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Dubray-Vautrin A, Chappey C, Taouachi R, Ghanem W, Choussy O. Upper Aerodigestive Tract Endoscopy Combining Rigid Laryngoscopy and Flexible Endoscopy. Surg Innov 2024:15533506241238870. [PMID: 38448034 DOI: 10.1177/15533506241238870] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
Upper Aerodigestive Tract Endoscopy (UATE) is recommended for initial examination of head and neck squamous cell carcinomas. Reducing delay of initial examination must be a challenge to manage head and neck cancers. We hereby describe the technic combining UATE and flexible endoscopy in a unique general anesthesia with overview of hypopharyngeal, larygeal, tracheal, esophageal, nasopharyngeal sub sites in a unique procedure with system of magnificense and to perform percutaneous gastrostomy during the same time before initiation of therapy.
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Affiliation(s)
- Antoine Dubray-Vautrin
- Department of Oto-Rhino-Laryngology, Head & Neck Surgery, Institut Curie, Paris, France
- Departement of Oto-Rhino-Laryngology, Head & Neck Surgery, Institut Curie, Saint-Cloud, France
| | - Christian Chappey
- Departement of Oto-Rhino-Laryngology, Head & Neck Surgery, Institut Curie, Saint-Cloud, France
| | - Rabah Taouachi
- Departement of Oto-Rhino-Laryngology, Head & Neck Surgery, Institut Curie, Saint-Cloud, France
| | - Wahib Ghanem
- Department of Oto-Rhino-Laryngology, Head & Neck Surgery, Institut Curie, Paris, France
| | - Olivier Choussy
- Department of Oto-Rhino-Laryngology, Head & Neck Surgery, Institut Curie, Paris, France
- Departement of Oto-Rhino-Laryngology, Head & Neck Surgery, Institut Curie, Saint-Cloud, France
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Tawa P, Lesnik M, Hoffmann C, Dubray-Vautrin A, Ghanem W, Rougier G, Choussy O, Badois N. Safety and reliability of the internal jugular vein for venous anastomoses in head and neck oncological reconstruction: A retrospective study. J Craniomaxillofac Surg 2024; 52:170-174. [PMID: 38142170 DOI: 10.1016/j.jcms.2023.10.002] [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: 07/08/2022] [Revised: 09/06/2023] [Accepted: 10/05/2023] [Indexed: 12/25/2023] Open
Abstract
This study aimed to assess the efficacy of utilizing the internal jugular vein (IJV) as the primary recipient site for venous anastomoses in head and neck oncological reconstruction. Patients who underwent a free flap reconstruction of the head and neck were retrospectively included. Venous anastomoses were preferentially performed less than 1 cm from the IJV, either end-to-side (EtS) on the IJV, or end-to-end (EtE) on the origin of the thyrolingofacial venous (TLF) trunk. When the pedicle length was insufficient to reach the IJV, anastomoses were performed EtE to a size-matched cervical vein. Of the 246 venous anastomoses, 216 (87.8%) were performed less than 1 cm from the IJV, including 150 EtS on the IJV (61.0%), and 66 EtE on the TLF trunk (26.8%). Thirty veins (12.1%) were anastomosed EtE on other cervical veins more than 1 cm from the IJV. Two venous thromboses occurred (0.9%) and were successfully managed after revision surgery. There was no evidence of an increased thrombosis rate in high-risk or pre-irradiated patients. These findings suggest that the internal jugular vein is safe and reliable as a first-choice recipient vessel for free flap transfers in head and neck oncological reconstruction.
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Affiliation(s)
- Pierre Tawa
- Department of Head and Neck Surgical Oncology, PSL University, Institut Curie, Paris, France.
