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Vergé R, Rouch A, Renaud C, Mazzoni L, Cazaux M, Rabinel P, Brouchet L. EP02.03-021 Uncertain Resection for Localized cN0M0 Non Small Cell-Lung Cancer: The Crucial Prognosis of Suboptimal Lymph Node Assessment. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.377] [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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Chavoin JP, Facchini F, Martinot-Duquennoy V, Duteille F, Herlin C, Le Pimpec-Barthes F, Assouad J, Chevallier B, Tiffet O, Brouchet L, Leyx P, Grolleau-Raoux JL, Chaput B, Dahan M. [Congenital thoracic deformities and 3D custom-made implants. New classification based on a series of 789 treated cases]. ANN CHIR PLAST ESTH 2022; 67:393-403. [PMID: 36031493 DOI: 10.1016/j.anplas.2022.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The authors present a new study on 789 cases of congenital thoracic malformations including 638 pectus excavatum and 151 Poland syndromes, according to a new classification which completes Chin's one. All these malformations were treated with silicone elastomer implants. The contribution of computer-aided design and manufacturing (CAD/CAM) since 2008 is essential. The one-stage surgical protocol is precisely described. The results are impressive, permanent, for life, and complications are rare. The authors evoke a common vascular etiopathogenesis theory at the embryonic stage and question the heavy techniques of invasive remodeling that are most often unjustified.
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Affiliation(s)
- J P Chavoin
- Service de chirurgie Plastique Reconstructrice et esthétique,Centre Hospitalier Universitaire de Toulouse-Rangueil, 1, avenue Jean Pouilhès, 31059, Toulouse, France.
| | - F Facchini
- Service de Chirurgie Pédiatrique, Hôpital Universitaire pédiatrique Meyer, Viale Gaetano Pieraccini, 24, 50139, Florence, Italie.
| | - V Martinot-Duquennoy
- Service de Chirurgie plastique reconstructrice et Esthétique CHU Hôpital Salengro, Avenue du Professeur Emile Laine, 59037, Lille, France.
| | - F Duteille
- Service de Chirurgie Plastique Reconstructrice et Esthétique, Centre des brûlés, CHU Hôtel Dieu, 1 Pl. Alexis-Ricordeau, 44039, Nantes, France.
| | - C Herlin
- Service de Chirurgie Plastique Reconstructrice et Esthétique CHU, Hôpital Lapeyronie, 371, avenue du Doyen Gaston Giraud, 34295, Montpellier, France.
| | - F Le Pimpec-Barthes
- Service de Chirurgie Thoracique et Transplantation pulmonaire Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015, Paris, France.
| | - J Assouad
- Service de Chirurgie Thoracique et Cardio-Vasculaire APHP Hôpital Tenon, 4 rue de la Chine, 75020, Paris, France.
| | - B Chevallier
- Service de chirurgie thoracique et cervicale et transplantation pulmonaire Hôpital Haut-Lévêque CHU de Bordeaux, 33600, Pessac, France.
| | - O Tiffet
- Service de Chirurgie Générale et thoracique CHU Saint Etienne, Avenue Albert Raimond, 42270, Saint-Priest-en-Jarez, France.
| | - L Brouchet
- Service de Chirurgie Thoracique, Chu Hôpital Larrey, 24 Chem. de Pouvourville, 31400, Toulouse, France.
| | - P Leyx
- Ingénieur CAO Anatomik Modeling SAS, 19 rue Jean Mermoz, 31100, Toulouse, France.
| | - J L Grolleau-Raoux
- Service de Chirurgie plastique reconstructrice et Esthétique CHU Rangueil, 1 rue Jean Poulhès, 31054, Toulouse, France.
| | - B Chaput
- Service de Chirurgie plastique reconstructrice et Esthétique CHU Rangueil, 1 rue Jean Poulhès, 31054, Toulouse, France.
| | - M Dahan
- Service de Chirurgie Thoracique, Chu Hôpital Larrey, 24 Chem. de Pouvourville, 31400, Toulouse, France.
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Vergé R, Rouch A, Renaud C, Mazzoni L, Cazaux M, Rabinel P, Brouchet L. 88P Uncertain resection for localized cN0M0 non-small cell lung cancer: The crucial prognosis of suboptimal lymph node assessment. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.098] [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: 11/01/2022] Open
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Wislez M, Mazieres J, Lavole A, Zalcman G, Carre O, Egenod T, Caliandro R, Gervais R, Jeannin G, Molinier O, Massiani M, Langlais A, Morin F, Le Pimpec Barthes F, Brouchet L, Assouad J, Milleron B, Damotte D, Antoine M, Westeel V. 1214O Neoadjuvant durvalumab in resectable non-small cell lung cancer (NSCLC): Preliminary results from a multicenter study (IFCT-1601 IONESCO). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1416] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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5
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Brosseau C, Danger R, Durand M, Durand E, Foureau A, Lacoste P, Tissot A, Roux A, Reynaud-Gaubert M, Kessler R, Mussot S, Dromer C, Brugière O, Mornex JF, Guillemain R, Claustre J, Magnan A, Brouard S, Velly J, Rozé H, Blanchard E, Antoine M, Cappello M, Ruiz M, Sokolow Y, Vanden Eynden F, Van Nooten G, Barvais L, Berré J, Brimioulle S, De Backer D, Créteur J, Engelman E, Huybrechts I, Ickx B, Preiser T, Tuna T, Van Obberghe L, Vancutsem N, Vincent J, De Vuyst P, Etienne I, Féry F, Jacobs F, Knoop C, Vachiéry J, Van den Borne P, Wellemans I, Amand G, Collignon L, Giroux M, Angelescu D, Chavanon O, Hacini R, Martin C, Pirvu A, Porcu P, Albaladejo P, Allègre C, Bataillard A, Bedague D, Briot E, Casez‐Brasseur M, Colas D, Dessertaine G, Francony G, Hebrard A, Marino M, Protar D, Rehm D, Robin S, Rossi‐Blancher M, Augier C, Bedouch P, Boignard A, Bouvaist H, Briault A, Camara B, Chanoine S, Dubuc M, Quétant S, Maurizi J, Pavèse P, Pison C, Saint‐Raymond C, Wion N, Chérion C, Grima R, Jegaden O, Maury J, Tronc F, Flamens C, Paulus S, Philit F, Senechal A, Glérant J, Turquier S, Gamondes D, Chalabresse L, Thivolet‐Bejui F, Barnel C, Dubois C, Tiberghien A, Pimpec‐Barthes F, Bel A, Mordant P, Achouh P, Boussaud V, Méléard D, Bricourt M, Cholley B, Pezella V, Brioude G, D'Journo X, Doddoli C, Thomas P, Trousse D, Dizier S, Leone M, Papazian L, Bregeon F, Coltey B, Dufeu N, Dutau H, Garcia S, Gaubert J, Gomez C, Laroumagne S, Mouton G, Nieves A, Picard C, Rolain J, Sampol E, Secq V, Perigaud C, Roussel J, Senage T, Mugniot A, Danner I, Haloun A, Abbes S, Bry C, Blanc F, Lepoivre T, Botturi‐Cavaillès K, Loy J, Bernard M, Godard E, Royer P, Henrio K, Dartevelle P, Fabre D, Fadel E, Mercier O, Stephan F, Viard P, Cerrina J, Dorfmuller P, Feuillet S, Ghigna M, Hervén P, Le Roy Ladurie F, Le Pavec J, Thomas de Montpreville V, Lamrani L, Castier Y, Mordant P, Cerceau P, Augustin P, Jean‐Baptiste S, Boudinet S, Montravers P, Dauriat G, Jébrak G, Mal H, Marceau A, Métivier A, Thabut G, Lhuillier E, Dupin C, Bunel V, Falcoz P, Massard G, Santelmo N, Ajob G, Collange O, Helms O, Hentz J, Roche A, Bakouboula B, Degot T, Dory A, Hirschi S, Ohlmann‐Caillard S, Kessler L, Schuller A, Bennedif K, Vargas S, Bonnette P, Chapelier A, Puyo P, Sage E, Bresson J, Caille V, Cerf C, Devaquet J, Dumans‐Nizard V, Felten M, Fischler M, Si Larbi A, Leguen M, Ley L, Liu N, Trebbia G, De