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Brenet E, Atallah S, Guerlain J, Moya-Plana A, Verillaud B, Kania R, Bakhos D, Philouze P, Righini CA, Bozorg A, Mérol JC, Labrousse M, Vergez S, Fakhry N, Gallet P, Cullié D, Malard O, Mauvais O, Fath L, Schultz P, Dufour X, Saroul N, Evrard D, Lesnik M, Even C, Costes V, Thariat J, Taillandier de Gabory LL, Makeieff M, Dubernard X, Baujat B. Carcinomas of the external auditory canal: Management and results: A multicenter REFCOR propensity score matching study. Eur J Cancer 2024; 201:113922. [PMID: 38364629 DOI: 10.1016/j.ejca.2024.113922] [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: 01/08/2024] [Revised: 01/31/2024] [Accepted: 02/06/2024] [Indexed: 02/18/2024]
Abstract
OBJECTIVES To analyse prognostic factors and survival outcomes of malignant tumors of the external auditory canal, to investigate the role of regional surgery, and adjuvant radiotherapy in early stages and to investigate the role of surgery in operable T4 stage. SETTING A retrospective analysis was conducted on all patients prospectively included in the national database of the French Expertize Network for Rare ENT Cancers (REFCOR) from January 2000 to December 2016. PARTICIPANTS 103 patients from 19 reference centers were included. A propensity score matching analysis was applied to enable comparisons between treatments. MAIN OUTCOMES AND MEASURES Event-free survival, overall survival and factors of poor prognosis of the cohort were described. The interest of local and regional surgery and postoperative radiotherapy were evaluated. RESULTS The factors of poor prognosis on event-free survival were immunosuppression (p = 0.002), Karnofsky status less than 90% (p = 0.02), body mass index less than 19 Kg / m2 (p = 0.0009), peripheric facial palsy (p = 0.0016), and positive margin (p = 0.0006). In early stages, locoregional surgery was associated with an increase in event-free survival (p = 0.003, HR = 0.21) versus local surgery alone, while postoperative radiotherapy was not associated with an increase in event-free survival (p = 0.86, HR = 0.91) or overall (p = 0.86, HR = 0.91). In locally advanced stages, locoregional surgery followed by radiotherapy was associated with an increase in event-free survival (p = 0.03, HR = 0.39) and overall (p = 0.02, HR = 0.34) versus chemoradiotherapy alone. CONCLUSION AND RELEVANCE Regional surgery is recommended for early stages of cancers of the external auditory canal. In operable cases, locoregional surgery followed by radiotherapy is recommended.
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Affiliation(s)
- Esteban Brenet
- Department of ENT-Head and Neck Surgery, Robert Debré University Hospital, 51100 Reims, France
| | - Sarah Atallah
- Department of ENT-Head and Neck Surgery, Tenon University Hospital, APHP, Sorbonne Universite, 75020 Paris, France; Doctoral School of Public Health, CESP, University of Paris Sud, 94807 Villejuif, France
| | - Joanne Guerlain
- Department of ENT-Head and Neck Surgery, Gustave Roussy Cancer Campus, 94800 Villejuif, France
| | - Antoine Moya-Plana
- Department of ENT-Head and Neck Surgery, Gustave Roussy Cancer Campus, 94800 Villejuif, France
| | - Benjamin Verillaud
- Department of ENT-Head and Neck Surgery, Lariboisière University Hospital, APHP, 75010 Paris, France
| | - Romain Kania
- Department of ENT-Head and Neck Surgery, Lariboisière University Hospital, APHP, 75010 Paris, France
| | - David Bakhos
- Department of ENT-Head and Neck Surgery, Bretonneau University Hospital, 37000 Tours, France
| | - Pierre Philouze
- Department of ENT-Head and Neck Surgery, La Croix Rousse University Hospital, HCL, 6900 Lyon, France
| | - Christian-Adrien Righini
- Department of ENT-Head and Neck Surgery, Grenoble Alpes University Hospital, 38043 Grenoble, France
| | - Alexis Bozorg
- Department of ENT-Head and Neck Surgery, François Mitterrand University Hospital, 21000 Dijon, France
| | - Jean-Claude Mérol
- Department of ENT-Head and Neck Surgery, Robert Debré University Hospital, 51100 Reims, France
| | - Marc Labrousse
- Department of ENT-Head and Neck Surgery, Robert Debré University Hospital, 51100 Reims, France
| | - Sébastien Vergez
- Department of ENT-Head and Neck Surgery, University Cancer Institute, 31100 Toulouse, France
| | - Nicolas Fakhry
- Department of ENT-Head and Neck Surgery, University Hospital of Marseille, APHM, 13915 Marseille, France
| | - Patrice Gallet
- Department of ENT-Head and Neck Surgery, University Hospital of Nancy, 54000 Nancy, France
| | - Dorian Cullié
- Department of ENT-Head and Neck Surgery, Lacassagne Cancer Institute, 06100 Nice, France
| | - Olivier Malard
- Department of ENT-Head and Neck Surgery, University Hospital of Nantes, 44093 Nantes, France
| | - Olivier Mauvais
- Department of ENT-Head and Neck Surgery, University Hospital of Besançon, 25000 Besançon, France
| | - Léa Fath
- Department of ENT-Head and Neck Surgery, University Hospital of Hautepierre, HUS, 67200 Strasbourg, France
| | - Philippe Schultz
- Department of ENT-Head and Neck Surgery, University Hospital of Hautepierre, HUS, 67200 Strasbourg, France
| | - Xavier Dufour
- Department of ENT-Head and Neck Surgery, University Hospital of Poitiers, 86021 Poitiers, France
| | - Nicolas Saroul
- Department of ENT-Head and Neck Surgery, University Hospital of Clermont-Ferrand, 63000, France
| | - Diane Evrard
- Department of ENT-Head and Neck Surgery, Bichat University Hospital, APHP, 75018 Paris, France
| | - Maria Lesnik
- Department of ENT-Head and Neck Surgery, Curie Cancer Institute, APHP, 75005 Paris, France
| | - Caroline Even
- Department of Oncology, Gustave Roussy Cancer Campus, 94800 Villejuif, France
| | - Valérie Costes
- Department of Pathologic Anatomy and onco-biology, University Hospital of Montpellier, France
| | - Juliette Thariat
- Department of Radiation Oncology, Cancer center Baclesse, 14076 Caen, France
| | | | - Marc Makeieff
- Department of ENT-Head and Neck Surgery, Robert Debré University Hospital, 51100 Reims, France
| | - Xavier Dubernard
- Department of ENT-Head and Neck Surgery, Robert Debré University Hospital, 51100 Reims, France
| | - Bertrand Baujat
- Department of ENT-Head and Neck Surgery, Tenon University Hospital, APHP, Sorbonne Universite, 75020 Paris, France.
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Bresson D, Hudelist B, Gaudioso P, Moya-Plana A, Herman P, Idriceanu T, Nicolai P, Ferrari M. Side-door temporoparietal fascia flap: First experience with a novel technique for anterior skull base reconstruction. Head Neck 2024; 46:772-784. [PMID: 38192046 DOI: 10.1002/hed.27611] [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: 03/28/2023] [Revised: 11/16/2023] [Accepted: 12/12/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND Modern achievements in transnasal endoscopic skull base (SB) surgery have led to complex resections that render reconstruction a challenge. Temporoparietal fascia flap (TPFF) is a suitable option for SB reconstruction. The side-door TPFF technique for anterior SB reconstruction is described here for the first time in a real-life surgical setting. METHODS Patients affected by a SB malignancy who underwent cranioendoscopic resection were included. For reconstruction, a multilayer reconstruction technique including side-door TPFF transposition was employed. RESULTS TPFF transposition was performed in five patients. The TPFF could be easily transposed via a side-door approach. It adequately covered the edges of the defect and supported optimal healing of the surgical site. During follow-up, vitality and integration of the TPFF were assessed endoscopically and radiologically. CONCLUSIONS The TPFF side-door transposition technique is a valuable option in anterior SB reconstruction that can provide fast and effective healing, especially in patients needing adjuvant radiotherapy.
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Affiliation(s)
- Damien Bresson
- Neurosurgery Department, Foch Hospital, Université Paris Saclay, Suresnes, France
| | - Benoit Hudelist
- Neurosurgery Department, AP-HP, Henri Mondor Hospital, Créteil, France
| | - Piergiorgio Gaudioso
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neuroscience DNS, University of Padova, Padova, Italy
| | - Antoine Moya-Plana
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Université Paris Saclay, Villejuif, France
| | - Philippe Herman
- Otorhinolaryngology and Skull Base Center, AP-HP, Hospital Lariboisière, Paris, France
| | - Tania Idriceanu
- Neurosurgery Department, AP-HP, Henri Mondor Hospital, Créteil, France
| | - Piero Nicolai
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neuroscience DNS, University of Padova, Padova, Italy
| | - Marco Ferrari
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neuroscience DNS, University of Padova, Padova, Italy
- Guided Therapeutics (GTx) Program International Scholarship, University Health Network (UHN), Toronto, Ontario, Canada
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Gasne C, Atallah S, Dauzier E, Thariat J, Fakhry N, Verillaud B, Classe M, Vergez S, Moya-Plana A, Costes-Martineau V, Righini C, de Gabory L, Digue L, Dupin C, Ferrand FR, Even C, Baujat B. Twelve years after: The french national network on rare head and neck tumours (REFCOR). Oral Oncol 2024; 151:106762. [PMID: 38513311 DOI: 10.1016/j.oraloncology.2024.106762] [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: 08/30/2023] [Revised: 01/23/2024] [Accepted: 03/12/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Rare cancers constitute less than 10% of head and neck cancers and lack sufficient evidence for standardized care. The French Rare Head and Neck Cancer Expert Network (REFCOR) as established a national database to collect data on these rare cancers. This study aims to describe patient and tumour characteristics in this database. METHODS Prospective data collection was conducted across multiple centers. Survival analyses were performed using Kaplan Meier method and Log Rank test. Odds ratios were used for comparing proportions. RESULTS A total of 7208 patients were included over a period of 10 years. The most frequent histologies were: Not Otherwise Specified (NOS) adenocarcinoma 13 %, adenoid cystic carcinoma 12 %, squamous cell carcinoma of rare locations 10 %, mucoepidermoid carcinoma 9 %, intestinal-type adenocarcinoma (8 %). Tumours were located in sinonasal area (38 %); salivary glands (32 %); oral cavity / oropharynx / nasopharynx (16 %); larynx / hypopharynx (3 %); ears (1 %); others (3 %). Tumours were predominantly classified as T4 (23 %), N0 (54 %), and M0 (62 %). Primary treatment approach involved tumour resection (78 %) and / or radiotherapy (63 %). Patients with salivary gland cancers exhibited better 5-year overall survival (OS) rates (p < 0.05), and lower recurrence rates compared to patients with sinonasal, laryngeal/ hypopharyngeal cancers. No significant differences were observed in the other comparisons. Acinar cell carcinoma demonstrated the best OS while mucous melanoma had the poorest prognosis. CONCLUSION Melanoma, carcinoma NOS, and sinonasal undifferenciated carcinoma still have poor prognoses. Efforts are being made, including training and guidelines, to expand network coverage (REFCOR, EURACAN), improve data collection and contribute to personalized therapies.
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Affiliation(s)
- Cassandre Gasne
- Otolaryngology-Head and Neck Surgery Department, Hopital Tenon, AP-HP, Sorbonne University, 75020 Paris, France
| | - Sarah Atallah
- Otolaryngology-Head and Neck Surgery Department, Hopital Tenon, AP-HP, Sorbonne University, 75020 Paris, France
| | - Etienne Dauzier
- Otolaryngology-Head and Neck Surgery Department, Hopital Tenon, AP-HP, Sorbonne University, 75020 Paris, France
| | - Juliette Thariat
- Radiotherapy department, Centre François Baclesse, Caen University, 14000 Caen, France
| | - Nicolas Fakhry
- Otolaryngology-Head and Neck Surgery Department, Centre Hospitalier Universitaire La Conception, APHM, Aix Marseille University, 13385 Marseille, France
| | - Benjamin Verillaud
- Otolaryngology-Head and Neck Surgery Department, Hopital Lariboisière, AP-HP, Paris University, 75010 Paris, France
| | - Marion Classe
- Pathology Department, Institut Gustave-Roussy, 94800 Villejuif, France
| | - Sebastien Vergez
- Service ORL-CCF, Hôpital Rangueil-Larrey, CHU de Toulouse, 31059 Toulouse, France
| | - Antoine Moya-Plana
- Otolaryngology-Head and Neck Surgery Department, Institut Gustave-Roussy, 94800 Villejuif, France
| | - Valerie Costes-Martineau
- Pathology Department, Centre Hospitalier Universitaire de Montpellier, Montpellier University, 34295 Montpellier, France
| | - Christian Righini
- Otolaryngology-Head and Neck Surgery Department, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble University, 38043 Grenoble, France
| | - Ludovic de Gabory
- Otolaryngology-Head and Neck Surgery Department, Centre Hospitalier Universitaire F-X Michelet, Bordeaux University, 33076 Bordeaux, France
| | - Laurence Digue
- Oncology Department, Centre Hospitalier Universitaire F-X Michelet, Bordeaux University, 33076 Bordeaux, France
| | - Charles Dupin
- Pathology Department, Centre Hospitalier Universitaire F-X Michelet, Bordeaux University, 33076 Bordeaux, France
| | | | - Caroline Even
- Oncology Department, Institut Gustave-Roussy, 94800 Villejuif, France
| | - Bertrand Baujat
- Otolaryngology-Head and Neck Surgery Department, Hopital Tenon, AP-HP, Sorbonne University, 75020 Paris, France.
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Hudelist B, Idriceanu T, Moya-Plana A, Herman P, Bresson D. The "Gift Wrap" Technique - A Method that Simplifies the Placement of Fascia Lata in the Reconstruction of the Skull Base Following Endoscopic Endonasal Surgery: A Technical Note. World Neurosurg 2024; 183:41-44. [PMID: 38092352 DOI: 10.1016/j.wneu.2023.12.035] [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: 09/27/2023] [Revised: 12/04/2023] [Accepted: 12/06/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND With the advancement of endoscopic endonasal surgery in the treatment of anterior skull base (ASB) pathologies, extended, watertight reconstructions are needed to prevent cerebrospinal fluid (CSF) leakage. This often involves the use of multilayers closure, with free fascia lata (FL) graft frequently used as an in- and/or outlay. However, positioning the FL properly can be challenging and time-consuming, particularly on wider defects. In this technical note, we present an easier and faster way to position FL using a silicone sheet. METHODS FL graft is harvested using a standard technique. The required dimensions are evaluated depending on the extent of the dural defect taking in consideration that FL graft should exceed the edges of the dural defect especially laterally. It is then wrapped around a semi rigid pattern (Silastic sheet) and secured with several monofilament 5/0 sutures. The "package" is transferred through the endonasal corridor to the defect. The sutures are divided and taken out; the fascia is unfolded, and its edges are inserted into the subdural space without any twisting or folding of the flap. Finally, the silicone sheet is withdrawn from the nasal cavity, leaving the FL well-stretched in perfect position. RESULTS We illustrate this technique in the management of a large anterior skull base chondrosarcoma, which necessitated significant bone and dural resection. CONCLUSIONS The "Gift wrap" technique offers an alternative approach for positioning the FL, which is less time-consuming compared to the traditional technique. Moreover, it enables improved placement of the FL, enhancing its efficacy.
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Affiliation(s)
- Benoit Hudelist
- Neurosurgery Department, GHU, Sainte-Anne Hospital, Paris, France.
| | - Tania Idriceanu
- Neurosurgery Department, AP-HP, Henri Mondor Hospital, Créteil, France
| | | | | | - Damien Bresson
- Neurosurgery Department, Foch Hospital, Suresnes, France
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Gazda P, Baujat B, Sarini J, Gomez-Brouchet A, Philouze P, Moya-Plana A, Malard O, Fakhry N, De Mones Del Pujol E, Garrel R, Page C, Mouawad F, Vaz E, Evrard D, Bach C, Dufour X, Lelonge Y, Schultz P, Mauvais O, Brenet E, Vergez S, Atallah S. Functional or radical surgical treatment of laryngeal chondrosarcoma, analysis of survival and prognostic factors: A REFCOR and NetSarc-ResOs multicenter study of 74 cases. Eur J Surg Oncol 2024; 50:107315. [PMID: 38219696 DOI: 10.1016/j.ejso.2023.107315] [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: 09/03/2023] [Revised: 11/22/2023] [Accepted: 12/03/2023] [Indexed: 01/16/2024]
Abstract
INTRODUCTION Laryngeal chondrosarcoma (LCS) is a rare tumor of slow evolution whose treatment is poorly codified. For a long time, a radical treatment by total laryngectomy (TL) was proposed. More recent studies tend to propose a conservative surgical approach of the larynx. The objective of this study was to compare the overall survival (OS) of total laryngectomized patients (TL+) versus non-laryngectomized patients (TL-). The secondary objectives were to analyse the reoperation free survival (RFS), the total laryngectomy free survival (TLFS) and to identify the preoperative factors leading surgeons to propose TL. MATERIALS AND METHODS A retrospective analysis of prospectively collected incident cases from the REFCOR and NetSarc-ResOs multicenter databases between March 1997 and June 2021 was conducted. A propensity score matching analysis was performed to compare the OS of TL+ and TL-patients. RESULTS 74 patients were included. After propensity score, the 5-year OS of TL+ and TL-patients was comparable (100 %, p = 1). The 5-year RFS rate was 69.2 % (95 % CI [57.5-83.4]) and the 5-year TLFS was 61.7 % (95 % CI [50.4-75.5]). Cricoid involvement greater than 50 % (HR 3.58; IC 95 % [1.61-7.92] p < 0.001), an ASA score of 3 or 4 (HR 5.07; IC 95 % [1.64-15.67] p = 0.009) and involvement of several cartilages (HR 5.26; IC 95 % [1.17-23.6] p = 0.04) are prognostic factors for TL. Dyspnea caused by the tumour is a prognostic factor for reoperation (HR 2.59; IC 95 % [1.04-6.45] p = 0.03). CONCLUSION These results demonstrate that conservative treatment should be considered as first-line treatment for laryngeal chondrosarcoma.
