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Pepponi M, Berti V, Fasciglione E, Montanini F, Canu L, Hubele F, Abenavoli E, Briganti V, Rapizzi E, Charpiot A, Taieb D, Pacak K, Goichot B, Imperiale A. [ 68Ga]DOTATOC PET-derived radiomics to predict genetic background of head and neck paragangliomas: a pilot investigation. Eur J Nucl Med Mol Imaging 2024:10.1007/s00259-024-06735-5. [PMID: 38687372 DOI: 10.1007/s00259-024-06735-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 04/23/2024] [Indexed: 05/02/2024]
Abstract
PURPOSE To investigate the [68Ga]DOTATOC PET radiomic profile of head and neck paragangliomas (HNPGLs) and identify radiomic characteristics useful as predictors of succinate dehydrogenase genes (SDHx) pathogenic variants. METHODS Sporadic and SDHx HNPGL patients, who underwent [68Ga]DOTATOC PET/CT, were retrospectively included. HNPGLs were analyzed using LIFEx software, and extracted features were harmonized to correct for batch effects and confronted testing for multiple comparison. Stepwise discriminant analysis was conducted to remove redundancy and identify best discriminating features. ROC analysis was used to define optimal cut-offs. Multivariate decision-tree analysis was performed using CHAID method. RESULTS 34 patients harboring 60 HNPGLs (51 SDHx in 25 patients) were included. Three sporadic and nine SDHx HNPGLs were metastatic. At stepwise discriminant analysis, both GLSZM-Zone Size Non-Uniformity (ZSNU, reflecting tumor heterogeneity) and IB-TLSRE (total lesion somatostatin receptor expression) were independent predictors of genetic status, with 96.4% of lesions and 91.6% of patients correctly classified after cross validation (p < 0.001). Among non-metastatic patients, GLSZM-ZSNU and IB-TLSRE were significantly higher in sporadic than SDHx HNPGLs (p < 0.001). No differences were revealed in metastatic patients. Decision-tree analysis highlights multifocality and IB-TLSRE as useful variables, correctly identifying 6/9 sporadic and 24/25 SDHx patients. Model failed to classify one SDHA and three sporadic patients (2 metastatic). CONCLUSION Radiomics features GLSZM-ZSNU and IB-TLSRE appear to reflect HNPGLs SDHx status and tumor behavior (metastatic vs. non-metastatic). If validated, especially IB-TLSRE might represent a simple and time-efficient radiomic index for SDHx variants early screening and prediction of tumor behavior in HNPGL cases.
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Affiliation(s)
- Miriam Pepponi
- Nuclear Medicine and Molecular Imaging, ICANS, University Hospitals of Strasbourg, University of Strasbourg, Strasbourg, France
- Department of Experimental and Clinical Biomedical Sciences 'Mario Serio', University of Florence, Florence, Italy
| | - Valentina Berti
- Department of Experimental and Clinical Biomedical Sciences 'Mario Serio', University of Florence, Florence, Italy
- Nuclear Medicine Unit, Careggi University Hospital, Florence, Italy
| | - Elsa Fasciglione
- Endocrinology, Diabetology, Nutrition, University Hospitals of Strasbourg, Strasbourg University, Strasbourg, France
| | - Flavio Montanini
- Nuclear Medicine Unit, Careggi University Hospital, Florence, Italy
| | - Letizia Canu
- Department of Experimental and Clinical Biomedical Sciences 'Mario Serio', University of Florence, Florence, Italy
- Centro di Ricerca e Innovazione sulle Patologie Surrenaliche, Careggi University Hospital, Florence, Italy
| | - Fabrice Hubele
- Nuclear Medicine and Molecular Imaging, ICANS, University Hospitals of Strasbourg, University of Strasbourg, Strasbourg, France
| | | | | | - Elena Rapizzi
- Department of Experimental and Clinical Biomedical Sciences 'Mario Serio', University of Florence, Florence, Italy
- Centro di Ricerca e Innovazione sulle Patologie Surrenaliche, Careggi University Hospital, Florence, Italy
| | - Anne Charpiot
- Otolaryngology and Maxillofacial Surgery, University Hospitals of Strasbourg, Strasbourg, France
| | - David Taieb
- La Timone University Hospital, CERIMED, Aix-Marseille University, Marseille, France
| | - Karel Pacak
- Eunice Kennedy Shriver NICHD, National Institutes of Health, Bethesda, MD, USA
| | - Bernard Goichot
- Endocrinology, Diabetology, Nutrition, University Hospitals of Strasbourg, Strasbourg University, Strasbourg, France
| | - Alessio Imperiale
- Nuclear Medicine and Molecular Imaging, ICANS, University Hospitals of Strasbourg, University of Strasbourg, Strasbourg, France.
- IPHC, UMR 7178, CNRS/Unistra, Strasbourg, France.
- Médecine Nucléaire et Imagerie Moléculaire, ICANS 17, rue Albert Calmette, Strasbourg, 67093, France.
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Mekkan-Bouv Hez M, Derbey L, de Mestier L, D L, Walter T, Perrier M, Cadiot G, Goichot B, Pracht M, Lièvre A, Coriat R, Valancot S, Guimbaud R, Carrere N, Bacoeur-Ouzillou O, Belleannée G, Smith D, Laboureau S, Hescot S, Julie C, Teissier MP, Thereaux J, Ferru A, Evrard C, Mathonnet M, Christou N. Survival of patients managed in France for duodenal neuroendocrine tumors (D-NET): a 20-year multicenter cohort study from the GTE group: a cohort study. Int J Surg 2024:01279778-990000000-01286. [PMID: 38573078 DOI: 10.1097/js9.0000000000001382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 03/11/2024] [Indexed: 04/05/2024]
Abstract
INTRODUCTION Duodenal neuroendocrine tumours (D-NETs) have a low incidence; however, their diagnosis has been increasing. Features such as tumour location, size, type, histological grade, and stage were used to adapt the treatment to either endoscopic (ER) or surgical (SR) resections. There is no consensus regarding the definitive treatment. The authors' study aimed to describe the management of non-metastatic, well-differentiated D-NETs in France and its impact on patient survival. METHODS A registry-based multicenter study using prospectively collected data between 2000 and 2019, including all patients managed for non-metastatic G1 and G2 D-NETs, was conducted in the GTE group. RESULTS A total of 153 patients were included. Fifty-eight benefited from an ER, and 95 had an SR. No difference in recurrence-free survival (RFS) was observed regardless of treatment type. There was no significant difference between the two groups (ER vs. SR) in terms of location, size, grade, or lymphadenopathy, regardless of the type of incomplete resection performed or regarding the pre-therapeutic assessment of lymph node invasion in imaging. The surgery allowed for significantly more complete resection (patients with R1 resection in the SR group: 9 vs. 14 in the ER group, P<0.001). Among the 51 patients with positive lymph node dissection after SR, tumour size was less than or equal to 1 cm in 25 cases. Surgical complications were more numerous (P=0.001). In the sub-group analysis of G1-G2 D-NETs between 11 and 19 mm, there was no significant difference in grade (P=0.977) and location (P=0.617) between the two groups (ER vs. SR). No significant difference was found in both morphological and functional imaging, focusing on the pre-therapeutic assessment of lymph node invasion (P=0.387). CONCLUSION Regardless of the resection type (ER or SR) of G1-G2 non-metastatic D-NETs, as well as the type of management of incomplete resection, which was greater in the ER group, long-term survival results were similar between ER and SR. Organ preservation seems to be the best choice owing to the slow evolution of these tumours.
