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Cid M, Gal J, Schiappa R, Azuar AS, Merello M, Delpech Y, Gosset M. Information and oncosexological management in breast cancer patients. Eur J Obstet Gynecol Reprod Biol 2023; 291:252-258. [PMID: 37944213 DOI: 10.1016/j.ejogrb.2023.10.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/23/2023] [Accepted: 10/29/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVES Breast cancer treatment is a particularly high-risk situation for the deterioration of sexual health, leading to an alteration in body image and physical deteriorations such as vaginal trophicity. The aim of this study was to evaluate the information received by patients concerning this alteration of their sexual health in relation to their treatment, and to identify their expectations and needs in terms of oncosexual management. STUDY DESIGN A bicentric qualitative retrospective study was conducted, involving women aged 18 to 80, treated for breast cancer by total or partial mastectomy after 2014 and having had a follow-up consultation between July and December 2019. Data were collected using medical files and a de-identified questionnaire sent by post or e-mail after obtaining consent. The main outcome measures were the proportion of patients who received informations about oncosexology and those who felt impact on their sexual health. RESULTS Of the 274 patients included in the study, 60% said they had received no information about the sexological side effects of their disease or treatment. Of these, 62.5% dared not talk about it during consultation. Patients were keen to receive oncosexological advice or treatment from a specialized nurse or doctor. In 76.1% of cases, patients declared that they had been sexually active in the year prior to their cancer diagnosis, compared with 54.94% after treatment. They reported a loss of femininity in 24% of cases, and 40.5% had no sexual desire. CONCLUSION Women treated for breast cancer report a lasting alteration in their body image and sexual activity. Information on the impact of the disease and its treatment on sexual health is inadequate, even though patients are keen to receive specialized care with professional sexology consultations. The impact of breast cancer on sexual health should systematically explained to the patients, especially as treatment options exist and can be offered.
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Affiliation(s)
- Marie Cid
- Department of Breast and Gynaecological Surgery, Centre Antoine Lacassagne, 33 avenue de Valombrose, 06100 Nice, France
| | - Jocelyn Gal
- Department of Epidemiology, Biostatistics and Health Data, Centre Antoine-Lacassagne, Université Côte d'Azur, 33 avenue de Valombrose, 06100 Nice, France
| | - Renaud Schiappa
- Department of Epidemiology, Biostatistics and Health Data, Centre Antoine-Lacassagne, Université Côte d'Azur, 33 avenue de Valombrose, 06100 Nice, France
| | - Anne-Sophie Azuar
- Department of Gynecology and Obstetrics, Grasse Hospital Center, Chemin de Clavary, 06130 Grasse, France
| | - Marion Merello
- Department of Gynecology and Obstetrics, Grasse Hospital Center, Chemin de Clavary, 06130 Grasse, France
| | - Yann Delpech
- Department of Breast and Gynaecological Surgery, Centre Antoine Lacassagne, 33 avenue de Valombrose, 06100 Nice, France
| | - Marie Gosset
- Department of Breast and Gynaecological Surgery, Centre Antoine Lacassagne, 33 avenue de Valombrose, 06100 Nice, France.
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Gosset M, Gal J, Schiappa R, Helwig C, Bonomo I, Delpech Y, Barranger E. Breast Cancer and SARS-Cov2: Lessons from a Pandemic. Anticancer Res 2023; 43:2235-2241. [PMID: 37097690 DOI: 10.21873/anticanres.16387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/17/2023] [Accepted: 03/02/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND/AIM The COVID-19 pandemic introduced drastic containment measures, which had a direct impact on breast cancer management. During the first wave, a delay in care and a decrease in new consultation numbers was observed. It would be interesting to study the resulting long-term consequences on breast cancer presentation and time to first treatment. PATIENTS AND METHODS This retrospective cohort study was conducted at the surgery Department of the Anti-Cancer Center of Nice, France. Two periods of 6 months were compared: a pandemic period from June to December 2020 (after the end of the first wave), and a control period one year earlier. The primary endpoint was to measure the time to care access. The patients and cancer characteristics and the management type were also compared. RESULTS A total of 268 patients underwent diagnosis for breast cancer in each period. The time from biopsy to consultation was shortened after the containment was lifted (16 days vs. 18 days, p=0.024). The time between first consultation and treatment was unchanged between the two periods. The tumor size was larger in the pandemic period (21 mm vs. 18 mm, p=0.028). The clinical presentation was different: 59.8% of patients consulted for a palpable mass in the pandemic period, vs. 49.6% in the control period (p=0.023). There was no significant change in therapeutic management. The use of genomic testing was significantly increased. The number of breast cancer cases diagnosed decreased by 30% during the first COVID-19 lockdown. Even though a rebound was expected after the first wave, the number of consultations for breast cancer remained constant. This finding shows the fragility of screening adherence. CONCLUSION It is necessary to reinforce education in the face of crises that may be repeated. Management of breast cancer did not change, which is a reassuring aspect regarding the care pathway in anticancer centers.
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Affiliation(s)
- Marie Gosset
- Département de Chirurgie Sénologique et Onco-Gynécologique, Centre Antoine-Lacassagne, Nice, France;
| | - Jocelyn Gal
- Département d'Epidémiologie, de Biostatistiques et des Données de Santé (DEBDS), Centre Antoine-Lacassagne, Université Côte d'Azur, Nice, France
| | - Renaud Schiappa
- Département d'Epidémiologie, de Biostatistiques et des Données de Santé (DEBDS), Centre Antoine-Lacassagne, Université Côte d'Azur, Nice, France
| | - Christopher Helwig
- Département de Chirurgie Sénologique et Onco-Gynécologique, Centre Antoine-Lacassagne, Nice, France
| | - Iris Bonomo
- Département de Chirurgie Sénologique et Onco-Gynécologique, Centre Antoine-Lacassagne, Nice, France
| | - Yann Delpech
- Département de Chirurgie Sénologique et Onco-Gynécologique, Centre Antoine-Lacassagne, Nice, France
| | - Emmanuel Barranger
- Département de Chirurgie Sénologique et Onco-Gynécologique, Centre Antoine-Lacassagne, Nice, France
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Najib B, Gosset M, Abdallah W, Haudebourg J, Elkind L, Delpech Y, Barranger E. SENODAY: A New Perspective of Handling Breast Cancer. Clin Breast Cancer 2023:S1526-8209(23)00090-3. [PMID: 37211516 DOI: 10.1016/j.clbc.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/16/2023] [Accepted: 04/18/2023] [Indexed: 05/23/2023]
Abstract
BACKGROUND To evaluate the feasibility of a same day breast cancer diagnosis and management protocol, consequently decreasing time to treatment and immediately reassuring patients with benign diagnosis. MATERIALS AND METHODS A total of 60 women underwent breast exam during SENODAY in our cancer center between January 2020 and December 2022. Patients are first seen by a breast surgeon who mentions whether the patient's history and physical exam are suspicious of malignancy. Patients are then sent to the radiologist who performs a complete radiologic assessment, classifies the lesions, and performs a biopsy when necessary. The specimen is sent to the pathologist who uses the imprint cytology technique to obtain a preliminary diagnosis. Effective counseling is established in case of breast cancer diagnosis. RESULTS Among 60 women, 25 patients were reassured by breast imaging and 35 underwent histopathological analysis (17 patients with a 1-day protocol and 18 with the standard definitive technique). Clinical examination was found to have a sensitivity of 100% and a specificity of 89.47%. The positive predictive value was 80 % and the negative predictive value was 100%. However, we did not find a strong correlation between imaging and definitive pathology. Moreover, on imprint cytology, sensitivity, specificity, PPV, and NPV were 100%. Finally, the mean time-to-treat was 28.6 days. CONCLUSIONS SENODAY reassured 68.3% of patients. It also offered effective counseling and a treatment plan to newly diagnosed breast cancer patients within 1 day. Same day histological diagnosis by imprint cytology is effective and feasible with an excellent accuracy.
