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Blay JY, Penel N, Valentin T, Anract P, Duffaud F, Dufresne A, Verret B, Cordoba A, Italiano A, Brahmi M, Henon C, Amouyel T, Ray-Coquard I, Ferron G, Boudou-Rouquette P, Tlemsani C, Salas S, Rochwerger R, Faron M, Bompas E, Ducassou A, Gangloff D, Gouin F, Firmin N, Piperno-Neumann S, Rios M, Ropars M, Kurtz JE, Le Nail LR, Bertucci F, Carrere S, Llacer C, Watson S, Bonvalot S, Leroux A, Perrin C, Gantzer J, Pracht M, Narciso B, Monneur A, Lebbe C, Hervieu A, Saada-Bouzid E, Dubray-Longeras P, Fiorenza F, Chaigneau L, Nevieres ZM, Soibinet P, Bouché O, Guillemet C, Spano JP, Ruzic JC, Isambert N, Vaz G, Meeus P, Karanian M, Ngo C, Coindre JM, De Pinieux G, Le Loarer F, Ducimetiere F, Chemin C, Morelle M, Toulmonde M, Le Cesne A. Improved nationwide survival of sarcoma patients with a network of reference centers. Ann Oncol 2024; 35:351-363. [PMID: 38246351 DOI: 10.1016/j.annonc.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 01/03/2024] [Accepted: 01/04/2024] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND We investigated the impact of the implementation of a network of reference centers for sarcomas (NETSARC) on the care and survival of sarcoma patients in France since 2010. PATIENTS AND METHODS NETSARC (netsarc.org) is a network of 26 reference sarcoma centers with specialized multidisciplinary tumor boards (MDTBs), funded by the French National Cancer Institute (INCa) since 2010. Its aims are to improve the quality of diagnosis and care of sarcoma patients. Patients' characteristics, treatments, and outcomes are collected in a nationwide database. The objective of this analysis was to compare the survival of patients in three periods: 2010-2012 (non-exhaustive), 2013-2015, and 2016-2020. RESULTS A total of 43 975 patients with sarcomas, gastrointestinal stromal tumors (GISTs), or connective tissue tumors of intermediate malignancy were included in the NETSARC+ database since 2010 (n = 9266 before 2013, n = 12 274 between 2013 and 2015, n = 22 435 in 2016-2020). Median age was 56 years, 50.5% were women, and 13.2% had metastasis at diagnosis. Overall survival was significantly superior in the period 2016-2020 versus 2013-2015 versus 2010-2012 for the entire population, for patients >18 years of age, and for both metastatic and non-metastatic patients in univariate and multivariate analyses (P < 0.0001). Over the three periods, we observed a significantly improved compliance to clinical practice guidelines (CPGs) nationwide: the proportion of patients biopsied before surgery increased from 62.9% to 72.6%; the percentage of patients presented to NETSARC MDTBs before first surgery increased from 31.7% to 44.4% (P < 0.0001). The proportion of patients with R0 resection on first surgery increased (from 36.1% to 46.6%), while R2 resection rate decreased (from 10.9% to 7.9%), with a better compliance and improvement in NETSARC centers. CONCLUSIONS The implementation of the national reference network for sarcoma was associated with an improvement of overall survival and compliance to guidelines nationwide in sarcoma patients. Referral to expert networks for sarcoma patients should be encouraged, though a better compliance to CPGs can still be achieved.
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Affiliation(s)
- J Y Blay
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon.