Miranda S, Douvry B, Gonin F, Grenet D, Hamid A, Neveu H, Parquin F, Picard C, Stern M, Bouillioud F, Cahen P, Colombat M, Dautricourt C, Delahousse M, D'Urso B, Gravisse J, Guth A, Hillaire S, Honderlick P, Lequintrec M, Longchampt E, Mellot F, Scherrer A, Temagoult L, Tricot L, Vasse M, Veyrie C, Zemoura L, Dahan M, Murris M, Benahoua H, Berjaud J, Le Borgne Krams A, Crognier L, Brouchet L, Mathe O, Didier A, Krueger T, Ris H, Gonzalez M, Aubert J, Nicod L, Marsland B, Berutto T, Rochat T, Soccal P, Jolliet P, Koutsokera A, Marcucci C, Manuel O, Bernasconi E, Chollet M, Gronchi F, Courbon C, Hillinger S, Inci I, Kestenholz P, Weder W, Schuepbach R, Zalunardo M, Benden C, Buergi U, Huber L, Isenring B, Schuurmans M, Gaspert A, Holzmann D, Müller N, Schmid C, Vrugt B, Rechsteiner T, Fritz A, Maier D, Deplanche K, Koubi D, Ernst F, Paprotka T, Schmitt M, Wahl B, Boissel J, Olivera‐Botello G, Trocmé C, Toussaint B, Bourgoin‐Voillard S, Séve M, Benmerad M, Siroux V, Slama R, Auffray C, Charron D, Lefaudeux D, Pellet J. Blood CD9 + B cell, a biomarker of bronchiolitis obliterans syndrome after lung transplantation. Am J Transplant 2019; 19:3162-3175. [PMID: 31305014 DOI: 10.1111/ajt.15532] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 06/12/2019] [Accepted: 07/07/2019] [Indexed: 01/25/2023]
Abstract
Bronchiolitis obliterans syndrome is the main limitation for long-term survival after lung transplantation. Some specific B cell populations are associated with long-term graft acceptance. We aimed to monitor the B cell profile during early development of bronchiolitis obliterans syndrome after lung transplantation. The B cell longitudinal profile was analyzed in peripheral blood mononuclear cells from patients with bronchiolitis obliterans syndrome and patients who remained stable over 3 years of follow-up. CD24hi CD38hi transitional B cells were increased in stable patients only, and reached a peak 24 months after transplantation, whereas they remained unchanged in patients who developed a bronchiolitis obliterans syndrome. These CD24hi CD38hi transitional B cells specifically secrete IL-10 and express CD9. Thus, patients with a total CD9+ B cell frequency below 6.6% displayed significantly higher incidence of bronchiolitis obliterans syndrome (AUC = 0.836, PPV = 0.75, NPV = 1). These data are the first to associate IL-10-secreting CD24hi CD38hi transitional B cells expressing CD9 with better allograft outcome in lung transplant recipients. CD9-expressing B cells appear as a contributor to a favorable environment essential for the maintenance of long-term stable graft function and as a new predictive biomarker of bronchiolitis obliterans syndrome-free survival.
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Affiliation(s)
- Carole Brosseau
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France.,Institut du thorax, Inserm UMR 1087, CNRS, UMR 6291, Université de Nantes, Nantes, France.,Institut du thorax, CHU de Nantes, Nantes, France
| | - Richard Danger
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France
| | - Maxim Durand
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France.,Faculté de Médecine, Université de Nantes, Nantes, France
| | - Eugénie Durand
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France
| | - Aurore Foureau
- Institut du thorax, Inserm UMR 1087, CNRS, UMR 6291, Université de Nantes, Nantes, France.,Institut du thorax, CHU de Nantes, Nantes, France
| | - Philippe Lacoste
- Institut du thorax, Inserm UMR 1087, CNRS, UMR 6291, Université de Nantes, Nantes, France.,Institut du thorax, CHU de Nantes, Nantes, France
| | - Adrien Tissot
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France.,Institut du thorax, Inserm UMR 1087, CNRS, UMR 6291, Université de Nantes, Nantes, France.,Institut du thorax, CHU de Nantes, Nantes, France.,Faculté de Médecine, Université de Nantes, Nantes, France
| | - Antoine Roux
- Hôpital Foch, Suresnes, France.,Université Versailles Saint-Quentin-en-Yvelines, UPRES EA220, Versailles, France
| | | | | | - Sacha Mussot
- Centre Chirurgical Marie Lannelongue, Service de Chirurgie Thoracique, Vasculaire et Transplantation Cardiopulmonaire, Le Plessis Robinson, France
| | | | - Olivier Brugière
- Hôpital Bichat, Service de Pneumologie et Transplantation Pulmonaire, Paris, France
| | | | | | - Johanna Claustre
- Clinique Universitaire Pneumologie, Pôle Thorax et Vaisseaux, CHU Grenoble Alpes, Université Grenoble Alpes, Inserm U1055, Grenoble, France
| | - Antoine Magnan
- Institut du thorax, Inserm UMR 1087, CNRS, UMR 6291, Université de Nantes, Nantes, France.,Institut du thorax, CHU de Nantes, Nantes, France
| | - Sophie Brouard
- Centre de Recherche en Transplantation et Immunologie, UMR 1064, INSERM, Université de Nantes, Nantes, France.,Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France.,Centre d'Investigation Clinique (CIC) Biothérapie, CHU Nantes, Nantes, France
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Chavoin JP, Grolleau JL, Chaput B, Moreno B, Le Pimpec Barthes F, Assouad J, Brouchet L, Dahan M. Le pectus excavatum : chirurgie secondaire par implants. ANN CHIR PLAST ESTH 2019; 64:620-633. [DOI: 10.1016/j.anplas.2019.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 05/21/2019] [Indexed: 10/26/2022]
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Carnot N, Dupuis M, Pontier S, Laborde F, Brouchet L, Didier A. [Different approaches to chest drainage in the management of primary spontaneous pneumothorax]. Rev Mal Respir 2019; 36:477-483. [PMID: 31005424 DOI: 10.1016/j.rmr.2019.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Accepted: 01/20/2019] [Indexed: 10/27/2022]
Abstract
Drainage of primary spontaneous pneumothorax (PSP) may be managed by different techniques and with different types of drain. It is mainly performed in the pneumology department or in the emergency department. The aim of the study was to evaluate the factors that influence the success of PSP drainage. This retrospective, monocentric study performed in University Hospital of Toulouse, included patients with a first episode of PSP requiring drainage. The primary outcome was the rate of success according to the techniques of drainage. Data on the size of the drain (>14F or<14F), the drainage technique (small bore catheter or chest tube drainage) and the drainage department (pneumology or emergency) were collected. One hundred and twenty-four patients had a drainage between 2014 and 2016: the late recurrence free success rate was 59% (n=73). Compared with emergency, drainage in pneumology increased the success rate threefold regardless of the drainage technique (P=0.0001) The success rate was similar whatever the technique used (Seldinger or classic technique) (P=0.31). Success and complications rates were similar whether the drain was large (>14F) or small (<14F) (respectively P=0.99 and P=0.58). In our study, the drainage of PSP in the pneumology department, with a small caliber inserted by the Seldinger technique, was associated with a significantly higher success rate.
