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Richaud C, Jochum F, Journo G, Toussaint A, Laurent M, Fontier Z, Langer A, Malhaire C, Laas E, Féron JG, Lecuru F, Pouget N, Guinebretière JM, El Zein S, Brain E, Watson S, Piperno-Neumann S, Blay JY, Bonvalot S, Bozec L, Hamy AS. Impact of guideline adherence and expert center referral on the early management and outcomes of uterine sarcoma patients: A retrospective analysis from the French NETSARC network. Eur J Surg Oncol 2024; 50:107319. [PMID: 38159391 DOI: 10.1016/j.ejso.2023.107319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 11/21/2023] [Accepted: 12/07/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE Uterine sarcomas are rare tumors with a poor prognosis. Their diagnosis is often incidental, following surgery. Our goal was to examine the early management strategies for uterine sarcomas, and to assess the impact of guideline adherence and expert center referral on both the management approaches and the clinical outcomes in patients with uterine sarcomas. METHODS We retrospectively analyzed medical records from patients with uterine sarcoma referred to the Institut Curie and registered in the database of the French NETSARC network. RESULTS In total, 100 patients, with a median age of 54 years, were included in the analyses. On MRI scans (n = 36), all patients had at least two signs suggestive of malignancy, and 77.8 % had four or more signs. No preoperative biopsy was performed in 65.6 % of cases. Only 14.1 % of patients underwent initial surgery at an expert center. Surgery performed outside the network was significantly associated with morcellation (32.9 % vs. 0 %; p = 0.036), fewer negative margins (R0 margins 52.4 % vs. 100 %; p = 0.006), and poor adherence to surgical guidelines (28.3 vs. 72.7 %; p = 0.013). Multivariate analysis showed that non-adherence to surgical recommendations was not significantly associated with relapse-free survival (HR = 0.54; 95 % CI [0.21-1.38]), but was an independent predictor of poor overall survival (HR = 0.12; 95 % CI [0.03-0.52]; p = 0.005). CONCLUSION Despite a high frequency of suspicious clinical and radiological signs, a large proportion of women undergoing sarcoma surgery are treated outside of expert networks. We provide guidelines, integrating the clinical context and radiological signs to encourage early referral to reference centers for sarcoma.
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Affiliation(s)
- Clarisse Richaud
- Department of Gynecology, Cochin Port-Royal Hospital, Paris, France
| | - Floriane Jochum
- Department of Gynecology, Strasbourg University Hospital, Strasbourg, France; Residual Tumor & Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, Université Paris Cité, Paris, France
| | | | | | | | | | - Adriana Langer
- Department of Radiology, Institut Curie, Saint Cloud, France
| | | | - Enora Laas
- Department of Breast, Gynecological and Reconstructive Surgery, Institut Curie, Université Paris Cité, Paris, France
| | - Jean-Guillaume Féron
- Department of Breast, Gynecological and Reconstructive Surgery, Institut Curie, Université Paris Cité, Paris, France
| | - Fabrice Lecuru
- Department of Breast, Gynecological and Reconstructive Surgery, Institut Curie, Université Paris Cité, Paris, France
| | - Nicolas Pouget
- Department of Breast, Gynecological and Reconstructive Surgery, Institut Curie, Saint-Cloud, France
| | | | - Sophie El Zein
- Department of Pathology, Institut Curie, Université PSL, Paris, France
| | - Etienne Brain
- Department of Medical Oncology, Institut Curie, Saint Cloud, France
| | - Sarah Watson
- Department of Medical Oncology, Universite Paris Cite, Paris, France
| | | | - Jean-Yves Blay
- Department of Medical Oncology, Center Léon Bérard, Lyon, France
| | - Sylvie Bonvalot
- Department of Surgical Oncology, Institut Curie, Université Paris Cité, Paris, France
| | - Laurence Bozec
- Department of Medical Oncology, Institut Curie, Saint Cloud, France
| | - Anne-Sophie Hamy
- Residual Tumor & Response to Treatment Laboratory, RT2Lab, Translational Research Department, INSERM, U932 Immunity and Cancer, Université Paris Cité, Paris, France.
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Nardi W, Nicolas N, El Zein S, Tzanis D, Bouhadiba T, Helfre S, Watson S, Brisse HJ, Servois V, Bonvalot S. Diagnostic accuracy and safety of percutaneous core needle biopsy of retroperitoneal tumours. Eur J Surg Oncol 2024; 50:107298. [PMID: 38086314 DOI: 10.1016/j.ejso.2023.107298] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/10/2023] [Accepted: 11/21/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND Histologic subtype of cancer guides treatment sequencing and the extent of surgery for retroperitoneal tumours (RPTs) but concerns persist regarding percutaneous core needle biopsy (CNB). OBJECTIVE Endpoints were the incidence of early complications, needle tract seeding (NTS) after CNB, diagnostic accuracy. METHODS Between 2015 and 2022, data from patients with RPT who underwent a CNB and who operated on at Institut Curie were collected. We retrospectively reviewed the medical records and microscopic analysis of both CNB and surgical specimens to evaluate the diagnostic accuracy of CNB (quantified using positive and negative predictive values, PPV/NPV). RESULTS 313 patients underwent CNB. In 10/326 (3 %) procedures, minor complications were observed. One of 212 (0.47 %) resected RPSs exhibited a local recurrence compatible with NTS. Microscopic analysis of CNB specimens allowed the classification of tumours between groups of cancers and benign/intermediate mesenchymal tumours in 307/313 (98 %) patients. Among the 204 patients with retroperitoneal sarcoma, the overall concordance between CNB and final pathology following resection was 178/204 (87.2 %). The respective PPVs of solitary fibrous tumour, dedifferentiated liposarcoma, leiomyosarcoma and well-differentiated liposarcoma were 100 %, 98 %, 97 % and 68 %, respectively. The diagnosis of a high-grade (G 2-3) sarcoma resulted in a high specificity (97 %) and PPV (98 %) but low sensitivity (76 %). CONCLUSIONS CNB allowed the classification of RPT in the vast majority of patients with a low morbidity rate. Concordance with final diagnosis was high for sarcomas with the exception of well-differentiated liposarcoma. As a result, CNB results should be integrated with imaging/radiomics by multidisciplinary tumour boards.
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Affiliation(s)
- Walter Nardi
- Department of Surgical Oncology, Institut Curie, Paris, France; Department of General Surgery, Surgical Oncology Unit, Buenos Aires British Hospital, Buenos Aires, Argentina.
| | | | - Sophie El Zein
- Department of Biopathology, Institut Curie, Paris, France.
| | - Dimitri Tzanis
- Department of Surgical Oncology, Institut Curie, Paris, France.
| | | | - Sylvie Helfre
- Department of Radiotherapy, Institut Curie, Paris, France.
| | - Sarah Watson
- Department of Medical Oncology and INSERM U830, Institut Curie, Paris, France.
| | | | | | - Sylvie Bonvalot
- Department of Surgical Oncology, Institut Curie, Paris, France.