| | - N Penel
- Department of Medical Oncology, Centre Oscar Lambret, Lille
| | - T Valentin
- Department of Medical Oncology, Institut Claudius Regaud & IUCT Oncopole Toulouse, Toulouse
| | - P Anract
- Department of Orthopedics, Hôpital Cochin Saint Vincent de Paul, Paris
| | - F Duffaud
- Department of Medical Oncology, La Timone University Hospital, Marseille
| | - A Dufresne
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - B Verret
- Department of Medicine, Gustave Roussy Cancer Campus, Villejuif; Department of Surgery, Gustave Roussy Cancer Campus, Villejuif
| | - A Cordoba
- Department of Medical Oncology, Centre Oscar Lambret, Lille
| | - A Italiano
- Department of Medical Oncology, Institut Bergonié, Bordeaux; Department of Surgical Oncology, Institut Bergonié, Bordeaux
| | - M Brahmi
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - C Henon
- Department of Medicine, Gustave Roussy Cancer Campus, Villejuif; Department of Surgery, Gustave Roussy Cancer Campus, Villejuif
| | - T Amouyel
- Department of Medical Oncology, Centre Oscar Lambret, Lille
| | - I Ray-Coquard
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - G Ferron
- Department of Medical Oncology, Institut Claudius Regaud & IUCT Oncopole Toulouse, Toulouse
| | | | - C Tlemsani
- Department of Orthopedics, Hôpital Cochin Saint Vincent de Paul, Paris
| | - S Salas
- Department of Medical Oncology, La Timone University Hospital, Marseille
| | - R Rochwerger
- Department of Medical Oncology, La Timone University Hospital, Marseille
| | - M Faron
- Department of Medicine, Gustave Roussy Cancer Campus, Villejuif; Department of Surgery, Gustave Roussy Cancer Campus, Villejuif
| | - E Bompas
- Department of Medical Oncology, Cochin Hospital, Paris; Department of Medical Oncology, Centre René Gauducheau, Nantes St. Herblain
| | - A Ducassou
- Department of Medical Oncology, Institut Claudius Regaud & IUCT Oncopole Toulouse, Toulouse
| | - D Gangloff
- Department of Medical Oncology, Institut Claudius Regaud & IUCT Oncopole Toulouse, Toulouse
| | - F Gouin
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Service Orthopedie, CHU Nantes, Nantes
| | - N Firmin
- Department of Medical & Surgical & Radiotherapy Oncology ICM, Montpellier
| | - S Piperno-Neumann
- INSERM U1194, IRCM, Univ Montpellier, Montpellier; Department of Medical Oncology, Institut Curie, Paris; Department of Surgical Oncology, Institut Curie, Paris
| | - M Rios
- Department of Medical Oncology, Centre Alexis Vautrin, Vandoeuvre-lès-Nancy
| | - M Ropars
- Department of Orthopedics, CHU Rennes, Rennes
| | | | | | - F Bertucci
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille
| | - S Carrere
- Service Orthopedie, CHU Nantes, Nantes
| | - C Llacer
- Service Orthopedie, CHU Nantes, Nantes
| | - S Watson
- Department of Medical & Surgical & Radiotherapy Oncology ICM, Montpellier
| | - S Bonvalot
- Department of Medical & Surgical & Radiotherapy Oncology ICM, Montpellier
| | - A Leroux
- INSERM U1194, IRCM, Univ Montpellier, Montpellier
| | - C Perrin
- Department of Medical Oncology, Eugene Marquis Comprehensive Cancer Center, Rennes
| | - J Gantzer
- Department of Medical Oncology, Centre Alexis Vautrin, Vandoeuvre-lès-Nancy
| | - M Pracht
- Department of Medical Oncology, Eugene Marquis Comprehensive Cancer Center, Rennes
| | - B Narciso
- Department of Orthopedic Surgery, Tours
| | - A Monneur
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille
| | - C Lebbe
- Department of Dermatology, INSERM U976 University Paris Diderot Saint Louis Hospital, Paris; Department of CIC, INSERM U976 University Paris Diderot Saint Louis Hospital, Paris
| | - A Hervieu
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon
| | - E Saada-Bouzid
- Department of Medical Oncology, Centre Antoine-Lacassagne, Nice
| | - P Dubray-Longeras
- Department of Medical Oncology, Centre Jean Perrin, Clermont-Ferrand
| | - F Fiorenza
- Department of Orthopedic Surgery, CHU Limoges, Limoges
| | - L Chaigneau
- Department of Medicine, CHU Besancon, Besancon
| | | | - P Soibinet
- Department of Medicine, Centre Francois Baclesse, Caen
| | - O Bouché
- Department of Gastroenterology, CHU Reims, Reims
| | - C Guillemet
- Department of Medical Oncology, Centre J Godinot Reims, Reims
| | - J P Spano
- Department of Oncology, Hôpital Pitié-Salpétriere, Paris
