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Aparicio T, Lavau-Denes S, Phelip JM, Maillard E, Jouve JL, Gargot D, Gasmi M, Locher C, Adhoute X, Michel P, Khemissa F, Lecomte T, Provençal J, Breysacher G, Legoux JL, Lepère C, Charneau J, Cretin J, Chone L, Azzedine A, Bouché O, Sobhani I, Bedenne L, Mitry E. Randomized phase III trial in elderly patients comparing LV5FU2 with or without irinotecan for first-line treatment of metastatic colorectal cancer (FFCD 2001-02). Ann Oncol 2015; 27:121-7. [PMID: 26487578 DOI: 10.1093/annonc/mdv491] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [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: 07/27/2015] [Accepted: 10/08/2015] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Metastatic colorectal cancer (mCRC) frequently occurs in elderly patients. However, data from a geriatric tailored randomized trial about tolerance to and the efficacy of doublet chemotherapy (CT) with irinotecan in the elderly are lacking. The benefit of first-line CT intensification remains an issue in elderly patients. PATIENTS AND METHODS Elderly patients (75+) with previously untreated mCRC were randomly assigned in a 2 × 2 factorial design (four arms) to receive 5-FU (5-fluorouracil)-based CT, either alone (FU: LV5FU2 or simplified LV5FU2) or in combination with irinotecan [IRI: LV5FU2-irinotecan or simplified LV5FU2-irinotecan (FOLFIRI)]. The CLASSIC arm was defined as LV5FU2 or LV5FU2-irinotecan and the SIMPLIFIED arm as simplified LV5FU2 or FOLFIRI. The primary end point was progression-free survival (PFS). Secondary end points were overall survival (OS), safety and objective response rate (ORR). RESULTS From June 2003 to May 2010, 71 patients were randomly assigned to LV5FU2, 71 to simplified LV5FU2, 70 to LV5FU2-irinotecan and 70 to FOLFIRI. The median age was 80 years (range 75-92 years). No significant difference was observed for the median PFS: FU 5.2 months versus IRI 7.3 months, hazard ratio (HR) = 0.84 (0.66-1.07), P = 0.15 and CLASSIC 6.5 months versus SIMPLIFIED 6.0 months, HR = 0.85 (0.67-1.09), P = 0.19. The ORR was superior in IRI (P = 0.0003): FU 21.1% versus IRI 41.7% and in CLASSIC (P = 0.04): CLASSIC 37.1% versus SIMPLIFIED 25.6%. Median OS was 14.2 months in FU versus 13.3 months in IRI, HR = 0.96 (0.75-1.24) and 15.2 months in CLASSIC versus 11.4 months in SIMPLIFIED, HR = 0.71 (0.55-0.92). More patients presented grade 3-4 toxicities in IRI (52.2% versus 76.3%). CONCLUSION In this elderly population, adding irinotecan to an infusional 5-FU-based CT did not significantly increase either PFS or OS. Classic LV5FU2 was associated with an improved OS compared with simplified LV5FU2. CLINICALTRIALSGOV NCT00303771.
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Affiliation(s)
- T Aparicio
- Department of Gastroenterology, CHU Avicenne, APHP and University Paris 13, Sorbonne Paris Cité, Bobigny
| | | | - J M Phelip
- Department of Gastroenterology, CHU Saint Etienne-Hôpital Nord, Saint Priest en Jarez
| | - E Maillard
- FFCD Data Center, Fédération Francophone de Cancérologie Digestive, Dijon
| | - J L Jouve
- Department of Gastroenterology, CHU Le Bocage, Dijon
| | - D Gargot
- Department of Gastroenterology, CH Blois, Blois
| | - M Gasmi
- Department of Gastroenterology, CHU Hôpital Nord, Marseille
| | - C Locher
- Department of Gastroenterology, CH Meaux, Meaux
| | - X Adhoute
- Department of Gastroenterology, CHU Haut Lévèque, Pessac
| | - P Michel
- Department of Gastroenterology, CHU Charles Nicolle, Rouen
| | - F Khemissa
- Department of Gastroenterology, CH Saint Jean, Perpignan
| | - T Lecomte
- Department of Gastroenterology, CHU Trousseau, Tours
| | - J Provençal