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Affiliation(s)
- N Carnot
- Service de pneumologie, hôpital Larrey, CHU de Toulouse, 31400 Toulouse, France.
| | - M Dupuis
- Service de pneumologie, hôpital Larrey, CHU de Toulouse, 31400 Toulouse, France
| | - S Pontier
- Service de pneumologie, hôpital Larrey, CHU de Toulouse, 31400 Toulouse, France
| | - F Laborde
- Service de pneumologie, hôpital Larrey, CHU de Toulouse, 31400 Toulouse, France
| | - L Brouchet
- Service de chirurgie thoracique, hôpital Larrey, CHU de Toulouse, 31400 Toulouse, France
| | - A Didier
- Service de pneumologie, hôpital Larrey, CHU de Toulouse, 31400 Toulouse, France
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Droneau S, Noel-Savina E, Plat G, Murris M, Leborgne-Krams A, Brouchet L, Dahan M, Didier A. L’échographie thoracique du patient transplanté pulmonaire. Rev Mal Respir 2018. [DOI: 10.1016/j.rmr.2017.10.029] [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: 11/26/2022]
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Perrin C, Conil J, Georges B, Bounes F, Marcheix B, Brouchet L, Fourcade O, Delmas C. Bloodstream infections in adults undergoing extracorporeal membrane oxygenation: Epidemiology and risk factors. Archives of Cardiovascular Diseases Supplements 2018. [DOI: 10.1016/j.acvdsp.2017.11.122] [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: 10/18/2022]
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Delmas C, Zapetskaia T, Conil JM, Georges B, Vardon-Bounes F, Seguin T, Crognier L, Fourcade O, Brouchet L, Minville V, Silva S. 3-month prognostic impact of severe acute renal failure under veno-venous ECMO support: Importance of time of onset. J Crit Care 2017; 44:63-71. [PMID: 29073534 DOI: 10.1016/j.jcrc.2017.10.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [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: 08/07/2017] [Revised: 09/19/2017] [Accepted: 10/17/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE Veno-venous ECMO is increasingly used for the management of refractory ARDS. In this context, acute kidney injury (AKI) is a major and frequent complication, often associated with poor outcome. We aimed to identify characteristics associated with severe renal failure (Kidney Disease Improving Global Outcome (KDIGO) 3) and its impact on 3-month outcome. METHODS Between May 2009 and April 2016, 60 adult patients requiring VV-ECMO in our University Hospital were prospectively included. RESULTS AKI occurrence was frequent (75%; n=45), 51% of patients (n=31) developed KDIGO 3 - predominantly prior to ECMO insertion - and renal replacement therapy was required in 43% (n=26) of cases. KDIGO 3 was associated with a lower mechanical ventilation weaning rate (24% vs 68% for patients with no AKI or other stages of AKI; p<0.001) and a higher 90-day mortality rate (72% vs 32%, p=0.002). Multivariate logistic regression suggested that KDIGO 3 occurrence prior to ECMO insertion, as well as PaCO2>57mmHg and mSOFA>12 were independent risks factors for 90-day mortality. CONCLUSION KDIGO 3 AKI occurrence is correlated with the severity of patients' clinical condition prior to ECMO insertion and is negatively associated with 90-day survival.
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Affiliation(s)
- C Delmas
- Intensive Care Unit, Anesthesia and Critical Care department, Rangueil University Hospital, 1 Avenue Jean-Poulhes, 31059 Toulouse, France; Intensive Cardiac care, Cardiology department, Rangueil University Hospital, 1 Av Jean-Poulhes, 31059 Toulouse, France; Institut des Maladies Métaboliques et Cardiovasculaires, INSERM 1048, Rangueil, Toulouse, France.
| | - T Zapetskaia
- Intensive Care Unit, Anesthesia and Critical Care department, Rangueil University Hospital, 1 Avenue Jean-Poulhes, 31059 Toulouse, France
| | - J M Conil
- Intensive Care Unit, Anesthesia and Critical Care department, Rangueil University Hospital, 1 Avenue Jean-Poulhes, 31059 Toulouse, France
| | - B Georges
- Intensive Care Unit, Anesthesia and Critical Care department, Rangueil University Hospital, 1 Avenue Jean-Poulhes, 31059 Toulouse, France
| | - F Vardon-Bounes
- Intensive Care Unit, Anesthesia and Critical Care department, Rangueil University Hospital, 1 Avenue Jean-Poulhes, 31059 Toulouse, France; Institut des Maladies Métaboliques et Cardiovasculaires, INSERM 1048, Rangueil, Toulouse, France
| | - T Seguin
- Intensive Care Unit, Anesthesia and Critical Care department, Rangueil University Hospital, 1 Avenue Jean-Poulhes, 31059 Toulouse, France
| | - L Crognier
- Intensive Care Unit, Anesthesia and Critical Care department, Rangueil University Hospital, 1 Avenue Jean-Poulhes, 31059 Toulouse, France
| | - O Fourcade
- Intensive Care Unit, Anesthesia and Critical Care department, Rangueil University Hospital, 1 Avenue Jean-Poulhes, 31059 Toulouse, France
| | - L Brouchet
- Thoracic Surgery department, Larrey University Hospital, 24 chemin de Pouvourville, TSA 30030, 31059 Toulouse, France
| | - V Minville
- Intensive Care Unit, Anesthesia and Critical Care department, Rangueil University Hospital, 1 Avenue Jean-Poulhes, 31059 Toulouse, France; Institut des Maladies Métaboliques et Cardiovasculaires, INSERM 1048, Rangueil, Toulouse, France
| | - S Silva
- Intensive Care Unit, Anesthesia and Critical Care department, Rangueil University Hospital, 1 Avenue Jean-Poulhes, 31059 Toulouse, France
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Thomas P, Falcoz PE, Bernard A, Le Pimpec-Barthes F, Jougon J, Brouchet L, Massard G, Dahan M. O-026BILOBECTOMY FOR LUNG CANCER: CONTEMPORARY NATIONAL EARLY MORBIDITY AND MORTALITY OUTCOMES. Interact Cardiovasc Thorac Surg 2015. [DOI: 10.1093/icvts/ivv204.26] [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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Leveque N, Brouchet L, Lepage B, Hermant C, Bigay-Game L, Plat G, Dahan M, Riviere D, Didier A, Mazieres J. Analyse des délais de prise en charge des cancers thoraciques : étude prospective. Rev Mal Respir 2014; 31:208-13. [DOI: 10.1016/j.rmr.2013.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 07/05/2013] [Indexed: 12/21/2022]
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Girard N, Gounant V, Mennecier B, Greillier L, Cortot A, Couraud S, Besse B, Brouchet L, Castelnau O, Ferretti G, Frappé P, Khalil A, Lefebure P, Laurent F, Liebart S, Margery J, Molinier O, Quoix E, Revel MP, Stach B, Souquet PJ, Thomas P, Trédaniel J, Lemarié E, Zalcman G, Barlési F, Milleron B. Le dépistage individuel du cancer broncho-pulmonaire en pratique. Perspectives sur les propositions du groupe de travail pluridisciplinaire de l’Intergroupe francophone de cancérologie thoracique, de la Société d’imagerie thoracique et du Groupe d’oncologie de langue française. Rev Mal Respir 2014; 31:91-103. [DOI: 10.1016/j.rmr.2013.10.641] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 09/18/2013] [Indexed: 12/21/2022]
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14
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Paleiron N, André M, Grassin F, Chouaïd C, Venissac N, Margery J, Couturaud F, Noël-Savina E, Tromeur C, Vinsonneau U, Vedrine L, Leroyer C, Nowak E, Berard H, Thomas P, Brouchet L, Bagan P, Fournel P, Mottier D, Robinet G. Évaluation de la ventilation non invasive préopératoire avant chirurgie de résection pulmonaire. Étude préOVNI GFPC 12-01. Rev Mal Respir 2013; 30:231-7. [DOI: 10.1016/j.rmr.2012.10.601] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Accepted: 09/29/2012] [Indexed: 11/26/2022]
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15
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Greillier L, Gounant V, Couraud S, Cortot AB, Mennecier B, Girard N, Besse B, Brouchet L, Debieuvre D, Falcoz PE, Ferretti GR, Guittet L, Fournel P, Khalil A, Laurent F, Molinier O, Quoix E, Souquet PJ, Thomas PA, Trédaniel J, Westeel V, Lemarié E, Barlési F, Zalcman G, Milleron B. Comment intégrer les résultats de l’essai NLST dans notre pratique ? Une réponse multidisciplinaire sous l’égide de l’IFCT et du GOLF. Rev Mal Respir 2013. [DOI: 10.1016/j.rmr.2012.10.058] [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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16
