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Su X, Lu X, Bazai SK, Dainese L, Verschuur A, Dumont B, Mouawad R, Xu L, Cheng W, Yan F, Irtan S, Lindner V, Paillard C, Le Bouc Y, Coulomb A, Malouf GG. Delineating the interplay between oncogenic pathways and immunity in anaplastic Wilms tumors. Nat Commun 2023; 14:7884. [PMID: 38036539 PMCID: PMC10689851 DOI: 10.1038/s41467-023-43290-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 11/06/2023] [Indexed: 12/02/2023] Open
Abstract
Wilms tumors are highly curable in up to 90% of cases with a combination of surgery and radio-chemotherapy, but treatment-resistant types such as diffuse anaplastic Wilms tumors pose significant therapeutic challenges. Our multi-omics profiling unveils a distinct desert-like diffuse anaplastic Wilms tumor subtype marked by immune/stromal cell depletion, TP53 alterations, and cGAS-STING pathway downregulation, accounting for one-third of all diffuse anaplastic cases. This subtype, also characterized by reduced CD8 and CD3 infiltration and active oncogenic pathways involving histone deacetylase and DNA repair, correlates with poor clinical outcomes. These oncogenic pathways are found to be conserved in anaplastic Wilms tumor cell models. We identify histone deacetylase and/or WEE1 inhibitors as potential therapeutic vulnerabilities in these tumors, which might also restore tumor immunogenicity and potentially enhance the effects of immunotherapy. These insights offer a foundation for predicting outcomes and personalizing treatment strategies for aggressive pediatric Wilms tumors, tailored to individual immunological landscapes.
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Affiliation(s)
- Xiaoping Su
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Xiaofan Lu
- Department of Cancer and Functional Genomics, Institute of Genetics and Molecular and Cellular Biology, CNRS/INSERM/UNISTRA, Illkirch, France
- Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Sehrish Khan Bazai
- Department of Cancer and Functional Genomics, Institute of Genetics and Molecular and Cellular Biology, CNRS/INSERM/UNISTRA, Illkirch, France
| | - Linda Dainese
- Department of Pathology, Hôpital Armand Trousseau, Assistance-Publique Hôpitaux de Paris, Sorbonne Université, Paris, France
- UF Tumorothèque HUEP, Hôpital Armand Trousseau, Assistance-Publique Hôpitaux de Paris, Sorbonne Université, Paris, France
- Centre de Recherche Saint-Antoine (CRSA), INSERM, Sorbonne Université, UMR_S .938, Paris, France
| | - Arnauld Verschuur
- Department of Pediatric Oncology, Hôpital d'Enfants de La Timone, F-13005, Marseille, France
| | - Benoit Dumont
- Centre Léon Bérard, Institut d'Hématologie et d'Oncologie Pédiatrique (IHOPe), Lyon, France
| | - Roger Mouawad
- Department of Medical Oncology, Groupe Hospitalier Pitié-Salpêtrière, Assistance-Publique Hôpitaux de Paris, Paris, France
| | - Li Xu
- Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Wenxuan Cheng
- Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Fangrong Yan
- Research Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing, China
| | - Sabine Irtan
- Department of Pediaric Surgery, AP-HP, Hôpital Armand Trousseau, Sorbonne Université, Paris, France
| | | | - Catherine Paillard
- Department of Pediatric Onco-hematology, CHRU Strasbourg, Strasbourg Université, Strasbourg, France
| | - Yves Le Bouc
- Centre de Recherche Saint-Antoine (CRSA), INSERM, Sorbonne Université, UMR_S .938, Paris, France
| | - Aurore Coulomb
- Department of Pathology, Hôpital Armand Trousseau, Assistance-Publique Hôpitaux de Paris, Sorbonne Université, Paris, France.
- UF Tumorothèque HUEP, Hôpital Armand Trousseau, Assistance-Publique Hôpitaux de Paris, Sorbonne Université, Paris, France.
- Centre de Recherche Saint-Antoine (CRSA), INSERM, Sorbonne Université, UMR_S .938, Paris, France.
| | - Gabriel G Malouf
- Department of Cancer and Functional Genomics, Institute of Genetics and Molecular and Cellular Biology, CNRS/INSERM/UNISTRA, Illkirch, France.
- Department of Medical Oncology, Institut de Cancérologie de Strasbourg, Strasbourg University, Strasbourg, France.
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Lehmann-Che J, Wong J, Tixier L, Lacroix L, Triki-Lacroix M, Lamy PJ, Garnier A, Quillien V, Godey F, Soubeyran I, MacGrogan G, Arnould L, Haudebourg J, Tallet A, Dainese L, Hugonin C, Penault-Llorca F. Abstract P3-08-25: Simosein registry, the French national real-life prospective evaluation of the impact of Endopredict® (EPclin) on treatment decision in ER-positive, HER2-negative breast cancers. Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p3-08-25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Breast cancer remains the first cause of death in women worldwide even if the average 10-year survival rate is 83%. It remains difficult to accurately evaluate the risk of recurrence, and consequently the need of chemotherapy, in estrogen receptor (ER)-positive, HER2-negative early breast cancers, at the individual level, leading to overtreatment for some patients. In that context, multigene prognostic scores are proposed in combination with clinicopathological parameters, to guide adjuvant treatment decisions. In our study, patients diagnosed with ER-positive, Her2-negative breast cancer, analyzed with the 12-gene EndoPredictTM test are prospectively included in the national SiMosein registry. The decision for Endopredict testing is determined by an oncological tumor board in expert breast cancer centers. The test is locally performed (10 national laboratories, evaluated by a national quality control exchange program). Clinicopathological parameters are recorded and the treatment decision before and after the genomic test is requested. The aim of the study is to prospectively evaluate the real-life use of the EndopredictTM test and the impact of the recurrence risk on the adjuvant treatment decision. A total of 3153 patients were included between May 2016 and December 2018. Patients are 75.6% post-menopausal (median age: 57.55y) and are mostly diagnosed as invasive ductal carcinoma not otherwise specified (81.2%) with SBR grade 2 (74.02%) and positive Ki67 staining (>14%, 66.4%). Tumor sizes are pT1ab, pT1c or pT2 in respectively 12.1%, 54.7% and 31.4% of the cases. Lymph node involvement is negative (pN0) in 70.5% of the cases. However, 29.5% of cases are pN1-3 with 5.2% of pN1mi. All cases are ER-positive, HER2-negative early breast cancers and 74.8% are progesterone receptor (PR)-positive (PR>10%) and 76.43% of the cases are of luminal B-like subtype. The population evaluated in this prospective study is in accordance to the intermediate prognostic subpopulation of luminal breast cancers where genomic signatures could contribute to guide the adjuvant treatment decision. The risk of relapse at 10 years, as reflected by the EPclin score, is of 13.16% on average, with 55.18% of high risk (positive threshold 10%). Treatment decisions before and after the test were recorded for 599 patients. The decision remains unmodified after the test in 54.59% of the cases. Conversely, change in adjuvant treatment decision was made from hormone therapy (HT) to adjunction of chemotherapy (HT+CT) in 18.20% of the cases and from (HT+CT) to (HT) leading to chemotherapy withdrawn in 27.21%. Finally, the national SiMosein registry, evaluated the utility of the test. The use of EndopredictTM is mostly restricted to the intermediate prognostic subgroup of the early luminal breast subtype as requested by the French health authority (HAS). The test is routinely used in France and clinicians need mainly the test for treatment decision. The EPclin score leads to 45.41% of modification of treatment with a majority of avoidance of chemotherapy (59.93%).
Citation Format: Jacqueline Lehmann-Che, Jennifer Wong, Lucie Tixier, Ludovic Lacroix, Magali Triki-Lacroix, Pierre-Jean Lamy, Agnes Garnier, Véronique Quillien, Florence Godey, Isabelle Soubeyran, Gaëtan MacGrogan, Laurent Arnould, Juliette Haudebourg, Anne Tallet, Linda Dainese, Caroline Hugonin, Frédérique Penault-Llorca. Simosein registry, the French national real-life prospective evaluation of the impact of Endopredict® (EPclin) on treatment decision in ER-positive, HER2-negative breast cancers [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P3-08-25.
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Affiliation(s)
| | - Jennifer Wong
- 1APHP - Molecular Oncology Unit, Saint Louis Hospital, Paris, France
| | - Lucie Tixier
- 2Department of Pathology-Centre Jean Perrin, Clermont-Ferrand, France
| | - Ludovic Lacroix
- 3Department of Medical Biology and Pathology-Gustave Roussy, Villejuif, France
| | | | | | | | | | - Florence Godey
- 6Department of Biology, Oncology Center Eugène Marquis, Rennes, France
| | | | - Gaëtan MacGrogan
- 7Department of Biopathology, Institut Bergonié, Bordeaux, France
| | - Laurent Arnould
- 8Department of Biology and Pathology of Tumors, Centre GF Leclerc, Dijon, France
| | | | - Anne Tallet
- 10Platform of Somatic Tumour Molecular Genetics, University Hospital, Tours, France
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Carola C, Ghiringhelli F, Kim S, André T, Barlet J, Bengrine-Lefevre L, Marijon H, Garcia-Larnicol ML, Borg C, Dainese L, Steuer N, Richa H, Benetkiewicz M, Larsen AK, Gramont AD, Chibaudel B. FOLFIRI3-aflibercept in previously treated patients with metastatic colorectal cancer. World J Clin Oncol 2018; 9:110-118. [PMID: 30254966 PMCID: PMC6153125 DOI: 10.5306/wjco.v9.i5.110] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 06/11/2018] [Accepted: 06/28/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate the efficacy and safety of the modified FOLFIRI3-aflibercept as second-line therapy in patients with metastatic colorectal cancer.
METHODS This is a retrospective multicenter cohort, evaluating the efficacy and safety of the association of aflibercept with FOLFIRI3 (day 1: aflibercept 4 mg/kg, folinic acid 400 mg/m2, irinotecan 90 mg/m2, 5-fluorouracil infusion 2400 mg/m2 per 46 h; day 3: irinotecan 90 mg/m2) in patients with previously treated metastatic colorectal cancer. The primary endpoint was overall response rate (ORR). Secondary endpoints were disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and safety.
RESULTS Among 74 patients treated in four French centers, nine were excluded due to prior use of aflibercept (n = 3), more than one prior treatment line in irinotecan-naïve patients (n = 3), and inadequate liver function (n = 3). In the “irinotecan-naïve” patients (n = 30), ORR was 43.3% and DCR was 76.7%. Median PFS and OS were 11.3 mo (95%CI: 6.1-29.0) and 17.0 mo (95%CI: 13.0-17.3), respectively. The most common (> 5%) grade 3-4 adverse events were diarrhea (37.9%), neutropenia (14.3%), stomatitis and anemia (10.4%), and hypertension (6.7%). In the “pre-exposed irinotecan” patients (n = 35), 20 (57.1%) received ≥ 2 prior lines of treatment. ORR was 34.3% and DCR was 60.0%. Median PFS and OS were 5.7 mo (95%CI: 3.9-10.4) and 14.3 mo (95%CI: 12.8-19.5), respectively.
CONCLUSION Minimally modified FOLFIRI has improvement dramatically the FOLFIRI3-aflibercept efficacy, whatever prior use of irinotecan. A prospective randomized trial is warranted to compare FOLFIRI-aflibercept to FOLFIRI3-aflibercept.
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Affiliation(s)
- Candice Carola
- Department of Medical Oncology, Franco-British Institute, Levallois-Perret 92300, France
| | | | - Stefano Kim
- Department of Medical Oncology, CHU Besançon, Besançon 25030, France
| | - Thierry André
- Department of Medical Oncology, Saint-Antoine Hospital, and Sorbonne Universités, UMPC, Paris 75012, France
| | - Juliette Barlet
- Department of Medical Oncology, Franco-British Institute, Levallois-Perret 92300, France
| | | | - Hélène Marijon
- Department of Medical Oncology, Franco-British Institute, Levallois-Perret 92300, France
| | - Marie-Line Garcia-Larnicol
- Department of Medical Oncology, Saint-Antoine Hospital, and Sorbonne Universités, UMPC, Paris 75012, France
| | - Christophe Borg
- Department of Medical Oncology, CHU Besançon, Besançon 25030, France
| | - Linda Dainese
- Department of Anatomy-Pathology, Paris Pathology Institute, Malakoff 92240, France
| | - Nils Steuer
- Department of Medical Oncology, Saint-Antoine Hospital, and Sorbonne Universités, UMPC, Paris 75012, France
| | - Hubert Richa
- Department of Gastrointestinal Surgery, Franco-British Institute, Levallois-Perret 92300, France
| | | | - Annette K Larsen
- Cancer Biology and Therapeutics, Centre de Recherche Saint-Antoine, INSERM U938, Faculté de Médecine Sorbonne Université, Paris 75012, France
| | - Aimery de Gramont
- Department of Medical Oncology, Franco-British Institute, Levallois-Perret 92300, France
| | - Benoist Chibaudel
- Department of Medical Oncology, Franco-British Institute, Levallois-Perret 92300, France
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Carola C, Ghiringhelli F, Kim S, Andre T, Barlet J, Bengrine L, Marijon H, Garcia ML, Borg C, Dainese L, Steuer N, Larsen AK, De Gramont A, Chibaudel B. FOLFIRI3-aflibercept as second- or later-line therapy in patients with metastatic colorectal cancer. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.4_suppl.817] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
817 Background: The efficacy of the standard FOLFIRI-aflibercept second-line therapy may be improved by the chemotherapy regimen in metastatic colorectal cancer (MCRC). FOLFIRI was optimized by splitting the dose of irinotecan on day 1 and day 3 and by removing the bolus of 5-FU in the FOLFIRI3 regimen. Methods: This is a retrospective multicentric cohort, evaluating efficacy and safety of the association of aflibercept with FOLFIRI3, in patients (pts) with previously treated MCRC. The primary endpoint was overall response rate (ORR). Secondary endpoints were disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and safety. Results: From September 2014 to December 2016, 74 pts were treated in four French centers. Nine pts were excluded due to prior use of aflibercept (n = 3), more than one prior line of treatment in irinotecan-naïve pts (n = 3) and inadequate liver function (n = 3). In the cohort of irinotecan-naïve pts (n = 30), ORR and DCR were 43.3% and 76.7%. Median PFS and OS were 11.3 months (95% CI 6.1-29.0) and 17.0 months (95% CI 13.0-17.3). The most common ( > 5%) grade 3-4 adverse events were diarrhea (37.9%), neutropenia (14.3%), stomatitis and anemia (10.4%), hypertension (6.7%). In the cohort of pts previously treated with irinotecan (n = 35), 20 (57.1%) pts received ≥2 prior lines of treatment with various prior irinotecan regimen (FOLFIRINOX, n = 21; FOLFIRI, n = 10; FOLFIRI3, n = 4). ORR and DCR were 34.3% and 60.0%. Median PFS and OS were 5.7 months (95% CI 3.9-10.4) and 14.3 months (95% CI 12.8-19.5). In 4 patients refractory to irinotecan, FOLFIRI3-aflibercept led to one partial response, 2 stabilizations, and one patient not evaluable. Conclusions: A minimal modification of the FOLFIRI regimen led to a dramatically improvement of efficacy with FOLFIRI3-aflibercept, whatever prior use of irinotecan. Further randomized trial is planned.
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Affiliation(s)
| | | | - Stefano Kim
- Universitary Hospital of Besançon, Besançon, France
| | | | | | | | | | | | | | | | | | - Annette K Larsen
- Cancer Biology and Therapeutics INSERM U938, Saint-Antoine Hospital, Paris, France
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Dainese L, Adam N, Boudjemaa S, Hadid K, Rosenblatt J, Jouannic JM, Heron D, Froissart R, Coulomb A. Glycogen Storage Disease Type IV and Early Implantation Defect: Early Trophoblastic Involvement Associated with a New GBE1 Mutation. Pediatr Dev Pathol 2017; 19:512-515. [PMID: 25489661 DOI: 10.2350/14-09-1557-cr.1] [Citation(s) in RCA: 7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A 29-year-old primigravida presented with a spontaneous miscarriage at 8 weeks of gestation. There was no consanguinity in the family. Aspiration was performed. Pathological examination showed immature villi with numerous slightly yellow intracytoplasmic inclusions within the early implantation stage cytotrophoblastic cells. Inclusions were periodic acid-Schiff and Alcian blue positive and partially positive with periodic acid-Schiff with amylase. Diagnosis of Glycogen storage disease type IV (GSD IV) was made. Genetic analysis of glycogen branching enzyme 1 gene (GBE1) was performed in parents and showed a novel deletion of 1 nucleotide, c.1937delT, affecting the mother and a mutation affecting a consensus splice site, c.691+2T>C, in the father. At time of subsequent pregnancy, genetic counseling with GBE1 gene analysis was performed on throphoblastic biopsy and showed a mutated allele, c.1937delT, inherited from the mother. The mother gave birth to a healthy, unaffected female newborn. Our findings demonstrate that GSD IV may affect early pregnancies, leading to trophoblastic damage and early fetal loss. Diagnosis can accurately be made on pathological examination and should be further documented by genetic analysis.
