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Bolze P, Schoenen S, Margaillan M, Braga A, Sauthier P, Elias K, Seckl M, Winter M, Coulter J, Lok C, Joneborg U, Undurraga Malinverno M, Hajri T, Massardier J, You B, Golfier F, Goffin F. Chemotherapy is not needed when complete evacuation of gestational choriocarcinoma leads to hCG normalization. Eur J Surg Oncol 2024; 50:108012. [PMID: 38350264 DOI: 10.1016/j.ejso.2024.108012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/23/2024] [Accepted: 02/07/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND The standard treatment for gestational choriocarcinoma is chemotherapy. OBJECTIVE To describe the risk of recurrence with expectant management of gestational choriocarcinoma that has reached a normal human chorionic gonadotropin level after tumor removal without adjuvant chemotherapy. METHODS A retrospective multicenter international cohort study was conducted from 1981 to 2017 involving 11 gestational trophoblastic disease reference centers with patient's follow-up extended until 2023. Clinical and biological data of included patients were extracted from each center's database. The inclusion criteria were i) histological diagnosis of gestational choriocarcinoma in any kind of placental tissue retrieved, ii) spontaneous normalization of human chorionic gonadotropin level following choriocarcinoma retrieval, iii) patient did not receive any oncological treatment for the choriocarcinoma, iv) and at least 6 months of follow-up after the first human chorionic gonadotropin level normalization. RESULTS Among 80 patients with retrieved gestational choriocarcinoma and whose human chorionic gonadotropin level normalized without any other oncological therapy, none had a recurrence of choriocarcinoma after a median follow-up of 50 months. The median interval between choriocarcinoma excision and human chorionic gonadotropin level normalization was 48 days. The International Federation of Gynecology and Obstetrics/World Health Organization risk score was ≤6 in 93.7% of the cases. CONCLUSIONS This multicenter international study reports that selected patients with gestational choriocarcinoma managed in gestational trophoblastic disease reference centers did not experience any relapse when the initial tumor evacuation is followed by human chorionic gonadotropin level normalization without any additional treatment. Expectant management may be a safe approach for highly selected patients.
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Affiliation(s)
- Pa Bolze
- Centre Français de Référence des Maladies Trophoblastiques, CHU Lyon Sud, France.
| | - S Schoenen
- Centre Belge de Référence des Maladies Trophoblastiques, Liège, Belgium.
| | - M Margaillan
- Centre Français de Référence des Maladies Trophoblastiques, CHU Lyon Sud, France
| | - A Braga
- Rio de Janeiro Trophoblastic Disease Reference Center, Rio de Janeiro, Brazil
| | - P Sauthier
- Réseau des Maladies Trophoblastiques Du Québec, Montréal, Canada
| | - K Elias
- New England Trophoblastic Disease Center, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, USA
| | - M Seckl
- Charing Cross Gestational Trophoblastic Disease Center, London, UK
| | - M Winter
- Sheffield Center for Trophoblastic Diseases, Sheffield, UK
| | - J Coulter
- Department of Gynaecology Obstetrics, Cork University Maternity Hospital, Cork, Ireland
| | - C Lok
- Center of Gynaecologic Oncology, Amsterdam, Netherlands
| | - U Joneborg
- Department of Women's and Children's Health and Department of Pelvic Cancer, Karolinska Institutet/University Hospital, Stockholm, Sweden
| | - M Undurraga Malinverno
- Unité D'oncogynécologie, Département de Gynécologie et Obstétrique, Hôpitaux Universitaires de Genève, Genève, Switzerland
| | - T Hajri
- Centre Français de Référence des Maladies Trophoblastiques, CHU Lyon Sud, France
| | - J Massardier
- Centre Français de Référence des Maladies Trophoblastiques, CHU Lyon Sud, France
| | - B You
- Centre Français de Référence des Maladies Trophoblastiques, CHU Lyon Sud, France
| | - F Golfier
- Centre Français de Référence des Maladies Trophoblastiques, CHU Lyon Sud, France
| | - F Goffin
- Centre Belge de Référence des Maladies Trophoblastiques, Liège, Belgium
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Lapaille L, De Cuypere M, Goffin F, Kakkos A, Gonne E, Hermesse J, Lovinfosse P, Delbecque K, Thille A, Kridelka F, Gennigens C. [Locally-advanced cervix cancer : multidisciplinary management]. Rev Med Liege 2021; 76:507-514. [PMID: 34080388] [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] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Cervical cancer is the fourth most common cancer in women and is linked in over 95 % of cases to papillomavirus infection, the incidence of which has fallen in recent years due to screening and vaccination. Almost half of these cancers are diagnosed at a locally advanced stage with an overall 5-year survival of around 65 %. In recent decades, the management strategy of these locally advanced cancers has changed considerably and has allowed the improvement of survival but above all of local control as well as the reduction of toxicity, due to the implementation of imaging. Standard treatment consists of external beam radiation therapy combined with concomitant chemotherapy followed by intrauterine brachytherapy. The role of neo-adjuvant and adjuvant chemotherapy is still being evaluated. New therapeutic approaches (particularly immunotherapy) in addition to standard treatment are also being studied.