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Savary C, Luciana L, Huchedé P, Tourbez A, Coquet C, Broustal M, Lopez Gonzalez A, Deligne C, Diot T, Naret O, Costa M, Meynard N, Barbet V, Müller K, Tonon L, Gadot N, Degletagne C, Attignon V, Léon S, Vanbelle C, Bomane A, Rochet I, Mournetas V, Oliveira L, Rinaudo P, Bergeron C, Dutour A, Cordier-Bussat M, Roch A, Brandenberg N, El Zein S, Watson S, Orbach D, Delattre O, Dijoud F, Corradini N, Picard C, Maucort-Boulch D, Le Grand M, Pasquier E, Blay JY, Castets M, Broutier L. Fusion-negative rhabdomyosarcoma 3D organoids to predict effective drug combinations: A proof-of-concept on cell death inducers. Cell Rep Med 2023; 4:101339. [PMID: 38118405 PMCID: PMC10772578 DOI: 10.1016/j.xcrm.2023.101339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 09/29/2023] [Accepted: 11/22/2023] [Indexed: 12/22/2023]
Abstract
Rhabdomyosarcoma (RMS) is the main form of pediatric soft-tissue sarcoma. Its cure rate has not notably improved in the last 20 years following relapse, and the lack of reliable preclinical models has hampered the design of new therapies. This is particularly true for highly heterogeneous fusion-negative RMS (FNRMS). Although methods have been proposed to establish FNRMS organoids, their efficiency remains limited to date, both in terms of derivation rate and ability to accurately mimic the original tumor. Here, we present the development of a next-generation 3D organoid model derived from relapsed adult and pediatric FNRMS. This model preserves the molecular features of the patients' tumors and is expandable for several months in 3D, reinforcing its interest to drug combination screening with longitudinal efficacy monitoring. As a proof-of-concept, we demonstrate its preclinical relevance by reevaluating the therapeutic opportunities of targeting apoptosis in FNRMS from a streamlined approach based on transcriptomic data exploitation.
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Affiliation(s)
- Clara Savary
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Léa Luciana
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Paul Huchedé
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Arthur Tourbez
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Claire Coquet
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Maëlle Broustal
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Alejandro Lopez Gonzalez
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Clémence Deligne
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Thomas Diot
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Olivier Naret
- DOPPL, EPFL Innovation Park, Building L, Ch. de la Dent d'Oche 1, 1024 Ecublens, Switzerland
| | - Mariana Costa
- DOPPL, EPFL Innovation Park, Building L, Ch. de la Dent d'Oche 1, 1024 Ecublens, Switzerland
| | - Nina Meynard
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Virginie Barbet
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Kevin Müller
- Université Aix-Marseille, CNRS 7258, INSERM 1068, Institute Paoli-Calmettes, Centre de Recherche en Cancérologie de Marseille (CRCM), 13009 Marseille, France
| | - Laurie Tonon
- Synergie Lyon Cancer, Gilles Thomas' Bioinformatics Platform, Centre Léon Bérard, 69008 Lyon, France
| | - Nicolas Gadot
- Anatomopathology Research Platform, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Cyril Degletagne
- Cancer Genomics Platform, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Valéry Attignon
- Cancer Genomics Platform, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Sophie Léon
- EX-VIVO Platform, Centre de recherche en cancérologie de Lyon (CRCL), Centre Léon Bérard, Université de Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Christophe Vanbelle
- Plateforme d'Imagerie cellulaire, Centre de recherche en cancérologie de Lyon (CRCL), Centre Léon Bérard, Université de Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Alexandra Bomane
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Isabelle Rochet
- Multisite Institute of Pathology, Groupement Hospitalier Est du CHU de Lyon, Hôpital Femme-Mère-Enfant, 69677 Bron, France; Department of Pediatric Oncology, Institut d'Hématologie et d'Oncologie Pédiatrique, Centre Léon Bérard, 69008 Lyon, France
| | | | | | | | - Christophe Bergeron
- Department of Pediatric Oncology, Institut d'Hématologie et d'Oncologie Pédiatrique, Centre Léon Bérard, 69008 Lyon, France
| | - Aurélie Dutour
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Martine Cordier-Bussat
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France
| | - Aline Roch
- DOPPL, EPFL Innovation Park, Building L, Ch. de la Dent d'Oche 1, 1024 Ecublens, Switzerland
| | - Nathalie Brandenberg
- DOPPL, EPFL Innovation Park, Building L, Ch. de la Dent d'Oche 1, 1024 Ecublens, Switzerland
| | - Sophie El Zein
- Department of Biopathology, Institut Curie, Paris, France
| | - Sarah Watson
- SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), Institut Curie, PSL Research University, Paris, France; INSERM U830, Diversity and Plasticity of Childhood Tumors Lab, Institut Curie, PSL Research University, Paris, France; Medical Oncology Department, Institut Curie, PSL Research University, Paris, France
| | - Daniel Orbach
- SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), Institut Curie, PSL Research University, Paris, France
| | - Olivier Delattre
- SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), Institut Curie, PSL Research University, Paris, France; INSERM U830, Diversity and Plasticity of Childhood Tumors Lab, Institut Curie, PSL Research University, Paris, France
| | - Frédérique Dijoud
- Multisite Institute of Pathology, Groupement Hospitalier Est du CHU de Lyon, Hôpital Femme-Mère-Enfant, 69677 Bron, France
| | - Nadège Corradini
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France; Department of Pediatric Oncology, Institut d'Hématologie et d'Oncologie Pédiatrique, Centre Léon Bérard, 69008 Lyon, France; Department of Translational Research in Pediatric Oncology PROSPECT, Centre Léon Bérard, 69008 Lyon, France
| | - Cécile Picard
- Multisite Institute of Pathology, Groupement Hospitalier Est du CHU de Lyon, Hôpital Femme-Mère-Enfant, 69677 Bron, France
| | - Delphine Maucort-Boulch
- Université Lyon 1, 69100 Villeurbanne, France; Hospices Civils de Lyon, Pôle Santé Publique, Service de Biostatistique et Bioinformatique, 69003 Lyon, France; CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, Équipe Biostatistique-Santé, 69100 Villeurbanne, France
| | - Marion Le Grand
- Université Aix-Marseille, CNRS 7258, INSERM 1068, Institute Paoli-Calmettes, Centre de Recherche en Cancérologie de Marseille (CRCM), 13009 Marseille, France
| | - Eddy Pasquier
- Université Aix-Marseille, CNRS 7258, INSERM 1068, Institute Paoli-Calmettes, Centre de Recherche en Cancérologie de Marseille (CRCM), 13009 Marseille, France
| | - Jean-Yves Blay
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France; Department of Translational Research in Pediatric Oncology PROSPECT, Centre Léon Bérard, 69008 Lyon, France
| | - Marie Castets
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France; Department of Translational Research in Pediatric Oncology PROSPECT, Centre Léon Bérard, 69008 Lyon, France.
| | - Laura Broutier
- Childhood Cancer & Cell Death Team (C3 Team), LabEx DEVweCAN, Institut Convergence Plascan, Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, 69008 Lyon, France; Department of Translational Research in Pediatric Oncology PROSPECT, Centre Léon Bérard, 69008 Lyon, France.
