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Baujat B, Broustaut N, Dauzier E, Tassart M, Wagner I, Atallah S, Marhic A. "Reinnervated Serratus free flap, for a functional outcome in tongue reconstruction: a surgical technique video". Plast Reconstr Surg 2024:00006534-990000000-02302. [PMID: 38563557 DOI: 10.1097/prs.0000000000011447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
The current benchmark for tongue reconstruction following the excision of locally advanced tumors involves the utilization of free skin or fasciocutaneous flaps, such as anterolateral thigh flap or forearm free flap. They facilitate the volumetric reconstruction of the tongue, leveraging passive mobility from the remaining native tongue tissue. The challenge in tongue reconstruction surgery persists in achieving functional restoration through adequate volume and optimized mobility, using tissue that is both adapted and comparable to native tissue. While the free serratus muscle flap has been described for various indications, its application in tongue reconstructions remains underexploited. Specifically, in cases of locally advanced tumors affecting the mobile tongue, typically within the junctional area and without extension to the floor of the mouth nor to the tip of the tongue, the serratus free flap has shown great results. Reinnervation of the flap is achieved connecting the thoracodorsal nerve to the descending branch of the XII nerve. This technique facilitates functional tongue reconstruction, promoting rapid mucosal epithelialization and reinnervation, which, in turn, preserves muscle volume and sustains adequate trophicity without fibrosis. Regarding these considerations, the pure muscle serratus free flap emerges as a valuable and effective alternative in tongue reconstruction. Notably, there is a dearth of step-by-step operative technique descriptions for this indication in the existing literature. We present a video demonstrating the surgical technique, showcasing procedures as performed at Tenon Hospital (Paris, France).
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Affiliation(s)
- Bertrand Baujat
- Service d'ORL, CHU Tenon, Assistance Publique-Hôpitaux de Paris, 4 rue de la Chine 75020 Paris, France
- Sorbonne Université, Paris, France
| | - Nicolas Broustaut
- Service d'ORL, CHU Tenon, Assistance Publique-Hôpitaux de Paris, 4 rue de la Chine 75020 Paris, France
| | - Etienne Dauzier
- Service d'ORL, CHU Tenon, Assistance Publique-Hôpitaux de Paris, 4 rue de la Chine 75020 Paris, France
| | - Marc Tassart
- Service d'Imagerie Médicale, CHU Tenon, Assistance Publique-Hôpitaux de Paris, 4 rue de la Chine 75020 Paris, France
| | - Isabelle Wagner
- Service d'ORL, CHU Tenon, Assistance Publique-Hôpitaux de Paris, 4 rue de la Chine 75020 Paris, France
| | - Sarah Atallah
- Service d'ORL, CHU Tenon, Assistance Publique-Hôpitaux de Paris, 4 rue de la Chine 75020 Paris, France
- Sorbonne Université, Paris, France
| | - Alix Marhic
- Service d'ORL, CHU Tenon, Assistance Publique-Hôpitaux de Paris, 4 rue de la Chine 75020 Paris, France
- Service d'Imagerie Médicale, CHU Tenon, Assistance Publique-Hôpitaux de Paris, 4 rue de la Chine 75020 Paris, France
- Sorbonne Université, Paris, France
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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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Barry B, Dolivet G, Clatot F, Huguet F, Abdeddaim C, Baujat B, Blanchard N, Calais G, Carrat X, Chatellier A, Coste F, Cupissol D, Cuvelier P, De Mones Del Pujol E, Deneuve S, Duffas O, Dupret-Bories A, Even C, Evrard C, Evrard D, Faivre S, Fakhry N, Garrel R, Gorphe P, Houliat T, Kaminsky MC, Krebs L, Lapeyre M, Lindas P, Malard O, Mirghani H, Mondina M, Moriniere S, Mouawad F, Pestre-Munier J, Pham Dang N, Picard A, Ramin L, Renard S, Salvan D, Schernberg A, Sire C, Thariat J, Vanbockstael J, Vo Tan D, Wojcik T, Klein I, Block V, Baumann-Bouscaud L, De Raucourt D. [French national standard for the treatment of squamous cell carcinoma of upper aero-digestive tract - General principles of treatment]. Bull Cancer 2024; 111:393-415. [PMID: 38418334 DOI: 10.1016/j.bulcan.2023.12.007] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 12/14/2023] [Accepted: 12/31/2023] [Indexed: 03/01/2024]
Abstract
OBJECTIVES The management of upper aerodigestive tract cancers is a complex specialty. It is essential to provide an update to establish optimal care. At the initiative of the INCa and under the auspices of the SFORL, the scientific committee, led by Professor Béatrix Barry, Dr. Gilles Dolivet, and Dr. Dominique De Raucourt, decided to develop a reference framework aimed at defining, in a scientific and consensus-based manner, the general principles of treatment for upper aerodigestive tract cancers applicable to all sub-locations. METHODOLOGY To develop this framework, a multidisciplinary team of practitioners was formed. A systematic analysis of the literature was conducted to produce recommendations classified by grades, in accordance with the standards of the French National Authority for Health (HAS). RESULTS The grading of recommendations according to HAS standards has allowed the establishment of a reference for patient care based on several criteria. In this framework, patients benefit from differentiated care based on prognostic factors they present (age, comorbidities, TNM status, HPV status, etc.), conditions of implementation, and quality criteria for indicated surgery (operability, resectability, margin quality, mutilation, salvage surgery), as well as quality criteria for radiotherapy (target volume, implementation time, etc.). The role of medical and postoperative treatments was also evaluated based on specific criteria. Finally, supportive care must be organized from the beginning and throughout the patients' care journey. CONCLUSION All collected data have led to the development of a comprehensive framework aimed at harmonizing practices nationally, facilitating decision-making in multidisciplinary consultation meetings, promoting equality in practices, and providing a state-of-the-art and reference practices for assessing the quality of care. This new framework is intended to be updated every 5 years to best reflect the latest advances in the field.
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Affiliation(s)
- Béatrix Barry
- AP-HP, hôpital Bichat-Claude-Bernard, ORL et CCF, Paris (75), France
| | - Gilles Dolivet
- Institut de cancérologie de Lorraine, ORL et CCF, Nancy (54), France.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Olivier Duffas
- Centre hospitalier de Libourne, ORL et CMF, Libourne, France
| | | | | | | | - Diane Evrard
- AP-HP, hôpital Bichat-Claude-Bernard, ORL et CCF, Paris (75), France
| | | | - Nicolas Fakhry
- Assistance publique-Hôpitaux de Marseille, ORL et CCF, Marseille, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Didier Salvan
- Centre hospitalier Sud Francilien, ORL et CCF, Corbeil-Essonnes, France
| | | | | | | | | | | | | | - Isabelle Klein
- Dispositif Spécifique Régional du Cancer Grand Est - NEON, Nancy (54), France
| | - Véronique Block
- Dispositif Spécifique Régional du Cancer Grand Est - NEON, Nancy (54), France
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Dolivet G, Barry B, Abdeddaim C, Baujat B, Blanchard N, Calais G, Carrat X, Chatellier A, Clatot F, Coste F, Cupissol D, Cuvelier P, de Mones Del Pujol E, Deneuve S, Duffas O, Dupret-Bories A, Even C, Evrard C, Evrard D, Faivre S, Fakhry N, Garrel R, Gorphe P, Houliat T, Huguet F, Kaminsky MC, Krebs L, Lapeyre M, Lindas P, Malard O, Mirghani H, Mondina M, Moriniere S, Mouawad F, Pestre-Munier J, Pham Dang N, Picard A, Ramin L, Renard S, Salvan D, Schernberg A, Sire C, Thariat J, Vanbockstael J, Vo Tan D, Wojcik T, Klein I, Block V, Baumann-Bouscaud L, de Raucourt D. [National standard for the treatment of squamous cell carcinoma of upper aerodigestive tract]. Bull Cancer 2024; 111:327-332. [PMID: 38336530 DOI: 10.1016/j.bulcan.2023.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/03/2023] [Accepted: 08/04/2023] [Indexed: 02/12/2024]
Affiliation(s)
- Gilles Dolivet
- ORL et CCF, Institut de cancérologie de Lorraine, Nancy, France.
| | - Béatrix Barry
- ORL et CCF, hôpital Bichat-Claude-Bernard, AP-HP, Paris, France
| | | | | | | | | | | | | | | | | | | | - Philippe Cuvelier
- ORL et CCF libéral à Bayonne et centre hospitalier Oloron, Oloron-Sainte-Marie, France
| | | | | | - Olivier Duffas
- ORL et CMF, centre hospitalier de Libourne, Libourne, France
| | | | | | | | - Diane Evrard
- ORL et CCF, hôpital Bichat-Claude-Bernard, AP-HP, Paris, France
| | | | - Nicolas Fakhry
- ORL et CCF, Assistance publique-Hôpitaux de Marseille, Marseille, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Sophie Renard
- ORL et CCF, Institut de cancérologie de Lorraine, Nancy, France
| | - Didier Salvan
- ORL et CCF, centre hospitalier sud francilien, Corbeil-Essonnes, France
| | | | | | | | | | | | | | - Isabelle Klein
- Dispositif spécifique régional du cancer Grand Est - NEON, Nancy, France
| | - Véronique Block
- Dispositif spécifique régional du cancer Grand Est - NEON, Nancy, France
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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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Céruse P, Vergez S, Marie JP, Baujat B, Jegoux F, Malard O, Albert S, Badet L, Blanc J, Deneuve S, Faure F, Fuchsmann C, Morelon E, Philouze P. Laryngeal graft after total laryngectomy in humans: A SWiM analysis. Eur Ann Otorhinolaryngol Head Neck Dis 2024; 141:81-85. [PMID: 38135563 DOI: 10.1016/j.anorl.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2023]
Abstract
Evaluation of the results of laryngeal transplantation (LT) in humans. Analysis of 3 bibliographic databases with the keywords "larynx, transplantation, autograft". In total, 626 abstracts were read and 25 articles selected. The main objective was to analyze the characteristics of laryngeal transplant patients. The accessory objectives comprised analysis of operative technique, immunosuppressive treatment and results. Four articles were selected for analysis. Two patients were transplanted after total laryngectomy for laryngeal carcinoma and 2 after laryngeal trauma. Three of the 4 patients had true transplantation with arterial, venous and neural microanastomosis. Two patients were decannulated and the tracheostomy tube was maintained in the other 2. Three of the 4 patients had good-quality phonation and could feed without a gastric tube. One patient died of carcinoma progression and 1 patient had to be explanted 14 years after transplantation. The number of LTs reported is too small for scientific determination of the place of this intervention in laryngology. The published results could, at first sight, suggest that the future of LT is uncertain. However, several elements, also suggest that otolaryngologists should continue to take an interest in this technique.
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Affiliation(s)
- P Céruse
- Centre Hospitalo-Universitaire Lyon Nord, Hospices Civils de Lyon, Lyon, France.
| | - S Vergez
- Centre Hospitalo-Universitaire de Toulouse, Hôpital Larrey, Toulouse, France
| | - J-P Marie
- Centre Hospitalo-Universitaire de Rouen, Rouen, France
| | - B Baujat
- Centre Hospitalo-Universitaire de Tenon, Paris, France
| | - F Jegoux
- Centre Hospitalo-Universitaire de Rennes, Rennes, France
| | - O Malard
- Centre Hospitalo-Universitaire de Nantes, Nantes, France
| | - S Albert
- Groupe Hospitalier Ambroise-Paré, Paris, France
| | | | - J Blanc
- Centre Hospitalo-Universitaire Lyon Nord, Hospices Civils de Lyon, Lyon, France
| | - S Deneuve
- Centre Hospitalo-Universitaire de Rouen, Rouen, France
| | - F Faure
- Centre Hospitalo-Universitaire Lyon Nord, Hospices Civils de Lyon, Lyon, France
| | - C Fuchsmann
- Centre Hospitalo-Universitaire Lyon Nord, Hospices Civils de Lyon, Lyon, France
| | | | - P Philouze
- Centre Hospitalo-Universitaire Lyon Nord, Hospices Civils de Lyon, Lyon, France
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7
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Tendron A, Atallah S, Wagner I, Baujat B, Dauzier E. Varying ENT practices in adult post-intubation laryngotracheal stenosis after the COVID epidemic in France: A CHERRIES analysis. Eur Ann Otorhinolaryngol Head Neck Dis 2024:S1879-7296(24)00025-5. [PMID: 38423860 DOI: 10.1016/j.anorl.2024.02.008] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
AIM The SARS-CoV-2 pandemic may increase the incidence of iatrogenic laryngotracheal stenosis (LTS), whereas management is not well defined. The aim of this study was to survey a panel of French otorhinolaryngologists about their practices and to evaluate their needs. METHOD A national-level survey of the management of iatrogenic LTS was conducted using a 41-item questionnaire, in 4 sections, sent to a panel of French otorhinolaryngologists between July and December 2022. The main endpoint was heterogeneity in responses between 55 proposals on LTS management. RESULTS The response rate was 20% (52/263). The response heterogeneity rate was 69% (38/55). Heterogeneity concerned general questions on diagnosis (7/12, 58%) and management (7/10, 70%), LTS case management (22/27, 81%), and otorhinolaryngologists' expectations (33%, 2/6). Quality of training was considered good or excellent by only 21% of respondents. More than 80% were strongly in favor of creating national guidelines, expert centers and a national database. DISCUSSION This study demonstrated the heterogeneity of adult post-intubation LTS management between otorhinolaryngologists in France. Training quality was deemed poor or mediocre by a majority of respondents. They were in favor of creating national guidelines and expert centers in LTS.
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Affiliation(s)
- A Tendron
- Service d'Oto-rhino-laryngologie et Chirurgie Cervicofaciale, Hôpital Tenon, AP-HP, Université Paris Sorbonne, Paris, France
| | - S Atallah
- Service d'Oto-rhino-laryngologie et Chirurgie Cervicofaciale, Hôpital Tenon, AP-HP, Université Paris Sorbonne, Paris, France
| | - I Wagner
- Service d'Oto-rhino-laryngologie et Chirurgie Cervicofaciale, Hôpital Tenon, AP-HP, Université Paris Sorbonne, Paris, France
| | - B Baujat
- Service d'Oto-rhino-laryngologie et Chirurgie Cervicofaciale, Hôpital Tenon, AP-HP, Université Paris Sorbonne, Paris, France
| | - E Dauzier
- Service d'Oto-rhino-laryngologie et Chirurgie Cervicofaciale, Hôpital Tenon, AP-HP, Université Paris Sorbonne, Paris, 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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Varoquaux A, Fakhry N, Baujat B, Verillaud B, Jegoux F, Barry B, Chabrillac E, Vergez S, Terroir-Cassou-Mounat M. Diagnostic imaging of salivary gland cancers: REFCOR recommendations by the formal consensus method. Eur Ann Otorhinolaryngol Head Neck Dis 2024; 141:27-31. [PMID: 38036312 DOI: 10.1016/j.anorl.2023.11.007] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
OBJECTIVE To define the indications for each imaging modality in the screening, characterization, extension and follow-up of salivary gland tumors. MATERIAL AND METHODS The French Network of Rare Head and Neck Tumors (REFCOR) formed a steering group who drafted a narrative review of the literature published on Medline and proposed recommendations. The level of adherence to the recommendations was then assessed by a rating group, according to the formal consensus method. RESULTS If a swelling of a salivary gland is palpable for 3 weeks, an ultrasound scan is recommended to confirm a tumoral lesion and rule out differential diagnoses. For a salivary gland tumor, MRI is recommended with diffusion-weighted and dynamic contrast-enhanced techniques. In the case of histologically proven malignancy or a highly suspicious lesion, a CT scan of the neck and chest is recommended to assess the tumor, lymph nodes and metastases. FDG-PET is not currently recommended in routine clinical practice for initial diagnosis, assessment of extension, evaluation of response to treatment, staging of recurrence, or follow-up of salivary gland tumors. CONCLUSION Assessing salivary tumors is based on MRI. Extension assessment is based on neck and chest CT.