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Affiliation(s)
- L Lapaille
- Service d'Oncologie médicale, CHU Liège, Belgique
| | - M De Cuypere
- Service de Gynécologie-Obstétrique, CHU Liège, Belgique
| | - F Goffin
- Service de Gynécologie-Obstétrique, CHU Liège, Belgique
| | - A Kakkos
- Service de Gynécologie-Obstétrique, CHU Liège, Belgique
| | - E Gonne
- Service d'Oncologie médicale, CHU Liège, Belgique
| | - J Hermesse
- Service de Radiothérapie, CHU Liège, Belgique
| | - P Lovinfosse
- Service de Médecine nucléaire, CHU Liège,Belgique
| | - K Delbecque
- Service d'Anatomie pathologique, CHU Liège,Belgique
| | - A Thille
- Service de Radiologie, CHU Liège, Belgique
| | - F Kridelka
- Service de Gynécologie-Obstétrique, CHU Liège, Belgique
| | - C Gennigens
- Service d'Oncologie médicale, CHU Liège, Belgique
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Vandewal A, Delbecque K, Van Rompuy AS, Noel JC, Marbaix E, Delvenne P, Nisolle M, Van Nieuwenhuysen E, Kridelka F, Vergote I, Goffin F, Han SN. Curative effect of second curettage for treatment of gestational trophoblastic disease - Results of the Belgian registry for gestational trophoblastic disease. Eur J Obstet Gynecol Reprod Biol 2020; 257:95-99. [PMID: 33383413 DOI: 10.1016/j.ejogrb.2020.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 11/30/2020] [Accepted: 12/03/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE We assessed the curative effect of a second curettage in patients with persistent hCG serum levels after first curettage for a gestational trophoblastic disease (GTD). STUDY DESIGN This prospective observational study used the data of the Belgian register for GTD between July 2012 and January 2017. We analysed the data of patients who underwent a second curettage. We included 313 patients in the database. Primary endpoints were need for second curettage and chemotherapy. RESULTS Thirty-seven patients of the study population (12 %) underwent a second curettage. 20 had persistent human chorionic gonadotropin hormone (hCG) elevation before second curettage. Of them, 9 patients (45 %) needed no further treatment afterwards. Eleven patients (55 %) needed further chemotherapy. Nine (82 %) were cured with single-agent chemotherapy and 2 patients (18 %) needed multi-agent chemotherapy. Of the 37 patients, patients with hCG levels below 5000 IU/L undergoing a second curettage were cured without chemotherapy in 65 % versus 45 % of patients with hCG level more than 5000 IU/L. Of the ten patients with a hCG level below 1000 IU/L, eight were cured without chemotherapy. CONCLUSIONS Patients with post-mole gestational trophoblastic neoplasia can benefit from a second curettage to avoid chemotherapy, especially when the hCG level is lower than 5000 IU/L.
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Affiliation(s)
- A Vandewal
- Department of Obstetrics and Gynaecology, Gynecologic Oncology, Leuven Cancer Institute University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - K Delbecque
- Department of Pathologic Anatomy, University Hospital of Liège, Liège, Belgium
| | - A S Van Rompuy
- Department of Pathologic Anatomy, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - J-Ch Noel
- Department of Pathologic Anatomy, Erasmus Hospital, Brussels, Belgium
| | - E Marbaix
- Department of Pathologic Anatomy, University Hospital Saint-Luc, Brussels, Belgium
| | - P Delvenne
- Department of Pathologic Anatomy, University Hospital of Liège, Liège, Belgium
| | - M Nisolle
- Department of Obstetrics and Gynaecology, University Hospital of Liège, Liège, Belgium
| | - E Van Nieuwenhuysen
- Department of Obstetrics and Gynaecology, Gynecologic Oncology, Leuven Cancer Institute University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - F Kridelka
- Department of Obstetrics and Gynaecology, University Hospital of Liège, Liège, Belgium
| | - I Vergote
- Department of Obstetrics and Gynaecology, Gynecologic Oncology, Leuven Cancer Institute University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - F Goffin
- Department of Obstetrics and Gynaecology, University Hospital of Liège, Liège, Belgium
| | - S N Han
- Department of Obstetrics and Gynaecology, Gynecologic Oncology, Leuven Cancer Institute University Hospitals Leuven, KU Leuven, Leuven, Belgium.
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4
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Kakkos A, Ver Eecke C, Ongaro S, Traen K, Peeters F, Van Trappen P, Laenen A, Despierre E, Van Nieuwenhuysen E, Vergote I, Goffin F. Robot-assisted surgery for women with endometrial cancer: Surgical and oncologic outcomes within a Belgium gynaecological oncology group cohort. Eur J Surg Oncol 2020; 47:1117-1123. [PMID: 33268212 DOI: 10.1016/j.ejso.2020.10.005] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 10/02/2020] [Accepted: 10/05/2020] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To evaluate surgical and oncologic outcomes of patients treated by robot-assisted surgery for endometrial cancer within the Belgium Gynaecological Oncology Group (BGOG). STUDY DESIGN We performed a retrospective analysis of women with clinically Stage I endometrial cancer who underwent surgical treatment from 2007 to 2018 in five institutions of the BGOG group. RESULTS A total of 598 consecutive women were identified. The rate of conversion to laparotomy was low (0.8%). The mean postoperative Complication Common Comprehensive Index (CCI) score was 3.4. The rate of perioperative complications did not differ between age groups, however the disease-free survival was significantly lower in patients over 75 years compared to patients under 65 years of age (p=0.008). Per-operative complications, conversion to laparotomy rate, post-operative hospital stay, CCI score and disease-free survival were not impacted by increasing BMI. CONCLUSION Robot-assisted surgery for the surgical treatment of patients suffering from early-stage endometrial cancer is associated with favourable surgical and oncologic outcomes, particularly for unfavourable groups such as elderly and obese women, thus permitting a low morbidity minimally-invasive surgical approach for the majority of patients in expert centres.
