chromosomes, Human, Pair 10, MESH : Glioma, [ SDV.NEU ] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Multivariate Analysis, Cancer research, MESH : World Health Organization, MESH : Survival Analysis, MESH: Chromosomes, Human, Pair 9, Chromosomes, Human, Pair 19, MESH : Loss of Heterozygosity
Abstract: International audience; The pathological classification of gliomas constitutes a critical step of the clinical management of patients, yet it is frequently challenging. To assess the relationship between genetic abnormalities and clinicopathological characteristics, we have performed a genetic and clinical analysis of a series of gliomas. A total of 112 gliomas were analyzed by comparative genomic hybridization on a BAC array with a 1 megabase resolution. Altered regions were identified and correlation analysis enabled to retrieve significant associations and exclusions. Whole chromosomes (chrs) 1p and 19q losses with centromeric breakpoints and EGFR high level amplification were found to be mutually exclusive, permitting identification of 3 distinct, nonoverlapping groups of tumors with striking clinicopathological differences. Type A tumors with chrs 1p and 19q co-deletion exhibited an oligodendroglial phenotype and a longer patient survival. Type B tumors were characterized by EGFR amplification. They harbored a WHO high grade of malignancy and a short patient survival. Finally, type C tumors displayed none of the previous patterns but the presence of chr 7 gain, chr 9p deletion and/or chr 10 loss. It included astrocytic tumors in patients younger than in type B and whose prognosis was highly dependent upon the number of alterations. A multivariate analysis based on a Cox model shows that age, WHO grade and genomic type provide complementary prognostic informations. Finally, our results highlight the potential of a whole-genome analysis as an additional diagnostic in cases of unclear conventional genetic findings.
Published: 2008

27. Randomized clinical trial of post-operative radiotherapy versus concomitant carboplatin and radiotherapy for head and neck cancers with lymph node involvement

Author: Jean-Jacques Mazeron, M. Martin, E. Haddad, Pierre Géhanno, Jocelyne Huet, Catherine Durdux, René-Jean Bensadoun, Séverine Racadot, Christian Diana, G. Calais, Catherine Journel, Michel Henry-Amar, V. Favrel, Brigitte Blaska-Jaulerry, Sophie Dussart, François Baillet, Martin Housset, Christophe Hennequin, Bernadette Dessard-Diana, Gérard Pillet, Mariette Mercier, Emmanuelle Malaurie, Centre Alexis Vautrin ( CAV ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Laboratoire Pierre Süe ( LPS ), Commissariat à l'énergie atomique et aux énergies alternatives ( CEA ) -Centre National de la Recherche Scientifique ( CNRS ), Centre Hospitalier Lyon Sud [CHU - HCL] ( CHLS ), Hospices Civils de Lyon ( HCL ), Universite Antonine ( UPA ), Université Antonine, Centre Alexis Vautrin (CAV), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (UR 3181) (CEF2P / CARCINO), 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), Laboratoire Pierre Süe (LPS), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Université Antonine (UA), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), and Universite Antonine (UPA)
Subjects: Male, MESH: Combined Modality Therapy, MESH: Lymphatic Metastasis, medicine.medical_treatment, MESH: Laryngeal Neoplasms, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, Carboplatin, MESH: Proportional Hazards Models, chemistry.chemical_compound, 0302 clinical medicine, MESH : Oropharyngeal Neoplasms, MESH: Carboplatin, MESH : Female, MESH : Carcinoma, Squamous Cell, Neoplasm Metastasis, MESH: Radiotherapy Dosage, 030223 otorhinolaryngology, Lymph node, MESH: Treatment Outcome, MESH : Laryngeal Neoplasms, education.field_of_study, MESH: Middle Aged, MESH : Radiotherapy Dosage, Hazard ratio, MESH: Carcinoma, Squamous Cell, MESH : Lymphatic Metastasis, Radiotherapy Dosage, Hematology, Middle Aged, MESH : Survival Rate, Combined Modality Therapy, 3. Good health, Survival Rate, MESH : Antineoplastic Agents, Oropharyngeal Neoplasms, medicine.anatomical_structure, Treatment Outcome, Oncology, 030220 oncology & carcinogenesis, MESH : Carboplatin, Lymphatic Metastasis, MESH : Neoplasm Metastasis, Carcinoma, Squamous Cell, Female, medicine.medical_specialty, MESH: Survival Rate, MESH : Male, Population, [SDV.CAN]Life Sciences [q-bio]/Cancer, Antineoplastic Agents, MESH : Treatment Outcome, 03 medical and health sciences, medicine, Humans, Radiology, Nuclear Medicine and imaging, MESH : Middle Aged, education, Survival rate, Laryngeal Neoplasms, Proportional Hazards Models, Chemotherapy, MESH: Humans, business.industry, MESH : Humans, MESH : Proportional Hazards Models, MESH: Neoplasm Metastasis, MESH: Male, Surgery, Radiation therapy, MESH: Oropharyngeal Neoplasms, chemistry, Concomitant, MESH: Antineoplastic Agents, business, MESH : Combined Modality Therapy, MESH: Female
Abstract: International audience; BACKGROUND AND PURPOSE: Post-operative radiotherapy is indicated for the treatment of head and neck cancers. In vitro, chemotherapy potentiates the cytotoxic effects of radiation. We report the results of a randomized trial testing post-operative radiotherapy alone versus concomitant carboplatin and radiotherapy for head and neck cancers with lymph node involvement. MATERIALS AND METHODS: The study involved patients undergoing curative-intent surgery for head and neck cancers with histological evidence of lymph node involvement. Patients were randomly assigned to receive radiotherapy alone (54-72Gy, 30-40 fractions, 6-8 weeks) or identical treatment plus concomitant Carboplatin (50mg/m(2) administered by IV infusion twice weekly). RESULTS: Between February 1994 and June 2002, 144 patients were included. With a median follow-up of 106 months (95% confidence interval (CI) [92-119]), the 2-year rate of loco-regional control was 73% (95% CI: 0.61-0.84) in the combined treatment group and 68% (95% CI: 0.57-0.80) in the radiotherapy group (p=0.26). Overall survival did not differ significantly between groups (hazard ratio for death, 1.05; 95% CI: 0.69-1.60; p=0.81). CONCLUSIONS: Twice-weekly administration of carboplatin concomitant to post-operative radiotherapy did not improve local control or overall survival rates in this population of patients with node-positive head and neck cancers.
Published: 2007