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Affiliation(s)
- Margaux Mekkan-Bouv Hez
- Service de Chirurgie Digestive, Endocrinienne et Générale, CHU de Limoges, Avenue Martin Luther King, Limoges Cedex
| | - Lea Derbey
- Gastro-entérologie, hépatologie et oncologie médicale, Hôpital Édouard-Herriot, Hospices civils de Lyon, Lyon
| | - Louis de Mestier
- Université de Paris, Department of Pancreatology and Digestive Oncology, Hospital Beaujon (APHP.Nord), Clichy
| | - Lorenzo D
- Université de Paris, Department of Pancreatology and Digestive Oncology, Hospital Beaujon (APHP.Nord), Clichy
| | - Thomas Walter
- Gastro-entérologie, hépatologie et oncologie médicale, Hôpital Édouard-Herriot, Hospices civils de Lyon, Lyon
| | - M Perrier
- Hépatogastro-entérologie et oncologie digestive, CHU de Reims
| | | | - B Goichot
- Service de Médecine interne, Endocrinologie et Nutrition, Pôle MIRNED , Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, Avenue Molière, Strasbourg Cedex
| | - M Pracht
- Oncologie médicale, Centre Eugène Marquis, 5 Rue Bataille Flandres-Dunkerque
| | - A Lièvre
- Gastro-entérologie, CHU Pontchaillou, Université Rennes, Inserm U1242, COSS (Chemistry Oncogenesis Stress Signaling), Rennes
| | - Romain Coriat
- Gastro-entérologie et hépatologie. CHU Cochin, AP-HP
| | | | | | | | - O Bacoeur-Ouzillou
- Chirurgie viscérale et digestive, CHU Clermont-Ferrand, Clermont-Ferrand
| | - G Belleannée
- Service de Pathologie, CHU de Bordeaux, Bordeaux
| | - Denis Smith
- Oncologie Digestive, CHU de Bordeaux, Service d'Hépato-Gastroentérologie et d'Oncologie Digestive, Centre Médico-Chirurgical Magellan, Hôpital Haut-Lévèque, Avenue Magellan, 33604 PESSAC cedex
| | - S Laboureau
- Département d'endocrinologie-diabétologie et nutrition, CHU Angers
| | - Sophie Hescot
- Endocrinologie et Métabolismes, Institut Curie, 26, Rue d'Ulm, Paris
| | - Catherine Julie
- EA4340 Université Versailles- Saint-Quentin-en-Yvelines, Anatomie Pathologique, Hôpital Ambroise Paré, APHP
| | - M P Teissier
- Endocrinologie-Diabète-Maladies métaboliques-CHU de Limoges
| | | | - A Ferru
- Cancérologie médicale, CHU de Poitiers
| | - C Evrard
- Cancérologie médicale, CHU de Poitiers
| | - Muriel Mathonnet
- Service de Chirurgie Digestive, Endocrinienne et Générale, CHU de Limoges, Avenue Martin Luther King, Limoges Cedex
| | - Niki Christou
- Service de Chirurgie Digestive, Endocrinienne et Générale, CHU de Limoges, Avenue Martin Luther King, Limoges Cedex
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Baudin E, Goichot B, Berruti A, Hadoux J, Moalla S, Laboureau S, Nölting S, de la Fouchardière C, Kienitz T, Deutschbein T, Zovato S, Amar L, Haissaguerre M, Timmers H, Niccoli P, Faggiano A, Angokai M, Lamartina L, Luca F, Cosentini D, Hahner S, Beuschlein F, Attard M, Texier M, Fassnacht M. Sunitinib for metastatic progressive phaeochromocytomas and paragangliomas: results from FIRSTMAPPP, an academic, multicentre, international, randomised, placebo-controlled, double-blind, phase 2 trial. Lancet 2024; 403:1061-1070. [PMID: 38402886 DOI: 10.1016/s0140-6736(23)02554-0] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 10/04/2023] [Accepted: 11/13/2023] [Indexed: 02/27/2024]
Abstract
BACKGROUND No randomised controlled trial has ever been done in patients with metastatic phaeochromocytomas and paragangliomas. Preclinical and first clinical evidence suggested beneficial effects of sunitinib. We aimed to evaluate the safety and efficacy of sunitinib in patients with metastatic phaeochromocytomas and paragangliomas. METHODS FIRSTMAPPP is a multicentre, international, randomised, placebo-controlled, double-blind, phase 2 trial done at 14 academic centres across four European countries. Eligible participants were adults (aged ≥18 years) with sporadic or inherited progressive metastatic phaeochromocytomas and paragangliomas. Patients were randomly assigned (1:1) to receive either oral sunitinib (37·5 mg per day) or placebo. Randomisation was stratified according to SDHB status (mutation present vs wild type) and number of previous systemic therapies (0 vs ≥1). Primary endpoint was the rate of progression-free survival at 12 months according to real-time central review (Response Evaluation Criteria in Solid Tumours version 1.1). On the basis of a two-step Simon model, we aimed for the accrual of 78 patients, assuming a 20% improvement of the 12-month progression-free survival rate from 20% to 40%, to conclude that sunitinib is effective. Crossover from the placebo group was allowed. This trial is registered with ClinicalTrials.gov, number NCT01371201, and is closed for enrolment. FINDINGS From Dec 1, 2011, to Jan 31, 2019, a total of 78 patients with progressive metastatic phaeochromocytomas and paragangliomas were enrolled (39 patients per group). 25 (32%) of 78 patients had germline SDHx variants and 54 (69%) had used previous therapies. The primary endpoint was met, with a 12-month progression-free survival in 14 of 39 patients (36% [90% CI 23-50]) in the sunitinib group. In the placebo group, the 12-month progression-free survival in seven of 39 patients was 19% (90% CI 11-31), validating the hypotheses of our study design. The most frequent grade 3 or 4 adverse events were asthenia (seven [18%] of 39 and one [3%] of 39), hypertension (five [13%] and four [10%]), and back or bone pain (one [3%] and three [8%]) in the sunitinib and placebo groups, respectively. Three deaths occurred in the sunitinib group: these deaths were due to respiratory insufficiency, amyotrophic lateral sclerosis, and rectal bleeding. Only the latter event was considered drug related. Two deaths occurred in the placebo group due to aspiration pneumonia and septic shock. INTERPRETATION This first randomised trial supports the use of sunitinib as the medical option with the highest level of evidence for anti-tumour efficacy in progressive metastatic phaeochromocytomas and paragangliomas. FUNDING French Ministry of Health, through the National Institute for Cancer, German Ministry of Education and Research, and the German Research Foundation within the CRC/Transregio 205/2, EU Seventh Framework Programme, and a private donator grant.
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Affiliation(s)
- Eric Baudin
- Department of Imaging, Endocrine Oncology Unit, Gustave Roussy, University Paris Saclay, Villejuif, France.
| | - Bernard Goichot
- Department of Endocrinology, Hopital de Hautepierre-Hopitaux Universitaires de Strasbourg, Strasbourg, France
| | - Alfredo Berruti
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Azienda Ospedaliera Spedali Civili di Brescia, Brescia, Italy
| | - Julien Hadoux
- Department of Imaging, Endocrine Oncology Unit, Gustave Roussy, University Paris Saclay, Villejuif, France
| | - Salma Moalla
- Department of Imaging, Endocrine Oncology Unit, Gustave Roussy, University Paris Saclay, Villejuif, France
| | - Sandrine Laboureau
- Department of Endocrinology Diabetology Nutrition, Hopitaux Universitaires d'Angers, Angers, France
| | - Svenja Nölting
- Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, Germany
| | | | - Tina Kienitz
- Department of Endocrinology and Metabolism, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Timo Deutschbein
- Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Würzburg, Würzburg, Germany
| | - Stefania Zovato
- Familial Cancer Clinics, Istituto Oncologico Veneto, IRCCS, Padova, Italy
| | - Laurence Amar
- Department of Hypertension PARIS, Hopital Europeen Georges-Pompidou, Université Paris Cité, Paris, France
| | | | - Henri Timmers
- Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands
| | - Patricia Niccoli
- Department of Medical Oncology, Institut Paoli Calmette, Marseille, France
| | - Antongiulio Faggiano
- Department of Clinical Medicine and Surgery, Endocrinology, Diabetology and Andrology Unit, Federico II University of Naples, Naples, Italy
| | - Moussa Angokai
- Office of Biostatistics and Epidemiology, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Inserm, Université Paris-Saclay, CESP U1018, Oncostat, labeled Ligue Contre le Cancer, Villejuif, France
| | - Livia Lamartina
- Department of Imaging, Endocrine Oncology Unit, Gustave Roussy, University Paris Saclay, Villejuif, France
| | - Florina Luca
- Department of Endocrinology, Hopital de Hautepierre-Hopitaux Universitaires de Strasbourg, Strasbourg, France
| | - Deborah Cosentini
- Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Azienda Ospedaliera Spedali Civili di Brescia, Brescia, Italy
| | - Stefanie Hahner
- Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Würzburg, Würzburg, Germany
| | - Felix Beuschlein
- Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, Germany
| | - Marie Attard
- Department of Imaging, Endocrine Oncology Unit, Gustave Roussy, University Paris Saclay, Villejuif, France
| | - Matthieu Texier
- Office of Biostatistics and Epidemiology, Gustave Roussy, Université Paris-Saclay, Villejuif, France; Inserm, Université Paris-Saclay, CESP U1018, Oncostat, labeled Ligue Contre le Cancer, Villejuif, France
| | - Martin Fassnacht
- Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of Würzburg, Würzburg, Germany; Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
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Bozzi MT, Mallereau CH, Todeschi J, Baloglu S, Ardellier FD, Romann J, Trouve L, Bocsksei Z, Alcazar J, Dannhoff G, Bahougne T, Goichot B, Chibbaro S, Cebula H. Is the OCT a predictive tool to assess visual impairment in optic chiasm compressing syndrome in pituitary macroadenoma? A prospective longitudinal study. Neurosurg Rev 2024; 47:50. [PMID: 38228894 DOI: 10.1007/s10143-024-02280-9] [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: 07/15/2023] [Revised: 12/19/2023] [Accepted: 01/03/2024] [Indexed: 01/18/2024]
Abstract
Visual dysfunction is a prevalent symptom in patients with non-functioning pituitary macroadenoma (NFPM); the role of OCT in such patients has not been yet determined. This is a prospective longitudinal observational study over a period of 6 years, on 20 patients presenting a radiological compression of the optic chiasma without visual acuity (VA) and visual field (VF) disturbances. The primary endpoint was to evaluate the impact of NFPA on neuro-axonal loss by measuring RNFL thickness using OCT at inclusion (T0), 12 months (T1), 24 months (T2), and 36 months (T3), respectively. The secondary endpoint was to monitor the evolution of OCT over time and assess any relationship between the degree of OCT alteration and the degree of radiological and clinical optic chiasm compression syndrome. Among the 20 patients included, eight (40%) showed an altered RNFL-OCT at diagnosis, while the remaining 12 (60%) showed a normal pattern. During a mean ophthalmologic follow-up of 60 months, 4 patients (20%) presented an asymptomatic reduction of RNFL-OCT thickness although all 20 had a VA/VF stable. To our knowledge, this study represents the first attempt to longitudinally evaluate the natural history and evolution of RNFL-OCT in patients with radiologically asymptomatic chiasmatic compression syndrome. The results do not clearly demonstrate the role of the OCT as an early prognostic factor for visual dysfunction.