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Affiliation(s)
- A Varoquaux
- Département d'Imagerie Médicale, Hôpital La Conception, AP-HM, Aix-Marseille Univ, Marseille, France
| | - N Fakhry
- Département d'ORL et Chirurgie Cervico-Faciale, Hôpital La Conception, AP-HM, Aix-Marseille Univ, Marseille, France.
| | - B Baujat
- Département d'ORL et Chirurgie Cervico-Faciale, Hôpital Tenon, AP-HP, Sorbonne Université, Paris, France
| | - B Verillaud
- Département d'ORL et de Chirurgie Cervico-Faciale, Hôpital Lariboisière, AP-HP, Inserm U1141, Université Paris Cité, Paris, France
| | - F Jegoux
- Département d'ORL et Chirurgie Cervico-Faciale, CHU de Rennes, Rennes, France
| | - B Barry
- Département d'ORL et Chirurgie Cervico-Faciale, Hôpital Bichat, AP-HP, Paris, France
| | - E Chabrillac
- Département de Chirurgie, Institut Universitaire du Cancer Toulouse - Oncopole, Toulouse, France
| | - S Vergez
- Département de Chirurgie, Institut Universitaire du Cancer Toulouse - Oncopole, Toulouse, France; Département de Chirurgie ORL et Cervico-Faciale, CHU de Toulouse-Larrey, Université Toulouse III Paul Sabatier, Toulouse, France
| | - M Terroir-Cassou-Mounat
- Département de Médecine Nucléaire, Institut Universitaire du Cancer Toulouse - Oncopole, Toulouse, France
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Céruse P, Albert S, Baujat B, Blanc J, Fuchsmann C, Faure F, Jegoux F, Marie JP, Malard O, Morelon E, Philouze P, Soldea V, Vergez S, Badet L. 2023: First laryngeal transplantation in France by the "ECLAT" group! Eur Ann Otorhinolaryngol Head Neck Dis 2024; 141:1-2. [PMID: 38057230 DOI: 10.1016/j.anorl.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Affiliation(s)
- P Céruse
- Centre hospitalier Lyon Nord, hospices civils de Lyon, université Lyon 1, Lyon, France.
| | - S Albert
- Centre hospitalier Ambroise-Paré, Paris, France
| | - B Baujat
- Centre hospitalier de Tenon, université la Sorbonne, Paris, France
| | - J Blanc
- Centre hospitalier Lyon Nord, hospices civils de Lyon, université Lyon 1, Lyon, France
| | - C Fuchsmann
- Centre hospitalier Lyon Nord, hospices civils de Lyon, université Lyon 1, Lyon, France
| | - F Faure
- Centre hospitalier Lyon Centre, hospices civils de Lyon, université Lyon 1, Lyon, France
| | - F Jegoux
- Centre hospitalier de Rennes, université de Rennes 1, Rennes, France
| | - J-P Marie
- Centre hospitalier de Rouen, université de Rouen Normandie, Rouen, France
| | - O Malard
- Centre hospitalier de l'Hôtel Dieu, université de Nantes, Nantes, France
| | - E Morelon
- Centre hospitalier Lyon Centre, hospices civils de Lyon, université Lyon 1, Lyon, France
| | - P Philouze
- Centre hospitalier Lyon Nord, hospices civils de Lyon, université Lyon 1, Lyon, France
| | - V Soldea
- Centre hospitalier Lyon Est, hospices civils de Lyon, Lyon, France
| | - S Vergez
- Hôpital Larrey, université de Toulouse III Paul-Sabatier, Toulouse, France
| | - L Badet
- Centre hospitalier Lyon Centre, hospices civils de Lyon, université Lyon 1, Lyon, France
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Pham Dang N, Jegoux F, Barry B, Verillaud B, Baujat B, Fakhry N, Chabrillac E, Vergez S. Surgery of sublingual and minor salivary gland cancer: REFCOR recommendations by the formal consensus method. Eur Ann Otorhinolaryngol Head Neck Dis 2023:S1879-7296(23)00163-1. [PMID: 38052702 DOI: 10.1016/j.anorl.2023.11.011] [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] [Indexed: 12/07/2023]
Abstract
OBJECTIVE To determine the indications and modalities for resection in the management of primary sublingual and minor salivary gland cancer, and the specific features of each primary location. MATERIAL AND METHODS The French Network of Rare Head and Neck Tumors (REFCOR) formed a steering group who drafted a narrative review of the literature published on Medline and proposed recommendations. The level of adherence to the recommendations was then assessed by a rating group, according to the formal consensus method. RESULTS Histological evidence (submucosal biopsy) is recommended before surgical treatment of minor salivary gland carcinoma. Surgical treatment is recommended, with optimal oncologic margins, adapted to anatomical factors, histologic type and grade and functional consequences, with reconstruction if necessary. CONCLUSION Treatment of primary minor salivary and sublingual gland cancer is surgical, with wide resection margins. The modalities of resection and reconstruction are highly dependent on tumor location, extension and histologic type.
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Affiliation(s)
- N Pham Dang
- Service de chirurgie maxillo-faciale, CHU de Clermont-Ferrand, université Clermont-Auvergne, Inserm, Neuro-Dol, 63000 Clermont-Ferrand, France
| | - F Jegoux
- Service d'ORL et chirurgie cervico-faciale, CHU de Rennes, Rennes, France
| | - B Barry
- Service d'ORL et chirurgie cervico-faciale, hôpital Bichat, AP-HP, Paris, France
| | - B Verillaud
- Service d'ORL et de chirurgie cervico-faciale, hôpital Lariboisière, AP-HP, Inserm U1141, université Paris Cité, Paris, France
| | - B Baujat
- Service d'ORL et chirurgie cervico-faciale, hôpital Tenon, AP-HP, Sorbonne université, Paris, France
| | - N Fakhry
- Service d'ORL et chirurgie cervico-faciale, hôpital La Conception, AP-HM, Aix-Marseille université, Marseille, France
| | - E Chabrillac
- Département de chirurgie, institut universitaire du cancer Toulouse - Oncopole, Toulouse, France
| | - S Vergez
- Département de chirurgie, institut universitaire du cancer Toulouse - Oncopole, Toulouse, France; Département de chirurgie ORL et cervico-faciale, CHU de Toulouse-Larrey, université Toulouse III Paul-Sabatier, 24, chemin de Pouvourville, 31059 Toulouse cedex 9, France.
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12
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Barry B, Verillaud B, Jegoux F, Pham Dang N, Baujat B, Chabrillac E, Vergez S, Fakhry N. Surgery of major salivary gland cancers: REFCOR recommendations by the formal consensus method. Eur Ann Otorhinolaryngol Head Neck Dis 2023:S1879-7296(23)00157-6. [PMID: 38040591 DOI: 10.1016/j.anorl.2023.11.005] [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] [Indexed: 12/03/2023]
Abstract
OBJECTIVE To determine the role of surgery of the primary tumor site in the management of primary major salivary gland cancer. MATERIAL AND METHODS The French Network of Rare Head and Neck Tumors (REFCOR) formed a steering group, which drafted a non-systematic narrative review of the literature published on Medline, and proposed recommendations. The level of adherence to the recommendations was then assessed by a rating group, according to the formal consensus method. RESULTS Treatment of salivary gland tumor is mainly surgical. The gold standard for parotid cancer is a total parotidectomy, to obtain clear margins and remove all intraparotid lymph nodes. For low-grade tumors, partial parotidectomy with wide excision of the tumor is acceptable in the case of postoperative diagnosis on definitive histology. In the event of positive margins on definitive analysis, revision surgery should be assessed for feasibility, and performed if possible. CONCLUSION Treatment of primary major salivary gland cancer is based on surgery with clear resection margins, as far away as possible from the tumor. The type of surgery depends on tumor location, pathologic type and extension.
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Affiliation(s)
- B Barry
- Département d'ORL et Chirurgie Cervico-Faciale, Hôpital Bichat, AP-HP, Paris, France
| | - B Verillaud
- Département d'ORL et de Chirurgie Cervico-Faciale, Inserm U1141, Hôpital Lariboisière, AP-HP, Université Paris Cité, Paris, France
| | - F Jegoux
- Département d'ORL et Chirurgie Cervico-Faciale, CHU de Rennes, Rennes, France
| | - N Pham Dang
- Service de Chirurgie Maxillo-Faciale, Inserm, Neuro-Dol, Université Clermont Auvergne, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - B Baujat
- Département d'ORL et Chirurgie Cervico-Faciale, Hôpital Tenon, AP-HP, Sorbonne Université, Paris, France
| | - E Chabrillac
- Département de Chirurgie, Institut Universitaire du Cancer Toulouse - Oncopole, Toulouse, France
| | - S Vergez
- Département de Chirurgie, Institut Universitaire du Cancer Toulouse - Oncopole, Toulouse, France; Département de Chirurgie ORL et Cervico-Faciale, CHU Toulouse-Larrey, Université Toulouse III Paul-Sabatier, Toulouse, France
| | - N Fakhry
- Service d'ORL et Chirurgie Cervico-Faciale, Hôpital La Conception, AP-HM, 147, boulevard Baille, 13005 Marseille, France.
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Baujat B, Vergez S, Jegoux F, Barry B, Verillaud B, Pham Dang N, Fakhry N, Chabrillac E. Lymph node surgery for salivary gland cancer: REFCOR recommendations by the formal consensus method. Eur Ann Otorhinolaryngol Head Neck Dis 2023:S1879-7296(23)00153-9. [PMID: 38036313 DOI: 10.1016/j.anorl.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
OBJECTIVE To determine the indications for neck dissection in the management of parotid, submandibular or minor salivary gland cancers depending on the clinical situation: i.e., clinical lymph node involvement (cN+) or not (cN0); low or high risk of occult nodal metastasis; diagnosis of malignancy before, during or after surgery. MATERIAL AND METHODS The French Network of Rare Head and Neck Tumors (REFCOR) formed a steering group which drafted a narrative review of the literature published on Medline and proposed recommendations. The level of adherence to the recommendations was then assessed by a rating group according to the formal consensus method. RESULTS In cN+ salivary gland cancer, ipsilateral neck dissection is recommended. In cN0 salivary gland cancer, ipsilateral neck dissection is recommended, except for tumors at low risk of occult nodal metastasis. If definitive pathology reveals a high risk of occult nodal involvement, additional neck treatment is recommended: ipsilateral neck dissection or elective nodal irradiation. CONCLUSION The rate of occult lymph node involvement, and therefore the indication for elective neck dissection, depends primarily on the pathologic grade of the salivary gland cancer.
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Affiliation(s)
- B Baujat
- Département d'ORL et chirurgie cervicofaciale, hôpital Tenon, Sorbonne université, AP-HP, Paris, France
| | - S Vergez
- Département de chirurgie, institut universitaire du cancer Toulouse - Oncopole, Toulouse, France; Département de chirurgie ORL et cervicofaciale, CHU de Toulouse-Larrey, université Toulouse III Paul-Sabatier, Toulouse, France
| | - F Jegoux
- Département d'ORL et chirurgie cervicofaciale, CHU de Rennes, Rennes, France
| | - B Barry
- Département d'ORL et chirurgie cervicofaciale, hôpital Bichat, AP-HP, Paris, France
| | - B Verillaud
- Inserm U1141, département d'ORL et de chirurgie cervico-faciale, hôpital Lariboisière, université Paris-Cité, AP-HP, Paris, France
| | - N Pham Dang
- Inserm, Neuro-Dol, service de chirurgie maxillofaciale, université Clermont Auvergne, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - N Fakhry
- Département d'ORL et chirurgie cervicofaciale, hôpital La Conception, AP-HM, Marseille, France
| | - E Chabrillac
- Département de chirurgie, institut universitaire du cancer Toulouse - Oncopole, Toulouse, France.
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Chabrillac E, Vergez S, Barry B, Jegoux F, Verillaud B, Pham Dang N, Baujat B, Fakhry N. Post-treatment monitoring of salivary gland cancer: REFCOR recommendations by the formal consensus method. Eur Ann Otorhinolaryngol Head Neck Dis 2023:S1879-7296(23)00155-2. [PMID: 38030444 DOI: 10.1016/j.anorl.2023.11.003] [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] [Indexed: 12/01/2023]
Abstract
OBJECTIVE To determine the frequency and modality of post-treatment monitoring of primary salivary gland cancer. MATERIAL AND METHODS The French Network of Rare Head and Neck Tumors (REFCOR) formed a steering group who drafted a narrative review of the literature published on Medline and proposed recommendations. The level of adherence to the recommendations was then assessed by a rating group, according to the formal consensus method. RESULTS Clinical monitoring should be adapted to the risk of recurrence: initially every 3 months and progressively spaced out, becoming annual after 5 years. Post-treatment head and neck and chest imaging is recommended at 3 months. Local and regional monitoring can then be carried out yearly or twice yearly with contrast-enhanced head and neck imaging. An annual chest CT scan is recommended for high-grade tumors. For lesions at high risk of late recurrence, very prolonged annual surveillance (up to 15 years) is recommended, including screening for pulmonary metastases. CONCLUSION Given the wide range of malignant salivary gland tumors, the modalities and frequency of post-treatment monitoring must be adapted to the expected course of the disease.
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Affiliation(s)
- E Chabrillac
- Département de chirurgie, institut universitaire du cancer Toulouse - Oncopole, 1, avenue Irène-Joliot-Curie, 31100 Toulouse, France.
| | - S Vergez
- Département de chirurgie, institut universitaire du cancer Toulouse - Oncopole, 1, avenue Irène-Joliot-Curie, 31100 Toulouse, France; Département de chirurgie ORL et cervico-faciale, CHU de Toulouse-Larrey, université Toulouse III Paul-Sabatier, Toulouse, France
| | - B Barry
- Département d'ORL et chirurgie cervico-faciale, hôpital Bichat, AP-HP, Paris, France
| | - F Jegoux
- Département d'ORL et chirurgie cervico-faciale, CHU de Rennes, Rennes, France
| | - B Verillaud
- Département d'ORL et de chirurgie cervico-faciale, hôpital Lariboisière, AP-HP, Inserm U1141, université Paris Cité, Paris, France
| | - N Pham Dang
- Service de chirurgie maxillo-faciale, université Clermont-Auvergne, CHU de Clermont-Ferrand, Inserm, Neuro-Dol, 63000 Clermont-Ferrand, France
| | - B Baujat
- Département d'ORL et chirurgie cervico-faciale, Sorbonne université, hôpital Tenon, AP-HP, Paris, France
| | - N Fakhry
- Département d'ORL et chirurgie cervico-faciale, hôpital La Conception, AP-HM, Marseille, France
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van Herpen C, Vander Poorten V, Skalova A, Terhaard C, Maroldi R, van Engen A, Baujat B, Locati LD, Jensen AD, Smeele L, Hardillo J, Costes Martineau V, Trama A, Kinloch E, Even C, Machiels JP. Corrigendum to 'Salivary gland cancer: ESMO-European Reference Network on Rare Adult Solid Cancers (EURACAN) Clinical Practice Guideline for diagnosis, treatment and follow-up': [ESMO Open 7(6):100602, December 2022]. ESMO Open 2023; 8:101630. [PMID: 37625197 PMCID: PMC10470209 DOI: 10.1016/j.esmoop.2023.101630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2023] Open
Affiliation(s)
- C van Herpen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands; Multidisciplinary Salivary Gland Society, Geneva, Switzerland
| | - V Vander Poorten
- Multidisciplinary Salivary Gland Society, Geneva, Switzerland; Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven; Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
| | - A Skalova
- Multidisciplinary Salivary Gland Society, Geneva, Switzerland; Department of Pathology, Charles University, Faculty of Medicine in Plzen, Plzen, Czech Republic
| | - C Terhaard
- Multidisciplinary Salivary Gland Society, Geneva, Switzerland; Department of Radiotherapy, University Medical Center, Utrecht, The Netherlands
| | - R Maroldi
- Department of Radiology, ASST Spedali Civili-Bresciad University of Brescia, Brescia, Italy
| | - A van Engen
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - B Baujat
- Department of Otorhinolaryngology, Head and Neck Surgery, Sorbonne Université Hôpital Tenon, Assistance Publique Hôpitaux de Paris, Paris, France
| | - L D Locati
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A D Jensen
- Faculty of Medicine, Philipps-University Marburg, Marburg; Department of Radiation Oncology, University Hospitals Gießen and Marburg (UKGM) Ltd, Gießen, Germany
| | - L Smeele
- Department of Head and Neck Oncology and Surgery, Antoni van Leeuwenhoek Ziekenhuis & Amsterdam UMC, Amsterdam
| | - J Hardillo
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - A Trama
- Evaluative Epidemiology, Department of Research, Fondazione IRCSS Istituto Nazionale dei Tumori, Milan, Italy
| | - E Kinloch
- Salivary Gland Cancer UK, London, UK
| | - C Even
- Head and Neck Department, Gustave Roussy, Paris; French Network for Rare Head and Neck Cancers, Paris, France
| | - J-P Machiels
- Service d'Oncologie Médicale, Institut Roi Albert II, Cliniques Universitaires Saint-Luc, Brussels; Institut de Recherche Clinique et Expérimentale, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
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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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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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Talbot JN, Périé S, Tassart M, Delbot T, Aveline C, Zhang-Yin J, Kerrou K, Gaujoux S, Wagner I, Bennis M, Ménégaux F, Breton S, Cochand-Priollet B, Christin-Maitre S, Groussin L, Haymann JP, Baujat B, Balogova S, Montravers F. 18F-fluorocholine PET/CT detects parathyroid gland hyperplasia as well as adenoma: 401 PET/CTs in one center. Q J Nucl Med Mol Imaging 2023; 67:96-113. [PMID: 36995286 DOI: 10.23736/s1824-4785.23.03513-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
BACKGROUND During the past decade, 18F-fluorocholine (FCH) PET/CT has been continuously performed at Tenon Hospital (Paris, France) for the detection of hyperfunctioning parathyroid glands (PT). METHODS A cohort of 401 patients, deliberately referred for HPT since September 2012, has been analyzed. The aim of this real-life retrospective study was to determine the diagnostic utility of FCH in this setting, overall and in subgroups according to the type of hyperparathyroidism (HPT), the context of FCH in the imaging work-up and in the patient's history: initial imaging or persistence or recurrence after previous parathyroidectomy (PTX). The influence of the histologic type of resected PTs, hyperplasia or adenoma, on the preoperatory detection on FCH PET/CT has been studied as well. RESULTS Four hundred one FCH PET/CTs were included in the cohort, performed in 323 patients with primary HPT (pHPT), including 18 with familial HPT (fHPT), and in 78 patients with secondary renal HPT (rHPT). The overall positivity rate in the 401 FCH PET/CTs was 73%. The PTX rate was twice greater in patients whose FCH PET/CT was positive than negative (73% vs. 35%). Abnormal PT(s) were pathology proven in 214 patients: only hyperplastic gland(s) in 75 cases and at least one adenoma in 136 cases; FCH PET/CT sensitivity was 89% and 92%, respectively. Similarly, there was no significant difference in patient-based sensitivity whether FCH PET/CT was performed as 1st line or later in the imaging work-up, or indicated for initial imaging or for suspicion of persistent or recurrent HPT. Gland-based sensitivity was significantly lower for hyperplasia than for adenoma (72% and 86%, respectively). The lowest gland-based sensitivity value was 65%, observed in case of hyperplasia and when FCH was performed late in the imaging work-up. FCH PET/CT correctly showed multiglandular HPT (MGD) in 36/61 proven cases, 59%. Results of ultrasonography (US) and 99mTc-sestaMIBI (MIBI) imaging were available in 346 and 178 patients, respectively. For both modalities, the corresponding sensitivity values were significantly less than those of FCH PET/CT (e.g., overall gland-based sensitivity 78% for FCH, 45% for US, 30% for MIBI) and MGD was detected in 32% of cases by US and 15% by MIBI. CONCLUSIONS Although FCH PET/CT has been performed since 2017 as 1st line imaging for HPT at Tenon Hospital (Paris, France), a large majority of patients underwent prior US and/or MIBI in their preoperative work-up. Therefore, a selection bias is very likely, as most patients referred to FCH PET/CT had non-conclusive or discordant results of US and MIBI, explaining the low performance of those modalities in the present cohort compared to published results. Nevertheless, the superiority of FCH PET/CT over US and MIBI in detecting abnormal PTs reported in various comparative studies is definitely confirmed in this larger real-life cohort. The detection with FCH PET/CT of hyperplastic PTs was somewhat lower than that of adenomas but was better than using US or MIBI. The present results lead to recommend FCH PET/CT as the first line imaging modality in HPT when it is widely available or, if less available, at least in HPT with predominance of hyperplasia and/or MGD.