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Affiliation(s)
- Linda Dainese
- 1 Service d'Anatomie et Cytologie Pathologiques-Hôpital d'Enfants Armand Trousseau-AP-HP, Paris, France
| | - Nicolas Adam
- 1 Service d'Anatomie et Cytologie Pathologiques-Hôpital d'Enfants Armand Trousseau-AP-HP, Paris, France
| | - Sabah Boudjemaa
- 1 Service d'Anatomie et Cytologie Pathologiques-Hôpital d'Enfants Armand Trousseau-AP-HP, Paris, France
| | - Kamel Hadid
- 1 Service d'Anatomie et Cytologie Pathologiques-Hôpital d'Enfants Armand Trousseau-AP-HP, Paris, France
| | - Jonathan Rosenblatt
- 2 Service de Gynécologie Obstétrique, Diagnostic Anténatal, Médecine Fœtale et Échographie, Hôpital d'Enfants Armand Trousseau-AP-HP, Paris, France
| | - Jean-Marie Jouannic
- 2 Service de Gynécologie Obstétrique, Diagnostic Anténatal, Médecine Fœtale et Échographie, Hôpital d'Enfants Armand Trousseau-AP-HP, Paris, France
| | - Delphine Heron
- 3 Département de Génétique et Cytogénétique, Unité Fonctionnelle de Génétique Médicale, Groupe Hospitalier Pitié-Salpêtrière, 75013 Paris, France
| | - Roseline Froissart
- 4 Laboratoire des Maladies Héréditaires du Métabolisme, Centre de Biologie Est, Hospices Civils de Lyon, 69677 BRON, France
| | - Aurore Coulomb
- 1 Service d'Anatomie et Cytologie Pathologiques-Hôpital d'Enfants Armand Trousseau-AP-HP, Paris, France
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Boudjemaa S, Dainese L, Héritier S, Masserot C, Hachemane S, Casanova JL, Coulomb A, Bustamante J. Disseminated Bacillus Calmette-Guérin Osteomyelitis in Twin Sisters Related to STAT1 Gene Deficiency. Pediatr Dev Pathol 2017; 20:255-261. [PMID: 28521627 DOI: 10.1177/1093526616686255] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Mendelian susceptibility to mycobacterial disease is a rare syndrome characterized by severe clinical infections usually caused by weakly virulent mycobacterial species such as Bacillus Calmette-Guérin vaccines and environmental nontuberculous mycobacteria or more virulent mycobacteria as mycobacterium tuberculosis. Since 1996, 9 genes including 7 autosomal ( STAT1, IFNGR1, IFNGR2, IL12B, IL12RB1, ISG15, and IRF8) and 2 X-linked genes ( NEMO and CYBB) have been identified. Allelic heterogeneity leaded to recognize about 18 genetic diseases with variable clinical phenotypes, but sharing a same physiological mechanism represented by a defect in human IL-12-dependant-INF-γ-mediated immunity. We report here a case of multifocal Bacillus Calmette-Guérin osteomyelitis in a context Mendelian susceptibility to mycobacterial disease mimicking a metastatic neuroblastoma in a child presenting with delayed growth. The investigation of her twin sister showed the same disease. A heterozygous mutation in exon 22 of STAT1 gene was found in both sisters, another sister and the father being healthy and heterozygous for the same mutation.
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Affiliation(s)
- Sabah Boudjemaa
- 1 Hôpital d'Enfants Armand Trousseau, France.,2 Université Pierre et Marie Curie, Paris, France
| | - Linda Dainese
- 1 Hôpital d'Enfants Armand Trousseau, France.,2 Université Pierre et Marie Curie, Paris, France
| | | | | | - Samia Hachemane
- 1 Hôpital d'Enfants Armand Trousseau, France.,2 Université Pierre et Marie Curie, Paris, France
| | - Jean-Laurent Casanova
- 3 St. Giles Laboratory of Human Genetics of Infectious Diseases, The Rockefeller University, New York, NY, USA.,4 Laboratory of Human Genetics of Infectious Diseases, Institut National de la Santé et de la Recherche Médicale, Paris, France.,5 Paris Descartes University, Imagine Institute, Paris, France.,6 Howard Hughes Medical Institute, New York, USA.,7 Pediatric Hematology-Immunology Unit, Necker Hospital for Sick Children, Paris, France
| | - Aurore Coulomb
- 1 Hôpital d'Enfants Armand Trousseau, France.,2 Université Pierre et Marie Curie, Paris, France
| | - Jacinta Bustamante
- 4 Laboratory of Human Genetics of Infectious Diseases, Institut National de la Santé et de la Recherche Médicale, Paris, France.,5 Paris Descartes University, Imagine Institute, Paris, France.,6 Howard Hughes Medical Institute, New York, USA.,8 Center for the Study of Primary Immunodeficiencies, Necker Hospital for Sick Children, Paris, France
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Chagtai T, Zill C, Dainese L, Wegert J, Savola S, Popov S, Mifsud W, Vujanić G, Sebire N, Le Bouc Y, Ambros PF, Kager L, O'Sullivan MJ, Blaise A, Bergeron C, Mengelbier LH, Gisselsson D, Kool M, Tytgat GAM, van den Heuvel-Eibrink MM, Graf N, van Tinteren H, Coulomb A, Gessler M, Williams RD, Pritchard-Jones K. Gain of 1q As a Prognostic Biomarker in Wilms Tumors (WTs) Treated With Preoperative Chemotherapy in the International Society of Paediatric Oncology (SIOP) WT 2001 Trial: A SIOP Renal Tumours Biology Consortium Study. J Clin Oncol 2016; 34:3195-203. [PMID: 27432915 PMCID: PMC5505170 DOI: 10.1200/jco.2015.66.0001] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
PURPOSE Wilms tumor (WT) is the most common pediatric renal tumor. Treatment planning under International Society of Paediatric Oncology (SIOP) protocols is based on staging and histologic assessment of response to preoperative chemotherapy. Despite high overall survival (OS), many relapses occur in patients without specific risk factors, and many successfully treated patients are exposed to treatments with significant risks of late effects. To investigate whether molecular biomarkers could improve risk stratification, we assessed 1q status and other potential copy number biomarkers in a large WT series. MATERIALS AND METHODS WT nephrectomy samples from 586 SIOP WT 2001 patients were analyzed using a multiplex ligation-dependent probe amplification (MLPA) assay that measured the copy number of 1q and other regions of interest. RESULTS One hundred sixty-seven (28%) of 586 WTs had 1q gain. Five-year event-free survival (EFS) was 75.0% in patients with 1q gain (95% CI, 68.5% to 82.0%) and 88.2% in patients without gain (95% CI, 85.0% to 91.4%). OS was 88.4% with gain (95% CI, 83.5% to 93.6%) and 94.4% without gain (95% CI, 92.1% to 96.7%). In univariable analysis, 1q gain was associated with poorer EFS (P < .001; hazard ratio, 2.33) and OS (P = .01; hazard ratio, 2.16). The association of 1q gain with poorer EFS retained significance in multivariable analysis adjusted for 1p and 16q loss, sex, stage, age, and histologic risk group. Gain of 1q remained associated with poorer EFS in tumor subsets limited to either intermediate-risk localized disease or nonanaplastic localized disease. Other notable aberrations associated with poorer EFS included MYCN gain and TP53 loss. CONCLUSION Gain of 1q is a potentially valuable prognostic biomarker in WT, in addition to histologic response to preoperative chemotherapy and tumor stage.
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Affiliation(s)
- Tasnim Chagtai
- Tasnim Chagtai, William Mifsud, Neil Sebire, Richard Dafydd Williams, and Kathy Pritchard-Jones, University College London Institute of Child Health, London; Sergey Popov, University Hospital of Wales; Gordan Vujanić, Cardiff University School of Medicine, Cardiff, United Kingdom; Christina Zill, Jenny Wegert, and Manfred Gessler, Wuerzburg University, Wuerzburg; Marcel Kool, German Cancer Research Center, Heidelberg; Norbert Graf, Saarland University Hospital, Homburg, Germany; Linda Dainese, Yves Le Bouc, Annick Blaise, and Aurore Coulomb, Sorbonne Universités; Linda Dainese, Yves Le Bouc, and Aurore Coulomb, Assistance Publique Hôpitaux de Paris-Hôpital Armand Trousseau, Paris; Christophe Bergeron, Centre Léon Bérard, Lyon, France; Suvi Savola, MRC-Holland; Harm van Tinteren, Netherlands Cancer Institute, Amsterdam; Godelieve A.M. Tytgat and Marry M. van den Heuvel-Eibrink, Princess Maxima Center for Pediatric Oncology/Hematology, Utrecht, the Netherlands; Peter F. Ambros and Leo Kager, Children's Cancer Research Institute; Leo Kager, St Anna Children's Hospital, Vienna, Austria; Maureen J. O'Sullivan, Our Lady's Children's Hospital, Dublin, Ireland; and Linda Holmquist Mengelbier and David Gisselsson, Lund University, Lund, Sweden
| | - Christina Zill
- Tasnim Chagtai, William Mifsud, Neil Sebire, Richard Dafydd Williams, and Kathy Pritchard-Jones, University College London Institute of Child Health, London; Sergey Popov, University Hospital of Wales; Gordan Vujanić, Cardiff University School of Medicine, Cardiff, United Kingdom; Christina Zill, Jenny Wegert, and Manfred Gessler, Wuerzburg University, Wuerzburg; Marcel Kool, German Cancer Research Center, Heidelberg; Norbert Graf, Saarland University Hospital, Homburg, Germany; Linda Dainese, Yves Le Bouc, Annick Blaise, and Aurore Coulomb, Sorbonne Universités; Linda Dainese, Yves Le Bouc, and Aurore Coulomb, Assistance Publique Hôpitaux de Paris-Hôpital Armand Trousseau, Paris; Christophe Bergeron, Centre Léon Bérard, Lyon, France; Suvi Savola, MRC-Holland; Harm van Tinteren, Netherlands Cancer Institute, Amsterdam; Godelieve A.M. Tytgat and Marry M. van den Heuvel-Eibrink, Princess Maxima Center for Pediatric Oncology/Hematology, Utrecht, the Netherlands; Peter F. Ambros and Leo Kager, Children's Cancer Research Institute; Leo Kager, St Anna Children's Hospital, Vienna, Austria; Maureen J. O'Sullivan, Our Lady's Children's Hospital, Dublin, Ireland; and Linda Holmquist Mengelbier and David Gisselsson, Lund University, Lund, Sweden
| | - Linda Dainese
- Tasnim Chagtai, William Mifsud, Neil Sebire, Richard Dafydd Williams, and Kathy Pritchard-Jones, University College London Institute of Child Health, London; Sergey Popov, University Hospital of Wales; Gordan Vujanić, Cardiff University School of Medicine, Cardiff, United Kingdom; Christina Zill, Jenny Wegert, and Manfred Gessler, Wuerzburg University, Wuerzburg; Marcel Kool, German Cancer Research Center, Heidelberg; Norbert Graf, Saarland University Hospital, Homburg, Germany; Linda Dainese, Yves Le Bouc, Annick Blaise, and Aurore Coulomb, Sorbonne Universités; Linda Dainese, Yves Le Bouc, and Aurore Coulomb, Assistance Publique Hôpitaux de Paris-Hôpital Armand Trousseau, Paris; Christophe Bergeron, Centre Léon Bérard, Lyon, France; Suvi Savola, MRC-Holland; Harm van Tinteren, Netherlands Cancer Institute, Amsterdam; Godelieve A.M. Tytgat and Marry M. van den Heuvel-Eibrink, Princess Maxima Center for Pediatric Oncology/Hematology, Utrecht, the Netherlands; Peter F. Ambros and Leo Kager, Children's Cancer Research Institute; Leo Kager, St Anna Children's Hospital, Vienna, Austria; Maureen J. O'Sullivan, Our Lady's Children's Hospital, Dublin, Ireland; and Linda Holmquist Mengelbier and David Gisselsson, Lund University, Lund, Sweden
| | - Jenny Wegert
- Tasnim Chagtai, William Mifsud, Neil Sebire, Richard Dafydd Williams, and Kathy Pritchard-Jones, University College London Institute of Child Health, London; Sergey Popov, University Hospital of Wales; Gordan Vujanić, Cardiff University School of Medicine, Cardiff, United Kingdom; Christina Zill, Jenny Wegert, and Manfred Gessler, Wuerzburg University, Wuerzburg; Marcel Kool, German Cancer Research Center, Heidelberg; Norbert Graf, Saarland University Hospital, Homburg, Germany; Linda Dainese, Yves Le Bouc, Annick Blaise, and Aurore Coulomb, Sorbonne Universités; Linda Dainese, Yves Le Bouc, and Aurore Coulomb, Assistance Publique Hôpitaux de Paris-Hôpital Armand Trousseau, Paris; Christophe Bergeron, Centre Léon Bérard, Lyon, France; Suvi Savola, MRC-Holland; Harm van Tinteren, Netherlands Cancer Institute, Amsterdam; Godelieve A.M. Tytgat and Marry M. van den Heuvel-Eibrink, Princess Maxima Center for Pediatric Oncology/Hematology, Utrecht, the Netherlands; Peter F. Ambros and Leo Kager, Children's Cancer Research Institute; Leo Kager, St Anna Children's Hospital, Vienna, Austria; Maureen J. O'Sullivan, Our Lady's Children's Hospital, Dublin, Ireland; and Linda Holmquist Mengelbier and David Gisselsson, Lund University, Lund, Sweden
| | - Suvi Savola
- Tasnim Chagtai, William Mifsud, Neil Sebire, Richard Dafydd Williams, and Kathy Pritchard-Jones, University College London Institute of Child Health, London; Sergey Popov, University Hospital of Wales; Gordan Vujanić, Cardiff University School of Medicine, Cardiff, United Kingdom; Christina Zill, Jenny Wegert, and Manfred Gessler, Wuerzburg University, Wuerzburg; Marcel Kool, German Cancer Research Center, Heidelberg; Norbert Graf, Saarland University Hospital, Homburg, Germany; Linda Dainese, Yves Le Bouc, Annick Blaise, and Aurore Coulomb, Sorbonne Universités; Linda Dainese, Yves Le Bouc, and Aurore Coulomb, Assistance Publique Hôpitaux de Paris-Hôpital Armand Trousseau, Paris; Christophe Bergeron, Centre Léon Bérard, Lyon, France; Suvi Savola, MRC-Holland; Harm van Tinteren, Netherlands Cancer Institute, Amsterdam; Godelieve A.M. Tytgat and Marry M. van den Heuvel-Eibrink, Princess Maxima Center for Pediatric Oncology/Hematology, Utrecht, the Netherlands; Peter F. Ambros and Leo Kager, Children's Cancer Research Institute; Leo Kager, St Anna Children's Hospital, Vienna, Austria; Maureen J. O'Sullivan, Our Lady's Children's Hospital, Dublin, Ireland; and Linda Holmquist Mengelbier and David Gisselsson, Lund University, Lund, Sweden
| | - Sergey Popov
- Tasnim Chagtai, William Mifsud, Neil Sebire, Richard Dafydd Williams, and Kathy Pritchard-Jones, University College London Institute of Child Health, London; Sergey Popov, University Hospital of Wales; Gordan Vujanić, Cardiff University School of Medicine, Cardiff, United Kingdom; Christina Zill, Jenny Wegert, and Manfred Gessler, Wuerzburg University, Wuerzburg; Marcel Kool, German Cancer Research Center, Heidelberg; Norbert Graf, Saarland University Hospital, Homburg, Germany; Linda Dainese, Yves Le Bouc, Annick Blaise, and Aurore Coulomb, Sorbonne Universités; Linda Dainese, Yves Le Bouc, and Aurore Coulomb, Assistance Publique Hôpitaux de Paris-Hôpital Armand Trousseau, Paris; Christophe Bergeron, Centre Léon Bérard, Lyon, France; Suvi Savola, MRC-Holland; Harm van Tinteren, Netherlands Cancer Institute, Amsterdam; Godelieve A.M. Tytgat and Marry M. van den Heuvel-Eibrink, Princess Maxima Center for Pediatric Oncology/Hematology, Utrecht, the Netherlands; Peter F. Ambros and Leo Kager, Children's Cancer Research Institute; Leo Kager, St Anna Children's Hospital, Vienna, Austria; Maureen J. O'Sullivan, Our Lady's Children's Hospital, Dublin, Ireland; and Linda Holmquist Mengelbier and David Gisselsson, Lund University, Lund, Sweden