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Affiliation(s)
| | - Charles-Henry Mallereau
- Department of Neurosurgery, Strasbourg University Hospital, 1, Av. Moliere, 67098, Strasbourg, France.
| | - Julien Todeschi
- Department of Neurosurgery, Strasbourg University Hospital, 1, Av. Moliere, 67098, Strasbourg, France
| | - Seyyid Baloglu
- Neuroradiology Unit, Strasbourg University Hospital, Strasbourg, France
| | | | - Julia Romann
- Department of Ophthalmology, Strasbourg University Hospital, Strasbourg, France
| | - Léa Trouve
- Department of Ophthalmology, Strasbourg University Hospital, Strasbourg, France
| | - Zsolt Bocsksei
- Department of Ophthalmology, Strasbourg University Hospital, Strasbourg, France
| | - Joffrey Alcazar
- Department of Ophthalmology, Strasbourg University Hospital, Strasbourg, France
| | - Guillaume Dannhoff
- Department of Neurosurgery, Strasbourg University Hospital, 1, Av. Moliere, 67098, Strasbourg, France
| | - Thibault Bahougne
- Department of Endocrinology, Diabetes and Nutrition, Strasbourg University Hospital, Strasbourg, France
- Institute of Cellular and Integrative Neuroscience, UPR CNRS, 3212, Strasbourg, France
| | - Bernard Goichot
- Department of Endocrinology, Diabetes and Nutrition, Strasbourg University Hospital, Strasbourg, France
| | - Salvatore Chibbaro
- Department of Neurosurgery, Strasbourg University Hospital, 1, Av. Moliere, 67098, Strasbourg, France
| | - Helene Cebula
- Department of Neurosurgery, Strasbourg University Hospital, 1, Av. Moliere, 67098, Strasbourg, France
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Perrier M, Brugel M, Gérard L, Goichot B, Lièvre A, Lepage C, Hautefeuille V, Do Cao C, Smith D, Thuillier P, Cros J, Cadiot G, Walter T, de Mestier L. Characteristics and treatment options of glucagonomas: a national study from the French Group of Endocrine Tumors and ENDOCAN-RENATEN network. Eur J Endocrinol 2023; 189:575-583. [PMID: 38039101 DOI: 10.1093/ejendo/lvad157] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 10/02/2023] [Accepted: 10/23/2023] [Indexed: 12/03/2023]
Abstract
OBJECTIVE Glucagonoma is a very rare functional pancreatic neuroendocrine tumor (PanNET). We aimed to provide data on the diagnosis, prognosis, and management of patients with glucagonoma. DESIGN AND METHODS In this retrospective national cohort, we included all patients with glucagonoma, defined by at least 1 major criterion (necrolytic migratory erythema [NME] and/or recent-onset diabetes, and/or weight loss ≥ 5 kg) associated with either glucagonemia > 2 × upper limit of normal or positive glucagon immunostaining. Antisecretory efficacy was defined as partial/complete resolution of glucagonoma symptoms. Antitumor efficacy was assessed according to the time to next treatment (TTNT). RESULTS Thirty-eight patients were included with median age 58.7 yo, primary PanNET located in the tail (68.4%), synchronous metastases (63.2%). Median Ki-67 index was 3%. Most frequent glucagonoma symptoms at diagnosis were NME (86.8%), weight loss (68.4%), and diabetes (50%). Surgery of the primary PanNET was performed in 76.3% of cases, mainly with curative intent (61.5%). After surgery, complete resolution of NME was seen in 93.8% (n = 15/16). The secretory response rates were 85.7%, 85.7%, 75%, and 60% with surgery of metastases (n = 6/7), chemotherapy (n = 6/7), liver-directed therapy (n = 6/8), and somatostatin analogs (n = 6/10), respectively. All lines combined, longer TTNT was reported with chemotherapy (20.2 months). Median overall survival (OS) was 17.3 years. The Ki-67 index > 3% was associated with shorter OS (hazard ratio 5.27, 95% CI [1.11-24.96], P = .036). CONCLUSION Patients with glucagonoma had prolonged survival, even in the presence of metastases at diagnosis. Curative-intent surgery should always be considered. Chemotherapy, peptide receptor radionuclide therapy, or liver-directed therapy seems to provide both substantial antitumor and antisecretory efficacies.
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Affiliation(s)
- Marine Perrier
- Reims-Champagne-Ardenne University, Department of Hepato-Gastroenterology and Digestive Oncology, Robert Debré Hospital, Reims 51100, France
| | - Mathias Brugel
- Reims-Champagne-Ardenne University, Department of Hepato-Gastroenterology and Digestive Oncology, Robert Debré Hospital, Reims 51100, France
| | - Laura Gérard
- Department of Digestive Oncology, ENETS Centre of Excellence, Hospices Civils de Lyon, Lyon 69003, France
| | - Bernard Goichot
- Department of Endocrinology, Diabetology & Nutrition, Hôpital Hautepierre, Strasbourg University Hospital, Strasbourg 67200, France
| | - Astrid Lièvre
- Department of Gastroenterology, Pontchaillou University Hospital, Rennes University, INSERM U1242, Rennes 35000, France
| | - Come Lepage
- Federation Francophone de Cancérologie Digestive (FFCD), EPICAD INSERM LNC-UMR 1231, University of Burgundy and Franche Comté, Dijon 21000, France
| | - Vincent Hautefeuille
- Department of Hepato-Gastroenterology and Digestive Oncology, Amiens University Hospital, Amiens 80480, France
| | - Christine Do Cao
- Department of Endocrinology, Hôpital Claude Huriez, Lille University Hospital, Lille 59000, France
| | - Denis Smith
- Department of Hepato-Gastroenterology and Digestive Oncology, Haut-Lévêque Hospital, Bordeaux University Hospital, Pessac 33600, France
| | - Philippe Thuillier
- Department of Endocrinology, University Hospital of Brest, Brest 29200, France
| | - Jérôme Cros
- Université Paris-Cité, Department of Pathology, ENETS Centre of Excellence, Beaujon Hospital (APHP.Nord), Clichy 92110, France
| | - Guillaume Cadiot
- Reims-Champagne-Ardenne University, Department of Hepato-Gastroenterology and Digestive Oncology, Robert Debré Hospital, Reims 51100, France
| | - Thomas Walter
- Department of Digestive Oncology, ENETS Centre of Excellence, Hospices Civils de Lyon, Lyon 69003, France
| | - Louis de Mestier
- Université Paris-Cité, Department of Pancreatology and Digestive Oncology, ENETS Centre of Excellence, Beaujon Hospital (APHP.Nord), Clichy 92110, France
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6
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De Rycke O, Perrier M, Ouvrard É, Mennetrey C, Lachachi C, Bando-Delaunay A, Morland D, Goichot B, Taieb D, Walter T, Cadiot G, Cros J, Hentic O, Ruszniewski P, Lebtahi R, Imperiale A, de Mestier L. High Tumor Uptake on 18F-FDOPA PET/CT Indicates Poor Prognosis in Patients with Metastatic Midgut Neuroendocrine Tumors: A Study from the Groupe d'étude des Tumeurs Endocrines and ENDOCAN-RENATEN Network. J Nucl Med 2023; 64:1699-1705. [PMID: 37652547 DOI: 10.2967/jnumed.123.265584] [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: 02/10/2023] [Revised: 07/17/2023] [Indexed: 09/02/2023] Open
Abstract
PET/CT with 6-18F-fluoro-l-dopa (18F-FDOPA) has high diagnostic performance for midgut neuroendocrine tumors (NETs). We explored the prognostic role of 18F-FDOPA PET/CT uptake in metastatic midgut NETs. Methods: We included, in a test cohort (n = 166) and a full external validation cohort (n = 86), all consecutive patients with metastatic midgut NETs who underwent 18F-FDOPA PET/CT in 5 expert centers from 2010 to 2021. We measured the maximal uptake (SUVmax and SUVpeak) of the tumor and nontumor liver on each 18F-FDOPA PET/CT scan. We measured overall survival (OS) from the time of PET/CT and assessed prognostic factors using Kaplan-Meier and multivariable Cox proportional-hazards analyses in the test cohort, with replication in the validation cohort. Results: Patients had similar characteristics in both cohorts. In the test cohort, median follow-up was 60.3 mo. Patients with an SUVpeak tumor-to-liver (T/L) ratio of more than 4.2 had significantly shorter survival than those with a ratio of 4.2 or less (P = 0.01), with a 5-y OS rate of 74.1% ± 4.5% versus 95% ± 3.4%, respectively. On multivariable analysis, an SUVpeak T/L ratio of more than 4.2 remained associated with shorter OS (hazard ratio, 2.30; 95% CI, 1.02-5.22; P = 0.046) after adjustment for age, grade, number of previous lines, number of metastatic sites, and presence of carcinoid syndrome. In the validation cohort, the 5-y OS rate was 100% versus 57.8% ± 12.5% in patients with an SUVpeak T/L ratio ≤ 4.2 or > 4.2, respectively (P = 0.075). An increasing SUVpeak T/L ratio over time tended to have a pejorative prognostic impact. Conclusion: Tumor uptake on 18F-FDOPA PET/CT is an independent prognostic factor in patients with metastatic midgut NETs.