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Couraud S, Cortot AB, Greillier L, Gounant V, Mennecier B, Girard N, Besse B, Brouchet L, Castelnau O, Frappé P, Ferretti GR, Guittet L, Khalil A, Lefebure P, Laurent F, Liebart S, Molinier O, Quoix E, Revel MP, Stach B, Souquet PJ, Thomas P, Trédaniel J, Lemarié E, Zalcman G, Barlési F, Milleron B. From randomized trials to the clinic: is it time to implement individual lung-cancer screening in clinical practice? A multidisciplinary statement from French experts on behalf of the French intergroup (IFCT) and the groupe d'Oncologie de langue francaise (GOLF). Ann Oncol 2012; 24:586-97. [PMID: 23136229 PMCID: PMC3574545 DOI: 10.1093/annonc/mds476] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [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] [Indexed: 12/26/2022] Open
Abstract
Background Despite advances in cancer therapy, mortality is still high except in early-stage tumors, and screening remains a challenge. The randomized National Lung Screening Trial (NLST), comparing annual low-dose computed tomography (LDCT) and chest X-rays, revealed a 20% decrease in lung-cancer-specific mortality. These results raised numerous questions. The French intergroup for thoracic oncology and the French-speaking oncology group convened an expert group to provide a coherent outlook on screening modalities in France. Methods A literature review was carried out and transmitted to the expert group, which was divided into three workshops to tackle specific questions, with responses presented in a plenary session. A writing committee drafted this article. Results The multidisciplinary group favored individual screening in France, when carried out as outlined in this article and after informing subjects of the benefits and risks. The target population involves subjects aged 55–74 years, who are smokers or have a 30 pack-year smoking history. Subjects should be informed about the benefits of quitting. Screening should involve LDCT scanning with specific modalities. Criteria for CT positivity and management algorithms for positive examinations are given. Conclusions Individual screening requires rigorous assessment and precise research in order to potentially develop a lung-cancer screening policy.
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Affiliation(s)
- S Couraud
- Respiratory Diseases Department, 'Hospices Civils de Lyon' Lyon University Hospital, Pierre-Bénite
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17
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Allera-Moreau C, Rouquette I, Lepage B, Oumouhou N, Walschaerts M, Leconte E, Schilling V, Gordien K, Brouchet L, Delisle MB, Mazieres J, Hoffmann JS, Pasero P, Cazaux C. DNA replication stress response involving PLK1, CDC6, POLQ, RAD51 and CLASPIN upregulation prognoses the outcome of early/mid-stage non-small cell lung cancer patients. Oncogenesis 2012; 1:e30. [PMID: 23552402 PMCID: PMC3503291 DOI: 10.1038/oncsis.2012.29] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [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] [Indexed: 01/04/2023] Open
Abstract
Lung cancer is the leading cause of cancer deaths worldwide. Clinical staging classification is generally insufficient to provide a reliable prognosis, particularly for early stages. In addition, prognostic factors are therefore needed to better forecast life expectancy and optimize adjuvant therapeutic strategy. Recent evidence indicates that alterations of the DNA replication program contribute to neoplasia from its early stages and that cancer cells are frequently exposed to endogenous replication stress. We therefore hypothesized that genes involved in the replication stress response may represent an under-explored source of biomarkers. Expressions of 77 DNA replication-associated genes implicated in different aspects of chromosomal DNA replication, including licensing, firing of origins, elongation, replication fork maintenance and recovery, lesion bypass and post-replicative repair were determined in primary tumors and adjacent normal tissues from 93 patients suffering from early- or mid-stage non-small cell lung cancer (NSCLC). We then investigated a statistically significant interaction between gene expressions and survival of early-stage NSCLC patients.The expression of five genes, that is, POLQ, PLK1, RAD51, CLASPIN and CDC6 was associated with overall, disease-free and relapse-free survival. The expression levels are independent of treatment and stage classification. Except RAD51, their prognostic role on survival persists after adjustment on age, sex, treatment, stage classification and conventional proliferation markers, with a hazard ratio of 36.3 for POLQ (95%CI 2.6–517.4, P=0.008), 23.5 for PLK1 (95%CI 1.9–288.4, P=0.01), 20.7 for CLASPIN (95%CI 1.5–275.9, P=0.02) and 18.5 for CDC6 (95%CI 1.3–267.4, P=0.03). We also show that a five-gene signature including POLQ, PLK1, RAD51, CLASPIN and CDC6 separates patients into low- and high-risk groups, with a hazard ratio of 14.3 (95% CI 5.1–40.3, P<0.001). This ‘replication stress' metamarker may be a reliable predictor of survival for NSCLC, and may also help understand the molecular mechanisms underlying tumor progression.
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Affiliation(s)
- C Allera-Moreau
- 1] Cancer Research Center of Toulouse, Inserm U1037, CNRS ERL5294, University of Toulouse, University Paul Sabatier, Toulouse, France [2] Rangueil-Larrey University Hospital, University of Toulouse, University Paul Sabatier, Toulouse, France
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18
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Mordant P, Lafarge M, Castier Y, Brouchet L, Falcoz P, Haloun A, Le Pimpec-Barthes F, Lesèche G, Maury JM, Reynaud-Gaubert M, Saint-Raymond C, Stern M, Mal H. 712 Extracorporeal Membrane Oxygenation as a Bridge to Lung Transplant: First Results of the French Experience, 2007-2011. J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.727] [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: 10/28/2022] Open
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19
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Lafarge M, Mordant P, Castier Y, Brouchet L, Falcoz PE, Haloun A, Le Pimpec-Barthes F, Leseche G, Maury JM, Reynaud-Gaubert M, Saint-Raymond C, Stern M, Mal H. Résultats de l’assistance par ECMO dans l’attente d’une transplantation pulmonaire en super urgence en France. Rev Mal Respir 2012. [DOI: 10.1016/j.rmr.2011.10.029] [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: 11/16/2022]
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20
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Rouquette I, Allera Moreau C, Lauwers-Cances V, Brouchet L, Bourcier C, Nicaise Y, Delisle MB, Mazières J. Caractéristiques du cancer bronchique chez la femme : analyse immunohistochimique et moléculaire de l’importance des facteurs hormonaux et des facteurs de croissance. Ann Pathol 2011. [DOI: 10.1016/j.annpat.2011.09.121] [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: 11/17/2022]
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21
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Abstract
INTRODUCTION The impressive results seen when giant and compressing lung bullae are resected has inspired pneumonologists and thoracic surgeons to consider the possibility of applying a similar approach to the treatment of respiratory failure due to chronic obstructive pulmonary disease (COPD). STATE OF THE ART The major problem with this surgical indication lies in our ability to understand fully the pathophysiology of lesions and thus identify which emphysematous patients will have a response most similar to that achieved in purely bullous disease. PERSPECTIVES At the present time consideration should be given as to whether surgery is the only means of reducing pulmonary distension. Indeed, as endoscopic alternatives develop could they reproduce its beneficial effects and what would be their place compared to the surgery? CONCLUSIONS While waiting the development of these innovations, if the selection of the candidates is correct, the surgical treatment of lung hyperinflation can temporarily improve the quality of life of these patients by decreasing their dyspnea and increasing their exercise tolerance.
