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Godet C, Sabbagh C, Beyer-Berjot L, Ouaissi M, Zerbib P, Valérie B, Manceau G, Panis Y, Buscail E, Venara A, Khaoudy I, Gaillard M, Viennet M, Thobie A, Menahem B, Eveno C, Bonnel C, Mabrut JY, Badic B, Chautard J, Eid Y, Duchalais E, Lakkis Z, Cotte E, Laforest A, Desfourneaux-Denis V, Maggiori L, Rebibo L, Niki C, Talal A, Mege D, Bonnamy C, Germain A, Mauvais F, Tresallet C, Roudie J, Laurent A, Trilling B, Bertrand M, Massalou D, Romain B, Tranchart H, Pellegrin A, Dejardin O, Alves A. Risk factors for emergency surgery for diverticulitis: A retrospective multicentric French study at 41 hospitals. Surgery 2024:S0039-6060(24)00072-2. [PMID: 38609785 DOI: 10.1016/j.surg.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 12/10/2023] [Accepted: 02/06/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND The observed increase in the incidence of complicated diverticulitis may lead to the performance of more emergency surgeries. This study aimed to assess the rate and risk factors of emergency surgery for sigmoid diverticulitis. METHOD The primary outcomes were the rate of emergency surgery for sigmoid diverticulitis and its associated risk factors. The urgent or elective nature of the surgical intervention was provided by the surgeon and in accordance with the indication for surgical treatment. A mixed logistic regression with a random intercept after multiple imputations by the chained equation was performed to consider the influence of missing data on the results. RESULTS Between 2010 and 2021, 6,867 patients underwent surgery for sigmoid diverticulitis in the participating centers, of which one-third (n = 2317) were emergency cases. In multivariate regression analysis with multiple imputation by chained equation, increasing age, body mass index <18.5 kg/m2, neurologic and pulmonary comorbidities, use of anticoagulant drugs, immunocompromised status, and first attack of sigmoid diverticulitis were independent risk factors for emergency surgery. The likelihood of emergency surgery was significantly more frequent after national guidelines, which were implemented in 2017, only in patients with a history of sigmoid diverticulitis attacks. CONCLUSION The present study highlights a high rate (33%) of emergency surgery for sigmoid diverticulitis in France, which was significantly associated with patient features and the first attack of diverticulitis.
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Affiliation(s)
- Camille Godet
- Department of Digestive Surgery, University Hospital of Caen, France.
| | - Charles Sabbagh
- Department of Digestive Surgery, Amiens University Hospital, France
| | - Laura Beyer-Berjot
- Department of Digestive Surgery Assistance Publique Hôpitaux de Marseille, North University Hospital, France
| | - Mehdi Ouaissi
- Department of Digestive, Oncological, Endocrine, Hepatobiliary, and Liver Transplant, Trousseau Hospital, University Hospital of Tours, France
| | - Philippe Zerbib
- Department of Digestive Surgery and Transplantation, Huriez Hospital, Universite Lille Nord de France, France
| | - Bridoux Valérie
- Department of Digestive Surgery, University Hospital of Rouen, France
| | - Gilles Manceau
- Department of Digestive and Oncological Surgery, European Georges Pompidou Hospital, Paris Cité University, AP-HP, Paris, France
| | - Yves Panis
- Colorectal surgery Center, Groupe Hospitalier Privé Ambroise-Paré Hartmann, Neuilly/Seine, France
| | - Etienne Buscail
- Department of Surgery, CHU Toulouse-Rangueil and Toulouse University, Toulouse, France
| | - Aurélien Venara
- Department of Digestive Surgery, University Hospital of Angers, Angers, France
| | - Iman Khaoudy
- Department of Digestive Surgery, Le Havre Hospital, Le Havre, France
| | - Martin Gaillard
- Department of Digestive Surgery, Cochin Hospital, Paris, France
| | - Manon Viennet
- Department of General Surgery, University Hospital of Bocage, Dijon, France
| | - Alexandre Thobie
- Department of Digestive Surgery, Avranches-Granville Hospital, Avranches, France
| | | | - Clarisse Eveno
- Department of Digestive Surgery, University Hospital of Lille, France
| | - Catherine Bonnel
- Department of Digestive Surgery, Nord-Essonne Hospital, Longjumeau, France
| | - Jean-Yves Mabrut
- Department of Digestive Surgery and Transplantation, Croix Rousse University Hospital, Lyon, France
| | - Bogdan Badic
- Department of General and Digestive Surgery, University Hospital, Brest, France
| | - Julien Chautard
- Department of Digestive Surgery, Memorial Hospital of Saint-Lô, France
| | - Yassine Eid
- 21 Department of Digestive Surgery, Robert Bisson Hospital, Lisieux, France
| | - Emilie Duchalais
- 22 Department of Oncological, Digestive and Endocrine Surgery, University Hospital of Nantes, France
| | - Zaher Lakkis
- Department of Digestive Surgical Oncology and Liver Transplantation, University Hospital of Besançon, France
| | - Eddy Cotte
- Department of Digestive Surgery, Hospital Lyon Sud, France
| | - Anaïs Laforest
- Department of Digestive Surgery, Montsouris Institut, Paris, France
| | | | - Léon Maggiori
- Department of Digestive Surgery, Hôpital Saint-Louis, Université Paris VII, APHP, France
| | - Lionel Rebibo
- Department of Digestive, Oesogastric and Bariatric Surgery, Hôpital Bichat-Claude-Bernard, Paris, France
| | - Christou Niki
- Department of Digestive Surgery, Limoges Hospital, France
| | - Ali Talal
- Department of Digestive Surgery, Argentan Hospital, France
| | - Diane Mege
- Department of Digestive Surgery, Aix Marseille Univ, APHM, Timone University Hospital, Marseille, France
| | - Cécile Bonnamy
- Department of Digestive Surgery, Bayeux Hospital, France
| | | | | | - Christophe Tresallet
- Department of Digestive Surgical Oncology, Avicenne University Hospital, Bobigny, Sorbonne Paris Nord University, France
| | - Jean Roudie
- Department of Digestive Surgery, Martinique Hospital, Fort-de-France, France
| | - Alexis Laurent
- Department of Digestive Surgery, Créteil Hospital, France
| | - Bertrand Trilling
- Univ. Grenoble Alpes, CNRS, UMR 5525, VetAgro Sup, Grenoble INP, CHU Grenoble Alpes, TIMC, Grenoble, France; Department of Digestive Surgery and Emergency, University Hospital of Grenoble, Alpes, France
| | - Martin Bertrand
- Department of Digestive Surgery, University Hospital of Nîmes, France
| | - Damien Massalou
- Department of Digestive Surgery, Hospital L'Archet, Nice University, Nice, France
| | - Benoit Romain
- Department of General and Digestive Surgery, Hautepierre Hospital, Strasbourg University Hospital, France
| | - Hadrien Tranchart
- Department of Minimally Invasive Digestive Surgery, Antoine Beclere Hospital, AP-HP, Clamart, France