| | - J C Ruzic
- Departement d'oncologie, CHU, La Reunion
| | - N Isambert
- Service d'oncologie, CHU Poitiers, Poitiers, France
| | - G Vaz
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - P Meeus
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - M Karanian
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - C Ngo
- Department of Medicine, Gustave Roussy Cancer Campus, Villejuif; Department of Surgery, Gustave Roussy Cancer Campus, Villejuif
| | - J M Coindre
- Department of Medical Oncology, Institut Bergonié, Bordeaux; Department of Surgical Oncology, Institut Bergonié, Bordeaux
| | | | - F Le Loarer
- Department of Medical Oncology, Institut Bergonié, Bordeaux; Department of Surgical Oncology, Institut Bergonié, Bordeaux
| | - F Ducimetiere
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - C Chemin
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - M Morelle
- Department of Medical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon; Department of Surgical Oncology, Centre Léon Bérard & Université Claude Bernard, Lyon
| | - M Toulmonde
- Department of Medical Oncology, Institut Bergonié, Bordeaux; Department of Surgical Oncology, Institut Bergonié, Bordeaux
| | - A Le Cesne
- Department of Medicine, Gustave Roussy Cancer Campus, Villejuif; Department of Surgery, Gustave Roussy Cancer Campus, Villejuif
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Monneur A, Bertucci F, Lardy-Cleaud A, Augereau P, Debled M, Levy C, Mouret-Reynier MA, Coudert B, Mailliez A, Bachelot T, Ferrero JM, Guiu S, Uwer L, Campone M, Cottu P, Jouannaud C, De la Motte Rouge T, Leheurteur M, Petit T, Pistilli B, Dalenc F, Simon G, Robain M, Viens P, Lerebours F, Gonçalves A. Abstract P5-17-04: Metastatic inflammatory breast cancer: Clinical features and outcomes in the national, multicentric, real-life ESME cohort. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p5-17-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:Primary inflammatory breast cancer (IBC) is a rare and aggressive form of breast cancer. Survival of IBC patients has been improved by multimodal therapy. However 5-year overall survival (OS) still remains close to 50-60%, due to high risk of disseminated disease. Given the low incidence, prognosis of metastatic cases stages is poorly described.
Methods:This study aimed to describe OS of IBC (T4d AJCC TNM classification) with upfront or recurrent metastatic disease compared with non-IBC patients in the ESME database (N=16,702 patients). OS was calculated from the diagnosis of metastasis to the date of death (from any cause), or censored to date of latest news. Secondary objectives included progression-free survival (PFS).
Results:From 2008 to 2014, 7,465 patients with diagnosis of MBC and known clinical status of their primary tumor (T) were identified, including 582 IBC (T4d) and 6,883 non-IBC. As expected, metastatic IBC was associated with pejorative features compared to non-IBC, with less hormonal receptors-positive tumors (44% vs 65.6%), more HER2-positive (30% vs 18.6%) or triple-negative (25.9% vs 15.8%) cases (p<0.001), more frequent upfront M1 stage (53.3% vs 27.7%; p<0.001), and shorter median disease-free interval (2.02 years vs. 4.9 years; p<0.001). With a median follow-up of 50.2 months (0-104), median OS was 28.4 [95%CI 24-33.8] versus 37.2 months [95%CI 36.1-38.5] in metastatic IBC and non-IBC cases respectively (p<0.0001, log-rank test). By multivariate Cox model with adjustment for major prognostic factors [including age, disease-free interval, type of relapse, visceral metastases, molecular subtype, grade], OS was significantly shorter in the metastatic IBC group compared with non-IBC group (HR 1.25 [95%CI 1.1-1.4], p=0.0002). Of note, survival of metastatic IBC patients improved over the last years: median OS 24 months [95%CI 20-31.9], 29 months [95%CI 21.7-39.9] and 36 months [95%CI 27.9-NE] if diagnosed before 2011, between 2011 and 2012, or after 2012 respectively (p=0.003). Such improvement was not observed in non-IBC patients. IBC was associated with shorter median PFS under first line systemic treatment compared with non-IBC (7.2 months [95%CI 6.6-8.3] vs 9.5 months [95%CI 9.1-9.8] respectively, p=0.0136). This was maintained in a multivariate Cox model adjusting for same factors as for OS (HR 1.15 [95%CI 1-1.3], p=0.0050).
