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Jové-Juncà T, Crespo-Piazuelo D, González-Rodríguez O, Pascual M, Hernández-Banqué C, Reixach J, Quintanilla R, Ballester M. Genomic architecture of carcass and pork traits and their association with immune capacity. Animal 2024; 18:101043. [PMID: 38113634 DOI: 10.1016/j.animal.2023.101043] [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: 05/25/2023] [Revised: 11/16/2023] [Accepted: 11/20/2023] [Indexed: 12/21/2023] Open
Abstract
Carcass and pork traits have traditionally been considered of prime importance in pig breeding programmes. However, the changing conditions in modern farming, coupled with antimicrobial resistance issues, are raising the importance of health and robustness-related traits. Here, we explore the genetic architecture of carcass and pork traits and their relationship with immunity phenotypes in a commercial Duroc pig population. A total of nine traits related to fatness, lean content and meat pH were measured at slaughter (∼190 d of age) in 378 pigs previously phenotyped (∼70 d of age) for 36 immunity-related traits, including plasma concentrations of immunoglobulins, acute-phase proteins, leukocytes subpopulations and phagocytosis. Our study showed medium to high heritabilities and strong genetic correlations between fatness, lean content and meat pH at 24 h postmortem. Genetic correlations were found between carcass and pork traits and white blood cells. pH showed strong positive genetic correlations with leukocytes and eosinophils, and strong negative genetic correlations with haemoglobin, haematocrit and cytotoxic T cell proportion. In addition, genome-wide association studies (GWASs) pointed out four significantly associated genomic regions for lean meat percentages in different muscles, ham fat, backfat thickness, and semimembranosus pH at 24 h. The functional annotation of genes located in these regions reported a total of 14 candidate genes, with BGN, DPP10, LEPR, LEPROT, PDE4B and SLC6A8 being the strongest candidates. After performing an expression GWAS for the expression of these genes in muscle, two signals were detected in cis for the BGN and SLC6A8 genes. Our results indicate a genetic relationship between carcass fatness, lean content and meat pH with a variety of immunity-related traits that should be considered to improve immunocompetence without impairing production traits.
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Affiliation(s)
- T Jové-Juncà
- Animal Breeding and Genetics Program, IRTA, Torre Marimon, 08140 Caldes de Montbui, Barcelona, Spain
| | - D Crespo-Piazuelo
- Animal Breeding and Genetics Program, IRTA, Torre Marimon, 08140 Caldes de Montbui, Barcelona, Spain
| | - O González-Rodríguez
- Animal Breeding and Genetics Program, IRTA, Torre Marimon, 08140 Caldes de Montbui, Barcelona, Spain
| | - M Pascual
- Animal Breeding and Genetics Program, IRTA, Torre Marimon, 08140 Caldes de Montbui, Barcelona, Spain
| | - C Hernández-Banqué
- Animal Breeding and Genetics Program, IRTA, Torre Marimon, 08140 Caldes de Montbui, Barcelona, Spain
| | - J Reixach
- Selección Batallé S.A., Av. dels Segadors s/n, 17421 Riudarenes, Girona, Spain
| | - R Quintanilla
- Animal Breeding and Genetics Program, IRTA, Torre Marimon, 08140 Caldes de Montbui, Barcelona, Spain
| | - M Ballester
- Animal Breeding and Genetics Program, IRTA, Torre Marimon, 08140 Caldes de Montbui, Barcelona, Spain.
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van der Gaag M, Heijmans M, Valli C, Orrego C, Ballester M, Rademakers J. Self-management interventions for chronically ill patients with limited health literacy: A descriptive analysis. Chronic Illn 2023:17423953231181410. [PMID: 37312500 DOI: 10.1177/17423953231181410] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVES To support patients with limited health literacy with the challenges they face in the day-to-day management of their disease(s), numerous self-management interventions (SMIs) have been developed. To date, it is unclear to what extent SMIs have been developed for chronically ill patients with limited health literacy. This study aims to provide a description of these SMIs and to provide insight in their methodological components. METHODS A secondary analysis of the COMPAR-EU database, consisting of SMIs addressing patients with diabetes, chronic obstructive pulmonary disease, obesity and heart failure, was conducted. The database was searched for SMIs addressing health literacy, including cognitive aspects and the capacity to act. RESULTS Of the 1681 SMIs in the COMPAR-EU database, 35 studies addressed health literacy, describing 39 SMIs. The overview yields a high variety in interventions given, with overlapping information, but also lacking of specific details. DISCUSSION This descriptive analysis shows that there was a large variety in the extensiveness of the description of intervention characteristics and their justification or explanation. A focus on the broad concept of health literacy, including functional skills, cognitive skills and the capacity to act could improve the effectiveness. This should be taken into account in the future development of SMIs.
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Affiliation(s)
- M van der Gaag
- Netherlands institute for health services research (Nivel), Utrecht, Netherlands
| | - M Heijmans
- Netherlands institute for health services research (Nivel), Utrecht, Netherlands
| | - C Valli
- Iberoamerican Cochrane Centre Barcelona, Barcelona, Spain
- Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - C Orrego
- Avedis Donabedian Research Institute (FAD), Barcelona, Spain
- Universitat Autonoma de Barcelona, Barcelona, Spain
- Red de investigación en servicios de salud en enfermedades crónicas (REDISSEC), Galdakao, Spain
| | - M Ballester
- Avedis Donabedian Research Institute (FAD), Barcelona, Spain
- Universitat Autonoma de Barcelona, Barcelona, Spain
- Red de investigación en servicios de salud en enfermedades crónicas (REDISSEC), Galdakao, Spain
| | - J Rademakers
- Netherlands institute for health services research (Nivel), Utrecht, Netherlands
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
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Boada M, Perez-Poch A, Ballester M, Tresanchez M, Sánchez E, Martínez G, González D, García S, Jordi T, Polyzos N. P-008 Microgravity exposure significantly decreases sperm motility and vitality. Can we consider human reproduction outside the Earth? Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Are fresh human sperm samples affected by different gravitational conditions than on Earth?
Summary answer
Motility and vitality of fresh human sperm samples are significantly decreased under microgravity conditions obtained by parabolic flight.
What is known already
Microgravity effects on the male reproductive system have mainly been studied in the animal model with diverse results and discouraging extrapolation in humans. While an increased motility was reported in bulls, mice models showed a decrease. Although preliminary data from the Micro-11 experiment presented by NASA reported human sperm alterations after microgravity exposure, our first study failed to show any significant effect of microgravity on “frozen” samples, suggesting that human sperm could be safely shipped outside the earth if important aspects related with cryopreservation were solved.
Study design, size, duration
Prospective study carried out in collaboration between the ART centre, a Technical University, and an Aviation Club specializing in parabolic flights.Two parabolic flights were conducted between 2020-2021, each consisting of 20 parabolic maneuvers, which means 160 seconds of microgravity exposure per sample. Fifteen sperm samples obtained from healthy men were included in the study in order to analyse the effects of microgravity and compare the results with those obtained in Earth gravity.
Participants/materials, setting, methods
Fresh sperm samples were checked pre-flight to evaluate vitality, concentration, motility and morphology. Samples were split into two to compare the effects of different gravity exposure: microgravity (flight) and Earth gravity (ground). After the flight, the same analysis were repeated, plus kinematics, DNA fragmentation by sperm chromatin dispersion, apoptosis by magnetic activated cell sorting, and oxidative stress by colorimetric test (Halosperm-Halotech). Computer Aided Semen Analysis (SCA-Scope) was used for cell counting.
Main results and the role of chance
On comparison of the mean values between fresh samples exposed to microgravity and those maintained on Earth gravity, statistical significant differences (p < 0,05) were found in the following parameters: vitality (69,7 ± 9,9 vs 72,4 ± 9,7 %), motile sperm concentration (23,7 ± 15,3 M/ml vs 31,5 ± 25,1 M/ml), grade “a” sperm concentration (8,7 ± 6,5 vs 11,7 ± 9,9 M/ml), percentage of spermatozoa with progressive motility (30 ± 12,9 vs 36 ± 14,3 %), curvilinear motility-VCL (45,7 ± 12,8 vs 47,7 ± 13,3 μm/s). Under the study conditions, non-statistically significant differences were observed in the other kinematic parameters: Lineal Velocity (VSL), Average Path Velocity (VAP), Straightness (STR), Amplitude of Lateral Head displacement (ALH), Linearity (LIN), Wobble (WOB), Beat-Cross Frequency (BCF), total sperm concentration (81,7 ± 112,1 vs 79,7 ± 89,8 M/ml), morphology (11,3 ± 6,3 vs 10,6 ± 5,3%), DNA fragmentation (14,6 ± 9,6 vs 15,7 ± 9,4), apoptosis (2,8 ± 2,8 vs 3,8 ± 4,4) and oxidative stress, since all samples maintained the same stress level in both splits.
Limitations, reasons for caution
Parabolic flight is an accepted ground-based method for obtaining microgravity conditions, but provides a short period of elapsed exposure to microgravity. Therefore, the results obtained need to be confirmed by using other platforms that provide a much longer time of exposure. More cases must be analysed to confirm the results.
Wider implications of the findings
Short exposure to microgravity significantly decreases sperm motility and vitality. Such an effect is likely to be stronger with longer exposure. These findings should be taken into account since this may eventually affect sperm fertilizing capacity and therefore natural conception or ART with fresh/frozen sperm, outside of the Earth.
Trial registration number
NCT03760783
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Affiliation(s)
- M Boada
- Women's Health Dexeus, Department of Obstetrics- Gynecology and Reproduction , Barcelona, Spain
| | - A Perez-Poch
- UPC Universitat Politècnica de Catalunya., Institute of Education Sciences. Department of Computer Science , Barcelona, Spain
| | - M Ballester
- Women's Health Dexeus, Department of Obstetrics- Gynecology and Reproduction , Barcelona, Spain
| | - M Tresanchez
- Women's Health Dexeus, Department of Obstetrics- Gynecology and Reproduction , Barcelona, Spain
| | - E Sánchez
- Microptic SL, Computer Engineering and Biology , Barcelona, Spain
| | - G Martínez
- Microptic SL, Computer Engineering and Biology , Barcelona, Spain
| | - D.V González
- Sabadell Airport, Aviation Club , Sabadell, Spain
| | - S García
- Women's Health Dexeus, Department of Obstetrics- Gynecology and Reproduction , Barcelona, Spain
| | - T Jordi
- UPC Universitat Politècnica de Catalunya., Institute of Education Sciences. Department of Computer Science , Barcelona, Spain
| | - N.P Polyzos
- Women's Health Dexeus, Department of Obstetrics- Gynecology and Reproduction , Barcelona, Spain
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Nguyen-Xuan HT, Benoit L, Dabi Y, Touboul C, Raimond E, Ballester M, Bendifallah S, Collinet P, Kerbage Y, Ouldamer L, Bricou A, Lavoue V, Carcopino X, Huchon C. How to predict para-aortic node involvement in advanced cervical cancer? Development of a predictive score. A FRANCOGYN study. Eur J Surg Oncol 2021; 47:2900-2906. [PMID: 34274203 DOI: 10.1016/j.ejso.2021.06.036] [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: 01/29/2021] [Revised: 04/12/2021] [Accepted: 06/29/2021] [Indexed: 10/20/2022] Open
Abstract
INTRODUCTION Node involvement is one of the main prognostic factors for cervical cancer. Para-aortic lymph node (PALN) assessment is crucial for treating advanced cervical cancer, to define irradiation fields. Objective of this study was to develop a score predicting para-aortic lymph node involvement in patients with advanced cervical cancer. PATIENTS AND METHOD We performed a multicenter, retrospective, study on 9 French centers from 2000 to 2015, including patients with advanced squamous cell cervix carcinoma who had PALN status assessed by imaging and/or by surgery. Factors associated with a risk of PALN involvement were determined by univariate and multivariate analysis using a logistic regression model. A score was then developed and validated. RESULTS A total of 1446 patients treated for cervical cancer were included. Of these, 498 had an advanced squamous cell cervical cancer. Ninety-one patients (18.3%) had positive PALN. After univariate and multivariate analysis, tumor size on pelvic MRI, initial SCC, and suspected pelvic node involvement on PET-CT were included in our score. This model allowed the population to be divided into 3 risk groups. Area under the ROC curve of the score was 0.81 (95%CI = 0.72-0.90). In the low-risk group, 9% (28/287) had PALN involvement, whereas in the high-risk group, 43% (22/51) had PALN involvement. CONCLUSION We developed a simple score predicting PALN involvement in advanced cervical cancers. Three risk groups can be defined, and patients considered to be at low risk may avoid para-aortic staging as well as extensive field irradiation.
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Affiliation(s)
- H T Nguyen-Xuan
- Department of Gynaecology and Obstetrics, Intercommunal Hospital Centre of Poissy-Saint-Germain-en-Laye, 78300, Poissy, France; Department of Gynaecology and Obstetrics, Assistance Publique - Hôpitaux de Paris, Hôpital Européen Georges Pompidou, France.
| | - L Benoit
- Department of Gynaecology and Obstetrics, Assistance Publique - Hôpitaux de Paris, Hôpital Européen Georges Pompidou, France; Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Paris 6, Institut Universitaire de Cancérologie (IUC), Paris, France
| | - Y Dabi
- Department of Obstetrics and Gynecology, Centre Hospitalier Intercommunal, Créteil, France
| | - C Touboul
- Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Paris 6, Institut Universitaire de Cancérologie (IUC), Paris, France
| | - E Raimond
- Department of Obstetrics and Gynaecology, Institute Alix de Champagne University Hospital, Reims, France
| | - M Ballester
- Department of Obstetrics and Gynecology, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France
| | - S Bendifallah
- Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Paris 6, Institut Universitaire de Cancérologie (IUC), Paris, France
| | - P Collinet
- Department of Obstetrics and Gynecology, Centre Hospitalier Régional Universitaire, Lille, France
| | - Y Kerbage
- Department of Obstetrics and Gynecology, Centre Hospitalier Régional Universitaire, Lille, France
| | - L Ouldamer
- Department of Obstetrics and Gynaecology, Centre Hospitalier Régional Universitaire de Tours, Hôpital Bretonneau, Tours, France
| | - A Bricou
- Department of Obstetrics and Gynecology, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France; Department of Obstetrics and Gynecology, Jean-Verdier University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France
| | - V Lavoue
- CRLCC Eugène-Marquis, Service de Gynécologie, CHU de Rennes, Université de Rennes 1, Rennes, France
| | - X Carcopino
- Department of Obstetrics and Gynecology, Hopital Nord, APHM, Marseille, France
| | - C Huchon
- Department of Gynaecology and Obstetrics, Intercommunal Hospital Centre of Poissy-Saint-Germain-en-Laye, 78300, Poissy, France; EA 7285 Risques Cliniques et Sécurité en Santé des Femmes, University of Versailles-Saint-Quentin en Yvelines, France; Department of Obstetrics and Gynecology, Assistance Publique - Hôpitaux de Paris, Hôpital LARIBOISIERE, University of Paris, France
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5
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Romero García C, Iftimi A, Briz-Redón Á, Zanin M, Otero M, Ballester M, de Andrés J, Landoni G, de las Marinas D, Catalá Bauset JC, Mandingorra J, Conca J, Correcher J, Ferrer C, Lozano M. Trends in Incidence and Transmission Patterns of COVID-19 in Valencia, Spain. JAMA Netw Open 2021; 4:e2113818. [PMID: 34143191 PMCID: PMC8214162 DOI: 10.1001/jamanetworkopen.2021.13818] [Citation(s) in RCA: 2] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
IMPORTANCE Limited information on the transmission and dynamics of SARS-CoV-2 at the city scale is available. OBJECTIVE To describe the local spread of SARS-CoV-2 in Valencia, Spain. DESIGN, SETTING, AND PARTICIPANTS This single-center epidemiological cohort study of patients with SARS-CoV-2 was performed at University General Hospital in Valencia (population in the hospital catchment area, 364 000), a tertiary hospital. The study included all consecutive patients with COVID-19 isolated at home from the start of the COVID-19 pandemic on February 19 until August 31, 2020. EXPOSURES Cases of SARS-CoV-2 infection confirmed by the presence of IgM antibodies or a positive polymerase chain reaction test result on a nasopharyngeal swab were included. Cases in which patients with negative laboratory results met diagnostic and clinical criteria were also included. MAIN OUTCOMES AND MEASURES The primary outcome was the characterization of dissemination patterns and connections among the 20 neighborhoods of Valencia during the outbreak. To recreate the transmission network, the inbound and outbound connections were studied for each region, and the relative risk of infection was estimated. RESULTS In total, 2646 patients were included in the analysis. The mean (SD) age was 45.3 (22.5) years; 1203 (46%) were male and 1442 (54%) were female (data were missing for 1); and the overall mortality was 3.7%. The incidence of SARS-CoV-2 cases was higher in neighborhoods with higher household income (β2 [for mean income per household] = 0.197; 95% CI, 0.057-0.351) and greater population density (β1 [inhabitants per km2] = 0.228; 95% CI, 0.085-0.387). Correlations with meteorological variables were not statistically significant. Neighborhood 3, where the hospital and testing facility were located, had the most outbound connections (14). A large residential complex close to the city (neighborhood 20) had the fewest connections (0 outbound and 2 inbound). Five geographically unconnected neighborhoods were of strategic importance in disrupting the transmission network. CONCLUSIONS AND RELEVANCE This study of local dissemination of SARS-COV-2 revealed nonevident transmission patterns between geographically unconnected areas. The results suggest that tailor-made containment measures could reduce transmission and that hospitals, including testing facilities, play a crucial role in disease transmission. Consequently, the local dynamics of SARS-CoV-2 spread might inform the strategic lockdown of specific neighborhoods to stop the contagion and avoid a citywide lockdown.
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Affiliation(s)
- Carolina Romero García
- Department of Anesthesia, Critical Care and Pain Unit, University General Hospital, Valencia, Spain
- Division of Research Methodology, European University, Valencia, Spain
| | - Adina Iftimi
- Department of Statistics and Operations Research, University of Valencia, Valencia, Spain
| | | | - Massimiliano Zanin
- Instituto de Física Interdisciplinar y Sistemas Complejos (CSIC-UIB), Palma de Mallorca, Spain
| | - Maria Otero
- Department of Anesthesia, Critical Care and Pain Unit, University General Hospital, Valencia, Spain
| | - Mayte Ballester
- Department of Anesthesia, Critical Care and Pain Unit, University General Hospital, Valencia, Spain
| | - José de Andrés
- Department of Anesthesia, Critical Care and Pain Unit, University General Hospital, Valencia, Spain
- Anesthesia Unit, Department of Surgical Specialties, Valencia University Medical School, Valencia, Spain
| | - Giovanni Landoni
- Department of Anesthesia and Intensive Care, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), San Raffaele Scientific Institute, Milan, Italy
- Faculty of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | | | | | - Jesus Mandingorra
- Department of Information Technology, University General Hospital, Universidad Católica de Valencia, Valencia, Spain
- Universidad Católica de Valencia. Valencia, Spain
| | - José Conca
- Department of Information Technology, University General Hospital, Universidad Católica de Valencia, Valencia, Spain
| | - Juan Correcher
- Department of Statistics and Operations Research, University of Valencia, Valencia, Spain
| | - Carolina Ferrer
- Department of Anesthesia, Critical Care and Pain Unit, University General Hospital, Valencia, Spain
| | - Manuel Lozano
- Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine Department, Universitat de Valencia, Valencia, Spain
- Epidemiology and Environmental Health Joint Research Unit, Foundation for the Promotion of Health and Biomedical Research of Valencia Region, Universitat Jaume I−Universitat de Valencia, Valencia, Spain
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6
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Zilliox M, Lecointre L, Azais H, Ballester M, Bendifallah S, Bolze PA, Bourdel N, Bricou A, Canlorbe G, Carcopino X, Chauvet P, Collinet P, Coutant C, Dabi Y, Dion L, Gauthier T, Graesslin O, Huchon C, Koskas M, Lavoue V, Mezzadri M, Mimoun C, Ouldamer L, Raimond E, Touboul C, Lapointe M, Akladios C. Management of borderline ovarian tumours during pregnancy: Results of a French multi-centre study. Eur J Obstet Gynecol Reprod Biol 2020; 256:412-418. [PMID: 33296755 DOI: 10.1016/j.ejogrb.2020.11.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 05/24/2020] [Revised: 10/05/2020] [Accepted: 11/10/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To assess the diagnostic and prognostic characteristics of borderline ovarian tumours (BOTs) detected during pregnancy, and to establish an inventory of French practices. MATERIALS AND METHODS A retrospective multi-centre case study of 14 patients treated for BOTs, diagnosed during pregnancy between 2005 and 2017, in five French pelvic cancerology expert centres, including data on clinical characteristics, histological tumour characteristics, surgical procedure, adjuvant treatments, follow-up and fertility. RESULTS The mean age of patients was 29.3 [standard deviation (SD) 6.2] years. Most BOTs were diagnosed on ultrasonography in the first trimester (85.7 %), and most of these cases (78.5 %) also underwent magnetic resonance imaging to confirm the diagnosis (true positives 54.5 %). Most patients underwent surgery during pregnancy (57 %), with complete staging surgery in two cases (14.3 %). Laparoscopy was performed more frequently than other procedures (50 %), and unilateral adnexectomy was more common than cystectomy (57.5 %). Tumour size influenced the surgical approach significantly (mean size 7.5 cm for laparoscopy, 11.9 cm for laparoconversion, 14 cm for primary laparotomy; P = 0.08), but the type of resection did not. Most patients were initially diagnosed with International Federation of Gynecology and Obstetrics stage IA (92.8 %) tumours, but many were upstaged after complete restaging surgery (57.1 %). Most BOTs were serous (50 %), two cases had a micropapillary component (28.5 %), and one case had a micro-invasive implant. BOTs were bilateral in two cases (14.2 %). Mean follow-up was 31.4 (SD 14.8) months. Recurrent lesions occurred in two patients (14.2 %) and no deaths have been recorded to date among the study population. CONCLUSION BOTs remain rare, but this study - despite its small sample size - supports the hypothesis that BOTs during pregnancy have potentially aggressive characteristics.