- Department of Oncology, CH Chambery, Chambery
| | - G Breysacher
- Department of Gastroenterology, CH Pasteur, Colmar
| | - J L Legoux
- Department of Gastroenterology, CH de la Source, Orléans
| | - C Lepère
- Department of Digestive Oncology, CHU Georges Pompidou, APHP, Paris
| | - J Charneau
- Department of Gastroenterology, CH Duchenne, Boulogne sur Mer
| | - J Cretin
- Department of Oncology, Clinique Bonnefon, Alès
| | - L Chone
- Department of Gastroenterology, CHU Nancy, Vandoeuvre-les-Nancy
| | - A Azzedine
- Department of Gastroenterology, CH Avignon, Avignon
| | - O Bouché
- Department of Gastroenterology, CHU Robert Debré, Reims
| | - I Sobhani
- Department of Gastroenterology, CHU Henri Mondor, APHP, Créteil
| | - L Bedenne
- FFCD Data Center, Fédération Francophone de Cancérologie Digestive, Dijon Department of Gastroenterology, CHU Le Bocage, Dijon
| | - E Mitry
- Department of Oncology, Institut Curie, Saint-Cloud University Versailles-St Quentin, St Quentin, France
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Hebbar M, Chibaudel B, André T, Mineur L, Smith D, Louvet C, Dutel JL, Ychou M, Legoux JL, Mabro M, Faroux R, Auby D, Brusquant D, Khalil A, Truant S, Hadengue A, Dalban C, Gayet B, Paye F, Pruvot FR, Bonnetain F, Taieb J, Brucker P, Landi B, Flesch M, Carola E, Martin P, Vaillant E, de Gramont A. FOLFOX4 versus sequential dose-dense FOLFOX7 followed by FOLFIRI in patients with resectable metastatic colorectal cancer (MIROX): a pragmatic approach to chemotherapy timing with perioperative or postoperative chemotherapy from an open-label, randomized phase III trial. Ann Oncol 2014; 26:340-7. [PMID: 25403578 DOI: 10.1093/annonc/mdu539] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Perioperative FOLFOX4 (oxaliplatin plus 5-fluorouracil/leucovorin) chemotherapy is the current standard in patients with resectable metastases from colorectal cancer (CRC). We aimed to determine whether a sequential chemotherapy with dose-dense oxaliplatin (FOLFOX7) and irinotecan (FOLFIRI; irinotecan plus 5-fluorouracil/leucovorin) is superior to FOLFOX4. The chemotherapy timing was not imposed, and was perioperative or postoperative. PATIENTS AND METHODS In this open-label, phase III trial, patients with resectable or resected metastases were randomly assigned either to 12 cycles of FOLFOX4 (oxaliplatin 85 mg/m(2)) or 6 cycles of FOLFOX7 (oxaliplatin 130 mg/m(2)) followed by 6 cycles of FOLFIRI (irinotecan 180 mg/m(2)). Randomization was done centrally, with stratification by chemotherapy timing, type of local treatment (surgery versus radiofrequency ablation with/without surgery), and Fong's prognostic score. The primary end point was 2-year disease-free survival (DFS). RESULTS A total of 284 patients were randomized, 142 in each treatment group. Chemotherapy was perioperative in 168 (59.2%) patients and postoperative in 116 (40.8%) patients. Perioperative chemotherapy was preferentially proposed for synchronous metastases, whereas postoperative chemotherapy was more frequently used for metachronous metastases. Two-year DFS was 48.5% in the FOLFOX4 group and 50.0% in the FOLFOX7-FOLFIRI group. In the multivariable analysis, more than one metastasis [hazard ratio (HR) = 2.15] and synchronous metastases (HR = 1.63) were independent prognostic factors for shorter DFS. Five-year overall survival (OS) rate was 69.5% with FOLFOX4 versus 66.6% with FOLFOX7-FOLFIRI. CONCLUSIONS FOLFOX7-FOLFIRI is not superior to FOLFOX4 in patients with resectable metastatic CRC. Five-year OS rates observed in both groups are the highest ever reported in this setting, possibly reflecting the pragmatic approach to chemotherapy timing. CLINICAL TRIALS NUMBER NCT00268398.