Compared with non-IBC, synchronous metastatic IBC showed worse median OS and PFS (39.9 months [95%CI 34.2-45.3] vs 48.4 months [95%CI 46.3-50.8], p=0.0035; 10 months [95%CI 8.8-12.7] vs 14.5 months [95%CI 13.6-15.7], p=0.0027, respectively. Similar results were obtained in metachronous metastatic cases (20.01 months [95%CI 17.1-21.2] vs 32.8 months [95%CI 31.5-34.3], p<0.0001; 5.1 months [95%CI 4.1-6] vs 7.9 months [95%CI 7.6-8.3], p<0.0001, respectively).
Conclusion:In this large national and multicentric study, IBC is a major and independent factor associated with adverse outcome in metastatic setting. Of note, the independent adverse impact on PFS identified in this study may suggest a lower sensitivity of metastatic IBC to available therapeutics. However, results seem to improve in the last years. Detailed analysis according to phenotype will be available.
Citation Format: Monneur A, Bertucci F, Lardy-Cleaud A, Augereau P, Debled M, Levy C, Mouret-Reynier MA, Coudert B, Mailliez A, Bachelot T, Ferrero J-M, Guiu S, Uwer L, Campone M, Cottu P, Jouannaud C, De la Motte Rouge T, Leheurteur M, Petit T, Pistilli B, Dalenc F, Simon G, Robain M, Viens P, Lerebours F, Gonçalves A. Metastatic inflammatory breast cancer: Clinical features and outcomes in the national, multicentric, real-life ESME cohort [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-17-04.
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Affiliation(s)
- A Monneur
- Institut Paoli-Calmettes, Marseille, France; Centre Léon Bérard - Biometrics Unit, Lyon, France; Institut de Cancérologie de l'Ouest, Angers, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Georges François Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Léon Bérard, Lyon, France; Centre Antoine Lacassagne, Nice, France; Institut du Cancer de Montpellier, Montpellier, France; Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France; Institut de Cancérologie de l'Ouest, Nantes St-Herblain, France; Institut Curie, Paris & Saint-Cloud, France; Institut de Cancérologie Jean-Godinot, Reims, France; Centre Eugéne Marquis, Rennes, France; Centre Henri Becquerel, Rouen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; Institut Claudius Regaud – IUCT Oncopole, Toulouse, France; Unicancer, Paris, France
| | - F Bertucci
- Institut Paoli-Calmettes, Marseille, France; Centre Léon Bérard - Biometrics Unit, Lyon, France; Institut de Cancérologie de l'Ouest, Angers, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Georges François Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Léon Bérard, Lyon, France; Centre Antoine Lacassagne, Nice, France; Institut du Cancer de Montpellier, Montpellier, France; Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France; Institut de Cancérologie de l'Ouest, Nantes St-Herblain, France; Institut Curie, Paris & Saint-Cloud, France; Institut de Cancérologie Jean-Godinot, Reims, France; Centre Eugéne Marquis, Rennes, France; Centre Henri Becquerel, Rouen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; Institut Claudius Regaud – IUCT Oncopole, Toulouse, France; Unicancer, Paris, France
| | - A Lardy-Cleaud
- Institut Paoli-Calmettes, Marseille, France; Centre Léon Bérard - Biometrics Unit, Lyon, France; Institut de Cancérologie de l'Ouest, Angers, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Georges François Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Léon Bérard, Lyon, France; Centre Antoine Lacassagne, Nice, France; Institut du Cancer de Montpellier, Montpellier, France; Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France; Institut de Cancérologie de l'Ouest, Nantes St-Herblain, France; Institut Curie, Paris & Saint-Cloud, France; Institut de Cancérologie Jean-Godinot, Reims, France; Centre Eugéne Marquis, Rennes, France; Centre Henri Becquerel, Rouen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; Institut Claudius Regaud – IUCT Oncopole, Toulouse, France; Unicancer, Paris, France
| | - P Augereau
- Institut Paoli-Calmettes, Marseille, France; Centre Léon Bérard - Biometrics Unit, Lyon, France; Institut de Cancérologie de l'Ouest, Angers, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Georges François Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Léon Bérard, Lyon, France; Centre Antoine Lacassagne, Nice, France; Institut du Cancer de Montpellier, Montpellier, France; Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France; Institut de Cancérologie de l'Ouest, Nantes St-Herblain, France; Institut Curie, Paris & Saint-Cloud, France; Institut de Cancérologie Jean-Godinot, Reims, France; Centre Eugéne Marquis, Rennes, France; Centre Henri Becquerel, Rouen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; Institut Claudius Regaud – IUCT Oncopole, Toulouse, France; Unicancer, Paris, France