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Affiliation(s)
- Pierre Gazda
- Department of ENT-Head and Neck Surgery, University Cancer Institute Toulouse, Toulouse University Hospital, 1 Avenue Irène Joliot-Curie, 31400, Toulouse, France; Department of ENT-Head and Neck Surgery, CHU Larrey Toulouse, 24 Chemin de Pouvourville, 31400 Toulouse, France
| | - Bertrand Baujat
- Sorbonne University, APHP, Department of ENT-Head and Neck Surgery, Tenon Hospital, 4 rue de la Chine 75020, Paris, France
| | - Jérôme Sarini
- Department of ENT-Head and Neck Surgery, University Cancer Institute Toulouse, Toulouse University Hospital, 1 Avenue Irène Joliot-Curie, 31400, Toulouse, France
| | - Anne Gomez-Brouchet
- Department of Pathology and Cytopathology, University Cancer Institute Toulouse, Toulouse University Hospital, 1 Avenue Irène Joliot-Curie, 31400, Toulouse, France
| | - Pierre Philouze
- Department of ENT-Head and Neck Surgery, Hospices Civils de Lyon, Lyon-Nord University Hospital, 103 Grande Rue de La Croix Rousse, 69000, Lyon, France
| | - Antoine Moya-Plana
- Department of ENT-Head and Neck Surgery, Gustave Roussy Cancer Campus, 114, Rue Edouard Vaillant, 94805, Villejuif, France
| | - Olivier Malard
- Department of ENT-Head and Neck Surgery, Nantes University Hospital, 1 Place Alexis-Ricordeau, 44000, Nantes, France
| | - Nicolas Fakhry
- Department of ENT-Head and Neck Surgery, University Hospital of Marseille, APHM, 13915, Marseille, France
| | - Erwan De Mones Del Pujol
- Department of ENT-Head and Neck Surgery, University Hospital of Bordeaux, 12 rue Dubernat 33404 Talence France
| | - Renaud Garrel
- Department of ENT-Head and Neck Surgery, University Hospital of Montpellier, 191 Av. du Doyen Gaston Giraud, 34295 Montpellier, France
| | - Cyril Page
- Department of ENT-Head and Neck Surgery, University Hospital of Amiens, 3 Rue des Louvels, 80000 Amiens, France
| | - Francois Mouawad
- Department of ENT-Head and Neck Surgery, CANTHER "Cancer heterogeneity, Plasticity and Resistance to Therapies", UMR9020 - U1277 Inserm - Lille University - University Hospital of Lille - Oscar Lambret Center, 59037 Lille Cedex, France
| | - Emmanuelle Vaz
- Department of Pathology and Cytopathology, Tenon Hospital, APHP, 4 rue de la Chine, 75020, Paris, France
| | - Diane Evrard
- APHP, Department of ENT-Head and Neck Surgery, Bichat Hospital, 46 rue Henri-Huchard, 75018 Paris, France
| | - Christine Bach
- Departement of ENT-Head and Neck Surgery, Clinique Chirurgicale du Val D'Or, 14 Rue Pasteur, 92210 Saint-Cloud, France
| | - Xavier Dufour
- Department of ENT-Head and Neck Surgery, University Hospital of Poitiers, 2 Rue de la Milétrie, 86000 Poitiers, France
| | - Yann Lelonge
- Department of ENT-Head and Neck Surgery, University Hospital of Saint-Etienne, Av. Albert Raimond, Saint-Etienne, France
| | - Philippe Schultz
- Department of ENT-Head and Neck Surgery, University Hospital of Strasbourg, 67000, Strasbourg, France
| | - Olivier Mauvais
- Department of ENT-Head and Neck Surgery, University Hospital of Besançon, France, 25000, Besançon, France
| | - Esteban Brenet
- Department of ENT-Head and Neck Surgery, Robert Debré University Hospital, 51100, Reims, France
| | - Sébastien Vergez
- Department of ENT-Head and Neck Surgery, University Cancer Institute Toulouse, Toulouse University Hospital, 1 Avenue Irène Joliot-Curie, 31400, Toulouse, France; Department of ENT-Head and Neck Surgery, CHU Larrey Toulouse, 24 Chemin de Pouvourville, 31400 Toulouse, France.
| | - Sarah Atallah
- Sorbonne University, APHP, Department of ENT-Head and Neck Surgery, Tenon Hospital, 4 rue de la Chine 75020, Paris, France
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Pouvreau P, Coelho J, Rumeau C, Malard O, Garrel R, Michel J, Righini C, Vergez S, Baudouin R, Bastit V, Marie JP, Villepelet A, Moya-Plana A, Philouze P, Saroul N, Digue L, Daste A, Renard S, Moriniere S, Carsuzaa F, Verillaud B, Poissonnet G, Schultz P, Brenet E, Mouawad F, Thariat J, Vulquin N, Castain C, de Gabory L, Dupin C. Management of 80 sinonasal undifferentiated carcinomas. Retrospective multicentre study of the French Network of Rare Head and Neck Cancers (REFCOR). Eur J Surg Oncol 2023; 49:107108. [PMID: 37866154 DOI: 10.1016/j.ejso.2023.107108] [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: 05/26/2023] [Revised: 09/13/2023] [Accepted: 10/02/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVES Sinonasal undifferentiated carcinoma (SNUC) is a rare and aggressive disease requiring multimodal treatment, and multiple new entities once included in the spectrum of SNUC, such as SWI/SNF-deficient carcinomas, are emerging. We aimed to provide new data regarding the role of chemotherapy and surgery and the prognostic factors of disease-free survival. METHODS This study was based on data from the REFCOR database and included patients with SNUC treated with curative intent from 2007 to 2021 across 22 centres in France. RESULTS A total of 80 patients were included in the analysis. Among the entire cohort, the 5-year disease-free survival (DFS) and overall survival (OS) rates were 58% and 63%, respectively. Of 100% of the patients treated with irradiation, 29% underwent surgery, 56% neoadjuvant chemotherapy (82% had either a partial or a complete response) and 76% chemoradiotherapy. No treatment modality was associated with a better OS or DFS, including surgery (p = 0.34). There was a trend for a better DFS for the patients treated with chemotherapy (neoadjuvant or concomitant, p = 0.062). Overall survival at 3 years was 58% for SWI/SNF deficient group and 86% for non deficient group (p = 0.14). The locoregional relapse rate without distant metastases was 21% in the exclusive radiotherapy group and 26% in the surgery group. Grade 3 or higher toxicities concerned 9%, 32% and 29% of patients for surgery, radiotherapy and chemotherapy respectively. CONCLUSION In the management of localised SNUC among all patients treated with irradiation, surgery yielded no benefit, whereas the addition of chemotherapy tended to improve disease-free survival.
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Affiliation(s)
- Pierre Pouvreau
- Department of Radiation Oncology, Bordeaux University Hospital, F33000, Bordeaux, France
| | - Julien Coelho
- Bordeaux University, na unit, UMR 6033, F-33000, Bordeaux, France
| | - Cécile Rumeau
- Department of Head and Neck Surgery, Nancy University Hospital, Vandoeuvre les Nancy, France
| | - Olivier Malard
- Department of Head and Neck Surgery, Nantes University Hospital, Nantes, France
| | - Renaud Garrel
- Department of Head and Neck Surgery, Montpellier University Hospital, Montpellier, France
| | - Justin Michel
- Department of Head and Neck Surgery, La Conception University Hospital, Marseille, France
| | - Christian Righini
- Department of Head and Neck Surgery, Grenoble University Hospital, Grenoble, France
| | - Sebastien Vergez
- Department of Head and Neck Surgery, Toulouse University Hospital, Toulouse, France
| | - Robin Baudouin
- Department of Head and Neck Surgery, Foch Hospital, Suresnes, France
| | - Vianney Bastit
- Department of Head and Neck Surgery, Caen University Hospital, Caen, France
| | - Jean-Paul Marie
- Department of Head and Neck Surgery, Rouen University Hospital, Rouen, France
| | - Aude Villepelet
- Department of Head and Neck Surgery, Créteil Intercommunal Hospital, Créteil, France
| | - Antoine Moya-Plana
- Department of Head and Neck Surgery, Institut Gustave Roussy, Villejuif, France
| | - Pierre Philouze
- Department of Head and Neck Surgery, Hospital Group of lyon, Lyon, France
| | - Nicolas Saroul
- Department of Head and Neck Surgery, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Laurence Digue
- Department of Oncology, Bordeaux University Hospital, F33000, Bordeaux, France
| | - Amaury Daste
- Department of Oncology, Bordeaux University Hospital, F33000, Bordeaux, France
| | - Sophie Renard
- Department of Head and Neck Surgery, Nancy University Hospital, Vandoeuvre les Nancy, France
| | - Sylvain Moriniere
- Department of Head and Neck Surgery, Tours University Hospital, Tours, France
| | - Florent Carsuzaa
- Department of Head and Neck Surgery, Poitiers University Hospital, Poitiers, France
| | - Benjamin Verillaud
- Department of Head and Neck Surgery, Lariboisière Hospital, Paris, France
| | - Gilles Poissonnet
- Department of Head and Neck Oncologic Surgery, Antoine Lacassagne Center, Nice, France
| | - Philippe Schultz
- Department of Head and Neck Surgery, Strasbourg University Hospital, Strasbourg, France
| | - Esteban Brenet
- Department of Head and Neck Surgery, Reims University Hospital, Reims, France
| | - François Mouawad
- Department of Head and Neck Surgery, Lille University Hospital, Lille, France
| | - Juliette Thariat
- Department of Radiation Oncology, François Baclesse Center, Caen, France
| | - Noémie Vulquin
- Department of Radiation Oncology, Georges François Leclerc Center, Dijon, France
| | - Claire Castain
- Department of Pathology, Bordeaux University Hospital, Bordeaux, France
| | - Ludovic de Gabory
- Department of Head and Neck Surgery, Bordeaux University Hospital, F33000, Bordeaux, France
| | - Charles Dupin
- Department of Radiation Oncology, Bordeaux University Hospital, F33000, Bordeaux, France; Bordeaux University, na unit, UMR 6033, F-33000, Bordeaux, France; BRIC (BoRdeaux Institute of OnCology), UMR1312, INSERM, University of Bordeaux, F-33000, Bordeaux, France.
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Ghanem W, Qassemyar Q, Julieron M, Kolb F, Leymarie N, Moya-Plana A, Janot F, Temam S, Benmoussa N. Reconstruction of subtotal pharyngolaryngectomy using a fasciocutaneous free flap with cartilage graft: A case series of 17 patients. Head Neck 2023; 45:2335-2343. [PMID: 37482897 DOI: 10.1002/hed.27474] [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: 02/13/2023] [Revised: 07/03/2023] [Accepted: 07/12/2023] [Indexed: 07/25/2023] Open
Abstract
INTRODUCTION Subcricoid-hemilaryngopharyngectomy (SCHLP) with a reconstruction using a fasciocutaneous free flap armed with cartilage graft (FFACG) aims to avoid permanent tracheostomy while still maintaining the laryngopharyngeal functions. The purpose of this study is to report the outcome of this surgical approach. MATERIALS AND METHODS Retrospective study including 17 men operated between 2001 and 2019. Specific survival rate included death caused by cancer or SCHLP complications. Complications, functional and oncological outcomes were evaluated retrospectively. RESULTS There were no locoregional recurrences. One patient died due to inhalation pneumonia 3 years after surgery. Tracheostomy was closed in 13 patients (76.5%). Mean decannulation time was at six [1-14] months after surgery. CONCLUSION SCHPL with FFACG could avoid total pharyngolaryngectomy with good oncologic results. However, tracheotomy is extended and deglutition recovery is long with high risk of aspirations. These complications justify that such surgery should be realized only on selected patients by experienced surgical teams. Expertise of the surgical team is critical.
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Affiliation(s)
- Wahib Ghanem
- Department of Head and Neck Oncology, Gustave Roussy, Paris-Saclay University, Villejuif, France
| | - Quentin Qassemyar
- Department of Plastic Surgery, Gustave Roussy, Paris-Saclay University, Villejuif, France
| | - Morbize Julieron
- Department of Head and Neck Oncology, Gustave Roussy, Paris-Saclay University, Villejuif, France
| | - Frédéric Kolb
- Department of Plastic Surgery, Gustave Roussy, Paris-Saclay University, Villejuif, France
| | - Nicolas Leymarie
- Department of Plastic Surgery, Gustave Roussy, Paris-Saclay University, Villejuif, France
| | - Antoine Moya-Plana
- Department of Head and Neck Oncology, Gustave Roussy, Paris-Saclay University, Villejuif, France
| | - François Janot
- Department of Head and Neck Oncology, Gustave Roussy, Paris-Saclay University, Villejuif, France
| | - Stéphane Temam
- Department of Head and Neck Oncology, Gustave Roussy, Paris-Saclay University, Villejuif, France
| | - Nadia Benmoussa
- Department of Head and Neck Oncology, Gustave Roussy, Paris-Saclay University, Villejuif, France
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Idriceanu T, Hudelist B, Moya-Plana A, Bresson D. How I do it: epidural transposition of the temporoparietal fascia flap for anterior skull base reconstruction. Acta Neurochir (Wien) 2023; 165:2327-2331. [PMID: 37103586 DOI: 10.1007/s00701-023-05602-w] [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: 01/31/2023] [Accepted: 04/16/2023] [Indexed: 04/28/2023]
Abstract
BACKGROUND Multilayer closures and the use of vascularized flaps have been showed to be very effective in the reconstruction of the anterior skull base (ASB) after extended endonasal approaches resulting in large bone and dural defects. In the case of unavailability of a local flap, regional ones like the temporoparietal fascia flap (TPFF), used until now via a transpterygoïd route (Bolzoni Villaret et al. in Eur Arch Otorhinolaryngol 270(4):1473-1479, 2023; Fortes et al. in Laryngoscope 117(6):970-976, 2017; Veyrat et al. in Acta Neurochir (Wien) 158(12):2291-2294, 2016), can be an effective alternative. METHOD We describe a step-by-step technique of TPFF transposition via an epidural supraorbital corridor for the reconstruction of a large midline ASB defect. CONCLUSION TPFF is a promising alternative for the reconstruction of the ASB defects.
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Affiliation(s)
- Tania Idriceanu
- Neurosurgery Department, AP-HP, Henri Mondor University Hospital, 51 avenue du Marechal de Lattre de Tassigny, 94000, Créteil, France.
| | - Benoit Hudelist
- Neurosurgery Department, AP-HP, Henri Mondor University Hospital, 51 avenue du Marechal de Lattre de Tassigny, 94000, Créteil, France
| | | | - Damien Bresson
- Neurosurgery Department, Foch University Hospital, 92150, Suresnes, France
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Suria S, Galy R, Bordenave L, Motamed C, Bourgain JL, Guerlain J, Moya-Plana A, Elmawieh J. High Frequency Jet Ventilation or Mechanical Ventilation for Panendoscopy for Cervicofacial Cancer: A Retrospective Study. J Clin Med 2023; 12:4039. [PMID: 37373732 DOI: 10.3390/jcm12124039] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/05/2023] [Accepted: 06/11/2023] [Indexed: 06/29/2023] Open
Abstract
Introduction-the upper airway panendoscopy, performed under general anesthesia, is mandatory for the diagnosis of cervicofacial cancer. It is a challenging procedure because the anesthesiologist and the surgeon have to share the airway space together. There is no consensus about the ventilation strategy to adopt. Transtracheal high frequency jet ventilation (HFJV) is the traditional method in our institution. However, the COVID-19 pandemic forced us to change our practices because HFJV is a high risk for viral dissemination. Tracheal intubation and mechanical ventilation were recommended for all patients. Our retrospective study compares the two ventilation strategies for panendoscopy: high frequency jet ventilation (HFJV) and mechanical ventilation with orotracheal intubation (MVOI). Methods-we reviewed all panendoscopies performed before the pandemic in January and February 2020 (HFJV) and during the pandemic in April and May 2020 (MVOI). Minor patients, patients with a tracheotomy before or after, were excluded. We performed a multivariate analysis adjusted on unbalanced parameters between the two groups to compare the risk of desaturation. Results-we included 182 patients: 81 patients in the HFJV group and 80 in the MVOI group. After adjustments based on BMI, tumor localization, history of cervicofacial cancer surgery, and use of muscle relaxants, the patients from the HFJV group showed significantly less desaturation than the intubation group (9.9% vs. 17.5%, ORa = 0.18, p = 0.047). Conclusion-HFJV limited the incidence of desaturation during upper airway panendoscopies in comparison to oral intubation.