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Affiliation(s)
- Jean-Noël Talbot
- Institut National des Sciences et Techniques Nucléaires - INSTN, Saclay, France
- Association des Praticiens en Médecine Nucléaire d´Ile de France - APRAMEN, Tenon Hospital, Paris, France
| | - Sophie Périé
- Unit of Head and Neck and Cervico-Facial Surgery, Groupe Hospitalier Privé Ambroise Paré/Hartmann, Neuilly sur Seine, France
| | - Marc Tassart
- Unit of Radiology, Tenon Hospital, Paris, France
| | - Thierry Delbot
- Unit of Nuclear Medicine, Cochin Hospital, Paris, France
| | | | | | | | - Sébastien Gaujoux
- Department of Surgery, GH Pitié-Salpétrière, Paris, France
- Sorbonne University, Paris, France
| | - Isabelle Wagner
- Unit of Head and Neck Surgery, Tenon Hospital, Paris, France
| | - Malika Bennis
- Unit of Surgery, Saint-Antoine Hospital, Paris, France
| | - Fabrice Ménégaux
- Department of Surgery, GH Pitié-Salpétrière, Paris, France
- Sorbonne University, Paris, France
| | - Sarah Breton
- Unit of Pathology, Tenon Hospital, Paris, France
| | - Beatrix Cochand-Priollet
- Unit of Pathology, AP-HP Center, Cochin Hospital, Université Paris-Cité, Paris, France
- Faculty of Medicine, University of Paris, Paris, France
| | - Sophie Christin-Maitre
- Sorbonne University, Paris, France
- Unit of Endocrinology, Saint-Antoine Hospital, Paris, France
| | - Lionel Groussin
- Faculty of Medicine, University of Paris, Paris, France
- Unit of Endocrinology, Cochin Hospital, Paris, France
| | - Jean-Philippe Haymann
- Sorbonne University, Paris, France
- Unit of Multidisciplinary Functional Explorations, Tenon Hospital, Paris, France
| | - Bertrand Baujat
- Sorbonne University, Paris, France
- Unit of Head and Neck Surgery, Tenon Hospital, Paris, France
| | - Sona Balogova
- Unit of Nuclear Medicine, Tenon Hospital, Paris, France -
- Unit of Nuclear Medicine, St. Elisabeth Oncology Institute, Comenius University, Bratislava, Slovakia
| | - Françoise Montravers
- Association des Praticiens en Médecine Nucléaire d´Ile de France - APRAMEN, Tenon Hospital, Paris, France
- Unit of Nuclear Medicine, Tenon Hospital, Paris, France
- Sorbonne University, Paris, France
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Chatelet F, Ferrand FR, Atallah S, Thariat J, Mouawad F, Fakhry N, Malard O, Even C, de Monès E, Uro-Coste E, Benzerdjeb N, Hans S, Testelin S, Mauvais O, Evrard D, Bastit V, Salas S, Espitalier F, Classe M, Digue L, Doré M, Wong S, Dupin C, Nguyen F, Bettoni J, Lapierre A, Colin E, Philouze P, Vergez S, Baujat B, Herman P, Verillaud B. Survival outcomes, prognostic factors, and effect of adjuvant radiotherapy and prophylactic neck dissection in salivary acinic cell carcinoma: A prospective multicenter REFCOR study of 187 patients. Eur J Cancer 2023; 185:11-27. [PMID: 36947928 DOI: 10.1016/j.ejca.2023.02.020] [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: 12/27/2022] [Revised: 02/17/2023] [Accepted: 02/22/2023] [Indexed: 03/05/2023]
Abstract
BACKGROUND Acinic cell carcinomas (AciCCs) are malignant tumours of the salivary glands. The aim of this work was to analyse data from the national REFCOR multicenter cohort (i) to investigate the prognostic factors influencing survival outcomes in AciCC, (ii) to assess the impact on survival of postoperative radiotherapy (RT) in patients treated for AciCC without high-grade transformation and (iii) to explore the prognostic impact of prophylactic neck dissection (ND) in patients treated for AciCC of the major salivary glands. PATIENTS AND METHODS Data from all the patients treated for salivary AciCC between 2009 and 2020 were extracted from the REFCOR database. Survival outcomes and prognostic factors influencing Disease-Free Survival (DFS) and Overall Survival (OS) were investigated using univariate and multivariate analyses. Propensity score matching was used to assess the impact of postoperative RT and prophylactic ND on DFS. RESULTS A total of 187 patients were included. After a median follow-up of 53 months, their 5-year OS and DFS rates were 92.8% and 76.2%, respectively. In multivariate analysis, male sex, older age, higher T and N status, and high grade were independently associated with a worse DFS. In the subpopulation analysed after propensity score matching, patients with cN0 AciCC without high-grade transformation who were treated by surgery and RT did not have an improved DFS compared to patients who were treated by surgery alone (hazard ratio (HR) = 0.87, p = 0.8). Factors associated with nodal invasion were T3-T4 status and intermediate/high histological grade. After propensity score matching, prophylactic ND was associated with a trend toward a better DFS (HR = 0.46, p = 0.16). CONCLUSIONS These results suggest that (i) long-term follow-up (>5 years) should be considered in patients with AciCC, (ii) treatment by surgery alone could be an option in selected cN0 patients with AciCC without high-grade transformation and (iii) prophylactic ND may be considered preferentially in patients with T3-T4 status and/or intermediate/high histological grade.
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Affiliation(s)
- Florian Chatelet
- Department of ENT-Head and Neck Surgery, AP-HP, Hôpital Lariboisière, 2 Rue Ambroise Paré, F-75010 Paris, France.
| | - François Régis Ferrand
- French Armed Forces Biomedical Research Institute, F-91220 Brétigny sur Orge, France; Head and Neck Oncology Department, Gustave Roussy Cancer Campus, 114 Rue Edouard Vaillant, F-94807 Villejuif, France
| | - Sarah Atallah
- Sorbonne University, APHP, Department of ENT-Head and Neck Surgery, Tenon Hospital, 4 rue de la chine, F-75020 Paris, France; Doctoral School of Public Health, CESP, University of Paris Sud, 16 Avenue Paul Vaillant Couturier, F-94807 Villejuif, France
| | - Juliette Thariat
- Department of Radiation Oncology, Centre Francois Baclesse, F-14000 Caen, France; ARCHADE Research Community, F-14000 Caen, France; Laboratoire de physique Corpusculaire IN2P3/ENSICAEN/CNRS UMR 6534-Normandie Université, F-14000 Caen, France
| | - François Mouawad
- Department of ENT-Head and Neck Surgery, Université de Lille, Hôpital Huriez, CHU de Lille, Rue Michel Polonovski, 59000 Lille, France; Inserm U 908, Université des Sciences et Technologies de Lille, UFR de Biologie - SN3, 59655 Villeneuve d'Ascq, France
| | - Nicolas Fakhry
- Department of ENT-Head and Neck Surgery, CHU La Conception, AP-HM. Aix-Marseille Univ (AMU), Marseille, France
| | - Olivier Malard
- Service d'ORL et de chirurgie cervico-faciale CHU 1, INSERM U1229-RMeS, Place A. Ricordeau Hôtel-Dieu, F-44093 Nantes Cedex, France
| | - Caroline Even
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, 114 Rue Edouard Vaillant, F-94807 Villejuif, France
| | | | - Emmanuelle Uro-Coste
- Department of Pathological Anatomy and Histology-Cytology, Rangueil Hospital, Toulouse, France
| | - Nazim Benzerdjeb
- Department of Otolaryngology-Head Neck Surgery, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France; Claude Bernard University, Lyon 1, France
| | - Stéphane Hans
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - Sylvie Testelin
- EA 7516 CHIMERE, Université de Picardie Jules Verne, Amiens, France; Department of Maxillofacial Surgery, Amiens-Picardy University Hospital, Université de Picardie Jules Verne, Amiens, France
| | - Olivier Mauvais
- Department of ENT-Head and Neck Surgery, Centre Hospitalier Universitaire de Besançon, Besançon, France
| | - Diane Evrard
- Université de Paris, Department of ENT-Head and Neck Surgery, Hôpital Bichat, AP-HP, 46 Rue Henri Huchard, F-75018 Paris, France
| | - Vianney Bastit
- Department of ENT-Head and Neck Surgery, François Baclesse Centre, 3 rue du Général Harris, 14000, Caen, France
| | - Sébastien Salas
- Medical Oncology Department, Centre Hospitalier (CHU) La Timone, F-13000, Marseille, France
| | - Florent Espitalier
- Department of Otolaryngology-Head and Neck Surgery, CHU de Nantes, F-44093 Nantes, France
| | - Marion Classe
- Pathology Department, Gustave Roussy Cancer Campus, France
| | | | - Mélanie Doré
- Institut de cancérologie de l'Ouest Nantes, 2 boulevard Jacques Monod, F-44805 Saint Herblain, France
| | - Stéphanie Wong
- Radiation Oncology Department, Hôpital Timone Adultes, 264 Rue Saint-Pierre, F-13005 Marseille, France
| | - Charles Dupin
- Department of Radiation Therapy, Hôpital de Haut Lévèque, Bordeaux University Hospital-CHU, F-33000 Bordeaux, France
| | - France Nguyen
- Onco-radiotherapy Department, Gustave Roussy Cancer Campus, 114 Rue Edouard Vaillant, F-94807 Villejuif, France
| | - Jeremie Bettoni
- EA 7516 CHIMERE, Université de Picardie Jules Verne, Amiens, France; Department of Maxillofacial Surgery, Amiens-Picardy University Hospital, Université de Picardie Jules Verne, Amiens, France
| | - Ariane Lapierre
- Claude Bernard University, Lyon 1, France; Department of Radiation Oncology, Centre Hospitalier Lyon Sud, 165 Chem. du Grand Revoyet, F-69310 Pierre-Bénite, France
| | - Emilien Colin
- EA 7516 CHIMERE, Université de Picardie Jules Verne, Amiens, France; Department of Maxillofacial Surgery, Amiens-Picardy University Hospital, Université de Picardie Jules Verne, Amiens, France
| | - Pierre Philouze
- Claude Bernard University, Lyon 1, France; Department of Otolaryngology-Head Neck Surgery, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Sébastien Vergez
- Department of Surgery, University Cancer Institute Toulouse - Oncopôle, University Hospital of Toulouse, F-31100 Toulouse, France
| | - Bertrand Baujat
- Sorbonne University, APHP, Department of ENT-Head and Neck Surgery, Tenon Hospital, 4 rue de la chine, F-75020 Paris, France
| | - Philippe Herman
- Department of ENT-Head and Neck Surgery, AP-HP, Hôpital Lariboisière, 2 Rue Ambroise Paré, F-75010 Paris, France; Université de Paris, INSERM U1141, Unité"NeuroDiderot", Université de Paris, F-75006 Paris, France
| | - Benjamin Verillaud
- Department of ENT-Head and Neck Surgery, AP-HP, Hôpital Lariboisière, 2 Rue Ambroise Paré, F-75010 Paris, France; Université de Paris, INSERM U1141, Unité"NeuroDiderot", Université de Paris, F-75006 Paris, France
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Talbot J, Tassart M, Aveline C, Kerrou K, Zhang Yin J, Périé S, Wagner I, Bennis M, Baujat B, Montravers F. Détection des parathyroïdes anormales : la TEP/TDM 18F-fluorocholine préalable améliore la sensibilité de l’échographie ; analyse de 300 examens pratiqués par le même échographiste. Médecine Nucléaire 2023. [DOI: 10.1016/j.mednuc.2023.01.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Trama A, Licitra L, Cavalieri S, Bonfarnuzzo S, Baili P, Ciarfella A, Parente P, Almadori G, Ansarin M, Bacigalupo A, Baumeister P, Baujat B, Bossi P, Cavalera E, Cercato MC, Dieleman F, Fakhry N, Ferraresi V, Gaino F, Galizia D, Halamkova J, Halme E, Hardillo J, Hofauer B, Kinloch E, Livi L, Locati LD, Mattheis S, Mercante G, Mirabile A, Molteni G, Orlandi E, Persio R, Sciallero S, Smeele L, Tagliabue M, Valentini V, Van Harpen C, Westphalen CB, Botta L. The observational clinical registry (cohort design) of the European Reference Network on Rare Adult Solid Cancers: The protocol for the rare head and neck cancers. PLoS One 2023; 18:e0283071. [PMID: 36928072 PMCID: PMC10019606 DOI: 10.1371/journal.pone.0283071] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 12/20/2022] [Indexed: 03/18/2023] Open
Abstract
INTRODUCTION Care for head and neck cancers is complex in particular for the rare ones. Knowledge is limited and histological heterogeneity adds complexity to the rarity. There is a wide consensus that to support clinical research on rare cancer, clinical registries should be developed within networks specializing in rare cancers. In the EU, a unique opportunity is provided by the European Reference Networks (ERN). The ERN EURACAN is dedicated to rare adults solid cancers, here we present the protocol of the EURACAN registry on rare head and neck cancers (ClinicalTrials.gov Identifier: NCT05483374). STUDY DESIGN Registry-based cohort study including only people with rare head and neck cancers. OBJECTIVES to help describe the natural history of rare head and neck cancers;to evaluate factors that influence prognosis;to assess treatment effectiveness;to measure indicators of quality of care. METHODS Settings and participants It is an hospital based registry established in hospitals with expertise in head and neck cancers. Only adult patients with epithelial tumours of nasopharynx; nasal cavity and paranasal sinuses; salivary gland cancer in large and small salivary glands; and middle ear will be included in the registry. This registry won't select a sample of patients. Each patient in the facility who meets the above mentioned inclusion criteria will be followed prospectively and longitudinally with follow-up at cancer progression and / or cancer relapse or patient death. It is a secondary use of data which will be collected from the clinical records. The data collected for the registry will not entail further examinations or admissions to the facility and/or additional appointments to those normally provided for the patient follow-up. Variables Data will be collected on patient characteristics (eg. patient demographics, lifestyle, medical history, health status); exposure data (eg. disease, procedures, treatments of interest) and outcomes (e.g. survival, progression, progression-free survival, etc.). In addition, data on potential confounders (e.g. comorbidity; functional status etc.) will be also collected. Statistical methods The data analyses will include descriptive statistics showing patterns of patients' and cancers' variables and indicators describing the quality of care. Multivariable Cox's proportional hazards model and Hazard ratios (HR) for all-cause or cause specific mortality will be used to determine independent predictors of overall survival, recurrence etc. Variables to include in the multivariable regression model will be selected based on the results of univariable analysis. The role of confounding or effect modifiers will be evaluated using stratified analysis or sensitivity analysis. To assess treatment effectiveness, multivariable models with propensity score adjustment and progression-free survival will be performed. Adequate statistical (eg. marginal structural model) methods will be used if time-varying treatments/confounders and confounding by indication (selective prescribing) will be present. RESULTS The registry initiated recruiting in May 2022. The estimated completion date is December 2030 upon agreement on the achievement of all the registry objectives. As of October 2022, the registry is recruiting. There will be a risk of limited representativeness due to the hospital-based nature of the registry and to the fact that hospital contributing to the registry are expert centres for these rare cancers. Clinical Follow-up could also be an issue but active search of the life status of the patients will be guaranteed.