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Affiliation(s)
- Bernard Najib
- Department of breast and gynecologic oncology, Centre Antoine Lacassagne, Nice, France.
| | - Marie Gosset
- Department of breast and gynecologic oncology, Centre Antoine Lacassagne, Nice, France
| | - Wael Abdallah
- Department of obstetrics and fetal medicine, Centre Hospitalier Intercommunal de Poissy, Poissy, France
| | | | - Laura Elkind
- Department of radiology, Centre Antoine Lacassagne, Nice, France
| | - Yann Delpech
- Department of breast and gynecologic oncology, Centre Antoine Lacassagne, Nice, France
| | - Emmanuel Barranger
- Department of breast and gynecologic oncology, Centre Antoine Lacassagne, Nice, France
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Foguem C, Seror R, Gosset M. Chemosensory dysfunction in primary Sjögren's syndrome: a topical review. Clin Rheumatol 2023; 42:1-14. [PMID: 36063255 PMCID: PMC9443648 DOI: 10.1007/s10067-022-06359-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 08/08/2022] [Accepted: 08/26/2022] [Indexed: 01/11/2023]
Abstract
Primary Sjögren's syndrome is an autoimmune exocrinopathy related to lymphocytic infiltration of the exocrine glandular epithelia (such as salivary, lacrimal, nasal, and sebaceous glands or vaginal mucosa) with systemic manifestations of an immuno-inflammatory nature, and not associated with any other systemic disease. It is characterized by severe dryness (Sicca syndrome), particularly in mouth and eyes, with potential strong impact on quality of life and could increase the risk of depression in Sjögren's patient. To date, the impairment of taste and olfactory functions related to Sjögren syndrome remains poorly assessed; so is the trigeminal functions which remain sparsely studied in patients with Sjögren disease. However, other factors can also modify chemosensory functions (olfactory or gustatory sensations and trigeminal nerves), in particular the reduction of the masticatory coefficient or halitosis, due to oral saliva flow decrease, and poor dental condition, which are often present in Sjögren patients. Of the 12 articles evaluated after a 22-year literature search of this review, chemosensory disorders (including taste, smell, and trigeminal impairments) are described and evaluated in pSS patients, with mainly poorer performance compared to healthy controls. Diagnostic and therapeutic (including rehabilitation) approaches of chemosensory disorders in pSS are discussed in this review. Clinician should be more attentive to taste as well as olfacto-trigeminal disorders in primary Sjögren's disease, if possible at the earlier stage, in order to take the best care of Sjögren's patients. This review also highlights some lack in knowledge on pSS chemosensory disorders that should provide new research perspectives. Key Points •Chemosensory functions (including taste, smell, and trigeminal functions) are altered in patients with primary Sjögren's syndrome (pSS) due to dryness of the mouth and the nose. •The trigeminal nerve which interacts with olfactory and gustatory nerves contributes to olfactory and taste perception but remains little studied to date. •Chemosensory function should be considered in the daily clinical assessment of patients with pSS. •Chemosensory function treatment is not standardized yet, however symptomatic treatment of Sjögren syndrome-associated dryness transiently would improve taste and smell, and olfactory or gustatory rehabilitation in pSS patients would be useful.
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Affiliation(s)
- C Foguem
- Auban Moët-Centre Hospitalier d'Epernay, Adresse:137, Rue de l'Hôpital, 51200, Epernay, France.
| | - R Seror
- Hôpital Bicêtre, Hôpitaux Universitaires Paris-Sud (AP-HP), Le Kremlin-Bicêtre, France
| | - M Gosset
- Service de Médecine Bucco-Dentaire, AP-HP, Hôpital Charles Foix, 94200, Ivry/seine, France
- Laboratory of Orofacial Pathologies, Imaging and Biotherapies URP2496, Université de Paris, 92120, Montrouge, France
- Laboratoire d'Excellence, INFLAMEX, Paris, France
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Vanhoye X, Janin A, Caillaud A, Rimbert A, Venet F, Gosset M, Dijk W, Marmontel O, Nony S, Chatelain C, Lindenbaum P, Cariou B, Moulin P, Di Filippo M. Leu351Arg in apoB, a new missense variant causing familial hypobetalipoproteinemia. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.667] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Detzen L, Cheat B, Besbes A, Hassan B, Marchi V, Baroukh B, Lesieur J, Sadoine J, Torrens C, Rochefort G, Bouchet J, Gosset M. NLRP3 is involved in long bone edification and the maturation of osteogenic cells. J Cell Physiol 2021; 236:4455-4469. [PMID: 33319921 DOI: 10.1002/jcp.30162] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 10/28/2020] [Accepted: 11/04/2020] [Indexed: 12/18/2022]
Abstract
Overexpression of the nucleotide-binding leucine-rich repeat protein 3 (NLRP3) inflammasome in chronic auto-immune diseases leads to skeletal anomalies, with severe osteopenia due to the activation of osteoclasts. Reproducing this phenotype in Nlrp3 knock-in mice has provided insights into the role of NLRP3 in bone metabolism. We studied the role of NLRP3 in physiological bone development using a complete Nlrp3 knock-out mouse model. We found impaired skeletal development in Nlrp3-/- mice, resulting in a shorter stature than that of Nlrp3+/+ mice. These growth defects were associated with altered femur bone growth, characterized by a deficient growth plate and an osteopenic profile of the trabeculae. No differences in osteoclast recruitment or activity were observed. Instead, Nlrp3-/- femurs showed a less mineralized matrix in the trabeculae than those of Nlrp3+/+ mice, as well as less bone sialoprotein (BSP) expressing hypertrophic chondrocytes. In vitro, primary osteoblasts lacking NLRP3 expression showed defective mineralization, together with the downregulation of BSP expression. Finally, follow-up by micro-CT highlighted the role of NLPR3 in bone growth, occurring early in living mice, as the osteopenic phenotype diminishes over time. Overall, our data suggest that NLRP3 is involved in bone edification via the regulation of hypertrophic chondrocyte maturation and osteoblast activity. Furthermore, the defect appeared to be transitory, as the skeleton recovered with aging.