| | | | - Olivier Dejardin
- Department of Research; CHU de Caen, ANTICIPE, Inserm Unity UMR 1086, France
| | - Arnaud Alves
- Department of Digestive Surgery, University Hospital of Caen, France; Department of Research; CHU de Caen, ANTICIPE, Inserm Unity UMR 1086, France
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2
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Sabbagh C, Beyer-Berjot L, Ouaissi M, Zerbib P, Bridoux V, Manceau G, Karoui M, Panis Y, Buscail E, Venara A, Khaoudy I, Gaillard M, Ortega-Deballon P, Viennet M, Thobie A, Menahem B, Eveno C, Bonnel C, Mabrut JY, Badic B, Godet C, Eid Y, Duchalais E, Lakkis Z, Cotte E, Laforest A, Defourneaux V, Maggiorri L, Rebibo L, Christou N, Talal A, Mege D, Bonnamy C, Germain A, Mauvais F, Tresallet C, Ahmed O, Regimbeau JM, Roudie J, Laurent A, Trilling B, Bertrand M, Massalou D, Romain B, Tranchart H, Giger U, Dejardin O, Pellegrin A, Alves A. Risk factors for severe morbidity and definitive stoma after elective surgery for sigmoid diverticulitis: a multicenter national cohort study. Tech Coloproctol 2024; 28:34. [PMID: 38369674 DOI: 10.1007/s10151-023-02906-y] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/18/2023] [Indexed: 02/20/2024]
Abstract
BACKGROUND In the decision to perform elective surgery, it is of great interest to have data about the outcomes of surgery to individualize patients who could safely undergo sigmoid resection. The aim of this study was to provide information on the outcomes of elective sigmoid resection for sigmoid diverticular disease (SDD) at a national level. METHODS All consecutive patients who had elective surgery for SDD (2010-2021) were included in this retrospective, multicenter, cohort study. Patients were identified from institutional review board-approved databases in French member centers of the French Surgical Association. The endpoints of the study were the early and the long-term postoperative outcomes and an evaluation of the risk factors for 90-day severe postoperative morbidity and a definitive stoma after an elective sigmoidectomy for SDD. RESULTS In total, 4617 patients were included. The median [IQR] age was 61 [18.0;100] years, the mean ± SD body mass index (BMI) was 26.8 ± 4 kg/m2, and 2310 (50%) were men. The indications for surgery were complicated diverticulitis in 50% and smoldering diverticulitis in 47.4%. The procedures were performed laparoscopically for 88% and with an anastomosis for 83.8%. The severe complication rate on postoperative day 90 was 11.7%, with a risk of anastomotic leakage of 4.7%. The independent risk factors in multivariate analysis were an American Society of Anesthesiologists (ASA) score ≥ 3, an open approach, and perioperative blood transfusion. Age, perioperative blood transfusion, and Hartmann's procedure were the three independent risk factors for a permanent stoma. CONCLUSIONS This series provides a real-life picture of elective sigmoidectomy for SDD at a national level. TRIAL REGISTRATION Comité National Information et Liberté (CNIL) (n°920361).
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Affiliation(s)
- C Sabbagh
- Department of Digestive Surgery Service, Amiens University Hospital, Rond Point du Pr Cabrol, 80054, Amiens Cedex 01, France.
| | - L Beyer-Berjot
- Department of Digestive Surgery Assistance Publique Hôpitaux de Marseille, North University Hospital, Marseille, France
| | - M Ouaissi
- Department of Digestive, Oncological, Endocrine, Hepatobiliary and Liver Transplant, Trousseau Hospital, University Hospital of Tours, Tours, France
| | - P Zerbib
- Department of Digestive Surgery and Transplantation, Huriez Hospital, Universite Lille Nord de France, Lille, France
| | - V Bridoux
- Department of Digestive Surgery, University Hospital of Rouen, Rouen, France
| | - G Manceau
- Department of Surgery, European Georges Pompidou Hospital, AP-HP, Paris, France
| | - M Karoui
- Department of Surgery, European Georges Pompidou Hospital, AP-HP, Paris, France
| | - Y Panis
- Colorectal Surgery Center, Groupe Hospitalier Privé Ambroise Paré-Hartmann, Neuilly, France
| | - E Buscail
- Department of Surgery, CHU Toulouse-Rangueil and Toulouse University, Toulouse, France
| | - A Venara
- Department of Digestive Surgery, University Hospital of Angers, Angers, France
| | - I Khaoudy
- Department of Digestive Surgery, Le Havre Hospital, Le Havre, France
| | - M Gaillard
- Department of Digestive Surgery, Cochin Hospital, Paris, France
| | - P Ortega-Deballon
- Department of General Surgery, University Hospital of Bocage, Dijon, France
| | - M Viennet
- Department of General Surgery, University Hospital of Bocage, Dijon, France
| | - A Thobie
- Department of Digestive Surgery, Avranches-Granville Hospital, Avranches, France
| | - B Menahem
- Department of Digestive Surgery, University Hospital of Caen, Caen, France
| | - C Eveno
- Department of Digestive Surgery, University Hospital of Lille, Lille, France
| | - C Bonnel
- Department of Digestive Surgery, Nord-Essonne Hospital, Longjumeau, France
| | - J-Y Mabrut
- Department of Digestive Surgery and Transplantation, Croix Rousse University Hospital, Lyon, France
| | - B Badic
- Department of General and Digestive Surgery, University Hospital, Brest, France
| | - C Godet
- Department of Digestive Surgery, Memorial Hospital of Saint-Lô, Saint-Lô, France
| | - Y Eid
- Department of Digestive Surgery, Robert Bisson Hospital, Lisieux, France
| | - E Duchalais
- Department of Oncological, Digestive and Endocrine Surgery, University Hospital of Nantes, Nantes, France
| | - Z Lakkis
- Department of Digestive Surgical Oncology and Liver Transplantation, University Hospital of Besançon, Besançon, France
| | - E Cotte
- Department of Digestive Surgery, Hôpital Lyon Sud, Lyon, France
| | - A Laforest
- Department of Digestive Surgery, Montsouris Institut, Paris, France
| | - V Defourneaux
- Department of Digestive Surgery, CHU Rennes, Rennes, France
| | - L Maggiorri
- Department of Digestive Surgery, Hôpital Saint-Louis, Université Paris VII, APHP, Paris, France
| | - L Rebibo
- Department of Digestive, Oesogastric and Bariatric Surgery, Hôpital Bichat-Claude-Bernard, Paris, France
| | - N Christou
- Department of Digestive Surgery, Limoges Hospital, Limoges, France
| | - A Talal
- Department of Digestive Surgery, Argentan Hospital, Argentan, France
| | - D Mege
- Department of Digestive Surgery, Aix Marseille Univ, APHM, Timone University Hospital, Marseille, France
| | - C Bonnamy
- Department of Digestive Surgery, Bayeux Hospital, Bayeux, France
| | - A Germain
- Department of Digestive Surgery, CHRU Nancy, Nancy, France
| | - F Mauvais