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Affiliation(s)
- Annalisa Trama
- Department of Epidemiology and Data Science, Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- * E-mail:
| | - Lisa Licitra
- Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Stefano Cavalieri
- Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Simone Bonfarnuzzo
- Department of Epidemiology and Data Science, Data Science Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Paolo Baili
- Department of Epidemiology and Data Science, Data Science Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Antonio Ciarfella
- Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milano, Italy
| | - Pablo Parente
- Department of Otorhinolaryngologyand Head and Neck Surgery, La Corunna University Hospital, Corunna, Spain
| | - Giovanni Almadori
- Department of Head-Neck Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli, Rome, Italy
| | - Mohssen Ansarin
- Head and Neck Program and Division of Otolaryngology Head &Nech Surgery, European Institue of Oncology, Milan, Italy
| | - Almalina Bacigalupo
- Radioterapia Oncologica, IRCCS-AOU Ospedale Policlinico San Martino – IST, Genoa, Italy
| | - Philipp Baumeister
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital, Ludwig-Maximilians University, Munich, Germany
| | - Bertrand Baujat
- Otorhinolaryngology – Head and Neck surgery Department, APHP/Sorbonne Université, Hospital Tenon, Paris, France
| | - Paolo Bossi
- Medical Oncology Unit, Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, ASST Ospedali Civili, Brescia, Italy
| | - Elisa Cavalera
- Department Oncological Radiotherapy, "Vito Fazzi" Hospital, Lecce, Italy
| | - Maria Cecilia Cercato
- Epidemiology and Cancer Registry Unit – IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Francois Dieleman
- Department of Head and Neck Surgical Oncology, UMC Utrecht Centre of Expertise for Head and Neck Cancer, UMC Utrecht Cancer Centre, Utrecht, the Netherlands
| | - Nicolas Fakhry
- Department of Oto-Rhino-Laryngology Head and Neck Surgery, La Conception University Hospital, AP-HM, Aix Marseille University, Marseilles, France
| | - Virginia Ferraresi
- Sarcoma and Rare Tumours Departmental Unit-IRCCS Regina Elena National Cancer Institute-Rome, Rome, Italy
| | - Francesca Gaino
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Department of Otorhinolaryngology - Head and Neck Surgery, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
| | | | - Jana Halamkova
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Brno, Czech Republic
- Faculty of Medicine, Department of Comprehensive Cancer Care, Masaryk University, Brno, Czech Republic
| | - Elina Halme
- Department of Otorhinolaryngology - Head and Neck Surgery, Tampere University Hospital, Tampere, Finland
| | - Jose Hardillo
- Department of otorhinolaryngology - Head and neck surgery, Erasmus University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | | | - Emma Kinloch
- Salivary Gland Cancer UK, International House, London, United Kingdom
| | - Lorenzo Livi
- Department of Oncological Radiotherapy, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Laura Deborah Locati
- Department of Medical Oncology of Head and Neck Tumours, ICS Maugeri SpA SB - IRCCS, Pavia, Italy
| | - Stefan Mattheis
- Ear, Nose and Throat Clinic, Essen Univerity Hospital, Essen, Germany
| | - Giuseppe Mercante
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
- Department of Otorhinolaryngology - Head and Neck Surgery, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
| | - Aurora Mirabile
- Department of Medical Oncology, IRCCS San Raffaele, Milan, Italy
| | - Gabriele Molteni
- Otolaryngology Head and Neck Surgery Department, University Hospital, Verona, Italy
| | - Ester Orlandi
- Clinical Department, Radiotherapy Unit, National Centre for Oncological Hadrontherapy (Fondazione CNAO), Pavia, Italy
| | | | - Stefania Sciallero
- Medical Oncology Unit 1, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Ludi Smeele
- Department of Head and Neck surgery, Surgical Oncology Division, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Marta Tagliabue
- Department of Otolaryngology Head & Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Valentino Valentini
- Unit of Surgical Oncology, Maxillo Facial Reconstruction, Policlinico Umberto I, Rome, Italy
| | - Carla Van Harpen
- Department Medical Oncology, Radboud University Medical Centre, HB Nijmegen (HP 455), Nijmegen, the Netherlands
| | - Christoph Benedikt Westphalen
- Comprehensive Cancer Centre Munich & Department of Medicine III, German Cancer Consortium (DKTK), Ludwig Maximilian University of Munich, Munich, Germany
| | - Laura Botta
- Department of Epidemiology and Data Science, Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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van Herpen C, Vander Poorten V, Skalova A, Terhaard C, Maroldi R, van Engen A, Baujat B, Locati LD, Jensen AD, Smeele L, Hardillo J, Martineau VC, Trama A, Kinloch E, Even C, Machiels JP. Salivary gland cancer: ESMO-European Reference Network on Rare Adult Solid Cancers (EURACAN) Clinical Practice Guideline for diagnosis, treatment and follow-up. ESMO Open 2022; 7:100602. [PMID: 36567082 PMCID: PMC9808465 DOI: 10.1016/j.esmoop.2022.100602] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [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: 06/09/2022] [Revised: 09/10/2022] [Accepted: 09/16/2022] [Indexed: 11/07/2022] Open
Abstract
•This ESMO–EURACAN Clinical Practice Guideline provides key recommendations for managing salivary gland cancer. •The guideline covers clinical and pathological diagnosis, staging and risk assessment, treatment and follow-up. •Treatment algorithms for parotid, submandibular, sublingual and minor salivary gland cancer are provided. •The author group encompasses a multidisciplinary group of experts from different institutions and countries in Europe. •Recommendations are based on available scientific data and the authors’ collective expert opinion.
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Affiliation(s)
- C van Herpen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands; Multidisciplinary Salivary Gland Society, Geneva, Switzerland. https://twitter.com/myESMO
| | - V Vander Poorten
- Multidisciplinary Salivary Gland Society, Geneva, Switzerland; Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven; Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
| | - A Skalova
- Multidisciplinary Salivary Gland Society, Geneva, Switzerland; Department of Pathology, Charles University, Faculty of Medicine in Plzen, Plzen, Czech Republic
| | - C Terhaard
- Multidisciplinary Salivary Gland Society, Geneva, Switzerland; Department of Radiotherapy, University Medical Center, Utrecht, The Netherlands
| | - R Maroldi
- Department of Radiology, ASST Spedali Civili Brescia-University of Brescia, Brescia, Italy
| | - A van Engen
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - B Baujat
- Department of Otorhinolaryngology, Head and Neck Surgery, Sorbonne Université Hôpital Tenon, Assistance Publique Hôpitaux de Paris, Paris, France
| | - L D Locati
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A D Jensen
- Faculty of Medicine, Philipps-University Marburg, Marburg; Department of Radiation Oncology, University Hospitals Gießen and Marburg (UKGM) Ltd, Gießen, Germany
| | - L Smeele
- Department of Head and Neck Oncology and Surgery, Antoni van Leeuwenhoek Ziekenhuis & Amsterdam UMC, Amsterdam
| | - J Hardillo
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - A Trama
- Evaluative Epidemiology, Department of Research, Fondazione IRCSS Istituto Nazionale dei Tumori, Milan, Italy
| | - E Kinloch
- Salivary Gland Cancer UK, London, UK
| | - C Even
- Head and Neck Department, Gustave Roussy, Paris; French Network for Rare Head and Neck Cancers, Paris, France
| | - J-P Machiels
- Service d'Oncologie Médicale, Institut Roi Albert II, Cliniques Universitaires Saint-Luc, Brussels; Institut de Recherche Clinique et Expérimentale, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
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Atallah S, Marc M, Schernberg A, Huguet F, Wagner I, Mäkitie A, Baujat B. Beyond Surgical Treatment in Adenoid Cystic Carcinoma of the Head and Neck: A Literature Review. Cancer Manag Res 2022; 14:1879-1890. [PMID: 35693117 PMCID: PMC9176735 DOI: 10.2147/cmar.s355663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 04/24/2022] [Indexed: 12/16/2022] Open
Abstract
Introduction Adenoid cystic carcinoma (AdCC) is a rare tumour as it accounts for about 10% of all salivary gland neoplasms. It occurs in all age groups with a predominance of women, but no risk factors have been identified to date. Although AdCC behaves as a slow-growing tumour, it is characterized by multiple and late recurrences. Therefore, we aim to update the knowledge of the treatment options in advanced and recurrent cases. Materials and Methods We performed a systematic literature review to provide a synthesis of the practical knowledge required for AdCC non-surgical management. Altogether, 99 out of the 1208 available publications were selected for analysis. Results AdCC is described as a basaloid tumour consisting of epithelial and myoepithelial cells. Immunohistochemistry is useful for diagnosis (PS100, Vimentin, CD117, CKit, muscle actin, p63) and for prognosis (Ki67). Identified mutations could lead to therapeutic opportunities (MYB-NFIB, Notch 1). The work-up is mainly based on neck and chest CT scan and MRI, and PET-CT with 18-FDG or PSMA can be considered. Surgical treatment remains the gold standard in resectable cases. Post-operative intensity modulated radiotherapy is the standard of care, but hadron therapy may be used in specific situations. Based on the available literature, no standard chemotherapy regimen can be recommended. Conclusion There is currently no consensus on the use of chemotherapy in AdCC, either concomitantly to RT in a postoperative setting or at a metastatic stage. Further, the available targeted therapies do not yet provide significant tumour response.
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Affiliation(s)
- Sarah Atallah
- Department of Otorhinolaryngology–Head and Neck Surgery, Sorbonne University, Tenon Hospital, AP-HP, Paris, France
- Doctoral School of Public Health, University of Paris Sud, CESP, INSERM U1018, University of Paris-Saclay, UVSQ, Villejuif, France
- Correspondence: Sarah Atallah, Hôpital Tenon, AP-HP, 4 rue de la Chine, Paris, 75020, France, Tel +33 156016417, Email
| | - Morgane Marc
- Department of Otorhinolaryngology–Head and Neck Surgery, Sorbonne University, Tenon Hospital, AP-HP, Paris, France
| | - Antoine Schernberg
- Department of Radiotherapy, Sorbonne University, Tenon Hospital, AP-HP, Paris, France
| | - Florence Huguet
- Department of Radiotherapy, Sorbonne University, Tenon Hospital, AP-HP, Paris, France
| | - Isabelle Wagner
- Department of Otorhinolaryngology–Head and Neck Surgery, Sorbonne University, Tenon Hospital, AP-HP, Paris, France
| | - Antti Mäkitie
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Bertrand Baujat
- Department of Otorhinolaryngology–Head and Neck Surgery, Sorbonne University, Tenon Hospital, AP-HP, Paris, France
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Poissonnet V, Chabrillac E, Schultz P, Morinière S, Gorphe P, Baujat B, Garrel R, Lasne-Cardon A, Villeneuve A, Chambon G, Fakhry N, Aubry K, Dufour X, Malard O, Mastronicola R, Vairel B, Gallet P, Ceruse P, Jegoux F, Ton Van J, De Bonnecaze G, Vergez S. Airway management during transoral robotic surgery for head and neck cancers: a French GETTEC group survey. Eur Arch Otorhinolaryngol 2022; 279:3619-3627. [DOI: 10.1007/s00405-021-07188-4] [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: 06/11/2021] [Accepted: 11/15/2021] [Indexed: 11/03/2022]
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Huguet F, Durand B, Atallah S, Prébet C, Richard S, Baujat B. Combination of radiation therapy-immunotherapy for head and neck cancers: Promises kept? Cancer Radiother 2021; 25:811-815. [PMID: 34711485 DOI: 10.1016/j.canrad.2021.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 08/16/2021] [Accepted: 08/18/2021] [Indexed: 12/24/2022]
Abstract
Chemoradiotherapy with concurrent cisplatin has been the standard treatment for locally advanced head and neck squamous cell carcinoma (HNSCC) for over 20 years. Recently, immunotherapy, a new therapeutic class, has emerged for patients with recurrent or metastatic HNSCC and has significantly extended their survival. Will it bring the same benefit to patients with localized tumors? There is a strong rationale for combining radiation therapy and checkpoint inhibitors for HNSCC. Indeed, radiation therapy can have both immunostimulatory and immunomodulatory effects. This is what explains the famous abscopal effect. The aim of this review is to present the data available on the combination of radiation therapy and immunotherapy for HNSCC.
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Affiliation(s)
- F Huguet
- Service d'Oncologie Radiothérapie, Hôpital Tenon, 4, rue de la Chine, 75020 Paris, France.
| | - B Durand
- Service d'Oncologie Radiothérapie, Hôpital Tenon, 4, rue de la Chine, 75020 Paris, France
| | - S Atallah
- Service d'Oto-Rhino-Laryngologie Chirurgie cervico-faciale, France
| | - C Prébet
- Service d'Oncologie Médicale, Hôpital Tenon, Sorbonne Université, AP-HP, Paris, France
| | - S Richard
- Service d'Oncologie Médicale, Hôpital Tenon, Sorbonne Université, AP-HP, Paris, France
| | - B Baujat
- Service d'Oto-Rhino-Laryngologie Chirurgie cervico-faciale, France
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26
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Carré F, Nguyen XL, Garrec P, Baujat B, Lacau St Guily J, Pételle B. Surgically assisted rapid maxillary expansion for obstructive sleep apnea adult patients: Our experience in 7 cases. Clin Otolaryngol 2021; 46:1200-1204. [PMID: 34061459 DOI: 10.1111/coa.13816] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 02/14/2021] [Revised: 04/19/2021] [Accepted: 05/15/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Fabienne Carré
- Department of ENT-Head and Neck Surgery, Sorbonne University, APHP, Tenon - Saint Antoine Hospital, Paris, France
| | | | - Pascal Garrec
- Department of ENT-Head and Neck Surgery, Sorbonne University, APHP, Tenon - Saint Antoine Hospital, Paris, France.,Garancière Dental Faculty, Sorbonne University, Paris, France
| | - Bertrand Baujat
- Department of ENT-Head and Neck Surgery, Sorbonne University, APHP, Tenon - Saint Antoine Hospital, Paris, France
| | - Jean Lacau St Guily
- Department of ENT-Head and Neck Surgery, Sorbonne University, APHP, Tenon - Saint Antoine Hospital, Paris, France
| | - Boris Pételle
- Department of ENT-Head and Neck Surgery, Sorbonne University, APHP, Tenon - Saint Antoine Hospital, Paris, France
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27
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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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Bossi P, Chan AT, Licitra L, Trama A, Orlandi E, Hui EP, Halámková J, Mattheis S, Baujat B, Hardillo J, Smeele L, van Herpen C, Castro A, Machiels JP. Nasopharyngeal carcinoma: ESMO-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up †. Ann Oncol 2021; 32:452-465. [PMID: 33358989 DOI: 10.1016/j.annonc.2020.12.007] [Citation(s) in RCA: 132] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/10/2020] [Accepted: 12/12/2020] [Indexed: 12/24/2022] Open
Affiliation(s)
- P Bossi
- Medical Oncology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia, ASST-Spedali Civili, Brescia, Italy
| | - A T Chan
- State Key Laboratory of Translational Oncology, The Chinese University of Hong Kong, Shatin, Hong Kong, Special Administrative Region, People's Republic of China
| | - L Licitra
- Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori and University of Milan, Milan, Italy
| | - A Trama
- Department of Research, Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - E Orlandi
- Radiation Oncology Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - E P Hui
- State Key Laboratory of Translational Oncology, The Chinese University of Hong Kong, Shatin, Hong Kong, Special Administrative Region, People's Republic of China
| | - J Halámková
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - S Mattheis
- Department of Otorhinolaryngology Head and Neck Surgery, University Hospital Essen, Essen, Germany
| | - B Baujat
- Sorbonne University, APHP, Department of ENT - Head and Neck Surgery, Tenon Hospital, Paris, France
| | - J Hardillo
- Department of ENT - Head and Neck Surgery, Erasmus Medical Center Rotterdam, Rotterdam
| | - L Smeele
- Department of Head and Neck Oncology and Surgery, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - C van Herpen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - A Castro
- Administration Board of Centro Hospitalar e Universitário do Algarve, Portugal
| | - J-P Machiels
- Institut Roi Albert II, Service d'Oncologie Médicale, Cliniques Universitaires Saint-Luc, Brussels, Belgium; Institut de Recherche Clinique et Expérimentale (POLE MIRO), Université Catholique de Louvain, Brussels, Belgium
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Atallah S, Bozec A, Ransy P, Davrou J, Longis J, Humbert M, Brenet E, Schultz P, Damecourt A, Lacau Saint Guily J, Baujat B. Functional evaluation of mandibular reconstruction with bone free flap. A GETTEC study. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 138:82-88. [PMID: 32800716 DOI: 10.1016/j.anorl.2020.08.005] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To assess the functional results of oromandibular reconstruction by free bone flap, in terms of swallowing, speech and esthetics. MATERIALS AND METHODS A transverse multicenter study included 134 patients reconstructed by free bone flap between 1998 and 2016, with more than 6 months' follow-up, in 9 centers. A standardized questionnaire collected data on patients and treatment. Study endpoints comprised: weight loss, mouth opening, gastrostomy dependence, type of feeding, and DHI score. The impact of patient baseline characteristics on these functional criteria was explored by uni/multivariate analysis. RESULTS Ninety of the 134 patients had cancer. Fibula flap was mainly used (80%). 94% of reconstructions were primary successes. 71% of patients had pre- or post-operative radiation therapy. 88% had less than 50% lingual resection. 97% recovered oral feeding. 89% had intelligible speech. 86% judged their esthetic appearance as good/average. 9% had dental prosthetic rehabilitation. Radiation therapy and extensive lingual resection significantly impacted swallowing function (P=0.04 and P=0.03, respectively). Radiation therapy and oropharyngeal extension significantly increased gastrostomy dependence (P=0.04 and P=0.02, respectively). CONCLUSION Oromandibular reconstruction by free bone flap enabled return to oral feeding in most cases. More than 80% of patients were satisfied with their result in terms of speech and esthetics. However, the rate of dental rehabilitation was low and the rate of complications was high.