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Affiliation(s)
- L Detzen
- UR 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Université de Paris, Montrouge, France
- Département de Parodontologie, Service d'Odontologie, AP-HP, Hôpital Rothschild, Paris, France
- Laboratoire d'Excellence INFLAMEX, France
| | - B Cheat
- UR 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Université de Paris, Montrouge, France
- Laboratoire d'Excellence INFLAMEX, France
| | - A Besbes
- UR 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Université de Paris, Montrouge, France
- Laboratoire d'Excellence INFLAMEX, France
- Faculté de Médecine Dentaire, Université de Monastir, Monastir, Tunisie
| | - B Hassan
- UR 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Université de Paris, Montrouge, France
- Laboratoire d'Excellence INFLAMEX, France
| | - V Marchi
- UR 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Université de Paris, Montrouge, France
- Laboratoire d'Excellence INFLAMEX, France
| | - B Baroukh
- UR 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Université de Paris, Montrouge, France
- Laboratoire d'Excellence INFLAMEX, France
| | - J Lesieur
- UR 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Université de Paris, Montrouge, France
- Laboratoire d'Excellence INFLAMEX, France
| | - J Sadoine
- UR 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Université de Paris, Montrouge, France
- Plateforme Imageries du Vivant, Faculté de Chirurgie Dentaire, Université de Paris, Paris, France
| | - C Torrens
- UR 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Université de Paris, Montrouge, France
- Laboratoire d'Excellence INFLAMEX, France
| | - G Rochefort
- UR 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Université de Paris, Montrouge, France
- Laboratoire d'Excellence INFLAMEX, France
| | - J Bouchet
- UR 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Université de Paris, Montrouge, France
- Laboratoire d'Excellence INFLAMEX, France
| | - M Gosset
- UR 2496, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Université de Paris, Montrouge, France
- Laboratoire d'Excellence INFLAMEX, France
- Service de Médecine Bucco-Dentaire, AP-HP, Hôpital Charles Foix, Ivry/seine, France
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Defer A, Tessier V, Haudebourg J, Dejode M, Gosset M, Barranger E, Delpech Y. [Is preoperative axillary radio-cytology justified after ACOSOG Z001?]. Bull Cancer 2021; 108:605-613. [PMID: 33975722 DOI: 10.1016/j.bulcan.2021.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 02/13/2021] [Accepted: 02/19/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Invasive breast cancer without clinical adenopathy (cN0) is currently explored by the sentinel node (GS) technique, except in the case of positive preoperative radio-cytological screening, where axillary curage (CA) remains systematic from the outset. Since the publication of the ACOSOG-Z0011 trial, abstention from CA is possible in patients presenting less than three metastatic GS. As a result, the value of axillary radio-cytological screening is being questioned as it could potentially lead to axillary surgical over-treatment. The objective of this study was to study clinically N0 patients with positive axillary cytology and to compare it to a group of patients with positive GS. METHOD One hundred and forty-seven patients with cN0 pN+ breast cancer treated between 2014 and 2016 were selected retrospectively. Two groups were constituted according to the initial radio-cytological evaluation. A CA was systematically performed. RESULTS Thirty-one patients with positive axillary cytology (n=31 vs. n=116) had more metastatic lymph nodes (P=0.01) in the AC, larger (P<0.001), less differentiated (P<0.001) tumours, and shorter recurrence-free survival (P=0.0114). It also appeared that 38.7 % of patients with a positive cytology had at most two metastatic nodes and could, according to the results of ACOSOG, benefit from therapeutic de-escalation. CONCLUSION X-ray cytological screening remains essential in order to select a subgroup of patients with a high lymph node tumour load. Additional studies are necessary in order to be able to offer therapeutic de-escalation to 1/3 of these patients without the risk of under-treatment for the remaining 2/3.
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Affiliation(s)
- Antoine Defer
- Centre Antoine-Lacassagne, département de chirurgie sénologique, onco-gynécologique et reconstruction, 33, avenue de Valombrose, 06189 Nice cedex 2, France.
| | - Vincent Tessier
- Centre Antoine-Lacassagne, département de chirurgie sénologique, onco-gynécologique et reconstruction, 33, avenue de Valombrose, 06189 Nice cedex 2, France
| | - Juliette Haudebourg
- Centre Antoine-Lacassagne, département des laboratoires, laboratoire d'anatomocytopathologie, 33, avenue de Valombrose, 06189 Nice cedex 2, France
| | - Magali Dejode
- Centre Antoine-Lacassagne, département de chirurgie sénologique, onco-gynécologique et reconstruction, 33, avenue de Valombrose, 06189 Nice cedex 2, France
| | - Marie Gosset
- Centre Antoine-Lacassagne, département de chirurgie sénologique, onco-gynécologique et reconstruction, 33, avenue de Valombrose, 06189 Nice cedex 2, France
| | - Emmanuel Barranger
- Centre Antoine-Lacassagne, département de chirurgie sénologique, onco-gynécologique et reconstruction, 33, avenue de Valombrose, 06189 Nice cedex 2, France
| | - Yann Delpech
- Centre Antoine-Lacassagne, département de chirurgie sénologique, onco-gynécologique et reconstruction, 33, avenue de Valombrose, 06189 Nice cedex 2, France
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Gosset M, Gal J, Schiappa R, Dejode M, Fouché Y, Alazet F, Roux E, Delpech Y, Barranger E. [Impact of COVID-19 pandemic on breast and gynecologic cancers management. Experience of the Surgery Department in the Nice Anticancer Center]. Bull Cancer 2020; 108:3-11. [PMID: 33358012 PMCID: PMC7690308 DOI: 10.1016/j.bulcan.2020.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/28/2020] [Accepted: 10/02/2020] [Indexed: 12/15/2022]
Abstract
Introduction Durant la pandémie de COVID-19, les mesures de confinement et les recommandations des sociétés savantes de cancérologie ont pu impacter le recours aux soins des patients. Méthodes Cette étude rétrospective unicentrique comparaît le nombre et les caractéristiques des patientes reçues pour une première consultation pour une tumeur du sein ou gynécologique entre la période du confinement et une période contrôle, ainsi que les délais de prise en charge et les traitements proposés. Résultats Durant le confinement, 91 patientes ont été vues pour une demande de prise en charge, contre 159 durant la période contrôle, soit une baisse de 43,5 %. Les patientes étaient plus âgées (62,9 contre 60,9 ans), sans que cette différence soit significative (p = 0,339). Le stade tumoral n’était pas modifié. En sénologie, le délai entre la biopsie et la première consultation a été allongé de 5,5 jours (différence non significative). Parmi les 51 patientes ayant une indication opératoire durant le confinement, 16 (31,4 %) ont été reportées après la levée du confinement. Malgré tout, le délai entre la consultation et le début des traitements n’a pas été impacté. Nous n’avons pas non plus mis en évidence de modification statistiquement significative des pratiques. Discussion Au plus fort de la pandémie, les bénéfices et les risques du traitement du cancer ont dû être évalués en permanence, face au risque d’exposition au SARS-CoV-2. L’évaluation des pratiques en oncologie est essentielle pour comprendre le réel impact de cette pandémie, et se préparer à d’éventuelles crises futures.
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Affiliation(s)
- Marie Gosset
- Université Côte d'Azur, centre Antoine-Lacassagne, département de chirurgie sénologique et onco-gynécologique, 33, avenue de Valombrose, 06189 Nice cedex, France.