| | - Maria Lesnik
- Department of Head and Neck Surgical Oncology, PSL University, Institut Curie, Paris, France
| | - Caroline Hoffmann
- Department of Head and Neck Surgical Oncology, PSL University, Institut Curie, Paris, France
| | - Antoine Dubray-Vautrin
- Department of Head and Neck Surgical Oncology, PSL University, Institut Curie, Paris, France
| | - Wahib Ghanem
- Department of Head and Neck Surgical Oncology, PSL University, Institut Curie, Paris, France
| | - Guillaume Rougier
- Department of Head and Neck Surgical Oncology, PSL University, Institut Curie, Paris, France
| | - Olivier Choussy
- Department of Head and Neck Surgical Oncology, PSL University, Institut Curie, Paris, France
| | - Nathalie Badois
- Department of Head and Neck Surgical Oncology, PSL University, Institut Curie, Paris, France
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Dubray-Vautrin A, Ghanem W, Bozec L, Gonin J, Choussy O. Head and neck INI1-deficient carcinoma without primary: a case report. J Med Case Rep 2023; 17:479. [PMID: 37974295 PMCID: PMC10655450 DOI: 10.1186/s13256-023-04214-3] [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: 07/07/2023] [Accepted: 10/13/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND SMARCB1, also known as INI1, is a member of a large protein complex involved in chromatin remodeling and thus the regulation of gene expression. It is located on chromosome 22q11.2. SMARCB1 tumors have been found in various locations, including the sinonasal region, gastrointestinal tract, central nervous system (in atypical teratoid and rhabdoid tumors), and perirenal region (in malignant rhabdoid tumors) in both adults and children. CASE PRESENTATION We describe here the first case in the literature of an INI1-deficient neck carcinoma without a primary tumor managed with surgical therapy and neck dissection in a young Caucasian woman of 29 years old, followed by chemotherapy before radiotherapy, with regional control after 18 months of follow-up. Histologic analysis showed an undifferentiated carcinoma without glandular or epidermoid differentiation. Biomolecular analysis of the tumor revealed a homozygous deletion of the SMARCB1 gene on RNA sequencing. CONCLUSION Research of INI1 deletion should be performed for undifferentiated carcinoma of young patients because of possibilities of molecular therapies such as autophagy inhibitors or proteasome inhibitors could be used in clinical trials.
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Affiliation(s)
- Antoine Dubray-Vautrin
- Department of Oto-Rhino-Laryngology, Head & Neck Surgery, Institut Curie, 26 Rue D'Ulm, 75005, Paris, France.
| | - Wahib Ghanem
- Department of Oto-Rhino-Laryngology, Head & Neck Surgery, Institut Curie, 26 Rue D'Ulm, 75005, Paris, France
| | - Laurence Bozec
- Department of Oncology, Institut Curie, Saint Cloud, France
| | - Julie Gonin
- Departement of Pathology, Institut Curie, Saint-Cloud, France
| | - Olivier Choussy
- Department of Oto-Rhino-Laryngology, Head & Neck Surgery, Institut Curie, 26 Rue D'Ulm, 75005, Paris, France
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Tourneau CL, Takacsi-Nagy Z, Finzi L, Liem X, Calugaru V, Moreno V, Calvo E, Salas S, Doger B, Dubray-Vautrin A, Mirabel X, Badois N, Chilles A, Fakhry N, Kam SWH, Houdas L, Debard A, Vivar OI, Farber LA, Lesnik M. Novel Radioenhancer NBTXR3 Activated by Radiotherapy in Cisplatin-Ineligible Locally Advanced HNSCC Patients: Final Results of a Phase I Trial. Int J Radiat Oncol Biol Phys 2023; 117:S99. [PMID: 37784620 DOI: 10.1016/j.ijrobp.2023.06.435] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) New approaches are needed for frail or elderly patients with locally advanced head and neck squamous cell carcinoma (LA HNSCC) who are unfit to receive cisplatin with concurrent radiotherapy (RT). NBTXR3 is a first-in-class radioenhancer, composed of functionalized hafnium oxide nanoparticles, administered by a single intratumoral (IT) injection and activated by RT. NBTXR3 locally amplifies the anti-tumoral response of RT without adding toxicity to surrounding healthy tissue as shown in a randomized trial in soft tissue sarcoma. This two-part study: dose-escalation followed by the dose-expansion part reported here, evaluated the safety and preliminary efficacy for NBTXR3 activated by RT in elderly or frail patients ineligible to cisplatin. MATERIALS/METHODS This trial enrolled patients who had previously untreated AJCC 8th Stage III-IVA or T3, T4 SCC of the oral cavity or oropharynx (OPC) ineligible to cisplatin. Eligible patients received a single IT injection of NBTXR3 at the recommended dose (22% of the baseline tumor volume) followed by RT (IMRT 70 Gy in 35 fractions). The primary objectives of the dose expansion part were to test the recommended dose, to confirm its safety, and obtain preliminary evidence of efficacy. The secondary objectives included the evaluation of progression-free survival (PFS) and overall survival (OS). RESULTS Fifty-sixpatients in the dose expansion part were treated from April 2019-January 2022; 44 patients were evaluable for objective tumor response. In the all-treated population, median age was 71.9 years. 64.3% had age-adjusted Charlson Comorbidity Index scores ≥4, 55.4% had OPC (45.2% HPV+) and 80% had T3-4. Median injected volume of NBTXR3 was 13.6 [0.5-57.1] mL. Grade ≥ 3 adverse events reported as potentially related to NBTXR3 or to injection procedure were 1.2% and 0.4% of all AEs reported, respectively. In the evaluable population, the best objective response rate of the NBTXR3 injected lesion was 81.8% with a complete response rate of 63.6%. The best overall response rate (injected and non-injected lesions) was 79.5%. Final analyses on PFS and OS with long-term follow-up will be presented. CONCLUSION NBTXR3 IT injection followed by activation with RT was confirmed to be feasible and well tolerated in elderly or frail patients with LA HNSSC and significant comorbidities. The high rate of best overall response suggests that NBTXR3+RT is effective in this elderly population ineligible to cisplatin with a high unmet medical need. These results support our ongoing phase III study comparing NBTXR3/RT ± cetuximab vs. RT ± cetuximab in platinum-based chemotherapy ineligible elderly patients with LA-HNSCC: NANORAY 312 (NCIT04892173).