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Affiliation(s)
- S Atallah
- Sorbonne Université, Hôpital Tenon, Service d'ORL et Chirurgie Cervico-Faciale, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - A Bozec
- Centre Antoine Lacassagne, département d'ORL et de chirurgie carcinologique de la Tête et du Cou, 33, avenue de Valombrose, 06189 Nice, France
| | - P Ransy
- Service ORL et de chirurgie cervico-faciale, CHU Sart Tilman, Liège, Belgium
| | - J Davrou
- Université Picardie Jules-Verne, CHRU, service de chirurgie maxillo-faciale et stomatologie, Place Victor Pauchet, 80054 Amiens Cedex, France
| | - J Longis
- Clinique de chirurgie maxillo-faciale et stomatologie, CHU Hôtel-Dieu, 1, place Alexis-Ricordeau, 44000 Nantes, France
| | - M Humbert
- Service d'ORL, CHU Côte de Nacre/Centre François Baclesse, Service du Dr MY Louis, Caen, France
| | - E Brenet
- CHU de Reims, Hôpital Robert Debré, Service ORL et Chirurgie Cervico-faciale, Reims, France
| | - P Schultz
- Service ORL et Chirurgie Cervico-Faciale, CHU Hautepierre, 1 Avenue Maline, 67098 Strasbourg, France
| | - A Damecourt
- Service d'ORL, CHU Gui de Chauliac, Montpellier, France
| | - J Lacau Saint Guily
- Sorbonne Université, Hôpital Tenon, Service d'ORL et Chirurgie Cervico-Faciale, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - B Baujat
- Sorbonne Université, Hôpital Tenon, Service d'ORL et Chirurgie Cervico-Faciale, AP-HP, 4, rue de la Chine, 75020 Paris, France.
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Abstract
Purpose The purpose of this study was to assess the impact of the COVID-19 pandemic on the surgical volume of three ENT departments in Ile-de-France, a region severely affected by the epidemic. Materials and methods The number and nature of surgeries was collected from three university hospital ENT departments from 17/03/2020 to 17/04/2020 and from 18/03/2019 to 18/04/2019. Centre 1 is a general adult ENT department specialized in otology, centre 2 is a general adult ENT department specialized in cancer and centre 3 is a paediatric ENT department. Comparative analysis of the decreased surgical volume was conducted between 2019 and 2020. Objective To analyse the reduction of ENT surgical volume. Results The three centres operated on 540 patients in 2019, versus 89 in 2020, i.e. an 84% decrease: 89% in Centre 1, 61% in Centre 2, and 95% in the paediatric centre. Otological surgery decreased by 97%, endonasal surgery decreased by 91%, head and neck surgery decreased by 54%, plastic surgery decreased by 82%, and transoral surgery decreased by 85%. The number of surgical operations for skin cancer decreased (24 vs. 9), while the total number of head and neck cancer surgeries remained stable (18 vs. 22). The number of planned tracheostomies increased from 8 to 22. Conclusion The number of ENT surgeries decreased by 84% during the first month of the COVID-19 epidemic. This decreased surgical volume mainly concerned functional surgery, while the level of cancer surgery remained stable. Hospital units will need to absorb a marked excess surgical volume after the epidemic.
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Affiliation(s)
- R Hervochon
- Service d'ORL, GHU Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France.
| | - S Atallah
- Service d'ORL, CHU Tenon, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - S Levivien
- Service d'ORL, CHU Robert Debré, Assistance Publique-Hôpitaux de Paris, Université Diderot, Paris, France
| | - N Teissier
- Service d'ORL, CHU Robert Debré, Assistance Publique-Hôpitaux de Paris, Université Diderot, Paris, France
| | - B Baujat
- Service d'ORL, CHU Tenon, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - F Tankere
- Service d'ORL, GHU Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
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31
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Saloner Dahan L, Giorgi R, Garrel R, Le Taillandier de Gabory L, Costes-Martineau V, Herman P, Poissonnet G, Mauvais O, Malard O, Vergez S, Uro-Coste E, Barry B, Bach C, Chevalier D, Mouawad F, Merol JC, Bastit V, Thariat J, Gilain L, Dufour X, Righini CA, Dessi P, Michel J, Radulesco T, Even C, Baujat B, Fakhry N. Management of cN0 low-grade mucoepidermoid carcinomas of salivary glands: Prospective multicentre study of 152 cases of the French Network of Rare Head and Neck Tumors (REFCOR). Clin Otolaryngol 2020; 45:926-931. [PMID: 32569444 DOI: 10.1111/coa.13600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 05/28/2020] [Accepted: 06/14/2020] [Indexed: 02/01/2023]
Affiliation(s)
- Laurie Saloner Dahan
- Service d'ORL et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire La Conception, Marseille, France.,Aix Marseille Univ, Marseille, France.,REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France
| | - Roch Giorgi
- Aix Marseille Univ, Marseille, France.,Faculté des Sciences Médicales et Paramédicales, SESSTIM, Marseille, France.,BIOSTIC, Hôpital de la Timone, Marseille, France
| | - Renaud Garrel
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL et Chirurgie cervico-faciale, CHU de Montpellier, Montpellier, France
| | - Ludovic Le Taillandier de Gabory
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL et Chirurgie cervico-faciale, CHU de Bordeaux, Bordeaux, France
| | - Valérie Costes-Martineau
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'Anatomie Pathologique, CHU de Montpellier, Montpellier, France
| | - Philippe Herman
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL Chirurgie maxillo-faciale et plastique, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Gilles Poissonnet
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL et chirurgie cervico-faciale, Centre Antoine Lacassagne, Institut Universitaire de la face et du cou, Nice, France
| | - Olivier Mauvais
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL Chirurgie cervico-faciale, Audiophoniatrie, CHU de Besançon, Besancon, France
| | - Olivier Malard
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL et chirurgie cervico-faciale, CHU de Nantes, Nantes, France
| | - Sébastien Vergez
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL et chirurgie cervico-faciale, CHU de Toulouse/Oncopôle, Toulouse, France
| | - Emmanuelle Uro-Coste
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'Anatomie et Cytologie Pathologiques, Institut Universitaire du Cancer-Oncopole, Toulouse, France
| | - Béatrix Barry
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL et chirurgie cervico-faciale, CHU Paris Nord-Val de Seine, Hôpital Xavier Bichat-Claude Bernard, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Christine Bach
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL et chirurgie de la face et du cou, Hôpital Foch, Suresnes, France
| | - Dominique Chevalier
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL et chirurgie cervico-faciale, CHU de Lille, Lille, France
| | - Francois Mouawad
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL et chirurgie cervico-faciale, CHU de Lille, Lille, France
| | - Jean-Claude Merol
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL et chirurgie cervico-faciale, CHU de reims, Reims, France
| | - Vianney Bastit
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL et chirurgie cervico-faciale, Centre François Baclesse, Caen, France
| | - Juliette Thariat
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL et chirurgie cervico-faciale, Centre François Baclesse, Caen, France
| | - Laurent Gilain
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL et chirurgie cervico-faciale, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Xavier Dufour
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL et chirurgie cervico-faciale, CHU de Poitiers, Poitiers, France
| | - Christian-Adrien Righini
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL et chirurgie cervico-faciale, CHU de Grenoble, Grenoble, France
| | - Patrick Dessi
- Service d'ORL et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire La Conception, Marseille, France.,Aix Marseille Univ, Marseille, France.,REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France
| | - Justin Michel
- Service d'ORL et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire La Conception, Marseille, France.,Aix Marseille Univ, Marseille, France.,REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France
| | - Thomas Radulesco
- Service d'ORL et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire La Conception, Marseille, France.,Aix Marseille Univ, Marseille, France.,REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France
| | - Caroline Even
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'Oncologie médicale tête et cou, Institut Gustave Roussy, Villejuif, France
| | - Bertrand Baujat
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL et Chirurgie Cervico-faciale, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Nicolas Fakhry
- Service d'ORL et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire La Conception, Marseille, France.,Aix Marseille Univ, Marseille, France.,REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France
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32
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Laccourreye O, Mirghani H, Evrard D, Bonnefont P, Brugel L, Tankere F, Coste A, Barry B, Baujat B, Atallah S, Kania R. Impact of the first month of Covid-19 lockdown on oncologic surgical activity in the Ile de France region university hospital otorhinolaryngology departments. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 137:273-276. [PMID: 32565242 PMCID: PMC7293504 DOI: 10.1016/j.anorl.2020.06.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To evaluate the impact of the first month of lockdown related to the Covid-19 epidemic on the oncologic surgical activity in the Ile de France region university hospital otorhinolaryngology departments. MATERIAL AND METHODS A multicenter prospective observational assessment was conducted in 6 university hospital otorhinolaryngology departments (Paris Centre, Nord, Est and Sorbonne) during the 1-month periods before (Month A) and after (Month B) lockdown on March 17, 2020. The main goal was to evaluate lockdown impact on oncologic surgical activity in the departments. Secondary goals were to report population characteristics, surgery conditions, postoperative course, progression of Covid status in patients and surgeons, and adverse events. RESULTS 224 procedures were performed. There was 10.9% reduction in overall activity, without significant difference between departments. Squamous cell carcinoma and larynx, hypopharynx, oropharynx, oral cavity and nasal cavity and sinus locations were predominant, at 79% and 75.8% of cases respectively, with no significant differences between months. T3/4 and N2/3 tumors were more frequent in Month B (P=.002 and .0004). There was no significant difference between months regarding surgical approach, type of reconstruction, postoperative course, tracheotomy and nasogastric feeding-tube time, intensive care stay or hospital stay. None of the Month A patients were Covid-19-positive, versus 3 in Month B, without adverse events. None of the otorhinolaryngologists involved in the procedures developed symptoms suggesting Covid-19 infestation. CONCLUSION The present study underscored the limited impact of the Covid-19 epidemic and lockdown on surgical diagnosis and cancer surgery in the Ile de France university otorhinolaryngology departments, maintaining chances for optimal survival without spreading the virus.
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Affiliation(s)
- O Laccourreye
- Service d'ORL et de Chirurgie Cervico-Faciale, Université Paris Centre, HEGP, AP-HP, 20-40, rue Leblanc, 75015 Paris, France.
| | - H Mirghani
- Service d'ORL et de Chirurgie Cervico-Faciale, Université Paris Centre, HEGP, AP-HP, 20-40, rue Leblanc, 75015 Paris, France
| | - D Evrard
- Service d'ORL et de Chirurgie Cervico-Faciale, Université Paris Centre, Hôpital Bichat, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France
| | - P Bonnefont
- Service d'ORL et de Chirurgie Cervico-Faciale, Université Paris Nord, Hôpital La Pitié-Salpétrière, AP-HP, 47-83; boulevard de l'Hôpital, 75013 Paris, France
| | - L Brugel
- Service d'ORL et de Chirurgie Cervico-Faciale, Université Paris Est, Centre Hospitalier Intercommunal de Créteil, 40, avenue de Verdun, 94000 Créteil, France
| | - F Tankere
- Service d'ORL et de Chirurgie Cervico-Faciale, Université Paris Nord, Hôpital La Pitié-Salpétrière, AP-HP, 47-83; boulevard de l'Hôpital, 75013 Paris, France
| | - A Coste
- Service d'ORL et de Chirurgie Cervico-Faciale, Université Paris Est, Centre Hospitalier Intercommunal de Créteil, 40, avenue de Verdun, 94000 Créteil, France
| | - B Barry
- Service d'ORL et de Chirurgie Cervico-Faciale, Université Paris Centre, Hôpital Bichat, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France
| | - B Baujat
- Service d'ORL et de Chirurgie Cervico-Faciale, Université Paris Sorbonne, Hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - S Atallah
- Service d'ORL et de Chirurgie Cervico-Faciale, Université Paris Sorbonne, Hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - R Kania
- Service d'ORL et de Chirurgie Cervico-Faciale, Université Paris Nord, AP-HP, Hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France
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33
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Sanchez-Guerrero JA, Guerlain J, Cebrià I Iranzo MÀ, Baujat B, Lacau St Guily J, Périé S. Expiratory airflow obstruction due to tracheostomy tube: A spirometric study in 50 patients. Clin Otolaryngol 2020; 45:703-709. [PMID: 32351009 DOI: 10.1111/coa.13561] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 04/22/2018] [Revised: 04/02/2020] [Accepted: 04/26/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Tracheostomy is commonly used in intensive care units and in head and neck departments. Airway obstruction due to occluded cuffless tracheostomy tubes themselves remains unknown, although capping trials are commonly used before decannulation. The aim of this study was to evaluate the extent to which airway obstruction can be caused by occluded cuffless tubes in patients who underwent head and neck surgery. DESIGN Prospective Research Outcome. SETTINGS University teaching hospital. PARTICIPANTS Fifty patients requiring transient tracheostomy after head and neck surgery. MAIN OUTCOME MEASURES A flow-volume loop (FVL) through the mouth using a portable spirometer, with the occluded fenestrated cuffless tube, was measured before and immediately after decannulation, by obstructing the orifice of tracheostomy tube. The measurement of FVL recorded the forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1 ), peak expiratory flow (PEF), forced expiratory flow at 50% of FVC, peak inspiratory flow (PIF) and forced inspiratory flow at 50% of FVC. RESULTS A statistically significant difference between all spirometric parameters was found. Mean PEF and PIF, respectively, increased from 2.8 to 4.5 L/s (P < .0001) and 2.3 to 2.7 L/s (P < .01) before and after decannulation, with a strong positive correlation (r = 0.7; P < .05). A mean expiratory (34%) and inspiratory (9%) airflow reduction was observed due to cannula. CONCLUSIONS Occluded cuffless tracheostomy tubes cause a dramatic airflow obstruction, mainly in the expiratory phase of FVL. This should be taken into account during capping trials.
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Affiliation(s)
- Jose Antonio Sanchez-Guerrero
- Department of Rehabilitation, Faculty of Medicine Sorbonne University, Hospital Tenon, Assistance Publique Hôpitaux Paris (APHP), Paris, France.,Department of Physiotherapy, University of Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Joanne Guerlain
- Department of Otolaryngology Head Neck Surgery, Faculty of Medicine Sorbonne University, Hospital Tenon, Assistance Publique Hôpitaux Paris (APHP), Paris, France
| | - Maria Àngels Cebrià I Iranzo
- Department of Physical Therapy, University of Valencia and Hospital Universitarii Politecnic La Fe, Valencia, Spain
| | - Bertrand Baujat
- Department of Otolaryngology Head Neck Surgery, Faculty of Medicine Sorbonne University, Hospital Tenon, Assistance Publique Hôpitaux Paris (APHP), Paris, France
| | - Jean Lacau St Guily
- Department of Otolaryngology Head Neck Surgery, Faculty of Medicine Sorbonne University, Hospital Tenon, Assistance Publique Hôpitaux Paris (APHP), Paris, France.,Department of Otolaryngology Head Neck Surgery, Rothshild Fondation, Paris, France
| | - Sophie Périé
- Department of Otolaryngology Head Neck Surgery, Faculty of Medicine Sorbonne University, Hospital Tenon, Assistance Publique Hôpitaux Paris (APHP), Paris, France.,Department of Otolaryngology Head and Neck Surgery, COM CCF Maillot, Hartmann Clinic, Neuilly sur Seine, France
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34
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Carsuzaa F, Gorphe P, Vergez S, Malard O, Fakhry N, Righini C, Philouze P, Lasne-Cardon A, Gallet P, Tonnerre D, Bozec A, de Mones E, Baujat B, Laccourreye L, Babin E, Dufour X, Thariat J. Consensus on resectability in N3 head and neck squamous cell carcinomas: GETTEC recommendations. Oral Oncol 2020; 106:104733. [PMID: 32335323 DOI: 10.1016/j.oraloncology.2020.104733] [Citation(s) in RCA: 2] [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: 04/17/2020] [Accepted: 04/20/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Among patients with T0-2 N3 head and neck squamous cell carcinomas (HNSCC), those undergoing upfront neck dissection have better oncological outcomes. However, there is no consensual definition of disease resectability of N3 nodes, leading to major treatment attrition and interpretation biases between studies. We established a Delphi method-based consensus to define resectability and impact on decision-making for upfront neck dissection in N3 patients. METHODS The Delphi method was designed as recommended by the French Haute Autorite de Sante among head and neck surgeons from university hospitals and cancer centers, using a 24-item questionnaire. Strong and relative agreements were subsequently established, and recommendations were written. The resulting recommendations were assessed by 30 independent surgeons. RESULTS N3 nodes with intraparenchymal brain invasion, foramen invasion, skull base erosion, nodes requiring bilateral XIIth cranial nerve sacrifice, retropharyngeal N3 node or a node above the plan of soft palate are major contraindications to neck dissection. When neck dissection requires unilateral sacrifice of the IXth or Xth or XIIth cranial nerves or cervical nerve roots, upfront neck dissection may be performed, based on a case-by-case assessment of other patient and tumor estimates. CONCLUSION Consensual contraindications to neck dissection in patients with T0-2 N3 HNSCC were defined among French head and neck surgeons as concerns skull base invasion, retropharyngeal nodes and bilateral XIIth cranial nerve sacrifice. This consensus should allow more reliable comparisons between surgical and non-surgical strategies in N3 patients.