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Di Prata C, Renouf B, Tzanis D, Bouhadiba T, Watson S, Zein SE, Helfre S, Nicolas N, Perlbarg-Samson J, Brenet O, Bonvalot S. Significant Predictors of Postoperative Morbidity After Radical Resection of Retroperitoneal Sarcoma in a Tertiary Center. Ann Surg Oncol 2023; 30:4515-4526. [PMID: 37160805 DOI: 10.1245/s10434-023-13459-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 12/21/2022] [Accepted: 02/16/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND The safety of multivisceral resection of retroperitoneal sarcoma is an issue. Previous reports have investigated its associations with the pattern of resection and factors recognized mostly per operatively. METHODS All consecutive RPS resections from May 2015 to April 2022 were studied retrospectively with respect to adverse events. Two univariate and multivariate logistic regression analyses were performed to investigate the associations between severe adverse events and factors recognized pre- and per operatively. Associations of adverse events with overall survival (OS) and local recurrence (LR) were investigated. RESULTS A total of 265 surgical interventions corresponding to 251 patients were recorded (38 RPS surgeries/year). Severe postoperative adverse events (Clavien-Dindo ≥ 3) occurred in 50 patients (18.9%), 15 (5.6%) patients underwent an iterative laparotomy, and 6 patients (2.3%) died within 90 days. On multivariate analysis including all parameters known preoperatively, male sex, performance status, dedifferentiated liposarcoma histology, and low serum albumin level were found to be significant predictors of major complications, whereas the timing of surgery and preoperative treatment were not. On univariate analysis including all per operative parameters, transfusion requirement, operative time, number of digestive anastomoses, and pancreas and/or major arterial resection were found to entail higher operative risk. On multivariate analysis, only transfusion requirement was significant. There was no impact of postoperative adverse events on OS or LR. CONCLUSIONS The recognition of preoperative parameters that impact safety could mitigate the extent of the surgery, specifically the resection of adherent organs not overtly invaded. For the best decision, this surgery should be performed in referral centers.
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Affiliation(s)
- Claudia Di Prata
- Department of Surgical Oncology, Institute Curie, Paris, France
- Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padua, Padua, Italy
| | - Benjamin Renouf
- Department of Hospital Research Direction, Institute Curie, Paris, France
| | - Dimitri Tzanis
- Department of Surgical Oncology, Institute Curie, Paris, France
| | | | - Sarah Watson
- Department of Medical Oncology, Institute Curie, Paris, France
| | - Sophie El Zein
- Department of Biopathology, Institute Curie, Paris, France
| | - Sylvie Helfre
- Department of Radiotherapy, Institute Curie, Paris, France
| | - Nayla Nicolas
- Department of Radiology, Institute Curie, Paris, France
| | | | - Olivier Brenet
- Department of Anesthesiology, Institute Curie, Paris, France
| | - Sylvie Bonvalot
- Department of Surgical Oncology, Institute Curie, Paris, France.
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5
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Di Prata C, Renouf B, Tzanis D, Bouhadiba T, Watson S, El Zein S, Helfre S, Nicolas N, Perlbarg-Samson J, Brenet O, Bonvalot S. ASO Visual Abstract: Significant Predictors of Postoperative Morbidity After Radical Resection of Retroperitoneal Sarcoma in a Tertiary Center. Ann Surg Oncol 2023; 30:4529-4530. [PMID: 37170038 DOI: 10.1245/s10434-023-13550-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Affiliation(s)
- Claudia Di Prata
- Department of Surgical Oncology, Institute Curie, Paris, France
- Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padua, Padua, Italy
| | - Benjamin Renouf
- Department of Hospital Research Direction, Institute Curie, Paris, France
| | - Dimitri Tzanis
- Department of Surgical Oncology, Institute Curie, Paris, France
| | | | - Sarah Watson
- Department of Medical Oncology, Institute Curie, Paris, France
| | - Sophie El Zein
- Department of Biopathology, Institute Curie, Paris, France
| | - Sylvie Helfre
- Department of Radiotherapy, Institute Curie, Paris, France
| | - Nayla Nicolas
- Department of Radiology, Institute Curie, Paris, France
| | | | - Olivier Brenet
- Department of Anesthesiology, Institute Curie, Paris, France
| | - Sylvie Bonvalot
- Department of Surgical Oncology, Institute Curie, Paris, France.
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Vinciguerra A, Bedarida V, Pronier C, El Zein S, Wassef M, Atallah S, Chatelet F, Molher J, Manivet P, Herman P, Adle-Biassette H, Verillaud B. Expression, Prognostic Value and Correlation with HPV Status of Hypoxia-Induced Markers in Sinonasal Squamous Cell Carcinoma. J Pers Med 2023; 13:jpm13050767. [PMID: 37240937 DOI: 10.3390/jpm13050767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 04/26/2023] [Accepted: 04/28/2023] [Indexed: 05/28/2023] Open
Abstract
(1) Background: In head and neck squamous cell carcinoma, tumor hypoxia has been associated with radio/chemoresistance and poor prognosis, whereas human papillomavirus (HPV)-positive status has a positive impact on treatment response and survival outcomes. The aim of this study was to evaluate the expression and the potential prognostic value of hypoxia-induced endogenous markers in patients treated for squamous cell carcinoma of the nasal cavity and paranasal sinuses (SNSCC), and their correlation with HPV status. (2) Methods: In this monocentric study, patients treated in a curative intent for a SNSCC were screened retrospectively. Protein expression of CA-IX, GLUT-1, VEGF, VEGF-R1, and HIF-1α was determined by immunohistochemical staining, scored, and then correlated with overall survival (OS) and locoregional recurrence free survival (LRRFS). HPV status was assessed and correlated with hypoxic markers. (3) Results: 40 patients were included. A strong expression of CA-IX, GLUT-1, VEGF, and VEGF-R1 was detected in 30%, 32.5%, 50%, and 37.5% of cases, respectively. HIF-1α was detected in 27.5% of cases. High CA-IX expression was associated in univariate analysis with poor OS (p = 0.035), but there was no significant association between GLUT-1, VEGF, VEGF-R1, and HIF-1α expression, and OS/LRRFS. There was no correlation found between HPV status and hypoxia-induced endogenous markers (all p > 0.05). (4) Conclusions: This study provides data on the expression of hypoxia-induced endogenous markers in patients treated for SNSCC and underlines the potential role of CA-IX as a prognostic biomarker for SNSCC.
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Affiliation(s)
- Alessandro Vinciguerra
- Otorhinolaryngology and Skull Base Center, AP-HP, Hôpital Lariboisière, 75010 Paris, France
| | - Vincent Bedarida
- Otorhinolaryngology and Skull Base Center, AP-HP, Hôpital Lariboisière, 75010 Paris, France
- Centre de Ressources Biologiques Biobank Lariboisière (BB-0033-00064), DMU BioGem, AP-HP, 75010 Paris, France
| | - Charlotte Pronier
- Université Rennes, CHU Rennes, Virology, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) UMR_S 1085, F-35000 Rennes, France
| | - Sophie El Zein
- Pathology Department, Institut Curie, 75010 Paris, France
| | - Michel Wassef
- Pathology Department, DMU DREAM, AP-HP, Hôpital Lariboisière, 75010 Paris, France
| | - Sarah Atallah
- Otorhinolaryngology and Skull Base Center, AP-HP, Hôpital Lariboisière, 75010 Paris, France
- Université Paris Cité, 75010 Paris, France
| | - Florian Chatelet
- Otorhinolaryngology and Skull Base Center, AP-HP, Hôpital Lariboisière, 75010 Paris, France
- Université Paris Cité, 75010 Paris, France
- INSERM UMR 1153 ECSTRRA Team, 75010 Paris, France
| | - Joffrey Molher
- Otorhinolaryngology and Skull Base Center, AP-HP, Hôpital Lariboisière, 75010 Paris, France
| | - Philippe Manivet
- Centre de Ressources Biologiques Biobank Lariboisière (BB-0033-00064), DMU BioGem, AP-HP, 75010 Paris, France
- Université Paris Cité, 75010 Paris, France
- INSERM U1141 NeuroDiderot, 75010 Paris, France
| | - Philippe Herman
- Otorhinolaryngology and Skull Base Center, AP-HP, Hôpital Lariboisière, 75010 Paris, France
- Université Paris Cité, 75010 Paris, France
- INSERM U1141 NeuroDiderot, 75010 Paris, France
| | - Homa Adle-Biassette
- Pathology Department, DMU DREAM, AP-HP, Hôpital Lariboisière, 75010 Paris, France
- Université Paris Cité, 75010 Paris, France
- INSERM U1141 NeuroDiderot, 75010 Paris, France
| | - Benjamin Verillaud
- Otorhinolaryngology and Skull Base Center, AP-HP, Hôpital Lariboisière, 75010 Paris, France
- Université Paris Cité, 75010 Paris, France
- INSERM U1141 NeuroDiderot, 75010 Paris, France
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7
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Gruel N, Quignot C, Vibert J, Bonvalot S, Zein SE, Tzanis D, Baulande S, Mariani O, Waterfall J, Delattre O, Watson S. Abstract 96: Integrated molecular analysis of human dedifferentiated liposarcoma identifies a population of liposarcoma progenitors vulnerable to TGF beta inhibition. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-96] [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: 04/07/2023]
Abstract
Abstract
Introduction: Dedifferentiated liposarcomas (DDLPS) are the most frequent high-grade soft tissue sarcoma in adults. From a pathological point of view, these tumors are composed of high-grade undifferentiated tumor cells (DD), often showing an abrupt transition from a compartment of well-differentiated adipocytic tumor cells (WD). Tumor cells from both WD and DD compartments are characterized by recurrent MDM2 amplification, but their cellular origin and the molecular mechanisms associated with dedifferentiation are poorly understood.