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Affiliation(s)
- M Hebbar
- Department of Medical Oncology, University Hospital, Lille
| | - B Chibaudel
- Department of Medical Oncology, Hospital Saint-Antoine, Paris
| | - T André
- Department of Medical Oncology, Hospital Saint-Antoine, Paris
| | - L Mineur
- Department of Radiotherapy, Institute Sainte-Catherine, Avignon
| | - D Smith
- Department of Medical Oncology and Radiotherapy, Hospital Saint-André, Bordeaux
| | - C Louvet
- Department of Oncology, Institute Mutualiste Montsouris, Paris
| | - J L Dutel
- Department of Medical Oncology, Radiotherapy Service, Hospital Centre Beauvais, Beauvais
| | - M Ychou
- Regional Centre against Cancer, Val d'Aurelle-Paul Lamarque, Montpellier
| | - J L Legoux
- Department of Hepatology and Gastroenterology, Hospital de Haut-Lévêque, Pessac
| | - M Mabro
- Department of Medical Oncology, Hospital Foch, Suresnes
| | - R Faroux
- Department of Gastroenterology, Hospital La Roche-sur-Yon, La Roche-sur-Yon
| | - D Auby
- Department of Medicine, Hospital Libourne, Libourne
| | | | - A Khalil
- Department of Medical Oncology, Hospital Tenon, Paris
| | - S Truant
- Department of Digestive Surgery and Transplantation, University Hospital, Lille
| | | | - C Dalban
- Methodology and Quality of Life in Oncology Department EA 3181, Hospital Besançon, Besançon
| | - B Gayet
- Department of Surgery, Institute Mutualiste Montsouris, Paris
| | - F Paye
- Department of Digestive Surgery, Hospital Saint-Antoine, Paris
| | - F R Pruvot
- Department of Digestive Surgery and Transplantation, University Hospital, Lille
| | - F Bonnetain
- Methodology and Quality of Life in Oncology Department EA 3181, Hospital Besançon, Besançon
| | - J Taieb
- Department of Gastroenterology and Digestive Oncology, Hôpital Européen Georges Pompidou, Université Paris Descartes, Paris
| | - P Brucker
- Department of Gastroenterology, Centre hospitalier François Maillot, Briey
| | - B Landi
- Department of Hepatogastroenterology and Digestive Oncology, Hôpital Européen Georges Pompidou Service Hépato-gastroentérologie; Paris
| | - M Flesch
- Department of Medical Oncology, Clinique Clément Drevon, Dijon
| | - E Carola
- Department of Medical Oncology, Centre Hospitalier, Senlis
| | - P Martin
- Department of Cancerology, Centre Bourgogne, Lille
| | - E Vaillant
- Department of Gastroenterology, Clinique Ambroise Paré, Lille, France
| | - A de Gramont
- Department of Medical Oncology, Hospital Saint-Antoine, Paris
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Tuvignon N, Liguory C, Ponchon T, Meduri B, Fritsch J, Sahel J, Boyer J, Legoux JL, Escourrou J, Boustiere C, Arpurt JP, Barthet M, Tuvignon P, Bommelaer G, Ducot B, Prat F. Long-term follow-up after biliary stent placement for postcholecystectomy bile duct strictures: a multicenter study. Endoscopy 2011; 43:208-16. [PMID: 21365514 DOI: 10.1055/s-0030-1256106] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
BACKGROUND AND STUDY AIMS Endoscopic stenting is a recognized treatment of postcholecystectomy biliary strictures. Large multicenter reports of its long-term efficacy are lacking. Our aim was to analyze the long-term outcomes after stenting in this patient population, based on a large experience from several centers in France. METHODS Members of the French Society of Digestive Endoscopy were asked to identify patients treated for a common bile duct postcholecystectomy stricture. Patients with successful stenting and follow-up after removal of stent(s) were subsequently included and analyzed. Main outcome measures were long-term success of endoscopic stenting and related predictors for recurrence (after one stenting period) or failure (at the end of follow-up). RESULTS A total of 96 patients were eligible for inclusion. The mean number of stents inserted at the same time was 1.9±0.89 (range 1-4). Stent-related morbidity was 22.9% (n=22). The median duration of stenting was 12 months (range 2-96 months). After a mean follow-up of 6.4±3.8 years (range 0-20.3 years) the overall success rate was 66.7% (n=64) after one period of stenting and 82.3% (n=79) after additional treatments. The mean time to recurrence was 19.7±36.6 months. The most significant independent predictor of both recurrence and failure was a pathological cholangiography at the time of stent removal. CONCLUSION Endoscopic stenting helps to avoid surgery in more than 80% of patients bearing postcholecystectomy common bile duct strictures. However, a persistent anomaly on cholangiography at the time of stent removal is a strong predictor of recurrence and may lead to consideration of surgery.