| | - M Debled
- Institut Paoli-Calmettes, Marseille, France; Centre Léon Bérard - Biometrics Unit, Lyon, France; Institut de Cancérologie de l'Ouest, Angers, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Georges François Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Léon Bérard, Lyon, France; Centre Antoine Lacassagne, Nice, France; Institut du Cancer de Montpellier, Montpellier, France; Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France; Institut de Cancérologie de l'Ouest, Nantes St-Herblain, France; Institut Curie, Paris & Saint-Cloud, France; Institut de Cancérologie Jean-Godinot, Reims, France; Centre Eugéne Marquis, Rennes, France; Centre Henri Becquerel, Rouen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; Institut Claudius Regaud – IUCT Oncopole, Toulouse, France; Unicancer, Paris, France
| | - C Levy
- Institut Paoli-Calmettes, Marseille, France; Centre Léon Bérard - Biometrics Unit, Lyon, France; Institut de Cancérologie de l'Ouest, Angers, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Georges François Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Léon Bérard, Lyon, France; Centre Antoine Lacassagne, Nice, France; Institut du Cancer de Montpellier, Montpellier, France; Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France; Institut de Cancérologie de l'Ouest, Nantes St-Herblain, France; Institut Curie, Paris & Saint-Cloud, France; Institut de Cancérologie Jean-Godinot, Reims, France; Centre Eugéne Marquis, Rennes, France; Centre Henri Becquerel, Rouen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; Institut Claudius Regaud – IUCT Oncopole, Toulouse, France; Unicancer, Paris, France
| | - MA Mouret-Reynier
- Institut Paoli-Calmettes, Marseille, France; Centre Léon Bérard - Biometrics Unit, Lyon, France; Institut de Cancérologie de l'Ouest, Angers, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Georges François Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Léon Bérard, Lyon, France; Centre Antoine Lacassagne, Nice, France; Institut du Cancer de Montpellier, Montpellier, France; Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France; Institut de Cancérologie de l'Ouest, Nantes St-Herblain, France; Institut Curie, Paris & Saint-Cloud, France; Institut de Cancérologie Jean-Godinot, Reims, France; Centre Eugéne Marquis, Rennes, France; Centre Henri Becquerel, Rouen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; Institut Claudius Regaud – IUCT Oncopole, Toulouse, France; Unicancer, Paris, France
| | - B Coudert
- Institut Paoli-Calmettes, Marseille, France; Centre Léon Bérard - Biometrics Unit, Lyon, France; Institut de Cancérologie de l'Ouest, Angers, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Georges François Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Léon Bérard, Lyon, France; Centre Antoine Lacassagne, Nice, France; Institut du Cancer de Montpellier, Montpellier, France; Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France; Institut de Cancérologie de l'Ouest, Nantes St-Herblain, France; Institut Curie, Paris & Saint-Cloud, France; Institut de Cancérologie Jean-Godinot, Reims, France; Centre Eugéne Marquis, Rennes, France; Centre Henri Becquerel, Rouen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; Institut Claudius Regaud – IUCT Oncopole, Toulouse, France; Unicancer, Paris, France
| | - A Mailliez
- Institut Paoli-Calmettes, Marseille, France; Centre Léon Bérard - Biometrics Unit, Lyon, France; Institut de Cancérologie de l'Ouest, Angers, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Georges François Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Léon Bérard, Lyon, France; Centre Antoine Lacassagne, Nice, France; Institut du Cancer de Montpellier, Montpellier, France; Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France; Institut de Cancérologie de l'Ouest, Nantes St-Herblain, France; Institut Curie, Paris & Saint-Cloud, France; Institut de Cancérologie Jean-Godinot, Reims, France; Centre Eugéne Marquis, Rennes, France; Centre Henri Becquerel, Rouen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; Institut Claudius Regaud – IUCT Oncopole, Toulouse, France; Unicancer, Paris, France
| | - T Bachelot