Methods: We performed an integrated molecular analysis of tumors collected from 11 patients undergoing surgery for primary untreated DDLPS. DDLPS tumors were analyzed by single-cell RNA sequencing (scRNAseq) and bulk RNA sequencing on paired WD and DD samples from the same tumors. Results were validated in vitro and in vivo in an additional cohort of human tumors, patient-derived xenografts and DDLPS cell lines.
Results: Through RNA-sequencing of 102,753 individual cells from 11 primary DDLPS lesions, major cell clusters were identified based on unsupervised clustering of gene expression profiles and canonical markers. They include 31 tumor microenvironment clusters and 11 tumor cell clusters. A cluster of tumor cells from the WD compartment is characterized by signatures of early adipocytic progenitors, previously identified as TGFβ-dependent, DPP4-positive stromal progenitors. We show that these cells harbor specifically the truncal genomic alterations of the cancer, with further subclonal mutations identifiable in both WD and DD compartments of DDLPS. Furthermore, these cells have multipotent properties and their differentiation towards the adipocytic lineage is inhibited by TGFβ. Treatment of DD tumor cells with TGFβ inhibitors restores their adipocytic phenotype in vitro and in vivo.
Conclusion: We provide the first single-cell atlas of human DDLPS tumor and microenvironment and identify a population of adipocytic tumor progenitors at the origin of both WD and DD compartments. This study provides rationale for the development of therapeutic strategies based on TGFβ inhibition in advanced DDLPS.
Citation Format: Nadège Gruel, Chloé Quignot, Julien Vibert, Sylvie Bonvalot, Sophie El Zein, Dimitri Tzanis, Sylvain Baulande, Odette Mariani, Joshua Waterfall, Olivier Delattre, Sarah Watson. Integrated molecular analysis of human dedifferentiated liposarcoma identifies a population of liposarcoma progenitors vulnerable to TGF beta inhibition [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 96.
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8
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Gruel N, El Zein S, Tzanis D, Nicolas N, Maraval A, Fieffe C, Bonvalot S, Caly M, Fuhrmann L, Ait Rais K, Jovelin S, Bonnet C, Pierron G, Watson S. MDM4 amplification in atypical lipomatous tumors/well-differentiated liposarcoma: Private event or alternative oncogenic mechanism? Genes Chromosomes Cancer 2023; 62:367-372. [PMID: 36744846 DOI: 10.1002/gcc.23130] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 01/28/2023] [Accepted: 01/31/2023] [Indexed: 02/07/2023] Open
Abstract
Adipocytic tumors are the most common mesenchymal tumors in soft tissues. Among them, a diagnostic challenge relies in the distinction between lipoma and atypical lipomatous tumor (ALT)/well differentiated liposarcoma (WDLPS), as both entities are often undistinguishable not only from a radiological point of view, but also at the microscopic level and particularly when dealing with small tumor specimen. Thus, detection of recurrent MDM2 amplifications may be the only criteria to discriminate malignant tumors from lipomas. In this study, we report the case of a patient diagnosed with a well differentiated, adipocytic tumor located in the inferior limb and lacking MDM2 amplification, whose diagnosis was reclassified for ALT/WDLPS after identification of an alternative MDM4 amplification by comparative genomic hybridization profiling, whole exome sequencing and fluorescence in situ hybridization (FISH). Screening of a cohort of 37 large, deep-seated, well-differentiated adipocytic tumors previously classified as lipomas using RT-qPCR and FISH failed to detect other cases of MDM4-amplified ALT/WDLPS. This report shows that MDM4 amplification is an exceptional molecular event alternative to MDM2 amplification in ALT/WDLPS. This alteration should be considered and looked for in suspicious adipocytic tumors to optimize their surgical management.
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Affiliation(s)
- Nadège Gruel
- INSERM U830, Équipe Labellisée Ligue Nationale Contre le Cancer, Diversity and Plasticity of Childhood Tumors Lab, PSL Research University, Institut Curie Research Center, Paris, France.,Department of Translationnal Research, Institut Curie Research Center, Paris, France
| | - Sophie El Zein
- Department of Diagnostic and Theranostic Medecine, Institut Curie Hospital, Paris, France
| | - Dimitri Tzanis
- Department of Surgical Oncology, Institut Curie Hospital, Paris, France
| | - Nayla Nicolas
- Department of Radiology, Institut Curie Hospital, Paris, France
| | - Aurélien Maraval
- INSERM U830, Équipe Labellisée Ligue Nationale Contre le Cancer, Diversity and Plasticity of Childhood Tumors Lab, PSL Research University, Institut Curie Research Center, Paris, France
| | - Christelle Fieffe
- INSERM U830, Équipe Labellisée Ligue Nationale Contre le Cancer, Diversity and Plasticity of Childhood Tumors Lab, PSL Research University, Institut Curie Research Center, Paris, France
| | - Sylvie Bonvalot
- Department of Surgical Oncology, Institut Curie Hospital, Paris, France
| | - Martial Caly
- Department of Diagnostic and Theranostic Medecine, Institut Curie Hospital, Paris, France
| | - Laetitia Fuhrmann
- Department of Diagnostic and Theranostic Medecine, Institut Curie Hospital, Paris, France
| | - Khadija Ait Rais
- Somatic Genetic Unit, Department of Genetics, Institut Curie Hospital, Paris, France
| | - Sylvie Jovelin
- Department of Diagnostic and Theranostic Medecine, Institut Curie Hospital, Paris, France
| | - Clément Bonnet
- Department of Medical Oncology, Institut Curie Hospital, Paris, France
| | - Gaëlle Pierron
- Somatic Genetic Unit, Department of Genetics, Institut Curie Hospital, Paris, France
| | - Sarah Watson
- INSERM U830, Équipe Labellisée Ligue Nationale Contre le Cancer, Diversity and Plasticity of Childhood Tumors Lab, PSL Research University, Institut Curie Research Center, Paris, France.,Department of Medical Oncology, Institut Curie Hospital, Paris, France
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Smadja J, El Zein S, Pierron G, Watson S, Laas E, Ramtohul T, Tzanis D, Servois V, Bonvalot S. Percutaneous Uterine Needle Biopsy with Microscopic and Array-CGH Analyses for Preoperative Sarcoma Diagnosis in Patients with Suspicious Myometrial Tumors on MRI: A Prospective Pilot Study (SARCGYN). Ann Surg Oncol 2023; 30:943-953. [PMID: 36287348 DOI: 10.1245/s10434-022-12697-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 10/04/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND Unlike for soft tissue sarcomas, percutaneous biopsy is not validated for uterine myometrial tumors, leading to leiomyosarcoma inadvertent morcellation and overtreatment in childbearing patients. This study aimed to evaluate preoperative percutaneous uterine needle biopsy (PUB) with microscopic examination (M-PUB) and array-comparative genomic hybridization (MCGH-PUB). METHODS This was a prospective single-center cohort study including all consecutive patients who were candidates for hysterectomy because of suspected uterine leiomyosarcoma on magnetic resonance imaging (MRI) who received PUB. Microscopic and array-CGH analyses with genomic index (GI) counts were performed to guide the therapeutic strategy. Smooth-muscle tumors with suspect features with a GI above 15 were deemed malignant, as were tumors without microscopic malignant features with a complex genomic profile (GI above 30 or malignant profile). Preoperative diagnoses based on M-PUB and MCGH-PUB were compared with the postsurgical pathological specimen or follow-up. RESULTS From November 2016 to February 2022, 34 patients were included. Based on the surgical specimen (N = 23) or follow-up (N = 11), final diagnoses were 11 sarcomas and 23 non-sarcomas. The median follow-up was 12 months (IQR 6-37). The diagnostic accuracies of M-PUB and MCGH-PUB were 94% and 100%, respectively. The sensitivity, specificity, and negative predictive value of MCGH-PUB were 100%, 100%, and 100%, respectively. A high GI was significantly associated with malignancy (P < 0.001). Genomic analyses allowed malignancy upgrades for four tumors. There were no complications and no dissemination along the biopsy track. CONCLUSION MCGH-PUB is safe and accurate for preoperatively diagnosing uterine sarcomas and should be used routinely after suspicious MRI to tailor surgery.