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Affiliation(s)
- M Zilliox
- Department of Gynaecology, University Hospital of Hautepierre, Strasbourg, France.
| | - L Lecointre
- Department of Gynaecology, University Hospital of Hautepierre, Strasbourg, France; I-Cube UMR 7357 Science Laboratory, Strasbourg, France; IHU: Institute for Minimally Invasive Hybrid Image Guided Surgery, Strasbourg, France
| | - H Azais
- Department of Gynaecology, Pitié Salpetriere Hospital, Paris, France
| | - M Ballester
- Department of Gynaecology, Diaconesses Croix Saint Simon, Paris, France
| | - S Bendifallah
- Department of Gynaecology, Tenon Hospital, Paris, France
| | - P A Bolze
- Department of Gynaecology, University Hospital South Lyon, Pierre-Bénite, France
| | - N Bourdel
- Department of Gynaecology, University Hospital of Clermont Ferrand, Clermont Ferrand, France
| | - A Bricou
- Department of Gynaecology, Diaconesses Croix Saint Simon, Paris, France
| | - G Canlorbe
- Department of Gynaecology, Pitié Salpetriere Hospital, Paris, France
| | - X Carcopino
- Department of Gynaecology, La Timone Hospital, Marseille, France
| | - P Chauvet
- Department of Gynaecology, University Hospital of Clermont Ferrand, Clermont Ferrand, France
| | - P Collinet
- Department of Gynaecology, Jeanne de Flandres Hospital, Lille, France
| | - C Coutant
- Centre de Lutte Contre le Cancer, Dijon, France
| | - Y Dabi
- Department of Gynaecology, Tenon Hospital, Paris, France
| | - L Dion
- Department of Gynaecology, University South Hospital, Rennes, France
| | - T Gauthier
- Department of Gynaecology, University Hospital, Limoges, France
| | - O Graesslin
- Department of Gynaecology, University Hospital, Reims, France
| | - C Huchon
- Department of Gynaecology, Intercommunal Hospital of Poissy, Poissy, France
| | - M Koskas
- Department of Gynaecology, Bichat Hospital, Paris, France
| | - V Lavoue
- Department of Gynaecology, University South Hospital, Rennes, France
| | - M Mezzadri
- Department of Gynaecology, Lariboisière Hospital, Paris, France
| | - C Mimoun
- Department of Gynaecology, Lariboisière Hospital, Paris, France
| | - L Ouldamer
- Department of Gynaecology, University Hospital of Tours, Tours, France
| | - E Raimond
- Department of Gynaecology, University Hospital, Reims, France
| | - C Touboul
- Department of Gynaecology, Tenon Hospital, Paris, France
| | - M Lapointe
- Department of Gynaecology, University Hospital of Hautepierre, Strasbourg, France
| | - C Akladios
- Department of Gynaecology, University Hospital of Hautepierre, Strasbourg, France
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7
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Boada M, Perez-Poch A, Ballester M, García-Monclús S, González DV, García S, Barri PN, Veiga A. Microgravity effects on frozen human sperm samples. J Assist Reprod Genet 2020; 37:2249-2257. [PMID: 32683528 PMCID: PMC7492354 DOI: 10.1007/s10815-020-01877-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 06/29/2020] [Indexed: 10/23/2022] Open
Abstract
PURPOSE Microgravity has severe effects on cellular and molecular structures as well as on metabolic interactions. The aim of this study is to investigate the effects of microgravity (μg) exposure on human frozen sperm samples. METHODS Sibling samples from 15 normozoospermic healthy donors were frozen using glycerol as cryoprotectant and analyzed under microgravity and ground conditions. Microgravity was obtained by parabolic flights using a CAP10B plane. The plane executed 20 parabolic maneuvers with a mean of 8.5 s of microgravity for each parabola. RESULTS Frozen sperm samples preserved in cryostraws and stored in a secure and specific nitrogen vapor cryoshipper do not suffer significant alterations after μg exposure. Comparing the study group (μg) and the control group (1 g), similar results were obtained in the main parameters studied: sperm motility (M/ml) 13.72 ± 12.57 vs 13.03 ± 12.13 (- 0.69 95% CI [- 2.9; 1.52]), progressive a + b sperm motility (%) 21.83 ± 11.69 vs 22.54 ± 12.83 (0.03 95% CI [- 0.08; 0.15]), sperm vitality (%) 46.42 ± 10.81 vs 44.62 ± 9.34 (- 0.04 95% CI [- 0.13; 0.05]), morphologically normal spermatozoa (%) 7.03 ± 2.61 vs 8.09 ± 3.61 (0.12 95% CI [0.01; 0.24]), DNA sperm fragmentation by SCD (%) 13.33 ± 5.12 vs 13.88 ± 6.14 (0.03 95% CI [- 0.09; 0.16]), and apoptotic spermatozoa by MACS (%) 15.47 ± 15.04 vs 23.80 ± 23.63 (- 0.20 95% CI [- 0.66; 1.05]). CONCLUSION The lack of differences obtained between frozen samples exposed to μg and those maintained in ground conditions provides the possibility of considering the safe transport of human male gametes to space. Nevertheless, further research is needed to validate the results and to consider the possibility of creating a human sperm bank outside the Earth. TRIAL REGISTRATION NUMBER ClinicalTrials.gov: NCT03760783.
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Affiliation(s)
- M Boada
- Women's Health Dexeus, Department of Obstetrics, Gynaecology and Reproduction, Hospital Universitari Dexeus, Avinguda Carles III 71-75, 08028, Barcelona, Spain.
| | - A Perez-Poch
- Universitat Politècnica de Catalunya, UPC BarcelonaTech, EEBE Campus Diagonal-Besòs, C. E. Maristany 16, 08019, Barcelona, Spain
| | - M Ballester
- Women's Health Dexeus, Department of Obstetrics, Gynaecology and Reproduction, Hospital Universitari Dexeus, Avinguda Carles III 71-75, 08028, Barcelona, Spain
| | - S García-Monclús
- Women's Health Dexeus, Department of Obstetrics, Gynaecology and Reproduction, Hospital Universitari Dexeus, Avinguda Carles III 71-75, 08028, Barcelona, Spain
| | - D V González
- Aeroclub Barcelona-Sabadell, Sabadell Airport, Carretera de Bellaterra s/n, 08205 Sabadell, Barcelona, Spain
| | - S García
- Women's Health Dexeus, Unit of Biostatistics, Avinguda Carles III 71-75, 08028, Barcelona, Spain
| | - P N Barri
- Women's Health Dexeus, Department of Obstetrics, Gynaecology and Reproduction, Hospital Universitari Dexeus, Avinguda Carles III 71-75, 08028, Barcelona, Spain
| | - A Veiga
- Women's Health Dexeus, Department of Obstetrics, Gynaecology and Reproduction, Hospital Universitari Dexeus, Avinguda Carles III 71-75, 08028, Barcelona, Spain
- Barcelona Stem Cell Bank, Centre of Regenerative Medicine in Barcelona, Hospital Duran i Reynals, Gran Via de l'Hospitalet 199, 08908 Hospitalet de Llobregat, Barcelona, Spain
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Sánchez JP, Legarra A, Velasco-Galilea M, Piles M, Sánchez A, Rafel O, González-Rodríguez O, Ballester M. Genome-wide association study for feed efficiency in collective cage-raised rabbits under full and restricted feeding. Anim Genet 2020; 51:799-810. [PMID: 32697387 PMCID: PMC7540659 DOI: 10.1111/age.12988] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 06/16/2020] [Accepted: 06/26/2020] [Indexed: 01/30/2023]
Abstract
Feed efficiency (FE) is one of the most economically and environmentally relevant traits in the animal production sector. The objective of this study was to gain knowledge about the genetic control of FE in rabbits. To this end, GWASs were conducted for individual growth under two feeding regimes (full feeding and restricted) and FE traits collected from cage groups, using 114 604 autosome SNPs segregating in 438 rabbits. Two different models were implemented: (1) an animal model with a linear regression on each SNP allele for growth trait; and (2) a two‐trait animal model, jointly fitting the performance trait and each SNP allele content, for FE traits. This last modeling strategy is a new tool applied to GWAS and allows information to be considered from non‐genotyped individuals whose contribution is relevant in the group average traits. A total of 189 SNPs in 17 chromosomal regions were declared to be significantly associated with any of the five analyzed traits at a chromosome‐wide level. In 12 of these regions, 20 candidate genes were proposed to explain the variation of the analyzed traits, including genes such as FTO, NDUFAF6 and CEBPA previously associated with growth and FE traits in monogastric species. Candidate genes associated with behavioral patterns were also identified. Overall, our results can be considered as the foundation for future functional research to unravel the actual causal mutations regulating growth and FE in rabbits.
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Affiliation(s)
- J P Sánchez
- Animal Breeding and Genetic Program, Institute of Agriculture and Food Research and Technology, Caldes de Montbui, 08140, Spain
| | - A Legarra
- GenPhySE, National Institute for Agronomic Research, Castanet-Tolosan, 31326, France
| | - M Velasco-Galilea
- Animal Breeding and Genetic Program, Institute of Agriculture and Food Research and Technology, Caldes de Montbui, 08140, Spain
| | - M Piles
- Animal Breeding and Genetic Program, Institute of Agriculture and Food Research and Technology, Caldes de Montbui, 08140, Spain
| | - A Sánchez
- Centre for Research in Agricultural Genomics, Campus Universitat Autònoma de Barcelona, Cerdanyola, 08193, Spain
| | - O Rafel
- Animal Breeding and Genetic Program, Institute of Agriculture and Food Research and Technology, Caldes de Montbui, 08140, Spain
| | - O González-Rodríguez
- Animal Breeding and Genetic Program, Institute of Agriculture and Food Research and Technology, Caldes de Montbui, 08140, Spain
| | - M Ballester
- Animal Breeding and Genetic Program, Institute of Agriculture and Food Research and Technology, Caldes de Montbui, 08140, Spain
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9
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Gaudet Chardonnet A, Azaïs H, Ballester M, Raimond E, Bendifallah S, Ouldamer L, Coutant C, Graesslin O, Touboul C, Collinet P, Bricou A, Huchon C, Daraï E, Lavoue V, Koskas M, Uzan C, Canlorbe G. Prognostic Value and Risk Factors of Peritoneal Carcinomatosis Recurrence for Patients with Endometrial Cancer: A Multicenter Study from the FRANCOGYN Group. Ann Surg Oncol 2020; 28:212-221. [PMID: 32648177 DOI: 10.1245/s10434-020-08812-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 06/15/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND The prognosis for patients with endometrial cancer (EC) peritoneal carcinomatosis (PC) recurrence has received little study. This study aimed to determine specific risk factors and prognosis of EC with PC recurrence (PCR) versus no PC recurrence (NPCR). METHODS Data of all patients with EC who received primary surgical treatment between January 2000 and February 2017 were abstracted from the French FRANCOGYN Research Group database. Clinical and pathologic variables were compared between the two groups (PCR vs. NPCR). Multivariate analysis was performed to define prognostic factors for peritoneal recurrence. Overall survivals (OS) of patients after recurrence were compared using the Kaplan-Meier method. RESULTS The study analyzed 1466 patients, and 257 of these patients (17.5%) had recurrence. At presentation, 63 of these patients had PC. International Federation of Gynecology and Obstetrics (FIGO) stages 3 and 4 disease were significantly associated with PCR versus NPCR (odds ratio 2.24; 95% confidence interval 1.23-4.07; p = 0.008). The death rate for the patients with PC was 47.6%, with a median survival of 12 months after diagnosis of recurrence. According to the histologic subtype, OS was 29 months (Q1-Q3, 13-NA) for endometrioid carcinomas, 7.5 months (Q1-Q3, 4-15) for serous carcinomas, and 10 months (Q1-Q3, 5-15) for clear cell carcinomas. Chemotherapy for treatment of PCR was associated with improved OS after recurrence (OSAR; p = 0.0025). CONCLUSION An initial advanced stage of EC is a risk factor for PCR. For women with PCR, a diagnosis of type 1 EC recurrence more than 12 months after the initial treatment and management of PCR with chemotherapy is associated with improved OSAR. Prospective studies are needed to determine the precise optimal management required in this clinical situation and to assess the relevance of biomarkers to predict the risk of PCR for EC patients.
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Affiliation(s)
- A Gaudet Chardonnet
- AP-HP (Assistance Publique des Hôpitaux de Paris), Department of Gynecological and Breast Surgery and Oncology, Pitié-Salpêtrière University Hospital, Paris, France
| | - H Azaïs
- AP-HP (Assistance Publique des Hôpitaux de Paris), Department of Gynecological and Breast Surgery and Oncology, Pitié-Salpêtrière University Hospital, Paris, France
| | - M Ballester
- Service de Chirurgie Gynécologique et Mammaire, Groupe Hospitalier Diaconesses Croix Saint Simon, Paris, France
| | - E Raimond
- Department of Obstetrics and Gynaecology, Institute Alix de Champagne University Hospital, Reims, France
| | - S Bendifallah
- AP-HP (Assistance Publique des Hôpitaux de Paris), Department of Gynaecology and Obstetrics, Tenon University Hospital, Paris, France.,INSERM UMR_S_938, "Cancer Biology and Therapeutics," Centre de Recherche Saint-Antoine (CRSA), Sorbonne University, Paris, France.,Institut Universitaire de Cancérologie (IUC), Sorbonne University, Paris, France
| | - L Ouldamer
- Department of Obstetrics and Gynaecology, Centre Hospitalier Régional Universitaire de Tours, Tours, France
| | - C Coutant
- Center de Lutte Contre le Cancer Georges François Leclerc, Dijon, France
| | - O Graesslin
- Department of Obstetrics and Gynaecology, Institute Alix de Champagne University Hospital, Reims, France
| | - C Touboul
- Department of Obstetrics and Gynaecology, Centre Hospitalier Intercommunal, Créteil, France
| | - P Collinet
- Department of Obstetrics and Gynaecology, Centre Hospitalier Intercommunal, Créteil, France.,Department of Obstetrics and Gynaecology, Centre Hospitalier Régional Universitaire, Lille, France
| | - A Bricou
- AP-HP (Assistance Publique des Hôpitaux de Paris), Department of Gynaecology and Obstetrics, Jean Verdier University Hospital, Bondy, France
| | - C Huchon
- Department of Gynaecology and Obstetrics, Centre Hospitalier Intercommunal, Poissy, France
| | - E Daraï
- AP-HP (Assistance Publique des Hôpitaux de Paris), Department of Gynaecology and Obstetrics, Tenon University Hospital, Paris, France.,INSERM UMR_S_938, "Cancer Biology and Therapeutics," Centre de Recherche Saint-Antoine (CRSA), Sorbonne University, Paris, France.,Institut Universitaire de Cancérologie (IUC), Sorbonne University, Paris, France
| | - V Lavoue
- Service de Gynécologie, INSERM 1242, Oncogenesis, Stress and Signaling, CRLC Eugène Marquis, Université de Rennes 1, Hopital Sud, CHU de Rennes, Rennes, France
| | - M Koskas
- Service de Chirurgie et Oncologie Gynécologique et Mammaire, APHP, Université Paris Diderot Hôpital Bichat, Paris, France
| | - C Uzan
- AP-HP (Assistance Publique des Hôpitaux de Paris), Department of Gynecological and Breast Surgery and Oncology, Pitié-Salpêtrière University Hospital, Paris, France.,INSERM UMR_S_938, "Cancer Biology and Therapeutics," Centre de Recherche Saint-Antoine (CRSA), Sorbonne University, Paris, France.,Institut Universitaire de Cancérologie (IUC), Sorbonne University, Paris, France
| | - G Canlorbe
- AP-HP (Assistance Publique des Hôpitaux de Paris), Department of Gynecological and Breast Surgery and Oncology, Pitié-Salpêtrière University Hospital, Paris, France. .,INSERM UMR_S_938, "Cancer Biology and Therapeutics," Centre de Recherche Saint-Antoine (CRSA), Sorbonne University, Paris, France. .,Institut Universitaire de Cancérologie (IUC), Sorbonne University, Paris, France.
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10
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Serre E, Diguisto C, Body G, Raimond E, Bendifallah S, Touboul C, Graesslin O, Carcopino X, Ballester M, Daraï E, Ouldamer L. [Prognostic significance of groin lymph node ratio in vulvar squamous cell carcinoma]. ACTA ACUST UNITED AC 2020; 48:729-735. [PMID: 32339764 DOI: 10.1016/j.gofs.2020.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim was to review the clinical impact of lymph node ratio (LNR) of groin metastatic nodal disease in women with vulvar squamous cell carcinoma. MATERIAL AND METHODS Cohort study of women with vulvar squamous cell carcinoma, managed between January 2005 and December 2015, in five institutions in France with prospectively maintained databases (French multicenter tertiary care centers). POPULATION In total, 636 women managed for VSCC of whom 508 (79.9%) underwent surgical groin nodal staging. MAIN OUTCOME MEASURES Comparison of overall and recurrence free survival between women according to LNR. RESULTS In total, 176 women (34.6%) had at least one positive lymph node (LN). There was a significant differences for the 5-year overall survival and recurrence free survival rates between women with LNR>0.2 and women with LNR<0.2. CONCLUSION LNR seems to be a significant prognostic factor in women with vulvar squamous cell carcinoma.
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Affiliation(s)
- E Serre
- Department of Gynecology, CHU de Tours, Tours, France; Inserm U1069, Université François-Rabelais, Tours, France
| | - C Diguisto
- Department of Gynecology, CHU de Tours, Tours, France
| | - G Body
- Department of Gynecology, CHU de Tours, Tours, France; Inserm U1069, Université François-Rabelais, Tours, France
| | - E Raimond
- Department of Obstetrics and Gynecology, Institute Alix-de-Champagne, University Hospital, Reims, France
| | - S Bendifallah
- Department of Obstetrics and Gynecology, GRC-6 UPMC, Hôpital Tenon, Université Pierre et Marie-Curie, AP-HP, Paris 6, France; UMR S 707, Epidemiology, Information Systems, Modeling, Université Pierre et Marie-Curie, Paris, France
| | - C Touboul
- Department of Obstetrics and Gynecology, centre hospitalier intercommunal, Créteil, France
| | - O Graesslin
- Department of Obstetrics and Gynecology, Institute Alix-de-Champagne, University Hospital, Reims, France
| | - X Carcopino
- Department of Gynecological surgery, AP-HP, Marseille, France
| | - M Ballester
- Department of Obstetrics and Gynecology, Institute Alix-de-Champagne, University Hospital, Reims, France; Inserm UMR S 938, Université Pierre et Marie-Curie, Paris, France
| | - E Daraï
- Department of Obstetrics and Gynecology, GRC-6 UPMC, Hôpital Tenon, Université Pierre et Marie-Curie, AP-HP, Paris 6, France; Inserm UMR S 938, Université Pierre et Marie-Curie, Paris, France
| | - L Ouldamer
- Department of Gynecology, CHU de Tours, Tours, France; Inserm U1069, Université François-Rabelais, Tours, France.
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11
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Vincent L, Jankowski C, Ouldamer L, Ballester M, Bendifallah S, Bolze PA, Akladios C, Costaz H, Lavoué V, Canlorbe G, Collinet P, Touboul C, Huchon C, Bricou A, Dridi S, Padéano MM, Bengrine L, Arnould L, Coutant C. Prognostic factors of overall survival for patients with FIGO stage IIIc or IVa ovarian cancer treated with neo-adjuvant chemotherapy followed by interval debulking surgery: A multicenter cohort analysis from the FRANCOGYN study group. Eur J Surg Oncol 2020; 46:1689-1696. [PMID: 32417154 DOI: 10.1016/j.ejso.2020.04.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 04/05/2020] [Accepted: 04/15/2020] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION The aim of this study was to identify prognostic factors of overall survival in patients with FIGO stage IIIc or IVa ovarian cancer (OC) treated by neo-adjuvant chemotherapy (NAC) followed by interval debulking surgery. MATERIALS AND METHODS Data from 483 patients with ovarian cancer were retrospectively collected, from January 1, 2000 to December 31, 2016, from the FRANCOGYN database, regrouping data from 11 centers specialized in ovarian cancer treatment. Median overall survival was determined using the Kaplan-Meier method. Univariate and multivariate analysis were performed to define prognostic factors of overall survival. RESULTS The median overall survival was 52 after a median follow up of 30 months. After univariate analysis, factors significantly associated with decreased overall survival were; no pelvic and/or para-aortic lymphadenectomy (p = 0.002), residual disease (CC1/CC2/CC3) after surgery (p < 0.001), positive cytology after NAC (p < 0.001), omental disease after NAC (p = 0.002), no pathologic complete response (pCR) (p = 0.002). In multivariate analysis, factors significantly associated with decreased overall survival were; residual disease after surgery (HR = 1.93; CI95% (1.16-3.21), p = 0.01) and positive cytology after NAC (HR = 1.59; CI95% (1.01-2.55), p = 0.05). Patients with no residual disease after surgery had a median overall survival of 64 months versus 35 months for patients with residual disease. Patients with negative cytology after NAC had a median overall survival of 71 months versus 43 months for patients with positive cytology after NAC. CONCLUSION In this first and largest French based retrospective study, complete cytoreductive surgery in ovarian cancer remains the main prognostic factor of overall survival.