| | - William Mifsud
- Tasnim Chagtai, William Mifsud, Neil Sebire, Richard Dafydd Williams, and Kathy Pritchard-Jones, University College London Institute of Child Health, London; Sergey Popov, University Hospital of Wales; Gordan Vujanić, Cardiff University School of Medicine, Cardiff, United Kingdom; Christina Zill, Jenny Wegert, and Manfred Gessler, Wuerzburg University, Wuerzburg; Marcel Kool, German Cancer Research Center, Heidelberg; Norbert Graf, Saarland University Hospital, Homburg, Germany; Linda Dainese, Yves Le Bouc, Annick Blaise, and Aurore Coulomb, Sorbonne Universités; Linda Dainese, Yves Le Bouc, and Aurore Coulomb, Assistance Publique Hôpitaux de Paris-Hôpital Armand Trousseau, Paris; Christophe Bergeron, Centre Léon Bérard, Lyon, France; Suvi Savola, MRC-Holland; Harm van Tinteren, Netherlands Cancer Institute, Amsterdam; Godelieve A.M. Tytgat and Marry M. van den Heuvel-Eibrink, Princess Maxima Center for Pediatric Oncology/Hematology, Utrecht, the Netherlands; Peter F. Ambros and Leo Kager, Children's Cancer Research Institute; Leo Kager, St Anna Children's Hospital, Vienna, Austria; Maureen J. O'Sullivan, Our Lady's Children's Hospital, Dublin, Ireland; and Linda Holmquist Mengelbier and David Gisselsson, Lund University, Lund, Sweden
| | - Gordan Vujanić
- Tasnim Chagtai, William Mifsud, Neil Sebire, Richard Dafydd Williams, and Kathy Pritchard-Jones, University College London Institute of Child Health, London; Sergey Popov, University Hospital of Wales; Gordan Vujanić, Cardiff University School of Medicine, Cardiff, United Kingdom; Christina Zill, Jenny Wegert, and Manfred Gessler, Wuerzburg University, Wuerzburg; Marcel Kool, German Cancer Research Center, Heidelberg; Norbert Graf, Saarland University Hospital, Homburg, Germany; Linda Dainese, Yves Le Bouc, Annick Blaise, and Aurore Coulomb, Sorbonne Universités; Linda Dainese, Yves Le Bouc, and Aurore Coulomb, Assistance Publique Hôpitaux de Paris-Hôpital Armand Trousseau, Paris; Christophe Bergeron, Centre Léon Bérard, Lyon, France; Suvi Savola, MRC-Holland; Harm van Tinteren, Netherlands Cancer Institute, Amsterdam; Godelieve A.M. Tytgat and Marry M. van den Heuvel-Eibrink, Princess Maxima Center for Pediatric Oncology/Hematology, Utrecht, the Netherlands; Peter F. Ambros and Leo Kager, Children's Cancer Research Institute; Leo Kager, St Anna Children's Hospital, Vienna, Austria; Maureen J. O'Sullivan, Our Lady's Children's Hospital, Dublin, Ireland; and Linda Holmquist Mengelbier and David Gisselsson, Lund University, Lund, Sweden
| | - Neil Sebire
- Tasnim Chagtai, William Mifsud, Neil Sebire, Richard Dafydd Williams, and Kathy Pritchard-Jones, University College London Institute of Child Health, London; Sergey Popov, University Hospital of Wales; Gordan Vujanić, Cardiff University School of Medicine, Cardiff, United Kingdom; Christina Zill, Jenny Wegert, and Manfred Gessler, Wuerzburg University, Wuerzburg; Marcel Kool, German Cancer Research Center, Heidelberg; Norbert Graf, Saarland University Hospital, Homburg, Germany; Linda Dainese, Yves Le Bouc, Annick Blaise, and Aurore Coulomb, Sorbonne Universités; Linda Dainese, Yves Le Bouc, and Aurore Coulomb, Assistance Publique Hôpitaux de Paris-Hôpital Armand Trousseau, Paris; Christophe Bergeron, Centre Léon Bérard, Lyon, France; Suvi Savola, MRC-Holland; Harm van Tinteren, Netherlands Cancer Institute, Amsterdam; Godelieve A.M. Tytgat and Marry M. van den Heuvel-Eibrink, Princess Maxima Center for Pediatric Oncology/Hematology, Utrecht, the Netherlands; Peter F. Ambros and Leo Kager, Children's Cancer Research Institute; Leo Kager, St Anna Children's Hospital, Vienna, Austria; Maureen J. O'Sullivan, Our Lady's Children's Hospital, Dublin, Ireland; and Linda Holmquist Mengelbier and David Gisselsson, Lund University, Lund, Sweden
| | - Yves Le Bouc
- Tasnim Chagtai, William Mifsud, Neil Sebire, Richard Dafydd Williams, and Kathy Pritchard-Jones, University College London Institute of Child Health, London; Sergey Popov, University Hospital of Wales; Gordan Vujanić, Cardiff University School of Medicine, Cardiff, United Kingdom; Christina Zill, Jenny Wegert, and Manfred Gessler, Wuerzburg University, Wuerzburg; Marcel Kool, German Cancer Research Center, Heidelberg; Norbert Graf, Saarland University Hospital, Homburg, Germany; Linda Dainese, Yves Le Bouc, Annick Blaise, and Aurore Coulomb, Sorbonne Universités; Linda Dainese, Yves Le Bouc, and Aurore Coulomb, Assistance Publique Hôpitaux de Paris-Hôpital Armand Trousseau, Paris; Christophe Bergeron, Centre Léon Bérard, Lyon, France; Suvi Savola, MRC-Holland; Harm van Tinteren, Netherlands Cancer Institute, Amsterdam; Godelieve A.M. Tytgat and Marry M. van den Heuvel-Eibrink, Princess Maxima Center for Pediatric Oncology/Hematology, Utrecht, the Netherlands; Peter F. Ambros and Leo Kager, Children's Cancer Research Institute; Leo Kager, St Anna Children's Hospital, Vienna, Austria; Maureen J. O'Sullivan, Our Lady's Children's Hospital, Dublin, Ireland; and Linda Holmquist Mengelbier and David Gisselsson, Lund University, Lund, Sweden
| | - Peter F Ambros
- Tasnim Chagtai, William Mifsud, Neil Sebire, Richard Dafydd Williams, and Kathy Pritchard-Jones, University College London Institute of Child Health, London; Sergey Popov, University Hospital of Wales; Gordan Vujanić, Cardiff University School of Medicine, Cardiff, United Kingdom; Christina Zill, Jenny Wegert, and Manfred Gessler, Wuerzburg University, Wuerzburg; Marcel Kool, German Cancer Research Center, Heidelberg; Norbert Graf, Saarland University Hospital, Homburg, Germany; Linda Dainese, Yves Le Bouc, Annick Blaise, and Aurore Coulomb, Sorbonne Universités; Linda Dainese, Yves Le Bouc, and Aurore Coulomb, Assistance Publique Hôpitaux de Paris-Hôpital Armand Trousseau, Paris; Christophe Bergeron, Centre Léon Bérard, Lyon, France; Suvi Savola, MRC-Holland; Harm van Tinteren, Netherlands Cancer Institute, Amsterdam; Godelieve A.M. Tytgat and Marry M. van den Heuvel-Eibrink, Princess Maxima Center for Pediatric Oncology/Hematology, Utrecht, the Netherlands; Peter F. Ambros and Leo Kager, Children's Cancer Research Institute; Leo Kager, St Anna Children's Hospital, Vienna, Austria; Maureen J. O'Sullivan, Our Lady's Children's Hospital, Dublin, Ireland; and Linda Holmquist Mengelbier and David Gisselsson, Lund University, Lund, Sweden
| | - Leo Kager
- Tasnim Chagtai, William Mifsud, Neil Sebire, Richard Dafydd Williams, and Kathy Pritchard-Jones, University College London Institute of Child Health, London; Sergey Popov, University Hospital of Wales; Gordan Vujanić, Cardiff University School of Medicine, Cardiff, United Kingdom; Christina Zill, Jenny Wegert, and Manfred Gessler, Wuerzburg University, Wuerzburg; Marcel Kool, German Cancer Research Center, Heidelberg; Norbert Graf, Saarland University Hospital, Homburg, Germany; Linda Dainese, Yves Le Bouc, Annick Blaise, and Aurore Coulomb, Sorbonne Universités; Linda Dainese, Yves Le Bouc, and Aurore Coulomb, Assistance Publique Hôpitaux de Paris-Hôpital Armand Trousseau, Paris; Christophe Bergeron, Centre Léon Bérard, Lyon, France; Suvi Savola, MRC-Holland; Harm van Tinteren, Netherlands Cancer Institute, Amsterdam; Godelieve A.M. Tytgat and Marry M. van den Heuvel-Eibrink, Princess Maxima Center for Pediatric Oncology/Hematology, Utrecht, the Netherlands; Peter F. Ambros and Leo Kager, Children's Cancer Research Institute; Leo Kager, St Anna Children's Hospital, Vienna, Austria; Maureen J. O'Sullivan, Our Lady's Children's Hospital, Dublin, Ireland; and Linda Holmquist Mengelbier and David Gisselsson, Lund University, Lund, Sweden
| | - Maureen J O'Sullivan
- Tasnim Chagtai, William Mifsud, Neil Sebire, Richard Dafydd Williams, and Kathy Pritchard-Jones, University College London Institute of Child Health, London; Sergey Popov, University Hospital of Wales; Gordan Vujanić, Cardiff University School of Medicine, Cardiff, United Kingdom; Christina Zill, Jenny Wegert, and Manfred Gessler, Wuerzburg University, Wuerzburg; Marcel Kool, German Cancer Research Center, Heidelberg; Norbert Graf, Saarland University Hospital, Homburg, Germany; Linda Dainese, Yves Le Bouc, Annick Blaise, and Aurore Coulomb, Sorbonne Universités; Linda Dainese, Yves Le Bouc, and Aurore Coulomb, Assistance Publique Hôpitaux de Paris-Hôpital Armand Trousseau, Paris; Christophe Bergeron, Centre Léon Bérard, Lyon, France; Suvi Savola, MRC-Holland; Harm van Tinteren, Netherlands Cancer Institute, Amsterdam; Godelieve A.M. Tytgat and Marry M. van den Heuvel-Eibrink, Princess Maxima Center for Pediatric Oncology/Hematology, Utrecht, the Netherlands; Peter F. Ambros and Leo Kager, Children's Cancer Research Institute; Leo Kager, St Anna Children's Hospital, Vienna, Austria; Maureen J. O'Sullivan, Our Lady's Children's Hospital, Dublin, Ireland; and Linda Holmquist Mengelbier and David Gisselsson, Lund University, Lund, Sweden
| | - Annick Blaise
- Tasnim Chagtai, William Mifsud, Neil Sebire, Richard Dafydd Williams, and Kathy Pritchard-Jones, University College London Institute of Child Health, London; Sergey Popov, University Hospital of Wales; Gordan Vujanić, Cardiff University School of Medicine, Cardiff, United Kingdom; Christina Zill, Jenny Wegert, and Manfred Gessler, Wuerzburg University, Wuerzburg; Marcel Kool, German Cancer Research Center, Heidelberg; Norbert Graf, Saarland University Hospital, Homburg, Germany; Linda Dainese, Yves Le Bouc, Annick Blaise, and Aurore Coulomb, Sorbonne Universités; Linda Dainese, Yves Le Bouc, and Aurore Coulomb, Assistance Publique Hôpitaux de Paris-Hôpital Armand Trousseau, Paris; Christophe Bergeron, Centre Léon Bérard, Lyon, France; Suvi Savola, MRC-Holland; Harm van Tinteren, Netherlands Cancer Institute, Amsterdam; Godelieve A.M. Tytgat and Marry M. van den Heuvel-Eibrink, Princess Maxima Center for Pediatric Oncology/Hematology, Utrecht, the Netherlands; Peter F. Ambros and Leo Kager, Children's Cancer Research Institute; Leo Kager, St Anna Children's Hospital, Vienna, Austria; Maureen J. O'Sullivan, Our Lady's Children's Hospital, Dublin, Ireland; and Linda Holmquist Mengelbier and David Gisselsson, Lund University, Lund, Sweden
| | - Christophe Bergeron
- Tasnim Chagtai, William Mifsud, Neil Sebire, Richard Dafydd Williams, and Kathy Pritchard-Jones, University College London Institute of Child Health, London; Sergey Popov, University Hospital of Wales; Gordan Vujanić, Cardiff University School of Medicine, Cardiff, United Kingdom; Christina Zill, Jenny Wegert, and Manfred Gessler, Wuerzburg University, Wuerzburg; Marcel Kool, German Cancer Research Center, Heidelberg; Norbert Graf, Saarland University Hospital, Homburg, Germany; Linda Dainese, Yves Le Bouc, Annick Blaise, and Aurore Coulomb, Sorbonne Universités; Linda Dainese, Yves Le Bouc, and Aurore Coulomb, Assistance Publique Hôpitaux de Paris-Hôpital Armand Trousseau, Paris; Christophe Bergeron, Centre Léon Bérard, Lyon, France; Suvi Savola, MRC-Holland; Harm van Tinteren, Netherlands Cancer Institute, Amsterdam; Godelieve A.M. Tytgat and Marry M. van den Heuvel-Eibrink, Princess Maxima Center for Pediatric Oncology/Hematology, Utrecht, the Netherlands; Peter F. Ambros and Leo Kager, Children's Cancer Research Institute; Leo Kager, St Anna Children's Hospital, Vienna, Austria; Maureen J. O'Sullivan, Our Lady's Children's Hospital, Dublin, Ireland; and Linda Holmquist Mengelbier and David Gisselsson, Lund University, Lund, Sweden
| | - Linda Holmquist Mengelbier
- Tasnim Chagtai, William Mifsud, Neil Sebire, Richard Dafydd Williams, and Kathy Pritchard-Jones, University College London Institute of Child Health, London; Sergey Popov, University Hospital of Wales; Gordan Vujanić, Cardiff University School of Medicine, Cardiff, United Kingdom; Christina Zill, Jenny Wegert, and Manfred Gessler, Wuerzburg University, Wuerzburg; Marcel Kool, German Cancer Research Center, Heidelberg; Norbert Graf, Saarland University Hospital, Homburg, Germany; Linda Dainese, Yves Le Bouc, Annick Blaise, and Aurore Coulomb, Sorbonne Universités; Linda Dainese, Yves Le Bouc, and Aurore Coulomb, Assistance Publique Hôpitaux de Paris-Hôpital Armand Trousseau, Paris; Christophe Bergeron, Centre Léon Bérard, Lyon, France; Suvi Savola, MRC-Holland; Harm van Tinteren, Netherlands Cancer Institute, Amsterdam; Godelieve A.M. Tytgat and Marry M. van den Heuvel-Eibrink, Princess Maxima Center for Pediatric Oncology/Hematology, Utrecht, the Netherlands; Peter F. Ambros and Leo Kager, Children's Cancer Research Institute; Leo Kager, St Anna Children's Hospital, Vienna, Austria; Maureen J. O'Sullivan, Our Lady's Children's Hospital, Dublin, Ireland; and Linda Holmquist Mengelbier and David Gisselsson, Lund University, Lund, Sweden
| | - David Gisselsson
- Tasnim Chagtai, William Mifsud, Neil Sebire, Richard Dafydd Williams, and Kathy Pritchard-Jones, University College London Institute of Child Health, London; Sergey Popov, University Hospital of Wales; Gordan Vujanić, Cardiff University School of Medicine, Cardiff, United Kingdom; Christina Zill, Jenny Wegert, and Manfred Gessler, Wuerzburg University, Wuerzburg; Marcel Kool, German Cancer Research Center, Heidelberg; Norbert Graf, Saarland University Hospital, Homburg, Germany; Linda Dainese, Yves Le Bouc, Annick Blaise, and Aurore Coulomb, Sorbonne Universités; Linda Dainese, Yves Le Bouc, and Aurore Coulomb, Assistance Publique Hôpitaux de Paris-Hôpital Armand Trousseau, Paris; Christophe Bergeron, Centre Léon Bérard, Lyon, France; Suvi Savola, MRC-Holland; Harm van Tinteren, Netherlands Cancer Institute, Amsterdam; Godelieve A.M. Tytgat and Marry M. van den Heuvel-Eibrink, Princess Maxima Center for Pediatric Oncology/Hematology, Utrecht, the Netherlands; Peter F. Ambros and Leo Kager, Children's Cancer Research Institute; Leo Kager, St Anna Children's Hospital, Vienna, Austria; Maureen J. O'Sullivan, Our Lady's Children's Hospital, Dublin, Ireland; and Linda Holmquist Mengelbier and David Gisselsson, Lund University, Lund, Sweden