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Affiliation(s)
| | | | | | - X Liem
- Univesrite Montreal, Montreal, QC, Canada
| | - V Calugaru
- Department of Radiation Oncology-Institut Curie, Paris, France
| | - V Moreno
- Hospital Fundación Jimenez Diaz, Madrid, Spain
| | | | - S Salas
- Assistance Publique Hôpitaux de Marseille, Timone Hospital, Marseille, France
| | | | | | | | | | - A Chilles
- Department of Radiation Oncology, Institut Curie, Paris, France
| | - N Fakhry
- Hôpital Timone, Marseille, France
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Marret G, Lamy C, Vacher S, Séné M, Ahmanache L, Courtois L, Beiano ZE, Klijanienko J, Martinat C, Servant N, Kamoun C, Chérif LL, Bronzini T, Balsat C, Laes JF, Prévot A, Sauvage S, Lienard M, Martin E, Genin B, Badois N, Lesnik M, Dubray-Vautrin A, Choussy O, Ghanem W, Taouachi R, Planchon JM, Bièche I, Kamal M, Tourneau CL. Abstract 3363: Spatial and longitudinal tumor heterogeneity in head and neck squamous cell carcinoma patients treated with primary surgery. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-3363] [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: 04/07/2023]
Abstract
Abstract
Introduction: Cell-free tumor DNA (ctDNA) is an emerging biomarker in head and neck squamous cell carcinoma (HNSCC) for disease staging, patients’ recurrence risk stratification and early detection of relapse. We aimed to compare variants identified in ctDNA versus surgical tumor specimen, and to study the evolution of the mutational landscape of ctDNA over time in HNSCC.
Patients and Method: Forty-one HNSCC patients treated with curative-intent primary surgery from SCANDARE cohort (NCT03017573) were evaluated for longitudinal ctDNA-based NGS. Overall, 28 patients were treated with adjuvant (chemo)radiotherapy, and 31 experienced recurrence. Formalin-fixed paraffin-embedded tumor tissues at surgery were available for 41 patients. Serial contributive ctDNA were retrieved from all 41 patients at the date of surgery, 36 patients within 19 weeks after surgery, 20 patients at six months after surgery, and 22 patients at recurrence. Tissue DNA was personalized detected with a custom NGS panel of 571 genes (DRAGON) and ctDNA was sequenced using another personalized dedicated NGS panel including up to 15 genes (OncoFOLLOW).
Results: Most frequently mutated genes in tissue included TP53 (15.9%), FAT1 (6.7%), NOTCH1 (5.5%) and PIK3CA (4.3%) with similar allelic ratio to ctDNA at baseline surgery. Higher prevalence of KRAS and TP53 mutations was found in ctDNA at recurrence in comparison with ctDNA and tissue, respectively, at baseline surgery (KRAS: 6.3% versus 1.6% and 0.6%; TP53: 31.2% versus 21.1% and 15.9%). Additional variants in NRAS, HRAS, TP53, JAK2 and SDHA were detected in 6 patients in ctDNA at surgery and were not found in tissue, suggesting spatial intratumor heterogeneity. Twenty-three/36 patients (64%) had detected ctDNA within 19 weeks after surgery among whom, 17/23 patients (74%) had disease recurrence. Eleven/20 patients (including 10 with adjuvant treatment) had detected ctDNA at six months after surgery among whom 6 patients (55%) had disease recurrence. Fifteen/22 patients (68%) had detected ctDNA at recurrence. Emerging pathogenic variants were found in patients with detected ctDNA after surgery (n=7/23; 30%), at six months after surgery (n=1/11; 9%) and at recurrence (n=4/15; 27%).