- Department of Digestive Surgery, Beauvais Hospital, Beauvais, France
| | - C Tresallet
- Department of Digestive Surgical Oncology, Avicenne University Hospital, Paris, France
| | - O Ahmed
- Department of Digestive Surgical Oncology, Avicenne University Hospital, Paris, France
| | - J-M Regimbeau
- Department of Digestive Surgery Service, Amiens University Hospital, Rond Point du Pr Cabrol, 80054, Amiens Cedex 01, France
| | - J Roudie
- Department of Digestive Surgery, Martinique Hospital, Fort-de-France, France
| | - A Laurent
- Department of Digestive Surgery, Créteil Hospital, Créteil, France
| | - B Trilling
- Department of Digestive and Emergency Surgery, Grenoble Alpes University Hospital, Grenoble, France
| | - M Bertrand
- Department of Digestive Surgery, Universitary Hospital of Nîmes, Nîmes, France
| | - D Massalou
- Department of Digestive Surgery, Hôpital L'Archet, Nice University, Nice, France
| | - B Romain
- Department of General and Digestive Surgery, Hautepierre Hospital, Strasbourg University Hospital, Strasbourg, France
| | - H Tranchart
- Department of Minimally Invasive Digestive Surgery, Antoine Beclere Hospital, AP-HP, Clamart, France
| | - U Giger
- ANTICIPE, Inserm Unity, UMR 1086, Caen, France
| | - O Dejardin
- ANTICIPE, Inserm Unity, UMR 1086, Caen, France
- Department of Clinical Research, University Hospital of Caen, Caen, France
| | - A Pellegrin
- Department of Digestive Surgery Service, Amiens University Hospital, Rond Point du Pr Cabrol, 80054, Amiens Cedex 01, France
| | - A Alves
- Department of Digestive Surgery, University Hospital of Caen, Caen, France
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3
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Gil C, Beyer-Bergeot L, Sabbagh C, Zerbib P, Bridoux V, Manceau G, Panis Y, Buscail E, Venara A, Khaoudy I, Gaillard M, Viennet M, Thobie A, Menahem B, Eveno C, Bonnel C, Mabrut JY, Badic B, Godet C, Eid Y, Duchalais E, Lakkis Z, Cotte E, Laforest A, Defourneaux V, Maggiori L, Rebibo L, Christou N, Talal A, Mege D, Bonnamy C, Germain A, Mauvais F, Tresallet C, Roudie J, Laurent A, Trilling B, Bertrand M, Massalou D, Romain B, Tranchart H, Giger U, Alves A, Ouaissi M. Impact of the first wave of COVID-19 epidemy on the surgical management of sigmoid diverticular disease in France: National French retrospective study. Int J Colorectal Dis 2023; 38:276. [PMID: 38040936 DOI: 10.1007/s00384-023-04564-w] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/08/2023] [Indexed: 12/03/2023]
Abstract
OBJECTIVE To analyze the surgical management of sigmoid diverticular disease (SDD) before, during, and after the first containment rules (CR) for the first wave of COVID-19. METHODS From the French Surgical Association multicenter series, this study included all patients operated on between January 2018 and September 2021. Three groups were compared: A (before CR period: 01/01/18-03/16/20), B (CR period: 03/17/20-05/03/20), and C (post CR period: 05/04/20-09/30/21). RESULTS A total of 1965 patients (A n = 1517, B n = 52, C n = 396) were included. The A group had significantly more previous SDD compared to the two other groups (p = 0.007), especially complicated (p = 0.0004). The rate of peritonitis was significantly higher in the B (46.1%) and C (38.4%) groups compared to the A group (31.7%) (p = 0.034 and p = 0.014). As regards surgical treatment, Hartmann's procedure was more often performed in the B group (44.2%, vs A 25.5% and C 26.8%, p = 0.01). Mortality at 90 days was significantly higher in the B group (9.6%, vs A 4% and C 6.3%, p = 0.034). This difference was also significant between the A and B groups (p = 0.048), as well as between the A and C groups (p = 0.05). There was no significant difference between the three groups in terms of postoperative morbidity. CONCLUSION This study shows that the management of SDD was impacted by COVID-19 at CR, but also after and until September 2021, both on the initial clinical presentation and on postoperative mortality.
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Affiliation(s)
- Camille Gil
- Department of Digestive, Oncological, Endocrine, Hepatobiliary and Liver Transplant, Trousseau Hospital, University Hospital of Tours, Avenue de la République, F37044 Tours, France
| | - Laura Beyer-Bergeot
- Department of Digestive Surgery Assistance Publique Hôpitaux de Marseille, North University Hospital, Marseille, France
| | - Charles Sabbagh
- Department of Surgery Department, Amiens University Hospital, Amiens, France
| | - Philippe Zerbib
- Department of Digestive Surgery and Transplantation, Huriez Hospital, Universite Lille Nord de France, Lille, France
| | - Valérie Bridoux
- Department of Digestive Surgery, University Hospital of Rouen, Rouen, France
| | - Gilles Manceau
- Department of digestive Surgery, Assistance Publique Hôpitaux de Paris, Georges Pompidou University Hospital, univeristy Paris Cité, Paris, France
| | - Yves Panis
- Colorectal Surgery Center, Groupe Hospitalier Privé Ambroise Paré-Hartmann, Neuilly/Seine, France
| | - Etienne Buscail
- Department of Surgery, CHU Toulouse-Rangueil and Toulouse University, Toulouse, France
| | - Aurélien Venara
- Department of Digestive Surgery, University Hospital of Angers, Angers, France
| | - Iman Khaoudy
- Department of Digestive Surgery, Le Havre Hospital, Le Havre, France
| | - Martin Gaillard
- Department of Digestive Surgery, Cochin Hospital, Paris, France
| | - Manon Viennet
- Department of General Surgery, University Hospital of Bocage, Dijon, France
| | - Alexandre Thobie
- Department of Digestive Surgery, Avranches-Granville Hospital, Avranches, France
| | - Benjamin Menahem
- Unité INSERM UMR 1086 ANTICIPE Registre spécialisé des Tumeurs Digestives du calvados-Service de chirurgie digestive, Université de Caen Normandie 14000, Caen, France
| | - Clarisse Eveno
- Department of Digestive Surgery, University Hospital of Lille, Lille, France
| | - Catherine Bonnel
- Department of Digestive Surgery, Nord-Essonne Hospital, Longjumeau, France
| | - Jean-Yves Mabrut
- Department of Digestive Surgery and Transplantation, Croix Rousse University Hospital, Lyon, France
| | - Bodgan Badic
- Department of General and Digestive Surgery, University Hospital, Brest, France
| | - Camille Godet
- Department of Digestive Surgery, Memorial Hospital of Saint-Lô, Saint-Lô, France
| | - Yassine Eid
- Department of Digestive Surgery, Polyclinique de Lisieux, Lisieux, France
| | - Emilie Duchalais
- Department of Oncological, Digestive and Endocrine Surgery, University Hospital of Nantes, Nantes, France
| | - Zaher Lakkis
- Department of Digestive Surgical Oncology and Liver Transplantation, University Hospital of Besançon, Besançon, France