| | - Marcel Kool
- Tasnim Chagtai, William Mifsud, Neil Sebire, Richard Dafydd Williams, and Kathy Pritchard-Jones, University College London Institute of Child Health, London; Sergey Popov, University Hospital of Wales; Gordan Vujanić, Cardiff University School of Medicine, Cardiff, United Kingdom; Christina Zill, Jenny Wegert, and Manfred Gessler, Wuerzburg University, Wuerzburg; Marcel Kool, German Cancer Research Center, Heidelberg; Norbert Graf, Saarland University Hospital, Homburg, Germany; Linda Dainese, Yves Le Bouc, Annick Blaise, and Aurore Coulomb, Sorbonne Universités; Linda Dainese, Yves Le Bouc, and Aurore Coulomb, Assistance Publique Hôpitaux de Paris-Hôpital Armand Trousseau, Paris; Christophe Bergeron, Centre Léon Bérard, Lyon, France; Suvi Savola, MRC-Holland; Harm van Tinteren, Netherlands Cancer Institute, Amsterdam; Godelieve A.M. Tytgat and Marry M. van den Heuvel-Eibrink, Princess Maxima Center for Pediatric Oncology/Hematology, Utrecht, the Netherlands; Peter F. Ambros and Leo Kager, Children's Cancer Research Institute; Leo Kager, St Anna Children's Hospital, Vienna, Austria; Maureen J. O'Sullivan, Our Lady's Children's Hospital, Dublin, Ireland; and Linda Holmquist Mengelbier and David Gisselsson, Lund University, Lund, Sweden
| | - Godelieve A M Tytgat
- Tasnim Chagtai, William Mifsud, Neil Sebire, Richard Dafydd Williams, and Kathy Pritchard-Jones, University College London Institute of Child Health, London; Sergey Popov, University Hospital of Wales; Gordan Vujanić, Cardiff University School of Medicine, Cardiff, United Kingdom; Christina Zill, Jenny Wegert, and Manfred Gessler, Wuerzburg University, Wuerzburg; Marcel Kool, German Cancer Research Center, Heidelberg; Norbert Graf, Saarland University Hospital, Homburg, Germany; Linda Dainese, Yves Le Bouc, Annick Blaise, and Aurore Coulomb, Sorbonne Universités; Linda Dainese, Yves Le Bouc, and Aurore Coulomb, Assistance Publique Hôpitaux de Paris-Hôpital Armand Trousseau, Paris; Christophe Bergeron, Centre Léon Bérard, Lyon, France; Suvi Savola, MRC-Holland; Harm van Tinteren, Netherlands Cancer Institute, Amsterdam; Godelieve A.M. Tytgat and Marry M. van den Heuvel-Eibrink, Princess Maxima Center for Pediatric Oncology/Hematology, Utrecht, the Netherlands; Peter F. Ambros and Leo Kager, Children's Cancer Research Institute; Leo Kager, St Anna Children's Hospital, Vienna, Austria; Maureen J. O'Sullivan, Our Lady's Children's Hospital, Dublin, Ireland; and Linda Holmquist Mengelbier and David Gisselsson, Lund University, Lund, Sweden
| | - Marry M van den Heuvel-Eibrink
- Tasnim Chagtai, William Mifsud, Neil Sebire, Richard Dafydd Williams, and Kathy Pritchard-Jones, University College London Institute of Child Health, London; Sergey Popov, University Hospital of Wales; Gordan Vujanić, Cardiff University School of Medicine, Cardiff, United Kingdom; Christina Zill, Jenny Wegert, and Manfred Gessler, Wuerzburg University, Wuerzburg; Marcel Kool, German Cancer Research Center, Heidelberg; Norbert Graf, Saarland University Hospital, Homburg, Germany; Linda Dainese, Yves Le Bouc, Annick Blaise, and Aurore Coulomb, Sorbonne Universités; Linda Dainese, Yves Le Bouc, and Aurore Coulomb, Assistance Publique Hôpitaux de Paris-Hôpital Armand Trousseau, Paris; Christophe Bergeron, Centre Léon Bérard, Lyon, France; Suvi Savola, MRC-Holland; Harm van Tinteren, Netherlands Cancer Institute, Amsterdam; Godelieve A.M. Tytgat and Marry M. van den Heuvel-Eibrink, Princess Maxima Center for Pediatric Oncology/Hematology, Utrecht, the Netherlands; Peter F. Ambros and Leo Kager, Children's Cancer Research Institute; Leo Kager, St Anna Children's Hospital, Vienna, Austria; Maureen J. O'Sullivan, Our Lady's Children's Hospital, Dublin, Ireland; and Linda Holmquist Mengelbier and David Gisselsson, Lund University, Lund, Sweden
| | - Norbert Graf
- Tasnim Chagtai, William Mifsud, Neil Sebire, Richard Dafydd Williams, and Kathy Pritchard-Jones, University College London Institute of Child Health, London; Sergey Popov, University Hospital of Wales; Gordan Vujanić, Cardiff University School of Medicine, Cardiff, United Kingdom; Christina Zill, Jenny Wegert, and Manfred Gessler, Wuerzburg University, Wuerzburg; Marcel Kool, German Cancer Research Center, Heidelberg; Norbert Graf, Saarland University Hospital, Homburg, Germany; Linda Dainese, Yves Le Bouc, Annick Blaise, and Aurore Coulomb, Sorbonne Universités; Linda Dainese, Yves Le Bouc, and Aurore Coulomb, Assistance Publique Hôpitaux de Paris-Hôpital Armand Trousseau, Paris; Christophe Bergeron, Centre Léon Bérard, Lyon, France; Suvi Savola, MRC-Holland; Harm van Tinteren, Netherlands Cancer Institute, Amsterdam; Godelieve A.M. Tytgat and Marry M. van den Heuvel-Eibrink, Princess Maxima Center for Pediatric Oncology/Hematology, Utrecht, the Netherlands; Peter F. Ambros and Leo Kager, Children's Cancer Research Institute; Leo Kager, St Anna Children's Hospital, Vienna, Austria; Maureen J. O'Sullivan, Our Lady's Children's Hospital, Dublin, Ireland; and Linda Holmquist Mengelbier and David Gisselsson, Lund University, Lund, Sweden
| | - Harm van Tinteren
- Tasnim Chagtai, William Mifsud, Neil Sebire, Richard Dafydd Williams, and Kathy Pritchard-Jones, University College London Institute of Child Health, London; Sergey Popov, University Hospital of Wales; Gordan Vujanić, Cardiff University School of Medicine, Cardiff, United Kingdom; Christina Zill, Jenny Wegert, and Manfred Gessler, Wuerzburg University, Wuerzburg; Marcel Kool, German Cancer Research Center, Heidelberg; Norbert Graf, Saarland University Hospital, Homburg, Germany; Linda Dainese, Yves Le Bouc, Annick Blaise, and Aurore Coulomb, Sorbonne Universités; Linda Dainese, Yves Le Bouc, and Aurore Coulomb, Assistance Publique Hôpitaux de Paris-Hôpital Armand Trousseau, Paris; Christophe Bergeron, Centre Léon Bérard, Lyon, France; Suvi Savola, MRC-Holland; Harm van Tinteren, Netherlands Cancer Institute, Amsterdam; Godelieve A.M. Tytgat and Marry M. van den Heuvel-Eibrink, Princess Maxima Center for Pediatric Oncology/Hematology, Utrecht, the Netherlands; Peter F. Ambros and Leo Kager, Children's Cancer Research Institute; Leo Kager, St Anna Children's Hospital, Vienna, Austria; Maureen J. O'Sullivan, Our Lady's Children's Hospital, Dublin, Ireland; and Linda Holmquist Mengelbier and David Gisselsson, Lund University, Lund, Sweden
| | - Aurore Coulomb
- Tasnim Chagtai, William Mifsud, Neil Sebire, Richard Dafydd Williams, and Kathy Pritchard-Jones, University College London Institute of Child Health, London; Sergey Popov, University Hospital of Wales; Gordan Vujanić, Cardiff University School of Medicine, Cardiff, United Kingdom; Christina Zill, Jenny Wegert, and Manfred Gessler, Wuerzburg University, Wuerzburg; Marcel Kool, German Cancer Research Center, Heidelberg; Norbert Graf, Saarland University Hospital, Homburg, Germany; Linda Dainese, Yves Le Bouc, Annick Blaise, and Aurore Coulomb, Sorbonne Universités; Linda Dainese, Yves Le Bouc, and Aurore Coulomb, Assistance Publique Hôpitaux de Paris-Hôpital Armand Trousseau, Paris; Christophe Bergeron, Centre Léon Bérard, Lyon, France; Suvi Savola, MRC-Holland; Harm van Tinteren, Netherlands Cancer Institute, Amsterdam; Godelieve A.M. Tytgat and Marry M. van den Heuvel-Eibrink, Princess Maxima Center for Pediatric Oncology/Hematology, Utrecht, the Netherlands; Peter F. Ambros and Leo Kager, Children's Cancer Research Institute; Leo Kager, St Anna Children's Hospital, Vienna, Austria; Maureen J. O'Sullivan, Our Lady's Children's Hospital, Dublin, Ireland; and Linda Holmquist Mengelbier and David Gisselsson, Lund University, Lund, Sweden
| | - Manfred Gessler
- Tasnim Chagtai, William Mifsud, Neil Sebire, Richard Dafydd Williams, and Kathy Pritchard-Jones, University College London Institute of Child Health, London; Sergey Popov, University Hospital of Wales; Gordan Vujanić, Cardiff University School of Medicine, Cardiff, United Kingdom; Christina Zill, Jenny Wegert, and Manfred Gessler, Wuerzburg University, Wuerzburg; Marcel Kool, German Cancer Research Center, Heidelberg; Norbert Graf, Saarland University Hospital, Homburg, Germany; Linda Dainese, Yves Le Bouc, Annick Blaise, and Aurore Coulomb, Sorbonne Universités; Linda Dainese, Yves Le Bouc, and Aurore Coulomb, Assistance Publique Hôpitaux de Paris-Hôpital Armand Trousseau, Paris; Christophe Bergeron, Centre Léon Bérard, Lyon, France; Suvi Savola, MRC-Holland; Harm van Tinteren, Netherlands Cancer Institute, Amsterdam; Godelieve A.M. Tytgat and Marry M. van den Heuvel-Eibrink, Princess Maxima Center for Pediatric Oncology/Hematology, Utrecht, the Netherlands; Peter F. Ambros and Leo Kager, Children's Cancer Research Institute; Leo Kager, St Anna Children's Hospital, Vienna, Austria; Maureen J. O'Sullivan, Our Lady's Children's Hospital, Dublin, Ireland; and Linda Holmquist Mengelbier and David Gisselsson, Lund University, Lund, Sweden
| | - Richard Dafydd Williams
- Tasnim Chagtai, William Mifsud, Neil Sebire, Richard Dafydd Williams, and Kathy Pritchard-Jones, University College London Institute of Child Health, London; Sergey Popov, University Hospital of Wales; Gordan Vujanić, Cardiff University School of Medicine, Cardiff, United Kingdom; Christina Zill, Jenny Wegert, and Manfred Gessler, Wuerzburg University, Wuerzburg; Marcel Kool, German Cancer Research Center, Heidelberg; Norbert Graf, Saarland University Hospital, Homburg, Germany; Linda Dainese, Yves Le Bouc, Annick Blaise, and Aurore Coulomb, Sorbonne Universités; Linda Dainese, Yves Le Bouc, and Aurore Coulomb, Assistance Publique Hôpitaux de Paris-Hôpital Armand Trousseau, Paris; Christophe Bergeron, Centre Léon Bérard, Lyon, France; Suvi Savola, MRC-Holland; Harm van Tinteren, Netherlands Cancer Institute, Amsterdam; Godelieve A.M. Tytgat and Marry M. van den Heuvel-Eibrink, Princess Maxima Center for Pediatric Oncology/Hematology, Utrecht, the Netherlands; Peter F. Ambros and Leo Kager, Children's Cancer Research Institute; Leo Kager, St Anna Children's Hospital, Vienna, Austria; Maureen J. O'Sullivan, Our Lady's Children's Hospital, Dublin, Ireland; and Linda Holmquist Mengelbier and David Gisselsson, Lund University, Lund, Sweden
| | - Kathy Pritchard-Jones
- Tasnim Chagtai, William Mifsud, Neil Sebire, Richard Dafydd Williams, and Kathy Pritchard-Jones, University College London Institute of Child Health, London; Sergey Popov, University Hospital of Wales; Gordan Vujanić, Cardiff University School of Medicine, Cardiff, United Kingdom; Christina Zill, Jenny Wegert, and Manfred Gessler, Wuerzburg University, Wuerzburg; Marcel Kool, German Cancer Research Center, Heidelberg; Norbert Graf, Saarland University Hospital, Homburg, Germany; Linda Dainese, Yves Le Bouc, Annick Blaise, and Aurore Coulomb, Sorbonne Universités; Linda Dainese, Yves Le Bouc, and Aurore Coulomb, Assistance Publique Hôpitaux de Paris-Hôpital Armand Trousseau, Paris; Christophe Bergeron, Centre Léon Bérard, Lyon, France; Suvi Savola, MRC-Holland; Harm van Tinteren, Netherlands Cancer Institute, Amsterdam; Godelieve A.M. Tytgat and Marry M. van den Heuvel-Eibrink, Princess Maxima Center for Pediatric Oncology/Hematology, Utrecht, the Netherlands; Peter F. Ambros and Leo Kager, Children's Cancer Research Institute; Leo Kager, St Anna Children's Hospital, Vienna, Austria; Maureen J. O'Sullivan, Our Lady's Children's Hospital, Dublin, Ireland; and Linda Holmquist Mengelbier and David Gisselsson, Lund University, Lund, Sweden.
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8
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Scalabre A, Bergeron C, Brioude F, Dainese L, Cropet C, Coulomb L'hermine A, Pasqualini C, Auber F, Verschuur A, Schleiermacher G, Le Bouc Y, Audry G, Irtan S. Is Nephron Sparing Surgery Justified in Wilms Tumor With Beckwith-Wiedemann Syndrome or Isolated Hemihypertrophy? Pediatr Blood Cancer 2016; 63:1571-7. [PMID: 27228957 DOI: 10.1002/pbc.26073] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 04/28/2016] [Accepted: 04/29/2016] [Indexed: 01/13/2023]
Abstract
BACKGROUND Patients with Beckwith-Wiedemann syndrome (BWS) or isolated hemihypertrophy (HH) treated for a Wilms tumor (WT) carry an increased risk of developing metachronous lesion. There are no guidelines on precise indications for nephron sparing surgery (NSS) in unilateral WT (UWT). The objective of this retrospective study was to delineate the indications of NSS in patients with BWS/HH treated for WT and to evaluate their outcome. PROCEDURE All cases of BWS/HH treated for a WT according to SIOP protocols from 1980 to 2013 were reviewed. Patients were divided into two groups (G): isolated UWT (G1) and bilateral lesions (G2) with two subgroups: bilateral tumors suspected of malignancy (G2a), and unilateral tumor suspected of malignancy with contralateral nephroblastomatosis (G2b). RESULTS Forty-six patients were included (34 G1, three G2a, and nine G2b). Nine NSS and 25 total nephrectomies (TN) were performed in G1, two bilateral NSS and one NSS with contralateral TN in G2a, and eight NSS and one TN in G2b. The 3-year event-free survival was 92.3% (95% CI [77.9-97.5%]). One death occurred after a local relapse following a TN for a stage III stromal WT (G1) and another after a combined local and distant relapse following a NSS for a stage I diffuse anaplastic WT (G2b). There were two metachronous WT (4%), 3 years after a TN (G1) and 12 years after a NSS (G2b). CONCLUSIONS NSS is recommended in bilateral WT and may be an option in selected UWT patients with BWS/HH because it was not associated with an increased risk of local relapse.