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Affiliation(s)
- Ophélie De Rycke
- Department of Pancreatology and Digestive Oncology, Beaujon Hospital, Université Paris-Cité, AP-HP.Nord, Clichy, France
- INSERM UMR 1149, Centre de Recherche sur l'Inflammation, Paris, France
| | - Marine Perrier
- Department of Hepato-Gastroenterology and Digestive Oncology, CHU Reims, Université de Reims Champagne-Ardenne, Reims, France
| | - Éric Ouvrard
- Department of Nuclear Medicine, Hautepierre University Hospital, Strasbourg, France
| | - Clément Mennetrey
- Department of Nuclear Medicine, La Timone University Hospital, Université d'Aix-Marseille, Marseille, France
| | - Choaib Lachachi
- Department of Nuclear Medicine, Edouard-Herriot University Hospital, Lyon, France
| | - Aurélie Bando-Delaunay
- INSERM UMR 1149, Centre de Recherche sur l'Inflammation, Paris, France
- Department of Nuclear Medicine, Beaujon Hospital, Université Paris-Cité, AP-HP.Nord, Clichy, France
| | - David Morland
- Department of Nuclear Medicine, Institut Godinot, Reims, France
- Université de Reims Champagne Ardenne, CReSTIC, EA 3804, Reims, France
| | - Bernard Goichot
- Department of Endocrinology, Hautepierre University Hospital, Strasbourg, France
| | - David Taieb
- Department of Nuclear Medicine, La Timone University Hospital, Université d'Aix-Marseille, Marseille, France
| | - Thomas Walter
- Department of Digestive Oncology, Edouard-Herriot University Hospital, Lyon, France; and
| | - Guillaume Cadiot
- Department of Hepato-Gastroenterology and Digestive Oncology, CHU Reims, Université de Reims Champagne-Ardenne, Reims, France
| | - Jérôme Cros
- INSERM UMR 1149, Centre de Recherche sur l'Inflammation, Paris, France
- Department of Pathology, Beaujon Hospital, AP-HP.Nord, Université Paris-Cité, Clichy, France
| | - Olivia Hentic
- Department of Pancreatology and Digestive Oncology, Beaujon Hospital, Université Paris-Cité, AP-HP.Nord, Clichy, France
| | - Philippe Ruszniewski
- Department of Pancreatology and Digestive Oncology, Beaujon Hospital, Université Paris-Cité, AP-HP.Nord, Clichy, France
- INSERM UMR 1149, Centre de Recherche sur l'Inflammation, Paris, France
| | - Rachida Lebtahi
- INSERM UMR 1149, Centre de Recherche sur l'Inflammation, Paris, France
- Department of Nuclear Medicine, Beaujon Hospital, Université Paris-Cité, AP-HP.Nord, Clichy, France
| | - Alessio Imperiale
- Department of Nuclear Medicine, Hautepierre University Hospital, Strasbourg, France
| | - Louis de Mestier
- Department of Pancreatology and Digestive Oncology, Beaujon Hospital, Université Paris-Cité, AP-HP.Nord, Clichy, France;
- INSERM UMR 1149, Centre de Recherche sur l'Inflammation, Paris, France
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Imperiale A, Pepponi M, Poterszman N, Jha A, Collen C, Brumaru D, Chenard MP, Taïeb D, Pacak K, Goichot B. Molecular imaging phenotyping of germline fumarate hydratase (FH) pathogenic variant-positive metastatic pheochromocytoma. Eur J Nucl Med Mol Imaging 2023; 50:3155-3156. [PMID: 37156926 DOI: 10.1007/s00259-023-06261-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 05/03/2023] [Indexed: 05/10/2023]
Affiliation(s)
- Alessio Imperiale
- Médecine Nucléaire et Imagerie Moléculaire, ICANS, Strasbourg University, 17, rue Albert Calmette, 67093, Strasbourg, France.
- Molecular Imaging-DRHIM, IPHC, UMR-7178, CNRS/Unistra, Strasbourg, France.
| | - Miriam Pepponi
- Médecine Nucléaire et Imagerie Moléculaire, ICANS, Strasbourg University, 17, rue Albert Calmette, 67093, Strasbourg, France
- Nuclear Medicine, Careggi University Hospital, University of Florence, Florence, Italy
| | - Nathan Poterszman
- Médecine Nucléaire et Imagerie Moléculaire, ICANS, Strasbourg University, 17, rue Albert Calmette, 67093, Strasbourg, France
| | - Abhishek Jha
- Eunice Kennedy Shriver NICHD, National Institutes of Health, Bethesda, MD, USA
| | - Cedric Collen
- Internal Medicine, Diabetes and Metabolic Disorders, University Hospitals of Strasbourg, Strasbourg University, Strasbourg, France
| | - Daniel Brumaru
- Biochemistry and Molecular Biology, University Hospitals of Strasbourg, Strasbourg University, Strasbourg, France
| | - Marie-Pierre Chenard
- Pathology, Strasbourg University Hospitals, University of Strasbourg, Strasbourg, France
| | - David Taïeb
- La Timone University Hospital, CERIMED, Aix-Marseille University, Marseille, France
| | - Karel Pacak
- Eunice Kennedy Shriver NICHD, National Institutes of Health, Bethesda, MD, USA
| | - Bernard Goichot
- Internal Medicine, Diabetes and Metabolic Disorders, University Hospitals of Strasbourg, Strasbourg University, Strasbourg, France
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8
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Goichot B, Taquet MC, Baltzinger P, Baloglu S, Gravaud M, Malouf GG, Noël G, Imperiale A. Should pituitary carcinoma be treated using a NET-like approach? A case of complete remission of a metastatic malignant prolactinoma with multimodal therapy including immunotherapy. Clin Endocrinol (Oxf) 2023; 98:633-637. [PMID: 34845727 DOI: 10.1111/cen.14645] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 11/04/2021] [Accepted: 11/12/2021] [Indexed: 01/01/2023]
Affiliation(s)
- Bernard Goichot
- Department of Internal Medicine and Endocrinology, Hôpital de Hautepierre, Hôpitaux Universitaires, Strasbourg, France
| | - Marie-Caroline Taquet
- Department of Internal Medicine and Endocrinology, Hôpital de Hautepierre, Hôpitaux Universitaires, Strasbourg, France
| | - Philippe Baltzinger
- Department of Internal Medicine and Endocrinology, Hôpital de Hautepierre, Hôpitaux Universitaires, Strasbourg, France
| | - Seyid Baloglu
- Department of Radiology, Hôpital de Hautepierre, Hôpitaux Universitaires, Strasbourg, France
| | - Marine Gravaud
- Department of Internal Medicine and Endocrinology, Hôpital de Hautepierre, Hôpitaux Universitaires, Strasbourg, France
| | - Gabriel G Malouf
- Department of Medical Oncology, Institut de Cancérologie de Strasbourg Europe (ICANS), Strasbourg, France
| | - Georges Noël
- Department of de Radiotherapy, Institut de Cancérologie de Strasbourg Europe (ICANS), Strasbourg, France
| | - Alessio Imperiale
- Department of Nuclear Medicine and Molecular Imaging, Institut de Cancérologie de Strasbourg Europe (ICANS), Strasbourg, France
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9
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Ouvrard E, Mestier LD, Boursier C, Lachachi B, Sahakian N, Chevalier E, Mikail N, Carullo J, Bando-Delaunay A, Walter T, Malouf GG, Addeo P, Poncet G, Sebag F, Lebtahi R, Goichot B, Taïeb D, Imperiale A. 18F-DOPA PET/CT at the Forefront of Initial or Presurgical Evaluation of Small-Intestine Neuroendocrine Tumors. J Nucl Med 2022; 63:1865-1870. [PMID: 35589408 DOI: 10.2967/jnumed.122.263984] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/27/2022] [Indexed: 01/11/2023] Open
Abstract
Our objective was to compare the respective value of 68Ga-DOTATOC and 18F-DOPA PET/CT for initial staging or presurgical work-up of patients with small-intestine neuroendocrine tumors (SiNETs). Methods: This was a retrospective, multicenter, noninterventional investigation involving 53 non-surgically treated SiNET patients who underwent both 68Ga-DOTATOC and 18F-DOPA PET/CT within a 6-mo interval without surgical intervention or therapeutic change between the 2 PET/CT studies. Percentage detection rate was calculated according to per-region and per-lesion analyses. Sensitivity for primary tumor detection was assessed in 37 surgically treated patients, taking surgical results (76 SiNETs) as the diagnostic gold standard. Results: 68Ga-DOTATOC PET/CT and 18F-DOPA PET/CT individually identified at least 1 primary SiNET in 92% (34/37) of the patients. Intestinal tumor multifocality was confirmed by histology in 8 patients. 68Ga-DOTATOC and 18F-DOPA PET/CT were concordantly positive for tumor multifocality in 5 patients, discordantly positive in 2 patients, and concordantly negative in 1 patient. The detection rate for subdiaphragmatic nodal metastases on per-region-based analysis was 91% and 98% for 68Ga-DOTATOC and 18F-DOPA PET/CT, respectively (P = 0.18). 18F-DOPA PET/CT detected a higher number of abnormal subdiaphragmatic nodes (P = 0.009). Regarding mesenteric nodes only, 18F-DOPA PET/CT detected more positive regions (P = 0.005) and nodal lesions (P = 0.003) than 68Ga-DOTATOC PET/CT, including nodes at the origin of mesenteric vessels. For detection of distant metastases, 68Ga-DOTATOC and 18F-DOPA PET/CT performed equally well on a per-region-based analysis. As compared with 68Ga-DOTATOC, 18F-DOPA PET/CT detected more hepatic (P < 0.001), peritoneal (P < 0.001), and lung metastases (P < 0.001). Conclusion: 18F-DOPA PET/CT detected more lesions than 68Ga-DOTATOC PET/CT in the studied patients. The respective roles of the two should be discussed in terms of disease staging and treatment selection.