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Affiliation(s)
- Jeremy Smadja
- Department of Radiology, Institut Curie, Université Paris Sciences et Lettres, Paris, France
| | - Sophie El Zein
- Department of Pathology, Institut Curie, Université Paris Sciences et Lettres, Paris, France
| | - Gaelle Pierron
- Laboratory of Somatic Genetics, Institut Curie, Université Paris Sciences et Lettres, Paris, France
| | - Sarah Watson
- Department of Medical Oncology, Institut Curie, Université Paris Sciences et Lettres, Paris, France
| | - Enora Laas
- Department of Surgical Oncology, Institut Curie, Université Paris Sciences et Lettres, Paris, France
| | - Toulsie Ramtohul
- Department of Radiology, Institut Curie, Université Paris Sciences et Lettres, Paris, France
| | - Dimitri Tzanis
- Department of Surgical Oncology, Institut Curie, Université Paris Sciences et Lettres, Paris, France
| | - Vincent Servois
- Department of Radiology, Institut Curie, Université Paris Sciences et Lettres, Paris, France
| | - Sylvie Bonvalot
- Department of Surgical Oncology, Institut Curie, Université Paris Sciences et Lettres, Paris, France.
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Smadja J, Zein SE, Pierron G, Watson S, Laas E, Ramtohul T, Tzanis D, Servois V, Bonvalot S. ASO Visual Abstract: Percutaneous Uterine Needle Biopsy with Microscopic and Array-CGH Analyses for Preoperative Sarcoma Diagnosis in Patients with Suspicious Myometrial Tumors on MRI: A Prospective Pilot Study (SARCGYN). Ann Surg Oncol 2023; 30:956-957. [PMID: 36417004 DOI: 10.1245/s10434-022-12799-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Jeremy Smadja
- Departments of Radiology, Institut Curie, Université Paris Sciences et Lettres, Paris, France
| | - Sophie El Zein
- Departments of Pathology, Institut Curie, Université Paris Sciences et Lettres, Paris, France
| | - Gaelle Pierron
- Laboratory of Somatic Genetics, Institut Curie, Université Paris Sciences et Lettres, Paris, France
| | - Sarah Watson
- Departments of Medical Oncology, Institut Curie, Université Paris Sciences et Lettres, Paris, France
| | - Enora Laas
- Department of Surgical Oncology, Institut Curie, Université Paris Sciences et Lettres, Paris, France
| | - Toulsie Ramtohul
- Departments of Radiology, Institut Curie, Université Paris Sciences et Lettres, Paris, France
| | - Dimitri Tzanis
- Department of Surgical Oncology, Institut Curie, Université Paris Sciences et Lettres, Paris, France
| | - Vincent Servois
- Departments of Radiology, Institut Curie, Université Paris Sciences et Lettres, Paris, France
| | - Sylvie Bonvalot
- Department of Surgical Oncology, Institut Curie, Université Paris Sciences et Lettres, Paris, France.
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11
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Djerroudi L, Masliah-Planchon J, Brisse HJ, El Zein S, Helfre S, Tzanis D, Hamzaoui N, Bonnet C, Laurence V, Bonvalot S, Watson S. Metastatic Malignant Perivascular Epithelioid Cell Tumors With Microsatellite Instability Within Lynch Syndrome Successfully Treated With Anti-PD1 Pembrolizumab. JCO Precis Oncol 2023; 7:e2200627. [PMID: 36716416 PMCID: PMC9928971 DOI: 10.1200/po.22.00627] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Sarcoma developed within Lynch Syndrome are rare but must be recognized. They can show complete response to anti-PD1
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Affiliation(s)
- Lounes Djerroudi
- Department of Diagnostic and Theranostic Medicine, Institut Curie Hospital, Paris, France
| | | | - Hervé J. Brisse
- Department of Radiology, Institut Curie Hospital, Paris, France
| | - Sophie El Zein
- Department of Diagnostic and Theranostic Medicine, Institut Curie Hospital, Paris, France
| | - Sylvie Helfre
- Department of Radiotherapy, Institut Curie Hospital, Paris, France
| | - Dimitri Tzanis
- Department of Surgical Oncology, Institut Curie Hospital, Paris, France
| | - Nadim Hamzaoui
- INSERM U1016, CNRS UMR8104, Université de Paris, CARPEM, Institut Cochin, Paris, France,Fédération de Génétique et Médecine Génomique, Hôpital Cochin, AP-HP Centre-Université de Paris, Paris, France
| | - Clément Bonnet
- Department of Medical Oncology, Institut Curie Hospital, Paris, France
| | - Valérie Laurence
- Department of Medical Oncology, Institut Curie Hospital, Paris, France
| | - Sylvie Bonvalot
- Department of Surgical Oncology, Institut Curie Hospital, Paris, France
| | - Sarah Watson
- Department of Medical Oncology, Institut Curie Hospital, Paris, France,INSERM U830, Équipe Labellisée Ligue Nationale Contre le Cancer, Diversity and Plasticity of Childhood Tumors Lab, PSL Research University, Institut Curie Research Center, Paris, France,Sarah Watson, MD, PhD, Department of Medical Oncology, Institut Curie Hospital, 26 rue d'Ulm, Paris 75005, France; Twitter: @SarahWatson1985; e-mail:
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12
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Vinciguerra A, Excoffier A, Zhi N, Guichard JP, Eliezer M, Zein SE, Kania R, Thieblemont C, Herman P, Verillaud B. Diagnostic value of permeative invasion radiologic pattern in sinonasal lymphomas. Int Forum Allergy Rhinol 2023; 13:85-87. [PMID: 35796523 DOI: 10.1002/alr.23057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 06/28/2022] [Accepted: 07/01/2022] [Indexed: 01/06/2023]
Affiliation(s)
| | - Aude Excoffier
- Otorhinolaryngology and Skull Base Center, AP-HP, Hospital, Lariboisière, Paris, France
| | - Nanxhi Zhi
- Department of Neuroradiology, AP-HP, Hôpital Lariboisière, Paris, France.,Université Paris Cité, Paris, France
| | | | - Michael Eliezer
- Department of Neuroradiology, AP-HP, Hôpital Lariboisière, Paris, France.,Université Paris Cité, Paris, France
| | - Sophie El Zein
- Université Paris Cité, Paris, France.,Department of Pathology, AP-HP, Hôpital Lariboisière, Paris, France
| | - Romain Kania
- Otorhinolaryngology and Skull Base Center, AP-HP, Hospital, Lariboisière, Paris, France.,Université Paris Cité, Paris, France.,Inserm U1141, Paris, France
| | - Catherine Thieblemont
- Université Paris Cité, Paris, France.,Department of Onco-hematology, AP-HP, Hôpital Saint Louis, Paris, France
| | - Philippe Herman
- Otorhinolaryngology and Skull Base Center, AP-HP, Hospital, Lariboisière, Paris, France.,Université Paris Cité, Paris, France.,Inserm U1141, Paris, France
| | - Benjamin Verillaud
- Otorhinolaryngology and Skull Base Center, AP-HP, Hospital, Lariboisière, Paris, France.,Université Paris Cité, Paris, France.,Inserm U1141, Paris, France
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13