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Affiliation(s)
- N Tuvignon
- Gastroenterology Department, Cochin Hospital, Paris, France
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Lombard-Bohas C, Mitry E, O'Toole D, Louvet C, Pillon D, Cadiot G, Borson-Chazot F, Aparicio T, Ducreux M, Lecomte T, Etienne PL, Cacheux W, Legoux JL, Seitz JF, Ruszniewski P, Chayvialle JA, Rougier P. Thirteen-month registration of patients with gastroenteropancreatic endocrine tumours in France. Neuroendocrinology 2009; 89:217-22. [PMID: 18719344 DOI: 10.1159/000151562] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2008] [Accepted: 05/09/2008] [Indexed: 11/19/2022]
Abstract
The prevalence, clinical profiles and management of gastroenteropancreatic endocrine tumours (GEP) in France are not known. From August 1, 2001 to September 1, 2002, standardized records on patients with GEP were prospectively completed in 87 participating centres. The total group amounted to 668 patients (median age: 56 years, range: 12-89). WHO performance status was 0/1 for 80.2% of patients. The primary sites were the small bowel and colon (288), pancreas (211), unknown (77), stomach (33), non-digestive primary sites (24), appendix (20), rectum-anus (12), and oesophagus or cardia (3). GEP were functional in 260 patients (39%). Most pancreatic tumours were non-functional (72%). Metastatic disease was observed in 73.4% of cases. Most tumours (85.8%) were well or moderately differentiated. Somatostatin receptor scintigraphy was performed in only 55% of patients. The following treatment modalities were employed: resection of primary tumour: 66%; systemic chemotherapy: 41%; somatostatin analogues: 44 and 26% for GEP of small intestine and pancreas, respectively; interferon: 12%, and intra-arterial hepatic (chemo)embolization in 23 and 15% of GEP arising from the midgut and pancreas, respectively. Despite their low prevalence, well-differentiated GEP represent a significant and heterogeneous clinical group, which warrants improved medical education, referral to expert centres at an early stage, and the design of prospective therapeutic trials.
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Graber I, Dumas R, Filoche B, Boyer J, Coumaros D, Lamouliatte H, Legoux JL, Napoléon B, Ponchon T. The efficacy and safety of duodenal stenting: a prospective multicenter study. Endoscopy 2007; 39:784-7. [PMID: 17703386 DOI: 10.1055/s-2007-966594] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND STUDY AIMS Duodenal stenting has become a popular treatment in cases of malignant stenosis. However, a prospective evaluation of the efficacy and morbidity of this procedure has not been performed. A prospective multicenter study of duodenal stenting was conducted by the Société Française d'Endoscopie Digestive (SFED). PATIENTS AND METHODS A total of 51 patients were selected (mean age 72), the majority (69%) having pancreatic adenocarcinoma. Palliative treatment was chosen because of irresectability (61.2%), inoperability (18.4%), or both (20.4 %). Enteral Wallstent prostheses were used, and the patients were followed up on day 3, after 1 month, and then every month, with weight measurement, and symptomatic and laboratory evaluation. RESULTS One prosthesis was sufficient in 46 patients. Stent positioning and deployment were correct in 50/51 patients (98%). Twenty patients also underwent biliary stenting in addition to the duodenal stenting. On day 3, 43 patients (84%) were able to tolerate soft solids or a full diet. Six complications were attributed to stenting: three intestinal hemorrhages, two cases of peritonitis due to bowel perforation, and one case of septicemia, and these led to five deaths (mortality 9.8%). Stent dysfunction was observed in 12 cases (23.5%) after a mean delay of 75 days, comprising 11-malignant obstructions and one migration: a new stent was inserted inside the first one and was effective in eight cases; and no treatment was given in the other four patients because of their clinical state. The median survival was 71.5 days. CONCLUSIONS Palliative endoscopic treatment of malignant duodenal stenosis using metallic prostheses is highly feasible, even with associated biliary stenting. Symptomatic improvement is fast. However, the mortality and the obstruction rate are high, suggesting that a prospective trial comparing this treatment with surgery is still required.
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Affiliation(s)
- I Graber
- Service d'Hépatogastroentérologie, Hôpital E. Herriot, Lyon, France.