| | - Eddy Cotte
- Department of Digestive Surgery, Hôpital Lyon Sud, Lyon, France
| | - Anais Laforest
- Department of Digestive Surgery, Montsouris Institut, Paris, France
| | | | - Léon Maggiori
- Department of Digestive Surgery, Hôpital Saint-Louis, Université Paris VII, APHP, Paris, France
| | - Lionel Rebibo
- Department of Digestive, Oesogastric and Bariatric Surgery, Hôpital Bichat-Claude-Bernard, Paris, France
| | - Niki Christou
- Department of Digestive Surgery, Limoges Hospital, Limoges, France
| | - Ali Talal
- Department of Digestive Surgery, Argentan Hospital, Argentan, France
| | - Diane Mege
- Department of Digestive Surgery, Aix Marseille Univ, APHM, Timone University Hospital, Marseille, France
| | - Cécile Bonnamy
- Department of Digestive Surgery, Bayeux Hospital, Bayeux, France
| | | | - François Mauvais
- Department of Digestive Surgery, Beauvais Hospital, Beauvais, France
| | - Christophe Tresallet
- Department of Digestive Surgical Oncology, Avicenne University Hospital, Sorbonne Paris Nord University, Paris, France
| | - Jean Roudie
- Department of Digestive Surgery, Martinique Hospital, Fort-de-France, France
| | - Alexis Laurent
- Department of Digestive Surgery, Créteil Hospital, Créteil, France
| | - Bertrand Trilling
- Department of Digestive and Emergency Surgery, Grenoble Alpes University Hospital, Grenoble, France
| | - Martin Bertrand
- Department of Digestive Surgery, Universitary Hospital of Nîmes, Nîmes, France
| | - Damien Massalou
- Department of Digestive Surgery, Hôpital L'Archet, Nice University, Nice, France
| | - Benoit Romain
- Department of General and Digestive Surgery, Hautepierre Hospital, Strasbourg University Hospital, Strasbourg, France
| | - Hadrien Tranchart
- Department of Minimally Invasive Digestive Surgery, Antoine Beclere Hospital, AP-HP, Clamart, France
| | - Urs Giger
- Fliedner Fachhochschule, University of Applied Sciences, Düsseldorf, Germany
| | - Arnaud Alves
- Unité INSERM UMR 1086 ANTICIPE Registre spécialisé des Tumeurs Digestives du calvados-Service de chirurgie digestive, Université de Caen Normandie 14000, Caen, France
| | - Mehdi Ouaissi
- Department of Digestive, Oncological, Endocrine, Hepatobiliary and Liver Transplant, Trousseau Hospital, University Hospital of Tours, Avenue de la République, F37044 Tours, France.
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4
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Halawa M, Elhefnawy M, Eid Y, Elhalawany S, Hegab A, Hendawy L. CLINICAL AND IMMUNOLOGICAL PROFILE OF NEWLY DIAGNOSED DIABETIC PATIENTS IN A COHORT OF YOUNG ADULTS OF NATIONAL HEPATITIS C VIRUS SURVEY IN EGYPT. Georgian Med News 2022:51-56. [PMID: 36780623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
T2DM (Type 2 diabetes mellitus) is considered a disease that affects old age group. Recently, it has become common in children, adolescents and adults. Aim of the work - to highlight the challenges in differentiating T1DM (type1 diabetes mellitus) from T2DM (type2 diabetes mellitus) in early onset diabetes in youth depending on clinical and laboratory characteristics. Our cross-sectional study was performed on 200 newly diagnosed diabetic patients aged (18-30) years. All patients were subjected to detailed medical history and full clinical examination. Laboratory investigations included FBS, 2hPP, HbA1C, fasting C peptide and GADA. About 59% (118) of our patients were T2DM while (82) 41% were T1DM. T1DM was more dominant than T2DM in age group less than 25 years (T1DM 79% versus T2DM 21%, P<0.001), while T2DM was more than T1DM in age group more than 25 years (T2DM 93% versus T1DM 17%, P<0.001). GADA was detected in 73.2% of T1DM patient and it was high titer while GADA was detected in only 8% of T2DM with low titer, in addition GADA positive patients were significantly younger than negative patients, age (20.9±2.5 years vs. 26.4±3.5 years respectively) (P <0.001). About 8% of phenotypically type 2 diabetic youth had GADA positive antibodies which did not confer impact on c peptide level or glycemic control yet type 1 diabetics who were GADA negative had a better glycemic control.
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Affiliation(s)
- M Halawa
- 1Department of Internal Medicine and Endocrinology, Ain shams university, Egypt
| | - M Elhefnawy
- 2National Institute of Diabetes and Endocrinology, Egypt
| | - Y Eid
- 1Department of Internal Medicine and Endocrinology, Ain shams university, Egypt
| | - S Elhalawany
- 1Department of Internal Medicine and Endocrinology, Ain shams university, Egypt
| | - A Hegab
- 2National Institute of Diabetes and Endocrinology, Egypt
| | - L Hendawy
- 1Department of Internal Medicine and Endocrinology, Ain shams university, Egypt
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5
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Thomas F, Bouvier AM, Cariou M, Bouvier V, Jooste V, Pouchucq C, Gardy J, Queneherve L, Launoy G, Alves A, Eid Y, Dejardin O. Influence of non-clinical factors on restorative rectal cancer surgery: An analysis of four specialized population-based digestive cancer registries in France. Dig Liver Dis 2022; 54:258-267. [PMID: 34301489 DOI: 10.1016/j.dld.2021.06.029] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/03/2021] [Accepted: 06/24/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND This study aims to measure the association between deprivation, health care accessibility and health care system with the likelihood of receiving non-restorative rectal cancer surgery (NRRCS). METHODS All adult patients who had rectal resection for invasive adenocarcinoma diagnosed between 2007 and 2016 in four French specialised cancer registries were included. A multilevel logistic regression with random effect was used to assess the link between patient and health care structure characteristics on the probability of NRRCS. RESULTS 2997 patients underwent rectal cancer resection in 68 health care structures: 708 (23.63%) had NRRCS. The likelihood of receiving NRCCS was associated with patients' characteristics (97%): age, sub peritoneal rectal tumors, neoadjuvant therapy, residual tumour and stage III . There was no impact of European Deprivation Index or remoteness on NRRCS. Inter-health care structure variability was modest (3%), of which 50% was explained by the high group volume of colorectal procedures and the type of health care structure which were associated with less NRRCS (p<0.01). CONCLUSION There is an influence of operating volume and type of structure on the probability of NRRCS, but it has truly little importance in explaining differences in performances. The probability of NRRCS is mainly affected by clinical determinant.