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Affiliation(s)
- Stephanie Suria
- Department of Anesthesiology, Gustave Roussy, Paris-Saclay, F-94805 Villejuif, France
| | - Raphaëlle Galy
- Department of Anesthesiology, Gustave Roussy, Paris-Saclay, F-94805 Villejuif, France
| | - Lauriane Bordenave
- Department of Anesthesiology, Gustave Roussy, Paris-Saclay, F-94805 Villejuif, France
| | - Cyrus Motamed
- Department of Anesthesiology, Gustave Roussy, Paris-Saclay, F-94805 Villejuif, France
| | - Jean-Louis Bourgain
- Department of Anesthesiology, Gustave Roussy, Paris-Saclay, F-94805 Villejuif, France
| | - Joanne Guerlain
- Department of Cervico Facial Oncology, Gustave Roussy, Paris-Saclay, F-94805 Villejuif, France
| | - Antoine Moya-Plana
- Department of Cervico Facial Oncology, Gustave Roussy, Paris-Saclay, F-94805 Villejuif, France
| | - Jamie Elmawieh
- Department of Anesthesiology, Gustave Roussy, Paris-Saclay, F-94805 Villejuif, France
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Chabrillac E, Even C, Costes-Martineau V, Fakhry N, Digue L, Moya-Plana A, Baujat B, Righini CA, De Gabory L, Verillaud B, Vergez S, Thariat J. [Rare cancers of the head and neck on behalf of the REFCOR, part 1]. Bull Cancer 2023; 110:692-699. [PMID: 37169603 DOI: 10.1016/j.bulcan.2023.04.008] [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: 02/18/2023] [Revised: 04/04/2023] [Accepted: 04/15/2023] [Indexed: 05/13/2023]
Abstract
Among the 16,000 new cases of malignant tumors of the head and neck diagnosed in France each year, 10% are not conventional squamous cell carcinomas. These so-called rare cancers are distinguished by their presentation and patterns of failure, which is important to recognize in order to offer specific adapted management and maximize the chances of tumor control. These cancers can be rare by their histology, which determines their local invasiveness, and their hematogenous/nodal spread. Their diagnosis can be difficult and often requires comprehensive immunohistochemistry and genomic techniques. Expert pathology review is recommended in the cases of undifferentiated tumors, sarcomas and at the slightest diagnostic doubt. These rare cancers can also be rare by their anatomical location when arising from the paranasal sinuses, salivary glands and ear. Their location requires knowledge of their specific extension routes, and may call for a specific surgical technique (skull base endoscopic sinus surgery, extended total parotidectomy, etc.) and adapted radiotherapy to spare healthy organs surrounding the tumor. This article (part 1) discusses the diagnostic and therapeutic specificities of these rare cancers, and develops the recommendations of the French ENT Cancer Expertise Network (REFCOR) concerning rare epithelial tumors, i.e., salivary tumors, sinonasal tumors, variants of conventional squamous cell carcinomas, neuroendocrine carcinomas, malignant odontogenic tumors, and ear tumors. A second article (part 2) is focused on non-epithelial tumors (sarcomas, mucosal melanomas, lymphomas, tumors of uncertain or undetermined malignancy) and describes the organization and missions of the REFCOR.
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Affiliation(s)
- Emilien Chabrillac
- Institut universitaire du cancer Toulouse - Oncopole, département de chirurgie, 1, avenue Irène Joliot-Curie, 31100 Toulouse, France
| | - Caroline Even
- Institut Gustave Roussy, département d'oncologie médicale, 114, rue Edouard-Vaillant, 94805 Villejuif, France
| | - Valérie Costes-Martineau
- CHU de Montpellier, département de biopathologie, 191, avenue du doyen Gaston-Giraud, 34295 Montpellier, France
| | - Nicolas Fakhry
- Hôpital La Conception, département de chirurgie ORL et cervico-faciale, 147, boulevard Baille, 13005 Marseille, France
| | - Laurence Digue
- Hôpital Saint-André, département d'oncologie médicale, 1, rue Jean-Burguet, 33000 Bordeaux, France
| | - Antoine Moya-Plana
- Institut Gustave Roussy, département de chirurgie ORL et cervico-faciale, 114, rue Edouard-Vaillant, 94805 Villejuif, France
| | - Bertrand Baujat
- Hôpital Tenon, département de chirurgie ORL et cervico-faciale, 4, rue de la Chine, 75020 Paris, France
| | - Christian-Adrien Righini
- CHU de Grenoble-Alpes, département de chirurgie ORL et cervico-faciale, 1, avenue du maquis du Grésivaudan, 38700 La Tronche, France
| | - Ludovic De Gabory
- CHU Pellegrin, département de chirurgie ORL et cervico-faciale, 1, place Amélie Raba-Léon, 33000 Bordeaux, France
| | - Benjamin Verillaud
- Hôpital Lariboisière, département de chirurgie ORL et cervico-faciale, 2, rue Ambroise Paré, 75010 Paris, France
| | - Sébastien Vergez
- CHU de Toulouse-Larrey et institut universitaire du cancer Toulouse - Oncopole, département de chirurgie ORL et cervico-faciale, 1, avenue Irène Joliot-Curie, 31100 Toulouse, France
| | - Juliette Thariat
- Centre François-Baclesse, département de radiothérapie, 3, avenue du général-Harris, 14000 Caen, France.
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11
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Chabrillac E, Even C, Costes-Martineau V, Fakhry N, Digue L, Moya-Plana A, Baujat B, Righini CA, De Gabory L, Verillaud B, Vergez S, Thariat J. [Rare cancers of the head and neck on behalf of the REFCOR, part 2]. Bull Cancer 2023:S0007-4551(23)00202-3. [PMID: 37169602 DOI: 10.1016/j.bulcan.2023.04.007] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 04/04/2023] [Accepted: 04/15/2023] [Indexed: 05/13/2023]
Abstract
Among the 16,000 new cases of malignant tumors of the head and neck diagnosed in France each year, 10% are not conventional squamous cell carcinomas. These so-called rare cancers are distinguished by their presentation and patterns of failure, which is important to recognize in order to offer specific adapted management and maximize the chances of tumor control. These cancers can be rare by their histology as well as their anatomical location when arising from the paranasal sinuses, salivary glands and ear. The management of these heterogeneous rare diseases of complex treatment has considerably been structured over the last 15 years, in particular via the French ENT Cancer Expertise Network (REFCOR) and international networks and registries (EURACAN, etc.). Structuration also favors research with identification of new entities and setting up of specific therapeutic trials. A first article (part 1) discusses the diagnostic and therapeutic specificities of these rare cancers, and develops the recommendations of the REFCOR concerning rare epithelial tumors, i.e., salivary tumors, sinonasal tumors, variants of conventional squamous cell carcinomas, neuroendocrine carcinomas, malignant odontogenic tumors, and ear tumors. This second article (part 2) is focused on non-epithelial tumors (sarcomas, mucosal melanomas, lymphomas, tumors of uncertain or undetermined malignancy) and describes the organization and missions of the REFCOR.
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Affiliation(s)
- Emilien Chabrillac
- Institut universitaire du cancer Toulouse-oncopole, département de chirurgie, 1, avenue Irène-Joliot-Curie, 31100 Toulouse, France
| | - Caroline Even
- Institut Gustave Roussy, département d'oncologie médicale, 114, rue Edouard-Vaillant, 94805 Villejuif, France
| | - Valérie Costes-Martineau
- CHU de Montpellier, département de biopathologie, 191, avenue du Doyen Gaston-Giraud, 34295 Montpellier, France
| | - Nicolas Fakhry
- Hôpital La Conception, département de chirurgie ORL et cervico-faciale, 147, boulevard Baille, 13005 Marseille, France
| | - Laurence Digue
- Hôpital Saint-André, département d'oncologie médicale, 1, rue Jean-Burguet, 33000 Bordeaux, France
| | - Antoine Moya-Plana
- Institut Gustave-Roussy, département de chirurgie ORL et cervico-faciale, 114, rue Edouard-Vaillant, 94805 Villejuif, France
| | - Bertrand Baujat
- Hôpital Tenon, département de chirurgie ORL et cervico-faciale, 4, rue de la Chine, 75020 Paris, France
| | - Christian-Adrien Righini
- CHU de Grenoble-Alpes, département de chirurgie ORL et cervico-faciale, 1, avenue du Maquis du Grésivaudan, 38700 La Tronche, France
| | - Ludovic De Gabory
- CHU de Pellegrin, département de chirurgie ORL et cervico-faciale, 1, Place Amélie-Raba-Léon, 33000 Bordeaux, France
| | - Benjamin Verillaud
- Hôpital Lariboisière, département de chirurgie ORL et cervico-faciale, 2, rue Ambroise-Paré, 75010 Paris, France
| | - Sébastien Vergez
- Institut Universitaire du Cancer Toulouse-Oncopole, CHU de Toulouse-Larrey, département de chirurgie ORL et cervico-faciale, 1, avenue Irène-Joliot-Curie, 31100 Toulouse, France
| | - Juliette Thariat
- Centre François-Baclesse, département de radiothérapie, 3, avenue du Général-Harris, 14000 Caen, France.
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Guerlain J, Marhic A, Casiraghi O, Lumbroso J, Garcia G, Breuskin I, Janot F, Temam S, Gorphe P, Moya-Plana A. Occult nodal metastases in T1-T2cN0 oral squamous cell carcinoma: Correlation between sentinel node positivity and completion neck dissection analysis. Oral Oncol 2023; 139:106338. [PMID: 36807087 DOI: 10.1016/j.oraloncology.2023.106338] [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: 12/01/2022] [Revised: 01/31/2023] [Accepted: 02/12/2023] [Indexed: 02/21/2023]
Abstract
OBJECTIVES Sentinel node procedure (SN) is a standard procedure that has shown its safety and effectiveness for T1/T2 cN0 oral squamous cell carcinoma (OSCC), with completion neck dissection (CND) for patients with positive SN. The aim of this study was to characterize the nodal involvement in a cohort of SN + OSCC. MATERIALS AND METHODS Patients with T1/T2 cN0 OSCC with positive SN with CND were included in this single-center, prospective cohort study between 2000 and 2013. RESULTS 54/301 patients had at least one positive SN. In 43/54 (80 %) cases, only the SN(s) were invaded; with only one SN involved (SN+=1) in 36/54 (67 %) cases. No predictive factors of nodal involvement in the CND were found considering the followings: SN micro/macrometastases, primary tumor's depth of invasion (DOI), perineural spread, lymphovascular involvement, primary tumor location, T stage and extranodal extension. The SN micrometastatic involvement (n = 22) was significantly associated with only one SN + CND- (p = 0.017). In the group of patients with unique micrometastatic involvement in the SN (n = 20/54), there was a higher isolated nodal recurrence free time (p = 0.017). CONCLUSION 80% of T1/T2 cN0 OSCC with positive SN had no other lymph node metastases in the CND, questioning the potential benefits of this procedure. Predictive factors such as the size of the SN metastasis need to be tested to stratify the risk of positive non-SN lymph nodes leading to a personalized treatment, lowering the therapeutic morbidity while maintaining the oncologic safety.
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Affiliation(s)
- J Guerlain
- Head & Neck Oncology Department, Gustave Roussy Cancer Campus, Grand Paris, France.
| | - A Marhic
- Head & Neck Oncology Department, Gustave Roussy Cancer Campus, Grand Paris, France
| | - O Casiraghi
- Department of Pathology, Gustave Roussy Cancer Campus, Grand Paris, France
| | - J Lumbroso
- Nuclear Medicine Department, Gustave Roussy Cancer Campus, Grand Paris, France
| | - G Garcia
- Department of Medical Imaging, Gustave Roussy Cancer Campus, Grand Paris, France
| | - I Breuskin
- Head & Neck Oncology Department, Gustave Roussy Cancer Campus, Grand Paris, France
| | - F Janot
- Head & Neck Oncology Department, Gustave Roussy Cancer Campus, Grand Paris, France
| | - S Temam
- Head & Neck Oncology Department, Gustave Roussy Cancer Campus, Grand Paris, France
| | - P Gorphe
- Head & Neck Oncology Department, Gustave Roussy Cancer Campus, Grand Paris, France
| | - A Moya-Plana
- Head & Neck Oncology Department, Gustave Roussy Cancer Campus, Grand Paris, France
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Moya-Plana A, Ngo C, Lanoy E, Vagner S, Robert C. eIF4F translation initiation complex, a predictive marker of response to immunotherapy in mucosal melanoma. Eur J Cancer 2023; 184:120-123. [PMID: 36917923 DOI: 10.1016/j.ejca.2023.01.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 01/30/2023] [Indexed: 02/17/2023]
Affiliation(s)
- Antoine Moya-Plana
- Head & Neck Surgery Department, Gustave Roussy Cancer Campus, Villejuif, France; Inserm U981, Melanoma Group, Gustave Roussy Cancer Campus, Villejuif, France.
| | - Carine Ngo
- Pathology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Emilie Lanoy
- Biostatistics and Epidemiology Unit, Gustave Roussy Cancer Campus, Villejuif, France; Paris-Saclay University, Villejuif, France
| | - Stephan Vagner
- Inserm U981, Melanoma Group, Gustave Roussy Cancer Campus, Villejuif, France
| | - Caroline Robert
- Inserm U981, Melanoma Group, Gustave Roussy Cancer Campus, Villejuif, France; Paris-Saclay University, Villejuif, France; Onco-dermatology Department, Gustave Roussy Cancer Campus, Grand Paris, France
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Haroun F, Benmoussa N, Bidault F, Lassau N, Moya-Plana A, Leymarie N, Honart JF, Kolb F, Qassemyar Q, Gorphe P. Outcomes of mandibular reconstruction using three-dimensional custom-made porous titanium prostheses. J Stomatol Oral Maxillofac Surg 2023; 124:101281. [PMID: 36084893 DOI: 10.1016/j.jormas.2022.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 07/18/2022] [Accepted: 09/05/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Our aim was to report the long-term outcomes of mandibular reconstruction using CAD-CAM-designed 3D-printed porous titanium implants in patients not amenable to a free vascularized fibula flap reconstruction. METHODS The implants were designed with ProPlan CMF® 2.2 software and manufactured with a Selective Laser Melting (SLM) "layer-by-layer" 3D-printing of pure porous titanium powder beds. Primary endpoints were implant exposure and implant removal calculated using Gray's tests. Secondary endpoints were predictive factors of implant exposure and implant removal, and rates of dental rehabilitation. RESULTS Thirty-six patients were operated between 2015 and 2017 and were included in this study. Reconstruction using a porous titanium 3D-printed implant was proposed due to medical contraindication for a fibula free flap (n = 13), due to the failure of a previous fibula free flap reconstruction (n = 7), or due to refusal of a fibula free flap reconstruction by the patient (n = 16). The medical indications for mandibular reconstruction were a primary tumor requiring mandibulectomy in nine patients, mandibular osteoradionecrosis requiring mandibulectomy in nineteen patients, and secondary reconstruction in eight patients. The 2-year rates of implant exposure and implant removal were 69.4% and 52.8%. Reconstruction of the symphysis was a high-risk exposure variable (OR 30; p = 0.0003). Only one patient underwent a successful dental rehabilitation. CONCLUSION The use of a porous titanium 3D- implant for mandibular reconstruction in head and neck cancer patients resulted in high rates of implant exposure and of implant removal, notably when symphysis involvement.
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Affiliation(s)
- Fabienne Haroun
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris Saclay, 114 Rue Edouard Vaillant, Villejuif 94800, France; BioMaps (UMR1281), University Paris Saclay, CNRS, INSERM, CEA, Orsay, France
| | - Nadia Benmoussa
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris Saclay, 114 Rue Edouard Vaillant, Villejuif 94800, France
| | - François Bidault
- BioMaps (UMR1281), University Paris Saclay, CNRS, INSERM, CEA, Orsay, France; Department of Radiology, Gustave Roussy Institute, University Paris Saclay, Villejuif, France
| | - Nathalie Lassau
- BioMaps (UMR1281), University Paris Saclay, CNRS, INSERM, CEA, Orsay, France; Department of Radiology, Gustave Roussy Institute, University Paris Saclay, Villejuif, France
| | - Antoine Moya-Plana
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris Saclay, 114 Rue Edouard Vaillant, Villejuif 94800, France
| | - Nicolas Leymarie
- Department of Plastic and Reconstructive Surgery, Gustave Roussy Institute, University Paris Saclay, Villejuif, France
| | - Jean-François Honart
- Department of Plastic and Reconstructive Surgery, Gustave Roussy Institute, University Paris Saclay, Villejuif, France
| | - Fréderic Kolb
- Plastic and Reconstructive Surgery, UC San Diego, University of California, CA, United States
| | | | - Philippe Gorphe
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris Saclay, 114 Rue Edouard Vaillant, Villejuif 94800, France.
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Obongo Anga R, Abbaci M, Guerlain J, Breuskin I, Casiraghi O, Marhic A, Benmoussa-Rebibo N, de Kermadec H, Moya-Plana A, Temam S, Gorphe P, Hartl DM. Intraoperative Autofluorescence Imaging for Parathyroid Gland Identification during Total Laryngectomy with Thyroidectomy. Cancers (Basel) 2023; 15:cancers15030875. [PMID: 36765832 PMCID: PMC9913419 DOI: 10.3390/cancers15030875] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/08/2022] [Accepted: 01/28/2023] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE Hypoparathyroidism is a known complication of total laryngectomy, although parathyroid preservation and/or reimplantation are not routine. Autofluorescence is a new technique for identifying parathyroid glands intraoperatively. The aim of this study was to evaluate the feasibility of autofluorescence in this context. MATERIALS AND METHODS A retrospective study of patients undergoing total laryngectomy/pharyngectomy with concomitant thyroidectomy using the Fluobeam® (Fluoptics, Grenoble, France) and frozen section of a parathyroid fragment in case of reimplantation. The rates of identification using autofluorescence, reimplantation, and hypoparathyroidism were evaluated. RESULTS Eighteen patients (16 males, median age 67) underwent total laryngectomy/pharyngectomy with total thyroidectomy (n = 12) or hemithyroidectomy (n = 6). A median of 2 parathyroid glands were identified per patient. Ninety-two percent were identified by autofluorescence before visualisation. All parathyroids were reimplanted due to devascularization. Temporary hypoparathyroidism occurred in nine patients, and was permanent in one patient. After 34 months of median follow-up (range 1-49), no tumor recurrence was observed in the reimplantation sites. CONCLUSIONS To our knowledge, this is the largest study to evaluate autofluorescence during total laryngectomy with thyroidectomy. No tumor recurrence occurred in the sites of parathyroid reimplantation.