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Affiliation(s)
- Eric Ouvrard
- Nuclear Medicine and Molecular Imaging, Institut de Cancérologie Strasbourg Europe, University Hospitals of Strasbourg, University of Strasbourg, Strasbourg, France
| | - Louis De Mestier
- Department of Pancreatology and Digestive Oncology, ENETS Centre of Excellence, Beaujon Hospital, Université de Paris, and INSERM U1149, Centre of Research in Inflammation, Paris, France
| | | | | | - Nicolas Sahakian
- Nuclear Medicine, La Timone University Hospital, Aix-Marseille University, Marseille, France
| | | | - Nidaa Mikail
- Nuclear Medicine, ENETS Centre of Excellence, Beaujon Hospital, Université de Paris, Paris, France
| | - Josefina Carullo
- Nuclear Medicine and Molecular Imaging, Institut de Cancérologie Strasbourg Europe, University Hospitals of Strasbourg, University of Strasbourg, Strasbourg, France.,Nuclear Medicine, Sanatorio Allende S.A., Cordoba, Argentina
| | - Aurélie Bando-Delaunay
- Nuclear Medicine, ENETS Centre of Excellence, Beaujon Hospital, Université de Paris, Paris, France
| | - Thomas Walter
- Medical Oncology, Edouard Herriot Hospital, Hospices Civils de Lyon, Université Lyon 1, Lyon, France
| | - Gabriel G Malouf
- Oncology, Institut de Cancérologie Strasbourg Europe, Strasbourg, France
| | - Pietro Addeo
- Hepato-Pancreato-Biliary Surgery and Liver Transplantation, University Hospitals of Strasbourg, Strasbourg, France
| | - Gilles Poncet
- Digestive and Oncologic Surgery, Edouard-Herriot University Hospital, Claude-Bernard Lyon 1 University, Lyon, France
| | - Frederic Sebag
- Endocrine Surgery, Conception University Hospital, Aix-Marseille University, Marseille, France
| | - Rachida Lebtahi
- Nuclear Medicine, ENETS Centre of Excellence, Beaujon Hospital, Université de Paris, Paris, France
| | - Bernard Goichot
- Diabetes and Metabolic Disorders, Internal Medicine, University Hospitals of Strasbourg, Strasbourg University, Strasbourg, France
| | - David Taïeb
- Nuclear Medicine, La Timone University Hospital, Aix-Marseille University, Marseille, France.,European Center for Research in Medical Imaging, Aix-Marseille University, Marseille, France; and
| | - Alessio Imperiale
- Nuclear Medicine and Molecular Imaging, Institut de Cancérologie Strasbourg Europe, University Hospitals of Strasbourg, University of Strasbourg, Strasbourg, France; .,Molecular Imaging-DRHIM, IPHC, UMR 7178, CNRS/Unistra, Strasbourg, France
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10
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Ilie MD, Villa C, Cuny T, Cortet C, Assie G, Baussart B, Cancel M, Chanson P, Decoudier B, Deluche E, Di Stefano AL, Drui D, Gaillard S, Goichot B, Huillard O, Joncour A, Larrieu-Ciron D, Libe R, Nars G, Vasiljevic A, Raverot G. Real-life efficacy and predictors of response to immunotherapy in pituitary tumors: a cohort study. Eur J Endocrinol 2022; 187:685-696. [PMID: 36111659 DOI: 10.1530/eje-22-0647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 09/15/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE After temozolomide failure, no evidence-based treatment is available for pituitary carcinomas (PCs) and aggressive pituitary tumors (APTs). To date, only 12 cases treated with immune-checkpoint inhibitors (ICIs) have been published, showing encouraging efficacy. Predictive factors of response are lacking. Here, we aimed to assess the real-life efficacy and predictors of response to ICIs in PCs and APTs. DESIGN AND METHODS This study is a multicentric, retrospective, observational cohort study, including all PCs and APTs treated with ICIs in France up to March 2022. PD-L1 immunohistochemistry and CD8+ T cell infiltration were evaluated centrally. RESULTS Six PCs (four corticotroph and two lactotroph) and nine APTs (five corticotroph and four lactotroph) were included. The real-life efficacy of ICIs was lower than previously published data. Three corticotroph tumors (33.3%) showed partial response, one (11.1%) stable disease, while five (55.6%) progressed. One lactotroph tumor (16.7%) showed partial response, one (16.7%) stable disease, while four (66.7%) progressed. PCs responded far better than APTs, with 4/6 PCs showing partial response compared to 0/9 APTs. Corticotroph tumors responded slightly better than lactotroph tumors. In the four responsive corticotroph tumors, PD-L1 staining was negative and CD8+ T cell infiltration attained a maximum of 1% in the tumor center. CONCLUSIONS Confirmation of the presence or absence of metastases is necessary before starting ICIs. After temozolomide failure, ICIs appear as a good therapeutic option for PCs, especially for corticotroph carcinomas. Negative PD-L1 staining and very low CD8+ T cell infiltration in the tumor center should not preclude ICI administration in corticotroph carcinomas. SIGNIFICANCE STATEMENT This is the first study to assess the real-life efficacy of ICIs in pituitary carcinomas (PCs) and aggressive pituitary tumors. We also assessed potential predictors of response and are the first to assess the predictive value of CD8+ cell infiltration. We identified the tumor type as a major predictor, ICIs proving far more effective in treating PCs. Our study provides evidence that ICIs are a good option after temozolomide failure for PCs (four of six responded), especially for corticotroph carcinomas (three of four responded). We also provide evidence that negative PD-L1 staining and very low CD8+ cell infiltration in the tumor center should not preclude ICI administration in corticotroph carcinomas. Moreover, our findings point toward the need to systematically perform extension workup before starting ICIs.