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Smadja J, Servois V, Pierron G, Zein SE, Laas E, Ramtohul T, Tzanis D, Watson S, Bonvalot S. 2022-RA-872-ESGO Percutaneous uterine needle biopsy with microscopic and array-CGH analyses in patients with suspicious myometrial tumors on MRI: a prospective study. Diagnostics (Basel) 2022. [DOI: 10.1136/ijgc-2022-esgo.164] [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: 12/23/2022] Open
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14
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Damiani G, Mikhael R, Tzanis D, El Zein S, Bonvalot S. Desmoid Tumors Arising on the Mesenteric Surgical Scar of Abdominal Sarcomas. Cureus 2022; 14:e21727. [PMID: 35251801 PMCID: PMC8887548 DOI: 10.7759/cureus.21727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2022] [Indexed: 11/05/2022] Open
Abstract
A sporadic desmoid tumor (DT) is a rare type of tumor of the mesenchymal connective tissues is now considered an intermediate disease or locally aggressive. They may develop on scars or after traumatism, favored by growth factors released during the initial phase of wound healing. Most of the abdominal DT arising on a scar is described on the wall incision. In this report, we describe two cases of DT arising on the intraperitoneal surgical scar, shortly after the resection of a low-grade retroperitoneal liposarcoma and a low-risk gastric gastrointestinal stromal tumor (GIST). Inconsistency between low risk according to the classification of the primary sarcoma and early local recurrence (LR) should raise the possibility of DT. Core needle biopsy (CNB) should be performed when it is feasible, including on local recurrences (LR). Surveillance has become the first-line treatment for DT. In case of progression between two imaging during the surveillance phase, surgery, when it's not mutilating, is indicated for selected cases as second-line treatment.
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El Zein S, Djeroudi L, Reynaud S, Guillemot D, Masliah-Planchon J, Frouin E, Nicolas N, Le Loarer F, Daniel C, Delattre O, Pierron G, Watson S. Novel EWSR1-UBP1 fusion expands the spectrum of spindle cell rhabdomyosarcomas. Genes Chromosomes Cancer 2021; 61:200-205. [PMID: 34877752 DOI: 10.1002/gcc.23019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 11/09/2021] [Revised: 12/02/2021] [Accepted: 12/04/2021] [Indexed: 01/09/2023] Open
Abstract
Over the last decade, the development of next-generation sequencing techniques has led to the molecular dismantlement of adult and pediatric sarcoma, with the identification of multiple gene fusions associated with specific subtypes and currently integrated into diagnostic classifications. In this report, we describe and discuss the identification of a novel EWSR1-UBP1 gene fusion in an adult patient presenting with multi-metastatic sarcoma. Extensive pathological, transcriptomic, and genomic characterization of this tumor in comparison with a cohort of different subtypes of pediatric and adult sarcoma revealed that this fusion represents a novel variant of spindle cell rhabdomyosarcoma with features of TFCP2-rearranged subfamily.
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Affiliation(s)
- Sophie El Zein
- Department of Diagnostic and Theranostic Medicine, Institut Curie Hospital, Paris, France
| | - Lounes Djeroudi
- Department of Diagnostic and Theranostic Medicine, Institut Curie Hospital, Paris, France
| | - Stéphanie Reynaud
- Somatic Genetic Unit, Department of Genetics, Institut Curie Hospital, Paris, France
| | - Delphine Guillemot
- Somatic Genetic Unit, Department of Genetics, Institut Curie Hospital, Paris, France
| | | | - Eléonore Frouin
- Bioinformatic Unit, Department of Genetics, Institut Curie Hospital, Paris, France
| | - Nayla Nicolas
- Department of Radiology, Institut Curie Hospital, Paris, France
| | - François Le Loarer
- Department of Pathology, Institut Bergonié Hospital, Bordeaux, France.,University of Bordeaux, Talence, France.,INSERM U1218, ACTION, Bordeaux, France
| | - Catherine Daniel
- Department of Medical Oncology, Institut Curie Hospital, Paris, France
| | - Olivier Delattre
- Somatic Genetic Unit, Department of Genetics, Institut Curie Hospital, Paris, France.,INSERM U830, Équipe Labellisée Ligue Nationale Contre le Cancer, Diversity and Plasticity of Childhood Tumors Lab, PSL Research University, Institut Curie Research Center, Paris, France
| | - Gaëlle Pierron
- Somatic Genetic Unit, Department of Genetics, Institut Curie Hospital, Paris, France
| | - Sarah Watson
- Department of Medical Oncology, Institut Curie Hospital, Paris, France.,INSERM U830, Équipe Labellisée Ligue Nationale Contre le Cancer, Diversity and Plasticity of Childhood Tumors Lab, PSL Research University, Institut Curie Research Center, Paris, France
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16
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Schmidt BAR, El Zein S, Cuoto J, Al-Ibraheemi A, Liang MG, Paltiel HJ, Anderson ME, Labow BI, Upton J, Fishman SJ, Mulliken JB, Greene AK, Warman ML, Kozakewich H. Verrucous Venous Malformation-Subcutaneous Variant. Am J Dermatopathol 2021; 43:e181-e184. [PMID: 33899768 DOI: 10.1097/dad.0000000000001963] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 11/26/2022]
Abstract
BACKGROUND Verrucous venous malformation (VVM), previously called "verrucous hemangioma," typically involves the dermis and the subcutaneous fat. We have encountered patients with VVM confined to the hypodermis. MATERIALS AND METHODS During a nearly 20-year period, 13 patients, aged 2-17 years, presented with a subcutaneous mass in the limb without clinically obvious epidermal alterations. Consequently, operative excisions did not include the skin. RESULTS Histopathologically, the specimens were composed of blood-filled channels with morphologic characteristics of capillaries and veins that infiltrated adipose tissue. Aggregates often formed nodules with variable fibrosis and a component of large and radially oriented vessels. A diagnosis of VVM was supported by endothelial immunopositivity for GLUT-1 (25%-75% immunopositive channels in 16/16 specimens); D2-40 (1%-25% channels in 14/15 specimens); and Prox-1 (1%-50% of channels in 14/16 specimens). A MAP3K3 mutation was identified by droplet digital PCR in 3 of the 6 specimens. CONCLUSIONS Diagnosis of VVM in this uncommon location is challenging because of absence of epidermal changes and lack of dermal involvement. Imaging is not pathognomonic, and mimickers are many. Appropriate immunohistochemical stains and molecular analysis contribute to the correct diagnosis.
