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Taieb J, Phelip J, Rinaldi Y, Barbier E, Bouche O, Khemissa Akouz F, Gratet A, Petorin C, Miglianico L, Malka D, Laharie Mineur H, Rebischung C, Lepage C, Francois E, Dahan L. Exploratory analyses of 400 patients enrolled in 2 FFCD trials of first line treatment for metastatic pancreatic cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy282.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Meunier-Beillard N, Ponthier N, Lepage C, Gagnaire A, Gheringuelli F, Bengrine L, Boudrant A, Rambach L, Quipourt V, Devilliers H, Lejeune C. Identification of resources and skills developed by partners of patients with advanced colon cancer: a qualitative study. Support Care Cancer 2018; 26:4121-4131. [PMID: 29872944 DOI: 10.1007/s00520-018-4283-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 05/21/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE Family caregivers play an important role in caring for patients with advanced cancer. To become competent, individuals must draw on and mobilise an adequate combination of resources. Our goal was to identify the skills developed by caregivers of patients with advanced cancer and the associated resources mobilised. We chose to do it with partners of patients with colon cancer. METHODS The study used a cross-sectional qualitative design based on 20 individual interviews and a focus group. Partners were recruited from patients treated in three hospitals of France. Semi-structured interviews were conducted until data saturation was achieved. Each interview was transcribed verbatim, and thematic analyses were performed to extract significant themes and subthemes. RESULTS Results from the individual and focus group interviews showed that the skills implemented by the partners (in domains of social relationships and health, domestic, organisational, emotional and well-being dimensions) were singular constructs, dependant on if resources (personal, external and schemes) may have been missing and insufficient. In addition, partners may have had these resources but not mobilised them. CONCLUSION The identification of the skills and associated resources could allow healthcare professionals better identifying and understanding of the difficulties met by partners in taking care of patients. This could enable them to offer appropriate support to help the caregivers in their accompaniment.
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Vicaut E, Smith D, Lombard-Bohas C, Dominguez S, Coriat R, Goichot B, Dubreuil O, Lecomte T, Santos A, Borie O, Lepage C. Étude OPALINE – étude observationnelle en vie réelle, des traitements systémiques des tumeurs neuroendocrines du pancréas (TNEp) non résécables ou métastatiques bien différenciées progressives. Rev Epidemiol Sante Publique 2018. [DOI: 10.1016/j.respe.2018.04.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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Vendrely V, Lemanski C, François E, Barbier E, Baba Hamed N, Bonichon-Lamichhane N, De La Rochefordière A, Bouché O, Tougeron D, Diaz O, Pommier P, Ronchin P, Saliou M, Cretin J, Lepage C, Quéro L. OC-0284: First results of the French cohort ANABASE : treatment and outcome in non-metastatic anal cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30594-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Mongaret C, Lepage C, Aubert L, Lestrille A, Slimano F. [Outcomes after a 2-year pharmaceutical care program for patients taking vitamin K antagonist therapy? Community pharmacist's perception]. ANNALES PHARMACEUTIQUES FRANÇAISES 2018; 76:114-121. [PMID: 29395013 DOI: 10.1016/j.pharma.2017.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 11/17/2017] [Accepted: 11/17/2017] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Since 2013 French community pharmacist are involved in pharmaceutical care program (PCP) for patients treated with vitamin K antagonist (VKA). While PCPs are now extending to other patient populations, we aimed to evaluate pharmacists' perception after 2-years implementation and leading of PCP. METHODS A prospective investigational survey from 1st August to 31st December, 2015 from 400 community pharmacies in Champagne-Ardenne Region. Survey focuses on 3 points: first about implementation and leading of PCP; secondly about patient's population description; finally on the global perception by CP about new tasks. RESULTS Among n=47, 72% of pharmacists performed VKA PCP. Almost all received appropriate training (96%). Remuneration appears to be insufficient given the time spent for 73%. Ninety-five percent met patient's refusal mainly because of interest lacking or time lacking (54% and 22%, respectively). Pharmacists reported 3 main lacks of knowledges of patients: drugs, which increase drug-drug interaction risk (28%), VKA overdose effects (27%) and VKA-food interactions (23%). Overall view of pharmacist for PCP appears to be positive (81%) in part because of improvement of pharmacist-patient relationship perception for 66%. CONCLUSIONS Community pharmacists' perception for PCP for patients treated by VKA is broadly positive. However, organizational or economic constraints can lead to a decreasing adherence by pharmacists to PCPs. A global issue about amount of compensation and communications campaigns to patients and others health professionals will be useful in order to reinforced PCP implementation and leading taxonomy.