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Affiliation(s)
- Raïs Obongo Anga
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, 94805 Villejuif, France
- Department of Head and Neck Cancer and ENT Surgery, Henri Becquerel Cancer Center, 76038 Rouen, France
| | - Muriel Abbaci
- Plateforme d’Imagerie et de Cytométrie, UMS AMMICa, Gustave-Roussy Cancer Campus—Grand Paris, Université Paris-Saclay, 94805 Villejuif, France; Laboratoire d’Imagerie Biomédicale Multimodale Paris Saclay, Université Paris-Saclay, CEA, CNRS, Inserm, 91401 Orsay, France
| | - Joanne Guerlain
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, 94805 Villejuif, France
| | - Ingrid Breuskin
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, 94805 Villejuif, France
| | - Odile Casiraghi
- Department of Pathology, Gustave Roussy Cancer Campus, 94805 Villejuif, France
| | - Alix Marhic
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, 94805 Villejuif, France
| | - Nadia Benmoussa-Rebibo
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, 94805 Villejuif, France
| | - Héloïse de Kermadec
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, 94805 Villejuif, France
| | - Antoine Moya-Plana
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, 94805 Villejuif, France
| | - Stéphane Temam
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, 94805 Villejuif, France
| | - Philippe Gorphe
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, 94805 Villejuif, France
| | - Dana M. Hartl
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, 94805 Villejuif, France
- Correspondence:
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Benmoussa N, D'andrea G, Moya-Plana A, Philippe C. Hippocrates: father of mini-invasive nasal surgery. Surg Radiol Anat 2022; 44:1375-1378. [PMID: 36208336 DOI: 10.1007/s00276-022-03030-6] [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] [Received: 05/04/2022] [Accepted: 09/29/2022] [Indexed: 11/28/2022]
Abstract
Hippocrates, a Greek physician during the fifth century BC., is often considered the father of medicine. The Corpus Hippocraticum comprising of 58 volumes was writing between 450 and 150 BC. The objective of our study was to detail the management of nasal polyps during this period. We read and analyzed all volumes of the Corpus Hippocraticum in French translation and extracted all passages dealing with nasal polyps (n = 6). Surgical procedures in the Corpus Hippocraticum are described in great detail. The first surgical strategy for the removal of nasal polyps was by mini-invasive nasal approach: the lopping method and the sponge method. We explain the two mini-invasive nasal approaches with drawings. The meticulously detailed observations of the corpus give us a precious insight into the early perception of diseases, their progression and early attempts of treatment.
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Affiliation(s)
- Nadia Benmoussa
- Laboratory Anthropology, Archaeology, Biology (LAAB), UFR of Health Sciences, (Paris-Saclay University/UVSQ, 2 avenue de la Source de la Bièvre, 78180, Montigny-Le-Bretonneux, France. .,Department of Head and Neck Surgical Oncology, Gustave Roussy, Paris-Saclay University, 94805, Villejuif, France.
| | - Grégoire D'andrea
- Department of ENT and Head and Neck Surgery, Antoine Lacassagne Centre, Institut Universitaire de la Face et du Cou, GCS Nice University Hospital, Côte d'Azur University, Nice, France
| | - Antoine Moya-Plana
- Department of Head and Neck Surgical Oncology, Gustave Roussy, Paris-Saclay University, 94805, Villejuif, France
| | - Charlier Philippe
- Laboratory Anthropology, Archaeology, Biology (LAAB), UFR of Health Sciences, (Paris-Saclay University/UVSQ, 2 avenue de la Source de la Bièvre, 78180, Montigny-Le-Bretonneux, France.,Department of Research and High Education, musée du quai Branly-Jacques Chirac, 222 rue de l'université, 75007, Paris, France
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Lemelle L, Moya-Plana A, Dumont B, Fresneau B, Laprie A, Claude L, Deneuve S, Cordero C, Pierron G, Couloigner V, Bernard S, Cardoen L, Brisse HJ, Jehanno N, Metayer L, Fréneaux P, Helfre S, Kolb F, Thariat J, Réguerre Y, Orbach D. NUT carcinoma in children, adolescents and young adults. Bull Cancer 2022; 109:491-504. [DOI: 10.1016/j.bulcan.2022.01.015] [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] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 01/22/2022] [Accepted: 01/31/2022] [Indexed: 10/18/2022]
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Moya-Plana A, Tselikas L, Lambotte O, Temam S, De Baere T, Deutsch E, Barlesi F, Blanchard P, Levy A. Postgraduate oncology educational shifts during the COVID-19 pandemic: results of faculty and medical student surveys. ESMO Open 2022; 7:100451. [PMID: 35427841 PMCID: PMC8888032 DOI: 10.1016/j.esmoop.2022.100451] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/08/2022] [Accepted: 02/22/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has disrupted clinical practice, research and teaching. During peaks, virtual courses were implemented but these changes are poorly described, especially for oncology postgraduate students and faculty teachers. PATIENTS AND METHODS We administered two surveys from June 2021 to October 2021 to students and faculty teachers (250 and 80 responses, respectively) who registered at Gustave Roussy School of Cancer Sciences (Université Paris-Saclay) during 3 consecutive university years (October 2018 to October 2021), where a major shift to e-learning was associated with COVID-19 pandemic. RESULTS Most students were female (53%), attending physicians (50%), aged 30-39 years (54%) and 2020-2021 (66.4%) was the main year of training. Most faculty teachers were male (58%), aged 40-50 years (44%) and had participated in training for at least 3 years (83%). More than half of the students received 100% virtual training [55% versus 45% face-to-face/mixed teaching modalities; online (84%) versus remote teaching (16%)]. Only 34% of students declared >80% 'active listening' and only 16% of teachers considered e-learning to be more suitable (compared with face-to-face) for postgraduate education. Virtual teaching decreased student-teacher interactions as compared with mixed/face-to-face (lessons were sufficiently interactive for 54% students if virtual only teaching versus for 71% if other teaching modalities; P = 0.009). Teachers stated that virtual learning did not lead to any improvements in terms of attendance (68%), interaction (74%) and quality of teaching (68%). However, most faculty (76%) acknowledged that partial e-learning training should be maintained outside the pandemic, if it represents ≤50% of the whole teaching (teachers: 79% versus student: 66%; P = 0.04). CONCLUSIONS COVID-19 accelerated the transition toward novel practices. Students and faculty teachers agreed on the need for future mixed (≤50% e-learning) teaching modalities. Adequate formation and the use of codified best newer virtual practices are required.
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Affiliation(s)
- A Moya-Plana
- Department of Head and Neck Oncology, Gustave Roussy, Villejuif, France; Université Paris-Saclay, INSERM U981, Villejuif, France; Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France.
| | - L Tselikas
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France; Interventional Radiology, Department of Surgery and Anesthesiology, Gustave Roussy, Villejuif, France; Université Paris-Saclay, INSERM 1428 CIC Biotheris, Villejuif, France.
| | - O Lambotte
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France; Université Paris-Saclay, AP-HP, Hôpital Bicêtre, Clinical Immunology Department, Le Kremlin Bicêtre, France; Université Paris-Saclay, Inserm, CEA, Center for Immunology of Viral, Auto-immune, Hematological and Bacterial Diseases (IDMIT/IMVA-HB), UMR1184, Le Kremlin Bicêtre, France
| | - S Temam
- Department of Head and Neck Oncology, Gustave Roussy, Villejuif, France
| | - T De Baere
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France; Interventional Radiology, Department of Surgery and Anesthesiology, Gustave Roussy, Villejuif, France
| | - E Deutsch
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France; Department of Radiation Oncology, Gustave Roussy, Villejuif, France; Université Paris-Saclay, INSERM U1030, Molecular Radiotherapy, Villejuif, France
| | - F Barlesi
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France; Department of Medical Oncology, Gustave Roussy, Villejuif, France; Aix Marseille University, CNRS, INSERM, CRCM, Marseille, France
| | - P Blanchard
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France; Department of Radiation Oncology, Gustave Roussy, Villejuif, France
| | - A Levy
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France; Department of Radiation Oncology, Gustave Roussy, Villejuif, France; Université Paris-Saclay, INSERM U1030, Molecular Radiotherapy, Villejuif, France.
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Gorphe P, Classe M, Ammari S, Garcia G, Even C, Casiraghi O, Breuskin I, Tao Y, Temam S, Blanchard P, Moya-Plana A. Patterns of disease events and causes of death in patients with HPV-positive versus HPV-negative oropharyngeal carcinoma. Radiother Oncol 2022; 168:40-45. [DOI: 10.1016/j.radonc.2022.01.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/13/2022] [Accepted: 01/16/2022] [Indexed: 01/27/2023]
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Bouaoud J, Benmoussa N, Honart JF, Temam S, Moya-Plana A, Leymarie N, Kolb F. Delto-acromial artery perforator flap combined with a radial forearm free flap as a "vascular bridge" for nasal reconstruction. J Stomatol Oral Maxillofac Surg 2021; 123:215-217. [PMID: 34688961 DOI: 10.1016/j.jormas.2021.10.006] [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] [Received: 09/10/2021] [Revised: 10/09/2021] [Accepted: 10/12/2021] [Indexed: 10/20/2022]
Abstract
Nasal reconstruction for total rhinectomy is challenging, especially if locoregional flaps are unavailable. Herein, we report the case of a nasal reconstruction combining a forearm free flap as "vascular bridge" and a Delto-Acromial Artery Perforator (DAAP) flap in its free form. The forearm free flap was used to restore missing elements of the nasal lining while the distal part of the radial pedicle has served as a donor vessel for the DAAP free flap which restores the nasal covering. A chondrocostal graft was used as a nasal framework. The nasal aspect at 24 months postop support the patient's satisfaction. The main advantages of the DAAP Flap are the pliability, relative hairless nature, skin thinness and its geographical proximity with the nose avoiding major dyschromia. Moreover, the anatomy consistency makes it easier to harvest, the underlying muscles are respected, and it allows for tension free primary closure without shoulder movement limitation.
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Affiliation(s)
- Jebrane Bouaoud
- Gustave Roussy, Paris-Saclay University, Department of Head and Neck Oncology, Villejuif F-94805, France; Gustave Roussy, Paris-Saclay University, Department of Plastic Surgery, Villejuif F-94805, France
| | - Nadia Benmoussa
- Gustave Roussy, Paris-Saclay University, Department of Head and Neck Oncology, Villejuif F-94805, France
| | - Jean-François Honart
- Gustave Roussy, Paris-Saclay University, Department of Plastic Surgery, Villejuif F-94805, France
| | - Stephane Temam
- Gustave Roussy, Paris-Saclay University, Department of Head and Neck Oncology, Villejuif F-94805, France
| | - Antoine Moya-Plana
- Gustave Roussy, Paris-Saclay University, Department of Head and Neck Oncology, Villejuif F-94805, France
| | - Nicolas Leymarie
- Gustave Roussy, Paris-Saclay University, Department of Plastic Surgery, Villejuif F-94805, France
| | - Frederic Kolb
- Department of Plastic Surgery, UC San Diego, University of California, San Diego, CA, United States
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Gorphe P, Moya-Plana A, Guerlain J, Tao Y, Nguyen F, Breuskin I, Blanchard P, Temam S. Disease-free time stratification in locally recurrent head and neck carcinoma after definitive radiotherapy or chemoradiotherapy. Eur Arch Otorhinolaryngol 2021; 279:3063-3069. [PMID: 34648050 DOI: 10.1007/s00405-021-07116-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 09/30/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE There is no standard definition of disease-free interval before local recurrence after treatment in head and neck carcinoma (HNSCC). We evaluated an easy-to-use stratification and its association with survival in a large cohort of patients. METHODS We performed a retrospective cohort analysis of prognostic variables in 325 HNSCC patients with a local recurrence after definitive radiotherapy or concurrent chemoradiotherapy. Endpoints were overall survival (OS) and post-recurrence survival (PRS). RESULTS Variables associated with the survival were the patient age (OS p < 0.0001, PRS p < 0.0001), the initial disease stage (OS p = 0.24, PRS p = 0.0358), localization (OS p = 0.012, PRS p = 0.0002), a complete initial response to treatment (OS p < 0.0001, PRS p = 0.019), synchronous regional or distant metastatic disease (OS p = 0.0094, PRS p < 0.0001), a salvage surgery (OS p < 0.0001, PRS p < 0.0001) and time to recurrence (OS p = 0.0002, PRS p = 0.0029). Time to recurrence could be stratified between specific prognostic time categories that comprised disease persistence, early recurrence (< 12 months), standard recurrence (12 months-5 years) and late recurrence (> 5 years). CONCLUSION In HNSCC patients, time to local recurrence is a prognostic variable that can be defined using an easy-to-use stratification.
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Affiliation(s)
- Philippe Gorphe
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, 114 Rue Edouard Vaillant, 94800, Villejuif, France.
| | - Antoine Moya-Plana
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, 114 Rue Edouard Vaillant, 94800, Villejuif, France
| | - Joanne Guerlain
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, 114 Rue Edouard Vaillant, 94800, Villejuif, France
| | - Yungan Tao
- Department of Radiotherapy, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - France Nguyen
- Department of Radiotherapy, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - Ingrid Breuskin
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, 114 Rue Edouard Vaillant, 94800, Villejuif, France
| | - Pierre Blanchard
- Department of Radiotherapy, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - Stéphane Temam
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, 114 Rue Edouard Vaillant, 94800, Villejuif, France
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Gorphe P, Temam S, Moya-Plana A, Leymarie N, Kolb F, Bout-Roumazeilles A, Qassemyar Q, Benmoussa N, Honart JF. Indications and Clinical Outcomes of Transoral Robotic Surgery and Free Flap Reconstruction. Cancers (Basel) 2021; 13:cancers13112831. [PMID: 34204149 PMCID: PMC8201082 DOI: 10.3390/cancers13112831] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 05/08/2021] [Revised: 06/02/2021] [Accepted: 06/03/2021] [Indexed: 12/21/2022] Open
Abstract
We reviewed the indications, peroperative feasibility, and postoperative clinical outcomes of our first 50 consecutive patients who underwent free flap reconstruction after TORS for complex pharyngeal defects at our institution. We analyzed indications according to previous radiotherapy, the size of the resection, and the transoral exposure of critical structures. We reviewed surgical data, postoperative complications, and functional outcomes comprising tracheostomy and alimentation management. Indications were upfront surgery (34%), a second primary surgery after radiotherapy (28%), or salvage surgery after chemoradiotherapy failure (38%). Localizations were the tongue base (44%), tonsillar fossa (28%), pharyngeal wall (22%), and soft palate (6%). T-classifications were T1 (6%), T2 (52%), T3 (20%), and T4 (22%). The mean length of the surgery was 574 min. Two patients were intraoperatively converted to a conventional approach at the beginning of the learning curve. In conclusion, TORS and free flap reconstruction in complex situations were associated with low rates of postoperative complications and satisfactory functional outcomes. They were, however, associated with a renewed learning curve.
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Affiliation(s)
- Philippe Gorphe
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, 94800 Villejuif, France; (S.T.); (A.M.-P.); (N.B.)
- Correspondence:
| | - Stéphane Temam
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, 94800 Villejuif, France; (S.T.); (A.M.-P.); (N.B.)
| | - Antoine Moya-Plana
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, 94800 Villejuif, France; (S.T.); (A.M.-P.); (N.B.)
| | - Nicolas Leymarie
- Department of Plastic and Reconstructive Surgery, Gustave Roussy Institute, University Paris-Saclay, 94800 Villejuif, France; (N.L.); (A.B.-R.); (J.-F.H.)
| | - Frédéric Kolb
- Plastic and Reconstructive Surgery, UC San Diego, University of California, La Jolla, CA 92121, USA;
| | - Apolline Bout-Roumazeilles
- Department of Plastic and Reconstructive Surgery, Gustave Roussy Institute, University Paris-Saclay, 94800 Villejuif, France; (N.L.); (A.B.-R.); (J.-F.H.)
| | - Quentin Qassemyar
- Department of Plastic Surgery, Tenon Hospital, AP-HP, 75020 Paris, France;
| | - Nadia Benmoussa
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, 94800 Villejuif, France; (S.T.); (A.M.-P.); (N.B.)
| | - Jean-François Honart
- Department of Plastic and Reconstructive Surgery, Gustave Roussy Institute, University Paris-Saclay, 94800 Villejuif, France; (N.L.); (A.B.-R.); (J.-F.H.)
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Surun A, Schneider DT, Ferrari A, Stachowicz-Stencel T, Rascon J, Synakiewicz A, Agaimy A, Martinova K, Kachanov D, Roganovic J, Bien E, Bisogno G, Brecht IB, Kolb F, Thariat J, Moya-Plana A, Orbach D. Salivary gland carcinoma in children and adolescents: The EXPeRT/PARTNER diagnosis and treatment recommendations. Pediatr Blood Cancer 2021; 68 Suppl 4:e29058. [PMID: 34174160 DOI: 10.1002/pbc.29058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/22/2021] [Accepted: 03/23/2021] [Indexed: 01/13/2023]
Abstract
Salivary gland carcinomas (SGCs) are rare during childhood and adolescence. Consequently, no standardized recommendations for the diagnosis and therapeutic management of pediatric SGC are available, and pediatric oncologists and surgeons generally follow adult guidelines. Complete surgical resection with adequate margins constitutes the cornerstone of treatment. However, the indications and modalities of adjuvant therapy remain controversial and may be challenging in view of the potential long-term toxicities in the pediatric population. This paper presents the consensus recommendations for the diagnosis and treatment of children and adolescents with SGCs, established by the European Cooperative Study Group for Pediatric Rare Tumors (EXPeRT) within the EU-funded PARTNER project (Paediatric Rare Tumours Network - European Registry).