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Affiliation(s)
- A Kakkos
- Department of Obstetrics and Gynaecology, Centre Hospitalier Universitaire de Liège, Site Notre Dame des Bruyères et Centre Hospitalier Régional, Liège, Belgium.
| | - C Ver Eecke
- Division of Gynaecological Oncology, Department of Obstetrics and Gynaecology, Leuven Cancer Institute, Catholic University of Leuven, Leuven, Belgium
| | - S Ongaro
- Department of Obstetrics and Gynaecology, Centre Hospitalier Universitaire de Liège, Site Notre Dame des Bruyères et Centre Hospitalier Régional, Liège, Belgium
| | - K Traen
- Department of Obstetrics and Gynaecology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
| | - F Peeters
- Department of Obstetrics and Gynaecology, General Hospital Klina, Brasschaat, Belgium
| | - Ph Van Trappen
- Department of Obstetrics and Gynaecology, General Hospital Sint-Jan, Bruges, Belgium
| | - A Laenen
- Department of Biostatistics and Methodology, Catholic University of Leuven, Leuven, Belgium
| | - E Despierre
- Department of Obstetrics and Gynaecology, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
| | - E Van Nieuwenhuysen
- Division of Gynaecological Oncology, Department of Obstetrics and Gynaecology, Leuven Cancer Institute, Catholic University of Leuven, Leuven, Belgium
| | - I Vergote
- Division of Gynaecological Oncology, Department of Obstetrics and Gynaecology, Leuven Cancer Institute, Catholic University of Leuven, Leuven, Belgium
| | - F Goffin
- Department of Obstetrics and Gynaecology, Centre Hospitalier Universitaire de Liège, Site Notre Dame des Bruyères et Centre Hospitalier Régional, Liège, Belgium
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Kerbage Y, Kakkos A, Kridelka F, Lambaudie E, Bats AS, Hébert T, Goffin F, Wallet J, Leblanc E, Hudry D, Narducci F. Lomboaortic Lymphadenectomy in Gynecological Oncology: Laparotomy, Laparoscopy or Robot-Assisted Laparoscopy? Ann Surg Oncol 2020; 27:3891-3897. [DOI: 10.1245/s10434-020-08471-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Indexed: 11/18/2022]
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Fabbro M, Moore K, Dørum A, Tinker A, Mahner S, Bover I, Banerjee S, Tognon G, Goffin F, Shapira-Frommer R, Wenham R, Hellman K, Provencher D, Harter P, Palacio Vázquez I, Follana P, Pineda M, Mirza M, Hazard S, Matulonis U. Safety and Efficacy of Niraparib in Elderly Patients (Pts) with Recurrent Ovarian Cancer (OC). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx372.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Boland B, Thomas S, Goffin F, Beguin C, Lambert M. Selected Abstracts of the Belgian Society of Internal Medicine. Acta Clin Belg 2016. [DOI: 10.1080/17843286.1997.11718597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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8
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Colombo N, Creutzberg C, Amant F, Bosse T, González-Martín A, Ledermann J, Marth C, Nout R, Querleu D, Mirza MR, Sessa C, Altundag O, Amant F, van Leeuwenhoek A, Banerjee S, Bosse T, Casado A, de Agustín L, Cibula D, Colombo N, Creutzberg C, del Campo JM, Emons G, Goffin F, González-Martín A, Greggi S, Haie-Meder C, Katsaros D, Kesic V, Kurzeder C, Lax S, Lécuru F, Ledermann J, Levy T, Lorusso D, Mäenpää J, Marth C, Matias-Guiu X, Morice P, Nijman H, Nout R, Powell M, Querleu D, Mirza M, Reed N, Rodolakis A, Salvesen H, Sehouli J, Sessa C, Taylor A, Westermann A, Zeimet A. ESMO-ESGO-ESTRO Consensus Conference on Endometrial Cancer: diagnosis, treatment and follow-up. Ann Oncol 2015; 27:16-41. [PMID: 26634381 DOI: 10.1093/annonc/mdv484] [Citation(s) in RCA: 685] [Impact Index Per Article: 76.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 10/05/2015] [Indexed: 12/27/2022] Open
Abstract
The first joint European Society for Medical Oncology (ESMO), European SocieTy for Radiotherapy & Oncology (ESTRO) and European Society of Gynaecological Oncology (ESGO) consensus conference on endometrial cancer was held on 11-13 December 2014 in Milan, Italy, and comprised a multidisciplinary panel of 40 leading experts in the management of endometrial cancer. Before the conference, the expert panel prepared three clinically relevant questions about endometrial cancer relating to the following four areas: prevention and screening, surgery, adjuvant treatment and advanced and recurrent disease. All relevant scientific literature, as identified by the experts, was reviewed in advance. During the consensus conference, the panel developed recommendations for each specific question and a consensus was reached. Results of this consensus conference, together with a summary of evidence supporting each recommendation, are detailed in this article. All participants have approved this final article.