| | - Jocelyn Gal
- Université Côte d'Azur, centre Antoine-Lacassagne, département d'épidémiologie, de biostatistiques et des données de santé (DEBDS), 33, avenue de Valombrose, 06189 Nice cedex, France
| | - Renaud Schiappa
- Université Côte d'Azur, centre Antoine-Lacassagne, département d'épidémiologie, de biostatistiques et des données de santé (DEBDS), 33, avenue de Valombrose, 06189 Nice cedex, France
| | - Magali Dejode
- Université Côte d'Azur, centre Antoine-Lacassagne, département de chirurgie sénologique et onco-gynécologique, 33, avenue de Valombrose, 06189 Nice cedex, France
| | - Yves Fouché
- Université Côte d'Azur, centre Antoine-Lacassagne, département de chirurgie sénologique et onco-gynécologique, 33, avenue de Valombrose, 06189 Nice cedex, France
| | - Fanny Alazet
- Université Côte d'Azur, centre Antoine-Lacassagne, département de chirurgie sénologique et onco-gynécologique, 33, avenue de Valombrose, 06189 Nice cedex, France
| | - Emilie Roux
- Université Côte d'Azur, centre Antoine-Lacassagne, département de chirurgie sénologique et onco-gynécologique, 33, avenue de Valombrose, 06189 Nice cedex, France
| | - Yann Delpech
- Université Côte d'Azur, centre Antoine-Lacassagne, département de chirurgie sénologique et onco-gynécologique, 33, avenue de Valombrose, 06189 Nice cedex, France
| | - Emmanuel Barranger
- Université Côte d'Azur, centre Antoine-Lacassagne, département de chirurgie sénologique et onco-gynécologique, 33, avenue de Valombrose, 06189 Nice cedex, France
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Hotton J, Koual M, Gosset M, Rossi L, Delomenie M, Ngo C, Lecuru F, Bats AS. Outcomes of robotic surgery for endometrial cancer in elderly women. Surg Oncol 2020; 33:24-29. [DOI: 10.1016/j.suronc.2019.12.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 12/09/2019] [Accepted: 12/30/2019] [Indexed: 01/11/2023]
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Uzan J, Bonsang-Kitzis H, Rossi L, Rance B, Bats AS, Gosset M, Deloménie M, Pujade-Lauraine E, Lécuru F, Ngô C. Prognostic impact of initial tumor load and intraperitoneal disease dissemination patterns in patients with advanced ovarian cancer undergoing complete cytoreductive surgery. Eur J Surg Oncol 2019; 45:1619-1624. [PMID: 31014987 DOI: 10.1016/j.ejso.2019.04.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 04/04/2019] [Accepted: 04/12/2019] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION Complete removal of disease is the most important prognostic factor for patients with advanced epithelial ovarian carcinoma. However, the influence of carcinomatosis distribution on prognosis is unknown and the prognostic impact of implant size according to their location is poorly studied. Our objective was to assess the impact of peritoneal carcinomatosis quantitative and qualitative localizations on progression free survival (PFS) in patients with advanced epithelial ovarian carcinoma (AEOC) after complete cytoreductive surgery. METHODS We conducted a monocentric cohort study, retrospective from October 2001 to July 2014. Inclusion criteria were high-grade AEOC patients without residual disease (CC0) after primary debulking surgery (PDS) or after interval debulking surgery (IDS) following neoadjuvant chemotherapy (NACT). Peritoneal carcinomatosis was assessed according to qualitative criteria and quantitative criteria. RESULTS One hundred and one patients were included. Median PFS was 21·2 months and median OS was 62·2 months. On the whole population, involvement of adipocytes-enriched areas tended to be associated with a decreased PFS and was significantly associated with a decreased OS. Any localization was associated with PFS or OS in the "IDS" subgroup. In the "PDS" subgroup, PCI score and involvement of the right mesocolic area were associated with a decreased PFS. CONCLUSION Initial tumor load has not been found associated with PFS after complete surgery. Adipocytes-enriched areas and right mesocolic areas involvement were associated with poor prognosis in patients receiving primary debulking surgery. Larger-scale studies are needed to assess whether initial tumor load has a prognostic impact even after complete cytoreductive surgery is achieved.
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Affiliation(s)
- Jennifer Uzan
- Department of Breast and Gynecological Surgical Oncology, Hôpital Européen Georges Pompidou, AP-HP, Paris, France
| | - Hélène Bonsang-Kitzis
- Department of Breast and Gynecological Surgical Oncology, Hôpital Européen Georges Pompidou, AP-HP, Paris, France
| | - Léa Rossi
- Department of Breast and Gynecological Surgical Oncology, Hôpital Européen Georges Pompidou, AP-HP, Paris, France; Paris-Descartes University, Sorbonne Paris Cité, Paris, France
| | - Bastien Rance
- Paris-Descartes University, Sorbonne Paris Cité, Paris, France; Department of Medical Informatics, Hôpital Européen Georges Pompidou, AP-HP, Paris, France
| | - Anne-Sophie Bats
- Department of Breast and Gynecological Surgical Oncology, Hôpital Européen Georges Pompidou, AP-HP, Paris, France; Paris-Descartes University, Sorbonne Paris Cité, Paris, France
| | - Marie Gosset
- Department of Breast and Gynecological Surgical Oncology, Hôpital Européen Georges Pompidou, AP-HP, Paris, France; Paris-Descartes University, Sorbonne Paris Cité, Paris, France
| | - Myriam Deloménie
- Department of Breast and Gynecological Surgical Oncology, Hôpital Européen Georges Pompidou, AP-HP, Paris, France
| | - Eric Pujade-Lauraine
- Women Cancer Center and Clinical Research, Hôpital Hôtel-Dieu, AP-HP, Paris, France; Paris-Descartes University, Sorbonne Paris Cité, Paris, France
| | - Fabrice Lécuru
- Department of Breast and Gynecological Surgical Oncology, Hôpital Européen Georges Pompidou, AP-HP, Paris, France; Paris-Descartes University, Sorbonne Paris Cité, Paris, France
| | - Charlotte Ngô
- Department of Breast and Gynecological Surgical Oncology, Hôpital Européen Georges Pompidou, AP-HP, Paris, France; Paris-Descartes University, Sorbonne Paris Cité, Paris, France.
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Pacelli J, Gosset M, Rossi L, Ngo C, Delomenie M, Nos C, Lécuru F, Bats AS. [Prophylactic hysterectomy in Lynch syndrome: Feasibility and outcomes]. ACTA ACUST UNITED AC 2019; 47:497-503. [PMID: 31003015 DOI: 10.1016/j.gofs.2019.04.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Lynch syndrome (LS) is a hereditary predisposition to cancers, first of all, colo-rectal and endometrial cancers in women. Although recommended, gynecologic screening has never proven its benefit. Prophylactic surgery can be considered once the parental project is completed. There are few data regarding the assessment of prophylactic surgery. The objectives of our study were to evaluate the feasibility and morbidity of prophylactic hysterectomy in patients with Lynch syndrome. METHODS This is a descriptive retrospective study of consecutive patients with LS undergoing prophylactic hysterectomy at the Georges-Pompidou European Hospital from 2002 to 2016. We collected demographic characteristics, results of preoperative assessment, intra- and postoperative data, final pathologic result as well as postoperative follow-up data. RESULTS Forty patients were included in the study, and seventeen women had a history of colon cancer surgery. All hysterectomies were performed by laparoscopy, with two cases of laparoconversion. Two intraoperative complications occurred: serosal small bowel injuries and superficial bladder injury. Two early postoperative complications occurred (a peritonitis on small bowel perforation and a peritonitis on left ureteral injury) and two late complications (vesico-vaginal fistula and adhesive small bowel obstruction). All operative specimens were benign. With a median follow-up of 28 months [5-52], no patient had peritoneal cancer. CONCLUSIONS Our study shows that prophylactic hysterectomy in Lynch syndrome should be done with caution. Per and postoperative complication rates appear to be higher than in general population, probably related to a more frequent history of colorectal cancer. However, total hysterectomy with bilateral salpingo-oophorectomy appears to be an effective strategy for preventing gynecological cancers in women with the Lynch syndrome.