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Affiliation(s)
- Aurore Surun
- SIREDO Oncology Center (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, PSL University, Paris, France
| | | | - Andrea Ferrari
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Jelena Rascon
- Center for Pediatric Oncology and Hematology, Vilnius University Hospital, Vilnius, Lithuania
| | - Anna Synakiewicz
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdańsk, Gdańsk, Poland
| | - Abbas Agaimy
- Institute of Pathology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Kata Martinova
- Department of Hematology and Oncology, University Clinic for Children's Diseases, Medical Faculty, Ss. Cyril and Methodius University of Skopje, Skopje, North Macedonia
| | - Denis Kachanov
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation
| | - Jelena Roganovic
- Department of Pediatrics, Clinical Hospital Center, Rijeka, Croatia
| | - Ewa Bien
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdańsk, Gdańsk, Poland
| | - Gianni Bisogno
- Hematology-Oncology Division, Department of Pediatrics, Padova University Hospital, Padua, Italy
| | - Ines B Brecht
- Pediatric Hematology and Oncology, Children's Hospital, Eberhard-Karls-Universitaet Tuebingen, Tübingen, Germany
| | - Frédéric Kolb
- Department of Surgery, Division of Plastic Surgery, University of California, San Diego, California, USA
| | - Juliette Thariat
- Radiation Oncology Department, Baclesse Cancer Center, Caen, France
| | - Antoine Moya-Plana
- Head and Neck Surgery Department, Gustave-Roussy Cancer Campus, Villejuif, France
| | - Daniel Orbach
- SIREDO Oncology Center (Care, Innovation and Research for Children, Adolescents and Young Adults with Cancer), Institut Curie, PSL University, Paris, France
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Dahan LS, Giorgi R, Vergez S, Le Taillandier de Gabory L, Costes-Martineau V, Herman P, Poissonnet G, Mauvais O, Malard O, Garrel R, Uro-Coste E, Barry B, Bach C, Chevalier D, Mouawad F, Merol JC, Bastit V, Thariat J, Gilain L, Dufour X, Righini CA, Moya-Plana A, Even C, Radulesco T, Michel J, Baujat B, Fakhry N, Albert S, Andry G, Babin E, Bach C, Badet JM, Badoual C, Baglin A, Banal A, Barry B, Baudin E, Baujat B, Bensadoun R, Bertolus C, Bessède JP, Blanchard D, Borel C, Bozorg-Grayeli A, Breheret R, Breton P, Brugel L, Calais G, Casiraghi O, Cassagnau E, Castillo L, Ceruse P, Chabolle F, Chevalier D, Chobaut J, Choussy O, Cosmidis A, Coste A, Costes V, Crampette L, Darrouzet V, Demez P, Dessi P, Devauchelle B, Dolivet G, Dubrulle F, Duflo S, Dufour X, Faivre S, Fakhry N, Ferron C, Floret F, de Gabory L, Garrel R, Geoffrois L, Gilain L, Giovanni A, Girod A, Guerrier B, Hans S, Herman P, Hofman P, Housset M, Jankowski R, Jegoux F, Juliéron M, Kaminsky MC, Kolb F, St Guily JL, Laccoureye L, Lallemant B, Lang P, Lartigau E, Lavieille JP, Lefevre M, Leroy X, Malard O, Massip F, Mauvais O, Merol JC, Michel J, Mom T, Morinière S, de Monès E, Moulin G, Noel G, Poissonnet G, Prades JM, Radulesco T, de Raucourt D, Reyt E, Righini C, Robin YM, Rolland F, Ruhin B, Sarroul N, Schultz P, Serrano E, Sterkers O, Strunski V, Sudaka A, Tassart M, Testelin S, Thariat J, Timochenko A, Toussaint B, Coste EU, Valette G, Van den Abbeele T, Varoquaux A, Veillon F, Vergez S, Wassef M. Mucoepidermoid carcinoma of salivary glands: A French Network of Rare Head and Neck Tumors (REFCOR) prospective study of 292 cases. Eur J Surg Oncol 2021; 47:1376-1383. [DOI: 10.1016/j.ejso.2020.11.123] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/31/2020] [Accepted: 11/13/2020] [Indexed: 12/18/2022] Open
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de Kerangal Q, Kapso R, Morinière S, Laure B, Bonastre J, Moya-Plana A. Sentinel lymph node biopsy versus selective neck dissection in patients with early oral squamous cell carcinoma: A cost analysis. J Stomatol Oral Maxillofac Surg 2021; 123:372-376. [PMID: 34000437 DOI: 10.1016/j.jormas.2021.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 05/07/2021] [Accepted: 05/11/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Sentinel lymph node biopsy (SLNB) has been proved to be as efficient as selective neck dissection (SND) for the treatment of occult metastases in T1-T2cN0 oral squamous cell carcinoma (OSCC). The aim of our study was to assess and compare the cost of these two surgical procedures. PATIENTS AND METHODS This retrospective cost analysis includes consecutive patients treated between 2012 and 2017 in two French hospitals either by SLNB or SND. Hospital cost (hospital stay for initial surgery and re-hospitalizations over a period of 60 days after the initial surgery), the length of hospital stay for the initial surgery and the perioperative management were described and compared between the two techniques. The propensity score regression adjustment method was used to address selection bias. RESULTS Ninety-four patients underwent SLNB procedure and seventy-seven patients underwent SND. The length of hospital stay for initial surgery was lower in SLNB group: 5.8 days (SD: 3.8) versus 9.2 days (SD: 5) in the SND group. Hospital costs were lower in SLNB group: €7 489 (standard deviation: €3 691) versus €8 886 (standard deviation: €4 381) but this difference was not significant after propensity score regression adjustment. The rate of complication, the delay of full oral feeding and postoperative drainage were lower in SLNB group. CONCLUSION SLNB in T1-T2cN0 OSCC is less invasive than SND with fewer complications, a shorter length of hospital stay and favorable perioperative management. This study shows that this technique could be also less expensive than SND.
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Affiliation(s)
- Quitterie de Kerangal
- Head and Neck Oncology Department, Gustave Roussy, Paris-Saclay University, F-94805, Villejuif, France.
| | - Raissa Kapso
- Biostatistics and Epidemiology Department, Gustave Roussy, Paris-Saclay University, F-94805, Villejuif, France
| | - Sylvain Morinière
- Head and Neck Surgery Department, Tours University Hospital, F-37044 Tours Cedex 9 France
| | - Boris Laure
- Maxillo-facial and Plastic Surgery Department, Tours University Hospital, F-37044 Tours Cedex 9, France
| | - Julia Bonastre
- Biostatistics and Epidemiology Department, Gustave Roussy, Paris-Saclay University, F-94805, Villejuif, France; UVSQ, CESP, INSERM, Paris-Saclay University, Paris-Sud University, F-94805, Villejuif, France
| | - Antoine Moya-Plana
- Head and Neck Oncology Department, Gustave Roussy, Paris-Saclay University, F-94805, Villejuif, France
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Carsuzaa F, Lapeyre M, Gregoire V, Maingon P, Beddok A, Marcy PY, Salleron J, Coutte A, Racadot S, Pointreau Y, Graff P, Beadle B, Benezery K, Biau J, Calugaru V, Castelli J, Chua M, Di Rito A, Dore M, Ghadjar P, Huguet F, Jardel P, Johansen J, Kimple R, Krengli M, Laskar S, Mcdowell L, Nichols A, Tribius S, Valduvieco I, Hu C, Liem X, Moya-Plana A, D'onofrio I, Parvathaneni U, Takiar V, Orlandi E, Psyrri A, Shenouda G, Sher D, Steuer C, Shan Sun X, Tao Y, Thomson D, Tsai MH, Vulquin N, Gorphe P, Mehanna H, Yom SS, Bourhis J, Thariat J. Recommendations for postoperative radiotherapy in head & neck squamous cell carcinoma in the presence of flaps: A GORTEC internationally-reviewed HNCIG-endorsed consensus. Radiother Oncol 2021; 160:140-147. [PMID: 33984351 DOI: 10.1016/j.radonc.2021.04.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 04/29/2021] [Accepted: 04/30/2021] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Head and neck reconstructive surgery using a flap is increasingly common. Best practices and outcomes for postoperative radiotherapy (poRT) with flaps have not been specified. We aimed to provide consensus recommendations to assist clinical decision-making highlighting areas of uncertainty in the presence of flaps. MATERIAL AND METHODS Radiation, medical, and surgical oncologists were assembled from GORTEC and internationally with the Head and Neck Cancer International Group (HNCIG). The consensus-building approach covered 59 topics across four domains: (1) identification of postoperative tissue changes on imaging for flap delineation, (2) understanding of tumor relapse risks and target volume definitions, (3) functional radiation-induced deterioration, (4) feasibility of flap avoidance. RESULTS Across the 4 domains, international consensus (median score ≥ 7/9) was achieved only for functional deterioration (73.3%); other consensus rates were 55.6% for poRT avoidance of flap structures, 41.2% for flap definition and 11.1% for tumor spread patterns. Radiation-induced flap fibrosis or atrophy and their functional impact was well recognized while flap necrosis was not, suggesting dose-volume adaptation for the former. Flap avoidance was recommended to minimize bone flap osteoradionecrosis but not soft-tissue toxicity. The need for identification (CT planning, fiducials, accurate operative report) and targeting of the junction area at risk between native tissues and flap was well recognized. Experts variably considered flaps as prone to tumor dissemination or not. Discrepancies in rating of 11 items among international reviewing participants are shown. CONCLUSION International GORTEC and HNCIG-endorsed recommendations were generated for the management of flaps in head and neck radiotherapy. Considerable knowledge gaps hinder further consensus, in particular with respect to tumor spread patterns.
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Affiliation(s)
| | - Michel Lapeyre
- Department of Radiation Oncology, Centre Jean Perrin, Clermont-Ferrand, France
| | - Vincent Gregoire
- Department of Radiation Oncology, Centre Léon Bérard, Lyon, France
| | - Philippe Maingon
- Department of Radiation Oncology, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Arnaud Beddok
- Department of Radiation Oncology, Institut Curie, Paris, France
| | - Pierre-Yves Marcy
- Department of Radiology, Clinique du Cap d'Or, La Seyne-sur-mer, France
| | - Julia Salleron
- Department of Biostatistics, Institut de cancérologie de Lorraine, France
| | - Alexandre Coutte
- Department of Radiation Oncology, Amiens Picardie University Medical Center, Amiens, France
| | - Severine Racadot
- Department of Radiation Oncology, Centre Léon Bérard, Lyon, France
| | - Yoann Pointreau
- Department of Radiation Oncology, Centre Jean Bernard, Le Mans, France
| | - Pierre Graff
- Department or Radiation Oncology, Institut C. Regaud, Toulouse, France
| | - Beth Beadle
- Department of Radiation Oncology, Stanford University Medical Center, Stanford University Medical Center, USA
| | - Karen Benezery
- Department of Radiation Oncology, Centre Antoine Lacassagne, Nice, France
| | - Julian Biau
- Department of Radiation Oncology, Centre Jean Perrin, Clermont-Ferrand, France
| | | | - Joel Castelli
- Department of Radiation Oncology, Centre Eugène Marquis, Rennes, France
| | - Melvin Chua
- Division of Radiation Oncology, National Cancer Centre Singapore, Duke-NUS Medical School, Singapore
| | - Alessia Di Rito
- Department of Radiation Oncology, OC Radioterapia Ospedale "Mons. A.R. Dimiccoli" di Barletta, Rome, Italy
| | - Melanie Dore
- Department of Radiation Oncology, Institut de cancérologie de l'Ouest, St Herblain, France
| | - Pirus Ghadjar
- Department of Radiation Oncology, Charité, Berlin, Germany
| | - Florence Huguet
- Department of Radiation Oncology, Hospital de Tenon, Paris, France
| | - Pauline Jardel
- Department of Radiation Oncology, CHU de la Milétrie, Poitiers, France
| | - Jorgen Johansen
- Department of Radiation Oncology, Odense University Hospital, Denmark
| | - Randall Kimple
- Department of Medical Oncology, University of Wisconsin-Madison, WI, USA
| | - Marco Krengli
- Department of Translational Medicine University of Piemonte Orientale, Novara, Italy
| | | | - Lachlan Mcdowell
- Department of Radiation Oncology, Peter McCallum Cancer Center, Melbourne, Australia
| | - Anthony Nichols
- Department of Head and Neck surgery, London Health Sciences Center, Ontario, Canada
| | - Silke Tribius
- Department of Radiation Oncology, Hermann-Holthusen-Institute for Radiation Oncology, Asklepios Hospital St. Georg, Hamburg, Germany
| | | | - Chaosu Hu
- Department of Radiation Oncology, Fundan University, Shanghai, China
| | - Xavier Liem
- Department of Radiation Oncology, Centre Oscar Lambret, Lille, France
| | | | - Ida D'onofrio
- Department of Radiation Oncology, Hospital Naples, Italy
| | | | - Vinita Takiar
- Department of Radiation Oncology, University of Cincinaty, USA
| | - Ester Orlandi
- Department of Radiation Oncology, CNAO, Milan, Italy
| | - Amanda Psyrri
- Department of Medical Oncology, Attikon University Hospital, Athens, Greece
| | - George Shenouda
- Department of Radiation Oncology, McGill University Health Centre, Montreal, Canada
| | - David Sher
- Department of Radiation Oncology, UT Southwestern, Dallas, USA
| | - Conor Steuer
- Department of Head and Neck Surgery, Winship Cancer Institute, Atlanta, USA
| | - Xu Shan Sun
- Department of Radiation Oncology, University hospital CHBM, Montbéliard, France
| | - Yungan Tao
- Department of Head and Neck Surgery, Gustave Roussy, Villejuif, France
| | - David Thomson
- Department of Radiation Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - Mu-Hung Tsai
- Department of Radiation Oncology, National Cheng Kung University Hospital, Tïnan, Taiwan
| | - Noemie Vulquin
- Department of Radiation Oncology, Centre Georges François Leclerc, Dijon, France
| | - Philippe Gorphe
- Department of Head and Neck Surgery, Gustave Roussy, Villejuif, France
| | - Hisham Mehanna
- Department of Radiation Oncology, Institute for Global Innovation, Birmingham, UK
| | - Sue S Yom
- Department of Radiation Oncology, NRG Oncology Cancer Research Group, USA
| | - Jean Bourhis
- Department of Radiation Oncology, UNIL-CHUV, Lausanne, Switzerland
| | - Juliette Thariat
- Department of Radiation Oncology, Centre François-Baclesse, Laboratoire de physique corpusculaire IN2P3/ENSICAEN - UMR6534. Normandie University, Caen, and GORTEC, France.
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Guyonvarch P, Benmoussa N, Moya-Plana A, Leymarie N, Mangialardi ML, Honart JF, Kolb F. Thoracodorsal artery perforator free flap with vascularized thoracodorsal nerve for head and neck reconstruction following radical parotidectomy with facial nerve sacrifice: Step-by-step surgical technique video. Head Neck 2021; 43:2255-2258. [PMID: 33818833 DOI: 10.1002/hed.26701] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 01/12/2021] [Accepted: 03/23/2021] [Indexed: 11/06/2022] Open
Abstract
Oncological surgery of the parotid region sometimes requires the sacrifice of the facial nerve (parotid cancers, extensive skin cancers of the face, soft tissue sarcomas). The sacrificed portion of nerve can be reconstructed by a vascularized nerve graft, especially if the patient must undergo radiotherapy after surgery. In those cases, the facial nerve sacrifice is associated to an important loss of substance from the parotid region (skin, masseter, parotid, and sometimes jaw). Chimeric flap permit the reconstruction at the same time of the external skin, soft tissues for the volume (fat or muscle), nerve, and bone (ramus and angular part of the mandible). An other option was to raise two flaps but it increased the risk of failure (time of surgery, number of anastomosis, etc.). Reconstruction with a chimeric flap appears to be an ideal choice. Based on these observations, we offer our patients at the Gustave Roussy Institute (Villejuif, France) a thoracodorsal artery perforator (TDAP) free flap including the motor nerve of the latissimus dorsi and vascularized by the thoraco-dorsal pedicle, thus allowing reconstruction in a single surgery. The surgical technique is explained with a step-by-step video. Functional outcomes are also shown in the video. The TDAP or chimeric scapulo-dorsal flap with vascularized nerve has many advantages in the facial reanimation of patients suffering from parotid region cancers. This video article explains surgical steps for other teams.
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Affiliation(s)
- Pierre Guyonvarch
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris Saclay, Villejuif, France
| | - Nadia Benmoussa
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris Saclay, Villejuif, France
| | - Antoine Moya-Plana
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris Saclay, Villejuif, France
| | - Nicolas Leymarie
- Department of Plastic Surgery, Gustave Roussy Institute, University Paris Saclay, Villejuif, France
| | - Maria Lucia Mangialardi
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris Saclay, Villejuif, France
| | - Jean-François Honart
- Department of Plastic Surgery, Gustave Roussy Institute, University Paris Saclay, Villejuif, France
| | - Frederic Kolb
- Department of Plastic Surgery, Gustave Roussy Institute, University Paris Saclay, Villejuif, France.,Department of Plastic Surgery, UC San Diego, University of California, San Diego, California, USA
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28
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Moya-Plana A, Mangin D, Blanchard P, Obongo R, Casiraghi O, Bidault F, Temam S, Robert C, Gorphe P. Prognostic value and therapeutic implications of nodal involvement in head and neck mucosal melanoma. Head Neck 2021; 43:2325-2331. [PMID: 33783056 DOI: 10.1002/hed.26694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 03/16/2021] [Accepted: 03/16/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The prognostic significance of nodal involvement is not well established in head and neck mucosal melanoma (HNMM). METHODS A retrospective, monocentric study was performed on 96 patients with HNMM treated between 2000 and 2017. RESULTS At diagnosis, seventeen patients (17.8%) were cN1, with a higher risk for HNMM arising from the oral cavity (p = 0.01). cN status had no prognostic value in patients with nonmetastatic resectable HNMM. No occult nodal metastasis was observed in the cN0 patients after a nodal dissection (ND). The nodal recurrence rate was similar in the cN1 and the cN0 patients. No isolated nodal recurrences were noted. Among the patients who underwent a ND, no benefit of this procedure was noted. CONCLUSIONS cN1 status is not a prognostic factor in patients with resectable HNMM. Elective ND should not be systematically performed in cN0 HNMM.