28. Identification of patients with prostate cancer who benefit from immediate postoperative radiotherapy: EORTC 22911

Author: Van der Kwast TH, Bolla M, Van Poppel H, Van Cangh P, Vekemans K, Da Pozzo L, Bosset JF, Kurth KH, Schröder FH, Collette L, and EORTC 22911, Van der Kwast, T, Bolla, M, Van Poppel, H, Van Cangh, P, Vekemans, K, Da Pozzo, L, Bosset, J, Kurth, K, Schröder, F, Collette, L, and EORTC, 2, 06 Operations Centre and intensive care, Département de cancérologie et radiothérapie, CHU Grenoble, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Pathology, and Urology
Subjects: Oncology, Male, Cancer Research, MESH: Combined Modality Therapy, medicine.medical_treatment, 030232 urology & nephrology, MESH : Aged, law.invention, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, MESH: Proportional Hazards Models, Prostate cancer, 0302 clinical medicine, Randomized controlled trial, law, MESH: Risk Factors, Risk Factors, Medicine, Stage (cooking), MESH : Prostate-Specific Antigen, MESH: Treatment Outcome, MESH: Aged, MESH: Middle Aged, Prostatectomy, Hazard ratio, Middle Aged, MESH : Risk Factors, Combined Modality Therapy, 3. Good health, MESH: Prostate-Specific Antigen, Europe, Treatment Outcome, 030220 oncology & carcinogenesis, Disease Progression, MESH : Disease-Free Survival, MESH: Disease Progression, Positive Surgical Margin, MESH : Prostatic Neoplasms, medicine.medical_specialty, MESH : Prostatectomy, MESH : Male, MESH : Europe, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH : Treatment Outcome, Disease-Free Survival, 03 medical and health sciences, MESH: Prostatectomy, SDG 3 - Good Health and Well-being, Internal medicine, Humans, MESH : Middle Aged, Aged, Proportional Hazards Models, MESH: Humans, business.industry, MESH : Humans, Cancer, Prostatic Neoplasms, MESH : Disease Progression, Prostate-Specific Antigen, medicine.disease, MESH : Proportional Hazards Models, MESH: Male, Surgery, Radiation therapy, MESH: Prostatic Neoplasms, MESH: Disease-Free Survival, MESH: Europe, business, MESH : Combined Modality Therapy, adjuvant radiotherapy, prostate cancer, survival, outcomes
Abstract: Purpose The randomized controlled European Organisation for Research and Treatment of Cancer (EORTC) trial 22911 studied the effect of radiotherapy after prostatectomy in patients with adverse risk factors. Review pathology data of specimens from participants in this trial were analyzed to identify which factors predict increased benefit from adjuvant radiotherapy. Patients and Methods After prostatectomy, 1,005 patients with stage pT3 and/or positive surgical margins were randomly assigned to a wait-and-see (n = 503) and an adjuvant radiotherapy (60 Gy conventional irradiation) arm (n = 502). Pathologic review data were available for 552 patients from 11 participating centers. The interaction between the review pathology characteristics and treatment benefit was assessed by log-rank test for heterogeneity (P < .05). Results Margin status assessed by review pathology was the strongest predictor of prolonged biochemical disease-free survival with immediate postoperative radiotherapy (heterogeneity, P < .01): by year 5, immediate postoperative irradiation could prevent 291 events/1,000 patients with positive margins versus 88 events/1,000 patients with negative margins. The hazard ratio for immediate irradiation was 0.38 (95% CI, 0.26 to 0.54) and 0.88 (95% CI, 0.53 to 1.46) in the groups with positive and negative margins, respectively. We could not identify a significant impact of the positive margin localization. Conclusion Provided careful pathology of the prostatectomy is performed, our results suggest that immediate postoperative radiotherapy might not be recommended for prostate cancer patients with negative surgical margins. These findings require validation on an independent data set.
Published: 2007

29. Phase III double-blind, placebo-controlled study of thalidomide in extensive-disease small-cell lung cancer after response to chemotherapy: an intergroup study FNCLCC cleo04 IFCT 00-01