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Affiliation(s)
- Flavie Thomas
- Department of Digestive Surgery, University Hospital of Caen, Caen, France; UMR INSERM U1086 Anticipe, Centre François Baclesse, Caen, France
| | - Anne-Marie Bouvier
- Digestive Cancers Registry of Burgundy, University Hospital Dijon, France; INSERM UMR 1231, University of Burgundy, Dijon, France
| | - Mélanie Cariou
- Finistère Digestive Cancer Registry, University Hospital of Brest, France; EA7479 SPURBO, University of Western Brittany, Brest, France
| | - Véronique Bouvier
- UMR INSERM U1086 Anticipe, Centre François Baclesse, Caen, France; Department of Research: Epidemiology Research and Evaluation Unit, University Hospital of Caen, Caen, France; Calvados Digestive Cancer Registry, Epidemiology Research and Evaluation Unit, University Hospital of Caen, Caen, France
| | - Valérie Jooste
- Digestive Cancers Registry of Burgundy, University Hospital Dijon, France; INSERM UMR 1231, University of Burgundy, Dijon, France
| | - Camille Pouchucq
- Department of Digestive Surgery, University Hospital of Caen, Caen, France; UMR INSERM U1086 Anticipe, Centre François Baclesse, Caen, France
| | - Joséphine Gardy
- UMR INSERM U1086 Anticipe, Centre François Baclesse, Caen, France; Calvados Digestive Cancer Registry, Epidemiology Research and Evaluation Unit, University Hospital of Caen, Caen, France
| | - Lucille Queneherve
- Finistère Digestive Cancer Registry, University Hospital of Brest, France; EA7479 SPURBO, University of Western Brittany, Brest, France; Gastroenterology Department, University Hospital, Brest, France
| | - Guy Launoy
- UMR INSERM U1086 Anticipe, Centre François Baclesse, Caen, France; Department of Research: Epidemiology Research and Evaluation Unit, University Hospital of Caen, Caen, France; Calvados Digestive Cancer Registry, Epidemiology Research and Evaluation Unit, University Hospital of Caen, Caen, France
| | - Arnaud Alves
- Department of Digestive Surgery, University Hospital of Caen, Caen, France; UMR INSERM U1086 Anticipe, Centre François Baclesse, Caen, France; Calvados Digestive Cancer Registry, Epidemiology Research and Evaluation Unit, University Hospital of Caen, Caen, France
| | - Yassine Eid
- Department of Digestive Surgery, University Hospital of Caen, Caen, France; UMR INSERM U1086 Anticipe, Centre François Baclesse, Caen, France
| | - Olivier Dejardin
- UMR INSERM U1086 Anticipe, Centre François Baclesse, Caen, France; Department of Research: Epidemiology Research and Evaluation Unit, University Hospital of Caen, Caen, France.
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Riffet M, Eid Y, Faisant M, Fohlen A, Menahem B, Alves A, Dubois F, Levallet G, Bazille C. Deciphering Promoter Hypermethylation of Genes Encoding for RASSF/Hippo Pathway Reveals the Poor Prognostic Factor of RASSF2 Gene Silencing in Colon Cancers. Cancers (Basel) 2021; 13:cancers13235957. [PMID: 34885067 PMCID: PMC8656858 DOI: 10.3390/cancers13235957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/20/2021] [Accepted: 11/23/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Colorectal cancer (CRC) is a major public health issue due to its incidence and mortality. Thus, the development of molecular biomarkers is essential to optimize its therapeutic management. Such markers could be identified among the members of the RASSF/Hippo pathway. Indeed, epigenetic alterations are strongly implicated in colorectal carcinogenesis and this pathway is altered in many cancers, mainly by hypermethylation of the promoter of the gene coding for its members. The objectives of the study were to map the hypermethylation of the RASSF/Hippo pathway promoters in a morphologically, clinically, and prognostically well-characterized population of colon cancers. This first report of a whole systematic analysis of the Hippo pathway in colon cancer highlights RASSF2 gene promoter hypermethylation as a worst prognostic factor and a tool to be sought in clinical practice to improve therapeutic management. Abstract The aims of this study were to assess the frequency of promoter hypermethylation of the genes encoding the Ras associated domain family (RASSF)/Hippo pathway, as well as the impact on overall (OS) and progression-free survival (PFS) in a single-center retrospective cohort of 229 patients operated on for colon cancers. Hypermethylation status was investigated by methylation-specific PCR on the promoters of the RASSF1/2, STK4/3 (encoding Mammalian Ste20-like protein 1 and 2 (MST1 and 2), respectively), and LATS1/2 genes. Clinicopathological characteristics, recurrence-free survival, and overall survival were analysed. We found the RASSF/Hippo pathway to be highly silenced in colon cancer, and particularly RASSF2 (86%). The other promoters were hypermethylated with a lesser frequency of 16, 3, 1, 10 and 6%, respectively for RASSF1, STK4, STK3, LATS1, and LATS2 genes. As the hypermethylation of one RASSF/Hippo family member was by no means exclusive from the others, 27% of colon cancers displayed the hypermethylation of at least two RASSF/Hippo member promotors. The median overall survival of the cohort was 60.2 months, and the median recurrence-free survival was 46.9 months. Survival analyses showed a significantly poorer overall survival of patients when the RASSF2 promoter was hypermethylated (p = 0.03). The median OS was 53.5 months for patients with colon cancer with a hypermethylated RASSF2 promoter versus still not reached after 80 months follow-up for other patients, upon univariate analysis (HR = 1.86, [95% CI: 1.05–3.3], p < 0.03). Such difference was not significant for relapse-free survival as in multivariate analysis. A logistic regression model showed that RASSF2 hypermethylation was an independent factor. In conclusion, RASSF2 hypermethylation is a frequent event and an independent poor prognostic factor in colon cancer. This biomarker could be investigated in clinical practice.
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Affiliation(s)
- Marc Riffet
- Department of Pathology, CHU de Caen, 14000 Caen, France; (M.R.); (M.F.); (F.D.)
- Normandie Université, UNICAEN, CEA, CNRS, ISTCT, CERVOxy Group, GIP CYCERON, 14074 Caen, France;
| | - Yassine Eid
- Polyclinique du Parc, 14000 Caen, France;
- Normandie Université, UNICAEN, INSERM UMR 1086, ANTICIPE, 14000 Caen, France; (B.M.); (A.A.)
| | - Maxime Faisant
- Department of Pathology, CHU de Caen, 14000 Caen, France; (M.R.); (M.F.); (F.D.)
| | - Audrey Fohlen
- Normandie Université, UNICAEN, CEA, CNRS, ISTCT, CERVOxy Group, GIP CYCERON, 14074 Caen, France;
- Department of Radiology, CHU de Caen, 14000 Caen, France
| | - Benjamin Menahem
- Normandie Université, UNICAEN, INSERM UMR 1086, ANTICIPE, 14000 Caen, France; (B.M.); (A.A.)
- Department of Digestive Surgery, CHU de Caen, 14000 Caen, France
| | - Arnaud Alves
- Normandie Université, UNICAEN, INSERM UMR 1086, ANTICIPE, 14000 Caen, France; (B.M.); (A.A.)
- Department of Digestive Surgery, CHU de Caen, 14000 Caen, France
| | - Fatéméh Dubois
- Department of Pathology, CHU de Caen, 14000 Caen, France; (M.R.); (M.F.); (F.D.)
- Normandie Université, UNICAEN, CEA, CNRS, ISTCT, CERVOxy Group, GIP CYCERON, 14074 Caen, France;
- Structure Fédérative D’oncogénétique cyto-MOléculaire du CHU de Caen (SF-MOCAE), CHU de Caen, 14000 Caen, France
| | - Guénaelle Levallet
- Department of Pathology, CHU de Caen, 14000 Caen, France; (M.R.); (M.F.); (F.D.)
- Normandie Université, UNICAEN, CEA, CNRS, ISTCT, CERVOxy Group, GIP CYCERON, 14074 Caen, France;
- Structure Fédérative D’oncogénétique cyto-MOléculaire du CHU de Caen (SF-MOCAE), CHU de Caen, 14000 Caen, France
- Correspondence: (G.L.); (C.B.)
| | - Céline Bazille
- Department of Pathology, CHU de Caen, 14000 Caen, France; (M.R.); (M.F.); (F.D.)