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Affiliation(s)
- J Pacelli
- Chirurgie cancérologique gynécologique et du sein, hôpital Européen Georges-Pompidou, AP-HP, 75015 Paris, France; Inserm UMR-S 747, université Paris-Descartes, 75015 Paris, France
| | - M Gosset
- Chirurgie cancérologique gynécologique et du sein, hôpital Européen Georges-Pompidou, AP-HP, 75015 Paris, France; Faculté de Médecine, Sorbonne Paris-Cité, université Paris-Descartes, 75006 Paris, France
| | - L Rossi
- Chirurgie cancérologique gynécologique et du sein, hôpital Européen Georges-Pompidou, AP-HP, 75015 Paris, France; Faculté de Médecine, Sorbonne Paris-Cité, université Paris-Descartes, 75006 Paris, France
| | - C Ngo
- Chirurgie cancérologique gynécologique et du sein, hôpital Européen Georges-Pompidou, AP-HP, 75015 Paris, France; Faculté de Médecine, Sorbonne Paris-Cité, université Paris-Descartes, 75006 Paris, France
| | - M Delomenie
- Chirurgie cancérologique gynécologique et du sein, hôpital Européen Georges-Pompidou, AP-HP, 75015 Paris, France
| | - C Nos
- Chirurgie cancérologique gynécologique et du sein, hôpital Européen Georges-Pompidou, AP-HP, 75015 Paris, France
| | - F Lécuru
- Chirurgie cancérologique gynécologique et du sein, hôpital Européen Georges-Pompidou, AP-HP, 75015 Paris, France; Faculté de Médecine, Sorbonne Paris-Cité, université Paris-Descartes, 75006 Paris, France
| | - A-S Bats
- Chirurgie cancérologique gynécologique et du sein, hôpital Européen Georges-Pompidou, AP-HP, 75015 Paris, France; Inserm UMR-S 747, université Paris-Descartes, 75015 Paris, France; Faculté de Médecine, Sorbonne Paris-Cité, université Paris-Descartes, 75006 Paris, France.
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Hotton J, Balaya V, Ngo C, Delomenie M, Gosset M, Mimouni M, Bonsang-Kitzis H, Bats AS, Lecuru F. Outcomes after (robot assisted) laparoscopic radical hysterectomy with sentinel lymph node dissection. Eur J Obstet Gynecol Reprod Biol 2019. [DOI: 10.1016/j.ejogrb.2018.08.444] [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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Balaya V, Guimiot F, Uhl JF, Ngo C, Delomenie M, Bonsang-Kitzis H, Gosset M, Mimouni M, Bats AS, Delmas V, Douard R, Lécuru F. Three-Dimensional Modelization of the Female Human Inferior Hypogastric Plexus: Implications for Nerve-Sparing Radical Hysterectomy. Gynecol Obstet Invest 2018; 84:196-203. [PMID: 30380543 DOI: 10.1159/000494255] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 10/02/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS This study aims to describe the autonomic nervous network of the female pelvis with a 3D model and to provide a safe plane of dissection during radical hysterectomy for cervical cancer. METHODS Pelvises of 3 human female fetuses were studied by using the computer-assisted anatomic dissection. RESULTS The superior hypogastric plexus (SHP) was located at the level of the aortic bifurcation in front of the sacral promontory and divided inferiorly and laterally into 2 hypogastric nerves (HN). HN ran postero-medially to the ureter and in the lateral part of the uterosacral ligament until the superior angle of the inferior hypogastric plexus (IHP). IHP extended from the anterolateral face of the rectum, laterally to the cervix and attempted to the base of the bladder. Vesical efferences merged from the crossing point of the ureter and the uterine artery and ran through the posterior layer of the vesico-uterine ligament. CONCLUSIONS The SHP could be injured during paraaortic lymphadenectomy. Following the ureter and resecting the medial fibrous part of the uterosacral ligament may spare the HN. No dissection should be performed under the crossing point of the ureter and the uterine artery.
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Affiliation(s)
- Vincent Balaya
- Department of Gynecologic and Breast Oncologic Surgery, Georges Pompidou European Hospital, Paris, .,Human Anatomy Institute EA 4465 UFR Biomédicale des Saints-Pères, Paris, .,Paris Descartes University, Sorbonne Paris Cité, Faculty of Medicine, Paris,
| | - Fabien Guimiot
- Department of Fetopathology, Robert Debré Hospital, Paris, France
| | - Jean-François Uhl
- Human Anatomy Institute EA 4465 UFR Biomédicale des Saints-Pères, Paris, France.,Paris Descartes University, Sorbonne Paris Cité, Faculty of Medicine, Paris, France
| | - Charlotte Ngo
- Department of Gynecologic and Breast Oncologic Surgery, Georges Pompidou European Hospital, Paris, France.,Paris Descartes University, Sorbonne Paris Cité, Faculty of Medicine, Paris, France
| | - Myriam Delomenie
- Department of Gynecologic and Breast Oncologic Surgery, Georges Pompidou European Hospital, Paris, France.,Paris Descartes University, Sorbonne Paris Cité, Faculty of Medicine, Paris, France
| | - Hélène Bonsang-Kitzis
- Department of Gynecologic and Breast Oncologic Surgery, Georges Pompidou European Hospital, Paris, France.,Paris Descartes University, Sorbonne Paris Cité, Faculty of Medicine, Paris, France
| | - Marie Gosset
- Department of Gynecologic and Breast Oncologic Surgery, Georges Pompidou European Hospital, Paris, France.,Paris Descartes University, Sorbonne Paris Cité, Faculty of Medicine, Paris, France
| | - Myriam Mimouni
- Department of Gynecologic and Breast Oncologic Surgery, Georges Pompidou European Hospital, Paris, France.,Paris Descartes University, Sorbonne Paris Cité, Faculty of Medicine, Paris, France
| | - Anne-Sophie Bats
- Department of Gynecologic and Breast Oncologic Surgery, Georges Pompidou European Hospital, Paris, France.,Paris Descartes University, Sorbonne Paris Cité, Faculty of Medicine, Paris, France
| | - Vincent Delmas
- Human Anatomy Institute EA 4465 UFR Biomédicale des Saints-Pères, Paris, France.,Paris Descartes University, Sorbonne Paris Cité, Faculty of Medicine, Paris, France
| | - Richard Douard
- Human Anatomy Institute EA 4465 UFR Biomédicale des Saints-Pères, Paris, France.,Paris Descartes University, Sorbonne Paris Cité, Faculty of Medicine, Paris, France.,Department of Digestive and Oncologic Surgery, European Georges Pompidou Hospital, Paris, France
| | - Fabrice Lécuru
- Department of Gynecologic and Breast Oncologic Surgery, Georges Pompidou European Hospital, Paris, France.,Paris Descartes University, Sorbonne Paris Cité, Faculty of Medicine, Paris, France
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Balaya V, Bonsang-Kitzis H, Ngo C, Delomenie M, Gosset M, Mimouni M, Nos C, David P, Bats A, Lecuru F. What about sentinel lymph node biopsy for early breast cancer during pregnancy? J Gynecol Obstet Hum Reprod 2018; 47:205-207. [DOI: 10.1016/j.jogoh.2018.03.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 02/28/2018] [Accepted: 03/02/2018] [Indexed: 11/26/2022]
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Bats AS, Rossi L, Le Frere-Belda MA, Narjoz C, Cournou C, Gosset M, Ngo C, Delomenie M, Nos C, Blons H, Laurent-Puig P, Lecuru F. [Lynch syndrome and endometrial cancer]. Bull Cancer 2017; 104:1013-1021. [PMID: 29061399 DOI: 10.1016/j.bulcan.2017.06.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 06/26/2017] [Indexed: 12/21/2022]
Abstract
Lynch syndrome is a hereditary predisposition to many tumors, in the forefront of which endometrial cancer in women. It is related to the mutation of a mismatch repair gene, involved in DNA mismatch repair. This mutation leads to a loss of expression of the corresponding protein, and to genome instability in tumor cells. Cumulative risk at the age of 70 years is over 40 %. Endometrial cancers related to Lynch syndrome are most of the time sentinel (They reveal the predisposition in half of families.) and are characterized by young age at onset (before 60 years) and low body mass index compared with patients presenting sporadic tumors. Pathological tumor characteristics are debated but it seems to be two types of tumors according to age, older patients having standard tumors and younger ones more aggressive pattern. Endometrial cancers related to Lynch syndrome can be synchronous of ovarian cancer. Therapeutic management does not present any particularity. Conservative treatment can be considered more frequently due to young age of patients but has to respect usual guidelines. Prognosis of these tumors is controversial. Gynaecological screening, although its benefit has not been proved, appears crucial in this population, as well as prophylactic surgery, which remains the best prevention.