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Affiliation(s)
- L Vincent
- Department of Surgical Oncology, Georges-Francois Leclerc Cancer Center, 1 Professeur Marion Street, 21000, Dijon, France; University of Burgundy, 7 Jeanne d'Arc boulevard, 21000, Dijon, France.
| | - C Jankowski
- Department of Surgical Oncology, Georges-Francois Leclerc Cancer Center, 1 Professeur Marion Street, 21000, Dijon, France
| | - L Ouldamer
- Department of Gynecology, Centre Hospitalier Universitaire de Tours, 2 Tonnelé boulevard, 37000, Tours, France; INSERM U1069 Université François-Rabelais, 10 Tonnelé boulevard, 37000, Tours, France
| | - M Ballester
- Department of Gynecologic and Breast Surgery, Groupe Hospitalier Diaconesses Croix Saint Simon, 125 Avron Street, 75020, Paris, France
| | - S Bendifallah
- Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), 4 Chine street, 75020, Paris, France
| | - P A Bolze
- Gynecological Surgery Service, CHU Lyon-Sud, 165 Grand Revoyet Road, 69495, Pierre-Bénite, France
| | - C Akladios
- Department of Surgical Gynecology, University Hospital of Strasbourg, Molière Avenue, 67200, Strasbourg, France
| | - H Costaz
- Department of Surgical Oncology, Georges-Francois Leclerc Cancer Center, 1 Professeur Marion Street, 21000, Dijon, France
| | - V Lavoué
- Department of Gynecological Surgery, Rennes University Hospital, 16 Bulgarie boulevard, 35200, Rennes, France
| | - G Canlorbe
- Department of Gynecologic and Breast Surgery and Oncology, AP-HP, Pitié-Salpêtrière University Hospital, 47-83 Hopital boulevard, 75013, Paris, France; INSERM,UMR S 938, Sorbonne University, 75005, Paris, France
| | - P Collinet
- Department of Gynecological Surgery, Jeanne de Flandre University Hospital, Eugéne Avinée Avenue, 59000, Lille, France
| | - C Touboul
- Department of Obstetrics and Gynaecology, Centre Hospitalier Intercommunal, 40 Verdun Avenue, 94010, Créteil, France
| | - C Huchon
- Department of Gynecology, Centre Hospitalier de Poissy, 10 Champ Gaillard Street, 78300, Poissy, France
| | - A Bricou
- Department of Gynaecology, Bobigny University, AP-HP, Hôpital Jean-Verdier, 14 Juillet Avenue, 93140, Bondy, France
| | - S Dridi
- Department of Surgical Oncology, Georges-Francois Leclerc Cancer Center, 1 Professeur Marion Street, 21000, Dijon, France; University of Burgundy, 7 Jeanne d'Arc boulevard, 21000, Dijon, France
| | - M M Padéano
- Department of Surgical Oncology, Georges-Francois Leclerc Cancer Center, 1 Professeur Marion Street, 21000, Dijon, France
| | - L Bengrine
- Department of Medical Oncology, Georges-Francois Leclerc Cancer Center, Dijon, 1 Professeur Marion Street, 21000, France
| | - L Arnould
- Department of Anatomopathology, Georges-Francois Leclerc Cancer Center, 1 Professeur Marion Street, 21000, Dijon, France
| | - C Coutant
- Department of Surgical Oncology, Georges-Francois Leclerc Cancer Center, 1 Professeur Marion Street, 21000, Dijon, France; University of Burgundy, 7 Jeanne d'Arc boulevard, 21000, Dijon, France
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12
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Boada M, Perez-Poch A, Ballester M, Gárcia S, González DV, Rodríguez I, Barri PN, Veiga A. Corrigendum to P-434 (Effect of microgravity on frozen human sperm samples. Can they be sent to space?). Hum Reprod 2020; 35:739. [PMID: 31504523 DOI: 10.1093/humrep/dez183] [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] [Received: 12/15/2017] [Revised: 04/29/2019] [Accepted: 05/20/2019] [Indexed: 11/14/2022] Open
Affiliation(s)
- M Boada
- Women's Health Dexeus, Department of Obstetrícs- Gynaecology and Reproduction, Barcelona, Spain
| | - A Perez-Poch
- Universitat Politècnica de Catalunya, UPC Barcelona Tech, Barcelona, Spain
| | - M Ballester
- Women's Health Dexeus, Department of Obstetrícs- Gynaecology and Reproduction, Barcelona, Spain
| | - S Gárcia
- Women's Health Dexeus, Department of Obstetrícs- Gynaecology and Reproduction, Barcelona, Spain
| | - D V González
- Aeroclub Barcelona-Sabadell, Aerobatic parabolic flights, Sabadell, Spain
| | - I Rodríguez
- Wome's Health Dexeus, Unit of Biostatistics, Barcelona, Spain
| | - P N Barri
- Women's Health Dexeus, Department of Obstetrícs- Gynaecology and Reproduction, Barcelona, Spain
| | - A Veiga
- Women's Health Dexeus, Department of Obstetrícs- Gynaecology and Reproduction, Barcelona, Spain
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13
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Akladios C, Azais H, Ballester M, Bendifallah S, Bolze PA, Bourdel N, Bricou A, Canlorbe G, Carcopino X, Chauvet P, Collinet P, Coutant C, Dabi Y, Dion L, Gauthier T, Graesslin O, Huchon C, Koskas M, Kridelka F, Lavoue V, Lecointre L, Mezzadri M, Mimoun C, Ouldamer L, Raimond E, Touboul C. [Guidelines for surgical management of gynaecological cancer during pandemic COVID-19 period - FRANCOGYN group for the CNGOF]. ACTA ACUST UNITED AC 2020; 48:444-447. [PMID: 32222433 PMCID: PMC7103920 DOI: 10.1016/j.gofs.2020.03.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Recommendations for the management of patients with gynecological cancer during the COVID-19 pandemic period. MATERIAL AND METHOD Recommendations based on the consensus conference model. RESULTS In the case of a COVID-19 positive patient, surgical management should be postponed for at least 15 days. For cervical cancer, the place of surgery must be re-evaluated in relation to radiotherapy and Radio-Chemotherapy-Concomitant and the value of lymph node staging surgeries must be reviewed on a case-by-case basis. For advanced ovarian cancers, neo-adjuvant chemotherapy should be favored even if primary cytoreduction surgery could be envisaged. It is lawful not to offer hyperthermic intraperitoneal chemotherapy during a COVID-19 pandemic. In the case of patients who must undergo interval surgery, it is possible to continue the chemotherapy and to offer surgery after 6 cycles of chemotherapy. For early stage endometrial cancer, in case of low and intermediate preoperative ESMO risk, hysterectomy with bilateral annexectomy associated with a sentinel lymph node procedure should be favored. It is possible to consider postponing surgery for 1 to 2 months in low-risk endometrial cancers (FIGO Ia stage on MRI and grade 1-2 endometrioid cancer on endometrial biopsy). For high ESMO risk, it ispossible to favor the MSKCC algorithm (combining PET-CT and sentinel lymph node biopsy) in order to omit pelvic and lumbar-aortic lymphadenectomies. CONCLUSION During COVID-19 pandemic, patients suffering from cancer should not lose life chance, while limiting the risks associated with the virus.
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Affiliation(s)
- C Akladios
- Service de gynécologie, CHU de Hautepierre, 67000 Strasbourg, France
| | - H Azais
- Service de gynécologie, hôpital la Pitié-Salpêtrière, 75013 Paris, France
| | - M Ballester
- Service de gynécologie, Dioconessess Croix Saint Simon, 75012 Paris, France
| | - S Bendifallah
- Service de gynécologie obstétrique, hôpital Tenon, 75020 Paris, France
| | - P-A Bolze
- Service de gynécologie obstétrique, CHU Lyon Sud, 69000 Lyon, France
| | - N Bourdel
- Service de gynécologie obstétrique, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - A Bricou
- Service de gynécologie, Dioconessess Croix Saint Simon, 75012 Paris, France
| | - G Canlorbe
- Service de gynécologie, hôpital la Pitié-Salpêtrière, 75013 Paris, France
| | - X Carcopino
- Service de gyécologie, La Timone, 13000 Marseille, France
| | - P Chauvet
- Service de gynécologie obstétrique, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - P Collinet
- Service de gynécologie, hôpital Jeanne de Flandres, 59000 Lille, France
| | - C Coutant
- Centre de lutte contre le cancer, 21000 Dijon, France
| | - Y Dabi
- Service de gynécologie obstétrique, hôpital Tenon, 75020 Paris, France
| | - L Dion
- Service de gynécologie, CHU hôpital Sud, 16, boulevard de Bulgarie, 35000 Rennes, France
| | - T Gauthier
- Service de gynécologie obstétrique, CHU, 87000 Limoges, France
| | - O Graesslin
- Service de gynécologie obstétrique, CHU, 51000 Reims, France
| | - C Huchon
- Service de gynécologie obstétrique, CHI Poissy, 78300 Poissy, France
| | - M Koskas
- Service de gynécologie obstétrique, hôpital Bichat, 75018 Paris, France
| | - F Kridelka
- Service de chirurgie oncologique, CHU, Liège, Belgique
| | - V Lavoue
- Service de gynécologie, CHU hôpital Sud, 16, boulevard de Bulgarie, 35000 Rennes, France.
| | - L Lecointre
- Service de gynécologie obstétrique, hôpital Tenon, 75020 Paris, France
| | - M Mezzadri
- Service de gynécologie, hôpital Lariboisière, 75010 Paris, France
| | - C Mimoun
- Service de gynécologie, hôpital Lariboisière, 75010 Paris, France
| | - L Ouldamer
- Service de gynécologie, CHU Tours, 37000 Tours, France
| | - E Raimond
- Service de gynécologie obstétrique, CHU, 51000 Reims, France
| | - C Touboul
- Service de chirurgie oncologique, CHU, Liège, Belgique
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14
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Rodríguez-Álvarez IH, Parés D, Julián JF, Ballester M. [Identification and review of low-value clinical practices in General and Digestive Surgery]. J Healthc Qual Res 2019; 34:323-330. [PMID: 31753714 DOI: 10.1016/j.jhqr.2019.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 06/22/2019] [Accepted: 07/16/2019] [Indexed: 11/16/2022]
Abstract
INTRODUCTION There are currently widespread clinical practices that, because they do not have been supported by available scientific evidence, are inappropriate for most patients. The objective of the present study was to identify and review these low-value clinical practices in General Surgery. MATERIAL AND METHODS A systematic review of the specialized databases and the published guidelines with identification of low-value practices in General Surgery was carried out. Of the low-value practices selected for a tertiary and university hospitals through the consensus of expert surgeons, those that do not provide clinical value were identified. RESULTS In a first search, 4,019 recommendations were found, of which 60 were selected because they were focused on General Surgery. After evaluation by the experts, a total of 29 clinical recommendations were selected to be implemented in a specialty service, which were divided into those corresponding to diagnostic processes (n=9), procedures and surgical technique (n=10) and of perioperative care and medication (n=10). CONCLUSIONS There is evidence in the literature of some clinical practices that provide little value in General Surgery. The changes referring to do-not-do these practices should be implemented in current clinical practice of this specialty.
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Affiliation(s)
- I H Rodríguez-Álvarez
- Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, Nuevo León, México.
| | - D Parés
- Servicio de Cirugía General y Digestiva, Hospital Germans Trias i Pujol, Universidad Autónoma de Barcelona, Badalona, España
| | - J F Julián
- Servicio de Cirugía General y Digestiva, Hospital Germans Trias i Pujol, Universidad Autónoma de Barcelona, Badalona, España
| | - M Ballester
- Dirección de Calidad, Hospital Germans Trias i Pujol, Badalona, España
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15
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Raimond E, Delorme C, Ouldamer L, Carcopino X, Bendifallah S, Touboul C, Daraï E, Ballester M, Graesslin O. Surgical treatment of vulvar cancer: Impact of tumor-free margin distance on recurrence and survival. A multicentre cohort analysis from the francogyn study group. Eur J Surg Oncol 2019; 45:2109-2114. [PMID: 31285094 DOI: 10.1016/j.ejso.2019.07.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 06/24/2019] [Accepted: 07/02/2019] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE In vulvar cancer, it is admitted that tumor-free margin distance is one of the most important element for locoregional control. It is currently recommended to surgically remove the tumor with at least an 8 mm tumor-free margin. The aim of this study was to evaluate the impact of tumor-free margin distance on recurrence and survival in vulvar cancer. MATERIAL AND METHODS From 2005 to 2016, 112 patients surgically treated for a vulvar squamous cell cancer were included in a retrospective multicenter study. Overall, disease-free and metastasis-free survivals were analyzed according to tumor-free margin distance. RESULTS Patients were divided into three groups: group 1 (margin <3 mm, n = 47); group 2 (margin ≥3 mm to < 8 mm, n = 48) and group 3 (margin ≥8 mm, n = 17). During the study, 26,8% patients developed recurrence (n = 30) after a median of 8 months (1-69). Analysis of 5-year overall survival, as well as disease-free and metastasis-free survivals, did not reveal a difference between groups. We performed a subgroup analysis in patients with a tumor-free margin <8 mm (group 1 and 2). It showed that histological lesions observed closest to the edge of the specimen were more often invasive or in situ carcinoma lesions in group 1 than in group 2, in which VIN lesions were mainly observed at this location. After re-excision, no patients in group 1 and 50% (n = 2) patients in group 2 developed recurrence. CONCLUSION This study did not reveal a significant impact of tumor-free margin distance on recurrence and survival in vulvar cancer. Moreover, the benefit of re-excision seems stronger when tumor-free margins are positive or very close (<3 mm), cases in which invasive or in situ lesions are often present closest to the edge of the specimen.
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Affiliation(s)
- E Raimond
- Department of Obstetrics and Gynaecology, Institute Alix de Champagne University Hospital, Reims, France.
| | - C Delorme
- Department of Obstetrics and Gynaecology, Institute Alix de Champagne University Hospital, Reims, France
| | - L Ouldamer
- Department of Obstetrics and Gynaecology, Centre Hospitalier Régional Universitaire de Tours, Hôpital Bretonneau, Tours, France; INSERM U1069, Université François-Rabelais, Tours, France
| | - X Carcopino
- Department of Obstetrics and Gynecology, Hopital Nord, APHM, Marseilles, France
| | - S Bendifallah
- Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Paris 6, Institut Universitaire de Cancérologie (IUC), France; INSERM UMR S 938, Université Pierre et Marie Curie, Paris, France
| | - C Touboul
- Department of Obstetrics and Gynaecology, Centre Hospitalier Intercommunal, Créteil, France; Faculté de Médecine de Créteil UPEC, Paris XII, France
| | - E Daraï
- Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Paris 6, Institut Universitaire de Cancérologie (IUC), France; INSERM UMR S 938, Université Pierre et Marie Curie, Paris, France
| | - M Ballester
- Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Paris 6, Institut Universitaire de Cancérologie (IUC), France; INSERM UMR S 938, Université Pierre et Marie Curie, Paris, France
| | - O Graesslin
- Department of Obstetrics and Gynaecology, Institute Alix de Champagne University Hospital, Reims, France
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16
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Lavoue V, Huchon C, Akladios C, Alfonsi P, Bakrin N, Ballester M, Bendifallah S, Bolze P, Bonnet F, Bourgin C, Chabbert-Buffet N, Collinet P, Courbiere B, De la motte rouge T, Devouassoux-Shisheboran M, Falandry C, Ferron G, Fournier L, Gladieff L, Golfier F, Gouy S, Guyon F, Lambaudie E, Leary A, Lecuru F, Lefrere-Belda M, Leblanc E, Lemoine A, Narducci F, Ouldamer L, Pautier P, Planchamp F, Pouget N, Ray-Coquard I, Rousset-Jablonski C, Senechal-Davin C, Touboul C, Thomassin-Naggara I, Uzan C, You B, Daraï E. Management of epithelial cancer of the ovary, fallopian tube, primary peritoneum. Long text of the joint French clinical practice guidelines issued by FRANCOGYN, CNGOF, SFOG, GINECO-ARCAGY, endorsed by INCa. (Part 2: systemic, intraperitoneal treatment, elderly patients, fertility preservation, follow-up). J Gynecol Obstet Hum Reprod 2019; 48:379-386. [DOI: 10.1016/j.jogoh.2019.03.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 03/19/2019] [Indexed: 10/27/2022]
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17
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Lavoue V, Huchon C, Akladios C, Alfonsi P, Bakrin N, Ballester M, Bendifallah S, Bolze PA, Bonnet F, Bourgin C, Chabbert-Buffet N, Collinet P, Courbiere B, De la Motte Rouge T, Devouassoux-Shisheboran M, Falandry C, Ferron G, Fournier L, Gladieff L, Golfier F, Gouy S, Guyon F, Lambaudie E, Leary A, Lecuru F, Lefrere-Belda MA, Leblanc E, Lemoine A, Narducci F, Ouldamer L, Pautier P, Planchamp F, Pouget N, Ray-Coquard I, Rousset-Jablonski C, Senechal-Davin C, Touboul C, Thomassin-Naggara I, Uzan C, You B, Daraï E. Management of epithelial cancer of the ovary, fallopian tube, and primary peritoneum. Long text of the Joint French Clinical Practice Guidelines issued by FRANCOGYN, CNGOF, SFOG, and GINECO-ARCAGY, and endorsed by INCa. Part 1: Diagnostic exploration and staging, surgery, perioperative care, and pathology. J Gynecol Obstet Hum Reprod 2019; 48:369-378. [PMID: 30936027 DOI: 10.1016/j.jogoh.2019.03.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 03/19/2019] [Indexed: 11/27/2022]
Abstract
An MRI is recommended for an ovarian mass that is indeterminate on ultrasound. The ROMA score (combining CA125 and HE4) can also be calculated (grade A). In presumed early-stage ovarian or tubal cancers, the following procedures should be performed: an omentectomy (at a minimum, infracolic), an appendectomy, multiple peritoneal biopsies, peritoneal cytology (grade C), and pelvic and para-aortic lymphadenectomies (grade B) for all histologic types, except the expansile mucinous subtypes, for which lymphadenectomies can be omitted (grade C). Minimally invasive surgery is recommended for early-stage ovarian cancer, when there is no risk of tumor rupture (grade B). For FIGO stages III or IV ovarian, tubal, and primary peritoneal cancers, a contrast-enhanced computed tomography (CT) scan of the thorax/abdomen/pelvis is recommended (grade B), as well as laparoscopic exploration to take multiple biopsies (grade A) and a carcinomatosis score (Fagotti score at a minimum) (grade C) to assess the possibility of complete surgery (i.e., leaving no macroscopic tumor residue). Complete surgery by a midline laparotomy is recommended for advanced ovarian, tubal, or primary peritoneal cancer (grade B). For advanced cancers, para-aortic and pelvic lymphadenectomies are recommended when metastatic adenopathy is clinically or radiologically suspected (grade B). When adenopathy is not suspected and when complete peritoneal surgery is performed as the initial surgery for advanced cancer, the lymphadenectomies can be omitted because they do not modify either the medical treatment or overall survival (grade B). Primary surgery (before other treatment) is recommended whenever it appears possible to leave no tumor residue (grade B).