Author: Jean Luc Breton, Virginie Westeel, Elisabeth Quoix, Dominique Maraninchi, Sabine Gameroff, Radj Gervais, Jean-Louis Pujol, H. Janicot, Philippe David, Jean Genève, Marie-Laure Tanguy, Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de pneumologie, CHU Strasbourg-Hopital Civil, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (UR 3181) (CEF2P / CARCINO), 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), Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC), Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), Centre François Baclesse, Service de biostatistiques et information médicale [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU), Département de Biostatistique, Santé Publique et Information Médicale [CHU Pitié-Salpêtrière] (BIOSPIM ), 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 Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO)
Subjects: Male, Cancer Research, Lung Neoplasms, medicine.medical_treatment, Placebo-controlled study, Gastroenterology, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, MESH: Proportional Hazards Models, 0302 clinical medicine, MESH : Female, MESH: Double-Blind Method, Carcinoma, Small Cell, Etoposide, 0303 health sciences, MESH: Middle Aged, MESH: Thalidomide, MESH: Carcinoma, Small Cell, Middle Aged, MESH : Survival Rate, Thalidomide, 3. Good health, Survival Rate, Oncology, 030220 oncology & carcinogenesis, MESH : Disease-Free Survival, Female, medicine.drug, medicine.medical_specialty, Cyclophosphamide, MESH: Survival Rate, MESH : Male, [SDV.CAN]Life Sciences [q-bio]/Cancer, Placebo, Disease-Free Survival, MESH : Thalidomide, 03 medical and health sciences, Double-Blind Method, Internal medicine, medicine, Humans, MESH : Double-Blind Method, MESH : Middle Aged, MESH : Lung Neoplasms, Lung cancer, Survival rate, Proportional Hazards Models, 030304 developmental biology, Chemotherapy, MESH: Humans, business.industry, MESH : Humans, medicine.disease, MESH : Proportional Hazards Models, MESH: Male, Surgery, MESH : Carcinoma, Small Cell, MESH: Lung Neoplasms, MESH: Disease-Free Survival, business, MESH: Female
Abstract: Purpose This randomized, double-blind, placebo-controlled phase III study aimed to determine whether thalidomide prolongs survival of patients with extensive-disease small-cell lung cancer (SCLC). Patients and Methods One hundred nineteen patients received two courses of etoposide, cisplatin, cyclophosphamide, and 4′-epidoxorubicin (PCDE). Responder patients who had recovered from chemotherapy toxicity were randomly assigned to receive four additional PCDE cycles plus thalidomide (400 mg daily) or placebo. Results After the first two PCDE cycles, objective response rate was 81.5%, and 92 patients were randomly assigned to placebo (n = 43) or thalidomide (n = 49). Median exposure duration to placebo was 4.5 months, and median exposure to thalidomide was 4.9 months. Patients treated with thalidomide had a longer survival compared with patients who received placebo, although the difference was not statistically significant (minimal follow-up, 3 years; median survival time, 11.7 v 8.7 months, respectively; log-rank test: hazard ratio [HR] = 0.74; 95% CI, 0.49 to 1.12; P = .16). Patients with a performance status (PS) of 1 or 2 who received thalidomide had a significantly longer survival (HR = 0.59; 95% CI, 0.37 to 0.92; P = .02). The disease also progressed slower in patients with PS of 1 or 2 receiving thalidomide (HR = 0.54; 95% CI, 0.36 to 0.87; P = .02), whereas the difference did not reach statistical significance for the whole population (HR = 0.74; 95% CI, 0.49 to 1.12; P = .15). Neuropathy occurred more frequently in the thalidomide group compared with the placebo group (33% v 12%, respectively). Conclusion Treatment with thalidomide was not associated with a significant improvement in survival of SCLC patients. There was pronounced heterogeneity in survival outcomes between groups of patients. Some benefit was observed among patients with a PS of 1 or 2 (exploratory analyses), deserving further studies targeting angiogenesis in this disease.
Published: 2007