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Affiliation(s)
| | - Philippe Gorphe
- Department of Head and Neck Oncology, Gustave Roussy, University Paris-Saclay, Villejuif, France
| | - Sébastien Vergez
- Institut Universitaire du Cancer de Toulouse Oncopole, University Hospital of Toulouse, France
| | - Olivier Malard
- Head and Neck Surgery, University Hospital of Nantes, France
| | - Nicolas Fakhry
- Head and Neck Surgery, APHM, La Conception University Hospital, Marseille, France
| | | | - Pierre Philouze
- Head and Neck Surgery, Croix Rousse Hospital, Hospices Civils de Lyon (Hospital Group of Lyon), France
| | | | - Patrice Gallet
- Head and Neck Surgery, University Hospital of Nancy, France
| | - Denis Tonnerre
- Head and Neck Surgery, University Hospital of Poitiers, France
| | - Alexandre Bozec
- Head and Neck Surgery, Institut Universitaire de la Face et du Cou, Nice, France
| | - Erwan de Mones
- Head and Neck Surgery, University Hospital of Bordeaux, France
| | | | | | - Emmanuel Babin
- Head and Neck Surgery, Centre François Baclesse, Caen, France
| | - Xavier Dufour
- Head and Neck Surgery, University Hospital of Poitiers, France
| | - Juliette Thariat
- Radiation Oncology, Centre François Baclesse/ARCHADE, Caen, France.
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35
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Thariat J, Moya Plana A, Vérillaud B, Vergez S, Régis-Ferrand F, Digue L, Even C, Costes V, Baujat B, de Gabory L, Baglin AC, Janot F. [Diagnosis, prognosis and treatment of sinonasal carcinomas (excluding melanomas, sarcomas and lymphomas)]. Bull Cancer 2020; 107:601-611. [PMID: 32305127 DOI: 10.1016/j.bulcan.2020.02.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 01/05/2020] [Revised: 02/08/2020] [Accepted: 02/28/2020] [Indexed: 12/21/2022]
Abstract
Sinonasal carcinomas account for 3% of ENT cancers. They are subdivided into squamous cell carcinomas (50%), adenocarcinomas [20%, mostly of intestinal type (ITAC)], and more rarely, adenoid cystic carcinomas, olfactory neuroblastomas (=esthesioneuroblastomas), neuroendocrine carcinomas or undifferentiated sinonasal carcinomas (SNUC). The 5-year survival rates are, in descending order, 72% for neuroblastomas, 63% for adenocarcinomas, 50-60% for large-cell neuroendocrine carcinomas, 53% for squamous cell carcinomas, 25-50% for adenoid cystic, 35% for small-cell neuroendocrine carcinomas and 35% for SNUC and newly discovered histologies. Surgery is the main treatment; endoscopic approaches reduce the morbidity with equivalent tumour control. Intensity-modulated radiation therapy (IMRT) is almost systematic. Nodal involvement is rare in ethmoidal adenocarcinomas and adenoid cystic carcinomas; it is intermediate and may justify prophylactic radiotherapy for N0 necks in SNUC, neuroblastoma, squamous cell carcinomas and sinonasal neuroendocrine carcinomas. IMRT or proton therapy is the mainstay of treatment of unresectable disease. Radiotherapy optimization by carbon ion therapy for adenoid cystic carcinomas, or by chemotherapy for all carcinomas with IMRT or proton therapy, is investigated within clinical trials in France. Neoadjuvant chemotherapy is reserved for rapidly progressive disease or histologies with a high metastatic potential such as neuroendocrine carcinomas or SNUC. Given their histologic and molecular specificities and different relapse patterns, an expertise of the REFCOR network, with REFCORpath review, is likely to correct diagnoses, rectify treatments, with an impact on survival.
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Affiliation(s)
- Juliette Thariat
- Baclesse Cancer Center, Radiation Oncology Department, Caen, France.
| | - Antoine Moya Plana
- Gustave-Roussy Cancer Campus, Head and Neck Surgery Department, Villejuif, France
| | | | - Sébastien Vergez
- Toulouse University Hospital Center, Head and Neck Surgery Department, Toulouse, France
| | - François Régis-Ferrand
- Gustave-Roussy Cancer Campus, Head and Neck Oncology Department, Villejuif, France; HIA Begin, Medical Oncology Department, Saint-Mandé, France
| | - Laurence Digue
- Pellegrin Hospital, Centre Michelet, Head and Neck Oncology Department, Bordeaux, France
| | - Caroline Even
- Gustave-Roussy Cancer Campus, Head and Neck Oncology Department, Villejuif, France
| | - Valérie Costes
- Montpellier Hospital, Department of Pathology, Montpellier, France
| | - Bertrand Baujat
- Tenon Hospital, Head and Neck Surgery Department, Paris, France
| | | | - Anne-Catherine Baglin
- Pellegrin Hospital, Centre Michelet, Head and Neck Surgery Department, Bordeaux, France
| | - François Janot
- Gustave-Roussy Cancer Campus, Head and Neck Surgery Department, Villejuif, France
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- French Rare Head and Neck Cancer Expert Network, France
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36
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Atallah S, Casiraghi O, Fakhry N, Wassef M, Uro-Coste E, Espitalier F, Sudaka A, Kaminsky MC, Dakpe S, Digue L, Bouchain O, Morinière S, Hourseau M, Bertolus C, Jegoux F, Thariat J, Calugaru V, Schultz P, Philouze P, Mauvais O, Righini CA, Badoual C, Saroul N, Goujon JM, Marie JP, Taouachi R, Brenet E, Aupérin A, Baujat B. A prospective multicentre REFCOR study of 470 cases of head and neck Adenoid cystic carcinoma: epidemiology and prognostic factors. Eur J Cancer 2020; 130:241-249. [PMID: 32171628 DOI: 10.1016/j.ejca.2020.01.023] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [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: 09/29/2019] [Revised: 01/14/2020] [Accepted: 01/28/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Adenoid cystic carcinoma (ACC) accounts for 1% of malignant head and neck tumours [1] and 10% of salivary glands malignant tumours. The main objective of our study is to investigate the prognostic factors influencing the event-free survival (EFS) of patients with ACC. PATIENTS AND METHODS A multicentre prospective study was conducted from 2009 to 2018. All 470 patients with ACC whose survival data appear in the REFCOR database were included in the study. The main judgement criterion was EFS. Both a bivariate survival analysis using log-rank test and a multivariate using Cox model were performed using the R software. RESULTS Average age was 55 years. Females accounted for 59.4% of the cohort. The body mass index (BMI) was normal in 86% of cases. Tumours were located in minor salivary glands in 60% of cases. T3/T4 stages represented 58%; 89% of patients were cN0. histological grade III was observed on 21% of patients. The EFS and overall 5-year survival rates were 50% and 85%, respectively. After adjustment, the most significant pejorative prognostic factors were age ≥65 years (hazard ratio [HR] = 1.67), BMI<16.5 (HR = 2.62), and lymph node invasion cN (HR = 2.08). CONCLUSION Age, BMI and N stage are the three main clinical prognostic factors determining EFS identified in this prospective series of patients with ACC. Such findings open new research perspectives on the influence of these components on initial patient care.
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Affiliation(s)
- Sarah Atallah
- Sorbonne University, APHP, Department of ENT-Head and Neck Surgery, Tenon Hospital, 4 Rue de La Chine, 75020, Paris, France; Doctoral School of Public Health, CESP, University of Paris Sud, 16 Avenue Paul Vaillant Couturier, 94807, Villejuif, France
| | - Odile Casiraghi
- Department of Biopathology, Gustave Roussy Cancer Campus, 114, Rue Edouard Vaillant, 94805, Villejuif, France
| | - Nicolas Fakhry
- Department of ENT-Head and Neck Surgery, University Hospital of Marseille, APHM, 13915, Marseille, France
| | - Michel Wassef
- Department of Pathology, Lariboisière University Hospital, Paris Diderot University, APHP, 75010, Paris, France
| | - Emmanuelle Uro-Coste
- Department of Pathology and Cytopathology, University Cancer Institute Toulouse, Toulouse University Hospital, 1 Avenue Irène Joliot-Curie, 31400, Toulouse, France
| | - Florent Espitalier
- Department of ENT-Head and Neck Surgery, Nantes University Hospital, 1 Place Alexis-Ricordeau, 44000, Nantes, France
| | - Anne Sudaka
- Department of Pathology, Centre Antoine-Lacassagne, 31 avenue de Valombrose, 06189, Nice, France
| | - Marie Christine Kaminsky
- Department of Medical Oncology, Oncology Institute of Lorraine, Vandoeuvre-Lès-Nancy, 54035, Nancy, France
| | - Stéphanie Dakpe
- Department of Maxillofacial Surgery, University Hospital of Amiens-Picardy, Avenue René Laennec, 80000, Amiens, France
| | - Laurence Digue
- Department of Medical Oncology, Radiotherapy, Dermatology and Palliative Care, University Hospital of Saint André, 1 Rue Jean Burguet, 33075, Bordeaux, France
| | - Olivier Bouchain
- Department of ENT-Head and Neck Surgery, University Hospital of Liège, Belgium
| | - Sylvain Morinière
- Department of ENT-Head and Neck Surgery, Tours Bretonneau University Hospital, 2 Boulevard Tonnellé, 37000, Tours, France
| | - Muriel Hourseau
- Department of Pathology, Hospital Bichat, APHP, 75018, Paris, France
| | - Chloé Bertolus
- Department of Oral and Maxillofacial Surgery, Sorbonne University, Pitié-Salpêtrière Hospital, APHP, 75013, Paris, France
| | - Franck Jegoux
- Department of ENT-Head and Neck Surgery, Rennes University Hospital, 2 Rue Henri Le Guilloux, 35000, Rennes, France
| | - Juliette Thariat
- Department of Radiotherapy, François Baclesse Centre, 3 Rue Du Général Harris, 14000, Caen, France
| | - Valentin Calugaru
- Department of Oncology Radiotherapy, Curie Institute, 26 Rue D'Ulm, 75005, Paris, France
| | - Philippe Schultz
- Department of ENT-Head and Neck Surgery, University Hospital of Strasbourg, 67000, Strasbourg, 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
| | - Olivier Mauvais
- Department of ENT-Head and Neck Surgery, University Hospital of Besançon, France, 25000, Besançon, France
| | - Christian A Righini
- Department of ENT-Head and Neck Surgery, Grenoble Alpes University Hospital, CS 10217, 38043, Grenoble, France
| | - Cécile Badoual
- Department of Pathology, European Georges Pompidou University Hospital, Assistance Publique-Hôpitaux de Paris, Paris Descartes University, Paris University, PARCC INSERM U970, Paris, France
| | - Nicolas Saroul
- Department of Radiotherapy, Jean Perrin Centre, University Clermont Auvergne, 63100, Clermont-Ferrand, France
| | - Jean Michel Goujon
- Department of Pathology, University Hospital of Poitiers, 2 Rue de La Milétrie, CS 90577, 86021, POITIERS, France
| | - Jean Paul Marie
- Department of ENT-Head and Neck Surgery, Rouen University Hospital, 1 Rue de Germont, 76031, Rouen, France
| | - Rabah Taouachi
- Department of ENT-Head and Neck Surgery, Curie Institute, René Huguenin Hospital, Saint-Cloud, France
| | - Esteban Brenet
- Department of ENT-Head and Neck Surgery, Robert Debré University Hospital, 51100, Reims, France
| | - Anne Aupérin
- INSERM U1018, CESP, Université Paris-Sud, Université Paris-Saclay, 16 Avenue Paul Vaillant Couturier, 94807, Villejuif, France
| | - Bertrand Baujat
- Sorbonne University, APHP, Department of ENT-Head and Neck Surgery, Tenon Hospital, 4 Rue de La Chine, 75020, Paris, France.
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Abstract
Laryngeal sarcomas constitute an extremely rare entity among head and neck malignancies. Furthermore, most of them are chondrosarcomas, and the osteogenic form remains a true rarity. In general, there is a lack of information on the characteristics of laryngeal osteosarcoma. Thus, we sought to critically review the existing world literature on laryngeal osteosarcoma in order to develop a more accurate clinicopathological profile of this malignancy. Laryngeal osteosarcoma has a predilection for elderly male patients, as 87% were male in the present series and the mean age was 62 years (range 32-80), and without a direct association with tobacco exposure. Osteosarcoma of the larynx is typically a highly malignant neoplasm that metastasizes early, has a propensity for hematogenous spread and also has a marked tendency to recur. Twelve (41%) out of the 29 cases in the present review with follow-up data had metastatic disease. The aspects that distinguish osteosarcoma from its differential diagnostic alternatives are discussed in this review.
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Affiliation(s)
- Antti A Mäkitie
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. .,Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland. .,Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska Hospital, Stockholm, Sweden. .,Sorbonne université, Service d'oto-rhino-laryngologie et de chirurgie cervicofaciale, DMU CHIR, Hôpital Tenon, Assistance-Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020, Paris, France.
| | | | - Bertrand Baujat
- Sorbonne université, Service d'oto-rhino-laryngologie et de chirurgie cervicofaciale, DMU CHIR, Hôpital Tenon, Assistance-Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020, Paris, France.,EURACAN (European Rare Cancer Network) Group 7 Head and Neck rare tumours, Paris, France.,REFCOR (Réseau d'Expertise Français sur les cancers ORL Rares), Paris, France
| | - Alhadi Almangush
- Department of Pathology, University of Helsinki, Helsinki, Finland.,Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.,Institute of Dentistry, University of Misurata, Misurata, Libya
| | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group, Padua, Italy
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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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Le Guevelou J, Lebars S, Kammerer E, de Gabory L, Vergez S, Janot F, Baujat B, Righini C, Jegoux F, Dufour X, Merol JC, Mauvais O, Lasne-Cardon A, Selleret L, Thariat J. Head and neck cancer during pregnancy. Head Neck 2019; 41:3719-3732. [PMID: 31329334 DOI: 10.1002/hed.25877] [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: 03/14/2019] [Revised: 06/28/2019] [Accepted: 07/03/2019] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND The incidence of cancer during pregnancy is low but is slightly increasing. Data on incidence and etiology of head and neck (HN) cancers in pregnant women are rare. We evaluated the frequency, tumor type, associated factors, and specific biomarkers in HN cancers occurring in pregnant (and peripartum) women. METHODS A systematic literature search was performed on PubMed, for any HN tumor site occurring in pregnant women. RESULTS Sixty cases of HN cancers occurring during pregnancy were identified. Most of them were oral cavity cancers. Relationships with oncogenic viruses, hormonal disturbance, and shift in maternal immunity profile were identified. CONCLUSION Carcinogenesis of HN cancers in pregnant women may be led by different cancer type-specific hallmarks. Relevance of these etiological factors with respect to treatments and birth control recommendations is being investigated by the REFCOR in an ambispective study.
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Affiliation(s)
| | | | | | - Ludovic de Gabory
- Service de Chirurgie ORL, Centre Hospitalier Universitaire Pellegrin, Bordeaux, France
| | - Sebastien Vergez
- Service de Chirurgie ORL, Centre Hospitalier Universitaire Rangueil-Larrey, Toulouse, France
| | - François Janot
- Service de Chirurgie ORL, Centre Gustave Roussy, Villejuif, France
| | - Bertrand Baujat
- Service de Chirurgie ORL, Hopital Tenon, Université Paris-Est, Paris, France
| | - Christian Righini
- Service de Chirurgie ORL, Centre Hospitalier Universitaire de Grenoble, Grenoble, France
| | - Franck Jegoux
- Service de Chirurgie ORL, Centre Hospitalier Universitaire Pontchaillou, Rennes, France
| | - Xavier Dufour
- Service de Chirurgie ORL, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
| | - Jean-Claude Merol
- Service de Chirurgie ORL, Centre Hospitalier Universitaire de Reims, Reims, France
| | - Olivier Mauvais
- Service de Chirurgie ORL, Centre Hospitalier Universitaire de Besançon, Besançon, France
| | - Audrey Lasne-Cardon
- Service de Chirurgie ORL Centre François Baclesse, Normandie Université-Unicaen, Caen, France
| | - Lise Selleret
- Service de Gynécologie Obstetrique, Hopital Tenon, Paris, France
| | - Juliette Thariat
- Service de Radiothérapie, Centre François Baclesse, Caen, France
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Villepelet A, Hugonin S, Atallah S, Job B, Baujat B, Lacau St Guily J, Lacave R. Effects of tobacco abuse on major chromosomal instability in human papilloma virus 16-positive oropharyngeal squamous cell carcinoma. Int J Oncol 2019; 55:527-535. [PMID: 31268157 DOI: 10.3892/ijo.2019.4826] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 05/31/2019] [Indexed: 11/05/2022] Open
Abstract
A substantial number of patients with oropharyngeal squamous cell carcinoma (OPSCC) have two oncogenic risk factors: Human papilloma virus (HPV) infection and tobacco use. These factors can be competitive or synergistic at the chromosomal and genomic levels, with strong prognostic and therapeutic implications. HPV16 has been shown in vitro to be a high‑risk HPV that induces low rates of chromosomal copy number alterations. However, chromosomal instability can be increased by smoking. Evaluating chromosomal instability in HPV‑positive patients according to their smoking status is therefore critical for assessing the prognosis and therapeutic impact. The aim of this study was to assess chromosomal instability in patients with HPV‑positive OPSCC according to smoking status. Chromosomal instability was investigated with array‑based comparative genomic hybridization (aCGH) in 50 patients with OPSCC. Differences in chromosomal alterations were examined according to the HPV and smoking status of the patients. HPV‑positive tumors (24/26 were HPV16‑positive) had fewer genomic aberrations (P=0.0082) and fewer breakpoints (P=0.048) than HPV‑negative tumors. We confirmed the association between HPV‑positive OPSCC and chromosomal losses at 11q. We verified the association between HPV‑negative OPSCC and losses at 3p and 9p and gains at 7q and 11q13. In the patients with OPSCC who were HPV‑positive, the total number of chromosomal aberrations per tumor was significantly higher in the group of patients who were smokers (P=0.003). However, the cytobands did not differ significantly according to the smoking status. On the whole, the data of this study may help to improve the stratification of HPV‑positive OPSCC patients and must be supplemented by next‑generation sequencing studies in order to describe the mutational and transcriptomic profiles of such patients according to smoking status.