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Affiliation(s)
- V Lavoue
- Service de gynécologie, CHU de Rennes, Hôpital sud, 16 Bd de Bulgarie, 35000 Rennes, France; INSERM 1242, Chemistry, Oncogenesis, Stress and Signaling, Centre Eugène Marquis, Rue Bataille Flandres-Dunkerques, Rennes, France.
| | - C Huchon
- Service de Gynécologie, CHI Poissy, France
| | - C Akladios
- Service de Gynécologie, Hôpital Hautepierre, CHU Strasbourg, France
| | - P Alfonsi
- Service d'Anesthésie, Hôpital Saint Joseph, Paris, France
| | - N Bakrin
- Service de chirurgie digestive, CHU Lyon-Sud, Pierre-Bénite, Lyon, France
| | - M Ballester
- Service de gynécologie, GH Diaconesses Croix Saint Simon, Paris, France
| | - S Bendifallah
- Service de Gynécologie-Obstétrique et Médecine de la Reproduction, Hôpital Tenon, 4 rue de La Chine, APHP, Institut Universitaire de Cancérologie Sorbonne Université, UMRS-938, France
| | - P A Bolze
- Service de chirurgie gynécologique, CHU Lyon-Sud, Pierre Bénite, Lyon, France
| | - F Bonnet
- Service d'anesthésie, Hôpital Tenon, AP-HP, Paris, France
| | - C Bourgin
- Service de Chirurgie Gynécologique, Hôpital Jeanne de Flandres, CHRU, Lille, France
| | - N Chabbert-Buffet
- Service de Gynécologie-Obstétrique et Médecine de la Reproduction, Hôpital Tenon, 4 rue de La Chine, APHP, Institut Universitaire de Cancérologie Sorbonne Université, UMRS-938, France
| | - P Collinet
- Service de Chirurgie Gynécologique, Hôpital Jeanne de Flandres, CHRU, Lille, France
| | - B Courbiere
- Pôle Femmes-Parents-Enfants - Centre Clinico-Biologique d'AMP, AP-HM La Conception, 147 bd Baille, 13005 Marseille/Aix Marseille Université, CNRS, IRD, Avignon Université, IMBE UMR 7263, 13397 Marseille, France
| | | | | | - C Falandry
- Service d'oncogériatrie, Hospices civiles de Lyon, CHU Lyon-Sud, Pierre-Bénite, Lyon, France
| | - G Ferron
- Service d'oncologie chirurgicale, Institut Claudius Regaud, IUCT Oncopole, Toulouse, France
| | - L Fournier
- Service de radiologie, Hôpital Européen Georges Pompidou, AP-HP, Paris, France
| | - L Gladieff
- Service d'oncologie médicale, Institut Claudius Regaud, IUCT Oncopole, Toulouse, France
| | - F Golfier
- Service de chirurgie gynécologique, CHU Lyon-Sud, Pierre Bénite, Lyon, France
| | - S Gouy
- Service de chirurgie, Institut Gustave Roussy, Villejuif, France
| | - F Guyon
- Service de chirurgie, Institut Bergonié, Bordeaux, France
| | - E Lambaudie
- Service de chirurgie, Institut Paoli Calmette, Marseille, France
| | - A Leary
- Service d'oncologie médicale, Institut Gustave Roussy, Villejuif, France
| | - F Lecuru
- Service de chirurgie gynécologique et oncologique, Hôpital Européen Georges Pompidou, AP-HP, Paris, France
| | - M A Lefrere-Belda
- Service d'anatomo-pathologie, Hôpital Européen Georges Pompidou, AP-HP, Paris, France
| | - E Leblanc
- Service de chirurgie, Centre Oscar Lambret, Lille, France
| | - A Lemoine
- Service d'anesthésie, Hôpital Tenon, AP-HP, Paris, France
| | - F Narducci
- Service de chirurgie, Centre Oscar Lambret, Lille, France
| | - L Ouldamer
- Service de chirurgie gynécologique, CHU de Tours, France
| | - P Pautier
- Service d'oncologie médicale, Institut Gustave Roussy, Villejuif, France
| | - F Planchamp
- Service de méthodologie, Institut Bergonié, Bordeaux, France
| | - N Pouget
- Service de chirurgie, Curie (site Saint Cloud), Paris, France
| | - I Ray-Coquard
- Service d'oncologie médicale, Centre Léon Bérard, Lyon, France
| | | | | | - C Touboul
- Service de chirurgie gynécologique, CHI de Créteil, Créteil, France
| | | | - C Uzan
- Service de chirurgie et cancérologie gynécologique et mammaire, Hôpital Pitié Salpêtrière, Institut Universitaire de Cancérologie, Sorbonne Université, INSERM U938, France
| | - B You
- Service d'oncologie médicale, Institut de cancérologie des Hospices Civils de Lyon, Pierre-Bénite, Lyon, Paris, France
| | - E Daraï
- Service de Gynécologie-Obstétrique et Médecine de la Reproduction, Hôpital Tenon, 4 rue de La Chine, APHP, Institut Universitaire de Cancérologie Sorbonne Université, UMRS-938, France
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18
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Lavoué V, Huchon C, Akladios C, Alfonsi P, Bakrin N, Ballester M, Bendifallah S, Bolze PA, Bonnet F, Bourgin C, Chabbert-Buffet N, Collinet P, Courbiere B, De la Motte Rouge T, Devouassoux-Shisheboran M, Falandry C, Ferron G, Fournier L, Gladieff L, Golfier F, Gouy S, Guyon F, Lambaudie E, Leary A, Lécuru F, Lefrère-Belda MA, Leblanc E, Lemoine A, Narducci F, Ouldamer L, Pautier P, Planchamp F, Pouget N, Ray-Coquard I, Rousset-Jablonski C, Sénéchal-Davin C, Touboul C, Thomassin-Naggara I, Uzan C, You B, Daraï E. [Part II drafted from the short text of the French guidelines entitled "Initial management of patients with epithelial ovarian cancer" developed by FRANCOGYN, CNGOF, SFOG, GINECO-ARCAGY and endorsed by INCa. (Systemic and intraperitoneal treatment, elderly, fertility preservation, follow-up)]. ACTA ACUST UNITED AC 2019; 47:111-119. [PMID: 30704955 DOI: 10.1016/j.gofs.2018.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Indexed: 10/27/2022]
Abstract
Adjuvant chemotherapy with carboplatin and paclitaxel is recommended for all high-grade ovarian or Fallopian tube cancers, stage FIGO I-IIA (grade A). After a complete first surgery, it is recommended to deliver 6 cycles of intravenous (grade A) or to propose intraperitoneal (grade B) chemotherapy, to be discussed with patient, according to the benefit/risk ratio. After a complete interval surgery for a FIGO III stage, the hyperthermic intra peritoneal chemotherapy (HIPEC) can be proposed in the same conditions of the OV-HIPEC trial (grade B). In case of tumor residue after surgery or FIGO stage IV, chemotherapy associated with bevacizumab is recommended (grade A). For BRCA mutated patient, Olaparib is recommended (grade B).
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Affiliation(s)
- V Lavoué
- Service de gynécologie, hôpital sud, CHU de Rennes, 16, boulevard de Bulgarie, 35000 Rennes, France; Inserm 1242, chemistry, oncogenesis, stress and signaling, centre Eugène-Marquis, rue Bataille-Flandres-Dunkerques, 35000 Rennes, France.
| | - C Huchon
- Service de gynécologie, CHI Poissy, 78000 Poissy, France
| | - C Akladios
- Service de gynécologie, hôpital Hautepierre, CHU de Strasbourg, 67000 Strasbourg, France
| | - P Alfonsi
- Service d'anesthésie, hôpital Saint-Joseph, 75014 Paris, France
| | - N Bakrin
- Service de chirurgie digestive, CHU Lyon-Sud, Pierre-Bénite, 69000 Lyon, France
| | - M Ballester
- Service de gynécologie, groupe hospitalier Diaconesses-Croix-Saint-Simon, 75020 Paris, France
| | - S Bendifallah
- Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France; Institut universitaire de cancérologie, UMRS-938, Sorbonne université, 75000 Paris, France
| | - P A Bolze
- Service de chirurgie gynécologique, CHU Lyon-Sud, Pierre-Bénite, 69000 Lyon, France
| | - F Bonnet
- Service d'anesthésie, hôpital Tenon, AP-HP, 75020 Paris, France
| | - C Bourgin
- Service de chirurgie gynécologique, hôpital Jeanne-de-Flandres, CHRU de Lille, 59000 Lille, France
| | - N Chabbert-Buffet
- Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France; Institut universitaire de cancérologie, UMRS-938, Sorbonne université, 75000 Paris, France
| | - P Collinet
- Service de chirurgie gynécologique, hôpital Jeanne-de-Flandres, CHRU de Lille, 59000 Lille, France
| | - B Courbiere
- Pôle Femmes-Parents-Enfants, centre clinico-biologique d'AMP, AP-HM La Conception, 147, boulevard Baille, 13005 Marseille, France; CNRS, IRD, IMBE UMR 7263, Avignon université, Aix Marseille université, 13397 Marseille, France
| | | | - M Devouassoux-Shisheboran
- Service d'anatomo-pathologie, hospices civiles de Lyon, CHU Lyon-Sud, Pierre-Bénite, 69000 Lyon, France
| | - C Falandry
- Service d'oncogériatrie, hospices civiles de Lyon, CHU Lyon-Sud, Pierre-Bénite, 69000 Lyon, France
| | - G Ferron
- Service d'oncologie chirurgicale, institut Claudius-Regaud, IUCT Oncopole, 31000 Toulouse, France
| | - L Fournier
- Service de radiologie, hôpital européen Georges-Pompidou, AP-HP, 75015 Paris, France
| | - L Gladieff
- Service d'oncologie médicale, institut Claudius-Regaud, IUCT Oncopole, 31000 Toulouse, France
| | - F Golfier
- Service de chirurgie gynécologique, CHU Lyon-Sud, Pierre-Bénite, 69000 Lyon, France
| | - S Gouy
- Service de chirurgie, institut Gustave-Roussy, 94000 Villejuif, France
| | - F Guyon
- Service de chirurgie, institut Bergonié, 33000 Bordeaux, France
| | - E Lambaudie
- Service de chirurgie, institut Paoli-Calmette, 13000 Marseille, France
| | - A Leary
- Service d'oncologie médicale, institut Gustave-Roussy, 94000 Villejuif, France
| | - F Lécuru
- Service de chirurgie gynécologique et oncologique, hôpital européen Georges-Pompidou, AP-HP, 75015 Paris, France
| | - M A Lefrère-Belda
- Service d'anatomo-pathologie, hôpital européen Georges-Pompidou, AP-HP, 75015 Paris, France
| | - E Leblanc
- Service de chirurgie, centre Oscar-Lambret, 59000 Lille, France
| | - A Lemoine
- Service d'anesthésie, hôpital Tenon, AP-HP, 75020 Paris, France
| | - F Narducci
- Service de chirurgie, centre Oscar-Lambret, 59000 Lille, France
| | - L Ouldamer
- Service de chirurgie gynécologique, CHU de Tours, 37000 Tours, France
| | - P Pautier
- Service d'oncologie médicale, institut Gustave-Roussy, 94000 Villejuif, France
| | - F Planchamp
- Service de méthodologie, institut Bergonié, 33000 Bordeaux, France
| | - N Pouget
- Service de chirurgie, Curie (site Saint-Cloud), 75000 Paris, France
| | - I Ray-Coquard
- Service d'oncologie médicale, centre Léon-Bérard, 69000 Lyon, France
| | | | | | - C Touboul
- Service de chirurgie gynécologique, CHI de Créteil, 94000 Créteil, France
| | | | - C Uzan
- Service de chirurgie et cancérologie gynécologique et mammaire, hôpital Pitié-Salpêtrière, 75013 Paris, France; Inserm U938, institut universitaire de cancérologie, Sorbonne université, 75000 Paris, France
| | - B You
- Service d'oncologie médicale, institut de cancérologie, hospices civils de Lyon, Pierre-Bénite, 69000 Lyon, France
| | - E Daraï
- Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France; Institut universitaire de cancérologie, UMRS-938, Sorbonne université, 75000 Paris, France
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19
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Lavoué V, Huchon C, Akladios C, Alfonsi P, Bakrin N, Ballester M, Bendifallah S, Bolze PA, Bonnet F, Bourgin C, Chabbert-Buffet N, Collinet P, Courbiere B, De la Motte Rouge T, Devouassoux-Shisheboran M, Falandry C, Ferron G, Fournier L, Gladieff L, Golfier F, Gouy S, Guyon F, Lambaudie E, Leary A, Lécuru F, Lefrère-Belda MA, Leblanc E, Lemoine A, Narducci F, Ouldamer L, Pautier P, Planchamp F, Pouget N, Ray-Coquard I, Rousset-Jablonski C, Sénéchal-Davin C, Touboul C, Thomassin-Naggara I, Uzan C, You B, Daraï E. [Part I drafted from the short text of the French Guidelines entitled "Initial management of patients with epithelial ovarian cancer" developed by FRANCOGYN, CNGOF, SFOG, GINECO-ARCAGY and endorsed by INCa. (Diagnosis management, surgery, perioperative care, and pathological analysis)]. ACTA ACUST UNITED AC 2019; 47:100-110. [PMID: 30686724 DOI: 10.1016/j.gofs.2018.12.010] [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: 12/28/2018] [Indexed: 10/27/2022]
Abstract
Faced to an undetermined ovarian mass on ultrasound, an MRI is recommended and the ROMA score (combining CA125 and HE4) can be proposed (grade A). In case of suspected early stage ovarian or fallopian tube cancer, omentectomy (at least infracolonic), appendectomy, multiple peritoneal biopsies, peritoneal cytology (grade C) and pelvic and para-aortic lymphadenectomy are recommended (grade B) for all histological types, except for the expansive mucinous subtype where lymphadenectomy may be omitted (grade C). Minimally invasive surgery is recommended for early stage ovarian cancer, if there is no risk of tumor rupture (grade B). Laparoscopic exploration for multiple biopsies (grade A) and to evaluate carcinomatosis score (at least using the Fagotti score) (grade C) are recommended to estimate the possibility of a complete surgery (i.e. no macroscopic residue). Complete medial laparotomy surgery is recommended for advanced cancers (grade B). It is recommended in advanced cancers to perform para-aortic and pelvic lymphadenectomy in case of clinical or radiological suspicion of metastatic lymph node (grade B). In the absence of clinical or radiological lymphadenopathy and in case of complete peritoneal surgery during an initial surgery for advanced cancer, it is possible not to perform a lymphadenectomy because it does not modify the medical treatment and the overall survival (grade B). Primary surgery is recommended when no tumor residue is possible (grade B).
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Affiliation(s)
- V Lavoué
- Service de gynécologie, hôpital sud, CHU de Rennes, 16, boulevard de Bulgarie, 35000 Rennes, France; Inserm 1242, Chemistry, Oncogenesis, Stress and Signaling, Centre Eugène Marquis, rue Bataille Flandres-Dunkerques, 35000 Rennes, France.
| | - C Huchon
- Service de gynécologie, CHI Poissy, 78000 Poissy, France
| | - C Akladios
- Service de gynécologie, hôpital Hautepierre, CHU Strasbourg, 67000 Strasbourg, France
| | - P Alfonsi
- Service d'anesthésie, hôpital Saint-Joseph, 75014 Paris, France
| | - N Bakrin
- Service de chirurgie digestive, CHU Lyon-Sud, Pierre-Bénite, 69000 Lyon, France
| | - M Ballester
- Service de gynécologie, groupe hospitalier Diaconesses Croix Saint Simon, 75020 Paris, France
| | - S Bendifallah
- Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France; UMRS-938, institut universitaire de cancérologie Sorbonne université, 75000 Paris, France
| | - P A Bolze
- Service de chirurgie gynécologique, CHU Lyon-Sud, Pierre-Bénite, 69000 Lyon, France
| | - F Bonnet
- Service d'anesthésie, hôpital Tenon, AP-HP, 75020 Paris, France
| | - C Bourgin
- Service de chirurgie gynécologique, hôpital Jeanne de Flandres, CHRU, 59000 Lille, France
| | - N Chabbert-Buffet
- Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France; UMRS-938, institut universitaire de cancérologie Sorbonne université, 75000 Paris, France
| | - P Collinet
- Service de chirurgie gynécologique, hôpital Jeanne de Flandres, CHRU, 59000 Lille, France
| | - B Courbiere
- Pôle Femmes-Parents-Enfants-Centre Clinico-Biologique d'AMP, AP-HM La Conception, 147, boulevard Baille, 13005 Marseille, France; IMBE UMR 7263, Aix-Marseille université, CNRS, IRD, Avignon université, 13397 Marseille, France
| | | | - M Devouassoux-Shisheboran
- Service d'anatomopathologie, hospices civiles de Lyon, CHU Lyon-Sud, Pierre-Bénite, 69000 Lyon, France
| | - C Falandry
- Service d'oncogériatrie, hospices civiles de Lyon, CHU Lyon-Sud, Pierre-Bénite, 69000 Lyon, France
| | - G Ferron
- Service d'oncologie chirurgicale, institut Claudius Regaud, IUCT Oncopole, 31000 Toulouse, France
| | - L Fournier
- Service de radiologie, hôpital Européen Georges Pompidou, AP-HP, 75015 Paris, France
| | - L Gladieff
- Service d'oncologie médicale, institut Claudius Regaud, IUCT Oncopole, 31000 Toulouse, France
| | - F Golfier
- Service de chirurgie gynécologique, CHU Lyon-Sud, Pierre-Bénite, 69000 Lyon, France
| | - S Gouy
- Service de chirurgie, institut Gustave Roussy, 94000 Villejuif, France
| | - F Guyon
- Service de chirurgie, institut Bergonié, 33000 Bordeaux, France
| | - E Lambaudie
- Service de chirurgie, institut Paoli Calmette, 13000 Marseille, France
| | - A Leary
- Service d'oncologie médicale, institut Gustave Roussy, 94000 Villejuif, France
| | - F Lécuru
- Service de chirurgie gynécologique et oncologique, hôpital Européen Georges Pompidou, AP-HP, 75015 Paris, France
| | - M A Lefrère-Belda
- Service d'anatomopathologie, hôpital Européen Georges Pompidou, AP-HP, 75015 Paris, France
| | - E Leblanc
- Service de chirurgie, Centre Oscar Lambret, 59000 Lille, France
| | - A Lemoine
- Service d'anesthésie, hôpital Tenon, AP-HP, 75020 Paris, France
| | - F Narducci
- Service de chirurgie, Centre Oscar Lambret, 59000 Lille, France
| | - L Ouldamer
- Service de chirurgie gynécologique, CHU de Tours, 37000 Tours, France
| | - P Pautier
- Service d'oncologie médicale, institut Gustave Roussy, 94000 Villejuif, France
| | - F Planchamp
- Service de méthodologie, institut Bergonié, 33000 Bordeaux, France
| | - N Pouget
- Service de chirurgie, Curie (site Saint Cloud), 75000 Paris, France
| | - I Ray-Coquard
- Service d'oncologie médicale, Centre Léon Bérard, 69000 Lyon, France
| | | | | | - C Touboul
- Service de chirurgie gynécologique, CHI de Créteil, 94000 Créteil, France
| | | | - C Uzan
- Service de chirurgie et cancérologie gynécologique et mammaire, hôpital Pitié-Salpêtrière, 75013 Paris, France; Inserm U938, institut universitaire de cancérologie, Sorbonne université, 75000 Paris, France
| | - B You
- Service d'oncologie médicale, institut de cancérologie des hospices Civils de Lyon, Pierre-Bénite, 69000 Lyon Paris, France
| | - E Daraï
- Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France; UMRS-938, institut universitaire de cancérologie Sorbonne université, 75000 Paris, France
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Collinet P, Fritel X, Revel-Delhom C, Ballester M, Bolze PA, Borghese B, Bornsztein N, Boujenah J, Brillac T, Chabbert-Buffet N, Chauffour C, Clary N, Cohen J, Decanter C, Denouël A, Dubernard G, Fauconnier A, Fernandez H, Gauthier T, Golfier F, Huchon C, Legendre G, Loriau J, Mathieu-d'Argent E, Merlot B, Niro J, Panel P, Paparel P, Philip CA, Ploteau S, Poncelet C, Rabischong B, Roman H, Rubod C, Santulli P, Sauvan M, Thomassin-Naggara I, Torre A, Wattier JM, Yazbeck C, Bourdel N, Canis M. Management of endometriosis: CNGOF/HAS clinical practice guidelines - Short version. J Gynecol Obstet Hum Reprod 2018; 47:265-274. [PMID: 29920379 DOI: 10.1016/j.jogoh.2018.06.003] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [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: 06/11/2018] [Accepted: 06/12/2018] [Indexed: 11/18/2022]
Abstract
First-line diagnostic investigations for endometriosis are physical examination and pelvic ultrasound. The second-line investigations are: targeted pelvic examination performed by an expert clinician, transvaginal ultrasound performed by an expert physician sonographer (radiologist or gynaecologist), and pelvic MRI. Management of endometriosis is recommended when the disease has a functional impact. Recommended first-line hormonal therapies for the management of endometriosis-related pain are combined hormonal contraceptives (CHCs) or the 52mg levonorgestrel-releasing intrauterine system (IUS). There is no evidence base on which to recommend systematic preoperative hormonal therapy solely to prevent surgical complications or facilitate surgery. After surgery for endometriosis, a CHC or 52mg levonorgestrel-releasing IUS is recommended as first-line treatment when pregnancy is not desired. In the event of failure of the initial treatment, recurrence, or multiorgan involvement, a multidisciplinary team meeting is recommended, involving physicians, surgeons and other professionals. A laparoscopic approach is recommended for surgical treatment of endometriosis. HRT can be offered to postmenopausal women who have undergone surgical treatment for endometriosis. Antigonadotrophic hormonal therapy is not recommended for patients with endometriosis and infertility to increase the chances of spontaneous pregnancy, including postoperatively. Fertility preservation options must be discussed with patients undergoing surgery for ovarian endometriomas.