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Affiliation(s)
- L Brouchet
- Service de Chirurgie Thoracique, Clinique des Voies Respiratoires, CHU de Larrey, Toulouse, France
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22
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Thomas P, Dahan M, Riquet M, Massart G, Falcoz PE, Brouchet L, Le Pimpec Barthes F, Doddoli C, Martinod E, Fadel E, Porte Pour La Société Française De Chirurgie Thoracique Et Cardio-Vasculaire H. [Practical issues in the surgical treatment of non-small cell lung cancer. Recommendations from the French Society of Thoracic and Cardiovascular Surgery]. Rev Mal Respir 2009; 25:1031-6. [PMID: 18971809 DOI: 10.1016/s0761-8425(08)74419-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- P Thomas
- Service de Chirurgie Thoracique, Hôpital Sainte Marguerite, Marseille, France.
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23
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Milano GA, Besnard T, Renée N, Etienne-Grimaldi M, Mouroux J, Brouchet L, Pop D, Garraffo R, Venissac N. A novel intra-thoracic hyperthermic schedule combining gemcitabine (Gem) and cisplatin (Pt) in patients with pleural mesothelioma: A pharmacokinetic analysis. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.2551] [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: 11/20/2022] Open
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24
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Benouaich V, Marcheix B, Grunenwald E, Dambrin C, Cron C, Brouchet L, Ghenin R, Dumonteil N, Galinier M, Cérène A. [Late complications of a pseudo aneurysm of the left ventricle: thrombus infection and purulent pericarditis]. Ann Cardiol Angeiol (Paris) 2007; 56:316-318. [PMID: 17963717 DOI: 10.1016/j.ancard.2007.09.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [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: 08/08/2007] [Accepted: 09/30/2007] [Indexed: 05/25/2023]
Abstract
Pseudoaneurysm is a rare complication of left ventricle myocardial infarction. Rupture with tamponade and sudden death is the usual outcome. Surgical intervention remains the treatment of choice. Long term survival cases without surgery are rare. Infection of the thrombus is also a possible event. We report the case of a patient with postinfarction left ventricular pseudoaneurysm complicated by infection of the thrombus and purulent pericarditis involving a peptostreptococcus. Infection must be considered a potential complication of left ventricular pseudoaneurysms.
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Affiliation(s)
- V Benouaich
- Service de chirurgie cardiovasculaire, CHU de Toulouse, hôpital Rangueil, 1, avenue Jean-Poulhès, 31059 Toulouse cedex, France.
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25
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26
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Brouchet L, Mazieres J, Bauvin E, Bigay-Game L, Renaud C, Berjaud J, Dahan M. Particularités de la prise en charge chirurgicale du cancer bronchique chez la femme. Rev Mal Respir 2007; 24:877-82. [DOI: 10.1016/s0761-8425(07)91390-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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27
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Falcoz P, Brouchet L, Conti M, Chocron S, Puyraveau M, Mercier M, Etievent J, Dahan M. A surgical predictive risk model of in-hospital mortality for primary resectable lung cancer: Statistical analysis of 8,796 patients from a nationally representative database. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.7677] [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: 11/20/2022] Open
Abstract
7677 Background: The aim of this study was twofold: to identify factors associated with in-hospital mortality among patients operated on for primary resectable lung cancer and to construct a risk model that could be used prospectively to inform decisions and retrospectively to enable comparisons and outcomes. Methods: Data from a nationally representative thoracic surgery database were collected prospectively in 59 hospitals between June 1, 2002 and December 1, 2006. Only adult patients with more than 95% of completed data were selected for the final analysis (n = 8,796 patients). Logistic regression analysis was used to predict the risk of in-hospital mortality. A risk model was developed with a training set of data (50% of patients) and validated on an independent test set (50% of patients). Its fit was assessed by the Hosmer-Lemeshow test (larger p value signifies greater reliability), and predictive accuracy was indicated by the area under the receiver operating characteristic curve (c-index). Results: Of the 8,796 original patients, 255 (2.9%) died during the same hospital admission. Within the data used to develop the model, the factors found to be significantly associated with the occurrence of in-hospital mortality in a multivariate analysis were: age, gender, performance status (World Health Organization) classification, side, class of procedure (lobectomy or wedge resection versus pneumonectomy), tumor histology, TNM stages and presence of co-morbid disease. The model was reliable (Hosmer-Lemeshow test = 8.94; p = 0.35) and accurate: the c-index (95% confidence interval) = 0.83 (0.81 to 0.85) for the training set and 0.82 (0.79 to 0.85) for the test set of data. The correlation between the expected and observed number of deaths was 0.99. Conclusions: The validated multivariate model for risk of in-hospital mortality among adult patients requiring surgery for primary resectable lung cancer described in this report was developed with national data, uses only 8 variables and has good performance characteristics. It would be useful both for calculating the mortality risk of an individual patient and contrasting expected and observed mortality rates for an institution or independent clinician. No significant financial relationships to disclose.
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Affiliation(s)
- P. Falcoz
- Jean Minjoz Hospital, Besançon, France; Larrey Hospital, Toulouse, France; Calmette Hospital, Lille, France; Saint-Jacques Hospital, Besançon, France; Medical School, Besançon, France
| | - L. Brouchet
- Jean Minjoz Hospital, Besançon, France; Larrey Hospital, Toulouse, France; Calmette Hospital, Lille, France; Saint-Jacques Hospital, Besançon, France; Medical School, Besançon, France
| | - M. Conti
- Jean Minjoz Hospital, Besançon, France; Larrey Hospital, Toulouse, France; Calmette Hospital, Lille, France; Saint-Jacques Hospital, Besançon, France; Medical School, Besançon, France
| | - S. Chocron
- Jean Minjoz Hospital, Besançon, France; Larrey Hospital, Toulouse, France; Calmette Hospital, Lille, France; Saint-Jacques Hospital, Besançon, France; Medical School, Besançon, France
| | - M. Puyraveau
- Jean Minjoz Hospital, Besançon, France; Larrey Hospital, Toulouse, France; Calmette Hospital, Lille, France; Saint-Jacques Hospital, Besançon, France; Medical School, Besançon, France
| | - M. Mercier
- Jean Minjoz Hospital, Besançon, France; Larrey Hospital, Toulouse, France; Calmette Hospital, Lille, France; Saint-Jacques Hospital, Besançon, France; Medical School, Besançon, France
| | - J. Etievent
- Jean Minjoz Hospital, Besançon, France; Larrey Hospital, Toulouse, France; Calmette Hospital, Lille, France; Saint-Jacques Hospital, Besançon, France; Medical School, Besançon, France
| | - M. Dahan
- Jean Minjoz Hospital, Besançon, France; Larrey Hospital, Toulouse, France; Calmette Hospital, Lille, France; Saint-Jacques Hospital, Besançon, France; Medical School, Besançon, France
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Arnal JF, Douin-Echinard V, Brouchet L, Tremollières F, Laurell H, Lenfant F, Gadeau AP, Guery JC, Gourdy P. Understanding the oestrogen action in experimental and clinical atherosclerosis. Fundam Clin Pharmacol 2007; 20:539-48. [PMID: 17109647 DOI: 10.1111/j.1472-8206.2006.00445.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Whereas hormone replacement/menopause therapy (HRT) in postmenopausal women increases the coronary artery risk, epidemiological studies (protection in premenopaused women) suggest and experimental studies (prevention of the development of fatty streaks in animals) demonstrate a major atheroprotective action of oestradiol (E2). The understanding of the deleterious and beneficial effects of oestrogens is thus required. The immuno-inflammatory system plays a key role in the development of fatty streak deposit as well as in the rupture of the atherosclerotic plaque. Whereas E2 favours an anti-inflammatory effect in vitro (cultured cells), it rather elicits in vivo a proinflammation at the level of several subpopulations of the immuno-inflammatory system, which could contribute to plaque destabilization. Endothelium is another important target for E2, as it potentiates endothelial NO and prostacyclin production, thus promoting the beneficial effects as vasorelaxation and inhibition of platelet aggregation. Prostacyclin, but not NO, appears to be involved in the atheroprotective effect of E2. E2 also accelerates endothelial regrowth, thus favouring vascular healing. Finally, most of these effects of E2 are mediated by oestrogen receptor alpha, and are independent of oestrogen receptor beta. In summary, a better understanding of the mechanisms of oestrogen action not only on the normal and atheromatous arteries, but also on innate and adaptive immune responses is required and should help to optimize the prevention of cardiovascular disease after menopause. These mouse models should help to screen existing and future selective oestrogen receptor modulators.