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Belleannée G, Legoux JL, Trouette H, Smith D, De Mascarel A. [A misleading mistake in the colorectal carcinoma classification, in the French version of 'TNM Atlas', Springer edition]. Gastroenterol Clin Biol 2001; 25:435. [PMID: 11449136] [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: 02/20/2023]
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Ardizzone JF, Causse X, Potier P, Lagasse JP, Gros J, Doyen M, Labarriere D, Legoux JL. [Current decontamination procedures for digestive tract endoscopy equipment are effective against risk of hepatitis C virus transmission]. Gastroenterol Clin Biol 2000; 24:975-6. [PMID: 11084442] [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: 02/18/2023]
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8
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Belleannée G, Legoux JL, Trouette H, Smith D, De Mascarel A. [A misleading mistake in the classification of colonic and rectal cancers, in the 4th edition of the TNM Atlas, published in French by Springer]. Ann Pathol 2000; 20:402-3. [PMID: 11015670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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De Lédinghen V, Person B, Legoux JL, Le Sidaner A, Desaint B, Greef M, Moesch C, Grollier G, Ingrand P, Sautereau D, Beauchant M. Prevention of biliary stent occlusion by ursodeoxycholic acid plus norfloxacin: a multicenter randomized trial. Dig Dis Sci 2000; 45:145-50. [PMID: 10695627 DOI: 10.1023/a:1005429914955] [Citation(s) in RCA: 16] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
We report a prospective randomized multicenter trial that tested the efficacy of combining ursodeoxycholic acid and norfloxacin in the prevention of polyethylene stent clogging in patients with obstructive jaundice due to an unresectable malignancy at the level of the common bile duct. After insertion of a 10-Fr straight polyethylene stent, patients were allocated to receive oral treatment with ursodeoxycholic acid and norfloxacin, or conservative treatment. The primary outcome measure was stent blockage within six months. Thirty-three patients (group I) received ursodeoxycholic acid and norfloxacin, and 29 received conservative treatment (group II). At six months, cumulative stent patency rate did not differ significantly between group I (47+/-11%, mean +/- SE, median 149 days) and group II patients (24+/-10%, mean +/- SE, median 100 days, P = 0.23, log-rank test). Four stents were clogged by ursodeoxycholic acid. Survival did not differ between the two groups. Combined therapy with ursodeoxycholic acid and norfloxacin failed to improve stent patency. Moreover, ursodeoxycholic acid can cause stent obstruction.
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Joseph-Reinette C, Causse X, Schoenwald M, Lagasse JP, Doumerc S, Labarière D, Ardizonne JF, Legoux JL. [Severe mixed thrombopenia during interferon treatment for chronic viral hepatitis C]. Presse Med 1999; 28:1572-4. [PMID: 10544706] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
BACKGROUND Thrombocytopenia occurred in a woman given alpha interferon for chronic hepatitis C without cirrhosis. Both central thrombocytopenia, clearly demonstrated, and peripheral thrombocytopenia, probably of autoimunne origin, were involved. CASE REPORT A 55-year-old woman with active chronic hepatitis C (Metavir score A2, F2) was given alpha interferon. One month after treatment onset, she developed thrombocytopenia (32 G/L). A second bone marrow aspirate and osteomedullary biopsy evidenced megalokaryocytes and the platelet count responded to polyvalent immunoglobulins. Five months after discontinuing interferon, the platelet count progressively returned to normal. DISCUSSION Central thrombocytopenia is classically described in patients given interferon and usually appears during the first weeks of treatment. In our case, the central mechanism was clearly demonstrated by the bone marrow aspirate and osteomedullary biopsy findings at a time when the platelet count was 32 G/L. A peripheral immunological participation was more difficult to prove but was strongly suggested by the persistence of thrombocytopenia despite the interruption of the interferon and the efficacy of immunoglobulins.