30. Indinavir trough concentration as a determinant of early nephrolithiasis in HIV-1-infected adults

Author: Collin, Fidéline, Chêne, Geneviève, Retout, Sylvie, Peytavin, Gilles, Salmon, Dominique, Bouvet, Elisabeth, Raffi, François, Garraffo, Rodolphe, Mentré, France, Duval, Xavier, Aproco-Copilote Study Group, Anrs Co8, Epidémiologie, santé publique et développement, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR99-ISPED, Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques (U738 / UMR_S738), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Diderot - Paris 7 (UPD7), Département d'épidémiologie, biostatistique et recherche clinique, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire de Pharmacologie Clinique, Service de médecine interne et centre de référence des maladies rares [CHU Cochin], Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service des maladies infectieuses et tropicales, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Hôtel-Dieu, Service de pharmacologie, Hôpital Pasteur [Nice] (CHU)-Centre Hospitalier Universitaire de Nice (CHU Nice), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Université Paris Diderot - Paris 7 (UPD7)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Collin, Fidéline, Université Bordeaux Segalen - Bordeaux 2 - Institut National de la Santé et de la Recherche Médicale (INSERM) - IFR99 - ISPED, Modèles et méthodes de l'évaluation thérapeutique des maladies chroniques, Université Paris Diderot - Paris 7 (UPD7) - Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) - AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) - CHU Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) - AP-HP - Hôpital Bichat - Claude Bernard [Paris] - Université Paris Diderot - Paris 7 (UPD7), and Hôpital Pasteur [Nice] (CHU) - CHU Nice
Subjects: Male, MESH : Prospective Studies, HIV Infections, Indinavir, MESH: Nephrolithiasis, 030226 pharmacology & pharmacy, Gastroenterology, MESH: Proportional Hazards Models, MESH: HIV-1, 0302 clinical medicine, MESH : Female, Pharmacology (medical), Prospective Studies, 030212 general & internal medicine, pharmacokinetic, Prospective cohort study, education.field_of_study, MESH : HIV Protease Inhibitors, Hazard ratio, Age Factors, Area under the curve, MESH: HIV Infections, MESH : Adult, 3. Good health, Area Under Curve, Female, MESH : HIV-1, medicine.drug, Adult, medicine.medical_specialty, MESH : Male, Population, Cmax, 03 medical and health sciences, plasma levels, Internal medicine, MESH : HIV Infections, medicine, Humans, MESH : Indinavir, Adverse effect, education, Proportional Hazards Models, MESH: HIV Protease Inhibitors, Pharmacology, MESH: Age Factors, MESH: Humans, business.industry, MESH: Indinavir, MESH : Humans, toxicity, MESH: Adult, HIV Protease Inhibitors, MESH : Proportional Hazards Models, Confidence interval, MESH: Prospective Studies, MESH: Male, Endocrinology, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, HIV-1, MESH: Area Under Curve, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH : Age Factors, MESH : Area Under Curve, MESH : Nephrolithiasis, business, MESH: Female, nephrolithiasis
Abstract: International audience; Indinavir plasma levels are associated with antiretroviral efficacy; however, little data are available regarding toxicity. We assessed the relationship between indinavir pharmacokinetic (PK) characteristics and severe nephrolithiasis as well as other severe or serious adverse reactions. Patients included in the ANRS CO8 APROCO-COPILOTE cohort and receiving 800 mg indinavir three times daily as a first-line protease inhibitor were eligible for this study. To be included in the analysis, their plasma sample at month 1 (M1) had to be available (n = 282) to estimate using population PK modeling, indinavir PK characteristics, ie, maximum (Cmax) and trough plasma (Cres) concentrations, area under the curve (AUC), and observed/predicted concentration ratio (CR). A Cox model was used to estimate the independent effect of Cmax, Cres, AUC, and CR on the hazard of severe nephrolithiasis and serious adverse reactions. At M1, median Cmax was 6205 ng/mL, Cres 631 ng/mL, AUC 24,242 ng . h/mL, and CR 0.6. After a median follow up of 12 months, 11% of patients (30 of 282) had experienced at least one serious adverse reaction among which 12 were nephrolithiasis. In the multivariate analyses, early high indinavir Cres (ie, >/=1000 ng/mL at M1) was associated with a higher rate of severe nephrolithiasis (hazard ratio = 6.7; 95% confidence interval = 1.8-25.2; P < 0.01) and was also associated with a higher rate of all serious adverse reactions but only when nephrolithiasis were included among those cases. Prospective and early indinavir Cres determination should be recommended in the patient's care management and dosage adjustments.
Published: 2007

31. Incidence of and risk factors for severe liver toxicity in HIV-infected patients on anti-tuberculosis treatment

Author: Pukenyte , E., Lescure , F. X., Rey , D., Rabaud , C., Hoen , B., Chavanet , P., Laiskonis , A. P., Schmit , J. L., May , T., Mouton , Y., Yazdanpanah , Y., Entente Interdépartementale pour la Démoustication, Région Rhône-Alpes, Service des maladies infectieuses et tropicales, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques, Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Lille - Economie et Management ( LEM ), and Université catholique de Lille ( UCL ) -Université de Lille-Centre National de la Recherche Scientifique ( CNRS )
Subjects: MESH : AIDS-Related Opportunistic Infections, MESH : Liver Function Tests, MESH : Retrospective Studies, MESH : Tuberculosis, Pulmonary, MESH : Male, MESH : Anti-HIV Agents, MESH : Humans, MESH : Adult, MESH : Antitubercular Agents, MESH : Proportional Hazards Models, MESH : Risk Factors, MESH : Incidence, [ SDV.MHEP.MI ] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, MESH : Drug-Induced Liver Injury, MESH : Regression Analysis, MESH : Female, MESH : Middle Aged, MESH : France
Abstract: International audience; OBJECTIVE: To assess the incidence and risk factors for severe liver toxicity in human immunodeficiency virus (HIV) infected patients on anti-tuberculosis treatment and the impact of patients' characteristics and concomitant medications instituted during the first week of antituberculosis treatment. METHODS: HIV-infected patients referred to six French hospitals between 1 January 1992 and 31 December 2004, with confirmed or 'presumptive' tuberculosis (TB). Liver toxicity was studied during the first 2 months of TB treatment. RESULTS: During the 12 years of the study period, 144 patients were enrolled. Severe liver toxicity developed in 15 (10.7%). The median time to development of liver toxicity was 14 days. In the univariate analysis, high baseline bilirubin levels (P = 0.004), CD4 cell counts between 50 and 100 cells/mm3 (P = 0.022) and the use of fluconazole (P = 0.0005) were associated with liver toxicity. In the multivariate analysis, independent risk factors were abnormal baseline alanine aminotransferase (ALT) (P = 0.028) and bilirubin levels (P = 0.033) and the use of fluconazole (P = 0.008). CONCLUSION: Severe liver toxicity is frequent, and occurs early in the course of anti-tuberculosis treatment. ALT and bilirubin levels should be closely monitored during the first month of treatment, especially in patients with high baseline ALT or bilirubin levels. We suggest caution when prescribing fluconazole and anti-tuberculosis drugs concomitantly, although this needs to be confirmed and further investigated.
Published: 2007