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Affiliation(s)
- Birgitta A R Schmidt
- Department of Pathology, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | | | - Javier Cuoto
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA
| | - Alyaa Al-Ibraheemi
- Department of Pathology, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Marilyn G Liang
- Department of Dermatology, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Harriet J Paltiel
- Department of Radiology, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Megan E Anderson
- Department of Orthopaedics, Beth Israel Deaconess Medical Center, Boston, MA
| | - Brian I Labow
- Department of Plastic and Oral Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Joseph Upton
- Department of Plastic and Oral Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Steven J Fishman
- Department of Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA; and
| | - John B Mulliken
- Department of Plastic and Oral Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Arin K Greene
- Department of Plastic and Oral Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Mathew L Warman
- Department of Orthopedics, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Harry Kozakewich
- Department of Pathology, Boston Children's Hospital and Harvard Medical School, Boston, MA
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17
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El Zein S, Gruel N, Bonvalot S, Mir O, Watson S. Neoadjuvant Everolimus for Adult Giant Mesenteric Cystic Lymphangioma with mTOR Pathway Activation. Oncologist 2021; 26:554-557. [PMID: 33797168 DOI: 10.1002/onco.13775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 03/12/2021] [Indexed: 12/17/2022] Open
Abstract
Cystic lymphangioma are rare benign vascular or lymphatic tumors, diagnosed mostly in newborns or children, that may become life-threatening because of local invasiveness. Surgical "en-bloc" resection with negative margins is the only curative treatment, but some patients are diagnosed with unresectable tumors. We describe the case of a young adult with giant unresectable mesenteric lymphangioma. Extensive pathological characterization as well as whole exome and transcriptome sequencing enabled us to identify mTOR pathway activation within endothelial tumor cells. The patient was treated with everolimus and experienced major partial response, leading to the surgical resection of the residual lesions. This case highlights the importance of molecular characterization of adult cystic lymphangioma for mTOR pathway activation because multidisciplinary therapeutic approaches, including neoadjuvant everolimus and secondary surgery, can lead to complete cure of this rare condition. KEY POINTS: The case of an adult patient diagnosed with giant unresectable mesenteric cystic lymphangioma, in which activation of the mTOR pathway was documented at both the pathological and transcriptomic levels, is reported. This patient showed major partial response to the mTOR inhibitor everolimus, which led to the successful resection of residual tumor lesions after 9 months of treatment. This report shows that mTOR targeting should be considered as neoadjuvant treatment in adult large cystic lymphangioma, as it can lead to complete surgery and cure of this rare condition.
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Affiliation(s)
- Sophie El Zein
- Department of Pathology, Institut Curie Hospital, Paris, France
| | - Nadège Gruel
- INSERM U830, Équipe Labellisée Ligue Nationale Contre le Cancer, Diversity and Plasticity of Childhood Tumors Lab, Paris Sciences et Lettres Research University, Institut Curie Research Center, Paris, France.,Department of Translational Research, Paris Sciences et Lettres Research University, Institut Curie Research Center, Paris, France
| | - Sylvie Bonvalot
- Department of Surgical Oncology, Institut Curie Hospital, Paris, France
| | - Olivier Mir
- Sarcoma Group, Gustave Roussy Cancer Institute, Villejuif, France
| | - Sarah Watson
- Department of Medical Oncology, Institut Curie Hospital, Paris, France.,INSERM U830, Équipe Labellisée Ligue Nationale Contre le Cancer, Diversity and Plasticity of Childhood Tumors Lab, Paris Sciences et Lettres Research University, Institut Curie Research Center, Paris, France
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El Zein S, Boccara O, Soupre V, Vieira AF, Bodemer C, Coulomb A, Wassef M, Fraitag S. The histopathology of congenital haemangioma and its clinical correlations: a long-term follow-up study of 55 cases. Histopathology 2020; 77:275-283. [PMID: 32281140 DOI: 10.1111/his.14114] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 04/02/2020] [Accepted: 04/04/2020] [Indexed: 01/12/2023]
Abstract
AIMS Congenital haemangiomas (CHs) can be subdivided into different subtypes [rapidly involuting CHs (RICHs), non-involuting CHs (NICHs), and partially involuting CHs (PICHs)]. During the first few days of life, RICHs may be associated with transient but sometimes marked thrombocytopenia. We sought to assess the histological aspects and clinicopathological correlations of the three subtypes. METHODS AND RESULTS We assessed the histopathological features of 10 RICHs, 25 NICHs, and 20 PICHs, described the patients' long-term clinical outcomes, and assessed clinicopathological correlations. All CHs were located in the dermis and hypodermis, and comprised both capillary lobules (with three distinct histopathological patterns) and extralobular large vessels. Most of the extralobular vessels were abnormal veins and abnormal lymphatic vessels. We did not observe significant correlations between the CH subtype, the histopathological pattern, and the time of the histopathological assessment. Interestingly, unexpected intralobular expression of podoplanin was found in neonatal biopsies of five RICHs and PICHs. Four of these five patients had concomitant thrombocytopenia. The podoplanin staining intensity decreased over time as the thrombocytopenia resolved and the tumour shrank. CONCLUSION The histopathological features were similar in all three subtypes of CH, and were related to the time since disease onset; we consider that RICH, PICH and NICH form a single entity and differ only in their involuting potential. Along with the transient expression of intralobular podoplanin observed in some specimens from the newborn, the lobular architecture might lead to misdiagnosis of tufted haemangioma or kaposiform haemangioendothelioma.