- Institut Paoli-Calmettes, Marseille, France; Centre Léon Bérard - Biometrics Unit, Lyon, France; Institut de Cancérologie de l'Ouest, Angers, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Georges François Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Léon Bérard, Lyon, France; Centre Antoine Lacassagne, Nice, France; Institut du Cancer de Montpellier, Montpellier, France; Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France; Institut de Cancérologie de l'Ouest, Nantes St-Herblain, France; Institut Curie, Paris & Saint-Cloud, France; Institut de Cancérologie Jean-Godinot, Reims, France; Centre Eugéne Marquis, Rennes, France; Centre Henri Becquerel, Rouen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; Institut Claudius Regaud – IUCT Oncopole, Toulouse, France; Unicancer, Paris, France
| | - J-M Ferrero
- Institut Paoli-Calmettes, Marseille, France; Centre Léon Bérard - Biometrics Unit, Lyon, France; Institut de Cancérologie de l'Ouest, Angers, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Georges François Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Léon Bérard, Lyon, France; Centre Antoine Lacassagne, Nice, France; Institut du Cancer de Montpellier, Montpellier, France; Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France; Institut de Cancérologie de l'Ouest, Nantes St-Herblain, France; Institut Curie, Paris & Saint-Cloud, France; Institut de Cancérologie Jean-Godinot, Reims, France; Centre Eugéne Marquis, Rennes, France; Centre Henri Becquerel, Rouen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; Institut Claudius Regaud – IUCT Oncopole, Toulouse, France; Unicancer, Paris, France
| | - S Guiu
- Institut Paoli-Calmettes, Marseille, France; Centre Léon Bérard - Biometrics Unit, Lyon, France; Institut de Cancérologie de l'Ouest, Angers, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Georges François Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Léon Bérard, Lyon, France; Centre Antoine Lacassagne, Nice, France; Institut du Cancer de Montpellier, Montpellier, France; Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France; Institut de Cancérologie de l'Ouest, Nantes St-Herblain, France; Institut Curie, Paris & Saint-Cloud, France; Institut de Cancérologie Jean-Godinot, Reims, France; Centre Eugéne Marquis, Rennes, France; Centre Henri Becquerel, Rouen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; Institut Claudius Regaud – IUCT Oncopole, Toulouse, France; Unicancer, Paris, France
| | - L Uwer
- Institut Paoli-Calmettes, Marseille, France; Centre Léon Bérard - Biometrics Unit, Lyon, France; Institut de Cancérologie de l'Ouest, Angers, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Georges François Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Léon Bérard, Lyon, France; Centre Antoine Lacassagne, Nice, France; Institut du Cancer de Montpellier, Montpellier, France; Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France; Institut de Cancérologie de l'Ouest, Nantes St-Herblain, France; Institut Curie, Paris & Saint-Cloud, France; Institut de Cancérologie Jean-Godinot, Reims, France; Centre Eugéne Marquis, Rennes, France; Centre Henri Becquerel, Rouen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; Institut Claudius Regaud – IUCT Oncopole, Toulouse, France; Unicancer, Paris, France
| | - M Campone
- Institut Paoli-Calmettes, Marseille, France; Centre Léon Bérard - Biometrics Unit, Lyon, France; Institut de Cancérologie de l'Ouest, Angers, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Georges François Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Léon Bérard, Lyon, France; Centre Antoine Lacassagne, Nice, France; Institut du Cancer de Montpellier, Montpellier, France; Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France; Institut de Cancérologie de l'Ouest, Nantes St-Herblain, France; Institut Curie, Paris & Saint-Cloud, France; Institut de Cancérologie Jean-Godinot, Reims, France; Centre Eugéne Marquis, Rennes, France; Centre Henri Becquerel, Rouen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; Institut Claudius Regaud – IUCT Oncopole, Toulouse, France; Unicancer, Paris, France
| | - P Cottu
- Institut Paoli-Calmettes, Marseille, France; Centre Léon Bérard - Biometrics Unit, Lyon, France; Institut de Cancérologie de l'Ouest, Angers, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Georges François Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Léon Bérard, Lyon, France; Centre Antoine Lacassagne, Nice, France; Institut du Cancer de Montpellier, Montpellier, France; Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France; Institut de Cancérologie de l'Ouest, Nantes St-Herblain, France; Institut Curie, Paris & Saint-Cloud, France; Institut de Cancérologie Jean-Godinot, Reims, France; Centre Eugéne Marquis, Rennes, France; Centre Henri Becquerel, Rouen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; Institut Claudius Regaud – IUCT Oncopole, Toulouse, France; Unicancer, Paris, France
| | - C Jouannaud