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Affiliation(s)
- N Colombo
- Division of Medical Gynecologic Oncology, European Institute of Oncology and University of Milan-Bicocca, Milan, Italy
| | - C Creutzberg
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - F Amant
- Department of Gynecological Oncology, University Hospital Leuven, Leuven, Belgium Center for Gynecological Oncology Amsterdam (CGOA), Antoni van Leeuwenhoek, Amsterdam
| | - T Bosse
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - A González-Martín
- Department of Medical Oncology, GEICO Cancer Center, Madrid Department of Medical Oncology, MD Anderson Cancer Center, Madrid, Spain
| | - J Ledermann
- Department of Oncology and Cancer Trials, UCL Cancer Institute, London, UK
| | - C Marth
- Department of Obstetrics and Gynecology, Innsbruck Medical University, Innsbruck, Austria
| | - R Nout
- Department of Radiotherapy, Leiden University Medical Center, Leiden, The Netherlands
| | - D Querleu
- Department of Surgery, Institut Bergonié, Bordeaux, France Department of Gynecology and Obstetrics, McGill University Health Centre, Montreal, Canada
| | - M R Mirza
- Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - C Sessa
- Department of Medical Oncology, Oncology Institute of Southern Switzerland, Ospedale San Giovanni, Bellinzona, Switzerland
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Delcominette S, Timmermans M, Delbecque K, Delvenne P, Marbaix E, Noel JC, Moerman P, Golfier F, Kridelka F, Nisolle M, Vergote I, Goffin F. [Belgian register and reference centers for gestational trophoblastic diseases]. Rev Med Liege 2015; 70:550-556. [PMID: 26738266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Gestational trophoblastic diseases include placental pathologies comprising fertilization abnormalities (hydatidiform moles) and malignant lesions (choriocarcinoma, placental site trophoblastic tumor and epithelioid trophoblastic tumor). Due to their low incidence and heterogeneity, their diagnosis, management and treatment are not always optimal. Following the example of other European countries, a national registration system with two reference centers has been set up to guide physicians and patients and to propose individualized management. The centers offer their expertise through a systematic centralised pathology review by a panel of experts. HCG values are plotted in regression curves. In case of gestational trophoblastic neoplasia, an imaging work-up is proposed, from which the FIGO score and stage are derived and will guide the choice of treatment. Belgian centers offer a multidisciplinary approach, in partnership with the referent physician. More information for practitioners and patients is available on a web site: www.mole-chorio-bgog.eu, which also harbours a forum of discussion.
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Hermesse J, Ben Mustapha S, Jansen N, Werenne X, Warlimont B, Gulyban A, Goffin F, Kridelka F, Coucke P, Lakosi F. EP-1909: Needle placement accuracy of intracavitary+interstitial cervical brachytherapy using same-day MRI preplanning. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)32027-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Werbrouck J, Bouche G, de Jonge E, Jacomen G, D'Hondt V, Denys H, Van Limbergen E, Vandermeersch B, De Schutter H, Van Eycken E, Goffin F, Amant F. Evaluation of the quality of the management of cancer of the corpus uteri--selection of relevant quality indicators and implementation in Belgium. Gynecol Oncol 2013; 131:512-9. [PMID: 24103471 DOI: 10.1016/j.ygyno.2013.10.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 09/30/2013] [Accepted: 10/01/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Describe the methodology and selection of quality indicators (QI) to be implemented in the EFFECT (EFFectiveness of Endometrial Cancer Treatment) project. EFFECT aims to monitor the variability in Quality of Care (QoC) of uterine cancer in Belgium, to compare the effectiveness of different treatment strategies to improve the QoC and to check the internal validity of the QI to validate the impact of process indicators on outcome. METHODS A QI list was retrieved from literature, recent guidelines and QI databases. The Belgian Healthcare Knowledge Center methodology was used for the selection process and involved an expert's panel rating the QI on 4 criteria. The resulting scores and further discussion resulted in a final QI list. An online EFFECT module was developed by the Belgian Cancer Registry including the list of variables required for measuring the QI. Three test phases were performed to evaluate the relevance, feasibility and understanding of the variables and to test the compatibility of the dataset. RESULTS 138 QI were considered for further discussion and 82 QI were eligible for rating. Based on the rating scores and consensus among the expert's panel, 41 QI were considered measurable and relevant. Testing of the data collection enabled optimization of the content and the user-friendliness of the dataset and online module. CONCLUSIONS This first Belgian initiative for monitoring the QoC of uterine cancer indicates that the previously used QI selection methodology is reproducible for uterine cancer. The QI list could be applied by other research groups for comparison.
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Affiliation(s)
- J Werbrouck
- Belgian Cancer Registry, Koningsstraat 215 bus 7, 1210 Brussel, Belgium.
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Vermeeren A, Swennen B, Mieremans MC, Goffin F. Résultats des mesures de couverture vaccinale en 2e secondaire en Fédération Wallonie Bruxelles (FWB). Rev Epidemiol Sante Publique 2013. [DOI: 10.1016/j.respe.2013.07.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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13
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Gziri MM, Goffin F, Debieve F, Amant F. [Cancer diagnosis during pregnancy: importance of a national and European registration]. Rev Med Liege 2013; 68:527-530. [PMID: 24298727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Cancer during pregnancy is relatively rare, but its incidence has been increasing over recent years. A European study has been launched in 2005 by F. Amant (KUL) to register all pregnant patients with a cancer diagnosis with or without treatment during pregnancy (surgery, chemotherapy and/or radiotherapy). All infants exposed to chemotherapy and/or radiotherapy are also followed up by pediatricians, neurologists, cardiologists and psychologists. In Belgium, French- and Dutch- language hospitals are working in close collaboration to follow these pregnant patients. The national results are summarized in this paper.
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Affiliation(s)
- M Mhallem Gziri
- Dienst Gynaécologie en Verloskunde, KUL, UZ Leuven, Belgique.
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Werenne X, Hermesse J, Coucke P, Louviaux I, Goffin F. [Clinical case of the month. The role of radiotherapy for the treatment of advanced squamous cell carcinoma of the vulva. Case report and review of the literature]. Rev Med Liege 2013; 68:391-395. [PMID: 24053096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Locally advanced squamous cell carcinoma of the vulva is treated with concomitant chemoradiotherapy if surgery is too mutilating and/or implies the use of stomy. We report in this paper, the unusual case of a young patient treated successfully with this non-surgical approach.
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Affiliation(s)
- X Werenne
- Service de Radiothérapie, CHU de Liège, Belgique.