- Normandie Université, UNICAEN, CEA, CNRS, ISTCT, CERVOxy Group, GIP CYCERON, 14074 Caen, France;
- Correspondence: (G.L.); (C.B.)
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Tabchouri N, Eid Y, Manceau G, Frontali A, Lakkis Z, Salame E, Lecomte T, Chapet S, Calais G, Heyd B, Karoui M, Alves A, Panis Y, Ouaissi M. Neoadjuvant Treatment in Upper Rectal Cancer Does Not Improve Oncologic Outcomes But Increases Postoperative Morbidity. Anticancer Res 2020; 40:3579-3587. [PMID: 32487661 DOI: 10.21873/anticanres.14348] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 04/24/2020] [Accepted: 04/27/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Neoadjuvant chemoradiation/radiation therapy in locally advanced (LA) upper rectal adenocarcinoma management remains unclear. The aim of this study was to compare outcomes between neoadjuvant chemoradiation therapy (CRT) and upfront surgery (US). PATIENTS AND METHODS A total of 127 patients were retrospectively included from 5 centers (79 treated with US and 48 with CRT). CRT and US groups were compared in terms of postoperative complications and long-term oncological and functional results. RESULTS Total mesorectal excision (TME) was more frequent in CRT (58% vs. 20% in US, p<0.001). CRT was associated with more overall and severe postoperative complications (60% vs. 30%, p<0.001 and 17% vs. 1%, p=0.002, respectively), and was the only risk factor [OR=18.8 (2.2-160.2), p=0.007]. Five-year overall survival and 5-year recurrence-free survival were similar between CRT and US (96% vs. 91% p=0.256 and 85.4% vs. 85%, p=0.495). The functional results were similar between the two groups. CONCLUSION CRT did not improve long-term oncological outcomes in patients with LA upper rectal adenocarcinoma, but increased postoperative complications compared with US.
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Affiliation(s)
- Nicolas Tabchouri
- Department of Digestive, Oncological, Endocrine, Hepato-Biliary, Pancreatic and Liver Transplant Surgery, Trousseau Hospital, Chambray Les Tours, France
| | - Yassine Eid
- Service de Chirurgie Digestive, CHU Caen, Université de Caen-Normandie, Caen, France
| | - Gilles Manceau
- Department of Digestive Surgery, Médecine Sorbonne University, Pitié Salpêtrière University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France
| | - Alice Frontali
- Department of Colorectal Surgery, Pôle des Maladies de l'Appareil Digestif (PMAD), Beaujon Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), University Denis Diderot (Paris VII), Clichy, France
| | - Zaher Lakkis
- Department of Digestive Surgery, Besançon University Hospital, Besançon, France
| | - Ephrem Salame
- Department of Digestive, Oncological, Endocrine, Hepato-Biliary, Pancreatic and Liver Transplant Surgery, Trousseau Hospital, Chambray Les Tours, France
| | - Thierry Lecomte
- Department of Hepatogastroenterology and Digestive Oncology, Trousseau Hospital, Tours, France
| | - Sophie Chapet
- Department of Radiotherapy, Bretonneau Hospital, Tours, France
| | - Gilles Calais
- Department of Radiotherapy, Bretonneau Hospital, Tours, France
| | - Bruno Heyd
- Department of Digestive Surgery, Besançon University Hospital, Besançon, France
| | - Mehdi Karoui
- Department of Digestive Surgery, Médecine Sorbonne University, Pitié Salpêtrière University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Paris, France
| | - Arnaud Alves
- Service de Chirurgie Digestive, CHU Caen, Université de Caen-Normandie, Caen, France
| | - Yves Panis
- Department of Colorectal Surgery, Pôle des Maladies de l'Appareil Digestif (PMAD), Beaujon Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), University Denis Diderot (Paris VII), Clichy, France
| | - Mehdi Ouaissi
- Department of Digestive, Oncological, Endocrine, Hepato-Biliary, Pancreatic and Liver Transplant Surgery, Trousseau Hospital, Chambray Les Tours, France
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Eid Y, Bouvier V, Dejardin O, Menahem B, Chaillot F, Chene Y, Dutheil JJ, Juul T, Morello R, Alves A. 'French LARS score': validation of the French version of the low anterior resection syndrome (LARS) score for measuring bowel dysfunction after sphincter-preserving surgery among rectal cancer patients: a study protocol. BMJ Open 2020; 10:e034251. [PMID: 32152168 PMCID: PMC7064062 DOI: 10.1136/bmjopen-2019-034251] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Many bowel problems following low anterior resection (LAR) for rectal cancer considerably impair the quality of life (QoL) of patients. The LAR syndrome (LARS) scale is a self-report questionnaire to identify and assess bowel dysfunction after rectal cancer surgery. It has been translated and validated in several languages but not in French (metropolitan French). The primary objective is to adapt the LARS scale to the French language (called French-LARS score) and to assess its psychometric properties. Secondary objectives are to assess both the prevalence and severity of LARS and to measure their impact on QoL. METHODS AND ANALYSIS A French multicentre observational cohort study has been designed. The validation study will include translation of the LARS scale following the current international recommendations, assessment of its reliability, convergent and discriminant validities, sensitivity, internal consistency, internal validity and confirmatory analyses. One thousand patients will be enrolled for the analyses. The questionnaire will be initially administered to the first 100 patients to verify the adequacy and degree of comprehension of the questions. Then reproducibility will be investigated by a test-retest procedure in the following 400 patients.An analysis will be conducted to determine the correlation between the LARS score and the Quality of Life Questionnaire (QLQ; European Organization for Treatment and Research of Cancer's QLQ-C30, QLQ-CR29). Risk factors linked to QoL deterioration will be identified and their impact will be measured. This study will meet the need for a validated tool to improve patient care and QoL. ETHICS AND DISSEMINATION The institutional review board of the University Hospital of Caen and the ethics committee (CPP Nord Ouest I, 25 January 2019) approved the study. TRIAL REGISTRATION NUMBER NCT03569488.