- Institut Paoli-Calmettes, Marseille, France; Centre Léon Bérard - Biometrics Unit, Lyon, France; Institut de Cancérologie de l'Ouest, Angers, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Georges François Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Léon Bérard, Lyon, France; Centre Antoine Lacassagne, Nice, France; Institut du Cancer de Montpellier, Montpellier, France; Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France; Institut de Cancérologie de l'Ouest, Nantes St-Herblain, France; Institut Curie, Paris & Saint-Cloud, France; Institut de Cancérologie Jean-Godinot, Reims, France; Centre Eugéne Marquis, Rennes, France; Centre Henri Becquerel, Rouen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; Institut Claudius Regaud – IUCT Oncopole, Toulouse, France; Unicancer, Paris, France
| | - T De la Motte Rouge
- Institut Paoli-Calmettes, Marseille, France; Centre Léon Bérard - Biometrics Unit, Lyon, France; Institut de Cancérologie de l'Ouest, Angers, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Georges François Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Léon Bérard, Lyon, France; Centre Antoine Lacassagne, Nice, France; Institut du Cancer de Montpellier, Montpellier, France; Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France; Institut de Cancérologie de l'Ouest, Nantes St-Herblain, France; Institut Curie, Paris & Saint-Cloud, France; Institut de Cancérologie Jean-Godinot, Reims, France; Centre Eugéne Marquis, Rennes, France; Centre Henri Becquerel, Rouen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; Institut Claudius Regaud – IUCT Oncopole, Toulouse, France; Unicancer, Paris, France
| | - M Leheurteur
- Institut Paoli-Calmettes, Marseille, France; Centre Léon Bérard - Biometrics Unit, Lyon, France; Institut de Cancérologie de l'Ouest, Angers, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Georges François Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Léon Bérard, Lyon, France; Centre Antoine Lacassagne, Nice, France; Institut du Cancer de Montpellier, Montpellier, France; Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France; Institut de Cancérologie de l'Ouest, Nantes St-Herblain, France; Institut Curie, Paris & Saint-Cloud, France; Institut de Cancérologie Jean-Godinot, Reims, France; Centre Eugéne Marquis, Rennes, France; Centre Henri Becquerel, Rouen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; Institut Claudius Regaud – IUCT Oncopole, Toulouse, France; Unicancer, Paris, France
| | - T Petit
- Institut Paoli-Calmettes, Marseille, France; Centre Léon Bérard - Biometrics Unit, Lyon, France; Institut de Cancérologie de l'Ouest, Angers, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Georges François Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Léon Bérard, Lyon, France; Centre Antoine Lacassagne, Nice, France; Institut du Cancer de Montpellier, Montpellier, France; Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France; Institut de Cancérologie de l'Ouest, Nantes St-Herblain, France; Institut Curie, Paris & Saint-Cloud, France; Institut de Cancérologie Jean-Godinot, Reims, France; Centre Eugéne Marquis, Rennes, France; Centre Henri Becquerel, Rouen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; Institut Claudius Regaud – IUCT Oncopole, Toulouse, France; Unicancer, Paris, France
| | - B Pistilli
- Institut Paoli-Calmettes, Marseille, France; Centre Léon Bérard - Biometrics Unit, Lyon, France; Institut de Cancérologie de l'Ouest, Angers, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Georges François Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Léon Bérard, Lyon, France; Centre Antoine Lacassagne, Nice, France; Institut du Cancer de Montpellier, Montpellier, France; Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France; Institut de Cancérologie de l'Ouest, Nantes St-Herblain, France; Institut Curie, Paris & Saint-Cloud, France; Institut de Cancérologie Jean-Godinot, Reims, France; Centre Eugéne Marquis, Rennes, France; Centre Henri Becquerel, Rouen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; Institut Claudius Regaud – IUCT Oncopole, Toulouse, France; Unicancer, Paris, France
| | - F Dalenc
- Institut Paoli-Calmettes, Marseille, France; Centre Léon Bérard - Biometrics Unit, Lyon, France; Institut de Cancérologie de l'Ouest, Angers, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Georges François Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Léon Bérard, Lyon, France; Centre Antoine Lacassagne, Nice, France; Institut du Cancer de Montpellier, Montpellier, France; Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France; Institut de Cancérologie de l'Ouest, Nantes St-Herblain, France; Institut Curie, Paris & Saint-Cloud, France; Institut de Cancérologie Jean-Godinot, Reims, France; Centre Eugéne Marquis, Rennes, France; Centre Henri Becquerel, Rouen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; Institut Claudius Regaud – IUCT Oncopole, Toulouse, France; Unicancer, Paris, France