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Barbare JC, Bedenne L, Bouché O, Cadiot G, Calais G, de Calan L, Conroy T, Ducreux M, Etienne PL, Elias D, Faivre J, Legoux JL, Maingon P, Mornex F, Nordlinger B, Ollier JC, Peiffert D, Pelletier G, Rat P, Rougier P, Ruskone-Fourmestraux A, Seitz JF, Triboulet JP, Trinchet JC, Ychou M. [What can be done for patients with digestive cancer in 1999? Guidelines of the French Foundation of Digestive Cancerology (2nd part)]. Gastroenterol Clin Biol 1999; 23:486-96. [PMID: 10429852] [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: 02/13/2023]
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Barbare JC, Bedenne L, Bouché O, Cadiot G, Calais G, de Calan L, Conroy T, Ducreux M, Etienne PL, Elias D, Faivre J, Legoux JL, Maingon P, Mornex F, Nordlinger B, Ollier JC, Peiffert D, Pelletier G, Rat P, Rougier P, Ruskone-Fourmestraux A, Seitz JF, Triboulet JP, Trinchet JC, Ychou M. [What can be done for digestive cancer in 1999? Recommendations of the French Foundation of Digestive Cancer (1st Part)]. Gastroenterol Clin Biol 1999; 23:502-12. [PMID: 10416114] [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: 02/13/2023]
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13
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Lagasse JP, Causse X, Legoux JL, Leyman P, Labarrière D, Brun H. Cytomegalovirus gastritis simulating cancer of the linitis plastica type on endoscopic ultrasonography. Endoscopy 1998; 30:S101-2. [PMID: 9932768 DOI: 10.1055/s-2007-1001430] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- J P Lagasse
- Dept. of Gastroenterology, CHR D'Orléans, France
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14
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Legoux JL, Labarrière D, Grézard O, Jaltel M, Lagasse JP, Bahallah ML, Maitre F, Causse X. [Chronic renal insufficiency (interstitial nephritis) under mesalazine]. Gastroenterol Clin Biol 1998; 22:737-9. [PMID: 9823565] [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: 02/09/2023]
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15
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Lagasse JP, Bahallah ML, Salem N, Debillon G, Labarrière D, Serve MP, Advenier V, Causse X, Legoux JL. [Acute thrombosis of the portal system. Treatment with alteplase and heparin or with heparin alone in 10 patients]. Gastroenterol Clin Biol 1998; 21:919-23. [PMID: 9587554] [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
OBJECTIVES We report the efficacy of alteplase (a recombinant tissue plasminogen activator) with heparin or heparin alone in the treatment of acute thrombosis of the portal venous system. METHODS Ten consecutive patients with acute portal venous system thrombosis were studied. Five patients were treated with alteplase and heparin, and the remaining 5 patients, who were asymptomatic or had a contraindication to alteplase, were treated with heparin alone. RESULTS In 3 of the 5 patients treated with alteplase, ultrasonography showed total resolution of the thrombus; the remaining 2 had partial resolution of the thrombus. In 4 of the 5 patients treated with heparin alone, ultrasonography showed total resolution of the thrombus, and no change in one. No bleeding occurred. CONCLUSION Treatment with heparin can result in complete recanalisation of acute portal venous system thrombosis. These data suggest that combined therapy with systemic alteplase does not increase the efficacy of heparin.
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Affiliation(s)
- J P Lagasse
- Service d'Hépato-Gastroentérologie, CHR, Orléans
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16
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Benoit R, Legoux JL, Serve MP, Khadre K, Festin D, Causse X. [Obstructive intramural hematoma of the esophagus after sclerotherapy]. Presse Med 1996; 25:1281-4. [PMID: 8949788] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
A case of obstructive intramural hematoma of the esophagus post variceal sclerotherapy is reported in a 44-year-old man who presented retrosternal pain and complete dysphagia. Endoscopy showed a bluish submucosal mass occupying the esophageal lumen. Diagnosis was confirmed by Computed Tomography. A favorable outcome was observed with symptomatic treatment.
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Affiliation(s)
- R Benoit
- Service d'Hépato-Gastroentérologie, Hôpital de la Source, Orléans
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Causse X, Germanaud J, Legoux A, Legoux JL. [Extra-hepatic manifestations of viral hepatitis]. Rev Prat 1995; 45:185-9. [PMID: 7725020] [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: 01/26/2023]
Abstract
A variety of prodromal symptoms of viral hepatitis (urticaria, fever, arthralgias, headache, polyradiculonevritis) are attributed to A, B, C, D or E hepatitis only when jaundice appears, and because they disappear with it. Spectacular extrahepatic symptoms (polyarteritis nodosa, cryoglobulinemia, glomerulonephritis, marrow aplasia...) may be associated with B or C hepatitis without any liver symptom. Some of the extrahepatic symptoms observed during chronic hepatitis C therapy with interferon (thyroid dysfunctions, cutaneo-mucous lichen) may be related to the immunomodulatory effects of interferon rather than to virus C itself.