32. Incidence of and risk factors for severe liver toxicity in HIV-infected patients on anti-tuberculosis treatment

Author: Pukenyte , E., Lescure , F. X., Rey , D., Rabaud , C., Hoen , B., Chavanet , P., Laiskonis , A. P., Schmit , J. L., May , T., Mouton , Y., Yazdanpanah , Y., Entente Interdépartementale pour la Démoustication, Région Rhône-Alpes, Service des maladies infectieuses et tropicales, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques, Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Lille - Economie et Management ( LEM ), and Université catholique de Lille ( UCL ) -Université de Lille-Centre National de la Recherche Scientifique ( CNRS )
Subjects: MESH : AIDS-Related Opportunistic Infections, MESH : Liver Function Tests, MESH : Retrospective Studies, MESH : Tuberculosis, Pulmonary, MESH : Male, MESH : Anti-HIV Agents, MESH : Humans, MESH : Adult, MESH : Antitubercular Agents, MESH : Proportional Hazards Models, MESH : Risk Factors, MESH : Incidence, [ SDV.MHEP.MI ] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, MESH : Drug-Induced Liver Injury, MESH : Regression Analysis, MESH : Female, MESH : Middle Aged, MESH : France
Abstract: International audience; OBJECTIVE: To assess the incidence and risk factors for severe liver toxicity in human immunodeficiency virus (HIV) infected patients on anti-tuberculosis treatment and the impact of patients' characteristics and concomitant medications instituted during the first week of antituberculosis treatment. METHODS: HIV-infected patients referred to six French hospitals between 1 January 1992 and 31 December 2004, with confirmed or 'presumptive' tuberculosis (TB). Liver toxicity was studied during the first 2 months of TB treatment. RESULTS: During the 12 years of the study period, 144 patients were enrolled. Severe liver toxicity developed in 15 (10.7%). The median time to development of liver toxicity was 14 days. In the univariate analysis, high baseline bilirubin levels (P = 0.004), CD4 cell counts between 50 and 100 cells/mm3 (P = 0.022) and the use of fluconazole (P = 0.0005) were associated with liver toxicity. In the multivariate analysis, independent risk factors were abnormal baseline alanine aminotransferase (ALT) (P = 0.028) and bilirubin levels (P = 0.033) and the use of fluconazole (P = 0.008). CONCLUSION: Severe liver toxicity is frequent, and occurs early in the course of anti-tuberculosis treatment. ALT and bilirubin levels should be closely monitored during the first month of treatment, especially in patients with high baseline ALT or bilirubin levels. We suggest caution when prescribing fluconazole and anti-tuberculosis drugs concomitantly, although this needs to be confirmed and further investigated.
Published: 2007

33. Incidence of and risk factors for severe liver toxicity in HIV-infected patients on anti-tuberculosis treatment

Author: Pukenyte , E., Lescure , F. X., Rey , D., Rabaud , C., Hoen , B., Chavanet , P., Laiskonis , A. P., Schmit , J. L., May , T., Mouton , Y., Yazdanpanah , Y., Entente Interdépartementale pour la Démoustication, Région Rhône-Alpes, Service des maladies infectieuses et tropicales, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques, Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Lille - Economie et Management ( LEM ), and Université catholique de Lille ( UCL ) -Université de Lille-Centre National de la Recherche Scientifique ( CNRS )
Subjects: MESH : AIDS-Related Opportunistic Infections, MESH : Liver Function Tests, MESH : Retrospective Studies, MESH : Tuberculosis, Pulmonary, MESH : Male, MESH : Anti-HIV Agents, MESH : Humans, MESH : Adult, MESH : Antitubercular Agents, MESH : Proportional Hazards Models, MESH : Risk Factors, MESH : Incidence, [ SDV.MHEP.MI ] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, MESH : Drug-Induced Liver Injury, MESH : Regression Analysis, MESH : Female, MESH : Middle Aged, MESH : France
Abstract: International audience; OBJECTIVE: To assess the incidence and risk factors for severe liver toxicity in human immunodeficiency virus (HIV) infected patients on anti-tuberculosis treatment and the impact of patients' characteristics and concomitant medications instituted during the first week of antituberculosis treatment. METHODS: HIV-infected patients referred to six French hospitals between 1 January 1992 and 31 December 2004, with confirmed or 'presumptive' tuberculosis (TB). Liver toxicity was studied during the first 2 months of TB treatment. RESULTS: During the 12 years of the study period, 144 patients were enrolled. Severe liver toxicity developed in 15 (10.7%). The median time to development of liver toxicity was 14 days. In the univariate analysis, high baseline bilirubin levels (P = 0.004), CD4 cell counts between 50 and 100 cells/mm3 (P = 0.022) and the use of fluconazole (P = 0.0005) were associated with liver toxicity. In the multivariate analysis, independent risk factors were abnormal baseline alanine aminotransferase (ALT) (P = 0.028) and bilirubin levels (P = 0.033) and the use of fluconazole (P = 0.008). CONCLUSION: Severe liver toxicity is frequent, and occurs early in the course of anti-tuberculosis treatment. ALT and bilirubin levels should be closely monitored during the first month of treatment, especially in patients with high baseline ALT or bilirubin levels. We suggest caution when prescribing fluconazole and anti-tuberculosis drugs concomitantly, although this needs to be confirmed and further investigated.
Published: 2007