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Affiliation(s)
- Antoine Moya-Plana
- Department of Head & Neck Surgery, Gustave Roussy Cancer Campus, Villejuif, France.,Inserm U981, Melanoma Group, Gustave Roussy Cancer Campus, Villejuif, France
| | - David Mangin
- Department of Head & Neck Surgery, Gustave Roussy Cancer Campus, Villejuif, France
| | - Pierre Blanchard
- Department of Onco-Radiotherapy, Gustave Roussy Cancer Campus, Villejuif, France
| | - Rais Obongo
- Department of Head & Neck Surgery, Gustave Roussy Cancer Campus, Villejuif, France
| | - Odile Casiraghi
- Department of Pathology, Gustave Roussy Cancer Campus, Villejuif, France
| | - François Bidault
- Department of Radiology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Stéphane Temam
- Department of Head & Neck Surgery, Gustave Roussy Cancer Campus, Villejuif, France
| | - Caroline Robert
- Inserm U981, Melanoma Group, Gustave Roussy Cancer Campus, Villejuif, France.,Department of Onco-Dermatology, Gustave Roussy Cancer Campus-Université Paris-Saclay, Villejuif, France
| | - Philippe Gorphe
- Department of Head & Neck Surgery, Gustave Roussy Cancer Campus, Villejuif, France
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29
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El Ayachy R, Sun R, Ka K, Laville A, Duhamel AS, Tailleur A, Dumas I, Bockel S, Espenel S, Blanchard P, Tao Y, Temam S, Moya-Plana A, Haie-Meder C, Chargari C. Pulsed Dose Rate Brachytherapy of Lip Carcinoma: Clinical Outcome and Quality of Life Analysis. Cancers (Basel) 2021; 13:cancers13061387. [PMID: 33808535 PMCID: PMC8003123 DOI: 10.3390/cancers13061387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 01/10/2021] [Revised: 03/09/2021] [Accepted: 03/15/2021] [Indexed: 01/04/2023] Open
Abstract
Simple Summary Lip cancer accounts for 25–30% of all oral cancers, with 23,000 new cases per year in the world. Carcinomas of the lip can be successfully treated with different methods: surgery, external beam radiotherapy (EBRT) and brachytherapy. The choice of the treatment depends on the tumor size, location and expected functional and esthetic results with each option, but also depends on treatment type accessibility. There are no randomized studies comparing these different treatment strategies. In this article, we investigated the complications and outcomes of patients treated with interstitial pulsed dose rate brachytherapy in our institution. Abstract Purpose: Lip carcinoma represents one of the most common types of head and neck cancer. Brachytherapy is a highly effective therapeutic option for all stages of lip cancers. We report our experience of pulsed dose rate brachytherapy (PDR) as treatment of lip carcinoma. Methods and Materials: this retrospective single center study included all consecutive patients treated for a lip PDR brachytherapy in our institution from 2010 to 2019. The toxicities and outcomes of the patients were reported, and a retrospective quality of life assessment was conducted by phone interviews (FACT H&N). Results: From October 2010 to December 2019, 38 patients were treated in our institution for a lip carcinoma by PDR brachytherapy. The median age was 73, and the majority of patients presented T1-T2 tumors (79%). The median total dose was 70.14 Gy (range: 60–85 Gy). With a mean follow-up of 35.4 months, two patients (5.6%) presented local failure, and seven patients (19%) had lymph node progression. The Kaplan–Meier estimated probability of local failure was 7.2% (95% CI: 0.84–1) at two and four years. All patients encountered radiomucitis grade II or higher. The rate of late toxicities was low: three patients (8.3%) had grade II fibrosis, and one patient had grade II chronic pain. All patients would highly recommend the treatment. The median FACT H&N total score was 127 out of 148, and the median FACT H&N Trial Outcome Index was 84. Conclusions: This study confirms that an excellent local control rate is achieved with PDR brachytherapy as treatment of lip carcinoma, with very limited late side effects and satisfactory functional outcomes. A multimodal approach should help to improve regional control.
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Affiliation(s)
- Radouane El Ayachy
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
| | - Roger Sun
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
| | - Kanta Ka
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
| | - Adrien Laville
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
| | - Anne-Sophie Duhamel
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
| | - Anne Tailleur
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
| | - Isabelle Dumas
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
| | - Sophie Bockel
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
| | - Sophie Espenel
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
| | - Pierre Blanchard
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
| | - Yungan Tao
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
| | - Stéphane Temam
- Head and Neck Surgery Department, Gustave Roussy, 94800 Villejuif, France; (S.T.); (A.M.-P.)
| | - Antoine Moya-Plana
- Head and Neck Surgery Department, Gustave Roussy, 94800 Villejuif, France; (S.T.); (A.M.-P.)
| | - Christine Haie-Meder
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
- Centre de Cancérologie, Département d’Oncologie Radiothérapie, Charlebourg la Défense, 92250 La Garenne Colombes, France
| | - Cyrus Chargari
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
- INSERM1030 Radiothérapie Moléculaire et Innovations Thérapeutiques, Université Paris-Saclay, 94800 Villejuif, France
- Correspondence:
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Guerlain J, Haroun F, Voicu A, Honoré C, Griscelli F, Temam S, Benmoussa N, Gorphe P, de Baere T, Ammari S, Garcia G, Balleyguier C, Rimareix F, Gouy S, Sitbon P, Gachot B, Breuskin I, Suria S, Moya-Plana A. Cancer surgery during the COVID-19 pandemic: The experience of a comprehensive cancer center performing preoperative screening by RT-PCR and chest CT scan. J Surg Oncol 2021; 123:815-822. [PMID: 33524172 DOI: 10.1002/jso.26335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 11/24/2020] [Revised: 11/30/2020] [Accepted: 11/30/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND AND OBJECTIVES During the worldwide pandemic of coronavirus disease 2019 (COVID-19), oncological procedures considered to be urgent could not be delayed, and a specific procedure was required to continue surgical activity. The objective was to assess the efficacy of our preoperative screening algorithm. METHODS This observational retrospective study was performed between the 25th of March and the 12th of May 2020 in a comprehensive cancer center in France. Patients undergoing elective oncologic surgery were tested by preoperative nasopharyngeal reverse-transcription polymerase chain reaction (RT-PCR) that could be associated with a chest computerized tomography (CT) scan. RESULTS Of the 510 screening tests (in 477 patients), only 5% (15/477) were positive for COVID-19 in 24 patients (18 RT-PCR+ and 7 CT scan+/RT-PCR-). Four patients were ultimately false positives based on the CT scan. In total, only 4.2% (20/477) of the patients were COVID-19+. The positivity rate decreased with time after the containment measures were implemented (from 7.4% to 0.8%). In the COVID-19+ group, 20% of the patients had postoperative pulmonary complications, whereas this was the case for 5% of the patients in the COVID-19 group. CONCLUSIONS Maintaining secure surgical activity is achievable and paramount in oncology care, even during the COVID-19 pandemic, with appropriate screening based on preoperative RT-PCR.
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Affiliation(s)
- Joanne Guerlain
- Surgical and Interventional Department, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Fabienne Haroun
- Surgical and Interventional Department, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Alexandra Voicu
- Surgical and Interventional Department, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Charles Honoré
- Surgical and Interventional Department, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Franck Griscelli
- Department of Laboratory Medicine and Pathology, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Stéphane Temam
- Surgical and Interventional Department, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Nadia Benmoussa
- Surgical and Interventional Department, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Philippe Gorphe
- Surgical and Interventional Department, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Thierry de Baere
- Surgical and Interventional Department, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Samy Ammari
- Department of Medical Imaging, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Gabriel Garcia
- Department of Medical Imaging, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Corinne Balleyguier
- Department of Medical Imaging, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Françoise Rimareix
- Surgical and Interventional Department, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Sébastien Gouy
- Surgical and Interventional Department, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Philippe Sitbon
- Surgical and Interventional Department, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Bertrand Gachot
- Infectious Diseases Unit, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Ingrid Breuskin
- Surgical and Interventional Department, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Stéphanie Suria
- Surgical and Interventional Department, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Antoine Moya-Plana
- Surgical and Interventional Department, Paris-Saclay University, Gustave Roussy, Villejuif, France
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Bouaoud J, Benmoussa N, Hennocq Q, Honart JF, Breuskin I, Gorphe P, Casiraghi O, Classe M, Blanchard P, Janot F, Kolb F, Leymarie N, Temam S, Moya-Plana A. Locally advanced nasal pyramid squamous cell carcinoma: our 15 years' experience in a series of 35 total rhinectomies. Rhinology 2021; 58:638-640. [PMID: 33006589 DOI: 10.4193/rhin20.381] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- J Bouaoud
- Department of Head and Neck Surgical Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France; Department of Plastic and Reconstructive Surgery, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - N Benmoussa
- Department of Head and Neck Surgical Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - Q Hennocq
- Department of Head and Neck Surgical Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - J-F Honart
- Department of Plastic and Reconstructive Surgery, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - I Breuskin
- Department of Head and Neck Surgical Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - P Gorphe
- Department of Head and Neck Surgical Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - O Casiraghi
- Department of Pathology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - M Classe
- Department of Pathology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - P Blanchard
- Department of Radiation Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - F Janot
- Department of Head and Neck Surgical Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - F Kolb
- Department of Plastic and Reconstructive Surgery, Gustave Roussy Institute, University Paris-Saclay, Villejuif,France
| | - N Leymarie
- Department of Plastic and Reconstructive Surgery, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - S Temam
- Department of Head and Neck Surgical Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - A Moya-Plana
- Department of Head and Neck Surgical Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
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Fierens S, Moya-Plana A, Vergez S, Bénard A, Gallard R, Molinier-Blossier S, Castain C, Orsel S, Verillaud B, Mortuaire G, de Gabory L. Do practitioners assess sinonasal adenocarcinoma extension similarly? Interdisciplinary concordance in 21 cases. Clin Otolaryngol 2021; 46:665-669. [PMID: 33377291 DOI: 10.1111/coa.13708] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 11/18/2020] [Accepted: 12/20/2020] [Indexed: 12/24/2022]
Affiliation(s)
- Sylvestre Fierens
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Bordeaux, Bordeaux, France
| | - Antoine Moya-Plana
- Department of Otorhinolaryngology-Head and Neck Surgery, Gustave Roussy Cancer Center, Villejuif, France
| | - Sebastien Vergez
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Toulouse, Toulouse, France
| | - Antoine Bénard
- Pôle de Santé Publique, Clinical Epidemiology Unit (USMR), Bordeaux, France
| | - Romain Gallard
- Pôle de Santé Publique, Clinical Epidemiology Unit (USMR), Bordeaux, France
| | | | - Claire Castain
- Department of Pathology, University Hospital of Bordeaux, Bordeaux, France
| | - Stephane Orsel
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Limoges, Limoges, France
| | - Benjamin Verillaud
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Lariboisière, Paris, France
| | - Geoffrey Mortuaire
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Lille, Lille, France
| | - Ludovic de Gabory
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Bordeaux, Bordeaux, France.,University of Bordeaux, Bordeaux, France
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Damiani M, Mercante G, Abdellaoui M, Guerlain J, Moya-Plana A, Casiraghi O, Temam S, Tao Y, Gorphe P. Prognostic Features in Intermediate-Size Supraglottic Tumors Treated With Open Supraglottic Laryngectomy. Laryngoscope 2021; 131:E1980-E1986. [PMID: 33399237 DOI: 10.1002/lary.29367] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 12/09/2020] [Accepted: 12/23/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVES/HYPOTHESIS We investigated growth patterns and pathological features in intermediate-size laryngeal carcinoma amenable to supraglottic laryngectomy. STUDY DESIGN Retrospective cohort study. METHODS We reviewed patients who underwent an open partial horizontal laryngectomy (OPHL) type I. We analyzed pathological data, tumor sizes, overall survival, disease-specific survival, local control, and laryngeal preservation. Results were stratified between three groups: group I comprised patients with endolaryngeal carcinoma, group II comprised patients with anterior epilaryngeal carcinoma who underwent an OPHL type I + base of tongue (BOT), group III comprised patients with lateral epilaryngeal carcinoma who underwent an OPHL type I + pyriform sinus (PIR). RESULTS Sixty-eight patients were analyzed. The 5-year rates of overall survival, disease-specific survival, local control, and laryngeal preservation were 68.4%, 83.7%, 91.6%, and 98.3%, respectively. The tumor sizes at pathological examination were similar between the three groups (mean 27 mm, P = .80) and were associated with pathological features, notably pre-epiglottic space (PES) invasion (24.9 mm vs. 32.2 mm, P = .01), occult invaded lymph nodes (22.6 mm vs. 29.9 mm, P = .03), and trends for margins status (26.5 mm vs. 29.3 mm, P = .45). The risks of PES invasion, occult lymph nodes, and positive margins, respectively, predominated in group I (41.7%), group II (56.3%), and group III (23.3%). CONCLUSION In intermediate-size tumors amenable to supraglottic laryngectomy, pathological features are associated with tumor size according to group stratification based on tumor location. LEVEL OF EVIDENCE 4 Laryngoscope, 131:E1980-E1986, 2021.
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Affiliation(s)
- Marialessia Damiani
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - Giuseppe Mercante
- Humanitas Clinical and Research Center - IRCCS, Rozzano, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Mohammed Abdellaoui
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - Joanne Guerlain
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - Antoine Moya-Plana
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - Odile Casiraghi
- Department of Pathology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - Stéphane Temam
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - Yungan Tao
- Department of Radiotherapy, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - Philippe Gorphe
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
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Marhic A, Guerlain J, Benmoussa N, Breuskin I, Honart JF, Janot F, Moya-Plana A, Temam S, Gorphe P. Replacement of lip-split mandibulotomy by pull-through approach for T3-4 oral carcinomas. Int J Oral Maxillofac Surg 2021; 50:1123-1130. [PMID: 33414034 DOI: 10.1016/j.ijom.2020.10.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 07/07/2020] [Revised: 09/06/2020] [Accepted: 10/29/2020] [Indexed: 11/19/2022]
Abstract
At the study hospital, the lip-split mandibulotomy (LSM) has progressively been replaced by a pull-through (PT) approach. This study compared the outcomes of the LSM and PT approaches in a series of 192 patients with T3-T4a oral tongue and floor of the mouth squamous cell carcinoma treated over the two last decades. No difference in margin status (P = 0.254), rate of early complications (local infections) (P = 0.867), haematoma/haemorrhage (P = 0.221), delayed wound healing (P = 0.438), re-operation (P = 0.083), or Clavien-Dindo classification (P= 0.5281) was found. The LSM approach was associated with a higher rate of late complications such as pseudarthrosis (14.5% vs 0.9%; OR 17.89, P = 0.0005) and trismus (35% vs 13.8%; OR 3.32, P = 0.025), and a trend towards a higher rate of fistulas (24.6% vs 13.1%; OR 2.16, P = 0.088). The quality of life of long-term survivors (median 132 months) was similar in the two groups, with a mean QLQC30 score of 59.7 (P = 0.099) and mean MDADI score of 57.4 (P = 0.213). The 5-year local control rate was 86.4% in the PT group and 86.2% in the LSM group (P = 0.878), while the 5-year overall survival rates were 50.0% and 48.3%, respectively (P = 0.68). In our experience, replacement of LSM by a PT approach in oral carcinoma was associated with decreased rates of late complications such as pseudarthrosis, fistula, and trismus, without any difference in oncological outcomes.
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Affiliation(s)
- A Marhic
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - J Guerlain
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - N Benmoussa
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - I Breuskin
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - J-F Honart
- Department of Plastic and Reconstructive Surgery, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - F Janot
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - A Moya-Plana
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - S Temam
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - P Gorphe
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France.
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Machavoine R, Helfre S, Bernier V, Bolle S, Leseur J, Corradini N, Rome A, Defachelles AS, Deneuve S, Bernard S, Fayoux P, Nicollas R, Mondain M, Luscan R, Denoyelle F, Simon F, Kadlub N, Kolb F, Honart JF, Orbach D, Minard-Colin V, Moya-Plana A, Couloigner V. Locoregional Control and Survival in Children, Adolescents, and Young Adults With Localized Head and Neck Alveolar Rhabdomyosarcoma-The French Experience. Front Pediatr 2021; 9:783754. [PMID: 35186818 PMCID: PMC8855824 DOI: 10.3389/fped.2021.783754] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 11/23/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION The head and neck (HN) are the most frequent sites of pediatric rhabdomyosarcoma (RMS). Alveolar RMS (ARMS) represents ~20% of all RMS cases and frequently spread to lymph nodes (LNs). The aim was to report locoregional control, event-free survival (EFS), and overall survival (OS), according to clinical and pathological features, LN staging, and treatment modalities. METHODS The study included all patients prospectively enrolled in EpSSG RMS 2005 study under 21 years of age with localized HN ARMS and diagnosed between 2005 and 2016 in France. Medical data including imaging, surgical report, and radiation therapy planes were analyzed. RESULTS Forty-eight patients (median age 6 years; range 4 months-21 years), corresponding to 30 parameningeal and 18 non-parameningeal ARMS, were included. There were 33 boys (69%). Tumor locations included the following: orbit (n = 7) among which four cases had bone erosion, paranasal sinuses and nasal cavity (n = 16), deep facial spaces (n = 10), nasolabial fold (n = 8), and other non-parameningeal HN sites (n = 7). A fusion transcript of PAX3-FOXO1 or PAX7-FOXO1 was expressed in 33 of the 45 cases (73%) with molecular analysis. At diagnosis, 10 patients had primary resection of the primary tumor (PRPT) (none with microscopic complete resection) and 9 had LN staging. After induction chemotherapy, 26 patients (54%) had secondary resection of the primary tumor (SRPT) and 13 patients (27%) had cervical LN dissection. A total of 43 patients (90%) were treated with radiation therapy.With a median follow-up of 7 years (range 2-13 years), 5-year OS and EFS were 78% (95% CI, 63-88%) and 66% (95% CI, 51-78%), respectively. We observed 16 events (10 deaths): 4 local, 4 regional, 1 local and regional, and 7 metastatic. In univariate analysis, OS was only superior for patients under 10 years of age (p = 0.002), while FOXO1-negative ARMS, SRPT for parameningeal ARMS, and LN surgery were associated with significantly better EFS. CONCLUSION Our study confirms a better outcome for fusion-negative ARMS and ARMS in children under 10 years. Moreover, LN surgery and SRPT of parameningeal tumor may improve EFS of ARMS. Larger studies are needed to confirm our findings.