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Affiliation(s)
- Yassine Eid
- Department of digestive surgery, University Hospital of Caen, Caen, France
- ANTICIPE" U1086 INSERM-University of Caen Normandy, Team « Ligue contre le Cancer », Centre François Baclesse, Caen, France
- Department of research, University Hospital of Caen, Normandy, France
| | - Véronique Bouvier
- ANTICIPE" U1086 INSERM-University of Caen Normandy, Team « Ligue contre le Cancer », Centre François Baclesse, Caen, France
- Digestive Cancer Registry of Calvados, University Hospital of Caen, Caen cedex, France
| | - Olivier Dejardin
- ANTICIPE" U1086 INSERM-University of Caen Normandy, Team « Ligue contre le Cancer », Centre François Baclesse, Caen, France
- Department of research, University Hospital of Caen, Normandy, France
| | - Benjamin Menahem
- Department of digestive surgery, University Hospital of Caen, Caen, France
| | - Fabien Chaillot
- Department of research, University Hospital of Caen, Normandy, France
| | - Yannick Chene
- Department of research, University Hospital of Caen, Normandy, France
| | | | - Therese Juul
- Department of Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Rémy Morello
- Department of research, University Hospital of Caen, Normandy, France
- Department of biostatistics and clinical research, University Hospital of Caen, Caen cedex, France
| | - Arnaud Alves
- Department of digestive surgery, University Hospital of Caen, Caen, France
- ANTICIPE" U1086 INSERM-University of Caen Normandy, Team « Ligue contre le Cancer », Centre François Baclesse, Caen, France
- Department of research, University Hospital of Caen, Normandy, France
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Eid Y, Menahem B, Bouvier V, Lebreton G, Thobie A, Bazille C, Finochi M, Fohlen A, Galais M, Dupont B, Lubrano J, Dejardin O, Morello R, Alves A. Has adherence to treatment guidelines for mid/low rectal cancer affected the management of patients? A monocentric study of 604 consecutive patients. J Visc Surg 2019; 156:281-290. [DOI: 10.1016/j.jviscsurg.2019.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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10
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Eid Y, Bouvier V, Menahem B, Thobie A, Dolet N, Finochi M, Renier M, Gardy J, Launoy G, Dejardin O, Morello R, Alves A, Abdelli A, Ahkong MV, Alkofer B, Apoil B, Paul Argouarch L, Armand P, Arsène D, Auvray S, Barthélémy R, Bazille C, Laure Bignon A, Bonnamy C, Bouhier-Leporrier K, Borotto E, Brefort JL, Chomontovski J, Cohen D, Cojocaru M, Collet T, Congard P, Corbinais S, Couque M, Degoutte E, Desfachelles JP, Dupont B, Elfadel S, Galais MP, Genuist F, Girard N, Gloro R, Granveau A, Guilloit JM, Hervé S, Hessissen M, Jacob J, Kalinski E, Koutsomanis D, Lagriffoul L, Lartigau C, Lechevallier L, Lebreton G, Lefebvre AC, Lefrançois D, Lepoittevin C, Leporrier J, Le Roux Y, L’Hirondel A, L’Hirondel C, Lion L, Makki A, Marchand P, Marion Y, Mauger D, Mosquet L, Mura DN, Ollivier JM, Parzy A, Polycarpe E, Polycarpe F, Reijasse D, Renet C, Rodriguez C, Saadi L, Samama G, Saplacan M, Sleman F, Siriser F, Soufron J, Teste Y, Tiengou LE, Toudic JP. Digestive and genitourinary sequelae in rectal cancer survivors and their impact on health-related quality of life: Outcome of a high-resolution population-based study. Surgery 2019; 166:327-335. [DOI: 10.1016/j.surg.2019.04.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 03/28/2019] [Accepted: 03/29/2019] [Indexed: 02/06/2023]
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Gardy J, Dejardin O, Thobie A, Eid Y, Guizard AV, Launoy G. Impact of socioeconomic status on survival in patients with ovarian cancer. Int J Gynecol Cancer 2019; 29:792-801. [PMID: 30712018 DOI: 10.1136/ijgc-2018-000097] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 12/07/2018] [Accepted: 12/28/2018] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE Socioeconomic status may impact survival in cancer patients. This study assessed whether low socioeconomic status has an impact on survival in patients with ovarian cancer and investigated whether differences in survival may be explained by type of therapy received. METHODS The study population comprised 318 patients with ovarian cancer diagnosed between 2011 and 2015 in the François Baclesse regional cancer care center in Caen, North-West France. Socioeconomic status was assessed by using the European deprivation index and overall survival was calculated at 3 years. RESULTS The unadjusted 3-year overall survival rate was 52% (95% CI 47 to 58). In a multivariable logistic regression model, a low socioeconomic status was associated with a lower probability of surgical resection (OR 0.34, 95% CI 0.16 to 0.74). A high socioeconomic status was associated with improved survival, adjusted for age, performance status, grade, and International Federation of Gynecology and Obstetrics (FIGO) stage (adjusted HR 1.53, 95% CI 1.04 to 2.26). When adjusting for treatment variables, there was no longer any significant difference in survival according to socioeconomic status (adjusted HR 1.24, 95% CI 0.83 to 1.84). CONCLUSIONS Higher socioeconomic status is associated with a greater probability of undergoing surgical resection and with improved survival in patients with ovarian cancer.
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Affiliation(s)
- Joséphine Gardy
- "ANTICIPE" U1086 INSERM-UCN, Centre François Baclesse, Caen, France .,Calvados General Cancer Registry, Caen, France.,Calvados Digestive Cancer Registry, Caen, France
| | - Olivier Dejardin
- "ANTICIPE" U1086 INSERM-UCN, Centre François Baclesse, Caen, France.,University Hospital of Caen, Caen, France
| | - Alexandre Thobie
- "ANTICIPE" U1086 INSERM-UCN, Centre François Baclesse, Caen, France
| | - Yassine Eid
- "ANTICIPE" U1086 INSERM-UCN, Centre François Baclesse, Caen, France
| | - Anne-Valérie Guizard
- "ANTICIPE" U1086 INSERM-UCN, Centre François Baclesse, Caen, France.,Calvados General Cancer Registry, Caen, France
| | - Guy Launoy
- "ANTICIPE" U1086 INSERM-UCN, Centre François Baclesse, Caen, France.,Calvados Digestive Cancer Registry, Caen, France.,University Hospital of Caen, Caen, France
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12
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Thobie A, Mulliri A, Dolet N, Eid Y, Bouvier V, Launoy G, Alves A, Dejardin O. Socioeconomic status impacts survival and access to resection in pancreatic adenocarcinoma: A high-resolution population-based cancer registry study. Surg Oncol 2018; 27:759-766. [PMID: 30449504 DOI: 10.1016/j.suronc.2018.10.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 10/05/2018] [Accepted: 10/15/2018] [Indexed: 01/13/2023]
Abstract
BACKGROUND Survival of patients with pancreatic adenocarcinoma (PA) is very poor. Resection status is highly associated with prognosis but only 15%-20% are resectable. The aim of this study was to analyse the impact of socioeconomic deprivation on PA survival and to define which management steps are affected. METHODS Between 01/01/2000 and 31/12/2014, 1451 incident cases of PA recorded in the digestive cancer registry of the French department of Calvados were included. The population was divided between less deprived areas (quintile 1) and more deprived areas (quintile 2,3,4,5 aggregated). RESULTS Patients from less deprived areas were younger at diagnosis than those from more deprived areas (69.9 vs 72.3 years, p = 0.01). There was no difference in stage or comorbidities. Three- and 5-year survival rates were significantly higher for less deprived areas than more deprived areas: 10.5% vs 5.15% and 4.7% vs 1.7% respectively (p = 0.01). In univariate analysis, those living in less deprived areas had a better survival than those in more deprived areas (HR = 0.81 [0.69-0.95], p = 0.009) but not in multivariable analysis (HRa = 0.93 [0.79-1.11], p = 0.383) or analysis stratified on resection. In multivariable regression, less deprived areas had more access to surgery than more deprived areas (ORa = 1.73 [1.08-2.47], p = 0.013). No difference was observed on access to adjuvant chemotherapy (ORa = 0.95 [0.38-2.34], p = 0.681). CONCLUSION The key to reducing survival inequalities in PA is access to resection, so future studies should investigate the factors impacting this issue.