| | - G Simon
- Institut Paoli-Calmettes, Marseille, France; Centre Léon Bérard - Biometrics Unit, Lyon, France; Institut de Cancérologie de l'Ouest, Angers, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Georges François Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Léon Bérard, Lyon, France; Centre Antoine Lacassagne, Nice, France; Institut du Cancer de Montpellier, Montpellier, France; Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France; Institut de Cancérologie de l'Ouest, Nantes St-Herblain, France; Institut Curie, Paris & Saint-Cloud, France; Institut de Cancérologie Jean-Godinot, Reims, France; Centre Eugéne Marquis, Rennes, France; Centre Henri Becquerel, Rouen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; Institut Claudius Regaud – IUCT Oncopole, Toulouse, France; Unicancer, Paris, France
| | - M Robain
- Institut Paoli-Calmettes, Marseille, France; Centre Léon Bérard - Biometrics Unit, Lyon, France; Institut de Cancérologie de l'Ouest, Angers, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Georges François Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Léon Bérard, Lyon, France; Centre Antoine Lacassagne, Nice, France; Institut du Cancer de Montpellier, Montpellier, France; Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France; Institut de Cancérologie de l'Ouest, Nantes St-Herblain, France; Institut Curie, Paris & Saint-Cloud, France; Institut de Cancérologie Jean-Godinot, Reims, France; Centre Eugéne Marquis, Rennes, France; Centre Henri Becquerel, Rouen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; Institut Claudius Regaud – IUCT Oncopole, Toulouse, France; Unicancer, Paris, France
| | - P Viens
- Institut Paoli-Calmettes, Marseille, France; Centre Léon Bérard - Biometrics Unit, Lyon, France; Institut de Cancérologie de l'Ouest, Angers, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Georges François Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Léon Bérard, Lyon, France; Centre Antoine Lacassagne, Nice, France; Institut du Cancer de Montpellier, Montpellier, France; Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France; Institut de Cancérologie de l'Ouest, Nantes St-Herblain, France; Institut Curie, Paris & Saint-Cloud, France; Institut de Cancérologie Jean-Godinot, Reims, France; Centre Eugéne Marquis, Rennes, France; Centre Henri Becquerel, Rouen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; Institut Claudius Regaud – IUCT Oncopole, Toulouse, France; Unicancer, Paris, France
| | - F Lerebours
- Institut Paoli-Calmettes, Marseille, France; Centre Léon Bérard - Biometrics Unit, Lyon, France; Institut de Cancérologie de l'Ouest, Angers, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Georges François Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Léon Bérard, Lyon, France; Centre Antoine Lacassagne, Nice, France; Institut du Cancer de Montpellier, Montpellier, France; Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France; Institut de Cancérologie de l'Ouest, Nantes St-Herblain, France; Institut Curie, Paris & Saint-Cloud, France; Institut de Cancérologie Jean-Godinot, Reims, France; Centre Eugéne Marquis, Rennes, France; Centre Henri Becquerel, Rouen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; Institut Claudius Regaud – IUCT Oncopole, Toulouse, France; Unicancer, Paris, France
| | - A Gonçalves
- Institut Paoli-Calmettes, Marseille, France; Centre Léon Bérard - Biometrics Unit, Lyon, France; Institut de Cancérologie de l'Ouest, Angers, France; Institut Bergonié, Bordeaux, France; Centre François Baclesse, Caen, France; Centre Jean Perrin, Clermont Ferrand, France; Centre Georges François Leclerc, Dijon, France; Centre Oscar Lambret, Lille, France; Centre Léon Bérard, Lyon, France; Centre Antoine Lacassagne, Nice, France; Institut du Cancer de Montpellier, Montpellier, France; Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France; Institut de Cancérologie de l'Ouest, Nantes St-Herblain, France; Institut Curie, Paris & Saint-Cloud, France; Institut de Cancérologie Jean-Godinot, Reims, France; Centre Eugéne Marquis, Rennes, France; Centre Henri Becquerel, Rouen, France; Centre Paul Strauss, Strasbourg, France; Institut Gustave Roussy, Villejuif, France; Institut Claudius Regaud – IUCT Oncopole, Toulouse, France; Unicancer, Paris, France
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