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Affiliation(s)
- Roxane Machavoine
- Department of Pediatric Oto-Rhino-Laryngology, Hôpital Necker-Enfants Malades, APHP, Paris, France
| | - Sylvie Helfre
- Department of Radiation Oncology, Institut Curie, Paris, France
| | - Valérie Bernier
- Département Universitaire de Radiothérapie-Curiethérapie, Institut de Cancérologie de Lorraine, Vandœuvre-lès-Nancy, France
| | - Stéphanie Bolle
- Department of Radiation Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Julie Leseur
- Service de Radiothérapie, Centre Eugène Marquis, Rennes, France
| | - Nadège Corradini
- Service d'Oncologie Pédiatrique, Institut d'Hématologie et d'Oncologie Pédiatrique, Hospices Civils de Lyon, Lyon, France
| | - Angélique Rome
- Pediatric Oncology Department, Hôpitaux Universitaires de Marseille Timone, AP-HM, Marseille, France
| | | | - Sophie Deneuve
- Service d'Oto-Rhino-Laryngologie, Centre Léon Bérard, Lyon, France
| | - Sophie Bernard
- Department of Pediatric Oto-Rhino-Laryngology, Hôpital Robert Debré, APHP, Paris, France
| | - Pierre Fayoux
- Department of Pediatric Oto-Rhino-Laryngology, Hôpital Jeanne de Flandre, CHRU Lille, Lille, France
| | - Richard Nicollas
- Department of Pediatric Oto-Rhino-Laryngology, Hôpitaux Universitaires de Marseille Timone, AP-HM, Marseille, France
| | - Michel Mondain
- Service d'Oto-Rhino-Laryngologie, CHU Montpellier, Montpellier, France
| | - Romain Luscan
- Department of Pediatric Oto-Rhino-Laryngology, Hôpital Necker-Enfants Malades, APHP, Paris, France
| | - Françoise Denoyelle
- Department of Pediatric Oto-Rhino-Laryngology, Hôpital Necker-Enfants Malades, APHP, Paris, France
| | - François Simon
- Department of Pediatric Oto-Rhino-Laryngology, Hôpital Necker-Enfants Malades, APHP, Paris, France
| | - Natacha Kadlub
- Department of Pediatric Maxillo-Facial and Plastic Surgery, Hôpital Necker-Enfants Malades, APHP, Paris, France
| | - Fréderic Kolb
- Plastic Surgery Department, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Jean-François Honart
- Plastic Surgery Department, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Daniel Orbach
- SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), PSL Research University, Institut Curie, Paris, France
| | - Véronique Minard-Colin
- Department of Pediatric and Adolescent Oncology, INSERM 1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Antoine Moya-Plana
- Department of Oto-Rhino-Laryngology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Vincent Couloigner
- Department of Pediatric Oto-Rhino-Laryngology, Hôpital Necker-Enfants Malades, APHP, Paris, France
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Romano G, Bouaoud J, Moya-Plana A, Benmoussa N, Honart JF, Leymarie N. Integra® dermal regeneration template for full thickness carcinologic scalp defects: Our 6 years' experience retrospective cohort and literature review. J Stomatol Oral Maxillofac Surg 2020; 122:256-262. [PMID: 32629168 DOI: 10.1016/j.jormas.2020.06.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 06/24/2020] [Accepted: 06/25/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND The aim of the study is the use of Integra® dermal regeneration template (DRT) in scalp reconstruction after tumor resection by comparing results of literature and Gustave Roussy Institut' series of 20 patients. MATERIEL AND METHODS A systematic review, with a PubMed search was performed using the following key words "artificial dermis OR DRT" AND "scalp". Eligible articles were selected to study patients and defects characteristics, operative modalities, and the follow up results. This case series presents the experience of immediate DRT reconstruction after scalp full thickness carcinologic surgery, in the plastic surgery service of Gustave Roussy cancer center. RESULTS Twenty patients with primary scalp tumors underwent two steps DRT reconstruction for full thickness scalp defect. The mean surface defect was 72cm2. The mean operative combined time was 94min, with a total healing delay of 68 days. All patients successfully recovered. Five patients had minor complications (3 delayed healing and 2 DRT infections) with no need of additional surgery. Fourteen articles, totalizing n=210 patients, were included and reviewed. Reported ages ranged from 58 to 82 years old. Almost all patients were operated for oncologic resections. The mean surface defect was 73cm2. The mean follow-up was 15 months. The skin graft taking rates ranged from 95% up to 100%. CONCLUSION In large scalp full thickness defects after cancer resection, DRT appears to be a suitable reconstruction option for patients with comorbidities, and aggressive tumors. This technique allows immediate coverage of the calvarium with short operative time and prevents from healing delay. The oncologic follow-up is no disturbed and cancer recurrences are easily diagnosed.
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Affiliation(s)
- G Romano
- Plastic and Reconstructive Surgery Department, Gustave Roussy Cancer Campus, 114, Rue Edouard Vaillant, 94805 Villejuif, France.
| | - J Bouaoud
- Plastic and Reconstructive Surgery Department, Gustave Roussy Cancer Campus, 114, Rue Edouard Vaillant, 94805 Villejuif, France; Department of Maxillo-facial Surgery and Stomatology, Pitié-Salpétrière Hospital, Pierre et Marie Curie University Paris 6, Sorbonne Paris Cite University, AP-HP, 75013 Paris, France; Head and Neck Department, Gustave Roussy Cancer Campus, 114, Rue Edouard Vaillant, 94805 Villejuif, France
| | - A Moya-Plana
- Head and Neck Department, Gustave Roussy Cancer Campus, 114, Rue Edouard Vaillant, 94805 Villejuif, France
| | - N Benmoussa
- Head and Neck Department, Gustave Roussy Cancer Campus, 114, Rue Edouard Vaillant, 94805 Villejuif, France
| | - J-F Honart
- Plastic and Reconstructive Surgery Department, Gustave Roussy Cancer Campus, 114, Rue Edouard Vaillant, 94805 Villejuif, France; Head and Neck Department, Gustave Roussy Cancer Campus, 114, Rue Edouard Vaillant, 94805 Villejuif, France
| | - N Leymarie
- Plastic and Reconstructive Surgery Department, Gustave Roussy Cancer Campus, 114, Rue Edouard Vaillant, 94805 Villejuif, France
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Boustani J, Ruffier A, Moya-Plana A, Tao Y, Nguyen F, Even C, Berthold C, Casiraghi O, Temam S, Blanchard P. Long-term outcomes and safety after reirradiation in locally recurrent nasopharyngeal carcinoma in a non-endemic area. Strahlenther Onkol 2020; 197:188-197. [PMID: 32514613 DOI: 10.1007/s00066-020-01647-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 02/09/2020] [Accepted: 05/25/2020] [Indexed: 01/22/2023]
Abstract
PURPOSE To determine outcomes and toxicities after reirradiation for locally recurrent nasopharyngeal carcinoma (rNPC) and to apply a prognostic index in a non-endemic region. METHODS We retrospectively reported progression-free survival (PFS), overall survival (OS), and treatment-related toxicities in patients treated with curative intent for locally rNPC. We applied the prognostic model for OS and grade 5 radiotherapy (RT)-related toxicities published by Li et al. and evaluated its prognostic accuracy by receiver operating characteristic (ROC) curve analysis. RESULTS Between 2005 and 2018, 33 patients were treated for rNPC in our institution. Median follow-up was 60 months. The mean time to local recurrence was 75 months. Six (18%) patients had a persistent grade 3 toxicity from a previous RT course. The median re-RT dose was 66 Gy. After re-RT, 13 patients had local failure and 3 patients had metastatic recurrence. Median PFS was 18 months with a 5-year PFS rate of 29%. Median OS was 35 months with a 5-year OS rate of 37%. Grade 3 or higher toxicities rate was 74%. There were 21% grade 5 toxicities. The median time to a grade 5 toxicity was less than 6 months following re-RT. The prognostic nomogram was not predictive for OS or grade 5 toxicities. CONCLUSION Reirradiation of rNPC is an effective treatment but is associated with a high rate of life-threatening toxicity. Stratification of patients based on their risk of developing severe toxicity is needed to select patients who will most likely benefit from re-RT.
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Affiliation(s)
- J Boustani
- Department of Radiation Oncology, Georges François Leclerc, Dijon, France.
- Department of Radiation Oncology, Gustave Roussy, 114 rue Edouard Vaillant, 94800, Villejuif, France.
| | - A Ruffier
- Department of Radiation Oncology, Gustave Roussy, 114 rue Edouard Vaillant, 94800, Villejuif, France
| | - A Moya-Plana
- Department of Head and Neck Oncology, Gustave Roussy, Villejuif, France
| | - Y Tao
- Department of Radiation Oncology, Gustave Roussy, 114 rue Edouard Vaillant, 94800, Villejuif, France
| | - F Nguyen
- Department of Radiation Oncology, Gustave Roussy, 114 rue Edouard Vaillant, 94800, Villejuif, France
| | - C Even
- Department of Head and Neck Oncology, Gustave Roussy, Villejuif, France
| | - C Berthold
- Department of Radiation Oncology, Gustave Roussy, 114 rue Edouard Vaillant, 94800, Villejuif, France
| | - O Casiraghi
- Department of Pathology, Gustave Roussy, Villejuif, France
| | - S Temam
- Department of Head and Neck Oncology, Gustave Roussy, Villejuif, France
| | - P Blanchard
- Department of Radiation Oncology, Gustave Roussy, 114 rue Edouard Vaillant, 94800, Villejuif, France
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Dinnoo A, Bidault F, Lassau N, Elmaalouf M, Moya-Plana A, Ruffier A, Janot F, Benmoussa N. Long-term recurrences of jaw osteoradionecrosis after apparent healing with the PENTOCLO protocol. Journal of Stomatology, Oral and Maxillofacial Surgery 2020; 121:286-287. [DOI: 10.1016/j.jormas.2019.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Accepted: 06/21/2019] [Indexed: 04/10/2023]
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Seban RD, Moya-Plana A, Antonios L, Yeh R, Marabelle A, Deutsch E, Schwartz LH, Gómez RGH, Saenger Y, Robert C, Ammari S, Dercle L. Prognostic 18F-FDG PET biomarkers in metastatic mucosal and cutaneous melanoma treated with immune checkpoint inhibitors targeting PD-1 and CTLA-4. Eur J Nucl Med Mol Imaging 2020; 47:2301-2312. [DOI: 10.1007/s00259-020-04757-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 03/03/2020] [Indexed: 01/23/2023]
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Gorphe P, Stein H, Moya-Plana A. Cervical-transoral robotic nasopharyngectomy: A preclinical study. Head Neck 2019; 42:394-400. [PMID: 31750609 DOI: 10.1002/hed.26013] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/17/2019] [Accepted: 10/30/2019] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND We performed a preclinical study to assess the feasibility of the cervical-transoral robotic pharyngectomy procedure in surgery for nasopharyngeal cancer, where deep margins and vascular safety are key issues. MATERIALS AND METHODS Four cadaveric dissections were performed with the da Vinci Xi system. The first step was a robotic parapharyngeal dissection along the internal carotid artery (ICA). The second step was a type 3 transoral robotic nasopharyngectomy. RESULTS In each procedure, a comprehensive dissection of the parapharyngeal space was performed along the ICA up to the foramen lacerum. A type 3 nasopharyngectomy was performed transorally with an "en-bloc" removal of the parapharyngeal space, and with complete removal of the eustachian tube up to its bony part. CONCLUSION A comprehensive cervical-transoral robotic type 3 nasopharyngectomy with "en-bloc" removal of the parapharyngeal space and the eustachian tube proved to be technically feasible in a preclinical study.
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Affiliation(s)
- Philippe Gorphe
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - Hubert Stein
- Department of Global Clinical Development, Intuitive Surgical Inc., Sunnyvale, California
| | - Antoine Moya-Plana
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
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Moya-Plana A, Veyrat M, Honart JF, de Fremicourt K, Alkhashnam H, Sarfati B, Janot F, Leymarie N, Temam S, Kolb F. Reconstruction of maxillectomy and midfacial defects using latissimus dorsi-scapular free flaps in a comprehensive cancer center. Oral Oncol 2019; 99:104468. [PMID: 31678764 DOI: 10.1016/j.oraloncology.2019.104468] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 09/04/2019] [Accepted: 10/22/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND The standard of care for sinonasal malignancies is a large surgical resection followed by radiotherapy. Midfacial defects resulting from maxillectomy require a complex reconstruction procedure. Given their adaptability, chimeric flaps such as latissimus dorsi-scapular (LDS) free flaps appear to be a good option. MATERIAL & METHODS We performed a single-center retrospective study of consecutive patients with sinonasal cancers where a LDS free flap was used for reconstruction. We assessed the postoperative complications and the functional, aesthetic and oncologic outcomes. RESULTS Eighty-four patients were included. Primary tumors were staged as T4a in 68% of cases; 38.3% of the patients received induction chemotherapy and 82.7% received adjuvant radiotherapy. Based on our classification of midfacial and palatal defects, the majority of the patients (69%) had a type IIa with interruption of the three facial pillars. The orbital floor was removed in 55.9% of cases. The median follow-up was 45 months. Total flap necrosis with no possible revascularization occurred in 5.9% of cases. For the orbital reconstruction, a revision procedure was needed for necrosis and/or infection of the costal cartilage graft in eight cases (17%). More than 90% of the patients had no functional disorders regarding speaking, swallowing and chewing. Soft palate involvement was a prognostic factor of speech (p < 10-4) and swallowing (p = .005) disorders. Dental rehabilitation was realized in 70.2% of the patients. No severe complications were observed in the donor site, except for one seroma. CONCLUSION A LDS free flap is a reliable technique for the reconstruction of complex midfacial defects.
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Affiliation(s)
- A Moya-Plana
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France.
| | - M Veyrat
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - J F Honart
- Plastic and Reconstructive Surgery Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - K de Fremicourt
- Plastic and Reconstructive Surgery Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - H Alkhashnam
- Plastic and Reconstructive Surgery Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - B Sarfati
- Plastic and Reconstructive Surgery Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - F Janot
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - N Leymarie
- Plastic and Reconstructive Surgery Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - S Temam
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - F Kolb
- Plastic and Reconstructive Surgery Department, Gustave Roussy Cancer Campus, Villejuif, France
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Moya-Plana A, Aupérin A, Obongo R, Baglin A, Ferrand FR, Baujat B, Saroul N, Casiraghi O, Vergez S, Herman P, Janot F, Thariat J, Vérillaud B, de Gabory L. Oncologic outcomes, prognostic factor analysis and therapeutic algorithm evaluation of head and neck mucosal melanomas in France. Eur J Cancer 2019; 123:1-10. [PMID: 31670075 DOI: 10.1016/j.ejca.2019.09.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 05/03/2019] [Accepted: 09/10/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND Head and neck mucosal melanoma (HNMM) is aggressive and rare, with a poor prognosis because of its high metastatic potential. The two main subtypes are sinonasal (sinonasal mucosal melanoma [SNMM]) and oral cavity (oral cavity mucosal melanoma [OCMM]). Consensual therapeutic guidelines considering the primary tumour site and tumour-node-metastasis (TNM) stage are not well established. MATERIAL & METHODS Patients with HNMM from the prospective national French Rare Head and Neck Cancer Expert Network database between 2000 and 2017 were included. Clinical characteristics, treatment modalities, outcomes and prognostic factors were analysed. RESULTS In total, 314 patients were included. The 5-year overall survival (OS) and progression-free survival (PFS) rates were 49.4% and 24.7%, respectively, in the surgery group; no long-term survivors were observed when surgery was not feasible. Moreover, even after surgery, a high recurrence rate was reported with a median PFS of 22 months. In multivariate analysis, Union for International Cancer Control (UICC) stage and tumour site correlated with PFS and OS. Postoperative radiotherapy (PORT) improved the PFS but not OS in patients with small (T3) SNMM and OCMM tumours. Nodal involvement was more frequent in patients with OCMM (p < 10-4), although, as in SNMM, it was not a significant prognostic predictor. CONCLUSION Even early HNMM was associated with poor oncologic outcomes due to distant metastases despite surgical resection with clear margins. Lymph node metastases had no impact on the prognosis, suggesting treatment de-escalation in cervical node management. PORT might be useful for local control.
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Affiliation(s)
- A Moya-Plana
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France.
| | - A Aupérin
- Biostatistics Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - R Obongo
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - A Baglin
- Department of Pathology, Lariboisière Hospital, Paris, France
| | - F R Ferrand
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France; Medical Oncology Department, HIA Begin, Saint Mandé, France
| | - B Baujat
- Head and Neck Surgery Department, Tenon Hospital, Paris, France
| | - N Saroul
- Head and Neck Surgery Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - O Casiraghi
- Department of Pathology, Gustave Roussy Cancer Campus, Villejuif, France
| | - S Vergez
- Head and Neck Surgery Department, Toulouse University Hospital Center, Toulouse, France
| | - P Herman
- Head and Neck Surgery Department, Lariboisière Hospital, Paris, France
| | - F Janot
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - J Thariat
- Radiation Oncology Department, Baclesse Cancer Center, Caen, France
| | - B Vérillaud
- Head and Neck Surgery Department, Lariboisière Hospital, Paris, France
| | - L de Gabory
- Head and Neck Surgery Department, Pellegrin Hospital, Centre Michelet, Bordeaux, France
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Moya-Plana A, Guerlain J, Casiraghi O, Bidault F, Grimaldi S, Breuskin I, Gorphe P, Temam S. [Sentinel lymph node biopsy in head and neck oncology]. Bull Cancer 2019; 107:653-659. [PMID: 31610909 DOI: 10.1016/j.bulcan.2019.06.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 06/23/2019] [Indexed: 02/06/2023]
Abstract
Sentinel lymph node biopsy (SLNB) has been initially developed for melanoma and breast cancers. Its application in head and neck cancers is recent, probably due to the complexity of the lymphatic drainage, the proximity between the primary tumor and the lymph nodes and the critical anatomical structures (such as the facial nerve). In onco-dermatology, SLNB is validated in head and neck surgery for melanoma with Breslow thickness up to 1mm or ulceration, Merkel carcinoma and high-risk squamous cell carcinoma. Considering the malignancies of the upper aerodigestive tract, the feasibility and oncologic safety of SLNB are now established for T1-T2N0 oral and oropharyngeal squamous cell carcinomas. Thus, it could allow patients with negative sentinel nodes to avoid an unnecessary neck dissection, leading to a decrease of morbidity with an quality of life improvement. For some primary locations (e.g., anterior floor of the mouth) with high proximity between tumor and lymph nodes, it is recommended to remove the tumor before the SLNB so as to improve the detection. New techniques of detection are currently being developed with intra-operative procedures and new tracers (such as tilmanocept), leading to a better accuracy of detection and, probably, new indications.