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Affiliation(s)
- J F Arnal
- INSERM U589, IFR 31, CHU Toulouse-Rangueil, BP 84225, 31432 Toulouse Cedex 4, France.
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29
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Arnal JF, Laurell H, Lenfant F, Douin-Echinard V, Brouchet L, Gourdy P. Estradiol action in atherosclerosis and reendothelialization. Ernst Schering Found Symp Proc 2007:69-86. [PMID: 17824172 DOI: 10.1007/2789_2006_017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Whereas hormonal replacement/menopause therapy (HRT) in postmenopausal women increases coronary artery disease risk, epidemiological studies (protection in premenopaused women) suggest and experimental studies (prevention of the development of fatty streaks in animals) demonstrate a major atheroprotective action of estradiol (E2). The understanding of the deleterious and beneficial effects of estrogens is thus required. The atheroprotective effect of E2 is absent in mice deficient in mature T and B lymphocytes, demonstrating the crucial role of the endothelium/immune system pair. The immunoinflammatory system appears to play a key role in the development of fatty streak deposit as well as in the rupture of the atherosclerotic plaque. Whereas E2 favors an anti-inflammatory effect in vitro (cultured cells), it elicits in vivo a proinflammation at the level of several subpopulations of the immunoinflammatory system, which could contribute to plaque destabilization. Endothelium appears to be an important target for E2, since it potentiates endothelial NO and prostacyclin production, thus promoting beneficial effects such as vasorelaxation and inhibition of platelet aggregation. Prostacyclin, but not NO, appear to be involved in the atheroprotective effect of E2, which also accelerates endothelial regrowth, thus favoring vascular healing. Finally, most of these E2 effects are mediated by estrogen receptor alpha and are independent of estrogen receptor beta. In summary, a better understanding of the mechanisms of estrogens on the normal and atheromatous arteries is required and should help to optimize the prevention of cardiovascular disease after menopause. These mouse models should help to screen existing and future selective estrogen receptor modulators (SERMs).
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Affiliation(s)
- J F Arnal
- INSERM U589, Institut L. Bugnard, 1 avenue Jean Poulhès, 31403 Toulouse, France.
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30
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Brouchet L, Rouquette I, Touriol C, Marchaix B, Rochaix P, Bigay-Game L, Hermant C, Mazieres J, Delord J, Renaud C, Didier A, Dahan M, Arnal J, Prats H. 040 Cancer bronchique rapidement évolutif : Expressions des marqueurs angiogéniques. Rev Mal Respir 2006. [DOI: 10.1016/s0761-8425(06)71868-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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31
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Brouchet L. [Does chemotherapy influence the postoperative mortality?]. Rev Pneumol Clin 2006; 62 Spec no 1:1S8-10. [PMID: 16719147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Affiliation(s)
- L Brouchet
- Service de Chirurgie thoracique, CHU Larrey, Toulouse, France
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32
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Crognier L, Pontier S, Renaud C, Brouchet L, Rouquette I, Dahan M, Carles P, Didier A. Place des biopsies pulmonaires chirurgicales dans la prise en charge des pneumopathies infiltratives diffuses au CHU de Toulouse de 1993 à 2004. Rev Mal Respir 2006. [DOI: 10.1016/s0761-8425(06)72449-4] [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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Falcoz P, Conti M, Brouchet L, Chocron S, Puyraveau M, Mercier M, Etievent JP, Dahan M. Modélisation du risque de mortalité hospitalière en chirurgie thoracique : résultats d’une base de données nationale. Rev Mal Respir 2006. [DOI: 10.1016/s0761-8425(06)72394-4] [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: 10/22/2022]
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Filipe C, Fontaine V, Werner N, Gourdy P, Billon A, Garmy-Susini B, Brouchet L, Doetschman T, Nickenig G, Arnal JF. Th-W59:5 Essential role of bone marrow FGF2 in the effect of estradiol on reendothelialization and EPC mobilisation. ATHEROSCLEROSIS SUPP 2006. [DOI: 10.1016/s1567-5688(06)81940-9] [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: 11/26/2022]
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Brouchet L, Valmary S, Dahan M, Didier A, Galateau-Salle F, Brousset P, Degano B. Detection of oncogenic virus genomes and gene products in lung carcinoma. Br J Cancer 2005; 92:743-6. [PMID: 15700034 PMCID: PMC2361883 DOI: 10.1038/sj.bjc.6602409] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
We investigated a series of 122 cases of small cell lung carcinomas and non-small cell lung carcinomas for the presence of several viruses that are known to be oncogenic in humans. Thus, viral genomes (DNA) and/or RNA transcripts and/or proteins of human papillomaviruses (HPV) 16, 18, 31, 33, 51, Epstein–Barr virus (EBV), human herpesvirus 8 (HHV-8), human cytomegalovirus (HCMV) and simian virus 40 (SV40) were investigated on tissue sections (prepared in tissue microarrays) with different techniques of immunohistochemistry and in situ hybridisation. None of the cases displayed a single positive tumour cell for all the viruses tested whatever the technique applied. Of note, in five cases of tumours with lymphoid infiltrates, we detected scattered EBV (EBER)-positive bystander lymphocytes. In three cases, a faint nuclear staining was found with the anti-latent nuclear antigen/LANA1 (HHV-8) antibody. These cases were checked by PCR with two sets of primers (orf 26 and orf 75) and remained negative for this latter virus. Taken together, our data strongly suggest that the conventional human oncogenic viruses (HPV, EBV, HCMV, HHV-8 and SV40) are unlikely to play some role in the development of lung carcinomas.