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Affiliation(s)
- Sophie El Zein
- Department of Biopathology, Institut Curie, Paris Sciences et Lettres Research University, Paris, France
| | - Olivia Boccara
- Paediatric Dermatology Department, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.,Paris Descartes University, Sorbonne Paris Cité, Paris, France
| | - Véronique Soupre
- Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Plastic and Maxillofacial Surgery Department, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Andre F Vieira
- Department of Biopathology, Institut Curie, Paris Sciences et Lettres Research University, Paris, France
| | - Christine Bodemer
- Paediatric Dermatology Department, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.,Paris Descartes University, Sorbonne Paris Cité, Paris, France
| | - Aurore Coulomb
- Department of Pathology, Armand Trousseau Hospital, AP-HP, Paris, France.,Pierre et Marie Curie University, Paris, France
| | - Michel Wassef
- Department of Pathology, Lariboisière Hospital, Paris Diderot University, Université de Paris, Paris, France
| | - Sylvie Fraitag
- Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Pathology Department, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
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Classe M, Burgess A, El Zein S, Wassef M, Herman P, Mortuaire G, Leroy X, Malouf GG, Verillaud B. Evaluating the prognostic potential of the Ki67 proliferation index and tumour-infiltrating lymphocytes in olfactory neuroblastoma. Histopathology 2019; 75:853-864. [PMID: 31306501 DOI: 10.1111/his.13954] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Accepted: 07/11/2019] [Indexed: 12/11/2022]
Abstract
AIMS Olfactory neuroblastomas (ONBs) are rare malignant tumours that arise in the nasal vault. To date, the Hyams grade remains the only widely used histological grading system. However, it is based only on morphological criteria, and has not been updated since 1988. The objective of this study was to explore the prognostic potential of the Ki67 proliferation index (PI) and tumour-infiltrating lymphocytes (TILs) in ONB. METHODS AND RESULTS A retrospective study was conducted on a bicentric series of 45 cases. The Ki67 PI was determined by counting at least 1000 nuclei on whole slides. TILs were evaluated with CD20, CD4 and CD8 immunohistochemical markers on whole slides. In this series, Hyams grades I, II, III and IV accounted for 13.4%, 44.4%, 20% and 22.2% of all cases, respectively. The Ki67 PI ranged from 1 to 93; the Ki67 PI was significantly higher in Hyams grade III-IV ONBs than in Hyams grade I-II ONBs (P < 0.0001). A Ki67 PI of ≥25 was associated with poorer survival (P = 0.02). TILs were present in both stromal and intratumoral compartments, but were located predominantly in the stromal component of the tumour. The numbers of intratumoral CD8+ cells/mm2 and CD4+ cells/mm2 were greater in high-grade ONBs than in low-grade ONBs (P = 0.0015 and P = 0.043, respectively). The numbers of T cells/mm2 and B cells/mm2 were not associated with survival, but a CD4/CD8 ratio of >2 was significantly associated with shorter survival (P = 0.04). CONCLUSION Our findings suggest that the Ki67 PI and TILs could be used as prognostic markers, as a potential alternative to the Hyams grade.
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Affiliation(s)
- Marion Classe
- Department of Pathology, Institut Gustave Roussy, Villejuif, France
| | - Alice Burgess
- Department of Otolaryngology - Head and Neck Surgery, Assistance Publique-Hopitaux de Paris, Lariboisière Hospital, Paris, France.,Faculty of Medicine, Paris Diderot University, Paris, France
| | - Sophie El Zein
- Department of Pathology, Assistance Publique-Hopitaux de Paris, Lariboisière Hospital, Paris, France
| | - Michel Wassef
- Department of Pathology, Assistance Publique-Hopitaux de Paris, Lariboisière Hospital, Paris, France
| | - Philippe Herman
- Department of Otolaryngology - Head and Neck Surgery, Assistance Publique-Hopitaux de Paris, Lariboisière Hospital, Paris, France.,Faculty of Medicine, Paris Diderot University, Paris, France
| | - Geoffrey Mortuaire
- Department of Otolaryngology - Head and Neck Surgery, University Hospital and Lille 2 Faculty of Medicine, Lille, France
| | - Xavier Leroy
- Department of Pathology, University Hospital and Lille 2 Faculty of Medicine, Lille, France
| | - Gabriel G Malouf
- Department of Medical Oncology, Hôpitaux Universtiaires de Strasbourg, Institut de Génomique et de Biologie Moléculaire et Cellulaire, Strasbourg, France
| | - Benjamin Verillaud
- Department of Otolaryngology - Head and Neck Surgery, Assistance Publique-Hopitaux de Paris, Lariboisière Hospital, Paris, France.,Faculty of Medicine, Paris Diderot University, Paris, France
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Simon F, Feuvret L, Bresson D, Guichard JP, El Zein S, Bernat AL, Labidi M, Calugaru V, Froelich S, Herman P, Verillaud B. Surgery and protontherapy in Grade I and II skull base chondrosarcoma: A comparative retrospective study. PLoS One 2018; 13:e0208786. [PMID: 30557382 PMCID: PMC6296545 DOI: 10.1371/journal.pone.0208786] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 11/26/2018] [Indexed: 11/19/2022] Open
Abstract
Objective Skull base chondrosarcoma is a rare tumour usually treated by surgery and proton therapy. However, as mortality rate is very low and treatment complications are frequent, a less aggressive therapeutic strategy could be considered. The objective of this study was to compare the results of surgery only vs surgery and adjuvant proton therapy, in terms of survival and treatment adverse effects, based on a retrospective series. Methods Monocentric retrospective study at a tertiary care centre. All patients treated for a skull base grade I and II chondrosarcoma were included. We collected data concerning surgical and proton therapy treatment and up-to-date follow-up, including Common Terminology Criteria for Adverse Events (CTCAE) scores. Results 47 patients (23M/24F) were operated on between 2002 and 2015; mean age at diagnosis was 47 years-old (10–85). Petroclival and anterior skull base locations were found in 34 and 13 patients, respectively. Gross total resection was achieved in 17 cases (36%) and partial in 30 (64%). Adjuvant proton therapy (mean total dose 70 GyRBE,1.8 GyRBE/day) was administered in 23 cases. Overall mean follow-up was 91 months (7–182). Of the patients treated by surgery only, 8 (34%) experienced residual tumour progression (mean delay 51 months) and 5 received second-line proton therapy. Adjuvant proton therapy was associated with a significantly lower rate of relapse (11%; p = 0.01). There was no significant difference in 10-year disease specific survival between patients initially treated with or without adjuvant proton therapy (100% vs 89.8%, p = 0.14). Difference in high-grade toxicity was not statistically significant between patients in both groups (25% (7) vs 11% (5), p = 0.10). The most frequent adverse effect of proton therapy was sensorineural hearing loss (39%). Conclusion Long-term disease specific survival was not significantly lower in patients without adjuvant proton therapy, but they experienced less adverse effects. We believe a surgery only strategy could be discussed, delaying as much as possible proton therapy in cases of relapse. Further prospective studies are needed to validate this more conservative strategy in skull base chondrosarcoma.
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Affiliation(s)
- François Simon
- AP-HP, Hôpital Lariboisière, Department of Otorhinolaryngology and Paris Diderot University, Paris, France
- * E-mail:
| | - Loïc Feuvret
- AP-HP, Hôpital Pitié-Salpêtrière, Department of Radiation Oncology and Pierre et Marie Curie University, Paris, France
- Institut Curie-Centre de protonthérapie d’Orsay, Department of Radiation Oncology and INSERM U61, Centre Universitaire, Orsay, France
| | - Damien Bresson
- AP-HP, Hôpital Lariboisière, Department of Neurosurgery and Paris Diderot University, Paris, France
| | - Jean-Pierre Guichard
- AP-HP, Hôpital Lariboisière, Department of Radiology and Paris Diderot University, Paris, France
| | - Sophie El Zein
- AP-HP, Hôpital Lariboisière, Department of Pathology and Paris Diderot University, Paris, France
| | - Anne-Laure Bernat
- AP-HP, Hôpital Lariboisière, Department of Neurosurgery and Paris Diderot University, Paris, France
| | - Moujahed Labidi
- AP-HP, Hôpital Lariboisière, Department of Neurosurgery and Paris Diderot University, Paris, France
| | - Valentin Calugaru
- Institut Curie-Centre de protonthérapie d’Orsay, Department of Radiation Oncology and INSERM U61, Centre Universitaire, Orsay, France
| | - Sébastien Froelich
- AP-HP, Hôpital Lariboisière, Department of Neurosurgery and Paris Diderot University, Paris, France
| | - Philippe Herman
- AP-HP, Hôpital Lariboisière, Department of Otorhinolaryngology and Paris Diderot University, Paris, France
| | - Benjamin Verillaud
- AP-HP, Hôpital Lariboisière, Department of Otorhinolaryngology and Paris Diderot University, Paris, France
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