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Affiliation(s)
- P Collinet
- CHRU Lille, Clinique de gynécologie, Hôpital Jeanne de Flandre, 59000 Lille, France; Université Lille-Nord-de-France, 59000 Lille, France
| | - X Fritel
- Service de Gynécologie-Obstétrique et Médecine de la reproduction, Inserm CIC 1402, 2, rue de la Milétrie, 86000 Poitiers, France; Université de Poitiers, 86000 Poitiers, France; Inserm CIC 1402, 86000 Poitiers, France
| | - C Revel-Delhom
- Haute Autorité de Santé, 5 avenue du Stade de France, 93218 La Plaine St Denis Cedex, France
| | - M Ballester
- Service de Gynécologie-Obstétrique et Médecine de la reproduction, CHU Tenon, APHP, 4, rue de la Chine, 75020 Paris, France
| | - P A Bolze
- Service de Chirurgie Gynécologique Oncologique, Obstétrique, CHU Lyon Sud, 165, chemin du Grand Revoyet, 69495 Pierre Bénite, France; Université Claude Bernard Lyon 1, 69000 Lyon, France
| | - B Borghese
- Service de Chirurgie Gynécologie Obstétrique 2 et Médecine de la Reproduction, CHU Cochin, APHP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Equipe Génomique, Epigénétique et Physiopathologie de la Reproduction, Département Développement, Reproduction, Cancer, Inserm U1016, Université Paris Descartes, Sorbonne Paris Cité, 12, rue de l'École de Médecine, 75270 Paris cedex 06, France
| | | | - J Boujenah
- Service de Gynécologie-Obstétrique, CHU Bondy, avenue du 14 Juillet, 93140 Bondy, France; Centre médical du Château, 22, rue Louis-Besquel, 94300 Vincennes, France
| | - T Brillac
- 98 route de Blagnac, 31200 Toulouse, France
| | - N Chabbert-Buffet
- Service de Gynécologie-Obstétrique et Médecine de la reproduction, CHU Tenon, APHP, 4, rue de la Chine, 75020 Paris, France; GRC-6 Centre Expert en Endométriose (C3E), Sorbonne Université, 75005 Paris, France; UMR-S938 INSERM Sorbonne Université, 75005 Paris, France
| | - C Chauffour
- Service de Gynécologie-Obstétrique et Reproduction Humaine, CHU Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France
| | - N Clary
- 3 rue Pablo Picasso, 92160 Antony, France
| | - J Cohen
- Service de Gynécologie-Obstétrique et Médecine de la reproduction, CHU Tenon, APHP, 4, rue de la Chine, 75020 Paris, France
| | - C Decanter
- Service d'Assistance médicale à la procréation et de préservation de la fertilité, Hôpital Jeanne de Flandre, CHRU Lille, 1, rue Eugène-Avinée, 59037 Lille cedex, France; EA 4308 Gamétogenèse et qualité du gamète, CHRU Lille, 59037 Lille cedex, France
| | - A Denouël
- EndoFrance, BP 50053, 01124 Montluel cedex, France
| | - G Dubernard
- Clinique gynécologique et obstétricale, CHU de Lyon HCL - GH Nord-Hôpital de la Croix Rousse, CHU de Lyon - HCL, 103, Grande Rue de la Croix-Rousse, 69317 Lyon cedex, France
| | - A Fauconnier
- Service de Gynécologie-Obstétrique, CHI Poissy-St-Germain, 10, rue du ChampGaillard, 78303 Poissy, France; EA 7285 Risques cliniques et sécurité en santé des femmes, Université Versailles - Saint-Quentin-en-Yvelines, 78180 Saint-Quentin-en-Yvelines, France
| | - H Fernandez
- Service de Gynécologie-Obstétrique, CHU Bicêtre, APHP, 78, avenue du Général de Gaulle, 94275 Le Kremlin-Bicêtre, France; CESP-INSERM, U1018, Equipe Epidémiologie et évaluation des stratégies de prise en charge: VIH, reproduction, pédiatrie, Université Paris Sud, 94807 Villejuif, France
| | - T Gauthier
- Service de Gynécologie-Obstétrique, Hôpital Mère-Enfant, CHU Limoges, 8, avenue Dominique Larrey, 87042 Limoges, France; UMR-1248, Faculté de Médecine, 87042 Limoges, France
| | - F Golfier
- Service de Chirurgie Gynécologique et Oncologique - Obstétrique, CHU Lyon Sud, 69495 Pierre-Bénite cedex, France
| | - C Huchon
- Service de Gynécologie-Obstétrique, CHI Poissy-St-Germain, 10, rue du ChampGaillard, 78303 Poissy, France
| | - G Legendre
- Service de Gynécologie-Obstétrique, CHU Angers, 4, rue Larrey, 49033 Angers cedex 01, France; CESP-INSERM, U1018, Equipe 7, Genre, Santé Sexuelle et Reproductive, Université Paris Sud, 94276 Le Kremlin-Bicêtre cedex, France
| | - J Loriau
- Service de Chirurgie digestive, GH Paris Saint-Joseph, 185, rue Raymond-Losserand, 75001 Paris, France
| | - E Mathieu-d'Argent
- Service de Gynécologie-Obstétrique et Médecine de la reproduction, CHU Tenon, APHP, 4, rue de la Chine, 75020 Paris, France; Université Pierre-et-Marie-Curie Paris 6, 75005 Paris, France; GRC6-UPMC: centre expert en endométriose (C3E), hôpital Tenon, Paris, France
| | - B Merlot
- 10 Clinique Tivoli-Ducos, 33000 Bordeaux, France
| | - J Niro
- Service de Gynécologie-Obstétrique, Centre Hospitalier de Versailles, 177, route de Versailles, 78157 Le Chesnay cedex, France
| | - P Panel
- Service de Gynécologie-Obstétrique, Centre Hospitalier de Versailles, 177, route de Versailles, 78157 Le Chesnay cedex, France
| | - P Paparel
- Service d'Urologie, CHU Lyon Sud, 165, chemin du Grand Revoyet, 60495 Pierre Bénite, France
| | - C A Philip
- Clinique gynécologique et obstétricale, CHU de Lyon HCL - GH Nord-Hôpital de la Croix Rousse, CHU de Lyon - HCL, 103, Grande Rue de la Croix-Rousse, 69317 Lyon cedex, France
| | - S Ploteau
- Service de Gynécologie-Obstétrique et Médecine de la Reproduction, Hôpital MèreEnfant, CHU Nantes, 8, boulevard Jean-Monnet, 44093 Nantes, France
| | - C Poncelet
- Service de Gynécologie-Obstétrique, CH Renée Dubos, 6, avenue de l'Ile-de-France, 95300 Pontoise, France; Université Paris 13, Sorbonne Paris Cité, UFR SMBH, 93022 Bobigny, France
| | - B Rabischong
- Service de Gynécologie-Obstétrique et Reproduction Humaine, CHU Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France
| | - H Roman
- Centre Expert de Diagnostic et Prise en Charge Multidisciplinaire de l'Endométriose, Clinique Gynécologique et Obstétricale, CHU Charles Nicolle, 1, rue de Germont, 76031 Rouen, France
| | - C Rubod
- CHRU Lille, Clinique de gynécologie, Hôpital Jeanne de Flandre, 59000 Lille, France; Université Lille-Nord-de-France, 59000 Lille, France
| | - P Santulli
- Service de Chirurgie Gynécologie Obstétrique 2 et Médecine de la Reproduction, CHU Cochin, APHP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Equipe Génomique, Epigénétique et Physiopathologie de la Reproduction, Département Développement, Reproduction, Cancer, Inserm U1016, Université Paris Descartes, Sorbonne Paris Cité, 12, rue de l'École de Médecine, 75270 Paris cedex 06, France
| | - M Sauvan
- Service de Gynécologie-Obstétrique, CHU Bicêtre, APHP, 78, avenue du Général de Gaulle, 94275 Le Kremlin-Bicêtre, France
| | - I Thomassin-Naggara
- Service d'Imagerie, Hôpital Tenon, APHP, 4, rue de la Chine, 75020 Paris, France; Sorbonne Universités, UPMC Univ Paris 06, Institut Universitaire de Cancérologie, Assistance Publique, 75006 Paris, France
| | - A Torre
- Service de Gynécologie-Obstétrique et Médecine de la Reproduction, Hôpital Arnaud de Villeneuve, CHU Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier, France
| | - J M Wattier
- Centre d'étude et traitement de la douleur, Hôpital Claude Huriez, CHRU Lille, rue Michel-Polonowski, 59000 Lille, France
| | - C Yazbeck
- Service de Gynécologie-Obstétrique, Hôpital Foch, APHP, 40, rue Worth, 92151 Suresnes, France; Centre d'Assistance Médicale à la Procréation, Clinique Pierre Cherest, 5, rue Pierre-Cherest, 92200 Neuilly-Sur-Seine, France
| | - N Bourdel
- Service de Gynécologie-Obstétrique et Reproduction Humaine, CHU Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France
| | - M Canis
- Service de Gynécologie-Obstétrique et Reproduction Humaine, CHU Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France
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Breillat P, Georgin Lavialle S, Deshayes S, Michel P, Molina J, Buob D, Fabiani B, Ballester M, Angelard B, Arnulf B, Talbot A, Grateau G. Amyloses associées à l’infection par le VIH : à propos de 23 cas dont 3 français et 20 issus de la littérature. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.03.336] [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: 10/14/2022]
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Collinet P, Fritel X, Revel-Delhom C, Ballester M, Bolze PA, Borghese B, Bornsztein N, Boujenah J, Bourdel N, Brillac T, Chabbert-Buffet N, Chauffour C, Clary N, Cohen J, Decanter C, Denouël A, Dubernard G, Fauconnier A, Fernandez H, Gauthier T, Golfier F, Huchon C, Legendre G, Loriau J, Mathieu-d'Argent E, Merlot B, Niro J, Panel P, Paparel P, Philip CA, Ploteau S, Poncelet C, Rabischong B, Roman H, Rubod C, Santulli P, Sauvan M, Thomassin-Naggara I, Torre A, Wattier JM, Yazbeck C, Canis M. [Management of endometriosis: CNGOF-HAS practice guidelines (short version)]. ACTA ACUST UNITED AC 2018; 46:144-155. [PMID: 29550339 DOI: 10.1016/j.gofs.2018.02.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Indexed: 10/17/2022]
Abstract
First-line investigations to diagnose endometriosis are clinical examination and pelvic ultrasound. Second-line investigations include pelvic examination performed by a referent clinician, transvaginal ultrasound performed by a referent echographist, and pelvic MRI. It is recommended to treat endometriosis when it is symptomatic. First-line hormonal treatments recommended for the management of painful endometriosis are combined with hormonal contraceptives or levonorgestrel 52mg IUD. There is no evidence to recommend systematic preoperative hormonal therapy for the unique purpose of preventing the risk of surgical complications or facilitating surgery. After endometriosis surgery, combined hormonal contraceptives or levonorgestrel SIU 52mg are recommended as first-line therapy in the absence of desire of pregnancy. In case of initial treatment failure, recurrence, or multiple organ involvement by endometriosis, medico-surgical and multidisciplinary discussion is recommended. The laparoscopic approach is recommended for the surgical treatment of endometriosis. HRT may be offered in postmenopausal women operated for endometriosis. In case of infertility related to endometriosis, it is not recommended to prescribe anti-gonadotropic hormone therapy to increase the rate of spontaneous pregnancy, including postoperatively. The possibilities of fertility preservation should be discussed with the patient in case of surgery for ovarian endometrioma.
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Affiliation(s)
- P Collinet
- Clinique de gynécologie, hôpital Jeanne-de-Flandre, CHRU de Lille, 59000 Lille, France; Université Lille-Nord-de-France, 59000 Lille, France.
| | - X Fritel
- Service de gynécologie-obstétrique et médecine de la reproduction, Inserm CIC 1402, 2, rue de la Milétrie, 86000 Poitiers, France; Université de Poitiers, 86000 Poitiers, France; Inserm CIC 1402, 86000 Poitiers, France
| | - C Revel-Delhom
- Haute Autorité de santé, 5, avenue du Stade-de-France, 93218 La Plaine-Saint-Denis cedex, France
| | - M Ballester
- Service de gynécologie-obstétrique et médecine de la reproduction, CHU Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - P A Bolze
- Service de chirurgie gynécologique oncologique, obstétrique, CHU Lyon-Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France; Université Claude-Bernard-Lyon 1, 69000 Lyon, France
| | - B Borghese
- Service de chirurgie gynécologie-obstétrique 2 et médecine de la reproduction, CHU Cochin, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Équipe génomique, épigénétique et physiopathologie de la reproduction, département développement, reproduction, cancer, Inserm U1016, université Paris Descartes, Sorbonne Paris Cité, 12, rue de l'École-de-Médecine, 75270 Paris cedex 06, France
| | | | - J Boujenah
- Service de gynécologie-obstétrique, CHU Bondy, avenue du 14-Juillet, 93140 Bondy, France; Centre médical du Château, 22, rue Louis-Besquel, 94300 Vincennes, France
| | - N Bourdel
- Service de gynécologie-obstétrique et reproduction humaine, CHU Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France; Faculté de médecine, Encov-ISIT, UMR6284 CNRS, université d'Auvergne, 28, place Henri-Dunant, 63000 Clermont-Ferrand, France
| | - T Brillac
- 98, route de Blagnac, 31200 Toulouse, France
| | - N Chabbert-Buffet
- Service de gynécologie-obstétrique et médecine de la reproduction, CHU Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France; GRC-6 centre expert en endométriose (C3E), Sorbonne université, Paris, France; UMR-S938 Inserm Sorbonne université, Paris, France
| | - C Chauffour
- Service de gynécologie-obstétrique et reproduction humaine, CHU Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France
| | - N Clary
- 3, rue Pablo-Picasso, 92160 Antony, France
| | - J Cohen
- Service de gynécologie-obstétrique et médecine de la reproduction, CHU Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - C Decanter
- Service d'assistance médicale à la procréation et de préservation de la fertilité, hôpital Jeanne-de-Flandre, CHRU de Lille, 1, rue Eugène-Avinée, 59037 Lille cedex, France; EA 4308 gamétogenèse et qualité du gamète, CHRU de Lille, 59037 Lille cedex, France
| | - A Denouël
- EndoFrance, BP 50053, 01124 Montluel cedex, France
| | - G Dubernard
- Université Claude-Bernard-Lyon 1, 69000 Lyon, France; Clinique gynécologique et obstétricale, hôpital de la Croix-Rousse, groupe hospitalier Nord, CHU de Lyon-HCL, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex, France
| | - A Fauconnier
- Service de gynécologie-obstétrique, CHI Poissy-St-Germain, 10, rue du Champ-Gaillard, 78303 Poissy, France; EA 7285 risques cliniques et sécurité en santé des femmes, université Versailles-Saint-Quentin-en-Yvelines, Saint-Quentin-en-Yvelines, France
| | - H Fernandez
- Service de gynécologie-obstétrique, CHU Bicêtre, AP-HP, 78, avenue du Général-de-Gaulle, 94275 Le Kremlin-Bicêtre, France; CESP-INSERM, U1018, équipe épidémiologie et évaluation des stratégies de prise en charge, VIH, reproduction, pédiatrie, université Paris-Sud, Paris, France
| | - T Gauthier
- Service de gynécologie-obstétrique, hôpital Mère-Enfant, CHU de Limoges, 8, avenue Dominique-Larrey, 87042 Limoges, France; UMR-1248, faculté de médecine, 87042 Limoges, France
| | - F Golfier
- Service de chirurgie gynécologique oncologique, obstétrique, CHU Lyon-Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France
| | - C Huchon
- Service de gynécologie-obstétrique, CHI Poissy-St-Germain, 10, rue du Champ-Gaillard, 78303 Poissy, France
| | - G Legendre
- Service de gynécologie-obstétrique, CHU d'Angers, 4, rue Larrey, 49033 Angers cedex 01, France; CESP-Inserm, U1018, équipe 7, genre, santé sexuelle et reproductive, université Paris-Sud, 94276 Le Kremlin-Bicêtre cedex, France
| | - J Loriau
- Service de chirurgie digestive, groupe hospitalier Paris Saint-Joseph, 185, rue Raymond-Losserand, 75001 Paris, France
| | - E Mathieu-d'Argent
- Service de gynécologie-obstétrique et médecine de la reproduction, CHU Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France; Université Pierre-et-Marie-Curie Paris 6, Paris, France; GRC6-UPMC, centre expert en endométriose (C3E), hôpital Tenon, Paris, France
| | - B Merlot
- Service de chirurgie gynécologique, clinique Tivoli, 220, rue Mandron, 33000 Bordeaux, France
| | - J Niro
- Service de gynécologie-obstétrique, centre hospitalier de Versailles, 177, route de Versailles, 78157 Le Chesnay cedex, France
| | - P Panel
- Service de gynécologie-obstétrique, centre hospitalier de Versailles, 177, route de Versailles, 78157 Le Chesnay cedex, France
| | - P Paparel
- Service d'urologie, CHU Lyon-Sud, 165, chemin du Grand-Revoyet, 60495 Pierre-Bénite, France
| | - C A Philip
- Université Claude-Bernard-Lyon 1, 69000 Lyon, France; Clinique gynécologique et obstétricale, hôpital de la Croix-Rousse, groupe hospitalier Nord, CHU de Lyon-HCL, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex, France
| | - S Ploteau
- Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Mère-Enfant, CHU de Nantes, 8, boulevard Jean-Monnet, 44093 Nantes, France
| | - C Poncelet
- Service de gynécologie-obstétrique, centre hospitalier Renée-Dubos, 6, avenue de l'Île-de-France, 95300 Pontoise, France; Université Paris 13, Sorbonne Paris Cité, UFR SMBH, 93022 Bobigny, France
| | - B Rabischong
- Service de gynécologie-obstétrique et reproduction humaine, CHU Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France
| | - H Roman
- Centre expert de diagnostic et prise en charge multidisciplinaire de l'endométriose, clinique gynécologique et obstétricale, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen, France
| | - C Rubod
- Clinique de gynécologie, hôpital Jeanne-de-Flandre, CHRU de Lille, 59000 Lille, France; Université Lille-Nord-de-France, 59000 Lille, France
| | - P Santulli
- Service de chirurgie gynécologie-obstétrique 2 et médecine de la reproduction, CHU Cochin, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Équipe génomique, épigénétique et physiopathologie de la reproduction, département développement, reproduction, cancer, Inserm U1016, université Paris Descartes, Sorbonne Paris Cité, 12, rue de l'École-de-Médecine, 75270 Paris cedex 06, France
| | - M Sauvan
- Service de gynécologie-obstétrique, CHU Bicêtre, AP-HP, 78, avenue du Général-de-Gaulle, 94275 Le Kremlin-Bicêtre, France
| | - I Thomassin-Naggara
- Service d'imagerie, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France; Sorbonne universités, UPMC université Paris 06, Paris, France; Institut universitaire de cancérologie, Assistance publique, Paris, France
| | - A Torre
- Service de gynécologie-obstétrique et médecine de la reproduction, hôpital Arnaud-de-Villeneuve, CHU de Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier, France
| | - J M Wattier
- Centre d'étude et traitement de la douleur, hôpital Claude-Huriez, CHRU de Lille, rue Michel-Polonowski, 59000 Lille, France
| | - C Yazbeck
- Service de gynécologie-obstétrique, hôpital Foch, AP-HP, 40, rue Worth, 92151 Suresnes, France; Centre d'assistance médicale à la procréation, clinique Pierre-Cherest, 5, rue Pierre-Cherest, 92200 Neuilly-Sur-Seine, France
| | - M Canis
- Service de gynécologie-obstétrique et reproduction humaine, CHU Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France; Faculté de médecine, Encov-ISIT, UMR6284 CNRS, université d'Auvergne, 28, place Henri-Dunant, 63000 Clermont-Ferrand, France
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Roman H, Ballester M, Loriau J, Canis M, Bolze PA, Niro J, Ploteau S, Rubod C, Yazbeck C, Collinet P, Rabischong B, Merlot B, Fritel X. [Strategies and surgical management of endometriosis: CNGOF-HAS Endometriosis Guidelines]. ACTA ACUST UNITED AC 2018. [PMID: 29526793 DOI: 10.1016/j.gofs.2018.02.020] [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] [Indexed: 10/17/2022]
Abstract
The article presents French guidelines for surgical management of endometriosis. Surgical treatment is recommended for mild to moderate endometriosis, as it decreases pelvic painful complaints and increases the likelihood of postoperative conception in infertile patients (A). Surgery may be proposed in symptomatic patients with ovarian endometriomas which diameter exceeds 20mm. Cystectomy allows for better postoperative pregnancy rates when compared to ablation using bipolar current, as well as for lower recurrences rates when compared to ablation using bipolar current or CO2 laser. Ablation of ovarian endometriomas using bipolar current is not recommended (B). Surgery may be employed in patients with deep endometriosis infiltrating the colon and the rectum, with good impact on painful complaints and postoperative conception. In these patients, laparoscopic route increases the likelihood of postoperative spontaneous conception when compared to open route. When compared to conservative rectal procedures (shaving or disc excision), segmental colorectal resection increases the risk of postoperative stenosis, requiring additional endoscopic or surgical procedures. In large deep endometriosis infiltrating the rectum (>20mm length of bowel infiltration), conservative rectal procedures do not improve postoperative digestive function when compared to segmental resection. In patients with bowel anastomosis, placing anti-adhesion agents on contact with bowel suture is not recommended, due to higher risk of bowel fistula (C). Various other recommendations are proposed in the text, however, they are based on studies with low level of evidence.