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MESH Headings
- Adenocarcinoma/virology
- Antibodies, Viral/analysis
- Carcinoid Tumor/virology
- Carcinoma, Large Cell/virology
- Carcinoma, Neuroendocrine/virology
- Carcinoma, Non-Small-Cell Lung/virology
- Carcinoma, Small Cell/virology
- Carcinoma, Squamous Cell/virology
- Cytomegalovirus/genetics
- DNA, Viral/isolation & purification
- Genome, Viral
- Herpesvirus 4, Human/genetics
- Herpesvirus 8, Human/genetics
- Humans
- Immunohistochemistry
- In Situ Hybridization
- Lung Neoplasms/chemistry
- Lung Neoplasms/virology
- Oncogenic Viruses/genetics
- Papillomaviridae/genetics
- Polymerase Chain Reaction
- RNA, Viral/isolation & purification
- Simian virus 40/genetics
- Viral Proteins/isolation & purification
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Affiliation(s)
- L Brouchet
- Department of Respiratory Diseases, CHU Rangueil-Larrey, Toulouse, France
| | - S Valmary
- Department of Pathology, Purpan Hospital and INSERM U563 (CPTP), CHU Purpan, Toulouse, France
| | - M Dahan
- Department of Respiratory Diseases, CHU Rangueil-Larrey, Toulouse, France
| | - A Didier
- Department of Respiratory Diseases, CHU Rangueil-Larrey, Toulouse, France
| | | | - P Brousset
- Department of Pathology, Purpan Hospital and INSERM U563 (CPTP), CHU Purpan, Toulouse, France
| | - B Degano
- Department of Respiratory Diseases, CHU Rangueil-Larrey, Toulouse, France
- Service de Pneumologie, CHU Rangueil-Larrey, TSA 30030, 31059 Toulouse Cedex 9, France. E-mail:
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36
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Garmy-Susini B, Delmas E, Gourdy P, Zhou M, Brouchet L, Bayard F, Prats AC, Doetschman T, Prats H, Arnal JF. HIGH MW FGF2, BUT NOT LOW MW FGF2 NOR VEGF, MEDIATES THE EFFECT OF ESTRADIOL ON REENDOTHELIALIZATION. J Hypertens 2004. [DOI: 10.1097/00004872-200406002-00655] [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: 11/25/2022]
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37
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Abstract
Surgery is an important therapeutic option for emphysema patients with invalidating dyspnea and poor quality-of-life. Preoperative tests must determine the degree of functional impairment (dyspnea score, walking test, quality-of-life) and evaluate lesion reversibility (imaging, function tests, TLCO, blood gases, scintigraphy, right microcatheterism) and assess the patient's general health status. Besides lung transplantation, the only surgical alternative is resection which, depending on the type of parenchymal damage, can involve excision of bullae or volume reduction. Several modalities can be proposed: atypical resection of the apexes via sternotomy, multiple unilateral atypical resection, simple lobectomy. The choice depends on the distribution of the parenchymal destruction and also on the severity of the emphysema and the patient's age. Operative mortality is now well below 10%. Volume reduction provides significant functional improvement in 80% of patients but with a temporary effect (4-5 years). Bullae excision is particularly important since functional recovery is achieved early and persists.
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Affiliation(s)
- L Brouchet
- Service de Chirurgie Thoracique, Hôpital Larrey-CHU, 24, chemin de Pouvourville, 31059 Toulouse.
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38
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Arnal JF, Gourdy P, Elhage R, Garmy-Susini B, Delmas E, Brouchet L, Castano C, Barreira Y, Couloumiers JC, Prats H, Prats AC, Bayard F. Estrogens and atherosclerosis. Eur J Endocrinol 2004; 150:113-7. [PMID: 14763907 DOI: 10.1530/eje.0.1500113] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Numerous epidemiological as well as experimental studies have suggested that estradiol (E2) prevents atherosclerosis development. However two controlled prospective and randomized studies in women using hormone replacement therapy (HRT) did not confirm this beneficial effect. We then decided to use mouse models of atherosclerosis to define the possible mechanisms involved and the reasons for the discrepancy. We have shown that, although serum cholesterol decreases, this influence on lipid metabolism is negligible. Surprisingly, E2 induces an inflammatory-immune response towards a T helper cell (Th1) profile with increasing interferon-gamma production that could destabilize atheromatous plaques, and could account for the increase in the frequency of cardiovascular events in women undergoing HRT. At the level of the endothelium, E2 induces an increase in nitric oxide (NO) biodisponibility, but this phenomenon does not concern the development of fatty streaks. Nevertheless, the atheroprotective effect is apparently mediated at the level of the endothelium by a mechanism that has still to be characterized in molecular terms. These new acquisitions constitute a basis for new pharmacological developments allowing the prevention of deleterious effects and preserving the beneficial ones.
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Affiliation(s)
- J-F Arnal
- INSERM U589, Institut L Bugnard, 1 avenue Jean Poulhes, 31403 Toulouse, France
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39
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Bayard F, Gourdy P, Elhage R, Brouchet L, Garmy-Susini B, Castano C, Barreira Y, Couloumiers JC, Arnal JF. Estrogens and atherosclerosis. Ernst Schering Res Found Workshop 2004:181-7. [PMID: 15248512 DOI: 10.1007/978-3-662-05386-7_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Affiliation(s)
- F Bayard
- INSERM U397, Institut Louis Bugnard, CHU Rangueil, Toulouse, France.
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40
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Andre F, Grunenwald D, Pujol JL, Girard P, Dujon A, Brouchet L, Brichon PY, Westeel V, Le Chevalier T. Patterns of relapse of N2 nonsmall-cell lung carcinoma patients treated with preoperative chemotherapy: should prophylactic cranial irradiation be reconsidered? Cancer 2001; 91:2394-400. [PMID: 11413530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
BACKGROUND Although it induces a relevant reduction in the risk of both visceral metastases and locoregional recurrences, the combination of chemotherapy and surgery only marginally improves the survival of patients with Stage IIIA(N2) (International Union Against Cancer staging and classification system) nonsmall-cell lung carcinoma (NSCLC). The purpose of the current study was to analyze the patterns of relapse in these patients. METHODS In this study, the authors compared the patterns of relapse in 81 patients with clinically detectable N2 NSCLC who had been treated with preoperative chemotherapy with the relapse patterns of 186 comparable patients who had been treated with primary surgery. Clinically detectable N2 (cN2) denotes mediastinal lymph node enlargement on computed tomography scan, which then is confirmed by mediastinoscopy. RESULTS Overall 20% of patients developed a locoregional recurrence. Chemotherapy decreased the risk of visceral metastasis as 28% of the patients preoperatively treated and 38%of those not treated with preoperative chemotherapy presented a visceral metastasis (P < 0.05). Preoperative chemotherapy and adenocarcinoma subtypes were associated with a higher rate of brain metastasis (P < 0.05). Thirty-two percent of the patients treated preoperatively and 18% of those not treated with preoperative chemotherapy presented a brain metastasis (P < 0.05), which was isolated in 22% and 11% of the patients, respectively (P < 0.05). CONCLUSION The current study found that preoperative chemotherapy for cN2 decreases the risk of visceral metastasis but is associated with a high rate of isolated brain metastases. Prophylactic cranial irradiation may need to be reinvestigated in clinical trials, especially in patients who present with an adenocarcinoma.
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Affiliation(s)
- F Andre
- Department of Medicine, Gustave Roussy Institute, Villejuif, France.
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41
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Brouchet L, Krust A, Dupont S, Chambon P, Bayard F, Arnal JF. Estradiol accelerates reendothelialization in mouse carotid artery through estrogen receptor-alpha but not estrogen receptor-beta. Circulation 2001; 103:423-8. [PMID: 11157695 DOI: 10.1161/01.cir.103.3.423] [Citation(s) in RCA: 177] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The atheroprotective effect of 17beta-estradiol (E(2)) has been suggested in women and clearly demonstrated in animals through both an effect on lipid metabolism and a direct effect on the cells of the arterial wall. It has been shown, for example, that E(2) promotes endothelium-dependent relaxation and accelerates reendothelialization in rats. Similar studies have been undertaken in mice to appreciate the molecular mechanism of this process. METHODS AND RESULTS We report here a model of electric carotid injury adapted from that described by Carmeliet et al (1997) that allows us to precisely evaluate the reendothelialization process. We demonstrate that E(2) accelerates endothelial regeneration in castrated female wild-type mice. In ovariectomized transgenic mice in which either the estrogen receptor (ER)-alpha or ERbeta gene has been disrupted, E(2) accelerated reendothelialization in female ERbeta knockout mice, whereas this effect was abolished in female ERalpha knockout mice. CONCLUSIONS This study demonstrates that ERalpha but not ERbeta mediates the beneficial effect of E(2) on reendothelialization and potentially the prevention of atherosclerosis.