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Affiliation(s)
- Alexandre Thobie
- Department of Digestive Surgery, University Hospital of Caen, Caen cedex, France; UMR INSERM 1086 « ANTICIPE », University of Normandy, Caen, France; Department of Research, University Hospital of Caen, Caen cedex, France.
| | - Andrea Mulliri
- Department of Digestive Surgery, University Hospital of Caen, Caen cedex, France; Registre des tumeurs digestives du Calvados, France
| | - Nathan Dolet
- UMR INSERM 1086 « ANTICIPE », University of Normandy, Caen, France; Department of Research, University Hospital of Caen, Caen cedex, France
| | - Yassine Eid
- Department of Digestive Surgery, University Hospital of Caen, Caen cedex, France; UMR INSERM 1086 « ANTICIPE », University of Normandy, Caen, France; Department of Research, University Hospital of Caen, Caen cedex, France
| | - Véronique Bouvier
- UMR INSERM 1086 « ANTICIPE », University of Normandy, Caen, France; Registre des tumeurs digestives du Calvados, France; Department of Research, University Hospital of Caen, Caen cedex, France
| | - Guy Launoy
- UMR INSERM 1086 « ANTICIPE », University of Normandy, Caen, France; Registre des tumeurs digestives du Calvados, France; Department of Research, University Hospital of Caen, Caen cedex, France
| | - Arnaud Alves
- Department of Digestive Surgery, University Hospital of Caen, Caen cedex, France; UMR INSERM 1086 « ANTICIPE », University of Normandy, Caen, France; Registre des tumeurs digestives du Calvados, France; Department of Research, University Hospital of Caen, Caen cedex, France
| | - Olivier Dejardin
- UMR INSERM 1086 « ANTICIPE », University of Normandy, Caen, France; Department of Research, University Hospital of Caen, Caen cedex, France
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Eid Y, Alves A, Lubrano J, Menahem B. Does previous transanal excision for early rectal cancer impair surgical outcomes and pathologic findings of completion total mesorectal excision? Results of a systematic review of the literature. J Visc Surg 2018; 155:445-452. [PMID: 29657063 DOI: 10.1016/j.jviscsurg.2018.03.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Transanal excision (TAE) is increasingly used in the treatment of early rectal cancer because of lower rate of both postoperative complications and postsurgical functional disorders as compared with total mesorectal excision (TME) OBJECTIVE: To compare in a meta-analysis surgical outcomes and pathologic findings between patients who underwent TAE followed by completion proctectomy with TME (TAE group) for early rectal cancer with unfavorable histology or incomplete resection, and those who underwent primary TME (TME group). METHODS The Medline and Cochrane Trials Register databases were searched for studies comparing short-term outcomes between patients who underwent TAE followed by completion TME versus primary TME. Studies published until December 2016 were included. The meta-analysis was performed using Review Manager 5.0 (Cochrane Collaboration, Oxford, UK). RESULTS Meta-analysis showed that completion TME after TAE was significantly associated with increased reintervention rate (OR=4.28; 95% CI, 1.10-16.76; P≤0.04) and incomplete mesorectal excision rate (OR=5.74; 95% CI, 2.24-14.75; P≤0.0003), as compared with primary TME. However there both abdominoperineal amputation and circumferential margin invasion rates were comparable between TAE and TME groups. CONCLUSIONS This meta-analysis suggests that previous TAE impaired significantly surgical outcomes and pathologic findings of completion TME as compared with primary TME. First transanal approach during completion TME might be evaluated in order to decrease technical difficulties.
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Affiliation(s)
- Y Eid
- Department of digestive surgery, university hospital of Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex, France
| | - A Alves
- Department of digestive surgery, university hospital of Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex, France; Centre François-Baclesse, Normandie université, UNICAEN, CHU de Caen, Inserm UMR1086, 3, avenue du Général-Harris, 14045 Caen cedex, France
| | - J Lubrano
- Department of digestive surgery, university hospital of Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex, France; Centre François-Baclesse, Normandie université, UNICAEN, CHU de Caen, Inserm UMR1086, 3, avenue du Général-Harris, 14045 Caen cedex, France
| | - B Menahem
- Department of digestive surgery, university hospital of Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex, France; Centre François-Baclesse, Normandie université, UNICAEN, CHU de Caen, Inserm UMR1086, 3, avenue du Général-Harris, 14045 Caen cedex, France.
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Eid Y, Dupont-Lucas C, Orbach D, Ravasse P, Rod J. Synovial sarcoma presenting as colonic intussusception in a child. Pediatr Blood Cancer 2017; 64:207-208. [PMID: 27572305 DOI: 10.1002/pbc.26211] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 07/06/2016] [Indexed: 12/12/2022]
Affiliation(s)
- Yassine Eid
- Department of Pediatric Surgery, University Hospital of Caen, Caen, France
| | - Claire Dupont-Lucas
- Department of Pediatric Gastroenterology, University Hospital of Caen, Caen, France
| | - Daniel Orbach
- Department of Pediatric Adolescent Young Adult Oncology, Institut Curie, Paris, France
| | - Philippe Ravasse
- Department of Pediatric Surgery, University Hospital of Caen, Caen, France
| | - Julien Rod
- Department of Pediatric Surgery, University Hospital of Caen, Caen, France
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15
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Abstract
1. We examined the effects of supplemental dietary vitamin E (Vit E) on semen quality and antioxidative status in male domestic fowls exposed to oxidative stress induced by synthetic glucocorticoid, dexamethasone (DEX) injection. 2. Thirty-six Egyptian local cross males, 42 weeks old, were housed individually in cages in an open-sided building under 16 h light:8 h dark and were provided with commercial feed and water ad libitum. Birds were divided into 4 groups: DEX (4 mg/bird/d), Vit E (200 mg/kg diet), DEX + Vit E (4 mg/bird/d + 200 mg/kg diet, respectively) and control, n = 9. All treatments lasted for 7 continuous days. 3. Oxidative stress induced by injection of DEX (4 mg/bird/d) resulted in decreased sperm count and motility correlated with an increased percentage of dead sperms. Vit E (200 mg/kg diet) enhanced sperm count and viability when supplemented to stress-induced birds, compared to DEX treatment alone. 4. In seminal plasma, low calcium concentration, high lipid peroxidation and reduced activity of glutathione peroxidase were associated with the oxidative stress. Vit E reduced lipid peroxidation in the seminal plasma. 5. In conclusion, excessive supplemental dietary Vit E improved semen quality when cockerels were subjected to stress conditions. It increased both sperm count and motility, reduced the percentage of dead sperm and enhanced the antioxidative status of seminal plasma.
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Affiliation(s)
- Y Eid
- Department of Poultry Production, Kafr El-Sheikh Faculty of Agriculture, Tanta University, Kafr El-Sheikh, Egypt.
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16
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Martin-Gousset D, Moulin M, Eid Y, Nicolas H. [4 cases of successful use of indomethacin eyedrops]. Bull Soc Ophtalmol Fr 1987; 87:1005-8. [PMID: 3501337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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