Conclusion: Our study suggests spatial and longitudinal tumor heterogeneity and reports emerging mutations in ctDNA over time in HNSCC. Prognostic significance characterization of the ctDNA dominant clone allele frequency is ongoing.
Citation Format: Grégoire Marret, Constance Lamy, Sophie Vacher, Mathieu Séné, Ladidi Ahmanache, Laura Courtois, Zakhia El Beiano, Jerzy Klijanienko, Charlotte Martinat, Nicolas Servant, Choumouss Kamoun, Linda Larbi Chérif, Thierry Bronzini, Cédric Balsat, Jean-François Laes, Aubray Prévot, Sébastien Sauvage, Maxime Lienard, Emmanuel Martin, Bérengère Genin, Nathalie Badois, Maria Lesnik, Antoine Dubray-Vautrin, Olivier Choussy, Wahib Ghanem, Rabah Taouachi, Julien Masliah Planchon, Ivan Bièche, Maud Kamal, Christophe Le Tourneau. Spatial and longitudinal tumor heterogeneity in head and neck squamous cell carcinoma patients treated with primary surgery [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 3363.
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Moreira A, Poulet A, Masliah-Planchon J, Lecerf C, Vacher S, Larbi Chérif L, Dupain C, Marret G, Girard E, Syx L, Hoffmann C, Jeannot E, Klijanienko J, Guillou I, Mariani O, Dubray-Vautrin A, Badois N, Lesnik M, Choussy O, Calugaru V, Borcoman E, Baulande S, Legoix P, Albaud B, Servant N, Bieche I, Le Tourneau C, Kamal M. Prognostic value of tumor mutational burden in patients with oral cavity squamous cell carcinoma treated with upfront surgery. ESMO Open 2021; 6:100178. [PMID: 34118772 PMCID: PMC8207209 DOI: 10.1016/j.esmoop.2021.100178] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 04/19/2021] [Accepted: 05/17/2021] [Indexed: 12/25/2022] Open
Abstract
Background Oral cavity is the most prevalent site of head and neck squamous cell carcinomas (HNSCCs). Most often diagnosed at a locally advanced stage, treatment is multimodal with surgery as the cornerstone. The aim of this study was to explore the molecular landscape of a homogenous cohort of oral cavity squamous cell carcinomas (OCSCCs), and to assess the prognostic value of tumor mutational burden (TMB), along with classical molecular and clinical parameters. Patients and methods One hundred and fifty-one consecutive patients with OCSCC treated with upfront surgery at the Institut Curie were analyzed. Sequencing of tumor DNA from frozen specimens was carried out using an in-house targeted next-generation sequencing panel (571 genes). The impact of molecular alterations and TMB on disease-free survival (DFS) and overall survival (OS) was evaluated in univariate and multivariate analyses. Results Pathological tumor stage, extranodal spread, vascular emboli, and perineural invasion were associated with both DFS and OS. TP53 was the most mutated gene (71%). Other frequent molecular alterations included the TERT promoter (50%), CDKN2A (25%), FAT1 (17%), PIK3CA (14%), and NOTCH1 (15%) genes. Transforming growth factor-β pathway alterations (4%) were associated with poor OS (P = 0.01) and DFS (P = 0.02) in univariate and multivariate analyses. High TMB was associated with prolonged OS (P = 0.01 and P = 0.02, in the highest 10% and 20% TMB values, respectively), but not with DFS. Correlation of TMB with OS remained significant in multivariate analysis (P = 0.01 and P = 0.005 in the highest 10% and 20% TMB values, respectively). Pathological tumor stage combined with high TMB was associated with good prognosis. Conclusion Our results suggest that a high TMB is associated with a favorable prognosis in patients with OCSCC treated with upfront surgery. High TMB is associated with a favorable prognosis in patients with OCSCC treated with upfront surgery Pathological tumor stage combined with high TMB is associated with good prognosis TP53 was the most mutated gene (71%). Other frequent molecular alterations included the TERT promoter (50%) TGFβ pathway alterations were associated with poor outcomes, although it was only observed in 4% of the patients
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Affiliation(s)
- A Moreira
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris and Saint-Cloud, France
| | - A Poulet
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris and Saint-Cloud, France
| | - J Masliah-Planchon
- Department of Genetics, Institut Curie, PSL Research University, Paris, France
| | - C Lecerf
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris and Saint-Cloud, France
| | - S Vacher
- Department of Genetics, Institut Curie, PSL Research University, Paris, France
| | - L Larbi Chérif
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris and Saint-Cloud, France
| | - C Dupain
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris and Saint-Cloud, France
| | - G Marret
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris and Saint-Cloud, France
| | - E Girard