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Affiliation(s)
- Aurélien Scalabre
- Sorbonne Universités, UPMC Univ Paris 06, APHP Hôpital Armand Trousseau, Pediatric Surgery, 75012 Paris, France
| | - Christophe Bergeron
- Institut d'Hématologie et d'Oncologie Pédiatrique, Department of Pediatrics, 690008 Lyon, France
| | - Frederic Brioude
- Universités, UPMC Univ Paris 06, Centre de Recherche St Antoine Inserm UMRS.938, APHP Hôpital Armand Trousseau Pediatric and Genetic Endocinology, 75012 Paris, France
| | - Linda Dainese
- Sorbonne Universités, UPMC Univ Paris 06, APHP Hôpital Armand Trousseau Pathology Department, Centre de Recherche St Antoine, Inserm UMRS.938, 75012 Paris, France
| | - Claire Cropet
- Université de Lyon - Centre Léon Bérard, Department of Statistics, 69008 Lyon, France
| | - Aurore Coulomb L'hermine
- Sorbonne Universités, UPMC Univ Paris 06, APHP Hôpital Armand Trousseau Pathology Department, Centre de Recherche St Antoine, Inserm UMRS.938, 75012 Paris, France
| | - Claudia Pasqualini
- Gustave Roussy Cancer Campus, Pediatric Oncology, 94800 Villejuif, France
| | - Frederic Auber
- Université de Bourgogne Franche-Comté, Laboratoire de Nanomédecine, Imagerie et Thérapeutique EA 4662, CHRU Besançon, Service de Chirurgie Pédiatrique, 25030 Besançon, France
| | - Arnauld Verschuur
- Department of Pediatric Hematology and Oncology, Hôpital de la Timone Enfant, 13005 Marseille, France
| | - Gudrun Schleiermacher
- Institut Curie, Paediatric oncology, 3 INSERM U830, Laboratoire de Génétique et Biologie des Cancers, 75005 Paris, France
| | - Yves Le Bouc
- Universités, UPMC Univ Paris 06, Centre de Recherche St Antoine Inserm UMRS.938, APHP Hôpital Armand Trousseau Pediatric and Genetic Endocinology, 75012 Paris, France
| | - Georges Audry
- Sorbonne Universités, UPMC Univ Paris 06, APHP Hôpital Armand Trousseau, Pediatric Surgery, 75012 Paris, France
| | - Sabine Irtan
- Sorbonne Universités, UPMC Univ Paris 06, APHP Hôpital Armand Trousseau Pediatric Surgery, Centre de Recherche St Antoine, Inserm UMRS.938, 75012 Paris, France
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9
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Kadlub N, Sessiecq Q, Dainese L, Joly A, Lehalle D, Marlin S, Badoual C, Galmiche L, Majoufre-Lefebvre C, Berdal A, Deckert M, Vazquez MP, Descroix V, Coudert AE, Picard A. Defining a new aggressiveness classification and using NFATc1 localization as a prognostic factor in cherubism. Hum Pathol 2016; 58:62-71. [PMID: 27498064 DOI: 10.1016/j.humpath.2016.07.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 07/16/2016] [Accepted: 07/17/2016] [Indexed: 10/21/2022]
Abstract
Cherubism is a rare genetic disease characterized by bilateral giant cell reparative granuloma of the jaws consisting of a fibrotic stroma with giant multinucleated cells (GMCs) and osteoclastic features. Cherubism severity is highly variable, and recurrence after surgery is the most important risk. Currently, there are no prognostic indicators. The aims of this study were to evaluate the osteoclastogenesis phenotype by histologic examination of nuclear factor of activated T cells 1 (NFATc1) localization and tartrate-resistant acid phosphatase (TRAP) activity and to correlate the results to disease aggressiveness to define prognostic indicators. Based on cherubism evolution 1 year after surgery, 3 classes of cherubism aggressiveness were identified: mild (group A), moderate (group B), and severe (group C). Histologically, in grade A and B cherubism lesions, GMCs were negative for both TRAP activity and NFATc1 nuclear localization. In contrast, in grade C cherubism lesions, GMCs were all positive for TRAP activity and NFATc1 nuclear localization and displayed osteoclast-like features. Other histopathologic findings were not different among the 3 groups. Our results establish that TRAP activity and NFTAc1 nuclear localization are associated with aggressive cherubism and therefore could be added to routine pathologic examination to aid in prognosis and management of the disease. The finding of NFATc1 nuclear localization in aggressive tumors supports the addition of anticalcineurin treatment to the therapeutic arsenal for cherubism.
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Affiliation(s)
- Natacha Kadlub
- INSERM, UMRS 1138, Centre de Recherche de Cordeliers, Molecular Oral Pathology, 75006 Paris, France; Université Paris Descartes, 75006 Paris, France; APHP, Necker Enfants Malades, Service de Chirurgie Maxillo-Faciale et Plastique, 75015 Paris, France; APHP, CRMR des Malformations Rares de la Face et de la Cavité Buccale, 75015 Paris, France.
| | - Quentin Sessiecq
- CHU de Bordeaux, Service de Chirurgie Maxillo-Faciale, 33000 Bordeaux, France
| | - Linda Dainese
- APHP, Hôpital Armand Trousseau, Service d'Anatomopathologie et Cytologie, 75012 Paris, France; Université Pierre et Marie Curie, 75005 Paris, France
| | - Aline Joly
- INSERM, UMRS 1138, Centre de Recherche de Cordeliers, Molecular Oral Pathology, 75006 Paris, France; Université Paris Descartes, 75006 Paris, France; APHP, Necker Enfants Malades, Service de Chirurgie Maxillo-Faciale et Plastique, 75015 Paris, France; APHP, CRMR des Malformations Rares de la Face et de la Cavité Buccale, 75015 Paris, France
| | | | - Sandrine Marlin
- APHP, Necker Enfants Malades, Service de Génétique, 75015 Paris, France
| | - Cecile Badoual
- Université Paris Descartes, 75006 Paris, France; APHP, Hôpital Européen Georges Pompidou, Service d'Anatomopathologie et Cytologie, 75015 Paris, France
| | - Louise Galmiche
- Université Paris Descartes, 75006 Paris, France; APHP, Necker Enfants Malades, Service d'Anatomopathologie et Cytologie, 75015 Paris, France
| | | | - Ariane Berdal
- INSERM, UMRS 1138, Centre de Recherche de Cordeliers, Molecular Oral Pathology, 75006 Paris, France; UFR Odontologie, Garancière, Université Paris Diderot, 75006 Paris, France
| | - Marcel Deckert
- INSERM, U1035, Université Nice Sophia-Antipolis, Microenvironment, Signaling and Cancer, 06000 Nice, France
| | - Marie-Paule Vazquez
- INSERM, UMRS 1138, Centre de Recherche de Cordeliers, Molecular Oral Pathology, 75006 Paris, France; Université Paris Descartes, 75006 Paris, France; APHP, Necker Enfants Malades, Service de Chirurgie Maxillo-Faciale et Plastique, 75015 Paris, France; APHP, CRMR des Malformations Rares de la Face et de la Cavité Buccale, 75015 Paris, France
| | - Vianney Descroix
- INSERM, UMRS 1138, Centre de Recherche de Cordeliers, Molecular Oral Pathology, 75006 Paris, France; UFR Odontologie, Garancière, Université Paris Diderot, 75006 Paris, France; APHP, Hôpital Pitié Salpétrière, Service d'Odontologie, 75013 Paris, France
| | - Amélie E Coudert
- INSERM, UMRS 1138, Centre de Recherche de Cordeliers, Molecular Oral Pathology, 75006 Paris, France; UFR Odontologie, Garancière, Université Paris Diderot, 75006 Paris, France
| | - Arnaud Picard
- INSERM, UMRS 1138, Centre de Recherche de Cordeliers, Molecular Oral Pathology, 75006 Paris, France; Université Paris Descartes, 75006 Paris, France; APHP, Necker Enfants Malades, Service de Chirurgie Maxillo-Faciale et Plastique, 75015 Paris, France; APHP, CRMR des Malformations Rares de la Face et de la Cavité Buccale, 75015 Paris, France
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10
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Malouf GG, Comperat E, Yao H, Mouawad R, Lindner V, Rioux-Leclercq N, Verkarre V, Leroy X, Dainese L, Classe M, Descotes JL, Barthelemy P, Yacoub M, Roupret M, Bernhard JC, Creighton CJ, Spano JP, Su X, Khayat D. Transcriptomic profiling of collecting duct carcinoma to reveal metabolic and immune aberrations. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.4572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | - Hui Yao
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | | | | | - Virginie Verkarre
- Hôpital Européen Georges Pompidou, University Paris V,, Paris, France
| | | | - Linda Dainese
- -HP, Hôpital Armand Trousseau, Department of Pathology, UPMC Univ Paris 06, Paris, France
| | - Marion Classe
- Hoopital Pitié-Salpêtrière, University Pierre and Marie Curie (Paris VI), Paris, France
| | | | | | - Mokrane Yacoub
- Department of Pathology Bordeaux University hospital, Bordeaux, France
| | - Morgan Roupret
- Groupe Hospitalier Pitié-Salpêtrière, Department of Urology, Paris, France
| | | | | | | | - Xiaoping Su
- The University of Texas MD Anderson Cancer Center, Houston, TX
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11
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Chagtai T, Zill C, Dainese L, Wegert J, Maschietto M, Vujanic G, Sebire N, Leuschner I, Ambros P, O'Sullivan M, Bergeron C, Gisselsson D, Kool M, Heuvel-Eibrink MVD, Graf N, Tinteren HV, Coulomb A, Gessler M, Williams R, Pritchard-Jones K. Abstract A1-67: Prognostic significance of copy number aberrations in Wilms tumor. Cancer Res 2015. [DOI: 10.1158/1538-7445.transcagen-a1-67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background and Purpose: Treatment of Wilms tumor (WT) patients under International Society of Paediatric Oncology (SIOP) protocols is currently stratified by staging and histopathology at nephrectomy after neoadjuvant chemotherapy. However, most relapses occur in cases without specific histopathological risk factors, and there is a clinical need for better prognostic biomarkers. Combined loss of heterozygosity (LOH) of 1p and 16q has recently been introduced in the US as an adverse prognostic indicator, while previous work in our and other laboratories suggests that 1q gain may have a similar association with poor outcome. To examine the clinical significance of 1q gain and assess its potential as a WT biomarker, we developed a simple, effective assay that measures its genomic copy number together with that of several other loci of interest, and applied it to a large tumor series.
Methods: 686 frozen tumor samples from the SIOP WT 2001 trial (from a total of 7 countries) were assayed using a rapid multiplex ligation-dependent probe amplification (MLPA) assay that was developed and optimized in association with MRC-Holland b.v. to assess the copy number status of 1p, 1q, 16q, WT1, WTX, TP53, MYCN and FBXW7. Analyses were conducted in 3 laboratories, with exchange of a blinded quality assurance sample set.
Results: 1q gain was present in 28% (190/686) of the cases. The 5- year Event Free Survival (EFS) rate was 72.6% (95% Confidence Interval (CI), 66.3%-85%) for those with 1q gain and 86.4% (95% CI, 83.4%-89.6%) for those who lacked 1q gain (p=<0.0001). The Overall Survival (OS) rate for 1q gain cases was 86.9% (95% CI, 82.1%-92.1%) compared to 93.8% (95% CI, 91.7%-92.1%) for cases without the aberration (p=0.01). Both the EFS and OS analysis showed a statistically significant poorer outcome for cases with 1q gain, but there was no association with disease stage. 1q gain was associated with a significantly increased risk of disease recurrence (HR = 2.18, p<0.0001). In this analysis the proportions of samples with 1p and 16q loss were respectively 8% and 16%. Both were marginally significant for EFS but in the OS analysis 1p lost its significance. MYCN gain, 4q (FBXW7) loss and 17p (TP53) loss were also associated with adverse outcome.
Conclusion: Gain of 1q is a potential adverse biomarker for WT. Its association with high risk histological features after pre-operative chemotherapy and independent impact on survival require assessment in a larger number of patients before consideration for clinical use.
Citation Format: Tasnim Chagtai, Christina Zill, Linda Dainese, Jenny Wegert, Mariana Maschietto, Gordan Vujanic, Neil Sebire, Ivo Leuschner, Peter Ambros, Maureen O'Sullivan, Christophe Bergeron, David Gisselsson, Marcel Kool, Marry van den Heuvel-Eibrink, Norbert Graf, Harm van Tinteren, Aurore Coulomb, Manfred Gessler, Richard Williams, Kathy Pritchard-Jones. Prognostic significance of copy number aberrations in Wilms tumor. [abstract]. In: Proceedings of the AACR Special Conference on Translation of the Cancer Genome; Feb 7-9, 2015; San Francisco, CA. Philadelphia (PA): AACR; Cancer Res 2015;75(22 Suppl 1):Abstract nr A1-67.
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Affiliation(s)
| | | | | | | | | | - Gordan Vujanic
- 4School of Medicine Cardiff University, Cardiff, United Kingdom,
| | - Neil Sebire
- 1UCL Institute of Child Health, London, United Kingdom,
| | | | - Peter Ambros
- 6Children's Cancer Research Institute, Vienna, Austria,
| | | | | | | | - Marcel Kool
- 10German Cancer Research Institute, Heidelberg, Germany,
| | | | - Norbert Graf
- 12Saarland University Hospital, Homburg, Germany,
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12
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Abstract
Soft tissue tumors arising in association with genetic or malformation syndromes have been increasingly reported. Malignant rhabdoid tumor (MRT) is a highly aggressive neoplasm of infancy and young childhood, characterized by typical morphology and biallelic inactivation of the SMARCB1 (INI1/hSNF5/BAF47) gene on chromosome 22q.2 which encodes a subunit of the SWI/SNF ATP-dependent chromatin remodeling complex. Congenital infantile disseminated MRT represents a unique clinicopathologic presentation of this tumor. We report a case occurring in a female neonate who presented at birth a voluminous left thigh mass. Surgical biopsy performed at day 9 showed morphology and immunoprofile of MRT. Staging evaluation identified hypercalcemia and distant nodules. The mass showed rapid growth. Despite chemotherapy, the tumor progressed with exteriorization through the biopsy scar. Chemotherapy was discontinued and treatment limited to palliative care and the child died on day 51. The tumor was homozygous for the SMARCB1 deletion with apparent de novo heterozygous germ line deletion in the infant, not identified in the parents.
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Affiliation(s)
- Sabah Boudjemaa
- 1 Service d'Anatomie et de Cytologie Pathologiques, Hôpital d'Enfants Armand Trousseau, 26 Avenue du Dr Arnold Netter, 75571 Paris Cedex 12, France, and Université Pierre et Marie Curie, Paris 6, France
| | - Arnaud Petit
- 3 Service d'Oncohématologie Pédiatrique, Hôpital d'Enfants Armand Trousseau, 26 Avenue du Dr Arnold Netter, 75571 Paris Cedex 12, France
| | - Linda Dainese
- 1 Service d'Anatomie et de Cytologie Pathologiques, Hôpital d'Enfants Armand Trousseau, 26 Avenue du Dr Arnold Netter, 75571 Paris Cedex 12, France, and Université Pierre et Marie Curie, Paris 6, France
| | - Franck Bourdeaut
- 4 Département de Pédiatrie et INSERM U830, Institut Curie, 26 rue d'Ulm, 75248 Paris Cedex, France
| | - Jill Lipsett
- 2 SA Pathology, Women's and Children's Hospital, 72 King Hospital Rd, North Adelaide, South Australia 5006, Australia
| | - Aurore Coulomb
- 1 Service d'Anatomie et de Cytologie Pathologiques, Hôpital d'Enfants Armand Trousseau, 26 Avenue du Dr Arnold Netter, 75571 Paris Cedex 12, France, and Université Pierre et Marie Curie, Paris 6, France
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13
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Lemale J, Dainese L, Tounian P. [Eosinophilic gastroenteritis and colitis in pediatric patients: Increasingly frequent diseases]. Arch Pediatr 2015; 22:769-77. [PMID: 26051270 DOI: 10.1016/j.arcped.2015.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 01/14/2015] [Accepted: 04/18/2015] [Indexed: 10/23/2022]
Abstract
Eosinophilic gastrointestinal disorders are a heterogeneous group of disorders characterized by no specific digestive symptoms associated with dense eosinophilic inflammation of the gastrointestinal tract in the absence of known causes for such tissue eosinophilia. Among these diseases, eosinophilic gastroenteritis (EGE) and colitis (EC) are less common than esophagitis, but their incidence and prevalence have been increasing over the past decade due in part to increased disease recognition. The exact pathophysiology is not clear: EGE and EC are immune-mediated diseases implicating adaptive T-helper cell type 2 immunity. According to the site of eosinophilic infiltration, there is a wide spectrum of digestive symptoms ranging from food refusal, nausea, vomiting, abdominal pain, weight loss, gastrointestinal bleeding (anemia), protein loosing enteropathy, ascites, bowel obstruction or perforation for EGE and diarrhea ± bleeding for CE. Endoscopic lesions are not specific: friability, erythematous mucosa with superficial erosions, or ulceration is often observed. Histologically, markedly increased numbers of mucosal eosinophils are seen in biopsy specimens. However, no standards for the diagnosis of EGE or CE exist and few findings support the diagnosis: intraepithelial eosinophils, eosinophil crypt abscesses, and eosinophils in muscularis mucosa and/or submucosa. Other organs are not involved. The other causes of tissue eosinophilia (infections, inflammatory bowel diseases) should be excluded. Food allergy appears to play a central role in driving inflammation in EGE and CE, as evidenced by symptomatic improvement with initiation of food exclusion or elemental diets. Dietary treatment should be the first therapeutic option in children. If the elimination diet fails, corticosteroids are currently the best characterized treatment but appropriate duration is unknown and relapses are frequent. In severe forms, immunomodulators or biologic agents (anti-IL5, anti-IgE, or anti-TNFa) can potentially play a role in the treatment of EGE and CE.