34. Role of immunosuppression and tumor differentiation in predicting recurrence after liver transplantation for hepatocellular carcinoma: a multicenter study of 412 patients

Author: Thomas Decaens, Françoise Roudot-Thoraval, Olivier Boillot, François Durand, Solange Bresson-Hadni, Yvon Calmus, Christian Ducerf, Daniel Cherqui, Christophe Duvoux, Pierre-Henri Bernard, Georges Philippe Pageaux, Philippe Compagnon, Sébastien Dharancy, Olivier Chazouillères, Carole Meyer, Jean Hardwigsen, Jean Gugenheim, Service de santé publique [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), WHO Collaborating Center on Prevention and Treatment of Human Echinococcosis, Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Service de Chirurgie Digestive / Centre de Transplantation Hépatique [CHU Nice], Centre Hospitalier Universitaire de Nice (CHU Nice), Laboratoire Adaptation et pathogénie des micro-organismes [Grenoble] (LAPM), Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), Service d'Hépato-Gastro-Entérologie, CHU Bordeaux [Bordeaux]-Hôpital Saint-André, Service de Chirurgie Digestive, Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Université de Lille, Droit et Santé, Hôpital Duriez, Service des Maladies de l'Appareil digestif et de la Nutrition, Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de Chirurgie Digestive et Transplantation Hépatique, Hôpital Archet II, Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Université de Franche-Comté ( UFC ), Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Laboratoire Adaptation et pathogénie des micro-organismes [Grenoble] ( LAPM ), Université Joseph Fourier - Grenoble 1 ( UJF ) -Centre National de la Recherche Scientifique ( CNRS ), CHU Cochin [AP-HP], Hôpital de la Conception [CHU - APHM] ( LA CONCEPTION ), Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), and Grenouillet, Frédéric
Subjects: Oncology, Pathology, MESH : Liver Neoplasms, medicine.medical_treatment, MESH : Analysis of Variance, Liver transplantation, MESH: Proportional Hazards Models, MESH: Cause of Death, 0302 clinical medicine, MESH: Liver Neoplasms, Cause of Death, MESH: Carcinoma, Hepatocellular, [ SDV.MP.MYC ] Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, [SDV.MP.MYC]Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, Cause of death, MESH : Neoplasm Recurrence, Local, Liver Neoplasms, Gastroenterology, MESH: Immunosuppression, Immunosuppression, General Medicine, MESH: Predictive Value of Tests, 3. Good health, surgical procedures, operative, 030220 oncology & carcinogenesis, Predictive value of tests, Hepatocellular carcinoma, MESH: Survival Analysis, MESH : Disease-Free Survival, 030211 gastroenterology & hepatology, MESH: Neoplasm Recurrence, Local, Rapid Communication, MESH : Carcinoma, Hepatocellular, medicine.medical_specialty, MESH: Liver Transplantation, Carcinoma, Hepatocellular, Disease-Free Survival, MESH: Multivariate Analysis, 03 medical and health sciences, Predictive Value of Tests, Internal medicine, MESH: Analysis of Variance, medicine, Carcinoma, Humans, MESH : Predictive Value of Tests, Survival analysis, Proportional Hazards Models, MESH : Cause of Death, Immunosuppression Therapy, Analysis of Variance, MESH: Humans, business.industry, Proportional hazards model, MESH : Humans, MESH : Multivariate Analysis, medicine.disease, MESH : Proportional Hazards Models, Survival Analysis, [SDV.MP.MYC] Life Sciences [q-bio]/Microbiology and Parasitology/Mycology, digestive system diseases, Liver Transplantation, Multivariate Analysis, MESH : Immunosuppression, MESH: Disease-Free Survival, Neoplasm Recurrence, Local, MESH : Survival Analysis, MESH : Liver Transplantation, business
Abstract: International audience; AIM: To assess pre-orthotopic liver transplantation (OLT) factors that could be evaluated pre-operatively or controlled post-operatively associated with hepatocellular carcinoma (HCC) recurrence and disease-free survival after liver transplantation (LT). METHODS: Four hundred and twelve patients transplanted for HCC between 1988 and 1998 in 14 French centers, who survived the postoperative period were studied. Kaplan Meier estimates were calculated for 24 variables potentially associated with recurrence of HCC. Uni- and multivariate analyses were conducted to identify independent predictors of recurrence. RESULTS: Overall 5-year disease-free survival was 57.1%. By univariate analysis, variables associated with disease-free survival were: presence of cirrhosis (P = 0.001), etiology of liver disease (P = 0.03), alpha fetoprotein level (< 200, 200 to 2000, or > 2000; P < 0.0001), gamma-GT activity (N, N to 2N or > 2N; P = 0.02), the number of nodules (1, 2-3 or > or = 4; P = 0.02), maximal diameter of the largest nodule (< 3 cm, 3 to 5 cm or > 5 cm; P < 0.0001), the sum of the diameter of the nodules (< 3 cm, 3 to 5 cm, 5 to 10 cm or > 10 cm; P < 0.0001), bi-lobar location (P = 0.01), preoperative portal thrombosis (P < 0.0001), peri-operative treatment of the tumor (P = 0.002) and chemoembolization (P = 0.03), tumor differentiation (P = 0.01), initial type of calcineurin inhibitor (P = 0.003), the use of antilymphocyte antibodies (P = 0.02), rejection episodes (P = 0.003) and period of LT (P < 0.0001). By multivariate analysis, 6 variables were independently associated with HCC recurrence: maximal diameter of the largest nodule (P < 0.0001), time of LT (P < 0.0001), tumor differentiation (P < 0.0001), use of anti-lymphocyte antibody (ATG) or anti-CD3 antibody (OKT3) (P = 0.005), preoperative portal thrombosis (P = 0.06) and the number of nodules (P = 0.06). CONCLUSION: This study identifies immunosuppression, through the use of ATG or OKT3, as a predictive factor of tumor recurrence, and confirms the prognostic value of tumor differentiation.
Published: 2006