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Affiliation(s)
- Aude Villepelet
- Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Otolaryngology-Head and Neck Surgery, Tenon Hospital, 75020 Paris, France
| | - Sylvain Hugonin
- Assistance Publique-Hôpitaux de Paris (AP-HP), Tumors Genomic Unit, Tenon Hospital, 75020 Paris, France
| | - Sarah Atallah
- Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Otolaryngology-Head and Neck Surgery, Tenon Hospital, 75020 Paris, France
| | - Bastien Job
- INSERM US23, Gustave Roussy Cancer Campus, 94805 Villejuif, France
| | - Bertrand Baujat
- Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Otolaryngology-Head and Neck Surgery, Tenon Hospital, 75020 Paris, France
| | - Jean Lacau St Guily
- Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Otolaryngology-Head and Neck Surgery, Tenon Hospital, 75020 Paris, France
| | - Roger Lacave
- Faculty of Medicine, Sorbonne University, GRC10, 75013 Paris, France
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Debureaux PE, Paccoud O, Guitard J, Baujat B, Ruggeri A, Battipaglia G, Duléry R, Giannotti F, Malard F, Mohty M, Brissot E. Rhino-orbital Mucormycosis presenting as facial cellulitis in a patient with high-risk acute myeloid leukemia in relapse. Curr Res Transl Med 2019; 67:76-78. [PMID: 30686650 DOI: 10.1016/j.retram.2019.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 01/13/2019] [Accepted: 01/15/2019] [Indexed: 11/15/2022]
Affiliation(s)
- Pierre-Edouard Debureaux
- Sorbonne Université, Université Pierre et Marie Curie, Paris, France; AP-HP, Hôpital Saint-Antoine, Service d'Hématologie Clinique, F-75012, Paris, France
| | - Olivier Paccoud
- Sorbonne Université, Université Pierre et Marie Curie, Paris, France; AP-HP, Hôpital Saint-Antoine, Service des maladies infectieuses et tropicales, F-75012, Paris, France
| | - Juliette Guitard
- Sorbonne Université, Université Pierre et Marie Curie, Paris, France; AP-HP, Hôpital Saint-Antoine, Laboratoire de Parasitologie-Mycologie, F-75012, Paris, France
| | - Bertrand Baujat
- Sorbonne Université, Université Pierre et Marie Curie, Paris, France; AP-HP, Hôpital Tenon, Service de chirurgie ORL, F-75020, Paris, France
| | - Annalisa Ruggeri
- AP-HP, Hôpital Saint-Antoine, Service d'Hématologie Clinique, F-75012, Paris, France
| | - Giorgia Battipaglia
- Sorbonne Université, Université Pierre et Marie Curie, Paris, France; AP-HP, Hôpital Saint-Antoine, Service d'Hématologie Clinique, F-75012, Paris, France
| | - Rémy Duléry
- AP-HP, Hôpital Saint-Antoine, Service d'Hématologie Clinique, F-75012, Paris, France
| | - Federica Giannotti
- Sorbonne Université, Université Pierre et Marie Curie, Paris, France; AP-HP, Hôpital Saint-Antoine, Service d'Hématologie Clinique, F-75012, Paris, France
| | - Florent Malard
- Sorbonne Université, Université Pierre et Marie Curie, Paris, France; AP-HP, Hôpital Saint-Antoine, Service d'Hématologie Clinique, F-75012, Paris, France; INSERM, UMR S 938,Centre de Recherche Saint-Antoine (CRSA), F-75012 Paris, France
| | - Mohamad Mohty
- Sorbonne Université, Université Pierre et Marie Curie, Paris, France; AP-HP, Hôpital Saint-Antoine, Service d'Hématologie Clinique, F-75012, Paris, France; INSERM, UMR S 938,Centre de Recherche Saint-Antoine (CRSA), F-75012 Paris, France
| | - Eolia Brissot
- Sorbonne Université, Université Pierre et Marie Curie, Paris, France; AP-HP, Hôpital Saint-Antoine, Service d'Hématologie Clinique, F-75012, Paris, France; INSERM, UMR S 938,Centre de Recherche Saint-Antoine (CRSA), F-75012 Paris, France.
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Lesnik M, De Crouy Chanel O, Lefèvre M, Samaha S, Périe S, Lacau St Guily J, Baujat B. Management of incidental discovery of microscopic squamous cell carcinoma in zones of osteoradionecrosis of the mandible. Eur Ann Otorhinolaryngol Head Neck Dis 2018; 136:83-86. [PMID: 30448178 DOI: 10.1016/j.anorl.2018.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Osteoradionecrosis (ORN) of the mandible is a common complication of head and neck radiotherapy and often requires surgical treatment. Squamous cell carcinoma (SCC) can be exceptionally discovered within zones of ORN on histological examination of the operative specimen. The authors discuss the management of these lesions based on a short patient series. MATERIALS AND METHODS This single-centre retrospective study was based on patients managed between 2012 and 2014 for ORN with incidental discovery of microscopic SCC. RESULTS Five patients with incidental discovery of microscopic SCC in a zone of ORN of the mandible were included in this study. The mean time to onset of ORN after the end of radiotherapy for locally advanced SCC of the oral cavity or oropharynx was 42 months. Surgical treatment consisted of marginal or segmental mandibulectomy with free flap reconstruction. No recurrence was observed with a mean follow-up of 35 months [24-46]. CONCLUSION The incidental discovery of microscopic SCC in a zone of ORN of the mandible is a rare event and has not been reported in the literature. Optimal management cannot be reliably defined due to the lack of data in the literature, but the present study supports careful histological examination of ORN specimens. Treatment must be as conservative as possible to avoid excessively invasive surgery.
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Affiliation(s)
- M Lesnik
- Service d'oto-rhino-laryngologie et de chirurgie cervicofaciale, université Pierre-et-Marie-Curie, Paris VI, Hôpital Tenon, Assistance-Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France.
| | - O De Crouy Chanel
- Service d'oto-rhino-laryngologie et de chirurgie cervicofaciale, université Pierre-et-Marie-Curie, Paris VI, Hôpital Tenon, Assistance-Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France
| | - M Lefèvre
- Service d'anatomie pathologique, Université Pierre-et-Marie-Curie, Paris VI, Hôpital Tenon, Assistance-Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France
| | - S Samaha
- Service d'oto-rhino-laryngologie et de chirurgie cervicofaciale, université Pierre-et-Marie-Curie, Paris VI, Hôpital Tenon, Assistance-Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France
| | - S Périe
- Service d'oto-rhino-laryngologie et de chirurgie cervicofaciale, université Pierre-et-Marie-Curie, Paris VI, Hôpital Tenon, Assistance-Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France
| | - J Lacau St Guily
- Service d'oto-rhino-laryngologie et de chirurgie cervicofaciale, université Pierre-et-Marie-Curie, Paris VI, Hôpital Tenon, Assistance-Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France
| | - B Baujat
- Service d'oto-rhino-laryngologie et de chirurgie cervicofaciale, université Pierre-et-Marie-Curie, Paris VI, Hôpital Tenon, Assistance-Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France
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Villepelet A, Lefèvre M, Verillaud B, Janot F, Garrel R, Vergez S, Bertolus C, Malard O, de Gabory L, Mauvais O, Baujat B. Salivary duct carcinoma: Prospective multicenter study of 61 cases of the Réseau d'Expertise Français des Cancers ORL Rares. Head Neck 2018; 41:584-591. [PMID: 30421824 DOI: 10.1002/hed.25194] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [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: 03/26/2017] [Revised: 01/08/2018] [Accepted: 03/02/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The purposes of this study were to describe the characteristics of a prospective multicenter series of patients with salivary duct carcinoma and to investigate prognostic factors. METHODS Patients included for salivary duct carcinoma between 2009 and 2016 in the Réseau d'Expertise Français des Cancers ORL Rares (REFCOR) database were selected. Immunohistochemical analyses were performed. RESULTS Sixty-one patients were included in this study. The primary site was the parotid gland in 90% of the cases. Fifty-seven percent of the tumors were stage IV, 65% of patients had lymph node involvement, and 10% had metastases. Tumors showed androgen receptor (89%) and human epidermal growth factor receptor 2 (HER2)/neu (36%). Ninety-four percent of patients underwent surgery and 86% had postoperative radiotherapy. Six patients were treated with targeted therapies. The 3-year overall survival (OS) was 74% and the 3-year disease-free survival (DFS) was 44%. Tumor stages III to IV reduced DFS (hazard ratio [HR] 4.3; P = .04). The N2/3 class reduced distant metastasis-free survival (HR 7.3; P = .007). CONCLUSION Salivary duct carcinoma prognosis is poor and is correlated with tumor stage and lymph node classification. Androgen receptor and HER2/neu should be tested as they offer the possibility of targeted therapies.
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Affiliation(s)
- Aude Villepelet
- Service d'ORL et de Chirurgie Cervicofaciale, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Paris / Université Pierre et Marie Curie, Paris, Paris, France
| | - Marine Lefèvre
- Service d'Anatomie Pathologique, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Benjamin Verillaud
- Service d'ORL et de Chirurgie Cervicofaciale, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - François Janot
- Département d'ORL et de Chirurgie Cervicofaciale, Institut Gustave-Roussy, Villejuif, Paris, France
| | - Renaud Garrel
- Service d'ORL et de Chirurgie Cervicofaciale, CHU de Montpellier, Paris, France
| | - Sébastien Vergez
- Service d'ORL et de Chirurgie Cervicofaciale, IUC Toulouse, Paris, France
| | - Chloé Bertolus
- Service de Chirurgie Maxillofaciale, Hôpital Pitié Salpétrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Olivier Malard
- Service d'ORL et de Chirurgie Cervicofaciale, CHU de Nantes, Paris, France
| | - Ludovic de Gabory
- Service d'ORL et de Chirurgie Cervicofaciale, CHU de Bordeaux, Paris, France
| | - Olivier Mauvais
- Service d'ORL et de Chirurgie Cervicofaciale, CHU de Besançon, Paris, France
| | - Bertrand Baujat
- Service d'ORL et de Chirurgie Cervicofaciale, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Paris / Université Pierre et Marie Curie, Paris, Paris, France
| | -
- Réseau d'Expertise Français des Cancers ORL Rares: (REFCOR, French Rare Head and Neck Cancer Expert Network): S. Albert, G. Andry, E. Babin, C. Bach, J.-M. Badet, C. Badoual, A.C. Baglin, A. Banal, B. Barry, E. Baudin, B. Baujat, R.J. Bensadoun, C. Bertolus, J.-P. Bessède, D. Blanchard, C. Borel, A. Bozorg-Grayeli, R. Breheret, P. Breton, L. Brugel, G. Calais, O. Casiraghi, E. Cassagnau, L. Castillo, P. Ceruse, F. Chabolle, D. Chevalier, J.C. Chobaut, O. Choussy, A. Cosmidis, A. Coste, V. Costes, L. Crampette, V. Darrouzet, P. Demez, P. Dessi, B. Devauchelle, G. Dolivet, F. Dubrulle, S. Duflo, X. Dufour, S. Faivre, N. Fakhry, C. Ferron, F. Floret, L. de Gabory, R. Garrel, L. Geoffrois, L. Gilain, A. Giovanni, A. Girod, B. Guerrier, S. Hans, P. Herman, P. Hofman, M. Housset, R. Jankowski, F. Jegoux, M. Juliéron, M.-C. Kaminsky, F. Kolb, J. Lacau St Guily, L. Laccoureye, B. Lallemant, P. Lang, E. Lartigau, J.-P. Lavieille, M. Lefevre, X. Leroy, O. Malard, F. Massip, O. Mauvais, J.-C. Merol, J. Michel, T. Mom, S. Morinière, E. de Monès, G. Moulin, G. Noel, G. Poissonnet, J.-M. Prades, D. de Raucourt, E. Reyt, C. Righini, Y. Marie Robin, F. Rolland, B. Ruhin, N. Sarroul, P. Schultz, E. Serrano, O. Sterkers, V. Strunski, A. Sudaka, M. Tassart, S. Testelin, J. Thariat, A. Timochenko, B. Toussaint, E. Uro Coste, G. Valette, T. Van den Abbeele, A. Varoquaux, F. Veillon, S. Vergez, M. Wassef
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de Bonnecaze G, Verillaud B, Chaltiel L, Fierens S, Chapelier M, Rumeau C, Malard O, Gavid M, Dufour X, Righini C, Uro-Coste E, Rives M, Bach C, Baujat B, Janot F, de Gabory L, Vergez S. Clinical characteristics and prognostic factors of sinonasal undifferentiated carcinoma: a multicenter study. Int Forum Allergy Rhinol 2018; 8:1065-1072. [PMID: 29935059 DOI: 10.1002/alr.22143] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [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: 01/09/2018] [Revised: 04/06/2018] [Accepted: 04/18/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND Sinonasal undifferentiated carcinoma (SNUC) is a very rare entity with a poor prognosis. Due to the lack of studies on the subject, evidence is lacking concerning its management. METHODS A multicenter collaborative study was conducted to assess treatment strategy, oncological outcome, and prognostic factors. RESULTS Definitive analyses focused on 54 patients with a majority of advanced stage; the 3-year overall survival (OS) and 3-year recurrence-free survival (RFS) rates were, respectively, 62.4% and 47.8%. During the follow-up, 18 patients (33.3%) died, 10 (18.5%) developed metastases, 7 had lymph-node involvement (13%), and 12 (22.2%) showed recurrence or local progression. In univariate analyses, treatment modalities associated with improved RFS were induction chemotherapy (p = 0.02) and intensity-modulated radiotherapy (p = 0.007). In the multivariate analyses, only induction chemotherapy (p = 0.047, hazard ratio [HR] = 0.39) was significantly associated with improved RFS. CONCLUSION Multimodal therapies including induction chemotherapy and intensity-modulated radiotherapy may improve the prognosis of SNUC; surgery might improve local control. Further multicenter studies are required.
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Affiliation(s)
- Guillaume de Bonnecaze
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Rangueil-Larrey, Toulouse, France
| | - Benjamin Verillaud
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Lariboisière, Paris, France
| | - Leonor Chaltiel
- Biostatistics Department, L'Institut Universitaire du Cancer de Toulouse-Oncopole (IUCT-Oncopole), Cancer Institute, Toulouse, France
| | - Sylvestre Fierens
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Pellegrin, Bordeaux, France
| | - Mark Chapelier
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Rangueil-Larrey, Toulouse, France
| | - Cécile Rumeau
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Nancy, Nancy, France
| | - Olivier Malard
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Nantes, Nantes, France
| | - Marie Gavid
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Saint-Etienne, Saint-Priest-en-Jarez, France
| | - Xavier Dufour
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Poitiers, Poitiers, France
| | - Christian Righini
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Grenoble, Grenoble, France
| | | | - Michel Rives
- Radiation Oncology Department, IUCT-Oncopôle, Cancer Institute, Toulouse, France
| | - Christine Bach
- Department of Otorhinolaryngology-Head and Neck Surgery, Hopital Foch, Suresnes, France
| | - Bertrand Baujat
- Department of Otorhinolaryngology-Head and Neck Surgery, Tenon Hospital, Paris-Est University, Paris, France
| | - François Janot
- Department of Otorhinolaryngology-Head and Neck Surgery, Institut Gustave Roussy, Villejuif, France
| | - Ludovic de Gabory
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Pellegrin, Bordeaux, France
| | - Sebastien Vergez
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Rangueil-Larrey, Toulouse, France
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Baujat B, Struk S, Lesnik M, de Crouy Chanel O, Barbut J, Lefevre M, Périé S, Lacau St. Guily J. Fascia Temporalis Free Flap for Cricotracheal Reconstruction: A Novel Approach. Ann Thorac Surg 2017; 104:1040-1046. [DOI: 10.1016/j.athoracsur.2017.02.078] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 01/20/2017] [Accepted: 02/24/2017] [Indexed: 11/16/2022]
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Lacau St Guily J, Rousseau A, Baujat B, Périé S, Schultz P, Barry B, Dufour X, Malard O, Pretet JL, Clavel C, Birembaut P, Franceschi S. Oropharyngeal cancer prognosis by tumour HPV status in France: The multicentric Papillophar study. Oral Oncol 2017; 67:29-36. [PMID: 28351578 DOI: 10.1016/j.oraloncology.2017.01.012] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 01/03/2017] [Accepted: 01/27/2017] [Indexed: 01/21/2023]
Abstract
AIMS To evaluate the impact of human papillomavirus (HPV) status, tobacco smoking and initial treatment approach on progression-free survival (PFS) and overall survival (OS) for oropharyngeal cancer (OPC) in France, a country where smoking declines started late (1990s). METHODS 340 OPC patients (median age: 60years) from 14 French hospitals were followed up (median 26.7months). PCR-based positivity for both HPV DNA and E6/E7 mRNA was used to distinguish HPV-positive OPC (27.1%). Hospital-stratified hazard ratios (HR) and corresponding 95% confidence intervals (CI) were used to compare PFS and OS according to HPV and other prognostic factors in hospital-stratified unadjusted and multivariate models. The combined effect of HPV status with either smoking, stage, or initial treatment on PFS was also evaluated. RESULTS PFS in multivariate analysis was better in HPV-positive patients (HR=0.42; 95% CI: 0.24-0.73) and worse in older patients (HR for 5-year age increase=1.12) and those having had firstly radiotherapy (HR=1.86; 95% CI: 1.19-2.92) or induction chemotherapy (HR=1.73; 95% CI: 1.08-2.79) instead of upfront surgery. Findings for OS were similar. Loco-regional recurrences were less frequent in HPV-positive (10.5%) than HPV-negative patients (26.0%) but distant recurrences were similarly frequent. HPV status did not modify the influence of smoking or stage on PFS but the impossibility to perform upfront surgery may be more relevant for HPV-negative patients. CONCLUSIONS HPV-positive OPC patients fare better than HPV-negative OPC and may benefit from toxicity-sparing. Whether HPV-negative patients responded less well to radiation and chemotherapy because of more severe genomic damage or bulkier tumours is unclear.