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Affiliation(s)
- X Causse
- Service d'hépato-gastro-entérologie, CHR d'Orléans
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Germanaud J, Pfau-Fandard B, Legoux JL, Festin D, Causse X. [Prevalence of chronic alcoholism in non-medical personnel at a hospital center]. Ann Gastroenterol Hepatol (Paris) 1994; 30:53-6. [PMID: 7911651] [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: 01/27/2023]
Abstract
The incidence of chronic alcoholism among the non-medical staff of a hospital was evaluated in an occupational health service context. Three criteria were sought routinely: suspicion by history of excessive alcohol intake, typical findings by physical examination, and suggestive behavioural changes reported by work colleagues. Gamma glutamyl transpeptidase levels and mean corpuscular volume were measured when one of these three criteria existed. The diagnosis of chronic alcoholism was made when two criteria were found or when only one criterion existed but accompanied by laboratory abnormalities. The incidence of chronic alcoholism was 6.2 per cent among male staff and 0.6 among female staff. It appeared to be less than in the population as a whole. The selective and non-systematic use of laboratory investigations and the frequent absence of indication to the occupational health physician of behavioural problems were sources of bias which probably contributed to underestimation of the incidence of chronic alcoholism among employees of the Orleans Regional Hospital Group. Provision of information to all staff is essential in order to explain the behavioural changes associated with chronic alcoholism and the usefulness of reporting employees showing evidence of such changes to the occupational physician. This enables medico-social diagnosis and the early care of those with early chronic alcohol abuse.
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Affiliation(s)
- J Germanaud
- Service de Médecine Préventive, CHR d'Orléans
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Gargot D, Causse X, Sapey T, Samuel D, Michenet P, Nguyen LD, Festin D, Legoux JL. [Black esophagus: a new case associated with hypoxic hepatitis]. Gastroenterol Clin Biol 1994; 18:177-179. [PMID: 8013805] [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: 05/22/2023]
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Legoux JL, Agnard P, Marchand JP, Versapuech JM, Maitre F. [Aneurysm of the splenic artery responsible for segmental portal hypertension and upper digestive tract hemorrhage]. Presse Med 1991; 20:1572. [PMID: 1835070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
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Legoux JL, Legoux A, Portier H, Maufoux C, Cortet P. [Yersinia enterocolitica: a germ to search for in any febrile diarrhea with erythema nodosum]. Gastroenterol Clin Biol 1980; 4:730-1. [PMID: 7439614] [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: 01/25/2023]
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Faivre J, Milan C, Bugnon P, Legoux JL, Martin F, Klepping C. Primary liver cancer in Cote d'Or (Burgundy). Results of three year's systematic registration in a well defined French population. Biomedicine 1979; 31:150-2. [PMID: 508898] [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: 12/15/2022]
Abstract
The registry of digestive tract cancers set up for the department of Cote d'Or (455, 727) was used to study primary liver cancer. The crude annual incidence rate was 10.4 per 100 000 for males, 2.3 per 100 000 for females. Among other cancer registries annual age standardized rates: 7.6 per 100 000 in males, 1.4 per 100 000 in females are in the intermediate range, close to the figure reported in Geneva and higher than incidence rates reported elsewhere in Europe. Most cancers were hepatocullular carcinomas (83%). Significant etiological factors were the sex ratio (5, 4), alcoholic cirrhosis associated with primary liver cancer in 61% of the patients. The one year crude survival rate was 8%.
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Abstract
The present study is based on the registry of digestive cancers set up for the French department of Côte-d'Or (455,727 residents). Large bowel cancer represents half of the gastrointestinal tract cancers recorded in the course of 2 years (1976-1977). The crude annual incidence rate was 52.2 per 100,000 for males, 41.7 per 100,000 for females. The age-standardized incidence rate for cancer of the rectum is one of the highest reported. The incidence rates for cancer of the colon are in the intermediate range. Half of the large bowel cancers were rectal cancers, nearly always adenocarcinoma. Coexisting benign polyps were seen in 21% of the cases at the time of diagnosis of carcinoma and were more common in males than in females. 54% of cancers of the colon and 62% of cancers of the rectum underwent curative surgery.
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Faivre J, Legoux JL, Martin F, Cabanne F, Klepping C. [Incidence of cancer of the stomach in the "Departement de la Côte-d'Or". Results of two years' registration in a well-defined population (author's transl)]. Gastroenterol Clin Biol 1978; 2:967-72. [PMID: 744455] [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: 12/24/2022]
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