- INSERM U900 Research Unit, Institut Curie, Paris and Saint-Cloud, France
| | - L Syx
- INSERM U900 Research Unit, Institut Curie, Paris and Saint-Cloud, France
| | - C Hoffmann
- INSERM U932 Research Unit, Institut Curie, PSL Research University, Paris, France; Department of Oncologic Surgery, Institut Curie, PSL Research University, Paris, France
| | - E Jeannot
- Department of Genetics, Institut Curie, PSL Research University, Paris, France; Department of Pathology, Institut Curie, PSL Research University, Paris, France
| | - J Klijanienko
- Department of Pathology, Institut Curie, PSL Research University, Paris, France
| | - I Guillou
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris and Saint-Cloud, France
| | - O Mariani
- Department of Pathology, Institut Curie, PSL Research University, Paris, France
| | - A Dubray-Vautrin
- Department of Oncologic Surgery, Institut Curie, PSL Research University, Paris, France
| | - N Badois
- Department of Oncologic Surgery, Institut Curie, PSL Research University, Paris, France
| | - M Lesnik
- Department of Oncologic Surgery, Institut Curie, PSL Research University, Paris, France
| | - O Choussy
- Department of Oncologic Surgery, Institut Curie, PSL Research University, Paris, France
| | - V Calugaru
- Department of Oncologic Radiotherapy, Institut Curie, PSL Research University, Paris, France
| | - E Borcoman
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris and Saint-Cloud, France
| | - S Baulande
- Institut Curie Genomics of Excellence (ICGex) Platform, PSL Research University, Paris, France
| | - P Legoix
- Institut Curie Genomics of Excellence (ICGex) Platform, PSL Research University, Paris, France
| | - B Albaud
- Institut Curie Genomics of Excellence (ICGex) Platform, PSL Research University, Paris, France
| | - N Servant
- INSERM U900 Research Unit, Institut Curie, Paris and Saint-Cloud, France
| | - I Bieche
- Department of Genetics, Institut Curie, PSL Research University, Paris, France; INSERM U1016, Paris Descartes University, Faculty of Pharmaceutical and Biological Sciences, Paris, France
| | - C Le Tourneau
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris and Saint-Cloud, France; INSERM U900 Research Unit, Institut Curie, Paris and Saint-Cloud, France; Paris-Saclay University, Paris, France
| | - M Kamal
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris and Saint-Cloud, France.
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Bequignon E, Dubray-Vautrin A, De Kermadec H, Jung C, Coste A. Contribution of drug-induced sleep endoscopy in comparison with awake endoscopy in the management of patients with obstructive sleep apnea syndrome: experience of a French ent sleep center. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ballivet de Régloix S, Dubray-Vautrin A, Girod A, Jouffroy T, Rodriguez J. [Progress in head and neck cancer]. Soins 2015:56; quiz 57. [PMID: 26369749 DOI: 10.1016/j.soin.2015.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
| | - Antoine Dubray-Vautrin
- Service de chirurgie oncologique ORL et cervicofaciale, Institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | - Angélique Girod
- Service de chirurgie oncologique ORL et cervicofaciale, Institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | - Thomas Jouffroy
- Service de chirurgie oncologique ORL et cervicofaciale, Institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | - Joseph Rodriguez
- Service de chirurgie oncologique ORL et cervicofaciale, Institut Curie, 26, rue d'Ulm, 75005 Paris, France.
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Dubray-Vautrin A, Ballivet de Régloix S, Girod A, Jouffroy T, Rodriguez J. [Epidemiology, diagnosis and treatment of head and neck cancers]. Soins 2015:32-5. [PMID: 26369742 DOI: 10.1016/j.soin.2015.07.002] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Cancers of the upper aerodigestive tracts are the fourth most common cancer in France. The main risk factors are smoking and alcohol. They do not necessarily present specific signs, making their early diagnosis difficult. A change in the patient's general condition is a late sign leading to a poor prognosis of the disease.
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Affiliation(s)
- Antoine Dubray-Vautrin
- Service de chirurgie oncologique ORL et cervico-faciale, Institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | | | - Angélique Girod
- Service de chirurgie oncologique ORL et cervico-faciale, Institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | - Thomas Jouffroy
- Service de chirurgie oncologique ORL et cervico-faciale, Institut Curie, 26, rue d'Ulm, 75005 Paris, France
| | - Joseph Rodriguez
- Service de chirurgie oncologique ORL et cervico-faciale, Institut Curie, 26, rue d'Ulm, 75005 Paris, France.
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