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Affiliation(s)
- J Lemale
- Service de nutrition et gastroentérologie pédiatriques, hôpital Trousseau, AP-HP, 26, avenue du Dr-Arnold-Netter, 75571 Paris cedex 12, France.
| | - L Dainese
- Service d'anatomo-pathologie, hôpital Trousseau, AP-HP, 26, avenue du Dr-Arnold-Netter, 75571 Paris cedex 12, France
| | - P Tounian
- Service de nutrition et gastroentérologie pédiatriques, hôpital Trousseau, AP-HP, 26, avenue du Dr-Arnold-Netter, 75571 Paris cedex 12, France
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14
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Malouf GG, Dainese L, Su X, Verschuur A, Bergeron C, Mouawad R, Blaise A, Le Bouc Y, Khayat D, Coulomb A. The genomic landscape of anaplastic Wilms tumors with diffuse versus focal anaplasia. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.10062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Gabriel G Malouf
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Medical Oncology, UPMC Univ Paris 06, Institut Universitaire de Cancérologie GRC5, Paris, France
| | - Linda Dainese
- -HP, Hôpital Armand Trousseau, Department of Pathology, UPMC Univ Paris 06, Paris, France
| | - Xiaoping Su
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Arnauld Verschuur
- Hôpital d'Enfants de La Timone, Department of Pediatric Oncology, Marseille, France
| | | | | | - Annick Blaise
- , UMR_S 938, CDR Saint-Antoine, Sorbonne Universités, UPMC Univ Paris 06, Paris, France
| | - Yves Le Bouc
- UMR_S 938, CDR Saint-Antoine, Sorbonne Universités, UPMC Univ Paris 06, Paris, France
| | - David Khayat
- Salpetriere Hospital, University Paris VI, Paris, France
| | - Aurore Coulomb
- Department of Pathology, Hopitaux Universitaires Est Parisien, Paris, France
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Kadlub N, Vazquez MP, Galmiche L, L'Herminé AC, Dainese L, Ulinski T, Fauroux B, Pavlov I, Badoual C, Marlin S, Deckert M, Leboulanger N, Berdal A, Descroix V, Picard A, Coudert AE. The calcineurin inhibitor tacrolimus as a new therapy in severe cherubism. J Bone Miner Res 2015; 30:878-85. [PMID: 25491283 DOI: 10.1002/jbmr.2431] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Cherubism is a rare genetic disorder characterized by extensive growth of a bilateral granuloma of the jaws, resulting in facial disfigurement. Cherubism is caused by gain-of-function mutations in the SH3BP2 gene, leading to overactivation of nuclear factor of activated T cells, cytoplasmic 1 (NFATc1)-dependent osteoclastogenesis. Recent findings in human and mouse cherubism have suggested that calcineurin inhibitors might be drug candidates in cherubism medical treatment. A 4-year-old boy with aggressive cherubism was treated with the calcineurin inhibitor tacrolimus for 1 year, and clinical, radiological, and molecular data were obtained. Immunohistologic analysis was performed to compare preoperative and postoperative NFATc1 staining and tartrate resistant acid phosphatase (TRAP) activity. Real-time PCR was performed to analyze the relative expression levels of OPG and RANKL. After tacrolimus therapy, the patient showed significant clinical improvement, including stabilization of jaw size and intraosseous osteogenesis. Immunohistologic analyses on granuloma showed that tacrolimus caused a significant reduction in the number of TRAP-positive osteoclasts and NFATc1 nuclear staining in multinucleated giant cells. Molecular analysis showed that tacrolimus treatment also resulted in increased OPG expression. We present the first case of effective medical therapy in cherubism. Tacrolimus enhanced bone formation by stimulating osteogenesis and inhibiting osteoclastogenesis.
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Affiliation(s)
- Natacha Kadlub
- Institut National de la Santé et de la Recherche Médicale (INSERM) UMRS1138, Team Molecular Oral Pathophysiology, Cordeliers Research Center, University Paris-Diderot, University Paris-Descartes, and University Pierre and Marie Curie, Paris, France; Service de Chirurgie Maxillo-Faciale, Hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France; Unités de Formation et de Recherche (UFR) de Médecine Paris Descartes, Université Paris V, Paris, France; Centre de Références des Malformations de la Face et de la Cavité Buccale, Paris, France; Laboratoire de Physiopathologie Orale et Moléculaire, INSERM, UMRS 872, Equipe 5, Centre de Recherche des Cordeliers, Paris, France
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16
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Kadlub N, Dainese L, Coulomb-L'Hermine A, Galmiche L, Soupre V, Lepointe HD, Vazquez MP, Picard A. Intraosseous haemangioma: semantic and medical confusion. Int J Oral Maxillofac Surg 2015; 44:718-24. [PMID: 25703595 DOI: 10.1016/j.ijom.2015.01.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 01/20/2015] [Accepted: 01/29/2015] [Indexed: 01/18/2023]
Abstract
The literature is rich in case reports of intraosseous haemangioma, although most of these are actually cases of venous or capillary malformations. To illustrate this confusion in terminology, we present three cases of slow-flow vascular malformations misnamed as intraosseous haemangioma. A retrospective study of children diagnosed with intraosseous haemangioma was conducted. Clinical and radiological data were evaluated. Histopathological examinations and immunohistochemical studies were redone by three independent pathologists to classify the lesions according to the International Society for the Study of Vascular Anomalies (ISSVA) and World Health Organization (WHO) classifications. Three children who had presented with jaw haemangiomas were identified. Computed tomography scan patterns were not specific. All tumours were GLUT-1-negative and D2-40-negative. The lesions were classified as central haemangiomas according to the WHO, and as slow-flow malformations according to the ISSVA. The classification of vascular anomalies is based on clinical, radiological, and histological differences between vascular tumours and malformations. Based on this classification, the evolution of the lesion can be predicted and adequate treatment applied. The binary ISSVA classification is widely accepted and should be applied for all vascular lesions.
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Affiliation(s)
- N Kadlub
- APHP, Hôpital Necker Enfants Malades, Service de Chirurgie Maxillo-faciale et Plastique Pédiatrique, Paris, France; Université Paris Descartes, Paris, France; INSERM, UMRS 1138, Oral and Molecular Pathology, Centre de Recherche des Cordeliers, 75006 Paris, France; APHP, CRMR des Malformations Rares de la Face et de la Cavité Buccale, 75015 Paris, France.
| | - L Dainese
- APHP, Hôpital d'Enfants Armand Trousseau, Service de Cytologie et Pathologie, Paris, France; Université Paris 6, Faculté de Médecine Pierre et Marie Curie, Paris, France
| | - A Coulomb-L'Hermine
- APHP, Hôpital d'Enfants Armand Trousseau, Service de Cytologie et Pathologie, Paris, France; Université Paris 6, Faculté de Médecine Pierre et Marie Curie, Paris, France
| | - L Galmiche
- Université Paris Descartes, Paris, France; APHP, Hôpital Necker Enfants Malades, Service de Cytologie et Pathologie, Paris, France
| | - V Soupre
- APHP, Hôpital Necker Enfants Malades, Service de Chirurgie Maxillo-faciale et Plastique Pédiatrique, Paris, France; APHP, CRMR des Malformations Rares de la Face et de la Cavité Buccale, 75015 Paris, France
| | - H Ducou Lepointe
- Université Paris 6, Faculté de Médecine Pierre et Marie Curie, Paris, France; APHP, Hôpital d'Enfants Armand Trousseau, Service d'Imagerie Médicale, Paris, France
| | - M-P Vazquez
- APHP, Hôpital Necker Enfants Malades, Service de Chirurgie Maxillo-faciale et Plastique Pédiatrique, Paris, France; Université Paris Descartes, Paris, France; INSERM, UMRS 1138, Oral and Molecular Pathology, Centre de Recherche des Cordeliers, 75006 Paris, France; APHP, CRMR des Malformations Rares de la Face et de la Cavité Buccale, 75015 Paris, France
| | - A Picard
- APHP, Hôpital Necker Enfants Malades, Service de Chirurgie Maxillo-faciale et Plastique Pédiatrique, Paris, France; Université Paris Descartes, Paris, France; INSERM, UMRS 1138, Oral and Molecular Pathology, Centre de Recherche des Cordeliers, 75006 Paris, France; APHP, CRMR des Malformations Rares de la Face et de la Cavité Buccale, 75015 Paris, France
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17
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Billon R, Dainese L, Constantinescu G, Boudjemaa S, Chretien-Marquet B, Fasola S, Vazquez MP, Picard A, Kadlub N. Primary cutaneous B-cell lymphoblastic lymphoma in children. Report of two cases. Pediatr Dermatol 2015; 32:e36-8. [PMID: 25322931 DOI: 10.1111/pde.12369] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 11/29/2022]
Abstract
Precursor B-cell lymphoblastic lymphoma (B-LBL) is an uncommon high-grade neoplasm. Primary cutaneous B-LBL is uncommon and clinical diagnosis is difficult. We report two cases of primary cutaneous B-LBL that had initially been diagnosed as an infected dermoid cyst and lipoma, respectively, and referred for excision. The cases demonstrate the importance of biopsy and histopathologic examination of subcutaneous tumors to guide appropriate therapy.
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Affiliation(s)
- Raphaelle Billon
- Department of Maxillofacial and Plastic Surgery, Necker Hôpital Enfants Malades, APHP, Paris, France; Université Paris Descartes, Paris, France
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18
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Besson C, Boudjemaa S, Hamdi L, Creidy R, Leblanc T, Lambilliote A, Dainese L, Doukoure B, Krziesek R, Coulomb A, Landman-Parker J. Hodgkin Lymphoma Subtypes and Peripheral B-cell Lymphopenia are Associated with EBV Status in Children and Adolescents in France: A Preliminary Report of the EuroNet LH EPI Project. Klin Padiatr 2014. [DOI: 10.1055/s-0034-1371106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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19
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Ducray F, Kaloshi G, Houillier C, Idbaih A, Ribba B, Psimaras D, Marie Y, Boisselier B, Alentorn A, Dainese L, Navarro S, Mokhtari K, Sanson M, Hoang-Xuan K, Delattre JY. Ongoing and prolonged response in adult low-grade gliomas treated with radiotherapy. J Neurooncol 2013; 115:261-5. [PMID: 23955572 DOI: 10.1007/s11060-013-1224-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Accepted: 08/04/2013] [Indexed: 11/25/2022]
Abstract
The aim of the present study was to evaluate the impact of first-line radiotherapy on low-grade gliomas (LGGs) growth kinetics. The mean tumor diameter (MTD) of 39 LGGs was retrospectively measured on serial magnetic resonance images before (n = 16) and after radiotherapy onset (n = 39). After radiotherapy, a decrease of the MTD was observed in 37 patients. Median duration of the MTD decrease was 1.9 years (range 0-8.1 years). According to RANO criteria, the rates of partial and minor responses were 15 and 28 % at the first evaluation after radiotherapy and 36 and 34 % at the time of maximal MTD decrease. The presence of a 1p19q codeletion and the absence of p53 expression were associated with longer durations of MTD decrease (5.3 vs 1 years, p = 0.02 and 2.4 vs 1.8 years, p = 0.05, respectively) while no association was observed between IDH1-R132H expression and duration of MTD decrease. In most patients, MTD decrease after radiotherapy occurred in two phases: an initial phase of rapid MTD decrease followed by a second phase of slower MTD decrease. Patients with a high rate of MTD decrease during the initial phase (>7 mm/year) had both a shorter duration of response (1.9 vs 5.3 years, p = 0.003) and a shorter overall survival (5.5 vs 11.6 years, p = 0.0004). LGGs commonly display a prolonged and ongoing volume decrease after radiotherapy. However, patients who respond rapidly should be carefully monitored because they are at a higher risk of rapid progression.
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Affiliation(s)
- F Ducray
- Lyon Neuroscience Research Center, INSERM U1028/CNRS UMR 5292, Université de Lyon - Université Claude Bernard Lyon 1, 69372, Lyon, France,
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20
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Dainese L, Monin ML, Demeret S, Brochier G, Froissart R, Spraul A, Schiffmann R, Seilhean D, Mochel F. Abnormal glycogen in astrocytes is sufficient to cause adult polyglucosan body disease. Gene 2012; 515:376-9. [PMID: 23266647 PMCID: PMC7126849 DOI: 10.1016/j.gene.2012.12.065] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2012] [Accepted: 12/03/2012] [Indexed: 11/18/2022]
Abstract
Background A 45-year old woman of Cambodian ethnic background presented with fatal respiratory failure due to a severe diaphragmatic dysfunction. Two years before, she had developed early onset of urinary symptoms. Methods and results Neuroimaging showed atrophy of the spine and medulla as well as a leukodystrophy affecting both supra- and infra-tentorial regions. At autopsy, polyglucosan bodies (PB) were seen in several peripheral tissues, including the diaphragm, and nervous tissues such as peripheral nerves, cerebral white matter, basal ganglia, hippocampus, brainstem and cerebellum. Immunohistochemistry and electron microscopy of the brain revealed an exclusive astrocytic localization of the PB. The diagnosis of adult polyglucosan body disease (APBD) was confirmed by enzymatic and molecular studies. Conclusion Storage of abnormal glycogen in astrocytes is sufficient to cause the leukodystrophy of APBD. Since brain glycogen is almost exclusively metabolized in astrocytes, this observation sheds light on the pathophysiology of APBD. In addition, this is the first report of an APBD patient presenting with a subacute diaphragmatic failure.
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Affiliation(s)
- Linda Dainese
- AP-HP, Department of Neuropathology, Hospital La Salpêtrière, Paris, France
- University Pierre and Marie Curie, Paris, France
- University of Insubria, Varese, Italy
| | - Marie-Lorraine Monin
- University Pierre and Marie Curie, Paris, France
- INSERM UMR S975, Brain and Spine Institute, Hospital La Salpêtrière, Paris, France
| | - Sophie Demeret
- AP-HP, Department of Neurology, Hospital La Salpêtrière, Paris, France
| | - Guy Brochier
- Institute of Myology, Histopathology Laboratory, Hospital La Salpêtrière, Paris, France
| | - Roseline Froissart
- Laboratory of Inborn Errors of Metabolism, Hospices Civils de Lyon, Bron, France
| | - Anne Spraul
- AP-HP, Laboratory of Biochemistry, Hospital Bicêtre, Le Kremlin Bicêtre, France
| | - Raphael Schiffmann
- Institute of Metabolic Disease, Baylor Research Institute, Dallas, TX, USA
| | - Danielle Seilhean
- AP-HP, Department of Neuropathology, Hospital La Salpêtrière, Paris, France
- University Pierre and Marie Curie, Paris, France
- INSERM UMR S975, Brain and Spine Institute, Hospital La Salpêtrière, Paris, France
| | - Fanny Mochel
- University Pierre and Marie Curie, Paris, France
- INSERM UMR S975, Brain and Spine Institute, Hospital La Salpêtrière, Paris, France
- AP-HP, Department of Genetic, Hospital La Salpêtrière, Paris, France
- Corresponding author at: INSERM UMR S975, Brain and Spine Institute, Hôpital de La Salpêtrière, Paris, France 75013. Tel.: + 33 1 57 27 46 82.