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Affiliation(s)
- Mirela Diana Ilie
- Inserm U1052, CNRS UMR5286, Claude Bernard Lyon 1 University, Cancer Research Center of Lyon, Lyon, France
- Endocrinology Department, 'C.I. Parhon' National Institute of Endocrinology, Bucharest, Romania
| | - Chiara Villa
- Neuropathology Department, Pitié-Salpêtrière University Hospital, AP-HP-Sorbonne University, Paris, France
- Inserm U1016, CNRS UMR8104, Cochin Institute, Paris, France
| | - Thomas Cuny
- Endocrinology Department, Conception University Hospital, AP-HM, Marseille, France
- Inserm U1251, Marseille Medical Genetics, Aix Marseille University, Marseille, France
| | - Christine Cortet
- Endocrinology Department, Lille University Hospital, Lille, France
| | - Guillaume Assie
- Inserm U1016, CNRS UMR8104, Cochin Institute, Paris, France
- Endocrinology Department, Cochin University Hospital, AP-HP, Paris, France
| | - Bertrand Baussart
- Inserm U1016, CNRS UMR8104, Cochin Institute, Paris, France
- Neurosurgery Department, Pitié-Salpêtrière University Hospital, AP-HP, Paris, France
| | - Mathilde Cancel
- Oncology Department, Tours University Hospital, Tours, France
| | - Philippe Chanson
- Department of Endocrinology and Reproduction Disorders, Bicêtre Hospital, AP-HP, Le Kremlin-Bicêtre, France
- Paris-Saclay University, Inserm, 'Physiologie et Physiopathologie Endocriniennes', Le Kremlin-Bicêtre, France
| | | | - Elise Deluche
- Oncology Department, Limoges University Hospital, Limoges, France
| | - Anna Luisa Di Stefano
- Neurology Department, Foch Hospital, Suresnes, France
- Neurosurgery Unit, Livorno Hospital, Livorno, Italy
| | - Delphine Drui
- Endocrinology Department, Nantes University Hospital, Nantes, France
| | - Stephan Gaillard
- Neurosurgery Department, Pitié-Salpêtrière University Hospital, AP-HP, Paris, France
| | - Bernard Goichot
- Internal Medicine Department, Strasbourg University Hospital, Strasbourg, France
| | - Olivier Huillard
- Medical Oncology Department, Cochin University Hospital, AP-HP, Paris Cancer Institute CARPEM, Paris, France
| | - Anthony Joncour
- Oncology Department, Poitiers University Hospital, Poitiers, France
| | | | - Rossella Libe
- Inserm U1016, CNRS UMR8104, Cochin Institute, Paris, France
- Endocrinology Department, Cochin University Hospital, AP-HP, Paris, France
| | - Guillaume Nars
- Internal Medicine Department, Strasbourg University Hospital, Strasbourg, France
| | - Alexandre Vasiljevic
- Inserm U1052, CNRS UMR5286, Claude Bernard Lyon 1 University, Cancer Research Center of Lyon, Lyon, France
- Pathology Department
| | - Gérald Raverot
- Inserm U1052, CNRS UMR5286, Claude Bernard Lyon 1 University, Cancer Research Center of Lyon, Lyon, France
- Endocrinology Department, Reference Center for Rare Pituitary Diseases HYPO, 'Groupement Hospitalier Est' Hospices Civils de Lyon, Bron, France
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11
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Smith D, Lepage C, Vicaut E, Dominguez S, Coriat R, Dubreuil O, Lecomte T, Baudin E, Venat Bouvet L, Samalin E, Santos A, Borie O, Bisot-Locard S, Goichot B, Lombard-Bohas C. Observational Study in a Real-World Setting of Targeted Therapy in the Systemic Treatment of Progressive Unresectable or Metastatic Well-Differentiated Pancreatic Neuroendocrine Tumors (pNETs) in France: OPALINE Study. Adv Ther 2022; 39:2731-2748. [PMID: 35419649 PMCID: PMC9123044 DOI: 10.1007/s12325-022-02103-7] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 02/22/2022] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Approval of sunitinib and everolimus for the treatment of progressive, unresectable or metastatic well-differentiated pancreatic neuroendocrine tumors (pNETs) was obtained in France in 2011 and 2012, respectively. OPALINE was set up as an observational study to evaluate the efficacy of sunitinib and everolimus compared to usual pNET treatments of chemotherapies and somatostatin analogues that had been previously recommended by the health authorities. METHODS The OPALINE study assessed the efficacy of everolimus and sunitinib in terms of survival, disease progression and tolerance. Patients (N = 144) were enrolled from May 2015 to September 2017, and their disease characteristics were analyzed from diagnosis to 2 years post-enrollment. RESULTS At inclusion most patients had comorbidities, and about 95% presented metastases. Patients received on average 3.2 lines of treatment from diagnosis to inclusion and two lines throughout the 2-year follow-up. Seventy-nine patients (59.0%) received at least one targeted therapy (TT) during their care path. For these patients, the overall survival (OS) was approximatively 176.5 months (95% CI: 97.2-not evaluable), with a 2-year survival rate estimated at 93.6% (SD 2.6%). Similar survival rates were observed whether the TTs were prescribed sooner or later in the treatment path. The main reasons for discontinuation of TTs were disease progression (54 patients) and adverse events (26 patients). Most patients receiving TTs did not change their dose during the follow-up reflecting the good treatment tolerability over time. No new safety alert was reported for everolimus and sunitinib during this study. CONCLUSION Given their good tolerance and positive impact on estimated OS, the two TTs have an important role to play in the care path of patients with pNETs. CLINICALTRIALS GOV NATIONAL CLINICAL TRIAL NUMBER NCT02264665.
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Affiliation(s)
- Denis Smith
- Oncologie digestive, Centre médico-chirurgical Magellan, Hôpital Universitaire de Bordeaux, Hôpital Haut-Lévèque, 33604 Pessac Cedex, France
| | - Côme Lepage
- Hépato-gastro-entérologie, Hôpital Universitaire Le Bocage, Dijon, France
| | - Eric Vicaut
- Unité de Recherche Clinique, Hôpital Lariboisière APHP, Paris, France
| | - Sophie Dominguez
- Hôpitaux Catholiques de Lille, Département d’Onco-hématologie, Université Catholique de Lille, Hôpital St Vincent de Paul, Lille, France
| | - Romain Coriat
- Unité de Gastro-entérologie, Hôpital Cochin, APHP Centre, Université de Paris, Paris, France
| | - Olivier Dubreuil
- Oncologie médicale, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France
| | - Thierry Lecomte
- Département d’ Hépato-gastro-entérologie et Oncologie digestive, CHRU de Tours, Tours, France
| | - Eric Baudin
- Institut Gustave Roussy, Service de Médecine Nucléaire, Villejuif, France
| | | | - Emmanuelle Samalin
- Département d’Oncologie médicale, Institut du Cancer de Montpellier (ICM), Université de Montpellier, Montpellier, France
| | | | | | | | - Bernard Goichot
- Département de Médecine interne, Hôpital Universitaire Hautepierre, Strasbourg, France
| | - Catherine Lombard-Bohas
- Service d’Oncologie Médicale Hôpital Edouard Herriot, GHC, Hospices Civils de Lyon, Lyon, France
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12
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Mennetrey C, Le Bras M, Bando-Delaunay A, Al-Mansour L, Haissaguerre M, Batisse-Lignier M, Ouvrard E, Ansquer C, Walter T, de Mestier L, Kelly A, Tlili G, Giraud S, North MO, Odou MF, Goichot B, Cuny T, Loundou A, Romanet P, Imperiale A, Taïeb D. Value of Somatostatin Receptor PET/CT in Patients With MEN1 at Various Stages of Their Disease. J Clin Endocrinol Metab 2022; 107:e2056-e2064. [PMID: 34940846 DOI: 10.1210/clinem/dgab891] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Indexed: 02/13/2023]
Abstract
CONTEXT Despite the growing evidence of the clinical value of somatostatin receptor (SSTR) positron emission tomography (PET) in the evaluation of neuroendocrine tumors (NETs), its role remains to be clarified at different time points in the journey of patients with multiple endocrine neoplasia type 1 (MEN1). The rarity of the disease is however a significant impediment to prospective clinical trials. OBJECTIVE The goals of the study were to assess the indications and value of SSTR PET/computed tomography (CT) in patients with MEN1. METHODS We retrospectively included patients from 7 French expert centers for whom data on SSTR PET/CT and morphological imaging performed at the same period were available. Detection rates of PET study were analyzed. RESULTS One hundred and 8 patients were included. SSTR PET/CT was performed at screening (n = 33), staging (n = 34), restaging (n = 37), and for peptide receptor targeted radiotherapy selection (n = 4). PET detected positive pancreatic lesions in 91% of cases at screening, with results comparable with magnetic resonance imaging but superior to CT (P = .049). Metastases (mostly lymph node [LN]) were present at the screening phase in 28% of cases, possibly due to the suboptimal value of screening morphological imaging in the assessment of nodal metastases and/or a long delay between imaging studies. SSTR PET/CT was considered superior or complementary to the reference standard in the assessment of LN or distant metastases in the vast majority of cases and regardless of the clinical scenario. CONCLUSION This study shows the potential added value of SSTR PET in the assessment of MEN1-associated NETs and provides great impetus toward its implementation in the evaluation of patients with MEN1.