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Affiliation(s)
- Anne-Sophie Bats
- Université Paris Descartes, Sorbonne Paris cité, faculté de médecine, 15, rue de l'École-de-médecine, 75006 Paris, France; Assistance publique-Hôpitaux de Paris, hôpital européen Georges-Pompidou, chirurgie cancérologique gynécologique et du sein, 20, rue Leblanc, 75015 Paris, France; Université Paris Descartes, Inserm UMR-S 1147, 45, rue des Saints-Pères, 75006 Paris, France.
| | - Léa Rossi
- Université Paris Descartes, Sorbonne Paris cité, faculté de médecine, 15, rue de l'École-de-médecine, 75006 Paris, France; Assistance publique-Hôpitaux de Paris, hôpital européen Georges-Pompidou, chirurgie cancérologique gynécologique et du sein, 20, rue Leblanc, 75015 Paris, France
| | - Marie-Aude Le Frere-Belda
- Assistance publique-Hôpitaux de Paris, hôpital européen Georges-Pompidou, anatomopathologie, 20, rue Leblanc, 75015 Paris, France; Université Paris Descartes, Inserm UMR-S 1124, 45, rue des Saints-Pères, 75006 Paris, France
| | - Céline Narjoz
- Université Paris Descartes, Sorbonne Paris cité, faculté de médecine, 15, rue de l'École-de-médecine, 75006 Paris, France; Université Paris Descartes, Inserm UMR-S 1147, 45, rue des Saints-Pères, 75006 Paris, France; Assistance publique-Hôpitaux de Paris, hôpital européen Georges-Pompidou, biochimie, 20, rue Leblanc, 75015 Paris, France
| | - Caroline Cournou
- Université Paris Descartes, Sorbonne Paris cité, faculté de médecine, 15, rue de l'École-de-médecine, 75006 Paris, France; Assistance publique-Hôpitaux de Paris, hôpital européen Georges-Pompidou, chirurgie cancérologique gynécologique et du sein, 20, rue Leblanc, 75015 Paris, France
| | - Marie Gosset
- Université Paris Descartes, Sorbonne Paris cité, faculté de médecine, 15, rue de l'École-de-médecine, 75006 Paris, France; Assistance publique-Hôpitaux de Paris, hôpital européen Georges-Pompidou, chirurgie cancérologique gynécologique et du sein, 20, rue Leblanc, 75015 Paris, France
| | - Charlotte Ngo
- Université Paris Descartes, Sorbonne Paris cité, faculté de médecine, 15, rue de l'École-de-médecine, 75006 Paris, France; Assistance publique-Hôpitaux de Paris, hôpital européen Georges-Pompidou, chirurgie cancérologique gynécologique et du sein, 20, rue Leblanc, 75015 Paris, France; Université Paris Descartes, Inserm UMR-S 1147, 45, rue des Saints-Pères, 75006 Paris, France
| | - Myriam Delomenie
- Assistance publique-Hôpitaux de Paris, hôpital européen Georges-Pompidou, chirurgie cancérologique gynécologique et du sein, 20, rue Leblanc, 75015 Paris, France
| | - Claude Nos
- Assistance publique-Hôpitaux de Paris, hôpital européen Georges-Pompidou, chirurgie cancérologique gynécologique et du sein, 20, rue Leblanc, 75015 Paris, France
| | - Hélène Blons
- Université Paris Descartes, Sorbonne Paris cité, faculté de médecine, 15, rue de l'École-de-médecine, 75006 Paris, France; Université Paris Descartes, Inserm UMR-S 1147, 45, rue des Saints-Pères, 75006 Paris, France; Assistance publique-Hôpitaux de Paris, hôpital européen Georges-Pompidou, biochimie, 20, rue Leblanc, 75015 Paris, France
| | - Pierre Laurent-Puig
- Université Paris Descartes, Sorbonne Paris cité, faculté de médecine, 15, rue de l'École-de-médecine, 75006 Paris, France; Université Paris Descartes, Inserm UMR-S 1147, 45, rue des Saints-Pères, 75006 Paris, France; Assistance publique-Hôpitaux de Paris, hôpital européen Georges-Pompidou, génétique, 20, rue Leblanc, 75015 Paris, France
| | - Fabrice Lecuru
- Université Paris Descartes, Sorbonne Paris cité, faculté de médecine, 15, rue de l'École-de-médecine, 75006 Paris, France; Assistance publique-Hôpitaux de Paris, hôpital européen Georges-Pompidou, chirurgie cancérologique gynécologique et du sein, 20, rue Leblanc, 75015 Paris, France; Université Paris Descartes, Inserm UMR-S 1124, 45, rue des Saints-Pères, 75006 Paris, France
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Ghighi M, Llorens A, Baroukh B, Chaussain C, Bouchard P, Gosset M. Differences between inflammatory and catabolic mediators of peri-implantitis and periodontitis lesions following initial mechanical therapy: An exploratory study. J Periodontal Res 2017; 53:29-39. [PMID: 28898426 DOI: 10.1111/jre.12483] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND OBJECTIVE The aim of this study was to analyze the differences in inflammatory and catabolic mediators expressed in peri-implantitis compared to periodontitis lesions after non-surgical therapy. Peri-implantitis is associated with a faster rate of bone loss when compared with periodontitis, and peri-implant non-surgical therapy is ineffective to cure peri-implantitis. This may be due to persistent inflammation in peri-implantitis tissues after initial mechanical treatment. MATERIAL AND METHODS Eleven patients with peri-implantitis and 10 with severe chronic periodontitis received non-surgical therapy. They were included at re-evaluation (8 weeks) if they presented pocket depth ≥6 mm with bleeding on probing, and the indication for open flap debridement surgery. Connective tissues were harvested during surgery from diseased sites. Healthy gingiva were harvested during third molar extraction in a third group of healthy patients (n=10). Explants were incubated for 24 hours in media culture and the release of cytokines, chemokines, growth factors, osteoprotegerin, receptor activator of nuclear factor kappa-B ligand (RANKL), matrix metalloproteinase and tissue inhibitors of matrix metalloproteinase (TIMP) in the conditioned media was analyzed by an exploratory multiplex immunoassay. When difference was found in the conditioned media, an immunohistochemistry was performed to compare expression in the tissues. RESULTS Connective tissues from non-stabilized peri-implantitis exhibited a distinct cytokine profile compared to periodontitis lesions that did not respond to initial therapy. Indeed, TIMP-2 was significantly increased in media from peri-implantitis (P≤.05). In addition, the in situ expression of TIMP-2, interleukin-10 and RANKL was also significantly increased in peri-implantitis tissues (P≤.05). However, the ratio of RANKL/osteoprotegerin-positive cells did not vary (P≥.05). CONCLUSION This study suggests that peri-implantitis and periodontitis connective tissues exhibit differences in response to non-surgical treatment, which may contribute to a different pattern of disease evolution.