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Affiliation(s)
- H Roman
- Centre expert de diagnostic et prise en charge multidisciplinaire de l'endométriose, clinique gynécologique et obstétricale, CHU Charles Nicolle, 1, rue de Germont, 76031 Rouen, France.
| | - M Ballester
- Service de gynécologie-obstétrique et médecine de la reproduction, CHU Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - J Loriau
- Service de chirurgie digestive, groupe hospitalier Paris Saint-Joseph, 185, rue Raymond Losserand, 75001 Paris, France
| | - M Canis
- Service de gynécologie-obstétrique et reproduction humaine, CHU Estaing, 1, place Lucie Aubrac, 63003 Clermont-Ferrand, France; Faculté de médecine, Encov-ISIT, UMR6284 CNRS, université d'Auvergne, 28, place Henri Dunant, 63000 Clermont-Ferrand, France
| | - P A Bolze
- Service de chirurgie gynécologique oncologique, obstétrique, CHU Lyon Sud, 165, chemin du Grand Revoyet, 69495 Pierre Bénite, France; Université Claude Bernard Lyon 1, 69000 Lyon, France
| | - J Niro
- Service de chirurgie gynécologique, clinique Tivoli, 220, rue Mandron, 33000 Bordeaux, France
| | - S Ploteau
- Service de gynecologie-obstétrique et médecine de la reproduction, hôpital Mère-Enfant, CHU Nantes, 8, boulevard Jean-Monnet, 44093 Nantes, France
| | - C Rubod
- Clinique de gynécologie, hôpital Jeanne-de-Flandre, CHRU Lille, 59000 Lille, France; Université Lille-Nord-de-France, 59000 Lille, France
| | - C Yazbeck
- Service de gynécologie-obstétrique, hôpital Foch, AP-HP, 40, rue Worth, 92151 Suresnes, France; Centre d'assistance médicale à la procréation, clinique Pierre Cherest, 5, rue Pierre Cherest, 92200 Neuilly-Sur-Seine, France
| | - P Collinet
- Clinique de gynécologie, hôpital Jeanne-de-Flandre, CHRU Lille, 59000 Lille, France; Université Lille-Nord-de-France, 59000 Lille, France
| | - B Rabischong
- Service de gynécologie-obstétrique et reproduction humaine, CHU Estaing, 1, place Lucie Aubrac, 63003 Clermont-Ferrand, France; Faculté de médecine, Encov-ISIT, UMR6284 CNRS, université d'Auvergne, 28, place Henri Dunant, 63000 Clermont-Ferrand, France
| | - B Merlot
- Service de chirurgie gynécologique, clinique Tivoli, 220, rue Mandron, 33000 Bordeaux, France
| | - X Fritel
- Service de gynécologie-obstétrique et médecine de la reproduction, inserm CIC 1402, 2, rue de la Milétrie, 86000 Poitiers, France; Université de Poitiers, 86000 Poitiers, France; Inserm CIC 1402, 86000 Poitiers, France
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Abstract
Deep endometriosis with colorectal involvement is considered one of the most severe forms of the disease due to its impact on patients' quality of life and fertility but also by the difficulties encountered by the clinicians when proposing a therapeutic strategy. Although the literature is very rich, evidence based medicine remains poor explaining the great heterogeneity concerning the management of such patients. Surgery therefore remains a therapeutic option. It improves the intensity of gynecological, digestive and general symptoms and the quality of life. Concerning the surgical approach, it appears that laparoscopy should be the first option; the laparoscopic robot-assisted route can also be proposed. The techniques of rectal shaving, discoid resection and segmental resection are the three techniques used for surgical excision of colorectal endometriosis. The parameters taken into account for the use of either technique are: the surgeon's experience, the depth of infiltration of the lesion within the rectosigmoid wall, the lesion size and circumference, multifocality and the distance of the lesion from the anal margin. In the case of deep endometriosis with colorectal involvement, performing an incomplete surgery increases the rate of pain recurrence and decreases postoperative fertility. In case of surgery for colorectal endometriosis, pregnancy rates are similar to those obtained after ART in non-operated patients. Existing data are insufficient to formally recommend first line surgery or ART in infertile patients with colorectal endometriosis. The surgery for colorectal endometriosis exposes to a risk of postoperative complications and recurrence of which the patients should be informed preoperatively.
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Affiliation(s)
- M Ballester
- Service de gynécologie-obstétrique et médecine de la reproduction, CHU de Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France.
| | - H Roman
- Centre expert de diagnostic et prise en charge multidisciplinaire de l'endométriose, clinique gynécologique et obstétricale, CHU Charles-Nicolle, 1, rue de Germont, 76031 Rouen, France
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Thomassin-Naggara I, Bendifallah S, Rousset P, Bazot M, Ballester M, Darai E. Performances et critères de qualité de l’IRM, du colo-scanner, de l’entéro IRM/CT pour le diagnostic d’endométriose pelvienne, RPC Endométriose CNGOF-HAS. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.gofs.2018.02.023] [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: 01/02/2023]
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Ferrier C, Roman H, Alzahrani Y, d'Argent EM, Bendifallah S, Marty N, Perez M, Rubod C, Collinet P, Daraï E, Ballester M. Fertility outcomes in women experiencing severe complications after surgery for colorectal endometriosis. Hum Reprod 2018; 33:411-415. [DOI: 10.1093/humrep/dex375] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Accepted: 12/10/2017] [Indexed: 11/12/2022] Open
Affiliation(s)
- C Ferrier
- Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, 75006 Paris, France
| | - H Roman
- Expert Center in the Diagnosis and Multidisciplinary Management of Endometriosis, Department of Gynecology and Obstetrics, Rouen University Hospital, 76031 Rouen, France
| | - Y Alzahrani
- Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, 75006 Paris, France
| | - E Mathieu d'Argent
- Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, 75006 Paris, France
| | - S Bendifallah
- Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, 75006 Paris, France
- Groupe de Recherche Clinique GRC6-UPMC, Centre Expert En Endométriose (C3E), University Pierre and Marie Curie, 75006 Paris, France
| | - N Marty
- Expert Center in the Diagnosis and Multidisciplinary Management of Endometriosis, Department of Gynecology and Obstetrics, Rouen University Hospital, 76031 Rouen, France
| | - M Perez
- Department of Gynaecology and Obstetrics, Jeanne de Flandre University Hospital, Université Lille Nord-de-France, CHRU de Lille, 59000 Lille, France
| | - C Rubod
- Department of Gynaecology and Obstetrics, Jeanne de Flandre University Hospital, Université Lille Nord-de-France, CHRU de Lille, 59000 Lille, France
| | - P Collinet
- Department of Gynaecology and Obstetrics, Jeanne de Flandre University Hospital, Université Lille Nord-de-France, CHRU de Lille, 59000 Lille, France
| | - E Daraï
- Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, 75006 Paris, France
- Groupe de Recherche Clinique GRC6-UPMC, Centre Expert En Endométriose (C3E), University Pierre and Marie Curie, 75006 Paris, France
- UMR_S938, Université Pierre et Marie Curie, 75006 Paris, France
| | - M Ballester
- Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, 75006 Paris, France
- Groupe de Recherche Clinique GRC6-UPMC, Centre Expert En Endométriose (C3E), University Pierre and Marie Curie, 75006 Paris, France
- UMR_S938, Université Pierre et Marie Curie, 75006 Paris, France
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Ballester M, Puig-Oliveras A, Castelló A, Revilla M, Fernández AI, Folch JM. Association of genetic variants and expression levels of porcine FABP4 and FABP5 genes. Anim Genet 2017; 48:660-668. [PMID: 29076225 DOI: 10.1111/age.12620] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2017] [Indexed: 12/31/2022]
Abstract
The FABP4 and FABP5 genes, coding for fatty acid transport proteins, have long been studied as positional candidate genes for SSC4 QTL affecting fat deposition and composition traits in pigs. Polymorphisms in these genes, FABP4:g.2634_2635insC and FABP5:g.3000T>G, have previously been associated with fatness traits in an Iberian by Landrace cross (IBMAP). The aim of the present work was to evaluate the functional implication of these genetic variants. For this purpose, FABP4 and FABP5 mRNA expression levels in 114 BC1_LD animals (25% Iberian × 75% Landrace) were analyzed using real-time quantitative PCR in backfat and muscle. FABP4 gene expression in backfat, but not in muscle, was associated with FABP4:g.2634_2635insC. In contrast, FABP5:g.3000T>G was not associated with gene expression levels. An expression-based genome-wide association study highlighted the FABP4:g.2634_2635insC polymorphism as the polymorphism most associated with FABP4 gene expression in backfat. Furthermore, other genomic regions associated in trans with the mRNA expression of FABP4 in backfat and FABP5 in muscle were also identified. Finally, two putative transcription binding sites for PPARG and NR4A2 may be affected by the FABP4:g.2634_2635insC polymorphism, modifying FABP4 gene expression. Our results reinforce FABP4 as a candidate gene for fatness traits on SSC4.
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Affiliation(s)
- M Ballester
- Plant and Animal Genomics, Centre de Recerca en Agrigenòmica (Consorci CSIC-IRTA-UAB-UB), Edifici CRAG, Campus UAB, Bellaterra, 08193, Barcelona, Spain.,Departament de Ciència Animal i dels Aliments, Facultat de Veterinària, Campus UAB, Bellaterra, 08193, Barcelona, Spain.,Genètica i Millora Animal, IRTA, Torre Marimon, 08140, Caldes de Montbui, Spain
| | - A Puig-Oliveras
- Plant and Animal Genomics, Centre de Recerca en Agrigenòmica (Consorci CSIC-IRTA-UAB-UB), Edifici CRAG, Campus UAB, Bellaterra, 08193, Barcelona, Spain.,Departament de Ciència Animal i dels Aliments, Facultat de Veterinària, Campus UAB, Bellaterra, 08193, Barcelona, Spain
| | - A Castelló
- Plant and Animal Genomics, Centre de Recerca en Agrigenòmica (Consorci CSIC-IRTA-UAB-UB), Edifici CRAG, Campus UAB, Bellaterra, 08193, Barcelona, Spain.,Departament de Ciència Animal i dels Aliments, Facultat de Veterinària, Campus UAB, Bellaterra, 08193, Barcelona, Spain
| | - M Revilla
- Plant and Animal Genomics, Centre de Recerca en Agrigenòmica (Consorci CSIC-IRTA-UAB-UB), Edifici CRAG, Campus UAB, Bellaterra, 08193, Barcelona, Spain.,Departament de Ciència Animal i dels Aliments, Facultat de Veterinària, Campus UAB, Bellaterra, 08193, Barcelona, Spain
| | - A I Fernández
- Departamento de Genética Animal, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA), 28040, Madrid, Spain
| | - J M Folch
- Plant and Animal Genomics, Centre de Recerca en Agrigenòmica (Consorci CSIC-IRTA-UAB-UB), Edifici CRAG, Campus UAB, Bellaterra, 08193, Barcelona, Spain.,Departament de Ciència Animal i dels Aliments, Facultat de Veterinària, Campus UAB, Bellaterra, 08193, Barcelona, Spain
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Daraï C, Bendifallah S, Foulot H, Ballester M, Chabbert-Buffet N, Daraï E. [Impact of osteopathic manipulative therapy in patient with deep with colorectal endometriosis: A classification based on symptoms and quality of life]. ACTA ACUST UNITED AC 2017; 45:472-477. [PMID: 28869181 DOI: 10.1016/j.gofs.2017.07.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 05/23/2017] [Accepted: 07/18/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVES A prospective study to evaluate the clinical impact of osteopathic manipulative therapy (OMT) on symptoms and quality of life (QOL) of patients with colorectal endometriosis. METHODS Forty-six patients with colorectal endometriosis completed the SF-36 QOL and symptoms questionnaire before and after OMT. A comparison and clustering analysis was performed to identify subgroups of patient's profile and symptom classification. RESULTS The mean age of the patients was 32±6.2 years. Prior surgery for endometriosis was recorded in 73.9 % of cases but none for deep infiltrating endometriosis. About three-quarters of the patients were nulliparous. The time between pre- and post-OMT completion of questionnaires was 28 days (15-63), A significant improvement in SF-36 QOL physical component summary (P<0.001) and mental component summary (P<0.001) was observed after OMT. Similarly, a significant improvement in gynecological, digestive and general symptoms values was observed. A clustering analysis allowed to identify four profiles of patients with colorectal endometriosis based on symptoms and a respective OMT gain of 30 %, 60 %, 64 % et 45 %. CONCLUSIONS Our results support that OMT improve QOL and endometriosis symptoms of patients with colorectal endometriosis. Moreover, this symptom classification based on OMT gain can serve to design future randomized trial.
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Affiliation(s)
- C Daraï
- Service de gynécologie-obstétrique et reproduction humaine, hôpital Tenon, université Pierre-et-Marie-Curie (UPMC), Assistance publique-Hôpitaux de Paris, Paris 6, 4, rue de La Chine, 75020 Paris, France; Groupe de recherche clinique (GRC-6 UPMC), centre expert en endométriose (C3E), hôpital Tenon, 75020 Paris, France; Cabinet d'ostéopathie, 1, rue Godefroy, 75013 Paris, France
| | - S Bendifallah
- Service de gynécologie-obstétrique et reproduction humaine, hôpital Tenon, université Pierre-et-Marie-Curie (UPMC), Assistance publique-Hôpitaux de Paris, Paris 6, 4, rue de La Chine, 75020 Paris, France; Groupe de recherche clinique (GRC-6 UPMC), centre expert en endométriose (C3E), hôpital Tenon, 75020 Paris, France.
| | - H Foulot
- Service de gynécologie-obstétrique et reproduction humaine, hôpital Cochin Port-Royal, université René Descartes Paris 5, Assistance publique-Hôpitaux de Paris, 75014 Paris, France
| | - M Ballester
- Service de gynécologie-obstétrique et reproduction humaine, hôpital Tenon, université Pierre-et-Marie-Curie (UPMC), Assistance publique-Hôpitaux de Paris, Paris 6, 4, rue de La Chine, 75020 Paris, France; Groupe de recherche clinique (GRC-6 UPMC), centre expert en endométriose (C3E), hôpital Tenon, 75020 Paris, France; UMRS-938, université Pierre-et-Marie-Curie, Paris 6, 75012 Paris, France
| | - N Chabbert-Buffet
- Service de gynécologie-obstétrique et reproduction humaine, hôpital Tenon, université Pierre-et-Marie-Curie (UPMC), Assistance publique-Hôpitaux de Paris, Paris 6, 4, rue de La Chine, 75020 Paris, France; Groupe de recherche clinique (GRC-6 UPMC), centre expert en endométriose (C3E), hôpital Tenon, 75020 Paris, France; UMRS-938, université Pierre-et-Marie-Curie, Paris 6, 75012 Paris, France
| | - E Daraï
- Service de gynécologie-obstétrique et reproduction humaine, hôpital Tenon, université Pierre-et-Marie-Curie (UPMC), Assistance publique-Hôpitaux de Paris, Paris 6, 4, rue de La Chine, 75020 Paris, France; Groupe de recherche clinique (GRC-6 UPMC), centre expert en endométriose (C3E), hôpital Tenon, 75020 Paris, France; UMRS-938, université Pierre-et-Marie-Curie, Paris 6, 75012 Paris, France
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Rousselin A, Bendifallah S, Nyangoh Timoh K, Ouldamer L, Canlorbe G, Raimond E, Hudry N, Coutant C, Graesslin O, Touboul C, Collinet P, Bricou A, Huchon C, Daraï E, Ballester M, Levêque J, Lavoue V. Patterns of care and the survival of elderly patients with high-risk endometrial cancer: A case-control study from the FRANCOGYN group. Eur J Surg Oncol 2017; 43:2135-2142. [PMID: 28888799 DOI: 10.1016/j.ejso.2017.07.019] [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] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Revised: 07/23/2017] [Accepted: 07/27/2017] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The standard of care of endometrial cancer involves complex procedures such as pelvic and para-aortic lymphadenectomy and omentectomy, particularly for high-risk endometrial cancer. Few data are available about these complex surgical procedures and adjuvant therapy in elderly women. We aim to examine treatment and survival of elderly women diagnosed with high-risk endometrial cancer. STUDY DESIGN We performed a case-control study of women diagnosed between 2001 and 2013 with high-risk endometrial cancers. Women older than 70 years (n = 198) were compared with patients <70 years (n = 198) after matching on high-risk for recurrence and LVSI status. RESULTS Elderly patients had lymphadenectomies less frequently compared with younger patients (76% vs 96%, p < 0.001) and no adjuvant treatment more frequently (17% vs 8%, p = 0.005) due to less chemotherapy being administered (23% vs 46%, p < 0.001). The 3-year DFS, CSS and OS of patients ≥70 years was 52% (43-61), 81% (74-88) and 61% (53-70), respectively. These were significantly lower than the 3-year DFS, CSS, and OS of younger patients, which was 75% (68-82) (p < 0.001), 92% (87-96) (p < 0.008) and 75% (69-82) (p = 0.018), respectively. Cox proportional hazard models found that elderly women had 57% increased risk of recurrence (hazard ratio 1.57, 95% CI 1.04-2.39) compared with younger patients. CONCLUSION Although we found an independently significant lower DFS in elderly patients with high-risk endometrial cancer when compared with young patients, elderly women are less likely to be treated with lymphadenectomy and chemotherapy. Specific guidelines for management of elderly patients with high-risk endometrial cancer are required to improve their prognosis.
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Affiliation(s)
- A Rousselin
- CHU de Rennes, Service de Gynécologie, Hopital Sud, 16 Bd de Bulgarie, 35000 Rennes, France; Université de Rennes 1, France; INSERM 1242, Oncogenesis, Stress and Signaling, CRLC Eugène Marquis, Rennes, France
| | - S Bendifallah
- Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Institut Universitaire de Cancérologie (IUC), Paris 6, France; INSERM UMR_S_707, "Epidemiology, Information Systems, Modeling", University Pierre and Marie Curie, Paris 6, France
| | - K Nyangoh Timoh
- CHU de Rennes, Service de Gynécologie, Hopital Sud, 16 Bd de Bulgarie, 35000 Rennes, France; Université de Rennes 1, France; INSERM 1242, Oncogenesis, Stress and Signaling, CRLC Eugène Marquis, Rennes, France
| | - L Ouldamer
- Department of Obstetrics and Gynaecology, Centre Hospitalier Régional Universitaire de Tours, Hôpital Bretonneau, Tours, France
| | - G Canlorbe
- Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Institut Universitaire de Cancérologie (IUC), Paris 6, France
| | - E Raimond
- Department of Obstetrics and Gynaecology, Institute Alix de Champagne University Hospital, Reims, France
| | - N Hudry
- Center de lutte contre le cancer Georges François Leclerc, Dijon, France
| | - C Coutant
- Center de lutte contre le cancer Georges François Leclerc, Dijon, France
| | - O Graesslin
- Department of Obstetrics and Gynaecology, Institute Alix de Champagne University Hospital, Reims, France
| | - C Touboul
- Department of Obstetrics and Gynaecology, Centre Hospitalier Intercommunal, Créteil, France
| | - P Collinet
- Department of Obstetrics and Gynaecology, Centre Hospitalier Régional Universitaire, Lille, France
| | - A Bricou
- Department of Gynaecology and Obstetrics, Jean Verdier University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Paris 13, France
| | - C Huchon
- Department of Gynaecology and Obstetrics, Centre Hospitalier Intercommunal, Poissy, France
| | - E Daraï
- Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Institut Universitaire de Cancérologie (IUC), Paris 6, France; INSERM UMR_S_938, University Pierre et Marie Curie, Paris 6, France
| | - M Ballester
- Department of Gynaecology and Obstetrics, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Institut Universitaire de Cancérologie (IUC), Paris 6, France; INSERM UMR_S_938, University Pierre et Marie Curie, Paris 6, France
| | - J Levêque
- CHU de Rennes, Service de Gynécologie, Hopital Sud, 16 Bd de Bulgarie, 35000 Rennes, France; Université de Rennes 1, France; INSERM 1242, Oncogenesis, Stress and Signaling, CRLC Eugène Marquis, Rennes, France
| | - V Lavoue
- CHU de Rennes, Service de Gynécologie, Hopital Sud, 16 Bd de Bulgarie, 35000 Rennes, France; Université de Rennes 1, France; INSERM 1242, Oncogenesis, Stress and Signaling, CRLC Eugène Marquis, Rennes, France.
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Furet E, Bendifallah S, Ballester M, Darai E. Spontaneous intergluteal cleft endometriosis. J Gynecol Obstet Hum Reprod 2017; 46:665-666. [PMID: 28603088 DOI: 10.1016/j.jogoh.2017.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 05/30/2017] [Accepted: 06/02/2017] [Indexed: 11/20/2022]
Abstract
Endometriosis is a condition where hormonal-responsive endometrial tissue grows outside the uterus usually within the pelvic cavity. Extra-abdominal endometriosis is less common and may involves the skin. Subcutaneous endometriosis is rare. We report the first case of spontaneous intergluteal cleft endometriosis revealed by pain and bleeding during menstruation.