35. Determinants of mortality for adults with cystic fibrosis admitted in Intensive Care Unit: a multicenter study

Author: Jean-Paul Mira, Dany Jamal, Joelle Texereau, Daniel Dusser, Pierre-Régis Burgel, Antoine Rabbat, Gerald Choukroun, Philippe Loirat, Jean-Luc Diehl, Dominique Hubert, Alexandre Duguet, Joël Coste, Antoine Parrot, Service de physiologie et explorations fonctionelles [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Cochin (UMR_S567 / UMR 8104), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de réanimation médicale polyvalente [CHU Cochin], Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de pneumologie [CHU Cochin], Service de réanimation médicale [CHU HEGP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-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)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Service de Pneumologie – Réanimation Médicale, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôtel-Dieu, Service de Réanimation Médicale, Hôpital Foch [Suresnes], Laboratoire d'Acoustique de l'Université du Mans (LAUM), Centre National de la Recherche Scientifique (CNRS)-Le Mans Université (UM), Service d'anesthésie et réanimation [CHU Tenon], Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Pneumologie – Réanimation Médicale [CHU Pitié-Salpêtrière], Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Service d'informatique médicale [CHU Cochin], Le Mans Université (UM)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Autard, Delphine, CHU Cochin [AP-HP]-Assistance publique - Hôpitaux de Paris (AP-HP), Institut Cochin ( UMR_S567 / UMR 8104 ), Université Paris Descartes - Paris 5 ( UPD5 ) -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)-CHU Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Européen Georges Pompidou [APHP] ( HEGP ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôtel-Dieu, Laboratoire d'acoustique de l'université du Mans ( LAUM ), Le Mans Université ( UM ) -Centre National de la Recherche Scientifique ( CNRS ), Service d'anesthésie et réanimation, Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Tenon [APHP], and Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP]
Subjects: Male, Exacerbation, Cystic Fibrosis, MESH: Risk Assessment, Cystic fibrosis, MESH : Intensive Care, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, law.invention, MESH: Proportional Hazards Models, 0302 clinical medicine, law, Risk Factors, MESH: Risk Factors, Outcome Assessment, Health Care, MESH : Female, 030212 general & internal medicine, MESH : Risk Assessment, MESH: Respiration, Artificial, MESH : Prognosis, MESH : Adult, MESH : Survival Rate, Prognosis, Intensive care unit, MESH : Risk Factors, 3. Good health, Survival Rate, Intensive Care Units, medicine.anatomical_structure, MESH: Survival Analysis, Female, France, MESH : Intensive Care Units, Pulmonary and Respiratory Medicine, Adult, medicine.medical_specialty, MESH : Outcome Assessment (Health Care), Critical Care, MESH: Cystic Fibrosis, MESH: Survival Rate, MESH : Male, Risk Assessment, MESH: Prognosis, 03 medical and health sciences, Intensive care, MESH : Cystic Fibrosis, medicine, Humans, MESH: Intensive Care, MESH : Respiration, Artificial, Intensive care medicine, MESH : France, Survival rate, MESH: Outcome Assessment (Health Care), Survival analysis, Proportional Hazards Models, lcsh:RC705-779, Lung, MESH: Humans, Proportional hazards model, business.industry, Research, MESH : Humans, MESH: Adult, lcsh:Diseases of the respiratory system, medicine.disease, MESH : Proportional Hazards Models, Respiration, Artificial, Survival Analysis, MESH: Male, MESH: France, 030228 respiratory system, Emergency medicine, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, MESH: Intensive Care Units, MESH : Survival Analysis, business, MESH: Female, [ SDV.MHEP.PSR ] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract
Abstract: Background Intensive care unit (ICU) admission of adults with cystic fibrosis (CF) is controversial because of poor outcome. This appraisal needs re-evaluation following recent changes in both CF management and ICU daily practice. Objectives were to determine long-term outcome of adults with CF admitted in ICU and to identify prognostic factors. Methods Retrospective multicenter study of 60 ICU hospitalizations for 42 adult CF patients admitted between 2000 and 2003. Reason for ICU admission, ventilatory support provided and one-year survival were recorded. Multiple logistic analysis was used to determine predictors of mortality. Results Prior to ICU admission, all patients (mean age 28.1 ± 8 yr) had a severe lung disease (mean FEV1 28 ± 12% predicted; mean PaCO2 47 ± 9 mmHg). Main reason for ICU hospitalization was pulmonary infective exacerbation (40/60). At admission, noninvasive ventilation was used in 57% of cases and was successful in 67% of patients. Endotracheal intubation was implemented in 19 episodes. Overall ICU mortality rate was 14%. One year after ICU discharge, 10 of the 28 survivors have been lung transplanted. Among recognized markers of CF disease severity, only the annual FEV1 loss was associated with a poor outcome (HR = 1.47 [1.18–1.85], p = 0.001). SAPSII (HR = 1.08 [1.03–1.12], p < 0.001) and endotracheal intubation (HR = 16.60 [4.35–63.34], p < 0.001) were identified as strong independent predictors of mortality. Conclusion Despite advanced lung disease, adult patients with CF admitted in ICU have high survival rate. Endotracheal intubation is associated with a poor prognosis and should be used as the last alternative. Although efforts have to be made in selecting patients with CF likely to benefit from ICU resources, ICU admission of these patients should be considered.
Published: 2006