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Affiliation(s)
- M Ghighi
- EA 2496, U.F.R. of Odontology, Paris Descartes University, Montrouge, France.,Department of Periodontology, U.F.R. of Odontology, Rothschild Hospital, AP-HP, Paris Diderot University, Paris, France
| | - A Llorens
- EA 2496, U.F.R. of Odontology, Paris Descartes University, Montrouge, France
| | - B Baroukh
- EA 2496, U.F.R. of Odontology, Paris Descartes University, Montrouge, France
| | - C Chaussain
- EA 2496, U.F.R. of Odontology, Paris Descartes University, Montrouge, France.,Department of Odontology, Bretonneau Hospital, AP-HP, Hôpitaux Universitaires Paris Nord Val de Seine (Bretonneau), Paris, France
| | - P Bouchard
- EA 2496, U.F.R. of Odontology, Paris Descartes University, Montrouge, France.,Department of Periodontology, U.F.R. of Odontology, Rothschild Hospital, AP-HP, Paris Diderot University, Paris, France
| | - M Gosset
- EA 2496, U.F.R. of Odontology, Paris Descartes University, Montrouge, France.,Department of Periodontology, Charles Foix Hospital, AP-HP, Hôpitaux Universitaires La Pitié Salpétrière - Charles Foix, Paris, France
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Affiliation(s)
- M Gosset
- Département de gynécologie obstétrique, centre hospitalier intercommunal André-Grégoire, 56, boulevard de la Boissière, 93100 Montreuil, France.
| | - A Ilenko
- Département de gynécologie obstétrique, centre hospitalier universitaire, Amiens-Picardie, Site Sud, 80054 Amiens, France
| | - J Bouyou
- Département de gynécologie obstétrique, centre hospitalier universitaire, Amiens-Picardie, Site Sud, 80054 Amiens, France
| | - B Renevier
- Département de gynécologie obstétrique, centre hospitalier intercommunal André-Grégoire, 56, boulevard de la Boissière, 93100 Montreuil, France
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Gosset M, Hamy AS, Mallon P, Delomenie M, Mouttet D, Pierga JY, Lae M, Fourquet A, Rouzier R, Reyal F, Feron JG. Prognostic Impact of Time to Ipsilateral Breast Tumor Recurrence after Breast Conserving Surgery. PLoS One 2016; 11:e0159888. [PMID: 27494111 PMCID: PMC4975471 DOI: 10.1371/journal.pone.0159888] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 07/08/2016] [Indexed: 01/02/2023] Open
Abstract
Background The poor prognosis of patients who experience ipsilateral breast tumor recurrence (IBTR) after breast conserving surgery (BCS) is established. A short time between primary cancer and IBTR is a prognostic factor but no clinically relevant threshold was determined. Classification of IBTR may help tailor treatment strategies. Purpose We determined a specific time frame, which differentiates IBTR into early and late recurrence, and identified prognostic factors for patients with IBTR at time of the recurrence. Methods We analyzed 2209 patients with IBTR after BCS. We applied the optimal cut-points method for survival data to determine the cut-off times to IBTR. A subgroup analysis was performed by hormone receptor (HR) status. Survival analyses were performed using a Cox proportional hazard model to determine clinical features associated with distant-disease-free survival (DDFS) after IBTR. We therefor built decision trees. Results On the 828 metastatic events observed, the majority occurred within the first 3 months after IBTR: 157 in the HR positive group, 98 in the HR negative group. We found different prognostic times to IBTR: 49 months in the HR positive group, 33 in the HR negative group. After multivariate analysis, time to IBTR was the first discriminant prognostic factor in both groups (HR 0.65 CI95% [0.54–0.79] and 0.42 [0.30–0.57] respectively). The other following variables were significantly correlated with the DDFS: the initial number of positive lymph nodes for both groups, the initial tumor size and grade for HR positive tumors. Conclusion A short interval time to IBTR is the strongest factor of poor prognosis and reflects occult distant disease. It would appear that prognosis after IBTR depends more on clinical and histological parameters than on surgical treatment. A prospective trial in a low-risk group of patients to validate the safety of salvage BCS instead of mastectomy in IBTR is needed.
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Affiliation(s)
- Marie Gosset
- Department of Surgery, Institut Curie, 75005, Paris, France
| | | | - Peter Mallon
- Breast Unit, Belfast City Hospital, Lisburn Road, Belfast, BT9 7AB, Northern Ireland
| | | | | | - Jean-Yves Pierga
- Department of Medical Oncology, 75005, Institut Curie, Paris, France
- Paris Descartes University, 75006, Paris, France
| | - Marick Lae
- Department of Tumor Biology, Institut Curie, 75005, Paris, France
| | - Alain Fourquet
- Department of Radiotherapy, Institut Curie, 75005, Paris, France
| | - Roman Rouzier
- Department of Surgery, Institut Curie, 75005, Paris, France
| | - Fabien Reyal
- Department of Surgery, Institut Curie, 75005, Paris, France
- Residual Tumor and Response to Treatment Lab, Translational Research Department, Institut Curie, 75005, Paris, France
- UMR932 Immunity and Cancer, INSERM, Institut Curie, 75005, Paris, France
- * E-mail:
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Campillo-Gimenez L, Renaudin F, Bobé P, Gosset M, Combes C, Cohen-Solal M, Lioté F, Ea HK. OP0287 Calcium Pyrophosphate Dihydrate Crystals Induce IL-1β Production by Monocytes through A Potassium Efflux-Dependent Pathway. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5708] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Gosset M, Geyl C, Mirshahi M, Maleki M, Rafii A, Touboul C. 168 Mesenchymal stem cells protects ovarian cancer cells from chemotherapy through IL6 secretion. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30065-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: 10/22/2022]
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Thibault C, Gosset M, Chamming'S F, Lefrere-Belda M, Pecuchet N, Fournier L, Roussel H, Oudard S, Lécuru F, Medioni J. Radiological-Histological Size Correlation in Triple-Negative Breast Cancer (Tnbc). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu327.38] [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: 11/13/2022] Open
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Laiguillon MC, Bougault C, Priam S, Gosset M, Mladenovic Z, Pigenet A, Jacques C, Houard X, Berenbaum F, Sellam J. AB0131 NAMPT/VISFATIN in osteoarthritis: An adipokine involved in the communication between cartilage and bone. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Priam S, Bougault C, Gosset M, Houard X, Sellam J, Berenbaum F, Jacques C. OP0126 Secreted 14-3-3E : Discovery by Proteomics of a New Subchondral Bone Mediator Involved in Cartilage Degradation During Osteoarthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Pecchi E, Priam S, Mladenovic Z, Gosset M, Saurel AS, Aguilar L, Berenbaum F, Jacques C. A potential role of chondroitin sulfate on bone in osteoarthritis: inhibition of prostaglandin E₂ and matrix metalloproteinases synthesis in interleukin-1β-stimulated osteoblasts. Osteoarthritis Cartilage 2012; 20:127-35. [PMID: 22179028 DOI: 10.1016/j.joca.2011.12.002] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [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] [Received: 07/04/2011] [Revised: 11/29/2011] [Accepted: 12/06/2011] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To determine the effect of chondroitin sulfate (CS) on inflammatory mediators and proteolytic enzymes induced by interleukin-1β (IL-1β) and related to cartilage catabolism in murine osteoblasts. DESIGN Osteoblasts were obtained by enzymatic digestion of calvaria from Swiss mice and cultured for 3 weeks as a primary culture. Cells were then stimulated with IL-1β (1 or 10 ng/ml). CS-treated osteoblasts were incubated with 100 μg/ml of CS during the last week of culture w/o IL-1β for the last 24 h. Expressions of cyclooxygenase-2 (COX-2), microsomal prostaglandin E synthase-1 (mPGES-1), 15-PG dehydrogenase (15-PGDH), matrix metalloproteinases-3 and -13 (MMP-3 and -13), osteoprotegerin (OPG) and receptor activator of nuclear factor-kappa B ligand (RANKL) were determined by real-time polymerase chain reaction (PCR). PGE₂, MMP-3 and MMP-13 release were assessed in the medium by enzyme-linked immunosorbent assay or western-blotting. RESULTS IL-1β increased COX-2, mPGES-1, MMP-3, MMP-13, RANKL expressions, decreased 15-PGDH expression, and increased PGE₂, MMP-3 and MMP-13 release. Interestingly, 7 days of CS treatment significantly counteracted IL-1β-induced expression of COX-2 (-62%, P<0.001), mPGES-1 (-63%, P<0.001), MMP-3 (-39%, P=0.08), MMP-13 (-60%, P<0.001) and RANKL (-84%, P<0.001). Accordingly, IL-1β-induced PGE₂, MMP-3 and MMP-13 releases were inhibited by 86% (P<0.001), 58%(P<0.001) and 38% (P<0.01) respectively. CONCLUSIONS In conclusion, our data demonstrate that, in an inflammatory context, CS inhibits the production of PGE₂ and MMPs. Since CS has previously been shown to counteract the production of these mediators in chondrocytes, we speculate that the beneficial effect of CS in Osteoarthritis (OA) could not only be due to its action on cartilage but also on subchondral bone.