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Affiliation(s)
- Jean Lacau St Guily
- Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Otolaryngology-Head and Neck Surgery, Tenon Hospital, 75020 Paris, France; Pierre-et-Marie Curie University - Sorbonne Universities, University Cancerology Institute UPMC, Paris, France.
| | - Alexandra Rousseau
- Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Clinical Pharmacology and Clinical Research Unit of East of Paris (URC-Est), Saint Antoine Hospital, 75012 Paris, France.
| | - Bertrand Baujat
- Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Otolaryngology-Head and Neck Surgery, Tenon Hospital, 75020 Paris, France; Pierre-et-Marie Curie University - Sorbonne Universities, University Cancerology Institute UPMC, Paris, France.
| | - Sophie Périé
- Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Otolaryngology-Head and Neck Surgery, Tenon Hospital, 75020 Paris, France; Pierre-et-Marie Curie University - Sorbonne Universities, University Cancerology Institute UPMC, Paris, France.
| | - Philippe Schultz
- Department of Otolaryngology-Head and Neck Surgery, Strasbourg University Hospital - Hautepierre, 67098 Strasbourg Cedex, France.
| | - Béatrix Barry
- Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Otolaryngology-Head and Neck Surgery, Bichat Hospital, and University-Paris 7, 75877 Paris Cedex 18, France.
| | - Xavier Dufour
- Department of Otolaryngology-Head and Neck Surgery, Poitiers University Hospital, 86021 Poitiers Cedex, France.
| | - Olivier Malard
- Department of Otolaryngology-Head and Neck Surgery, Nantes University Hospital - Hotel-Dieu, 44093 Nantes Cedex 1, France.
| | - Jean-Luc Pretet
- Franche-Comte University, COMUE UBFC, Besançon University Hospital - Jean Minjoz, 25030 Besançon Cedex, France; Inserm CIC 1431, 25030 Besançon Cedex, France.
| | - Christine Clavel
- INSERM UMR-S903, Reims University Hospital - Maison Blanche, 51092 Reims Cedex, France.
| | - Philippe Birembaut
- Laboratory of Biopathology, Reims University Hospital - Maison Blanche, Reims-Champagne-Ardenne University, 51092 Reims Cedex, France.
| | - Silvia Franceschi
- International Agency for Research on Cancer, 150 Cours Albert Thomas, 69372 Lyon Cedex 08, France.
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Meyers M, Granger B, Herman P, Janot F, Garrel R, Fakhry N, Poissonnet G, Baglin AC, Lefèvre M, Baujat B. Erratum to "Head and neck adenoid cystic carcinoma: A prospective multicenter REFCOR study of 95 cases" [Eur. Ann. Otorhinolaryngol. Head Neck Dis. 133 (1) (2016) 13-7]. Eur Ann Otorhinolaryngol Head Neck Dis 2017; 133:453. [PMID: 28340916 DOI: 10.1016/j.anorl.2016.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- M Meyers
- Service ORL-CCF, hôpital Foch, 40, rue Worth, 92151 Suresnes, France; Service ORL-CCF, hôpital Tenon, université Paris VI, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - B Granger
- Service de santé publique et biostatistiques, hôpital Pitié Salpétrière, AP-HP, 47-83, boulevard de l'Hôpital, 75651 Paris, France
| | - P Herman
- Service ORL-CCF, hôpital Lariboisière, université Paris VII, AP-HP, 2, rue Ambroise-Paré, 75475 Paris, France
| | - F Janot
- Département ORL-CCF, institut Gustave-Roussy, 114, rue Edouard-Vaillant, 94800 Villejuif, France
| | - R Garrel
- Service ORL-CCF, hôpital Gui-de-Chauliac, université de Montpellier, 80, avenue Augustin-Fliche, 34090 Montpellier, France
| | - N Fakhry
- Service ORL-CCF, hôpital la Timone, université de Marseille, 264, rue Saint-Pierre, 13385 Marseille, France
| | - G Poissonnet
- Service ORL-CCF, centre Lacassagne, 33, avenue Valombrose, 06100 Nice, France
| | - A-C Baglin
- AP-HP, service d'anatomie pathologique, hôpital Lariboisière, 2, rue Ambroise-Paré, 75475 Paris, France
| | - M Lefèvre
- AP-HP, service d'anatomie pathologique, hôpital Tenon, Université Paris VI, 4, rue de la Chine, 75020 Paris, France
| | - B Baujat
- Service ORL-CCF, hôpital Tenon, université Paris VI, AP-HP, 4, rue de la Chine, 75020 Paris, France.
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Meyers M, Granger B, Herman P, Janot F, Garrel R, Fakhry N, Poissonnet G, Baujat B. Head and neck adenoid cystic carcinoma: A prospective multicenter REFCOR study of 95 cases. Eur Ann Otorhinolaryngol Head Neck Dis 2015; 133:13-7. [PMID: 26493113 DOI: 10.1016/j.anorl.2015.09.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [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] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To describe the clinical, histological and therapeutic characteristics of a prospective multicenter series of 95 head and neck adenoid cystic carcinoma patients, and to determine any prognostic factors for disease-free survival. PATIENTS AND METHODS Ninety-five patients with adenoid cystic carcinoma were included in the Réseau d'Expertise Français Des Cancers ORL Rares (REFCOR, French Rare Head and Neck Cancer Expert Network) database between 2009 and 2012. The primary site was the salivary glands in 39 cases, sinus cavities (including hard palate) in 36 cases, pharynx-larynx-trachea in 14 cases, and lips and oral cavity in 4 cases. The tumor was stage I in 15% of cases, stage II in 23%, stage III in 26% and stage IV in 36%. Nine patients had cervical lymph node involvement and 5 had metastases at diagnosis. Fifty-six percent of patients were managed by surgery with postoperative radiation therapy. During follow-up, 3 patients died, 9 developed metastases and 12 showed recurrence or local progression. RESULTS Mean follow-up was 18 months. On univariate analysis, disease-free survival correlated with T stage (P=0.05), N stage (P=0.003), resection margins (P=0.04), lymph node involvement on histology (P=0.01), and absence of chemotherapy (P=0.03). On multivariate analysis, disease-free survival correlated with T stage (P=0.01), N stage (P=0.09) and surgery (P=0.005). CONCLUSION The essential issue in adenoid cystic carcinoma is long-term control. The present results confirm that the reference attitude is radical surgical resection for optimal local control. Adjuvant radiation therapy did not emerge as a prognostic factor. This study also provides a starting-point for translational studies in pathology and genetics.
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Affiliation(s)
- M Meyers
- Service ORL-CCF, hôpital Foch, 40, rue Worth, 92151 Suresnes, France; Service ORL-CCF, hôpital Tenon, université Paris VI, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - B Granger
- Service de santé publique et biostatistiques, hôpital Pitié Salpétrière, AP-HP, 47-83, boulevard de l'Hôpital, 75651 Paris, France
| | - P Herman
- Service ORL-CCF, hôpital Lariboisière, université Paris VII, AP-HP, 2, rue Ambroise-Paré, 75475 Paris, France
| | - F Janot
- Département ORL-CCF, institut Gustave-Roussy, 114, rue Edouard-Vaillant, 94800 Villejuif, France
| | - R Garrel
- Service ORL-CCF, hôpital Gui-de-Chauliac, université de Montpellier, 80, avenue Augustin-Fliche, 34090 Montpellier, France
| | - N Fakhry
- Service ORL-CCF, hôpital la Timone, université de Marseille, 264, rue Saint-Pierre, 13385 Marseille, France
| | - G Poissonnet
- Service ORL-CCF, centre Lacassagne, 33, avenue Valombrose, 06100 Nice, France
| | - B Baujat
- Service ORL-CCF, hôpital Tenon, université Paris VI, AP-HP, 4, rue de la Chine, 75020 Paris, France.
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Cuny F, Babin E, Lacau-Saint-Guily J, Baujat B, Bensadoun R, Bozec A, Chevalier D, Choussy O, Deneuve S, Fakhry N, Guigay J, Makeieff M, Merol JC, Mouawad F, Pavillet J, Rebiere C, Righini C, Sostras MC, Tournaille M, Vergez S. French Society of ENT (SFORL) guidelines for care pathway organization in head and neck oncology (short version). Early management of head and neck cancer. Eur Ann Otorhinolaryngol Head Neck Dis 2015; 132:205-8. [PMID: 26183548 DOI: 10.1016/j.anorl.2015.06.007] [Citation(s) in RCA: 6] [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] [Indexed: 10/23/2022]
Abstract
Early management in oncology is based on coordination and high-quality exchange between the various health-care partners. The present guidelines are based on a literature search with levels of evidence. Treatment waiting time can be optimized by performing assessment as early as possible (Expert opinion), to limit the interval (ideally, less than 4 weeks) between first consultation and data collection. In the first specialist consultation, diagnostic work-up should be scheduled and the data required for management should be determined (Grade B). Work-up may be conducted on a day-care basis or with conventional admission (Expert opinion). The patient's medico-social context should be taken into account from the outset, with social work involvement whenever necessary (Expert opinion). Pain and nutritional management should be planned for (Grade A) and realistic therapeutic education be provided (Expert opinion). Community-hospital teamwork for supportive care should be optimized (Expert opinion). Management should be early and multidisciplinary, to shorten delay between diagnosis and treatment initiation.
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Affiliation(s)
- F Cuny
- Inserm U1086 cancers et prévention, service d'ORL et chirurgie cervico-faciale, CHU, avenue de la Côte-de-Nacre, 14000 Caen, France.
| | - E Babin
- Inserm U1086 cancers et prévention, service d'ORL et chirurgie cervico-faciale, CHU, avenue de la Côte-de-Nacre, 14000 Caen, France
| | | | - B Baujat
- Service d'ORL, hôpital Tenon, 4, rue de la Chine, 75018 Paris, France
| | - R Bensadoun
- Service de radiothérapie, centre Antoine-Lacassagne, 33, avenue Valombrose, 06100 Nice, France
| | - A Bozec
- Service d'ORL et chirurgie cervico-faciale, centre Antoine-Lacassagne, 33, avenue Valombrose, 06100 Nice, France
| | - D Chevalier
- Service d'ORL et chirurgie cervico-faciale, hôpital Claude-Huriez, CHRU, rue Michel Polonovski, 59037 Lille cedex, France
| | - O Choussy
- Service d'ORL et chirurgie cervico-faciale, hôpital Charles-Nicolle, 1, rue de Germont, 76000 Rouen, France
| | - S Deneuve
- Service d'ORL et chirurgie cervico-faciale, CRLCC centre Léon-Bérard, 28, promenade Léa-et-Napoléon-Bullukian, 69008 Lyon, France
| | - N Fakhry
- Service d'ORL et de chirurgie cervico-faciale, hôpital de la Conception, CHU, 147, boulevard Baille, 13005 Marseille, France
| | - J Guigay
- Unité de cancérologie médicale en cancérologie cervico-faciale, centre Antoine-Lacassagne, 33, avenue Valombrose, 06100 Nice, France
| | - M Makeieff
- Service d'ORL et chirurgie cervico-faciale, hopital Robert-Debré, CHU, avenue du Général-Koenig, 51100 Reims, France
| | - J-C Merol
- Service d'ORL et chirurgie cervico-faciale, hopital Robert-Debré, CHU, avenue du Général-Koenig, 51100 Reims, France
| | - F Mouawad
- Service d'ORL et chirurgie cervico-faciale, hôpital Claude-Huriez, CHRU, rue Michel Polonovski, 59037 Lille cedex, France
| | - J Pavillet
- Service d'oncologie médicale, CHU de Grenoble, avenue Maquis-du-Grésivaudan, 38700 La Tronche, France
| | - C Rebiere
- Service social, CHU, avenue de la Côte-de-Nacre, 14000 Caen, France
| | - C Righini
- Clinique universitaire d'ORL, pôle TCCR, CHU de Grenoble Site Nord, Pavillon Dauphiné, 38043 Grenoble cedex, France
| | - M-C Sostras
- Service social, hôpital Tenon, 4, rue de la Chine, 75018 Paris, France
| | - M Tournaille
- Service social, CLCC François-Baclesse, avenue du Général-Harris, 14000 Caen, France
| | - S Vergez
- Service d'ORL et chirurgie cervico-faciale, pôle voies respiratoires, hôpital Larrey, 24, chemin de Pouvourville, 31400 Toulouse, France
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Deneuve S, Babin E, Lacau-St-Guily J, Baujat B, Bensadoun RJ, Bozec A, Chevalier D, Choussy O, Cuny F, Fakhry N, Guigay J, Makeieff M, Merol JC, Mouawad F, Pavillet J, Rebiere C, Righini CA, Sostras MC, Tournaille M, Vergez S. Guidelines (short version) of the French Otorhinolaryngology - Head and Neck Surgery Society (SFORL) on patient pathway organization in ENT: The therapeutic decision-making process. Eur Ann Otorhinolaryngol Head Neck Dis 2015; 132:213-5. [PMID: 26139415 DOI: 10.1016/j.anorl.2015.06.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The authors present the guidelines of the French Otorhinolaryngology - Head and Neck Surgery Society (SFORL) for patient pathway organization in head and neck cancer, and in particular for multidisciplinary team meetings. The present article concerns the therapeutic decision-making process. METHODS A multidisciplinary work group was entrusted with a review of the scientific literature on the above topic. Guidelines were drawn up, based on the articles retrieved and the group members' individual experience. They were then read over by an editorial group independent of the work group. The final version was established in a coordination meeting. The guidelines were graded as A, B, C or expert opinion, by decreasing level of evidence. RESULTS It is recommended that: an organ specialist should contribute to all multidisciplinary meetings on head and neck cancer; all members of the multidisciplinary meeting should have specific knowledge in head and neck cancer; any referring physician who does not follow the multidisciplinary meeting's advice should justify that decision; there should be sufficient time to prepare, discuss and sum up the cases dealt with in the multidisciplinary team meeting.
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Affiliation(s)
- S Deneuve
- Département de chirurgie oncologique, centre de lutte contre le cancer Léon-Bérard, 28, rue Laennec, 69008 Lyon, France.
| | - E Babin
- Service d'ORL, CHU, avenue de la Côte-de-Nacre, 14000 Caen, France
| | - J Lacau-St-Guily
- Service d'ORL, hôpital Tenon, 4, rue de la Chine, 75018 Paris, France
| | - B Baujat
- Service d'ORL, hôpital Tenon, 4, rue de la Chine, 75018 Paris, France
| | - R-J Bensadoun
- Service d'oncologie et de radiothérapie, centre de Haute Énergie, 10, boulevard Pasteur, 06000 Nice, France
| | - A Bozec
- Service d'ORL, institut universitaire de la face et du cou, 31, avenue Valombrose, 06100 Nice, France
| | - D Chevalier
- Service d'ORL, hôpital Claude-Huriez, rue Michel Polonovski, 59037 Lille cedex, France
| | - O Choussy
- Service d'ORL, hôpital Charles-Nicolle, 1, rue de Germont, 76000 Rouen, France
| | - F Cuny
- Service d'ORL, CHU, avenue de la Côte-de-Nacre, 14000 Caen, France
| | - N Fakhry
- Service d'ORL et de chirurgie cervico-faciale, hôpital de la Conception, CHU, 147, boulevard Baille, 13005 Marseille, France
| | - J Guigay
- Service d'oncologie médicale, institut universitaire de la face et du cou, 31, avenue Valombrose, 06100 Nice, France
| | - M Makeieff
- Service d'ORL, hopital Robert-Debré, avenue du Général-Koenig, 51100 Reims, France
| | - J-C Merol
- Service d'ORL, hopital Robert-Debré, avenue du Général-Koenig, 51100 Reims, France
| | - F Mouawad
- Service d'ORL, hôpital Claude-Huriez, rue Michel Polonovski, 59037 Lille cedex, France
| | - J Pavillet
- Service d'oncologue médicale, CHU, 38043 Grenoble, France
| | - C Rebiere
- Service social, CHU, 14000 Caen, France
| | - C-A Righini
- Service d'ORL, hôpital Nord Michalon, BP 217, 38043 Grenoble cedex, France
| | - M-C Sostras
- Service social, hôpital Tenon, 4, rue de la Chine, 75018 Paris, France
| | - M Tournaille
- Service social, CLCC François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France
| | - S Vergez
- Service d'ORL, hôpital Larrey, 24, chemin de Pouvourville, TSA 30030, 31059 Toulouse cedex 9, France
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