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35 results on '"MESH : Proportional Hazards Models"'

1. Long-Term Clinical Outcomes According to Previous Manifestations of Atherosclerotic Disease (from the FAST-MI 2010 Registry)

2. Incremental predictive value of mean platelet volume/platelet count ratio in in-hospital stroke after acute myocardial infarction

3. The health and economic burden of bloodstream infections caused by antimicrobial-susceptible and non-susceptible Enterobacteriaceae and Staphylococcus aureus in European hospitals, 2010 and 2011: a multicentre retrospective cohort study

4. Cardiac rehabilitation and 5-year mortality after acute coronary syndromes: The 2005 French FAST-MI study

5. Incidence, Medical and Socio-Behavioural Predictors of Psychiatric Events in An 11-Year Follow-Up of HIV-Infected Patients on Antiretroviral Therapy

6. Therapeutic vaccination with TG4010 and first-line chemotherapy in advanced non-small-cell lung cancer: a controlled phase 2B trial

7. Early surgery for failure after chemoradiation in operable thoracic oesophageal cancer. Analysis of the non-randomised patients in FFCD 9102 phase III trial: Chemoradiation followed by surgery versus chemoradiation alone

8. Relationships between sex, early valve surgery and mortality in patients with left-sided infective endocarditis analysed in a population-based cohort study

9. Toward a NOTCH1/FBXW7/RAS/PTEN-based oncogenetic risk classification of adult T-cell acute lymphoblastic leukemia: a Group for Research in Adult Acute Lymphoblastic Leukemia study

10. In-hospital and 1-year mortality in patients undergoing early surgery for prosthetic valve endocarditis

11. Usefulness of a single-item measure of depression to predict mortality: the GAZEL prospective cohort study. : single-item of depression and mortality

12. Ten-year diabetes incidence in 1046 HIV-infected patients started on a combination antiretroviral treatment

13. Renal cell carcinoma (RCC) in patients with end-stage renal disease exhibits many favourable clinical, pathologic, and outcome features compared with RCC in the general population

14. Locally advanced unresectable pancreatic cancer: Induction chemoradiotherapy followed by maintenance gemcitabine versus gemcitabine alone: Definitive results of the 2000-2001 FFCD/SFRO phase III trial

15. Alteration of nutritional status at diagnosis is a prognostic factor for survival of amyotrophic lateral sclerosis patients

16. High levels of antibodies against merkel cell polyomavirus identify a subset of patients with merkel cell carcinoma with better clinical outcome

17. Analysis of an ordinal outcome in a multicentric randomized controlled trial: application to a 3-arm anti-malarial drug trial in Cameroon

18. Immuno-fluorescence in situ hybridization index predicts survival in patients with diffuse large B-cell lymphoma treated with R-CHOP: a GELA study

19. Lymphoproliferative disorders in patients receiving thiopurines for inflammatory bowel disease: a prospective observational cohort study

20. Duration of androgen suppression in the treatment of prostate cancer

21. The abdominoperineal resection itself is associated with an adverse outcome: the European experience based on a pooled analysis of five European randomised clinical trials on rectal cancer

22. Overall genomic pattern is a predictor of outcome in neuroblastoma

23. The expression of Twist has an impact on survival in human bladder cancer and is influenced by the smoking status

24. The performance of multiple imputation for missing covariate data within the context of regression relative survival analysis

25. Adjuvant therapy with pegylated interferon alfa-2b versus observation alone in resected stage III melanoma: final results of EORTC 18991, a randomised phase III trial

26. BAC array CGH distinguishes mutually exclusive alterations that define clinicogenetic subtypes of gliomas

27. Randomized clinical trial of post-operative radiotherapy versus concomitant carboplatin and radiotherapy for head and neck cancers with lymph node involvement

28. Identification of patients with prostate cancer who benefit from immediate postoperative radiotherapy: EORTC 22911

29. Phase III double-blind, placebo-controlled study of thalidomide in extensive-disease small-cell lung cancer after response to chemotherapy: an intergroup study FNCLCC cleo04 IFCT 00-01

30. Indinavir trough concentration as a determinant of early nephrolithiasis in HIV-1-infected adults

31. Incidence of and risk factors for severe liver toxicity in HIV-infected patients on anti-tuberculosis treatment

32. Incidence of and risk factors for severe liver toxicity in HIV-infected patients on anti-tuberculosis treatment

33. Incidence of and risk factors for severe liver toxicity in HIV-infected patients on anti-tuberculosis treatment

34. Role of immunosuppression and tumor differentiation in predicting recurrence after liver transplantation for hepatocellular carcinoma: a multicenter study of 412 patients

35. Determinants of mortality for adults with cystic fibrosis admitted in Intensive Care Unit: a multicenter study

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35 results on '"MESH : Proportional Hazards Models"'

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