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Affiliation(s)
- Clément Mennetrey
- Department of Nuclear Medicine, La Timone University Hospital, CERIMED, Aix-Marseille University, France
| | - Maëlle Le Bras
- Department of Endocrinology, Diabetology and Nutrition, l'institut du thorax, CHU Nantes, Nantes, France
| | - Aurélie Bando-Delaunay
- Université de Paris, Department of Nuclear Medicine, Beaujon University Hospital (APHP.Nord), Clichy, France
| | | | | | | | - Eric Ouvrard
- Department of Nuclear Medicine and Molecular Imaging - Institut de Cancérologie de Strasbourg Europe (ICANS), IPHC, UMR 7178, CNRS/University of Strasbourg, France
| | - Catherine Ansquer
- Nuclear Medicine Department, CHU de Nantes, Hôtel-Dieu, Nantes, France
| | - Thomas Walter
- Department of Oncology, Hospices Civils of Lyon, France
| | - Louis de Mestier
- Université de Paris, Department of Gastroenterology-Pancreatology, Beaujon University Hospital (APHP. Nord), Clichy, France
| | - Antony Kelly
- Department of Nuclear Medicine, Centre Jean Perrin, Clermont-Ferrand, France
| | - Ghoufrane Tlili
- Department of Nuclear Medicine, Haut Leveque University Hospital, Bordeaux, France
| | - Sophie Giraud
- Genetics Department, Hospices Civils de LYON (HCL), University Hospital, East Pathology Center, LYON
| | - Marie-Odile North
- Department of Genetic & Molecular Biology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Marie-Françoise Odou
- Laboratory of biochemistry and molecular biology, Lille university hospital, Inserm U1286, France
| | - Bernard Goichot
- Department of Internal Medicine, University hospitals of Strasbourg, France
| | - Thomas Cuny
- Department of Endocrinology, Conception Hospital, Aix-Marseille University, France
| | - Anderson Loundou
- Department of Public health, Aix-Marseille University, Marseille, France
| | - Pauline Romanet
- Aix Marseille Univ, APHM, INSERM, MMG, Laboratory of Molecular Biology Hospital La Conception, Marseille, France
| | - Alessio Imperiale
- Department of Nuclear Medicine and Molecular Imaging - Institut de Cancérologie de Strasbourg Europe (ICANS), IPHC, UMR 7178, CNRS/University of Strasbourg, France
| | - David Taïeb
- Department of Nuclear Medicine, La Timone University Hospital, CERIMED, Aix-Marseille University, France
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Addeo P, Cusumano C, Goichot B, Guerra M, Faitot F, Imperiale A, Bachellier P. Simultaneous Resection of Pancreatic Neuroendocrine Tumors with Synchronous Liver Metastases: Safety and Oncological Efficacy. Cancers (Basel) 2022; 14:cancers14030727. [PMID: 35158996 PMCID: PMC8833522 DOI: 10.3390/cancers14030727] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/24/2021] [Accepted: 12/29/2021] [Indexed: 02/07/2023] Open
Abstract
Simple Summary Up to half of all newly diagnosed pancreatic neuroendocrine tumors (PNET) present with liver metastases (LM). The surgical resection of PNETs and LMs can provide complete tumor clearance and improve long-term survival. However, the combination of liver and pancreatic resection simultaneously can theoretically cumulate the morbidity and mortality of two separate operations. In the current study, we analyzed the outcomes of the synchronous surgical resection of PNETs and LMs in 51 patients. There were no differences in the postoperative outcomes in terms of mortality and morbidity according to the type of pancreatic resection. The tumor grade was identified as the sole prognostic factor for survival. The resection of well-differentiated PNETs with LMs was characterized by the longest survival rates (median overall survival 128 months, 5-year overall survival 83%). The optimal sequential surgical strategies for PNETs with LM and the use of neoadjuvant/adjuvant chemotherapy in this category of patients remain to be further investigated. Abstract Whether the simultaneous resection of pancreatic neuroendocrine tumors (PNET) with synchronous liver metastases (LM) is safe and oncologically efficacious remains to be debated. We retrospectively reviewed clinical data from patients who underwent the simultaneous resection of PNETs with LMs over the last 25 years. Fifty-one consecutive patients with a median age of 54 years (range 27–80 years) underwent pancreaticoduodenectomy (PD) (n = 16), distal pancreatosplenectomy (DSP) (n = 32) or total pancreatectomy (n = 3) with synchronous LM resection. There were no differences in the postoperative outcomes in term of mortality (p = 0.33) and morbidity (p = 0.76) between PD and DSP. The median overall survival (OS) was 64.78 months (95% CI: 49.7–119.8), and the overall survival rates at 1, 3, and 5 years were 97.9%, 86.2% and 61%, respectively. The OS varied according to the tumor grade (G): G1 (OS 128 months, 5-year OS 83%) vs. G2 (OS 60.5 months, 5-year OS 58%) vs. G3 (OS 49.7 months, 5-year OS 0%) (p = 0.03). Multivariate Cox analysis identified G as the only prognostic factor (HR: 5.56; 95% CI: 0.91–9.60; p = 0.01). Simultaneous PNETS with LMs can be performed safely with acceptable morbidity and mortality at tertiary centers. Well-differentiated PNETs had longer survival and might benefit the most from these extended surgeries.
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Affiliation(s)
- Pietro Addeo
- Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, 67098 Strasbourg, France; (C.C.); (M.G.); (F.F.); (P.B.)
- Correspondence: ; Tel.: +33-3-8812-7265; Fax: +33-3-8812-7286
| | - Caterina Cusumano
- Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, 67098 Strasbourg, France; (C.C.); (M.G.); (F.F.); (P.B.)
| | - Bernard Goichot
- Internal Medicine, Diabetes and Metabolic Disorders, University Hospitals of Strasbourg, Strasbourg University, 67200 Strasbourg, France;
| | - Martina Guerra
- Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, 67098 Strasbourg, France; (C.C.); (M.G.); (F.F.); (P.B.)
| | - François Faitot
- Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, 67098 Strasbourg, France; (C.C.); (M.G.); (F.F.); (P.B.)
| | - Alessio Imperiale
- Nuclear Medicine and Molecular Imaging, Institut de Cancérologie de Strasbourg Europe (ICANS), University Hospitals of Strasbourg, Strasbourg University, 67200 Strasbourg, France;
- Molecular Imaging—DRHIM, IPHC, UMR 7178, CNRS/Unistra, 67037 Strasbourg, France
| | - Philippe Bachellier
- Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, 67098 Strasbourg, France; (C.C.); (M.G.); (F.F.); (P.B.)
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Mariette X, Hermine O, Tharaux PL, Resche-Rigon M, Porcher R, Ravaud P, Bureau S, Dougados M, Tibi A, Azoulay E, Cadranel J, Emmerich J, Fartoukh M, Guidet B, Humbert M, Lacombe K, Mahevas M, Pene F, Pourchet-Martinez V, Schlemmer F, Yazdanpanah Y, Baron G, Perrodeau E, Vanhoye D, Kedzia C, Demerville L, Gysembergh-Houal A, Bourgoin A, Dalibey S, Raked N, Mameri L, Alary S, Hamiria S, Bariz T, Semri H, Hai DM, Benafla M, Belloul M, Vauboin P, Flamand S, Pacheco C, Walter-Petrich A, Stan E, Benarab S, Nyanou C, Montlahuc C, Biard L, Charreteur R, Dupré C, Cardet K, Lehmann B, Baghli K, Madelaine C, D'Ortenzio E, Puéchal O, Semaille C, Savale L, Harrois A, Figueiredo S, Duranteau J, Anguel N, Pavot A, Monnet X, Richard C, Teboul JL, Durand P, Tissieres P, Jevnikar M, Montani D, Bulifon S, Jaïs X, Sitbon O, Pavy S, Noel N, Lambotte O, Escaut L, Jauréguiberry S, Baudry E, Verny C, Noaillon M, Lefèvre E, Zaidan M, Le Tiec CLT, Verstuyft C, Roques AM, Grimaldi L, Molinari D, Leprun G, Fourreau A, Cylly L, Virlouvet M, Meftali R, Fabre S, Licois M, Mamoune A, Boudali Y, Georgin-Lavialle S, Senet P, Pialoux G, Soria A, Parrot A, François H, Rozensztajn N, Blin E, Choinier P, Camuset J, Rech JS, Canellas A, Rolland-Debord C, Lemarié N, Belaube N, Nadal M, Siguier M, Petit-Hoang C, Chas J, Drouet E, Lemoine