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Affiliation(s)
- E Furet
- Clinical Research Group: GRC-6 UPMC, Centre Expert En Endométriose (C3E), UMRS-938, service de gynécologie obstétrique, hôpital Tenon, AP-HP, université Pierre-et-Marie-Curie Paris 6, Paris, France.
| | - S Bendifallah
- Clinical Research Group: GRC-6 UPMC, Centre Expert En Endométriose (C3E), UMRS-938, service de gynécologie obstétrique, hôpital Tenon, AP-HP, université Pierre-et-Marie-Curie Paris 6, Paris, France
| | - M Ballester
- Clinical Research Group: GRC-6 UPMC, Centre Expert En Endométriose (C3E), UMRS-938, service de gynécologie obstétrique, hôpital Tenon, AP-HP, université Pierre-et-Marie-Curie Paris 6, Paris, France
| | - E Darai
- Clinical Research Group: GRC-6 UPMC, Centre Expert En Endométriose (C3E), UMRS-938, service de gynécologie obstétrique, hôpital Tenon, AP-HP, université Pierre-et-Marie-Curie Paris 6, Paris, France
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Ouldamer L, Bendifallah S, Nikpayam M, Body G, Fritel X, Uzan C, Morice P, Daraï E, Ballester M. Improving the clinical management of women with borderline tumours: a recurrence risk scoring system from a French multicentre study. BJOG 2017; 124:937-944. [DOI: 10.1111/1471-0528.14577] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2017] [Indexed: 12/12/2022]
Affiliation(s)
- L Ouldamer
- Department of Gynaecology; Centre Hospitalier Universitaire de Tours; Tours France
- INSERM U1069; Université François-Rabelais; Tours France
| | - S Bendifallah
- Department of Obstetrics and Gynaecology; Hôpital Tenon; Paris France
- UMR S 707; Epidemiology; Information Systems; Modelling; Université Pierre et Marie Curie; Paris France
| | - M Nikpayam
- Department of Obstetrics and Gynaecology; Hôpital Tenon; Paris France
- UMR S 707; Epidemiology; Information Systems; Modelling; Université Pierre et Marie Curie; Paris France
| | - G Body
- Department of Gynaecology; Centre Hospitalier Universitaire de Tours; Tours France
- INSERM U1069; Université François-Rabelais; Tours France
| | - X Fritel
- Department of Obstetrics and Gynaecology; Faculté de Médecine et Pharmacie; CHU de Poitiers; Université de Poitiers; Poitiers France
- INSERM CIC 1402; CHU de Poitiers; Poitiers France
| | - C Uzan
- Department of Gynaecological Surgery; Institut Gustave Roussy; Villejuif France
- INSERM U 10-30; Institut Gustave Roussy; Villejuif France
| | - P Morice
- Department of Gynaecological Surgery; Institut Gustave Roussy; Villejuif France
- INSERM U 10-30; Institut Gustave Roussy; Villejuif France
| | - E Daraï
- Department of Obstetrics and Gynaecology; Hôpital Tenon; Paris France
- INSERM UMR S 938; Université Pierre et Marie Curie; Paris France
| | - M Ballester
- Department of Obstetrics and Gynaecology; Hôpital Tenon; Paris France
- INSERM UMR S 938; Université Pierre et Marie Curie; Paris France
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Kanté F, Belghiti J, Roseau G, Thomassin-Naggara I, Bazot M, Daraï E, Ballester M. [Comparison of the accuracy of rectal endoscopic sonography and magnetic resonance imaging in the diagnosis of colorectal endometriosis]. ACTA ACUST UNITED AC 2017; 45:131-136. [PMID: 28256410 DOI: 10.1016/j.gofs.2017.01.009] [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: 09/11/2016] [Accepted: 01/18/2017] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To compare the accuracy of magnetic resonance imaging (MRI) and rectal endoscopic sonography (RES) for the diagnosis of colorectal endometriosis. METHODS In retrospective study, 407 patients operated on service of gynecology of Tenon hospital for deep endometriosis with suspected colorectal involvement. All patients underwent MRI and then RES. RESULTS In the study, 239 patients (59%) had colorectal endometriosis which were diagnosed with the histology. The sensitivity, specificity, positive and negative predictive value (PPV and NPV) of RES and MRI for the diagnosis of colorectal endometriosis were respectively 92%, 87%, 91%, 88% and 85%, 88%, 91%, 80%. The accuracy of RES was not significantly different than MRI (90% versus 86%, P=0.09). CONCLUSION RES is a good exam to diagnose colorectal endometriosis. It is able to improve diagnosis performances.
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Affiliation(s)
- F Kanté
- Service de gynécologie-obstétrique, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France; Service de radiologie, hôpital Tenon, AP-HP, Paris, France.
| | - J Belghiti
- Service de chirurgie et oncologie gynécologique et mammaire, hôpital Pitié-Salpêtrière, AP-HP, 75013 Paris, France.
| | - G Roseau
- Centre chirurgical Trocadéro, département d'endoscopie digestive, Paris, France.
| | - I Thomassin-Naggara
- Service de radiologie, hôpital Tenon, AP-HP, Paris, France; GRC6-UPMC, centre expert en endométriose (C3E), Paris, France; UMR_S938, université Pierre-et-Marie-Curie Paris 6, 75012 Paris, France.
| | - M Bazot
- Service de radiologie, hôpital Tenon, AP-HP, Paris, France; GRC6-UPMC, centre expert en endométriose (C3E), Paris, France; UMR_S938, université Pierre-et-Marie-Curie Paris 6, 75012 Paris, France.
| | - E Daraï
- Service de gynécologie-obstétrique, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France; GRC6-UPMC, centre expert en endométriose (C3E), Paris, France; UMR_S938, université Pierre-et-Marie-Curie Paris 6, 75012 Paris, France.
| | - M Ballester
- Service de gynécologie-obstétrique, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France; GRC6-UPMC, centre expert en endométriose (C3E), Paris, France; UMR_S938, université Pierre-et-Marie-Curie Paris 6, 75012 Paris, France.
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Mounsambote L, Cohen J, Bendifallah S, d'Argent EM, Selleret L, Chabbert-Buffet N, Ballester M, Antoine JM, Daraï E. [Deep infiltrative endometriosis without digestive involvement, what is the impact of surgery on in vitro fertilization outcomes? A retrospective study]. ACTA ACUST UNITED AC 2017; 45:15-21. [PMID: 28238309 DOI: 10.1016/j.gofs.2016.12.008] [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: 09/02/2016] [Accepted: 11/18/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate the impact of complete removal of endometriosis in case of deep infiltrative endometriosis without digestive involvement, on in vitro fertilization outcomes. METHODS Retrospective monocentric study. We included infertile women with deep infiltrative endometriosis without colorectal involvement that underwent IVF. Women were divided in two groups, following their history: "surgery" when they underwent complete endometriosis resection before IVF and "without surgery" when they underwent IVF without endometriosis removal. We analysed IVF outcomes considering pregnancy rates per cycle and cumulative pregnancy rates per patient. RESULTS We included 72 patients: 35 in the "surgery" group and 37 in the "without surgery" group. Women in the two groups were comparable in terms of baseline characteristics (age, body mass index, anti-Müllerian hormone, antral follicular count), endometriosis localizations and in vitro fertilization parameters. Cumulative pregnancy rates per patient were similar in both groups (40 % in the "surgery" group and 41 % in the "without surgery" group; P=1). Clinical pregnancy rate per cycle were also comparable groups (24 % in the "surgery" group and 28 % in the "without surgery" group; P=0.67). Surgery performed was comparable in women that became pregnant and in women that did not. Age was lower in women that became pregnant (P=0.01) and there were more pregnancy obtained in women under 35 years. CONCLUSION In women with deep infiltrative endometriosis without digestive involvement, in vitro fertilization outcomes were not impacted by surgery. Therapeutic choice between IVF or surgery as first-line treatment remains thus questionable and shall be guided by other influencing factors, such as pain symptomatology, age, tubal permeability, ovarian reserve, partner's sperm characteristics and woman's choice.
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Affiliation(s)
- L Mounsambote
- Department of Obstetrics, Gynecology and Reproductive Medicine, hôpital Tenon, GRC 6-UPMC centre expert en endométriose (C3E), université Pierre-et-Marie-Curie-Paris 6, Assistance publique-Hôpitaux de Paris, 75020 Paris, France
| | - J Cohen
- Department of Obstetrics, Gynecology and Reproductive Medicine, hôpital Tenon, GRC 6-UPMC centre expert en endométriose (C3E), université Pierre-et-Marie-Curie-Paris 6, Assistance publique-Hôpitaux de Paris, 75020 Paris, France; Inserm UMRS 938, université Pierre-et-Marie-Curie, 75012 Paris, France.
| | - S Bendifallah
- Department of Obstetrics, Gynecology and Reproductive Medicine, hôpital Tenon, GRC 6-UPMC centre expert en endométriose (C3E), université Pierre-et-Marie-Curie-Paris 6, Assistance publique-Hôpitaux de Paris, 75020 Paris, France
| | - E Mathieu d'Argent
- Department of Obstetrics, Gynecology and Reproductive Medicine, hôpital Tenon, GRC 6-UPMC centre expert en endométriose (C3E), université Pierre-et-Marie-Curie-Paris 6, Assistance publique-Hôpitaux de Paris, 75020 Paris, France
| | - L Selleret
- Department of Obstetrics, Gynecology and Reproductive Medicine, hôpital Tenon, GRC 6-UPMC centre expert en endométriose (C3E), université Pierre-et-Marie-Curie-Paris 6, Assistance publique-Hôpitaux de Paris, 75020 Paris, France
| | - N Chabbert-Buffet
- Department of Obstetrics, Gynecology and Reproductive Medicine, hôpital Tenon, GRC 6-UPMC centre expert en endométriose (C3E), université Pierre-et-Marie-Curie-Paris 6, Assistance publique-Hôpitaux de Paris, 75020 Paris, France; Inserm UMRS 938, université Pierre-et-Marie-Curie, 75012 Paris, France
| | - M Ballester
- Department of Obstetrics, Gynecology and Reproductive Medicine, hôpital Tenon, GRC 6-UPMC centre expert en endométriose (C3E), université Pierre-et-Marie-Curie-Paris 6, Assistance publique-Hôpitaux de Paris, 75020 Paris, France; Inserm UMRS 938, université Pierre-et-Marie-Curie, 75012 Paris, France
| | - J M Antoine
- Department of Obstetrics, Gynecology and Reproductive Medicine, hôpital Tenon, GRC 6-UPMC centre expert en endométriose (C3E), université Pierre-et-Marie-Curie-Paris 6, Assistance publique-Hôpitaux de Paris, 75020 Paris, France
| | - E Daraï
- Department of Obstetrics, Gynecology and Reproductive Medicine, hôpital Tenon, GRC 6-UPMC centre expert en endométriose (C3E), université Pierre-et-Marie-Curie-Paris 6, Assistance publique-Hôpitaux de Paris, 75020 Paris, France; Inserm UMRS 938, université Pierre-et-Marie-Curie, 75012 Paris, France
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Ouldamer L, Bendifallah S, Body G, Canlorbe G, Touboul C, Graesslin O, Raimond E, Collinet P, Coutant C, Lavoué V, Lévêque J, Daraï E, Ballester M. Call for Surgical Nodal Staging in Women with ESMO/ESGO/ESTRO High–Intermediate Risk Endometrial Cancer: A Multicentre Cohort Analysis from the FRANCOGYN Study Group. Ann Surg Oncol 2017; 24:1660-1666. [DOI: 10.1245/s10434-016-5731-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Indexed: 01/25/2023]
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Ramayo-Caldas Y, Renand G, Ballester M, Saintilan R, Rocha D. P5007 Systems biology approach provides novel insights into gene networks controlling tenderness and meat quality traits across French beef breeds. J Anim Sci 2016. [DOI: 10.2527/jas2016.94supplement4118a] [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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Revilla M, Ballester M, Puig-Oliveras A, Castelló A, Fernández AI, Folch JM. P3018 Gene expression analysis in backfat and identification of eQTL regions for fatness and fatty acid composition candidate genes in pigs. J Anim Sci 2016. [DOI: 10.2527/jas2016.94supplement460x] [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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Thomin A, Belghiti J, David C, Marty O, Bornes M, Ballester M, Roman H, Daraï E. Maternal and neonatal outcomes in women with colorectal endometriosis. BJOG 2016; 125:711-718. [DOI: 10.1111/1471-0528.14221] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2016] [Indexed: 11/30/2022]
Affiliation(s)
- A Thomin
- Department of Gynaecology and Obstetrics; Hôpital Tenon; Assistance Publique des Hôpitaux de Paris; Université Pierre et Marie Curie; Paris France
- GRC 6 UPMC (C3E) Centre Expert en Endométriose; Paris France
| | - J Belghiti
- Department of Gynaecology and Obstetrics; Hôpital Tenon; Assistance Publique des Hôpitaux de Paris; Université Pierre et Marie Curie; Paris France
- GRC 6 UPMC (C3E) Centre Expert en Endométriose; Paris France
| | - C David
- Department of Gynaecology and Obstetrics; Rouen University Hospital; Hospital-Charles Nicolle; Rouen France
| | - O Marty
- Department of Gynaecology and Obstetrics; Hôpital Tenon; Assistance Publique des Hôpitaux de Paris; Université Pierre et Marie Curie; Paris France
- GRC 6 UPMC (C3E) Centre Expert en Endométriose; Paris France
| | - M Bornes
- Department of Gynaecology and Obstetrics; Hôpital Tenon; Assistance Publique des Hôpitaux de Paris; Université Pierre et Marie Curie; Paris France
- GRC 6 UPMC (C3E) Centre Expert en Endométriose; Paris France
| | - M Ballester
- Department of Gynaecology and Obstetrics; Hôpital Tenon; Assistance Publique des Hôpitaux de Paris; Université Pierre et Marie Curie; Paris France
- GRC 6 UPMC (C3E) Centre Expert en Endométriose; Paris France
- UMRS938; Université Pierre et Marie Curie; Paris France
| | - H Roman
- Department of Gynaecology and Obstetrics; Rouen University Hospital; Rouen France
- Research Group 4308, Spermatogenesis and Gamete Quality; IHU Rouen Normandy; IFRMP23; Reproductive Biology Laboratory; Rouen University Hospital; Rouen France
| | - E Daraï
- Department of Gynaecology and Obstetrics; Hôpital Tenon; Assistance Publique des Hôpitaux de Paris; Université Pierre et Marie Curie; Paris France
- GRC 6 UPMC (C3E) Centre Expert en Endométriose; Paris France
- UMRS938; Université Pierre et Marie Curie; Paris France
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Ouldamer L, Bendifallah S, Naoura I, Body G, Uzan C, Morice P, Ballester M, Daraï E. Nomogram to predict live birth rate after fertility-sparing surgery for borderline ovarian tumours. Hum Reprod 2016; 31:1732-7. [DOI: 10.1093/humrep/dew137] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 05/19/2016] [Indexed: 12/23/2022] Open
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Ballester M, Revilla M, Puig-Oliveras A, Marchesi JAP, Castelló A, Corominas J, Fernández AI, Folch JM. Analysis of the porcine APOA2 gene expression in liver, polymorphism identification and association with fatty acid composition traits. Anim Genet 2016; 47:552-9. [PMID: 27296287 DOI: 10.1111/age.12462] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2016] [Indexed: 12/20/2022]
Abstract
APOA2 is a protein implicated in triglyceride, fatty acid and glucose metabolism. In pigs, the APOA2 gene is located on pig chromosome 4 (SSC4) in a QTL region affecting fatty acid composition, fatness and growth traits. In this study, we evaluated APOA2 as a candidate gene for meat quality traits in an Iberian × Landrace backcross population. The APOA2:c.131T>A polymorphism, located in exon 3 of APOA2 and determining a missense mutation, was associated with the percentage of hexadecenoic acid [C16:1(n-9)], linoleic acid [C18:2(n-6)], α-linolenic acid [C18:3(n-3)], dihomo-gamma-linolenic acid [C20:3(n-6)] and polyunsaturated fatty acids (PUFAs) in backfat. Furthermore, this SNP was associated with the global mRNA expression levels of APOA2 in liver and was used as a marker to determine allelic expression imbalance by pyrosequencing. We determined an overexpression of the T allele in heterozygous samples with a mean ratio of 2.8 (T/A), observing a high variability in the allelic expression among individuals. This result suggests that complex regulatory mechanisms, beyond a single polymorphism (e.g. epigenetic effects or multiple cis-acting polymorphisms), may be regulating APOA2 gene expression.
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Affiliation(s)
- M Ballester
- Departament de Ciència Animal i dels Aliments, Facultat de Veterinària, Campus UAB, Bellaterra, 08193, Barcelona, Spain. .,Plant and Animal Genomics, Centre de Recerca en Agrigenòmica (Consorci CSIC-IRTA-UAB-UB), Edifici CRAG, Campus UAB, Bellaterra, 08193, Barcelona, Spain. .,IRTA, Genètica i Millora Animal, Torre Marimon, 08140, Caldes de Montbui, Spain.
| | - M Revilla
- Departament de Ciència Animal i dels Aliments, Facultat de Veterinària, Campus UAB, Bellaterra, 08193, Barcelona, Spain.,Plant and Animal Genomics, Centre de Recerca en Agrigenòmica (Consorci CSIC-IRTA-UAB-UB), Edifici CRAG, Campus UAB, Bellaterra, 08193, Barcelona, Spain
| | - A Puig-Oliveras
- Departament de Ciència Animal i dels Aliments, Facultat de Veterinària, Campus UAB, Bellaterra, 08193, Barcelona, Spain.,Plant and Animal Genomics, Centre de Recerca en Agrigenòmica (Consorci CSIC-IRTA-UAB-UB), Edifici CRAG, Campus UAB, Bellaterra, 08193, Barcelona, Spain
| | - J A P Marchesi
- Plant and Animal Genomics, Centre de Recerca en Agrigenòmica (Consorci CSIC-IRTA-UAB-UB), Edifici CRAG, Campus UAB, Bellaterra, 08193, Barcelona, Spain
| | - A Castelló
- Departament de Ciència Animal i dels Aliments, Facultat de Veterinària, Campus UAB, Bellaterra, 08193, Barcelona, Spain.,Plant and Animal Genomics, Centre de Recerca en Agrigenòmica (Consorci CSIC-IRTA-UAB-UB), Edifici CRAG, Campus UAB, Bellaterra, 08193, Barcelona, Spain
| | - J Corominas
- Departament de Ciència Animal i dels Aliments, Facultat de Veterinària, Campus UAB, Bellaterra, 08193, Barcelona, Spain.,Plant and Animal Genomics, Centre de Recerca en Agrigenòmica (Consorci CSIC-IRTA-UAB-UB), Edifici CRAG, Campus UAB, Bellaterra, 08193, Barcelona, Spain
| | - A I Fernández
- Departamento de Genética Animal, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA), 28040, Madrid, Spain
| | - J M Folch
- Departament de Ciència Animal i dels Aliments, Facultat de Veterinària, Campus UAB, Bellaterra, 08193, Barcelona, Spain.,Plant and Animal Genomics, Centre de Recerca en Agrigenòmica (Consorci CSIC-IRTA-UAB-UB), Edifici CRAG, Campus UAB, Bellaterra, 08193, Barcelona, Spain
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Dreyfus C, Ballester M, Gligorov J, Agranat P, Antoine M, Tengher I, Bricou A. [Impact of the 21-gene assay in decision-making during multidisciplinary breast meeting: A French experience]. Gynecol Obstet Fertil 2015; 43:780-5. [PMID: 26584893 DOI: 10.1016/j.gyobfe.2015.10.002] [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] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Accepted: 09/29/2015] [Indexed: 01/12/2023]
Abstract
OBJECTIVES The 21-gene assay (Oncotype DX(®)) test is used to estimate the risk of recurrence and to predict the benefit of adjuvant chemotherapy at an early stage of endocrine responsive breast cancers, without HER2 overexpression or amplification. This test corresponds to a recurrence score (RS), classifying patients into three groups (low, intermediate or high risk). The objective of this two-center prospective study is to define the impact of Oncotype DX(®) in clinical practice. METHODS Between August 2013 and May 2015, an Oncotype DX(®) test was decided in multidisciplinary meeting, to certain patients with an indication of adjuvant chemotherapy for HR+ and HER2 negative cancers. The therapeutic changes after knowledge of RS were collected. An estimate of the economic impact was performed and a correlation between the RS and usual breast cancer prognostic markers was investigated. RESULTS Thirty-nine patients had a test, twenty-six (66.7%) of them have finally been no indication retaining chemotherapy. The economy obtained through the use of the test was estimated around 173,000euros. It has not been demonstrated correlation between the RS, the usual decisional and prognostic factors for breast cancer or with adjuvant! Online. CONCLUSIONS The RS has an additional decision value compared to other common decision criteria. Use of Oncotype DX(®) reduced in our experience the indications of adjuvant chemotherapy. The medical and economic impact could be significant.
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Affiliation(s)
- C Dreyfus
- Service de gynécologie-obstétrique, université Paris XIII-Bobigny, AP-HP, Jean-Verdier, avenue du 14-Juillet, 93143 Bondy cedex, France
| | - M Ballester
- Service de gynécologie-obstétrique, Sorbonne université, AP-HP, Tenon, IUC-UPMC, Paris, France
| | - J Gligorov
- Service d'oncologie médicale, Sorbonne université, AP-HP, Tenon, IUC-UPMC, Paris, France
| | - P Agranat
- Service d'oncologie médicale, université Paris XIII-Bobigny, AP-HP, Avicenne, 125, rue de Stalingrad, 93000 Bobigny, France
| | - M Antoine
- Laboratoire d'anatomopathologie, Sorbonne université, AP-HP, Tenon, IUC-UPMC, Paris, France
| | - I Tengher
- Laboratoire d'anatomopathologie, université Paris XIII-Bobigny, AP-HP, Jean-Verdier, avenue du 14-Juillet, 93143 Bondy cedex, France
| | - A Bricou
- Service de gynécologie-obstétrique, université Paris XIII-Bobigny, AP-HP, Jean-Verdier, avenue du 14-Juillet, 93143 Bondy cedex, France.