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Simoens C, Goffin F, Simon P, Barlow P, Antoine J, Foidart JM, Arbyn M. Adverse obstetrical outcomes after treatment of precancerous cervical lesions: a Belgian multicentre study. BJOG 2012; 119:1247-55. [DOI: 10.1111/j.1471-0528.2012.03429.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Arbyn M, Simoens C, Goffin F, Noehr B, Bruinsma F. Treatment of cervical cancer precursors: influence of age, completeness of excision and cone depth on therapeutic failure, and on adverse obstetric outcomes. BJOG 2011; 118:1274-5; author reply 1275-6. [PMID: 21834887 DOI: 10.1111/j.1471-0528.2011.03068.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Balsat C, Blacher S, Signolle N, Beliard A, Munaut C, Goffin F, Noel A, Foidart JM, Kridelka F. Whole slide quantification of stromal lymphatic vessel distribution and peritumoral lymphatic vessel density in early invasive cervical cancer: a method description. ISRN Obstet Gynecol 2011; 2011:354861. [PMID: 21876817 PMCID: PMC3163137 DOI: 10.5402/2011/354861] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2011] [Accepted: 06/20/2011] [Indexed: 11/23/2022]
Abstract
Peritumoral Lymphatic Vessel Density (LVD) is considered to be a predictive marker for the presence of lymph node metastases in cervical cancer. However, when LVD quantification relies on conventional optical microscopy and the hot spot technique, interobserver variability is significant and yields inconsistent conclusions. In this work, we describe an original method that applies computed image analysis to whole slide scanned tissue sections following immunohistochemical lymphatic vessel staining. This procedure allows to determine an objective LVD quantification as well as the lymphatic vessel distribution and its heterogeneity within the stroma surrounding the invasive tumor bundles. The proposed technique can be useful to better characterize lymphatic vessel interactions with tumor cells and could potentially impact on prognosis and therapeutic decisions.
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Affiliation(s)
- C Balsat
- Laboratory of Tumor and Development Biology, Groupe Interdisciplinaire de Génoprotéomique Appliquée (GIGA-Cancer), University of Liège, Pathology Tower (B23), 4000 Liège, Belgium
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18
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Kridelka F, Goffin F. [Laparoscopic paraaortic lymph nodes staging in advanced survival cancer: impact and surgical techniques]. Rev Med Liege 2007; 62 Spec No:6-8. [PMID: 18214353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The stage of a cervical neoplasm is defined on clinical criteria as reported by the International Federation of Gynecology and Obstetrics. Treatment planning however is based on this clinical stage, but moreover on histological variables obtained at surgical staging. Regarding advanced stage cervical cancer, the recommanded treatment consists in a radical radiotherapy together with concomitant chemotherapy. The target volume of the radiation treatment is directly dependent on the paraaortic lymph node status, the radiological evaluation of which remains unsatisfactory due to lack of sensitivity. We report our experience with two laparoscopic approaches (transperitoneal and retroperitoneal) allowing a histological paraaortic nodal status to be obtained prior to initiating the definitive treatment.
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Affiliation(s)
- F Kridelka
- Service de Gynécologie-Obstétrique, CHU Sart Tilman-NDB, Liège, Belgique
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19
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Petignat P, Laurini R, Goffin F, Bruchim I, Bischof P. Expression of matrix metalloproteinase-2 and mutant p53 is increased in hydatidiform mole as compared with normal placenta. Int J Gynecol Cancer 2006; 16:1679-84. [PMID: 16884384 DOI: 10.1111/j.1525-1438.2006.00643.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Matrix metalloproteinases (MMPs) are group of enzymes thought to play an important role in trophoblastic and tumor invasion. The aim of our study was to investigate the trophoblastic expression of MMPs and p53 in normal trophoblast and hydatidiform moles (HM). Paraffin sections of 45 specimens, including 14 complete hydatidiform moles (CM), 15 partial hydatidiform moles (PM), 8 atypical partial hydatidiform moles (aPM), and 8 controls were selected. Classification of HM was established on histologic criteria and supported by the DNA ploidy results. Tissue sections from each case were immunostained with monoclonal antibodies, cytokeratin-7, MMP-2, MMP-9, tissue inhibitors of metalloproteinases (TIMP)-1, and p53 wild type (p53wt) and mutant types (mutp53). Staining for cytokeratin-7 revealed a positive reaction in 93% of the samples. MMP-2 was mainly expressed in the syncytiotrophoblast of HM and found in 62% of aPM, 60% PM, and 93% CM. The mutp53 was mainly and focally expressed in syncytiotrophoblastic cells and was found in 63% of aPM, 80% PM, and 93% CM. Expression of MMP-2 and mutp53 was both significantly greater in HM vs control group (P < 0.05) and greater in CM vs PM and aPM (P < 0.05). No significant difference was observed for cytokeratin-7, MMP-9, TIMP-1, and p53wt between the HM subgroups and between HM and control group. MMP-2 and mutp53 are overexpressed in HM as compared with normal trophoblast and might participate in the invasive behavior of the HM.
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Affiliation(s)
- P Petignat
- Department of Obstetrics and Gynecology, Hormone Laboratory, University of Geneva, Switzerland.