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Bui P, Pons Guiraud A, Lepage C. [Benefits of volumetric to facial rejuvenation. Part 2: Dermal fillers]. ANN CHIR PLAST ESTH 2017; 62:550-559. [PMID: 28911889 DOI: 10.1016/j.anplas.2017.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 07/10/2017] [Indexed: 06/07/2023]
Abstract
Injectable substances known as fillers are used to palliate age-related atrophy and ptosis, and for their so-called "pseudo-lifting" action. They do not replace face and neck lift, but allow it to be postponed or, when injected after surgical lifting, make the result durable. Hyaluronic acid has a predominant and unchallenged place among fillers, well ahead of poly-L-lactic acid or calcium hydroxyapatite. Approaches and injection methods are the same for all fillers, corresponding to those for autologous fat injection, the reference substance, with a few particularities. The substance used, the level of hyaluronic acid reticulation, and the depth of the injection depend on the injection site and intended effect. Effects range from smoothing superficial wrinkles to remodeling whole parts of the face. Complications related to such fillers are well known, especially in the case of hyaluronic acid, where overcorrection is the most frequent. To limit the risk of complications and also to offer each patient the most individually adapted corrections, before any procedure, the plastic surgeon needs to question the patient and perform precise medical examination.
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Bachet JB, Lucidarme O, Levache C, Maillard E, Raoul J, Lecomte T, Desauw C, Brocard F, Pernot S, Breysacher G, Lagasse JP, Di Fiore F, Etienne P, Dupuis O, Aleba A, Lepage C, Taieb J. FOLFIRINOX as induction treatment in rectal cancer patients with synchronous metastases (RCSM): Final results of the FFCD 1102 phase II trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Gallois C, Taieb J, Le Corre D, Le Malicot K, Tabernero J, Mulot C, Seitz JF, Aparicio T, Folprecht G, Lepage C, Mini E, Van Laethem JL, Emile J, Laurent-Puig P. Prognostic value of methylator phenotype in stage III colon cancer treated with oxaliplatin-based adjuvant chemotherapy. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Michel P, André T, Boige V, Aparicio T, Maillard E, Bez J, Blot J, Bachet JB, Dahan L, Guimbaud R, Manfredi S, Tougeron D, Taieb J, Selves J, Lepage C, Di Fiore F. PRODIGE 50 - ASPIK French: French double blind randomised study of aspirin versus placebo in resected stage III or high risk stage II colon cancer with PIK3CA mutation. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Karoui M, Rullier A, Mariette C, Maillard E, Bardier A, Poizat F, Luciani A, Sarran A, Legoux JL, De Chaisemartin C, Lecaille C, Bouche O, Mauvais F, Brunetti F, Prudhomme M, Seitz JF, Lepage C, Taieb J. Neoadjuvant FOLFOX 4 versus FOLFOX 4 plus cetuximab versus immediate surgery for high-risk stage II and III colon cancers: A phase II multicentre randomised controlled trial (PRODIGE 22). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Aparicio T, Bennouna J, Le Malicot K, Boige V, Taieb J, Bouche O, Francois E, Phelip JM, Borel C, Faroux R, Dahan L, Bachet JB, Egreteau J, Kaminsky-Forrett MC, Gornet JM, Cojocarasu O, Gasmi M, Guerin-Meyer V, Ghiringhelli F, Lepage C. Predictive factors for early progression during induction chemotherapy (IC) and chemotherapy-free interval (CFI): Analysis from PRODIGE 9 trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Walter T, Tougeron D, Baudin E, Le Malicot K, Lecomte T, Malka D, Hentic O, Manfredi S, Bonnet I, Guimbaud R, Coriat R, Lepère C, Desauw C, Thirot-Bidault A, Dahan L, Roquin G, Aparicio T, Legoux JL, Lombard-Bohas C, Scoazec JY, Lepage C, Cadiot G. Poorly differentiated gastro-entero-pancreatic neuroendocrine carcinomas: Are they really heterogeneous? Insights from the FFCD-GTE national cohort. Eur J Cancer 2017; 79:158-165. [PMID: 28501762 DOI: 10.1016/j.ejca.2017.04.009] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 04/05/2017] [Accepted: 04/06/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Diagnosis and management of poorly differentiated gastro-entero-pancreatic (GEP) neuroendocrine carcinomas (NECs) remain challenging. Recent studies suggest prognostic heterogeneity. We designed within the French Group of Endocrine Tumours a prospective cohort to gain insight in the prognostic stratification and treatment of GEP-NEC. PATIENTS AND METHODS All patients with a diagnosis of GEP-NEC between 1st January 2010 and 31st December 2013 could be included in this national cohort. Adenoneuroendocrine tumours were excluded. RESULTS 253 patients from 49 centres were included. Median age was 66 years. Main primary locations were pancreas (21%), colorectal (27%), oesophagus-stomach (18%); primary location was unknown in 20%. Tumours were metastatic at diagnosis in 78% of cases. Performance status (PS) at diagnosis was 0-1 in 79% of patients. Among the 147 (58%) cases reviewed by an expert pathological network, 39% were classified as small cell NEC and 61% as large cell NEC. Median Ki67 index was 75% (range, 20-100). Median overall survival was 15.6 (13.6-17.0) months. Significant adverse prognostic factors in univariate analysis were PS > 1 (hazard ratio [HR] = 2.5), metastatic disease (HR = 1.6), NSE>2 upper limit of normal [ULN]; HR = 3.2), CgA>2 ULN (HR = 1.7) and lactate dehydrogenase >2 ULN (HR = 2.1). After first-line palliative chemotherapy (CT1) with platinum-etoposide (n = 152), objective response, progression-free survival and overall survival were 50%, 6.2 and 11.6 months; they were 24%, 2.9 and 5.9, respectively, after post-CT1 FOLFIRI regimen (n = 72). CONCLUSIONS We report a large prospective series of GEP-NEC which show the predominance of large cell type and advanced stage at diagnosis. Prognosis was found more homogeneous than previously reported, mainly impacted by PS and tumour burden.
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Taieb J, Balogoun R, Le Malicot K, Tabernero J, Mini E, Folprecht G, Van Laethem JL, Emile JF, Mulot C, Fratté S, Levaché CB, Saban-Roche L, Thaler J, Petersen LN, Bridgewater J, Perkins G, Lepage C, Van Cutsem E, Zaanan A, Laurent-Puig P. Adjuvant FOLFOX +/- cetuximab in full RAS and BRAF wildtype stage III colon cancer patients. Ann Oncol 2017; 28:824-830. [PMID: 28031175 DOI: 10.1093/annonc/mdw687] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Indexed: 12/14/2022] Open
Abstract
Background RAS mutations have been shown to confer resistance to anti- epidermal growth factor receptor (EGFR) treatment. We analysed the results of the PETACC8 trial (cetuximab + FOLFOX vs FOLFOX) in full RAS and BRAF wildtype (WT) patients (pts) with resected stage III colon cancer. Patients and methods Exons 2, 3 and 4 of KRAS and NRAS, and BRAF exons 11 and 15, were sequenced using the Ampliseq colon-lung cancer panel version 2, in PETACC8 trial pts who consented to translational research. The impact of cetuximab on time to recurrence (TTR), disease-free survival (DFS) and overall survival (OS) was investigated in pts with tumours harbouring RAS and BRAF WT, and RAS mutations. The prognostic value of each individual mutation was also tested. Results Among the 2559 pts analysed, 745 pts (29%) were known to have KRAS exon 2 mutations and 163 pts (6.4%) the BRAF V600E mutation. Of the remaining 1651 pts, 1054 were assessed by NGS, showing that a further 227 pts (21%) had KRAS exon 2, 3, 4 or NRAS exon 2, 3, 4 mutations, and that 46 pts (4.4%) had a newly diagnosed BRAF mutation. Cetuximab added to FOLFOX did not significantly improve TTR, DFS or OS in pts with RAS WT or RAS and BRAF WT tumours (HR 0.77-1.03, all P > 0.05). Cetuximab addition was not either significantly deleterious in RAS mutant pts or in pts with rare RAS or BRAF mutations. In the overall trial population, NRAS and KRAS codon 61 mutations were the only rare mutations with the same pejorative prognostic value as KRAS exon 2 or BRAF V600E mutations. Conclusion Though not significant, the clinically relevant 0.76 adjusted HR observed for DFS in favour of adding cetuximab to FOLFOX, in full RAS and BRAF WT stage III colon cancer pts, may justify a new randomized controlled trial testing EGFR inhibitors in this setting. Clinical trial number This is an ancillary study of the PETACC8 trial: EUDRACT 2005-003463-23.