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Chéreau E, Gouy S, Lambaudie E, Ballester M, Fourchotte V, Guyon F, Pomel C, Colombo P, Delroeux D, Martin-Francoise S, Bihan C, Leblanc E, Lecuru F, Fouche Y, Ghazi Y, Pau D, Selle F, Cottu P, Joly F, Rouzier R. 2740 Independent review committee assessment of Fagotti carcinomatosis score from 8 laparoscopic images: Ancillary analysis of ANTHALYA, a randomized, open-label, phase II study assessing the efficacy and safety of bevacizumab addition to neoadjuvant therapy for women with ovarian, tubal or peritoneal adenocarcinoma, initially unresectable. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31506-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bendifallah S, Canlorbe G, Collinet P, Arsène E, Huguet F, Coutant C, Hudry D, Graesslin O, Raimond E, Touboul C, Daraï E, Ballester M. Just how accurate are the major risk stratification systems for early-stage endometrial cancer? Br J Cancer 2015; 112:793-801. [PMID: 25675149 PMCID: PMC4453957 DOI: 10.1038/bjc.2015.35] [Citation(s) in RCA: 96] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 01/06/2015] [Accepted: 01/12/2015] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND To compare the accuracy of five major risk stratification systems (RSS) in classifying the risk of recurrence and nodal metastases in early-stage endometrial cancer (EC). METHODS Data of 553 patients with early-stage EC were abstracted from a prospective multicentre database between January 2001 and December 2012. The following RSS were identified in a PubMed literature search and included the Post Operative Radiation Therapy in Endometrial Carcinoma (PORTEC-1), the Gynecologic Oncology Group (GOG)-99, the Survival effect of para-aortic lymphadenectomy (SEPAL), the ESMO and the ESMO-modified classifications. The accuracy of each RSS was evaluated in terms of recurrence-free survival (RFS) and nodal metastases according to discrimination. RESULTS Overall, the ESMO -modified RSS provided the highest discrimination for both RFS and for nodal metastases with a concordance index (C-index) of 0.73 (95% CI, 0.70-0.76) and an area under the curve (AUC) of 0.80 (0.78-0.72), respectively. The other RSS performed as follows: the PORTEC1, GOG-99, SEPAL, ESMO classifications gave a C-index of 0.68 (0.66-0.70), 0.65 (0.63-0.67), 0.66 (0.63-0.69), 0.71 (0.68-0.74), respectively, for RFS and an AUC of 0.69 (0.66-0.72), 0.69 (0.67-0.71), 0.68 (0.66-0.70), 0.70 (0.68-0.72), respectively, for node metastases. CONCLUSIONS None of the five major RSS showed high accuracy in stratifying the risk of recurrence or nodal metastases in patients with early-stage EC, although the ESMO-modified classification emerged as having the highest power of discrimination for both parameters. Therefore, there is a need to revisit existing RSS using additional tools such as biological markers to better stratify risk for these patients.
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Affiliation(s)
- S Bendifallah
- 1] Department of Obstetrics and Gynaecology, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Institut Universitaire de Cancérologie (IUC), Paris 6, France [2] INSERM UMR S 707, 'Epidemiology, Information Systems, Modeling', University Pierre and Marie Curie, Paris 6, France
| | - G Canlorbe
- Department of Obstetrics and Gynaecology, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Institut Universitaire de Cancérologie (IUC), Paris 6, France
| | - P Collinet
- Department of Gynecological Surgery, Jeanne de Flandre University Hospital, Lille, France
| | - E Arsène
- Department of Gynecological Surgery, Jeanne de Flandre University Hospital, Lille, France
| | - F Huguet
- Department of Radiation Oncology, Tenon University Hospital, University Pierre and Marie Curie, Paris 6, France
| | - C Coutant
- Centre de lutte contre le cancer Georges François Leclerc, Dijon, France
| | - D Hudry
- Centre de lutte contre le cancer Georges François Leclerc, Dijon, France
| | - O Graesslin
- Department of Obstetrics and Gynaecology, Institute Alix de Champagne University Hospital, Reims, France
| | - E Raimond
- Department of Obstetrics and Gynaecology, Institute Alix de Champagne University Hospital, Reims, France
| | - C Touboul
- Department of Obstetrics and Gynecology, Centre Hospitalier Intercommunal, Créteil, France
| | - E Daraï
- 1] Department of Obstetrics and Gynaecology, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Institut Universitaire de Cancérologie (IUC), Paris 6, France [2] INSERM UMR S 938, University Pierre et Marie Curie, Paris 6, France
| | - M Ballester
- 1] Department of Obstetrics and Gynaecology, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Institut Universitaire de Cancérologie (IUC), Paris 6, France [2] INSERM UMR S 938, University Pierre et Marie Curie, Paris 6, France
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Ramírez O, Burgos-Paz W, Casas E, Ballester M, Bianco E, Olalde I, Santpere G, Novella V, Gut M, Lalueza-Fox C, Saña M, Pérez-Enciso M. Genome data from a sixteenth century pig illuminate modern breed relationships. Heredity (Edinb) 2015; 114:175-84. [PMID: 25204303 PMCID: PMC4815627 DOI: 10.1038/hdy.2014.81] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 07/09/2014] [Accepted: 08/06/2014] [Indexed: 01/16/2023] Open
Abstract
Ancient DNA (aDNA) provides direct evidence of historical events that have modeled the genome of modern individuals. In livestock, resolving the differences between the effects of initial domestication and of subsequent modern breeding is not straight forward without aDNA data. Here, we have obtained shotgun genome sequence data from a sixteenth century pig from Northeastern Spain (Montsoriu castle), the ancient pig was obtained from an extremely well-preserved and diverse assemblage. In addition, we provide the sequence of three new modern genomes from an Iberian pig, Spanish wild boar and a Guatemalan Creole pig. Comparison with both mitochondrial and autosomal genome data shows that the ancient pig is closely related to extant Iberian pigs and to European wild boar. Although the ancient sample was clearly domestic, admixture with wild boar also occurred, according to the D-statistics. The close relationship between Iberian, European wild boar and the ancient pig confirms that Asian introgression in modern Iberian pigs has not existed or has been negligible. In contrast, the Guatemalan Creole pig clusters apart from the Iberian pig genome, likely due to introgression from international breeds.
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Affiliation(s)
- O Ramírez
- Institut de Biologia Evolutiva (CSIC-Universitat Pompeu Fabra), PRBB, Barcelona, Spain
| | - W Burgos-Paz
- Centre for Research in Agricultural Genomics (CRAG), CSIC-IRTA-UAB-UB Consortium, Bellaterra, Spain
- Departament de Ciència Animal i dels Aliments, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - E Casas
- Centre for Research in Agricultural Genomics (CRAG), CSIC-IRTA-UAB-UB Consortium, Bellaterra, Spain
| | - M Ballester
- Centre for Research in Agricultural Genomics (CRAG), CSIC-IRTA-UAB-UB Consortium, Bellaterra, Spain
- Departament de Ciència Animal i dels Aliments, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - E Bianco
- Centre for Research in Agricultural Genomics (CRAG), CSIC-IRTA-UAB-UB Consortium, Bellaterra, Spain
- Departament de Ciència Animal i dels Aliments, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - I Olalde
- Institut de Biologia Evolutiva (CSIC-Universitat Pompeu Fabra), PRBB, Barcelona, Spain
| | - G Santpere
- Institut de Biologia Evolutiva (CSIC-Universitat Pompeu Fabra), PRBB, Barcelona, Spain
| | - V Novella
- Departament de Prehistòria, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - M Gut
- Centro Nacional de Análisis Genómico (CNAG), PCB, Barcelona, Spain
| | - C Lalueza-Fox
- Institut de Biologia Evolutiva (CSIC-Universitat Pompeu Fabra), PRBB, Barcelona, Spain
| | - M Saña
- Departament de Prehistòria, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - M Pérez-Enciso
- Centre for Research in Agricultural Genomics (CRAG), CSIC-IRTA-UAB-UB Consortium, Bellaterra, Spain
- Departament de Ciència Animal i dels Aliments, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Institut Català de Recerca i Estudis Avançats (ICREA), Carrer de Lluís Companys 23, Barcelona, Spain
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Cohen J, Thomin A, Mathieu D'Argent E, Laas E, Canlorbe G, Zilberman S, Belghiti J, Thomassin-Naggara I, Bazot M, Ballester M, Daraï E. Fertility before and after surgery for deep infiltrating endometriosis with and without bowel involvement: a literature review. Minerva Ginecol 2014; 66:575-587. [PMID: 25373015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM Endometriosis affects from 10% to 15% of women of childbearing age and 20% of these women have deep infiltrating endometriosis (DIE). The goal of this review was to assess the impact of various locations of DIE on spontaneous fertility and the benefit of surgery and Medically Assisted Reproduction (MAR) (in vitro fertilization and intrauterine insemination) on fertility outcomes. METHODS MEDLINE search for articles on fertility in women with DIE published between 1990 and April 2013 using the following terms: "deep infiltrative endometriosis", "colorectal", "bowel", "rectovaginal", "uterosacral", "vaginal", "bladder" and "fertility" or "infertility". Twenty-nine articles reporting fertility outcomes in 2730 women with DIE were analysed. RESULTS Among the women with DIE and no bowel involvement (N.=1295), no preoperative data on spontaneous pregnancy rate (PR) were available. The postoperative spontaneous PR rate in these women was 50.5% (95% Confidence Interval [CI] =46.8-54.1) and overall PR (spontaneous pregnancies and after MAR) was 68.3% (95% CI=64.9-71.7). No evaluation of fertility outcome according to locations of DIE was feasible. For women with DIE with bowel involvement without surgical management (N.=115), PR after MAR was 29%; 95% CI=20.7-37.4). For those with bowel involvement who were surgically managed (N.=1320), postoperative spontaneous PR was 28.6% (95% CI=25-32.3) and overall postoperative PR was 46.9% (95% CI=42.9-50.9). CONCLUSION For women with DIE without bowel involvement, surgery alone offers a high spontaneous PR. For those with bowel involvement, the low spontaneous and relatively high overall PR suggests the potential benefit of combining surgery and MAR.
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Affiliation(s)
- J Cohen
- Department of Gynecology and Obstetrics Hôpital Tenon, Assistance Publique des Hôpitaux de Paris Université Pierre et Marie Curie Paris 6 GRC 6-UPMC Centre Expert en Endométriose (C3E), Paris, France -
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Frati A, Ballester M, Dubernard G, Bats AS, Heitz D, Mathevet P, Marret H, Querleu D, Golfier F, Leblanc E, Rouzier R, Daraï E. Contribution of Lymphoscintigraphy for Sentinel Lymph Node Biopsy in Women with Early Stage Endometrial Cancer: Results of the SENTI-ENDO Study. Ann Surg Oncol 2014; 22:1980-6. [PMID: 25391264 DOI: 10.1245/s10434-014-4203-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Indexed: 02/04/2023]
Abstract
BACKGROUND This study was designed to evaluate detection rate and anatomical location of sentinel lymph node (SLN) at lymphoscintigraphy, to compare short and long lymphoscintigraphy protocols, and to correlate lymphoscintigraphic and surgical mapping of SLN in patients with early-stage endometrial cancer (EC). METHODS Subanalysis of the prospective multicenter study Senti-endo performed from July 2007 to August 2009. Patients with stage I and II EC received four cervical injections of 0-2 mL of unfiltered technetium sulphur colloid the day before (long protocol) or the morning (short protocol) before surgery. SLN detection used a combined technetium/patent blue labeling technique, and all patients had a systematic bilateral pelvic lymphadenectomy. RESULTS A total of 133 patients were enrolled in the study and 118 (94.5 %) underwent a lymphoscintigraphy. Of these 118 patients, 44 (37 %) underwent a short protocol and 66 (56 %) a long protocol (data on lymphoscintigraphy were not available in eight patients). Lymphoscintigraphic detection rate was 74.6 % (34 % for short protocol and 60.2 % for long protocol). No difference in the detection rate was observed according to lymphoscintigraphy protocol (p = 0.22), but a higher number of SLN was noted for the long protocol (p = 0.02). Aberrant drainage was noted on lymphoscintigraphy in 30.5 % of the patients. Paraaortic SLNs were exclusively detected using the long protocol. A poor correlation was noted between short (κ test = 0.24) or long lymphoscintigraphy (κ test = 0.3) protocol and SLN surgical mapping. CONCLUSIONS Our study demonstrates that preoperative lymphoscintigraphy allowed a high SLN detection rate and that long lymphoscintigraphy protocol was associated with a higher detection of aberrant drainage especially in the paraaortic area.
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Affiliation(s)
- A Frati
- Department of Obstetrics and Gynaecology, Tenon University Hospital, Paris, France,
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Bendifallah S, Canlorbe G, Raimond E, Hudry D, Coutant C, Graesslin O, Touboul C, Huguet F, Cortez A, Daraï E, Ballester M. A clue towards improving the European Society of Medical Oncology risk group classification in apparent early stage endometrial cancer? Impact of lymphovascular space invasion. Br J Cancer 2014; 110:2640-6. [PMID: 24809776 PMCID: PMC4037837 DOI: 10.1038/bjc.2014.237] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 03/30/2014] [Accepted: 04/10/2014] [Indexed: 11/17/2022] Open
Abstract
Background: Lymphovascular space invasion (LVSI) is one of the most important predictors of nodal involvement and recurrence in early stage endometrial cancer (EC). Despite its demonstrated prognostic value, LVSI has not been incorporated into the European Society of Medical Oncology (ESMO) classification. The aim of this prospective multicentre database study is to investigate whether it may improve the accuracy of the ESMO classification in predicting the recurrence risk. Methods: Data of 496 patients with apparent early-stage EC who received primary surgical treatment between January 2001 and December 2012 were abstracted from prospective multicentre database. A modified ESMO classification including six risk groups was created after inclusion of the LVSI status in the ESMO classification. The primary end point was the recurrence accuracy comparison between the ESMO and the modified ESMO classifications with respect to the area under the receiver operating characteristic curve (AUC). Results: The recurrence rate in the whole population was 16.1%. The median follow-up and recurrence time were 31 (range: 1–152) and 27 (range: 1–134) months, respectively. Considering the ESMO modified classification, the recurrence rates were 8.2% (8 out of 98), 23.1% (15 out of 65), 25.9% (15 out of 58), and 45.1% (28 out of 62) for intermediate risk/LVSI−, intermediate risk/LVSI+, high risk/LVSI−, and high risk/LVSI+, respectively (P<0.001). In the low risk group, LVSI status was not discriminant as only 7.0% (14 out of 213) had LVSI+. The staging accuracy according to AUC criteria for ESMO and ESMO modified classifications were of 0.71 (95% CI: 0.68–0.74) and 0.74 (95% CI: 0.71–0.77), respectively. Conclusions: The current modified classification could be helpful to better define indications for nodal staging and adjuvant therapy, especially for patients with intermediate risk EC.
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Affiliation(s)
- S Bendifallah
- 1] Department of Obstetrics and Gynaecology, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Paris 6, Institut Universitaire de Cancérologie (IUC), Paris, France [2] INSERM UMR S 707, 'Epidemiology, Information Systems, Modeling', University Pierre and Marie Curie, Paris, France
| | - G Canlorbe
- Department of Obstetrics and Gynaecology, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Paris 6, Institut Universitaire de Cancérologie (IUC), Paris, France
| | - E Raimond
- Department of Obstetrics and Gynaecology, Institute Alix de Champagne University Hospital, Reims, France
| | - D Hudry
- Centre de lutte contre le cancer Georges François Leclerc, Dijon, France
| | - C Coutant
- Centre de lutte contre le cancer Georges François Leclerc, Dijon, France
| | - O Graesslin
- Department of Obstetrics and Gynaecology, Institute Alix de Champagne University Hospital, Reims, France
| | - C Touboul
- Department of Obstetrics and Gynecology, Centre Hospitalier Intercommunal, Créteil, France
| | - F Huguet
- Department of Radiation Oncology, Tenon University Hospital, University Pierre and Marie Curie, Paris, France
| | - A Cortez
- Department of Pathology, Tenon University Hospital, University Pierre and Marie Curie, Paris, France
| | - E Daraï
- 1] Department of Obstetrics and Gynaecology, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Paris 6, Institut Universitaire de Cancérologie (IUC), Paris, France [2] INSERM UMR S 938, University Pierre et Marie Curie, Paris, France
| | - M Ballester
- 1] Department of Obstetrics and Gynaecology, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Pierre and Marie Curie, Paris 6, Institut Universitaire de Cancérologie (IUC), Paris, France [2] INSERM UMR S 938, University Pierre et Marie Curie, Paris, France
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Zacharopoulou C, Bazot M, Ballester M, Jarboui L, Darai E. Computed Tomography with Water Enema (CT-WE): Is It Useful for the Detection of Ileocecal Endometriosis? J Minim Invasive Gynecol 2013. [DOI: 10.1016/j.jmig.2013.08.022] [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: 11/27/2022]
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Bonneau C, Cortez A, Lis R, Mirshahi M, Fauconnier A, Ballester M, Daraï E, Touboul C. Lymphatic and nerve distribution throughout the parametrium. Gynecol Oncol 2013; 131:708-13. [PMID: 24125751 DOI: 10.1016/j.ygyno.2013.10.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 10/03/2013] [Accepted: 10/04/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Our objective was to concomitantly assess distribution of lymphatic and nerve structures in the parametrium. METHODS Twenty hemipelvises from ten fresh cadavers were dissected to differentiate between, three different parts of the parametrium: the lateral parametrium, the proximal and the distal part of the posterior parametrium. Histologic and immunofluorescence analyses of nerve and lymphatic structures were performed using NSE and LYVE-1 staining, respectively. The percentage of structures was independently scored as 0 (0%), 1 (1-20%), 2 (20-50%), 3 (50-80%), 4 (>80%). RESULTS The lateral parametrium and the proximal part of the posterior parametrium contained both nerve (scored 2.25 and 2.50, respectively) and lymphatic (scored 2.50 and 2.00, respectively) structures. The distal part of the posterior parametrium also contained numerous nerve structures (scored 2.00) but lymphatic structures were rare (scored 0.88). No difference in nerve distribution was found according to the parts of parametrium while a significantly lower distribution of lymphatic vessels was observed in the distal part of the posterior parametrium (p=0.03). CONCLUSION The distal part of the posterior parametrium is of high nerve density and low lymphatic density raising the issue as to whether it should be removed during radical hysterectomy.
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Affiliation(s)
- C Bonneau
- UMRS 872, Centre de Recherche des Cordeliers, 15 rue de l'école de médecine, 75006 Paris, France
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Bendifallah S, Canlorbe G, Raimond E, Bazire L, Huguet F, Graesslin O, Rouzier R, Darai E, Ballester M. An external validation study of nomograms designed to predict isolated loco-regional and distant endometrial cancer recurrences: how applicable are they? Br J Cancer 2013; 109:1498-503. [PMID: 23989946 PMCID: PMC3777006 DOI: 10.1038/bjc.2013.500] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Revised: 07/28/2013] [Accepted: 07/30/2013] [Indexed: 11/09/2022] Open
Abstract
Background: To externally validate and assess the robustness of two nomograms to predict the recurrence risk of women with endometrial cancer (EC). Methods: Using an independent, multicentre external patient cohort we assessed the discrimination and calibration of two nomograms – the 3-year isolated loco-regional (ILRR) and distant (DR) recurrence nomograms – in women with surgically treated stage I–III EC. Results: Two hundred and seventy one eligible women were identified from two university hospital databases and the Senti-Endo trial. The median follow-up and initial recurrence time were 38.1 (range: 12–69) and 22.0 (range: 8.3–55) months, respectively. The overall recurrence rate was 13.8% (37 out of 271). Predictive accuracy according to the discrimination was 0.69 (95% CI, 0.58–0.79) and 0.66 (95% CI, 0.60–0.71) for the 3-year ILRR and DR nomograms, respectively. The correspondence between observed recurrence rate and the nomogram predictions suggests a moderate calibration of the nomograms in the validation cohort. Conclusion: The nomograms were externally validated and shown to be partly generalisable to a new and independent patient population. The tools need to be improved by including information on the lymph node status and adjuvant therapies.
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Affiliation(s)
- S Bendifallah
- 1] Department of Obstetrics and Gynaecology, Tenon University Hospital, University Pierre and Marie Curie, CHU Tenon, APHP, 4 Rue de la Chine, 75020 Paris, France [2] UMR S 707, 'Epidemiology, Information Systems, Modeling', University Pierre and Marie Curie, Paris, France
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Bonneau C, Zilberman S, Ballester M, Thomin A, Thomassin-Naggara I, Bazot M, Daraï E. Incidence of pre- and postoperative urinary dysfunction associated with deep infiltrating endometriosis: relevance of urodynamic tests and therapeutic implications. Minerva Ginecol 2013; 65:385-405. [PMID: 24051939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Although many series have been published on the management of digestive or urinary deep infiltrating endometriosis (DIE), few data exist on pre- and postoperative urinary dysfunction (UD) and urodynamic tests. Hence, the objective of this review was to evaluate the pre- and postoperative incidence of UD and the contribution of urodynamic tests as well as their therapeutic implications. Studies published between January 1995 and April 2012, available in the databases Medline, Embase or the Cochrane Library and responding to a key word algorithm were selected. Studies were classified according to their level of evidence in the Canadian Task Force classification. Sixty-three studies were included in this review. The incidence of preoperative UD is unknown in patients with DIE without colorectal involvement but ranges from 2% to 48% in patients with colorectal endometriosis. About half of all the patients had abnormal urodynamic test results. DIE surgery is associated with a risk of urinary dysfunction mainly corresponding to de novo voiding dysfunction in 1.4% to 29.2% of cases with a mean value of 4.8%. The rate of persistent voiding dysfunction ranges from 0 to 14.7% with a mean value of 4.6%. Risk factors of postoperative UD are the need for partial colpectomy, parametrectomy and patients requiring colo-anal anastomosis. For patients with urinary tract endometriosis, the incidence of preoperative UD is comprised between 24.4% and 79.2% with a rate of postoperative voiding dysfunction ranging from 0% to 16.9% with a mean value of 11.1%. Prevention of postoperative UD is based on nerve-sparing surgery. Treatment of voiding dysfunction requires self-catheterization. There is a lack of data on medical treatment and surgical techniques to manage postoperative UD. More effort needs to be made to detect preoperative UD associated with DIE. Preoperative evaluation by urodynamic tests and possibly electrophysiology could be of interest especially in patients with risk factors. The current review underlines the difficulties of establishing clear recommendations due to heterogeneity of the studies and the absence of a consensual definition of UD.
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Affiliation(s)
- C Bonneau
- Department of Gynecology and Obstetrics Hôpital Tenon, Assistance Publique des Hôpitaux de Paris Université Pierre et Marie Curie Paris VI, Paris, France -
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