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20
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Frankenne F, Noel A, Bajou K, Sounni NE, Goffin F, Masson V, Munaut C, Remacle A, Foidart JM. Molecular interactions involving urokinase plasminogen activator (uPA), its receptor (uPAR) and its inhibitor, plasminogen activator inhibitor-1 (PAI-1), as new targets for tumour therapy. ACTA ACUST UNITED AC 2005. [DOI: 10.1517/14728222.3.3.469] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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21
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Perrier d'Hauterive S, Charlet-Renard C, Berndt S, Dubois M, Munaut C, Goffin F, Hagelstein MT, Noël A, Hazout A, Foidart JM, Geenen V. Human chorionic gonadotropin and growth factors at the embryonic-endometrial interface control leukemia inhibitory factor (LIF) and interleukin 6 (IL-6) secretion by human endometrial epithelium. Hum Reprod 2004; 19:2633-43. [PMID: 15388676 DOI: 10.1093/humrep/deh450] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The elucidation of the molecular mechanisms by which the embryo contributes to its implantation is an area of extensive research. The main objective of this study was to investigate the pattern of leukemia inhibitory factor (LIF) and interleukin-6 (IL-6) secretion by human endometrial epithelium, and their regulation by human chorionic gonadotropin (hCG) and other growth factors present at the embryonic-endometrial interface. METHODS Endometrial epithelial cells (EEC) were isolated from biopsies collected at both proliferative and secretory phases of fertile women. RESULTS HCG (1-50 IU/ml) increased LIF secretion by EEC cultures derived from follicular phase (up to 285+/-75%) or from secretory phase (up to 212+/-16%). In contrast, hCG reduced IL-6 secretion by EEC in both phases. The hCG/LH receptor gene was transcribed by EEC as evidenced by RT-PCR. Insulin-like growth factors 1 and 2 increased LIF secretion by EEC. Transforming growth factor beta1 stimulated LIF and reduced IL-6 secretion. CONCLUSIONS Through hCG, the blastocyst may be involved in the control of its implantation (via an increase of proimplantatory LIF) and tolerance (via an inhibition of proinflammatory IL-6). Other growth factors present at the embryonic-endometrial interface are also involved in the control of LIF and IL-6 endometrial secretion.
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Affiliation(s)
- S Perrier d'Hauterive
- Center of Immunology and Laboratory of Tumour and Developmental Biology, Institute of Pathology CHU-B23, University of Liege, B-4000 Liege-Sart Tilman, Belgium.
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22
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Goffin F, Munaut C, Malassiné A, Evain-Brion D, Frankenne F, Fridman V, Dubois M, Uzan S, Merviel P, Foidart JM. Evidence of a limited contribution of feto-maternal interactions to trophoblast differentiation along the invasive pathway. Tissue Antigens 2003; 62:104-16. [PMID: 12889991 DOI: 10.1034/j.1399-0039.2003.00085.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Trophoblast differentiation is a key event in human placental development. During extravillous trophoblast (EVT) differentiation, stem cells from the anchoring villi detach from their basement membrane and proliferate to form aggregates called trophoblast cell columns (TCCs). They subsequently invade the decidua and differentiate into interstitial and endovascular trophoblasts. The influence of the decidua on EVT differentiation is controversial. We therefore compared the pattern of trophoblast differentiation marker expression in viable intrauterine and tubal pregnancies, as decidual cell markers (prolactin [PRL] and insulin-like growth factor binding Protein-1 [IGFBP1]) were only expressed in endometrial implantation sites. Extravillous trophoblast differentiation in anchoring villi from uterine and ectopic pregnancies exhibited a comparable phenotypical switch: alpha6 integrin subunit, E-cadherin, EGF receptor, Ki 67 and connexin 40 were localized in the proximal part of the TCC, while alpha5beta1 and alpha1 integrins, c-erb B2, hPL and HLA-G were expressed by invasive cytotrophoblasts. The cyclin-dependent kinase inhibitors p16 and p57 were mainly detected in invasive cytotrophoblasts some distance from the columns. However, the TCC was markedly longer in tubal pregnancy than in intrauterine pregnancy. These findings suggest that the decidua is not necessary to trigger EVT invasion, but that it is likely to limit the extent of the TCC and to accelerate the onset of EVT migration.
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Affiliation(s)
- F Goffin
- Laboratory of Tumor and Developmental Biology, Institute of Pathology, Liège, Belgium
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23
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Kridelka FJ, Cormann B, Eloy S, Thille A, Fridman V, Goffin F, Belhocine T, Paulus P, Foidart JM. EVALUATION OF COMBINED PELVIC MRI AND FDG WHOLE BODY PET SCAN IN THE PREOPERATIVE ASSESSMENT OF PATIENTS WITH STAGE 1B CERVICAL CANCER. Int J Gynecol Cancer 2003. [DOI: 10.1136/ijgc-00009577-200303001-00026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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24
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Cronier L, Defamie N, Dupays L, Théveniau-Ruissy M, Goffin F, Pointis G, Malassiné A. Connexin expression and gap junctional intercellular communication in human first trimester trophoblast. Mol Hum Reprod 2002; 8:1005-13. [PMID: 12397213 DOI: 10.1093/molehr/8.11.1005] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Connexin (Cx) expression and gap junctional intercellular communication (GJIC) are involved in development and differentiation processes, and recently mutation of connexin genes has been implicated in pathologies. In the human placenta, two distinct differentiation pathways of cytotrophoblastic cells coexist and lead to a fusion phenotype (villous trophoblast) and a proliferative/invasive phenotype (extravillous trophoblast). Here we characterized in situ and in vitro the expression of Cx transcripts and proteins in the villous and extravillous trophoblast of first trimester placenta. In addition, the GJIC functionality was investigated using the gap-fluorescence recovery after photobleaching (gap-FRAP) method. We demonstrated in the villous trophoblast the presence of Cx43 mRNA and of Cx43 protein localized between cytotrophoblastic cells and between cytotrophoblastic cells and syncytiotrophoblast. In vitro, a transient functional gap junctional intertrophoblastic communication was demonstrated during the trophoblast fusion leading to the multinucleated syncytiotrophoblast. During the proliferative process of the extravillous trophoblast, Cx40 is expressed in the proximal part of the cell columns. When cytotrophoblastic cells were cultured on Matrigel for 2 days, alpha5beta1 integrin expression was observed concomitant with the presence of Cx40 mRNA and of Cx40 protein between the cells. No evidence for a GJIC was detected in this induced extravillous phenotype. In addition, Cx32 was detected between some aggregated cells after 72 h of culture. Our data show that the presence of Cx43 allows an inter-trophoblastic GJIC and is associated with the fusion process leading to the villous syncytiotrophoblast and that the presence of Cx40 does not allow GJIC and is associated with the extravillous phenotype.