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21
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Mathon B, Boch AL, Clémenceau S, Bitar A, Mokhtari K, Adam C, Dainese L, Galanaud D, Kalfon F, Cornu P, Carpentier A. Paragangliomes de la queue de cheval : à propos de six cas et revue de la littérature. Neurochirurgie 2012. [DOI: 10.1016/j.neuchi.2012.10.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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22
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Ribba B, Kaloshi G, Peyre M, Ricard D, Calvez V, Tod M, Cajavec-Bernard B, Idbaih A, Psimaras D, Dainese L, Pallud J, Cartalat-Carel S, Delattre JY, Honnorat J, Grenier E, Ducray F. A tumor growth inhibition model for low-grade glioma treated with chemotherapy or radiotherapy. Clin Cancer Res 2012; 18:5071-80. [PMID: 22761472 DOI: 10.1158/1078-0432.ccr-12-0084] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To develop a tumor growth inhibition model for adult diffuse low-grade gliomas (LGG) able to describe tumor size evolution in patients treated with chemotherapy or radiotherapy. EXPERIMENTAL DESIGN Using longitudinal mean tumor diameter (MTD) data from 21 patients treated with first-line procarbazine, 1-(2-chloroethyl)-3-cyclohexyl-l-nitrosourea, and vincristine (PCV) chemotherapy, we formulated a model consisting of a system of differential equations, incorporating tumor-specific and treatment-related parameters that reflect the response of proliferative and quiescent tumor tissue to treatment. The model was then applied to the analysis of longitudinal tumor size data in 24 patients treated with first-line temozolomide (TMZ) chemotherapy and in 25 patients treated with first-line radiotherapy. RESULTS The model successfully described the MTD dynamics of LGG before, during, and after PCV chemotherapy. Using the same model structure, we were also able to successfully describe the MTD dynamics in LGG patients treated with TMZ chemotherapy or radiotherapy. Tumor-specific parameters were found to be consistent across the three treatment modalities. The model is robust to sensitivity analysis, and preliminary results suggest that it can predict treatment response on the basis of pretreatment tumor size data. CONCLUSIONS Using MTD data, we propose a tumor growth inhibition model able to describe LGG tumor size evolution in patients treated with chemotherapy or radiotherapy. In the future, this model might be used to predict treatment efficacy in LGG patients and could constitute a rational tool to conceive more effective chemotherapy schedules.
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Affiliation(s)
- Benjamin Ribba
- Ribba, INRIA, Project-team NUMED, Ecole Normale Superieure de Lyon, 46 allee d0Italie, 69007 Lyon Cedex 07, France.
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23
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Mercante G, Marchesi A, Covello R, Dainese L, Spriano G. Mixed squamous cell carcinoma and follicular carcinoma of the thyroid gland. Auris Nasus Larynx 2012; 39:310-3. [DOI: 10.1016/j.anl.2011.07.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Revised: 07/27/2011] [Accepted: 07/28/2011] [Indexed: 10/17/2022]
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Zoli S, Trabattoni P, Dainese L, Annoni A, Saccu C, Fumagalli M, Spirito R, Biglioli P. Cumulative radiation exposure during thoracic endovascular aneurysm repair and subsequent follow-up. Eur J Cardiothorac Surg 2012; 42:254-59; discussion 259-60. [DOI: 10.1093/ejcts/ezr301] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
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Dainese L, Biglioli P. Human or animal homograft: could they have a future as a biological scaffold for engineered heart valves? J Cardiovasc Surg (Torino) 2010; 51:449-456. [PMID: 20523298] [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: 05/29/2023]
Abstract
Tissue-engineered heart valves (TEHVs) promise to be the ideal heart valve replacement: they have the potential to grow and repair within the host, to minimise inflammatory and immunological responses and to limit thromboembolism. Viable cells included in TEHVs can theoretically adapt to a growing and changing environment exactly as a native biological structure. This could be extremely important in case of paediatric applications, where reoperations are frequently required to replace failed valve substitutes or to accommodate the growth of the patient. At present time the biological matrix from allogenic or xenogenic decellularized valves represents an appropriate valve scaffold in TEHVs, showing theoretically an ability to grow and repair within the host. Viable cells included in extracellular valve matrix can theoretically adapt to a growing and changing environment like the native biological structure. The aim of this paper is to present a review concerning the use of homograft and allograft valves as an ideal substrate for cardiac engineered tissue valves that represent an exciting possibility for in situ regeneration and repair of heart valves.
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Affiliation(s)
- L Dainese
- Department of Cardiac Surgery, University of Milan, Centro Cardiologico Monzino IRCCS, Milan, Italy.
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Minardi F, Cavalca V, Veglia F, Squellerio I, Dainese L, Guarino A, Tremoli E, Caruso D. Abstract: P795 SIMULTANEOUS QUANTIFICATION OF OXIDATIVE STRESS AND PLATELETS ACTIVATION IN ATHEROSLEROTIC PATIENTS. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)70950-x] [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: 11/28/2022]
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27
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La Rosa S, Klersy C, Uccella S, Dainese L, Albarello L, Sonzogni A, Doglioni C, Capella C, Solcia E. Improved histologic and clinicopathologic criteria for prognostic evaluation of pancreatic endocrine tumors. Hum Pathol 2008; 40:30-40. [PMID: 18715612 DOI: 10.1016/j.humpath.2008.06.005] [Citation(s) in RCA: 146] [Impact Index Per Article: 9.1] [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: 04/02/2008] [Revised: 06/10/2008] [Accepted: 06/11/2008] [Indexed: 12/13/2022]
Abstract
Currently used histopathologic criteria for the diagnosis of pancreatic endocrine tumors are still under discussion as far as to their capacity to identify prognostically different tumor subsets, which are potentially helpful for patient management. A recently developed TNM staging system and a variety of proposed histologic and clinicopathologic parameters still need to be fully validated. One hundred fifty-five pancreatic endocrine tumors encompassing all the main histologic types and stages, operated with intention to cure and then followed up for a median 126 months, were carefully investigated histologically to identify prognostically informative parameters at univariable, bivariable, and multivariable analysis. Ki67 index, mitotic rate, neuroinvasion with or without vascular, peritumoral or stromal infiltrative patterns, as well as tumor size, and association with endocrine syndromes other than insulinoma proved effective in predicting recurrence and disease-specific death among well-differentiated tumors. Poorly differentiated histologic features, more than 10 mitoses/10 high power fields, and necrosis were helpful in the identification of high-grade cancers with an invariably poor prognosis. The TNM system proved to be highly predictive of patient outcome and easy to combine with histologic and clinicopathologic parameters to classify pancreatic endocrine tumors into groups of increasing malignant potential.
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MESH Headings
- Adenoma, Islet Cell/diagnosis
- Adenoma, Islet Cell/metabolism
- Adenoma, Islet Cell/pathology
- Biomarkers, Tumor/metabolism
- Carcinoma, Islet Cell/diagnosis
- Carcinoma, Islet Cell/metabolism
- Carcinoma, Islet Cell/pathology
- Carcinoma, Pancreatic Ductal/diagnosis
- Carcinoma, Pancreatic Ductal/metabolism
- Carcinoma, Pancreatic Ductal/pathology
- Humans
- Insulinoma/diagnosis
- Insulinoma/metabolism
- Insulinoma/pathology
- Ki-67 Antigen/analysis
- Mitotic Index
- Necrosis/pathology
- Neoplasm Invasiveness
- Neoplasm Recurrence, Local/pathology
- Neoplasm Staging
- Pancreatic Neoplasms/diagnosis
- Pancreatic Neoplasms/metabolism
- Pancreatic Neoplasms/pathology
- Prognosis
- Retrospective Studies
- Survival Rate
- Tumor Burden
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Affiliation(s)
- Stefano La Rosa
- Department of Pathology, Ospedale di Circolo, 21100 Varese, Italy.
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La Rosa S, Uccella S, Dainese L, Marchet S, Placidi C, Vigetti D, Capella C. Characterization of c-kit (CD117) expression in human normal pituitary cells and pituitary adenomas. Endocr Pathol 2008; 19:104-11. [PMID: 18568298 DOI: 10.1007/s12022-008-9032-4] [Citation(s) in RCA: 9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
c-kit (CD117) is a tyrosine kinase receptor involved in the proliferation, differentiation, and secretory functions of various cells. In experimental animal models, c-kit has been detected in the pars intermedia of the normal pituitary gland and in alpha-melanocyte-stimulating-hormone-positive adenomas and it has been suggested that it plays a role in regulating adrenocorticotropic hormone (ACTH) secretion. To the best of our knowledge, the expression of c-kit in normal human pituitary cells and in pituitary adenomas has never been reported, so the possible biological role of this receptor in the control of pituitary hormone secretion remains unclear. The aim of this study was to evaluate the immunohistochemical expression of c-kit in normal human pituitary glands and in a series of 62 well-characterized pituitary adenomas. In normal adenohypophyses, several cells, mainly located in the central mucoid wedge, showed a c-kit immunoreactivity (IR). Double label immunostaining procedures showed that the c-kit-IR cells corresponded to ACTH cells. Out of 62 adenomas, 15 (24%) were c-kit-IR, including 7/16 (44%) ACTH cell, 3/7 (42%) null cell, 4/11 (36%) alpha-subunit cell, and 1/11 (10%) follicle-stimulating hormone-luteinizing hormone cell adenomas. By contrast, all ten prolactin cell and seven growth hormone cell adenomas were c-kit negative. These data suggest that, in normal conditions, c-kit may be involved in the pituitary-adrenal axis regulation.
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Affiliation(s)
- Stefano La Rosa
- Department of Pathology, Ospedale di Circolo, Viale Borri 57, Varese, Italy.
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29
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Dainese L, Barili F, Guarino A, Parolari A, Trabattoni P, Alamanni F, Polvani GL, Biglioli P. Ultrastructural and nervous characteristics of the aortic valve: surgical implications. Minerva Cardioangiol 2007; 55:277-8. [PMID: 17342045] [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: 05/14/2023]
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Dainese L, Barili F, Spirito R, Topkara VK, Pompilio G, Trezzi M, Polvani G, Biglioli P. Abdominal Aortic Aneurysm Repair in Octogenarians: Outcomes and Predictors. Eur J Vasc Endovasc Surg 2006; 31:464-9. [PMID: 16387519 DOI: 10.1016/j.ejvs.2005.11.010] [Citation(s) in RCA: 10] [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] [Received: 06/15/2005] [Accepted: 11/08/2005] [Indexed: 11/18/2022]
Abstract
OBJECTIVES This study was undertaken to evaluate predictors and outcomes of octogenarians who underwent abdominal aortic aneurysm repair. DESIGN A prospective observational study. MATERIALS AND METHODS Between January 1st, 1997 and April 15th, 2005, 31 octogenarians were admitted to our Department with the diagnosis of abdominal aortic aneurysm. Mean follow-up time was 53.7+/-27.2 months. All patients were in good clinical condition and represented a selected healthy group of octogenarians. RESULTS The overall perioperative (30-days) mortality rate was 3.1%. The total in-hospital morbidity rate was 22.6%. Overall survival estimates at 48 and 96 months were 81+/-8% and 46+/-21%, respectively. The actuarial freedom from aneurysm-related death at 48 and 96 months was 96+/-4% and 96+/-4%, respectively. The actuarial freedom from aneurysm-unrelated death at 48 and 96 months was 84+/-7% and 48+/-21%. Only coronary artery disease was a significant predictor of survival using multivariate stepwise logistic regression analysis. CONCLUSIONS In this series, AAA surgery was carried out in selected octogenarians without affecting long-term survival.
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Affiliation(s)
- L Dainese
- Department of Cardiovascular Surgery, Centro Cardiologico Monzino, University of Milan, Via Parea 4, 20138 Milan, Italy.
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Spirito R, Pompilio G, Alamanni F, Agrifoglio M, Dainese L, Parolari A, Reali M, Grillo F, Fusari M, Biglioli P. A preoperative index of mortality for patients undergoing surgery of type A aortic dissection. J Cardiovasc Surg (Torino) 2001; 42:517-24. [PMID: 11455290] [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: 02/20/2023]
Abstract
BACKGROUND The aim of this study was to identify and stratify the most important preoperative factors for in-hospital death after surgery for type A aortic dissection. METHODS From January 1985 to June 1998, 108 patients underwent surgery for type A aortic dissection. 89.9% of the patients had an acute type A dissection (AD), whereas 11.1% had a chronic dissection (CD). Cardiac tamponade and shock occurred in 22% and 14.8% of the patients, respectively. The location of the primary intimal tear was in the ascending aorta in 71.2% of the cases, in the arch in 16.6% and in the descending aorta in 7.4%. Univariate and multivariate analyses were conducted to identify non-embolic variables independently correlated to in-hospital death. A predictive model of in-hospital mortality was then constructed by means of a mathematical method with the variables selected from logistic regression analysis. RESULTS The overall in-hospital mortality rate was 20.3% (22/108 patients), being 9% for CD and 21.6% for AD. Emergent procedures had an in-hospital mortality rate of 47.6%, whereas non-emergent operations had an in-hospital mortality rate of 13.7% (p<0.01). Univariate analysis revealed among 39 preoperative and operative variables, age (years), age >70 years, remote myocardial infarction, cerebrovascular dysfunction, diabetes, preoperative renal failure, shock, cardiopulmonary bypass time (minutes), emergency operation as factors associated to in-hospital death (p<0.05). Stepwise logistic regression analysis selected as independent predicting variables (p<0.05), remote myocardial infarction (p=0.006), preoperative renal failure (p=0.032), shock (p=0.001), age >70 years (p=0.007). Finally, a probability table of death risk was obtained with the logistic regression coefficients. The lower death probability (10.6%) was calculated in absence of risk variables; the higher one in presence of all of them (79.7%). Between these extremes, a total of 64 combinations of death risk were obtained. CONCLUSIONS Increasing age, shock, coronary artery disease and renal failure are variously associated to a high risk of in-hospital death after surgical correction of type A aortic dissection. This predictive model of death probability allows to collocate preoperatively patients with type A aortic dissection at different levels of risk for in-hospital death.
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Affiliation(s)
- R Spirito
- Department of Cardiovascular Surgery, Cardiological Center I Monzino Foundation, IRCCS, University of Milan, Via Parea 4, 20138 Milan, Italy
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Alamanni F, Parolari A, Zanobini M, Porqueddu M, Dainese L, Bertera A, Costa C, Fusari M, Spirito R, Biglioli P. Centrifugal pump and reduction of neurological risk in adult cardiac surgery. J Extra Corpor Technol 2001; 33:4-9. [PMID: 11315131] [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: 02/19/2023]
Abstract
This study was performed to assess if the kind of pump used for CPB (roller vs. centrifugal) can influence neurological outcomes of adult cardiac surgery patients. Between 1994 and 1998, 3438 patients underwent coronary and/or valve surgery at our hospital; of these, 1805 (52.5%) underwent surgery with the use of a centrifugal pump, and 1633 (47.5%) were operated with a roller pump. The effect of the type of the pump and of common preoperative and intraoperative risk factors for five different neurological outcomes (permanent neurological deficit, coma, delirium, transient neurological deficit, overall neurological complications) were assessed with univariate and multivariate analyses in the whole patients population, in patients > or = 75 years old and in patients with histories of previous neurological events. Centrifugal pump use was the only protective factor for perioperative permanent neurological deficit in multivariable models developed for the whole patient population and for patients > or = 75 years old. In addition, it resulted as the only protective factor for perioperative coma occurrence in multivariable models developed for patients > or = 75 years old, and for patients with histories of previous neurological events. The use of the centrifugal pump provided a risk reduction for the considered events ranging from 23 to 84%. Centrifugal pump use can be helpful in reducing the occurrence of some of the most feared neurological complications of adult cardiac surgery patients.
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Affiliation(s)
- F Alamanni
- Department of Cardiac Surgery, University of Milano, Centro Cardiologico, Fondazione I Monzino IRCCS, Italy
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33
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Parolari A, Alamanni F, Gherli T, Bertera A, Dainese L, Costa C, Schena M, Sisillo E, Spirito R, Porqueddu M, Rona P, Biglioli P. Cardiopulmonary bypass and oxygen consumption: oxygen delivery and hemodynamics. Ann Thorac Surg 1999; 67:1320-7. [PMID: 10355405 DOI: 10.1016/s0003-4975(99)00261-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.1] [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: 12/25/2022]
Abstract
BACKGROUND This study was undertaken to investigate the relations between whole body oxygen consumption (VO2), oxygen delivery (DO2), and hemodynamic variables during cardiopulmonary bypass. METHODS One hundred one patients were studied during cooling, hypothermia, and rewarming. Oxygen consumption, DO2, hemodynamics, and DO2crit were measured at these times. RESULTS There was a direct linear relation between DO2 and VO2 during all three times. No relation between VO2 and hemodynamics was detected during cooling; during hypothermia, an inverse linear relation with peripheral arterial resistance was found. Finally, during rewarming, there was a direct relation with pump flow rate, and an inverse relation with arterial pressure and arterial resistance. The same relations among the variables were found at delivery levels above or below DO2crit. CONCLUSIONS During cardiopulmonary bypass there is a direct linear relation between DO2 and VO2; the relations with hemodynamic variables depend on the phases of cardiopulmonary bypass. This suggests that increasing delivery levels may recruit and perfuse more vascular beds, and higher delivery levels are advisable during perfusion. During rewarming and hypothermia, lower arterial resistances are also desirable to optimize VO2.