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Affiliation(s)
- Antoine Moya-Plana
- Université Paris-Saclay, département de cancérologie cervico-faciale, Gustave Roussy, 94805 Villejuif, France.
| | - Joanne Guerlain
- Université Paris-Saclay, département de cancérologie cervico-faciale, Gustave Roussy, 94805 Villejuif, France
| | - Odile Casiraghi
- Université Paris-Saclay, département d'anatomopathologie, Gustave Roussy, 94805 Villejuif, France
| | - François Bidault
- Université Paris-Saclay, département de radiologie, Gustave Roussy, 94805 Villejuif, France
| | - Séréna Grimaldi
- Université Paris-Saclay, département de médecine nucléaire, Gustave Roussy, 94805 Villejuif, France
| | - Ingrid Breuskin
- Université Paris-Saclay, département de cancérologie cervico-faciale, Gustave Roussy, 94805 Villejuif, France
| | - Philippe Gorphe
- Université Paris-Saclay, département de cancérologie cervico-faciale, Gustave Roussy, 94805 Villejuif, France
| | - Stéphane Temam
- Université Paris-Saclay, département de cancérologie cervico-faciale, Gustave Roussy, 94805 Villejuif, France
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Moya-Plana A, Mangin D, Dercle L, Taouachi R, Casiraghi O, Ammari S, Nguyen F, Temam S, Robert C, Gorphe P. Risk-based stratification in head and neck mucosal melanoma. Oral Oncol 2019; 97:44-49. [PMID: 31421470 DOI: 10.1016/j.oraloncology.2019.07.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 07/23/2019] [Accepted: 07/26/2019] [Indexed: 01/18/2023]
Abstract
BACKGROUND Head and neck mucosal melanoma (HNMM) is a rare and aggressive disease with a high metastatic potential. Two staging systems are currently available: one specific to HNMM (mmTNM) and one specific to primary tumour sites (sccTNM). Our main objective was to assess the prognostic value of both of these classifications in order to allow accurate risk-based classification. METHODS We performed a retrospective cohort study of patients with HNMM treated consecutively between 2000 and 2017. All of the patients were restaged using the mmTNM and the sccTNM. A prognostic analysis was carried out according to both staging systems. RESULTS There were 96 patients with an HNMM in our cohort, of whom 80 underwent surgical treatment followed by radiotherapy. The median overall survival (OS) and progression-free survival (PFS) for the operated patients were 39 months (95% CI, 21.6-56.4 months) and 18 months (95% CI, 6.5-29.5 months), respectively. A paranasal sinus localization was associated with lower survival compared to a nasal cavity primary localization (p < 1 0-4). Both of the classifications correlated with OS, PFS, and distant metastasis-free survival. High-risk HNMM were characterized as T4/stage IV by the mmTNM and T3-4/stage III-IV by the sccTNM. Given the primary tumour location, both TNM classifications were suitable for risk-stratification of sinonasal mucosal melanomas. However, combining both TNM, we defined new stages mmT3A and mmT3B according to sccTNM with a more accurate risk stratification (p < 1 0-4). CONCLUSIONS Both of the classifications should be combined, in order to improve the risk-stratification of patients with HNMM.
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Affiliation(s)
- Antoine Moya-Plana
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, Villejuif, France; Inserm U981, Melanoma Group, Gustave Roussy Cancer Campus, Villejuif, France.
| | - David Mangin
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Laurent Dercle
- Radiology Department, Columbia University Medical Center, New York Presbyterian Hospital, New York, NY, USA
| | - Rabah Taouachi
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Odile Casiraghi
- Pathology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Samy Ammari
- Radiology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - France Nguyen
- Radiotherapy Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Stéphane Temam
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Caroline Robert
- Inserm U981, Melanoma Group, Gustave Roussy Cancer Campus, Villejuif, France; Onco-Dermatology Department, Gustave Roussy Cancer Campus, Villejuif, France; Université Paris-Saclay, Villejuif, France
| | - Philippe Gorphe
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, Villejuif, France
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Seban RD, Nemer JS, Marabelle A, Yeh R, Deutsch E, Ammari S, Moya-Plana A, Mokrane FZ, Gartrell RD, Finkel G, Barker L, Bigorgne AE, Schwartz LH, Saenger Y, Robert C, Dercle L. Prognostic and theranostic 18F-FDG PET biomarkers for anti-PD1 immunotherapy in metastatic melanoma: association with outcome and transcriptomics. Eur J Nucl Med Mol Imaging 2019; 46:2298-2310. [PMID: 31346755 DOI: 10.1007/s00259-019-04411-7] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 06/20/2019] [Indexed: 12/31/2022]
Abstract
PURPOSE An imaging-based stratification tool is needed to identify melanoma patients who will benefit from anti Programmed Death-1 antibody (anti-PD1). We aimed at identifying biomarkers for survival and response evaluated in lymphoid tissue metabolism in spleen and bone marrow before initiation of therapy. METHODS This retrospective study included 55 patients from two institutions who underwent 18F-FDG PET/CT before anti-PD1. Parameters extracted were SUVmax, SUVmean, HISUV (SUV-based Heterogeneity Index), TMTV (total metabolic tumor volume), TLG (total lesion glycolysis), BLR (Bone marrow-to-Liver SUVmax ratio), and SLR (Spleen-to-Liver SUVmax ratio). Each parameter was dichotomized using the median as a threshold. Association with survival, best overall response (BOR), and transcriptomic analyses (NanoString assay) were evaluated using Cox prediction models, Wilcoxon tests, and Spearman's correlation, respectively. RESULTS At 20.7 months median follow-up, 33 patients had responded, and 29 patients died. Median PFS and OS were 11.4 (95%CI 2.7-20.2) and 28.5 (95%CI 13.4-43.8) months. TMTV (>25cm3), SLR (>0.77), and BLR (>0.79) correlated with shorter survival. High TMTV (>25 cm3), SLR (>0.77), and BLR (>0.79) correlated with shorter survival, with TMTV (HR PFS 2.2, p = 0.02, and HR OS 2.5, p = 0.02) and BLR (HR OS 2.3, p = 0.04) remaining significant in a multivariable analysis. Low TMTV and TLG correlated with BOR (p = 0.03). Increased glucose metabolism in bone marrow (BLR) was associated with transcriptomic profiles including regulatory T cell markers (p < 0.05). CONCLUSION Low tumor burden correlates with survival and objective response while hematopoietic tissue metabolism correlates inversely with survival. These biomarkers should be further evaluated for potential clinical application.
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Affiliation(s)
- Romain-David Seban
- Département d'imagerie Médicale, Gustave Roussy, Université Paris-Saclay, 94800, Villejuif, France
| | - John S Nemer
- Department of Medicine, Division of Hematology Oncology, New York-Presbyterian Hospital/Columbia University Medical Center, New York, NY, USA.,Department of Radiology, New York Presbyterian Hospital - Columbia University Medical Center, New York, NY, 10039, USA
| | - Aurélien Marabelle
- Drug Development Department (DITEP), Gustave Roussy, Villejuif, France.,UMR1015, Gustave Roussy, Université Paris Saclay, 94800, Villejuif, France
| | - Randy Yeh
- Department of Radiology, New York Presbyterian Hospital - Columbia University Medical Center, New York, NY, 10039, USA
| | - Eric Deutsch
- Drug Development Department (DITEP), Gustave Roussy, Villejuif, France
| | - Samy Ammari
- Département d'imagerie Médicale, Gustave Roussy, Université Paris-Saclay, 94800, Villejuif, France
| | - Antoine Moya-Plana
- Inserm U981, Melanoma group, Gustave Roussy Cancer Campus, Villejuif, France
| | - Fatima-Zohra Mokrane
- Department of Radiology, New York Presbyterian Hospital - Columbia University Medical Center, New York, NY, 10039, USA
| | - Robyn D Gartrell
- Department of Medicine, Division of Hematology Oncology, New York-Presbyterian Hospital/Columbia University Medical Center, New York, NY, USA
| | - Grace Finkel
- Department of Medicine, Division of Hematology Oncology, New York-Presbyterian Hospital/Columbia University Medical Center, New York, NY, USA
| | - Luke Barker
- Department of Medicine, Division of Hematology Oncology, New York-Presbyterian Hospital/Columbia University Medical Center, New York, NY, USA
| | - Amélie E Bigorgne
- Drug Development Department (DITEP), Gustave Roussy, Villejuif, France.,UMR1015, Gustave Roussy, Université Paris Saclay, 94800, Villejuif, France.,Inserm U1163, Imagine Institute, Paris, France.,University Paris Descartes, Paris, France
| | - Lawrence H Schwartz
- Department of Radiology, New York Presbyterian Hospital - Columbia University Medical Center, New York, NY, 10039, USA
| | - Yvonne Saenger
- Department of Medicine, Division of Hematology Oncology, New York-Presbyterian Hospital/Columbia University Medical Center, New York, NY, USA
| | - Caroline Robert
- Inserm U981, Melanoma group, Gustave Roussy Cancer Campus, Villejuif, France
| | - Laurent Dercle
- Department of Radiology, New York Presbyterian Hospital - Columbia University Medical Center, New York, NY, 10039, USA. .,UMR1015, Gustave Roussy, Université Paris Saclay, 94800, Villejuif, France.
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Moya-Plana A, Herrera Gómez RG, Rossoni C, Dercle L, Ammari S, Girault I, Roy S, Scoazec JY, Vagner S, Janot F, Eggermont AMM, Robert C. Evaluation of the efficacy of immunotherapy for non-resectable mucosal melanoma. Cancer Immunol Immunother 2019; 68:1171-1178. [PMID: 31172258 PMCID: PMC11028088 DOI: 10.1007/s00262-019-02351-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [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: 10/11/2018] [Accepted: 05/28/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Immune checkpoint inhibitors are now standard-of-care treatments for metastatic cutaneous melanoma. However, for rare sub-groups, such as mucosal melanomas, few published data are available, and with no established therapeutic guidelines. Our objective was to assess the response to anti-CTLA4 and anti-PD1 immunotherapy in patients with mucosal melanomas. METHODS We performed a single-center, prospective cohort analysis of patients with non-surgical locally advanced and/or metastatic mucosal melanoma receiving anti-CTLA4 and/or anti-PD1 immunotherapy from 2010 to 2016. RESULTS Forty-four patients were enrolled, including 18 (40.9%) with head and neck, 12 (27.3%) with vulvo-vaginal and 14 (31.8%) with ano-rectal primary tumours. Eleven (25%) patients had stage 3 disease, and 11 (25%) had distant metastases. The first-line immunotherapy was ipilimumab in 24 patients and pembrolizumab in 20. The objective response rate (ORR) was 8.2% (one complete response) for ipilimumab and 35% (four complete responses) for pembrolizumab. No significant difference was observed for primary tumour location. The median follow-up was 24 months (range 4-73). The median progression-free survival (PFS) in the first-line ipilimumab and pembrolizumab groups was 3 months [95% confidence interval (CI) 2.5-4.6] and 5 months (95% CI 2.6-33.1), respectively (p = 0.0147). CONCLUSION In the patients with unresectable and/or metastatic mucosal melanoma, we found ORR and PFS rates comparable to those in patients with cutaneous melanoma, with no significant differences in the types of mucosal surfaces involved. Anti-PD1 therapy has a more favorable benefit-risk ratio than ipilimumab and should be used preferentially.
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Affiliation(s)
- Antoine Moya-Plana
- Head and Neck Surgery Department, Gustave Roussy Cancer Campus, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France.
- Inserm U981, Melanoma Group, Gustave Roussy Cancer Campus, Villejuif, France.
| | | | - Caroline Rossoni
- Biostatistics Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Laurent Dercle
- Radiology Department, Columbia University Medical Center, New York Presbyterian Hospital, New York, NY, USA
| | - Samy Ammari
- Radiology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Isabelle Girault
- Inserm U981, Melanoma Group, Gustave Roussy Cancer Campus, Villejuif, France
| | - Séverine Roy
- Inserm U981, Melanoma Group, Gustave Roussy Cancer Campus, Villejuif, France
| | - Jean-Yves Scoazec
- Inserm U981, Melanoma Group, Gustave Roussy Cancer Campus, Villejuif, France
- Pathology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Stephan Vagner
- Inserm U981, Melanoma Group, Gustave Roussy Cancer Campus, Villejuif, France
| | - François Janot
- Head and Neck Surgery Department, Gustave Roussy Cancer Campus, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France
| | | | - Caroline Robert
- Inserm U981, Melanoma Group, Gustave Roussy Cancer Campus, Villejuif, France
- Université Paris-Saclay, Villejuif, France
- Onco-dermatology Department, Gustave Roussy Cancer Campus, Grand Paris, France
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Ruffier-Loubière A, Tao Y, NGuyen F, Moya-Plana A, Even C, Berthold C, Casiraghi O, Temam S, Blanchard P. OC-010 Local recurrence of nasopharyngeal carcinomas outcomes after reirradiation. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30176-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Schernberg A, Canova C, Blanchard P, Gorphe P, Breuskin I, Mirghani H, Moya-Plana A, Janot F, Bidault F, Chargari C, Bellefqih S, Ruffier A, Even C, Nguyen F, Temam S, Tao Y. Prognostic factors in patients with soft palate squamous cell carcinoma. Head Neck 2019; 41:1441-1449. [PMID: 30636178 DOI: 10.1002/hed.25598] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 10/02/2018] [Accepted: 12/05/2018] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND To define the prognostic factors associated with outcome in patients with soft palate squamous cell carcinoma (SCC). METHODS Previously untreated patients with soft palate and uvula SCC treated in our institution between 1997 and 2012 were collected. The prognostic value of clinical, hematological, and treatment characteristics was examined. RESULTS We identified 156 patients, median age 58 years, with 71% drinkers, 91% smokers; 19% had synchronous cancer. Front-line treatment was chemoradiotherapy in 58 (37%), radiotherapy alone in 60 (39%), surgery in 17 (11%), and induction chemotherapy in 21 patients (14%). The 5-year actuarial overall survival (OS) and progression-free survival (PFS) were 41% and 37%, respectively. In univariate analysis, T3-T4 vs T1-T2 stage, N2-N3 vs N0-N1 stage, and neutrophil count >7 g/L were associated with worse OS and PFS (P < .05). CONCLUSION In patients with soft palate SCC, inflammation biomarkers were associated with OS.
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Affiliation(s)
- Antoine Schernberg
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Paris, France.,INSERM1030, Gustave Roussy Cancer Campus, Paris, France
| | - Charles Canova
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - Pierre Blanchard
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Paris, France.,Faculté de Médecine du Kremlin-Bicetre, Université Paris Sud, Université Paris Saclay, Paris, France
| | - Philippe Gorphe
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - Ingrid Breuskin
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - Haitham Mirghani
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - Antoine Moya-Plana
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - François Janot
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - Francois Bidault
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - Cyrus Chargari
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Paris, France.,INSERM1030, Gustave Roussy Cancer Campus, Paris, France.,French Military Health Services Academy, Paris, France.,Institut de Recherche Biomédicale des Armées, Paris, France
| | - Sara Bellefqih
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - Amandine Ruffier
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - Caroline Even
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - France Nguyen
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - Stéphane Temam
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - Yungan Tao
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Paris, France.,INSERM1030, Gustave Roussy Cancer Campus, Paris, France
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Gorphe P, Chekkoury Idrissi Y, Tao Y, Moya-Plana A, Casiraghi O, Janot F, Blanchard P, Mirghani H, Temam S. Smoking and papillomavirus DNA in patients with p16-positive N3 oropharyngeal squamous cell carcinoma. Head Neck 2018; 41:1039-1045. [PMID: 30552841 DOI: 10.1002/hed.25523] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 08/20/2018] [Accepted: 10/05/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND We investigated the survival of patients with a p16-positive N3 oropharyngeal squamous cell carcinoma (OPSCC) and the prognostic significance of patient, tumor, and treatment characteristics. METHODS We retrospectively reviewed the data of patients treated at our Cancer Center for a p16-positive N3 OPSCC between 2003 and 2016. End points were overall survival (OS) and progression-free survival (PFS). RESULTS A total of 29 patients were included. The 5-year OS and PFS were 67.5% and 59.1%, respectively. Smoking history above 10 pack-years and the absence of human papillomavirus DNA were associated with worse OS (P = .02 and P = .03, respectively) and PFS (P = .02 and P = .02, respectively). Induction chemotherapy or radical neck dissection were not associated with different treatment outcomes. CONCLUSION Patients with an N3 p16-positive oropharyngeal cancer in our series had a 5-year OS rate of 67.5%. Smoking history and viral DNA were prognostic factors associated with survival.
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Affiliation(s)
- Philippe Gorphe
- Department of Head and Neck Oncology, Gustave Roussy Institute, Université Paris-Saclay, Villejuif, France
| | - Younes Chekkoury Idrissi
- Department of Head and Neck Oncology, Gustave Roussy Institute, Université Paris-Saclay, Villejuif, France
| | - Yungan Tao
- Department of Radiotherapy, Gustave Roussy Institute, Université Paris-Saclay, Villejuif, France
| | - Antoine Moya-Plana
- Department of Head and Neck Oncology, Gustave Roussy Institute, Université Paris-Saclay, Villejuif, France
| | - Odile Casiraghi
- Department of Pathology, Gustave Roussy Institute, Université Paris-Saclay, Villejuif, France
| | - François Janot
- Department of Head and Neck Oncology, Gustave Roussy Institute, Université Paris-Saclay, Villejuif, France
| | - Pierre Blanchard
- Department of Radiotherapy, Gustave Roussy Institute, Université Paris-Saclay, Villejuif, France
| | - Haïtham Mirghani
- Department of Head and Neck Oncology, Gustave Roussy Institute, Université Paris-Saclay, Villejuif, France
| | - Stéphane Temam
- Department of Head and Neck Oncology, Gustave Roussy Institute, Université Paris-Saclay, Villejuif, France
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50
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Darbord D, Cerezo M, Agoussi S, Allard D, Claps G, Girault I, Guemiri R, Libenciuc C, Moya-Plana A, Quidville V, Routier E, Roy S, Shen S, Vagner S, Robert C. Identification de TBX3 comme nouveau régulateur de l’expression de PDL1 dans le mélanome. Ann Dermatol Venereol 2018. [DOI: 10.1016/j.annder.2018.09.098] [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] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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