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Affiliation(s)
- L Cronier
- LBSC, CNRS UMR 6558, Université de Poitiers, 86022 Poitiers cedex
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25
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Geenen V, Perrier de Hauterive S, Puit M, Hazout A, Goffin F, Frankenne F, Moutschen M, Foidart JM. Autoimmunity and pregnancy: theory and practice. Acta Clin Belg 2002; 57:317-24. [PMID: 12723249 DOI: 10.1179/acb.2002.059] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- V Geenen
- Liege Center of Immunology, Institute of Pathology CHU-B23, B-4000 Liège 1-Sart Tilman, Belgium.
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26
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Perrier D'hauterive S, Charlet-Renard C, Goffin F, Foidart M, Geenen V. [The implantation window]. J Gynecol Obstet Biol Reprod (Paris) 2002; 31:440-55. [PMID: 12379828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
BACKGROUND Embryo implantation is a complex event involving apposition followed by adhesion of the blastocyst to the maternal endometrium, and finally invasion of this endometrium. Though implantation could occur in any human tissue, the endometrium is the only tissue where embryo implantation cannot occur except during a restricted period called the implantation window. During this window, the endometrium is highly receptive to the embryo. MATERIAL and methods. We reviewed the literature concerning the different factors involved in improved endometrial receptivity and implantation. RESULTS Maternal - embryo crosstalk is favored by the implantation window. Endometrial receptivity results from the acquisition of ligands or receptors facilitating apposition, then adhesion of the embryo, or from the loss of components preventing it. The molecular basis of the implantation window remains to be defined. CONCLUSION Despite progress in assisted reproduction technologies, the lack of control of implantation remains a major obstacle to successful pregnancy. It is of prime importance to determine the characteristic features of a receptive endometrium and, among the many markers proposed by in vitro studies, to analyze in humans those demonstrated by knock-out experiments to play a crucial role in mice.
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Affiliation(s)
- S Perrier D'hauterive
- Centre d'Immunologie, Université de Liège, Institut de Pathologie CHU B-23, 4000 Liège-Sart Tilman, Belgique.
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27
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Goffin F, Frankenne F, Béliard A, Perrier D'Hauterive S, Pignon MR, Geenen V, Foidart JM. Human endometrial epithelial cells modulate the activation of gelatinase a by stromal cells. Gynecol Obstet Invest 2002; 53:105-11. [PMID: 11961384 DOI: 10.1159/000053003] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Metalloproteinases (MMPs) are central effectors in endometrial physiology. Their production is tightly regulated by ovarian steroids and cytokines. Using zymography, we investigated MMP-2 production by human endometrial cells treated with estradiol-17beta + progesterone (E(2)+P) and by various key cytokines in endometrial physiology (IL-1beta, LIF, TGF-beta, and TNF-alpha). No gelatinase activity was detected in the culture media of epithelial cells. In basal conditions, stromal cells produced the pro form of MMP-2. MMP-2 production/activation was not directly affected by cytokine treatment. Interestingly, activated MMP-2 was only detected after treatment of stromal cells with culture medium from epithelial cells. Cytokine treatment of epithelial cells increased the capacity of conditioned medium to stimulate stromal cells to activate MMP-2. As the tissue inhibitor of MMP-2 (TIMP-2) is a regulator of gelatinase A activity, its concentration was measured by ELISA. TIMP-2 production by stromal cells was not affected by cytokines or by epithelial cell-conditioned medium. These results strongly suggest that regulation of stromal MMP-2 activation involves soluble factor(s) derived from the epithelial compartment.
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Affiliation(s)
- F Goffin
- Department of Tumor, University of Liège, Belgium
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28
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Pröll J, Bensussan A, Goffin F, Foidart JM, Berrebi A, Le Bouteiller P. Tubal versus uterine placentation: similar HLA-G expressing extravillous cytotrophoblast invasion but different maternal leukocyte recruitment. Tissue Antigens 2000; 56:479-91. [PMID: 11169237 DOI: 10.1034/j.1399-0039.2000.560601.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The nonclassical HLA-G class I gene is expressed by extravillous cytotrophoblast that invades decidua in uterine pregnancy, suggesting that it may contribute to the immunological mechanisms that protect the fetus against maternal alloimmune response and/or pathogen infections. We first addressed the question of whether HLA-G expression was dependent on maternal tissue environment by comparing uterine and ectopic tubal pregnancies. Using HLA-G-specific mAb on placental cryosections, we found by immunohistochemistry that all subtypes of extravillous cytotrophoblast similarly expressed HLA-G in pregnant tubes, demonstrating that its expression was independent of the site of implantation. We next compared by immunohistochemistry the phenotype of maternal leukocytes recruited in both pregnant tissues. In contrast to decidua, pregnant tubes were characterized firstly, by the lack of natural killer (NK) cells and of cells expressing CD94 receptor specific for HLA-E, secondly, by a prominent increase of CD8+ T cells, dendritic cells, and macrophages, the latter co-expressing the LIR1/ILT2 killer immunoglobulin-like receptor (KIR), and finally, by the presence of cells expressing LIR2/ILT4 KIR or BY55 NK receptors, known to bind to HLA-G. Such cell types may favor a unique innate defense in pregnant tubes. These observations also suggest that trophoblast HLA-G expression does not influence the recruitment of particular maternal leukocytes in pregnant tissues.