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MESH Headings
- Animals
- Arteriosclerosis/prevention & control
- Carotid Artery Injuries/blood
- Carotid Artery Injuries/drug therapy
- Carotid Artery Injuries/physiopathology
- Carotid Artery, Common/drug effects
- Carotid Artery, Common/metabolism
- Carotid Artery, Common/ultrastructure
- Castration
- Disease Models, Animal
- Endothelium, Vascular/physiopathology
- Estradiol/blood
- Estradiol/pharmacology
- Estrogen Receptor alpha
- Estrogen Receptor beta
- Evans Blue
- Female
- Mice
- Mice, Inbred C57BL
- Mice, Knockout
- Microscopy, Electron, Scanning
- Receptors, Estrogen/deficiency
- Receptors, Estrogen/drug effects
- Regeneration
- Staining and Labeling
- Time Factors
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Affiliation(s)
- L Brouchet
- INSERM U397, Institut L. Bugnard, CHU Rangueil, Toulouse, France
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42
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Andre F, Grunenwald D, Pujol JL, Girard P, Dujon A, Brouchet L, Brichon PY, Westeel V, Le Chevalier T. Patterns of relapse of N2 nonsmall-cell lung carcinoma patients treated with preoperative chemotherapy. Cancer 2001. [DOI: 10.1002/1097-0142(20010615)91:12<2394::aid-cncr1273>3.0.co;2-6] [Citation(s) in RCA: 87] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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43
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Andre F, Grunenwald D, Pignon JP, Dujon A, Pujol JL, Brichon PY, Brouchet L, Quoix E, Westeel V, Le Chevalier T. Survival of patients with resected N2 non-small-cell lung cancer: evidence for a subclassification and implications. J Clin Oncol 2000; 18:2981-9. [PMID: 10944131 DOI: 10.1200/jco.2000.18.16.2981] [Citation(s) in RCA: 401] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Patients who suffer from non-small-cell lung cancer (NSCLC) with ipsilateral mediastinal lymph node involvement (N2) belong to a heterogeneous subgroup of patients. We analyzed the prognosis of patients with resected N2 NSCLC to propose homogeneous patient subgroups. PATIENTS AND METHODS The present study comprised 702 consecutive patients from six French centers who underwent surgical resection of N2 NSCLC. Initially, two groups of patients were defined: patients with clinical N2 (cN2) and those with minimal N2 (mN2) disease were patients in whom N2 disease was and was not detected preoperatively at computed tomographic scan, respectively. RESULTS The median duration of follow-up was 52 months (range, 18 to 120 months). A multivariate analysis using Cox regression identified four negative prognostic factors, namely, cN2 status (P <. 0001), involvement of multiple lymph node levels (L2+; P <.0001), pT3 to T4 stage (P <.0001), and no preoperative chemotherapy (P <. 01). For patients treated with primary surgery, 5-year survival rates were as follows: mN2, one level involved (mN2L1, n = 244): 34%; mN2, multiple level involvement (mN2L2+, n = 78): 11%; cN2L1 (n = 118): 8%; and cN2L2+ (n = 122): 3%. When only patients with mN2L1 disease were considered, the site of lymph node involvement according to the American Thoracic Society numbering system had no prognostic significance (P =.14). Preoperative chemotherapy was associated with a better prognosis for those with cN2 (P <.0001). Five-year survival rates were 18% and 5% for cN2 patients treated with and without preoperative chemotherapy, respectively. CONCLUSION This study has identified homogeneous N2 NSCLC prognostic subgroups and suggests different therapeutic approaches according to the subgroup profile.
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Affiliation(s)
- F Andre
- Departments of Medicine and Biostatistics, Institut Gustave Roussy, Villejuif, France.
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44
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Arnal JF, Elhage R, Brouchet L, Rami J, Maret A, Bayard F. [Estrogens and the arterial wall]. Ann Endocrinol (Paris) 2000; 61:80-4. [PMID: 10790597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Two isoforms of oestrogens receptor (alpha and B) have been identified in the cells of the arterial wall, and an heterogenity of their expression according to the animal species, to the vascular bed and to sex has been reported. Estrogens can thus directly influence the vascular physiology through a genomic mechanism, but extra-genomic mechanisms responsible for a short-term effect have also been suggested. Endothelium appears to be an important target for estradiol, because this hormone potentiates endothelium-dependant relaxation through an increase in NO bioavailability, and accelerates endothelial regrowth. In the model of apolipoprotein E-deficient mice, as the atrhroprotective effect deposit. The immune system appears to play a key role, as the athroprotective effect of estradiol is absent in mice deficient in T and B lymphocytes. Estrogens potentiate the endothelium-dependant relaxation through the increase in nitric oxide bioavailability. Endothelial dysfunction (abnormality of the endothelium-dependent vasodilation) occurs in atheromatous arteries. Estrogens prevent and even correct this endothelial dysfunction. In monkeys, this beneficial effect of estrogens is not altered by coadministration of progesterone, but is abolished.
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Affiliation(s)
- J F Arnal
- INSERM U397 et Laboratoire de Physiologie, CHU Rangueil, 31403 Toulouse, France
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45
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Dahan M, Berjaud J, Brouchet L. [Indications and limits of pulmonary volume reduction surgery]. Rev Mal Respir 1999; 16 Suppl 3:S192. [PMID: 10088316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- M Dahan
- Service de Chirurgie Thoracique, Purpan, Toulouse
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46
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Dujon A, Saab M, Riquet M, Dahan M, Jancovici R, Brouchet L. [Video-guided surgical resection of solitary pulmonary nodules. Significance of thoraco-conversion in cancer cases. Apropos of 34 cases]. Rev Pneumol Clin 1998; 54:239-242. [PMID: 9894278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The use of video-guides surgery for major pulmonary resections in cancer patients raises a problem of safety and oncological quality. The aim of this prospective study was to demonstrate the oncological contribution of systematic thoracotomy in suspected stage I cancer patients. Between February 1993 and December 1996, we operated 34 consecutive patients with a solitary primary neoplastic lung nodule using normal fibroscopy and preoperative CT scan to detect mediastinal nodes. The nodules measured a mean 18.5 mm. Diagnosis was confirmed at peroperative pathology examination of the video-guided surgical resection, generally leading to thoracotomy for lobectomy-dissection. The final tumoral stage affirmed the initial diagnosis (stage I) in only 19 cases (56%). Peroperative findings showed that the other patients had more advance disease: 2 stage II (T1N1) (6%), 11 stage IIa (T1N2) (32%) and 2 stage IIIb (satellite nodule in the remaining lobe measuring 6 and 7 cm) (6%). These findings emphasize the importance of complete node dissection as well as the need to carefully palpate the entire lung. Thoracotomy remains the most reliable and reproducible method for safely fulfilling the oncological requirements.
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Affiliation(s)
- A Dujon
- CMC du Cèdre, Bois-Guillaume
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47
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Dahan M, Sanchez P, Brouchet L. [Physiopathology of closed thoracic trauma]. Rev Prat 1997; 47:946-50. [PMID: 9208682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Any thoracic trauma causes more or less severe hypoxia, due to pain, pleural effusion, mechanical ventilation disorders and pulmonary contusion. These four factors lead to bronchial congestion, which in turn aggravates hypoxia. More or less rapidly a vicious circle of respiratory failure is created. It can be broken only by early treatment of the cause. Without such treatment, respiratory failure quickly becomes autonomic and treatment of the cause is no longer sufficient.
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Affiliation(s)
- M Dahan
- Service de chirurgie thoracique, CHU Purpan, Toulouse
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