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Affiliation(s)
- A Parolari
- Department of Cardiac Surgery, University of Milan, Centro Cardiologico, Fondazione I Monzino IRCCS, Italy.
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34
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Dainese L, Polvani GL, Fumero A, Spirito R, Alamanni F, Agrifoglio M, Parolari A, Biglioli P. [Glucose-insulin-potassium (GIK) in the reduction of acute myocardial ischemia after an aortocoronary bypass intervention]. G Ital Cardiol 1999; 29:575-9; discussion 580-2. [PMID: 10367228] [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: 02/12/2023]
Affiliation(s)
- L Dainese
- Cattedra di Cardiochirurgia, Università degli Studi di Milano, Centro Cardiologico Fondazione Monzino, IRCCS
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35
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Biglioli P, Spirito R, Porqueddu M, Agrifoglio M, Pompilio G, Parolari A, Dainese L, Sisillo E. Quick, simple clamping technique in descending thoracic aortic aneurysm repair. Ann Thorac Surg 1999; 67:1038-43; discussion 1043-4. [PMID: 10320248 DOI: 10.1016/s0003-4975(99)00146-0] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.7] [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: 10/16/2022]
Abstract
BACKGROUND Although significant advances have been made in the surgical treatment of diseases affecting the descending thoracic aorta, paraplegia remains a devastating complication. We propose the quick, simple clamping technique to prevent spinal cord ischemic injury. METHODS From 1983 to 1998, 143 patients had descending thoracic aorta aneurysm repair. We divided the patients into the following three groups according to the surgical technique used: selective atriodistal bypass was used in group 1 (66 patients); simple clamping technique in group 2 (28 patients); and quick simple clamping technique in group 3 (49 patients). Mean aortic cross clamp time was 39+/-13 minutes in group 1, 37+/-11 minutes in group 2, and 17+/-6 minutes in group 3 (p<0.01 group 3 versus group 1 and group 2). RESULTS The overall incidence of paraplegia was 4.8% (7 patients), 4.5% (3 patients) in group 1, 14.3% (4 patients) in group 2, and 0 in group 3 (p<0.05 group 3 versus group 2). The overall in-hospital mortality rate was 5.5%. Multivariate logistic regression analysis showed a powerful effect of aortic cross-clamping time as risk factor for both paraplegia (p<0.008), with an odds ratio of 1.03 per minute, and in-hospital mortality (p<0.001), with an odds ratio of 2.5 per minute. The mean follow-up time was 65 months with a lower overall mortality rate in group 3 than in group 1 and group 2 (p<0.05). CONCLUSION In descending thoracic aortic aneurysm repair, spinal cord perfusion can be maintained adequately without reimplantation of segmental vessels or use of atriodistal bypass when the aortic cross-clamp time is short (<15 to 20 minutes).
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Affiliation(s)
- P Biglioli
- Department of Cardiovascular Surgery, University of Milan and Centro Cardiologico I Monzino Foundation - IRCCS, Italy
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36
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Alamanni F, Parolari A, Gherli T, Dainese L, Bertera A, Costa C, Schena M, Biglioli P. [Oxygen consumption during cardiovascular surgery conducted under extra-corporeal circulation]. Minerva Cardioangiol 1998; 46:445-53. [PMID: 10207292] [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] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Whole-body oxygen consumption (VO2) is universally considered both a measure of the metabolic activity of the body and an indicator of the adequacy of tissue perfusion during cardiopulmonary bypass as well. There is little agreement in the literature about the main determinants of oxygen consumption during CPB, except for the role of temperature in reducing the metabolic activity of the body. Many studies, which have been performed both on animals and in humans, have reached some contradictory conclusions about the role of delivery and perfusion flow rates, of haemodynamic variables, of the acid-base status, and of drugs influencing the variations of oxygen consumption during CPB. Aim of this paper is to review the evidences in literature about the determinants of whole-body oxygen consumption during cardiopulmonary bypass in man.
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Affiliation(s)
- F Alamanni
- Cattedra di Cardiochirurgia, Università degli Studi, Milano
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37
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Pompilio G, Rossoni G, Sala A, Polvani GL, Berti F, Dainese L, Porqueddu M, Biglioli P. Endothelial-dependent dynamic and antithrombotic properties of porcine aortic and pulmonary valves. Ann Thorac Surg 1998; 65:986-92. [PMID: 9564915 DOI: 10.1016/s0003-4975(98)00075-7] [Citation(s) in RCA: 18] [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: 02/07/2023]
Abstract
BACKGROUND In the present study, the endothelium-dependent antithrombotic and dynamic properties of porcine aortic (AoV) and pulmonary valves (PuV) were investigated. METHODS Fifteen fresh AoV and 15 fresh PuV were obtained from 25 9-month-old swines. The valves were examined for endothelial function by pharmacologic evaluation (with and without endothelium) of both the endothelial-releasing capacity of prostacyclin and the endothelial-dependent dynamic response to relaxing (acetylcholine from 10[-10] mol/L to 10[-4] mol/L in AoV and PuV segments precontracted with norepinephrine [3 x 10(-6) mol/L]) and contracting (endothelin-1, from 10[-11] mol/L to 10[-5] mol/L; and NG-monomethyl-L-arginine, 10[-4] mol/L) drugs. The ultrastructural integrity of the endothelial valve layer was also examined with transmission electron microscopy. RESULTS Acetylcholine caused potent relaxation in both AoV and PuV specimens with, but not in those without, endothelium. Endothelin-1 produced a concentration-dependent tension increase in AoV and PuV with and without endothelium. However, the intrinsic activity of the peptide significantly increased in tissues without endothelium. NG-monomethyl-L-arginine evoked a progressive increase in resting tension of the preparations, but the AoV and PuV without endothelium were less sensitive to the inhibition of the nitric oxide generation. Aortic and pulmonary valves with an intact endothelium showed a spontaneous ability to release prostacyclin. The basal release of this lipidic autacoid significantly decreased in cardiac valves without endothelium. This phenomenon was observed in both basal conditions, and under stimulation with the aforementioned drugs. Transmission electron microscopy showed the perfect preservation of endothelial cells in all the preparations examined. CONCLUSIONS Valvular endothelium of AoV and PuV seems to have similar antithrombotic and dynamic functions of vascular endothelium, actively participating in valvular homeostasis.
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Affiliation(s)
- G Pompilio
- Department of Cardiac Surgery, University of Milan, Centro Cardiologico I Monzino Foundation IRCCS, Italy
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38
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Porqueddu M, Spirito R, Agrifoglio M, Parolari A, Dainese L, Fratto P, Alamanni F, Biglioli P. [Spinal cord protection in surgery of the descendent thoracic aorta]. Cardiologia 1998; 43:253-9. [PMID: 9611852] [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: 02/07/2023]
Affiliation(s)
- M Porqueddu
- Centro Cardiologico-Fondazione Monzino, IRCCS, Cattedra di Cardiochirurgia, Università degli Studi, Milano
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39
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Spirito R, Dainese L, Polvani G, Zanobini M, Porqueddu M, Varesi C, Biglioli P. Extracardiac myxoma: an unusual right ventricular epicardial location. J Thorac Cardiovasc Surg 1997; 114:672-4. [PMID: 9338655 DOI: 10.1016/s0022-5223(97)70059-x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- R Spirito
- Department of Cardiac Surgery, University of Milan, Italy
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40
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Spirito R, Musumeci S, Parolari A, Porqueddu M, Dainese L, Agrifoglio M, Antona C, Alamanni F, Biglioli P. [Surgery of the ascending aorta: the 1984-1995 experience of the cardiac surgery teaching unit in the University of Milan. Multivariate analysis of its risk factors for hospital mortality and reduced long-term survival]. G Ital Cardiol 1997; 27:775-85. [PMID: 9312505] [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: 02/05/2023]
Abstract
Between 1984 and 1995, 183 patients underwent an ascending aorta procedure at our institution. Their mean age was 60 +/- 12.3 years; 116 (63.4%) patients were male, 35 (19.1%) had a history of congestive heart failure, 72 (39.3%) presented acute type A dissection, 23 (12.6%) were redos and 63 (34.4%) were operated on an emergency basis. In-hospital mortality was 10% (12/120) in elective procedures and 36.5% (23/63) in emergency operations (p < 0.0001). Multivariate stepwise logistic regression analysis identified cardiopulmonary by-pass time, emergency operation, arch replacement and the need for femoral vein cannulation at surgery as independent predictors of in-hospital death. Mean follow-up time was 54 +/- 30 months (median 50 months), with a Kaplan-Meier survival of 69 +/- 4% and of 60 +/- 5% at 5 and 7 years, respectively. Cox regression analysis identified arch replacement, perioperative myocardial infarction, preoperative NYHA class, acute type A aortic dissection, the need for femoral vein cannulation at intervention and redo operations as independent predictors of reduced survival at follow-up. When this kind of analysis was performed on hospital survivors only, postoperative tracheostomy, reexploration for bleeding, and the occurrence of postoperative ventricular arrhythmias emerged as risk factors. In conclusion, multiple factors affect both early and long-term outcome following ascending aorta surgery. Preoperative clinical status of patients, priority of surgery and aortic dissection are the main determinants of the short-term results. Otherwise, in hospital survivors, the main determinant for long-term outcome seems to be the immediate postoperative course.
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Affiliation(s)
- R Spirito
- Cattedra di Cardiochirurgia, Università degli Studi di Milano, Fondazione I. Monzino IRCCS
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41
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Porqueddu M, Polvani G, Guarino A, Pompilio G, Dainese L, Franzè V, Sala A, Biglioli P. [Cryopreserved homograft cardiac valves: structural modifications brought about by the use of sterilization and cryopreservation methods]. Cardiologia 1997; 42:351-7. [PMID: 9244642] [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: 02/04/2023]
Affiliation(s)
- M Porqueddu
- Cattedra di Cardiochirurgia, Università degli Studi, Centro Cardiologico, Fondazione Monzino, IRCCS, Milano
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42
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Spirito R, Parolari A, Dainese L, Fusari M, Agrifoglio M, Alamanni E, Antona C, Cavoretto D, Repossini A, Biglioli P. [Surgical therapy for prosthetic infections of the thoracic aorta. Conservative approach]. Minerva Cardioangiol 1997; 45:101-6. [PMID: 9213817] [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] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The prosthetic graft infection of the thoracic aorta is a dreaded complication and it is associated with a high mortality rate. There is not substantial agreement in literature about how to manage a vascular graft infection, except for local anti-septic irrigation with a systemic antibiotic therapy. The main point of discussion is if it is mandatory to remove or not the infected thoracic aorta prosthesis: some authors prefer to eliminate all the thoracic aortic prostheses which may be infected, while others propose graft removal only when the sutures lines are involved. In this paper we report our experience on the conservative management of infected thoracic aorta prostheses using a local antiseptic irrigation, a perigraft debridement and leaving the original graft "in situ" when there is evidence of graft damage especially or involvement of the sutures lines. This approach has been performed in three patients: two had an infected aortic arch prosthesis, while one had a descending thoracic aorta prosthesis infection.
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Affiliation(s)
- R Spirito
- Cattedra di Cardiochirurgia, Università degli Studi, Milano
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43
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Biglioli P, Spirito R, Agrifoglio M, Pompilio G, Parolari A, Dainese L, Arena V, Sala A. Surgery of descending thoracic aortic aneurysms with centrifugal pump support. Cardiovasc Surg 1997; 5:99-103. [PMID: 9158130 DOI: 10.1016/s0967-2109(96)00068-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Fifty-five patients with descending thoracic aortic aneurysms were operated upon between October 1987 and October 1994. All patients were supported by a centrifugal pump during operation. The mean(s.d.) duration of cross-clamping was 39(13) min. In order to evaluate the efficacy of the centrifugal pump, haemodynamic and metabolic measurements were made on four occasions (before cross-clamping, immediately after cross-clamping and before cross-clamp removal) and again after cross-clamp removal. The haemodynamic data remained stable throughout the procedure: central venous pressure (15(4.6) versus 16(4.8) versus 16(4.6) versus 15(4.6) mmHg; P = n.s.), pulmonary artery pressure (25(6.2) versus 24(5.1) versus 22(5.3) versus 23(4.4) mmHg; P = n.s.), radial systolic pressure (119(19.9) versus 116(25.2) versus 111(25.9) versus 111(20.7) mmHg; P = n.s.) and heart rate (75(12.6) versus 77(14) versus 76(15.6) versus 78(16) beats/min; P = n.s.). The acid-base status deteriorated slowly during surgery. Values before and after cross-clamping were: pH (7.42 (0.04) versus 7.37(0.06); P < 0.05), base excess (-0.67(2.20) versus -3.70(2.50); P < 0.05) and bicarbonates (24(8.9) versus 20(1.9); P < 0.05). The cerebrospinal fluid pressure remained constant: 20(5.7) versus 19(5.9) versus 18(5) versus 19(5) mmHg; P = n.s. Renal function, measured before, and at 1, 3 and 7 days after the operation also remained stable (creatinine: 1.1(0.4) versus 1.2(0.4) versus 1.2(0.4) versus 1.2(0.4); P = n.s.; blood urea nitrogen: 46(18.7) versus 46(18.6) versus 51(24.9) versus 55(27.9); P = n.s.). Step-wise multiple linear regression comparing cerebrospinal fluid pressure against haemodynamic and metabolic data showed that during aortic cross-clamping there was a significant relationship between central venous pressure (P < 0.0013) and arterial pH (P < 0.0148), while before and after cross-clamping multivariate analysis showed a relationship only between central venous pressure and cerebrospinal fluid pressure (P < 0.0035). The results confirm that centrifugal pump support is effective in stabilizing haemodynamics and protecting the kidney during thoracoabdominal aneurysm repair.
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Affiliation(s)
- P Biglioli
- Department of Cardiac Surgery, University of Milan, Centro Cardiologico Hospital-Fondazione Monzino IRCCS, Italy
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Pompilio G, Antona C, Musumeci S, Arena V, Dainese L, Polvani G, Porqueddu M, Biglioli P. [Myocardial revascularization in aged patients: what is the surgical risk?]. Cardiologia 1994; 39:181-5. [PMID: 8039196] [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: 01/28/2023]
Abstract
There are still controversies about the surgical results of myocardial revascularization in aged population, in terms of cardiac and non-cardiac morbidity and mortality. This issue prompted us to study retrospectively 71 patients older than 75 years electively operated of coronary artery bypass grafting (CABG) from June 1990 to June 1993 (Group A). Elderly population was compared with a contemporaneous and concurrent control group of patients younger than 75 years (Group B). Patients > 75 years have been divided in successive subgroups according to the severity of coronary artery disease (3 vessel disease 67.7%, 2 vessel disease 26.7%, 1 vessel disease 5.6%), echocardiographic ejection fraction (EF > 50%: 40.8%; 50-30%: 42.2%; < 30%: 16.9%) and preoperative risk factors. Left internal thoracic artery (LITA) utilization rate was 97.1% in Group B and 57.7% in Group A (p < 0.001). Cardiopulmonary bypass circulation, aortic cross-clamping time and number of coronary anastomoses were similar in the 2 groups (2.87 +/- 0.9 versus 2.8 +/- 0.8, NS). Operative mortality rate of aged population was 4.2% while no patient of Group B died (NS). Concerning the cardiac morbidity, there were no significantly differences between the 2 groups: myocardial infarction occurred in 3 patients of Group B (4.2%) and in 5 patients of Group A (7%; NS). Atrioventricular block was also similar in the 2 groups. Non-cardiac complications occurred more frequently in the aged population group: neurologic complications in 11.2% versus 1.4% (p < 0.04), renal insufficiency in 12.6% versus 1.4% (p < 0.03) and respiratory failure in 9.8% versus 1.4% (p = 0.06). (ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- G Pompilio
- Cattedra di Cardiochirurgia, Università degli Studi, Centro Cardiologico Fondazione I Monzino, Milano
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