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MESH Headings
- Antibodies, Monoclonal
- Antigens, CD
- Antigens, CD1/analysis
- CD4-Positive T-Lymphocytes/chemistry
- CD4-Positive T-Lymphocytes/cytology
- CD4-Positive T-Lymphocytes/immunology
- CD56 Antigen/analysis
- CD8-Positive T-Lymphocytes/chemistry
- CD8-Positive T-Lymphocytes/cytology
- CD8-Positive T-Lymphocytes/immunology
- Fallopian Tubes/chemistry
- Fallopian Tubes/immunology
- Female
- HLA Antigens/analysis
- HLA Antigens/immunology
- HLA-G Antigens
- Histocompatibility Antigens Class I/analysis
- Histocompatibility Antigens Class I/immunology
- Humans
- Killer Cells, Natural/chemistry
- Killer Cells, Natural/cytology
- Killer Cells, Natural/immunology
- Leukocyte Immunoglobulin-like Receptor B1
- Leukocytes/chemistry
- Leukocytes/cytology
- Leukocytes/immunology
- Lipopolysaccharide Receptors/analysis
- Membrane Glycoproteins
- Pregnancy
- Pregnancy, Tubal/immunology
- Receptors, Antigen, T-Cell, gamma-delta/analysis
- Receptors, Immunologic/analysis
- Trophoblasts/chemistry
- Trophoblasts/immunology
- Up-Regulation/immunology
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Affiliation(s)
- J Pröll
- Institut National de la Santé et de la Recherche Médicale U395, H pital de Purpan, Toulouse, France
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29
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Foidart JM, Gilliquet A, Nondonfaz N, Goffin F, Kridelka F, Dubois M. [Precancerous states of the endometrium: hormonal aspects]. Bull Acad Natl Med 1997; 181:1395-404; discussion 1404-5. [PMID: 9528183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The two types of endometrial carcinomas are preceded by precancerous lesions. Type I endometrial carcinomas are most commonly encountered in perimenopausal women with the classical risk factors associated with estrogen exposure: obesity, multiparity, diabetes, estrogen treatment, ... Hyperplasia (simple, followed by complex forms without cellular atypias and subsequently by complex hyperplasias with cellular transformation) precede such cancers. Estrogens exert a promoting effect on these lesions but do not initiate them. Progesterone and progestins exert a preventive and protective effect. However, the progressive loss of steroidal receptors is correlated to the progression of tissular anomalies and to the onset of cytogenetic anomalies and to mutations of p53 anti-oncogene. The preventive role of progestin is well established, but their curative beneficial effect on atypical precursors forms of endometrial cancers and on endometrial carcinomas remains controversial. The second type of endometrial cancer appears during the postmenopause and is characterized by an increased invasiveness and a poor prognosis, devoid of identifiable risks factors, these aggressive cancers are not preceded by hormone-sensitive precancerous lesions, but by an intra-epithelial endometrial carcinoma. This lesion appears most often in an atrophic endometrium. Finally, the two types of precancerous states are characterized by distinct gene anomalies suggesting two different pathogenic mechanisms of cancerisation.
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Affiliation(s)
- J M Foidart
- Service de Gynécologie-Obstétrique, Hôpital de la Citadelle, CHU de Liège, Belgique
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30
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Malgrange B, Rigo JM, Lefebvre PP, Coucke P, Goffin F, Xhauflaire G, Belachew S, Van de Water TR, Moonen G. Diazepam-insensitive GABAA receptors on postnatal spiral ganglion neurones in culture. Neuroreport 1997; 8:591-6. [PMID: 9106729 DOI: 10.1097/00001756-199702100-00003] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Using dissociated spiral ganglion cell cultures obtained from 3-day-old rat cochlea, we investigated the response of auditory neurones to gamma-aminobutyric acid (GABA) using patch-clamp techniques. In our recording conditions, GABA elicited inward currents in > 95% of the neurones which reversed around 0 mV. Similar inward currents were measured using isoguvacin, a specific agonist of GABAA receptors. GABA-gated currents were reversibly inhibited by the channel blocker picrotoxin and the GABA competitive antagonist bicuculline. These functional GABAA receptors are characterized by an insensitivity to benzodiazepines and a relatively high sensitivity to beta-carbolines and barbiturates. These results show that the GABAA receptor pharmacological properties of spiral ganglion neurones are close to those of cerebellar granule cells.
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Affiliation(s)
- B Malgrange
- Department of Human Physiology and Pathophysiology, University of Liège, Belgium
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31
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Deleixhe-Mauhin F, Nikkels A, Paquet P, Goffin F, Piérard-Franchimont C, Piérard GE. [Is mesotherapy without hazards?]. Rev Med Liege 1991; 46:213-5. [PMID: 2052815] [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] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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32
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Goffin F. [Local muscle fatigue during static effort: quantitative myoelectric evaluation and modalities of application (author's transl)]. J Belge Rhumatol Med Phys 1974; 29:135-40. [PMID: 4443349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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33
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Goffin F. [Physical revalidation in spasticity: an electrophysiological evaluation of local cryotherapy]. J Belge Rhumatol Med Phys 1970; 25:195-201. [PMID: 5514549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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34
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Goffin F. [Lumbar hyperlordosis, coupled with lower backache. Several aspects of physical management]. J Belge Rhumatol Med Phys 1965; 20:137-44. [PMID: 4221915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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