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Affiliation(s)
- E Pecchi
- UR 4, University Pierre & Marie Curie Paris VI, Paris Universitas, Aging, Stress and Inflammation Laboratory, 7 quai St-Bernard, 75252 Paris Cedex 5, France
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Gosset M, Andréjak C, Magois E, Aubry P, Mayeux I, Toublanc B, Ammenouche N, Carmi D, Renard C, Jounieaux V. [Dyspnea with fever]. Rev Mal Respir 2009; 26:1011-3. [PMID: 19953051 DOI: 10.1016/s0761-8425(09)73340-6] [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: 11/26/2022]
Affiliation(s)
- M Gosset
- Service de Pneumologie et réanimation respiratoire, Centre Hospitalier Universitaire Sud, Amiens, France
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Gabay O, Gosset M, Levy A, Salvat C, Sanchez C, Pigenet A, Sautet A, Jacques C, Berenbaum F. Stress-induced signaling pathways in hyalin chondrocytes: inhibition by Avocado-Soybean Unsaponifiables (ASU). Osteoarthritis Cartilage 2008; 16:373-84. [PMID: 17707661 DOI: 10.1016/j.joca.2007.06.016] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [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: 11/30/2006] [Accepted: 06/25/2007] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Avocado-Soybean Unsaponifiables (ASU) represent one of the most commonly used drugs for symptomatic osteoarthritis (OA). The mechanisms of its activities are still poorly understood. We investigate here the effects of ASU on signaling pathways in mouse or human chondrocytes. METHODS Mouse or human chondrocytes stimulated with interleukin-1beta (IL1beta, 10 ng/ml) and cartilage submitted to a compressive mechanical stress (MS) were studied in the presence or absence of ASU (10 microg/ml). Nuclear factor kappaB (NF-kappaB) activation was assessed by immunoblot, using an I-kappa B alpha antibody, nuclear translocation of NF-kappaB using p65 antibody, and extra-cellular signal-regulated kinase (ERK)1/2 activation using phospho and ERK1/2 antibodies. The binding of the p50/p65 complex on DNA was studied by electrophoretic mobility shift assay. RESULTS ASU decrease matrix metalloproteinases-3 and -13 expressions and Prostaglandin E(2) (PGE(2)) release in our model. The degradation of I-kappa B alpha is prevented in the presence of ASU as shown by the persistent expression of I-kappa B alpha protein in the cytosol when chondrocytes are stimulated by IL1beta or MS. Nuclear translocation of the NF-kappaB complex is shown by the decrease of the p65 protein from the cytosol, whereas p65 appears in the nucleus under IL1beta stimulation. This translocation is abolished in the presence of ASU. Moreover, bandshift experiments show an inhibition of the IL1beta-induced binding of p50/p65 complexes to NF-kappaB responsive elements in response to ASU. Finally, among the different mitogen-activated protein kinases known to be induced by IL1beta, ERK1/2 was the sole kinase inhibited by ASU. CONCLUSION These results demonstrate that ASU express a unique range of activities, which could counteract deleterious processes involved in OA, such as inflammation.
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Affiliation(s)
- O Gabay
- UMR 7079 University Pierre and Marie Curie Paris VI/CNRS, Physiology and Pathophysiology Laboratory, 7 Quai St Bernard, Paris, 75252 Cedex 5, France
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Poissonnier MH, Brossard Y, Demedeiros N, Vassileva J, Parnet F, Larsen M, Gosset M, Chavinie J, Huchet J. Two hundred intrauterine exchange transfusions in severe blood incompatibilities. Am J Obstet Gynecol 1989; 161:709-13. [PMID: 2506755 DOI: 10.1016/0002-9378(89)90386-4] [Citation(s) in RCA: 66] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Two hundred intrauterine exchange transfusions were performed under local anesthesia in 107 cases of blood incompatibilities (60 fetuses with severe anemia and 47 with hydrops). Under sonographic guidance, depending on fetal and placental position, an optimal puncturing site was selected along the umbilical vein: placental insertion, fetal insertion, or fetal intraabdominal segment. Tests were immediately performed to confirm fetal origin of blood obtained and estimate hemoglobin level. Blood used for exchange transfusion was compatible with maternal blood and had a hematocrit value of 75%. Exchange transfusion was continued until a hemoglobin level of 16 gm/dl was reached. This procedure was first associated with intraperitoneal transfusions and was subsequently used independently once a month to maintain an adequate hemoglobin level. In 4 fetuses with hydrops, antenatal regression of this sign was observed in 33 cases (70.2%). Overall outcome of 107 fetuses after exchanges was 84 living neonates (78.5%), 15 deaths in utero, and eight neonatal deaths. The survival rate was 91.6% for fetuses without hydrops and 61.7% for those with hydrops. The advantage of exchange transfusion appears to be rapid and efficient correction of anemia with elimination of incompatible fetal red blood cells.
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Affiliation(s)
- M H Poissonnier
- Service de Gynécologie Obstétrique, Hôpital Saint-Vincent-De-Paul, Paris, France
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Brossard Y, Gosset M, Feuillet-Fieux MN, Bignozzi C, Dangu C. [Functional study of 11 monoclonal anti-Rh D IgG antibodies. Attempt to define selection criteria with regard to their use in Rh immunoprophylaxis]. Rev Fr Transfus Immunohematol 1988; 31:711-24. [PMID: 3148993 DOI: 10.1016/s0338-4535(88)80079-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Crégut R, Gosset M, Pinon F. [Determination of anti-D activity in plasma pools and gamma globulins destined for Rh prevention]. Rev Fr Transfus 1973; 16:167-74. [PMID: 4136334 DOI: 10.1016/s0035-2977(73)80075-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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