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Van Laethem JL, Carneiro F, Ducreux M, Messman H, Lordick F, Ilson DH, Allum WH, Haustermans K, Lepage C, Matysiak-Budnik T, Cats A, Schmiegel W, Cervantes A, Van Cutsem E, Rougier P, Seufferlein T. The multidisciplinary management of gastro-oesophageal junction tumours: European Society of Digestive Oncology (ESDO): Expert discussion and report from the 16th ESMO World Congress on Gastrointestinal Cancer, Barcelona. Dig Liver Dis 2016; 48:1283-1289. [PMID: 27590840 DOI: 10.1016/j.dld.2016.08.112] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 08/03/2016] [Accepted: 08/05/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND SCOPE The management of GOJ cancers remains controversial and may vary between countries. Evidence-based attitudes and guidelines are not easy to elaborate since most of the trials and studies reported mixed cases of oesophageal (both adenocarcinoma and squamous cell tumours), GOJ and gastric cancers. The aim of this expert discussion and position paper is to elaborate practical recommendations that integrate evidence-reported literature and experience-based attitude covering all clinical aspects of GOJ cancer across different specialities and countries in Europe. METHODOLOGY Opinion leaders, selected on scientific merit were asked to answer to a prepared set of questions covering the approach of GOJ tumours from definition to therapeutic strategies. All answers were then discussed during a plenary session and reported here in providing a well-balanced reflection of both clinical expertise and updated evidence-based medicine. RESULTS Definition, classification, diagnosis and staging of GOJ tumours were updated and debated. Therapeutic aspects including endoscopic therapy, surgical management, both multimodal curative and palliative management were also reviewed for proposing practical and consensual positions and recommendations whenever possible. CONCLUSION GOJ tumours deserve specific attention,not only for uniformising clinical management across countries but also for performing specific clinical and translational research,mainly in the curative perioperative setting.
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Lepage C, Phelip JM, Cany L, Maillard E, Lievre A, Chatellier T, Faroux R, Duchmann JC, Ben Abdelghani M, Breysacher G, Geoffroy P, Pere-Verge D, Pelaquier A, Pillon D, Ezenfis J, Rinaldi Y, Darut-Jouve A, Duluc M, Adenis A, Bouché O. Effect of 5 years of imaging and CEA follow-up to detect recurrence of colorectal cancer - PRODIGE 13 a FFCD and Unicancer phase III trial: baseline characteristics. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.31] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Laurent-Puig P, Balogoun R, Cayre A, Le Malicot K, Tabernero J, Mini E, Folprecht G, van Laethem JL, Thaler J, Petersen LN, Sanchez E, Bridgewater J, Ellis S, Locher C, Lagorce C, Ramé JF, Lepage C, Penault-Llorca F, Taieb J. ERBB2 alterations a new prognostic biomarker in stage III colon cancer from a FOLFOX based adjuvant trial (PETACC8). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.08] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
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Taieb J, Le Malicot K, Balogoum R, Tabernero J, Mini E, Folprecht G, van Laethem JL, Emile JF, Mulot C, Fratté S, Levaché CB, Saban-Roche L, Thaler J, Petersen LN, Sanchez E, Bridgewater J, Perkins G, Lepage C, Zaanan A, Laurent-Puig P. Adjuvant FOLFOX+ cetuximab vs FOLFOX in full RAS and BRAF wild type stage III colon cancer patients: Results from the PETACC8 trial. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.10] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Chez M, Lepage C, Parise C, Dang-Chu A, Hankins A. A Randomized, Blinded, Placebo-controlled, Crossover Study to Assess the Efficacy of Stem Cells from Autologous Umbilical Cord Blood to Improve Language and Behavior in Children with Autism. Cytotherapy 2016. [DOI: 10.1016/j.jcyt.2016.03.222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hebbar M, Heurgue-Berlot A, Boige V, Le Malicot K, Bernard-Chabert B, Marcus C, Dharancy S, Sergent G, Perarnau J, Ehrhard F, Ollivier-Hourmand I, Vergniol J, Michel P, Edeline J, Rinaldi Y, Seitz J, Lepage C, De Baere T. 2305 Randomized phase 2/3 trial of transcatheter arterial chemoembolization (TACE) plus sunitinib or placebo in patients with hepatocellular carcinoma (HCC) (PRODIGE 16/SATURNE study): Results of the Phase II part. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31221-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Sant M, Francisci S, Minicozzi P, Otter R, Primic-Zakeli M, Gatta G, Rossi S, Baili P, Anderson L, Holleczek B, Lepage C, Crocetti E, Trama A, Marcos-Gragera R, Visser O, Berrino F, Capocaccia R, De Angelis R. 1LBA Is Europe doing better in cancer care since the 90s? The latestfindings from the EUROCARE-5 study. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(15)30066-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Manfredi S, Walter T, Cadiot G, Baudin E, Coriat R, Ruszniewski P, Lecomte T, Laurenty A, Goichot B, Rohmer V, Roquin G, Cojocarasu O, Cardot-bauters C, Legoux J, Borson-chazot F, Teissier M, Goudet P, Lepage C, Laine F, Lombard-boas C. 2228 Gastric neuroendocrine tumors (NETs): Data from the national French cohort of the Groupe d'Etude des Tumeurs Endocrines (GTE), CARGAS study. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31144-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Farras Roca JA, Dao TH, Lantieri L, Lepage C, Bosc R, Meyblum E, Pigneur F, Beaussart P, Assaf E, Totobenazara JL, Calitchi E, Belkacemi Y, Rahmouni A, Luciani A. Ipsilateral breast cancer recurrence after Deep Inferior Epigastric Perforator (DIEP) flap reconstruction: Incidence and radiological presentation. Diagn Interv Imaging 2015; 97:203-9. [PMID: 26282051 DOI: 10.1016/j.diii.2015.06.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2015] [Revised: 06/16/2015] [Accepted: 06/19/2015] [Indexed: 12/14/2022]
Abstract
PURPOSE To assess the incidence and presentation of ipsilateral cancer recurrences (ICR) after deep inferior epigastric perforator (DIEP) flap reconstruction for breast cancer. PATIENTS AND METHODS Data of 247 consecutive women with DIEP flap reconstruction after breast cancer in our institution between 1997 and 2009 were retrospectively reviewed. RESULTS Mean follow-up time was 4.1years±3.2 (SD) (median: 3years; range: 1month - 14years). Thirty-one patients (12.5%, 95%CI: =8.7-17.3) presented 34 relapses, in average 4.1years±2.6 after mastectomy: 14 (41%) were ipsilateral, 6 (18%) contralateral and 14 (41%) metastatic. ICRs occurred earlier (3.9 vs. 5.8years; P<0.05) than non-ICRs. Most ICRs (10/14, 71%) involved the periphery of the flap and presented as palpable nodules. The remaining (4/14, 29%) involved the axilla and 3/4 (75%) were palpable. Imaging procedures detected infra-clinical ICRs in 3 of 10 imaged patients (30%). CONCLUSION ICRs after DIEP flap reconstruction are more frequent than contralateral recurrences suggesting the need for imaging follow-up of the reconstructed breast.
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Tremblay A, Lepage C, Panahi S, Couture C, Drapeau V. Adaptations to a diet-based weight-reducing programme in obese women resistant to weight loss. Clin Obes 2015; 5:145-53. [PMID: 25872975 DOI: 10.1111/cob.12094] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 03/04/2015] [Accepted: 03/08/2015] [Indexed: 11/30/2022]
Abstract
The aim of this study was to assess energy intake, resting metabolic rate (RMR), appetite sensations, eating behaviours and sleep duration and quality in obese women resistant to body weight loss when subjected to a diet-based weight-reducing programme. A pooled cohort of obese women (n = 75; aged 39 ± 8 years; body mass index: 33 ± 4 kg m(-2)) participated in a 12-16-week diet-based weight loss programme targeting a daily energy deficit of 500-700 kcal d(-1). Women were classified in tertiles a posteriori based on the response of their body weight to dietary supervision (high, moderate and low responders). Post-intervention, mean weight loss was 3.3 ± 2.8 kg and explained by the 2.9 ± 2.6 kg reduction in fat mass. Mean weight loss was 6.2 ± 1.6, 3.4 ± 0.6 and 0.2 ± 1.4 kg in participants classified in the high, middle and low tertiles, respectively. Women in the low tertile reduced their daily energy intake and susceptibility to hunger during the programme to a lesser extent than those in the high tertile and had higher fasting hunger in response to the dietary intervention. Women in the high tertile maintained their RMR, which was in contrast to the significant decrease predicted by their weight loss. They also reported a significant improvement in sleep quality and an increase in sleep duration compared with other tertiles. The differences in the response of body weight to dietary supervision may be explained, in part, by variations in energy intake, eating behaviours, appetite sensations and sleep duration and quality.
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Drouillard A, Lepage C. Cancer du côlon : bilan et surveillance. ONCOLOGIE 2014. [DOI: 10.1007/s10269-014-2471-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Vadot L, Boulin M, Guiu B, Aho LS, Vourc'h M, Musat A, Hillon P, Lepage C, Guignard MH, Fagnoni P. Clinical and economic impact of drug eluting beads in transarterial chemoembolization for hepatocellular carcinoma. J Clin Pharm Ther 2014; 40:83-90. [DOI: 10.1111/jcpt.12230] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Accepted: 09/10/2014] [Indexed: 01/09/2023]
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