M, Phibel A, Aunay L, Bertrand E, Ravato S, Vayssettes M, Adda A, Wilpotte C, Thibaut P, Fillon J, Debrix I, Fellahi S, Bastard JP, Lefèvre G, Fallet V, Gottenberg JE, Hansmann Y, Andres E, Bayer S, Becker G, Blanc F, Brin S, Castelain V, Chatelus E, Chatron E, Collange O, Danion F, De Blay F, Demonsant E, Diemunsch P, Diemunsch S, Felten R, Goichot B, Greigert V, Guffroy A, Heger B, Hutt A, Kaeuffer C, Kassegne L, Korganow AS, Le Borgne P, Lefebvre N, Martin T, Mertes PM, Metzger C, Meyer N, Nisand G, Noll E, Oberlin M, Ohlmann-Caillard S, Poindron V, Pottecher J, Ruch Y, Sublon C, Tayebi H, Weill F, Mekinian A, Abisror N, Jachiet V, Chopin D, Fain O, Garnier M, Krause le Garrec J, Morgand M, Pacanowski J, Urbina T, McAvoy C, Pereira M, Aratus G, Berard L, Simon T, Daguenel-Nguyen A, Antignac M, Leplay C, Arlet JB, Diehl JL, Bellenfant F, Blanchard A, Buffet A, Cholley B, Fayol A, Flamarion E, Godier A, Gorget T, Hamada SR, Hauw-Berlemont C, Hulot JS, Lebeaux D, Livrozet M, Michon A, Neuschwander A, Penet MA, Planquette B, Ranque B, Sanchez O, Volle G, Briois S, Cornic M, Elisee V, Jesuthasan D, Djadi-Prat J, Jouany P, Junquera R, Henriques M, Kebir A, Lehir I, Meunier J, Patin F, Paquet V, Tréhan A, Vigna V, Sabatier B, Bergerot D, Jouve C, Knosp C, Lenoir O, Mahtal N, Resmini L, Lescure FX, Ghosn J, BACHELARD A, BIRONNE T, BORIE R, BOUNHIOL A, BOUSSARD C, CHAUFFiER J, CHALAL S, CHALAL L, CHANSOMBAT M, CRESPIN P, CRESTANI B, DACONCEICAO O, DECONINCK L, DIEUDE P, DOSSIER A, DUBERT M, DUCROCQ G, FUENTES A, GERVAIS A, GILBERT M, ISERNIA V, ISMAEL S, JOLY V, JULIA Z, LARIVEN S, LE GAC S, LE PLUART D, LOUNI F, NDIAYE A, PAPO T, PARISEY M, PHUNG B, POURBAIX A, RACHLINE A, RIOUX C, SAUTEREAU A, STEG G, TARHINI H, VALAYER S, VALLOIS D, VERMES P, VOLPE T, Nguyen Y, Honsel V, Weiss E, Codorniu A, Zarrouk V, De Lastours V, Uzzan M, Olivier O, Rossi G, Gamany N, Rahli R, Louis Z, Boutboul D, Galicier L, Amara Y, Archer G, Benattia A, Bergeron A, Bondeelle L, De Castro N, Clément M, Darmont M, Denis B, Dupin C, Feredj E, Feyeux D, Joseph A, Lengliné E, Le Guen P, Liégeon G, Lorillon G, Mabrouki A, Mariotte E, Martin de Frémont G, Mirouse A, Molina JM, Peffault de Latour R, Oksenhendler E, Saussereau J, Tazi A, Tudesq JJ, Zafrani L, Brindele I, Bugnet E, Celli Lebras K, Chabert J, Djaghout L, Fauvaux C, Jegu AL, Kozaliewicz E, Meunier M, Tremorin MT, Davoine C, Madeleine I, Caillat-Zucman S, Delaugerre C, Morin F, SENE D, BURLACU R, CHOUSTERMAN B, MEGARBANE B, RICHETTE P, RIVELINE JP, FRAZIER A, VICAUT E, BERTON L, HADJAM T, VASQUEZ-IBARRA MA, JOURDAINE C, JACOB A, SMATI J, RENAUD S, MANIVET P, PERNIN C, SUAREZ L, Semerano L, ABAD S, Benainous R, Bloch Queyrat C, Bonnet N, Brahmi S, Cailhol J, Cohen Y, Comparon C, Cordel H, Dhote R, Dournon N, Duchemann B, Ebstein N, Giroux-Leprieur B, Goupil de Bouille J, Jacolot A, Nunes H, Oziel J, Rathouin V, Rigal M, Roulot D, Tantet C, Uzunhan Y, COSTEDOAT-CHALUMEAU N, Ait Hamou Z, Benghanem S, BLANCHE P, CANOUI E, CARLIER N, CHAIGNE B, CONTEJEAN A, DUNOGUE B, DUPLAND P, DUREL - MAURISSE A, GAUZIT R, JAUBERT P, Joumaa H, Jozwiak M, KERNEIS S, LACHATRE M, Lafoeste H, LEGENDRE P, LUONG NGUYEN LB, MAREY J, MORBIEU C, MOUTHON L, NGUYEN L, Palmieri LJ, REGENT A, SZWEBEL TA, TERRIER B, GUERIN C, ZERBIT J, CHEREF K, CHITOUR K, CISSE MS, CLARKE A, CLAVERE G, DUSANTER I, GAUDEFROY C, JALLOULI M, KOLTA S, LE BOURLOUT C, MARIN N, MENAGE N, MOORES A, PEIGNEY I, PIERRON C, SALEH-MGHIR S, VALLET M, MICHEL M, MELICA G, LELIEVRE JD, FOIS E, LIM P, MATIGNON M, GUILLAUD C, THIEMELE A, SCHMITZ D, BOUHRIS M, BELAZOUZ S, LANGUILLE L, MEKONTSO-DESSAPS A, SADAOUI T, Mayaux J, Cacoub P, Corvol JC, Louapre C, Sambin S, Mariani LL, Karachi C, Tubach F, Estellat C, Gimeno L, Martin K, Bah A, Keo V, Ouamri S, Messaoudi Y, Yelles N, Faye P, Cavelot S, Larcheveque C, Annonay L, Benhida J, Zahrate-Ghoul A, Hammal S, Belilita R, Lecronier M, Beurton A, Haudebourg L, Deleris R, Le Marec J, Virolle S, Nemlaghi S, Bureau C, Mora P, De Sarcus M, Clovet O, Duceau B, Grisot PH, Pari MH, Arzoine J, Clarac U, Faure M, Delemazure J, Decavele M, Morawiec E, Demoule A, Dres M, Vautier M, Allenbach Y, Benveniste O, Leroux G, Rigolet A, Guillaume-Jugnot P, Domont F, Desbois AC, Comarmond C, Champtiaux N, Toquet S, Ghembaza A, Vieira M, Maalouf G, Boleto G, Ferfar Y, Charbonnier F, AGUILAR C, ALBY-LAURENT F, ALYANAKIAN MA, BAKOUBOULA P, BROISSAND C, BURGER C, CAMPOS-VEGA C, CHAVAROT N, CHOUPEAUX L, FOURNIER B, GRANVILLE S, ISSORAT E, ROUZAUD C, VIMPERE D, Geri G, Derridj N, Sguiouar N, Meddah H, Djadel M, Chambrin-Lauvray H, Duclos-Vallée JC, Saliba F, Sacleux SC, Koumis I, Michot JM, Stoclin A, Colomba E, Pommeret F, Willekens C, Sakkal M, Da Silva R, Dejean V, Mekid Y, Ben-Mabrouk I, Pradon C, Drouard L, Camara-Clayette V, Morel A, Garcia G, Mohebbi A, Berbour F, Dehais M, Pouliquen AL, Klasen A, Soyez-Herkert L, London J, Keroumi Y, Guillot E, Grailles G, El Amine Y, Defrancq F, Fodil H, Bouras C, Dautel D, Gambier N, Dieye T, Razurel A, Bienvenu B, Lancon V, Lecomte L, Beziriganyan K, Asselate B, Allanic L, Kiouris E, Legros MH, Lemagner C, Martel P, Provitolo V, Ackermann F, Le Marchand M, Clan Hew Wai A, Fremont D, Coupez E, Adda M, Duée F, Bernard L, Gros A, Henry E, Courtin C, Pattyn A, Guinot PG, Bardou M, Maurer A, Jambon J, Cransac A, Pernot C, Mourvillier B, Servettaz A, Deslée G, Wynckel A, Benoit P, Marquis E, Roux D, Gernez C, Yelnik C, Poissy J, Nizard M, Denies F, Gros H, Mourad JJ, Sacco E, Renet S. Sarilumab in adults hospitalised with moderate-to-severe COVID-19 pneumonia (CORIMUNO-SARI-1): An open-label randomised controlled trial. The Lancet Rheumatology 2022; 4:e24-e32. [PMID: 34812424 PMCID: PMC8598187 DOI: 10.1016/s2665-9913(21)00315-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background Patients with COVID-19 pneumonia can have increased inflammation and elevated cytokines, including interleukin (IL)-6, which might be deleterious. Thus, sarilumab, a high-affinity anti-IL-6 receptor antibody, might improve the outcome of patients with moderate-to-severe COVID-19 pneumonia. Methods We did a multicentric, open-label, Bayesian randomised, adaptive, phase 2/3 clinical trial, nested within the CORIMUNO-19 cohort, to test a superiority hypothesis. Patients 18 years or older hospitalised with COVID-19 in six French centres, requiring at least 3L/min of oxygen but without ventilation assistance and a WHO Clinical Progression Scale [CPS] score of 5 were enrolled. Patients were randomly assigned (1:1) via a web-based system, according to a randomisation list stratified on centre and with blocks randomly selected among 2 and 4, to receive usual care plus 400 mg of sarilumab intravenously on day 1 and on day 3 if clinically indicated (sarilumab group) or usual care alone (usual care group). Primary outcomes were the proportion of patients with WHO-CPS scores greater than 5 on the 10-point scale on day 4 and survival without invasive or non-invasive ventilation at day 14. This completed trial is closed to new participants and is registered with ClinicalTrials.gov, NCT04324073. Findings 165 patients were recruited from March 27 to April 6, 2020, and 148 patients were randomised (68 patients to the sarilumab group and 80 to the usual care group) and followed up for 90 days. Median age was 61·7 years [IQR 53·0–71·1] in the sarilumab group and 62·8 years [56·0–71·7] in the usual care group. In the sarilumab group 49 (72%) of 68 were men and in the usual care group 59 (78%) of 76 were men. Four patients in the usual care group withdrew consent and were not analysed. 18 (26%) of 68 patients in the sarilumab group had a WHO-CPS score greater than 5 at day 4 versus 20 (26%) of 76 in the usual care group (median posterior absolute risk difference 0·2%; 90% credible interval [CrI] −11·7 to 12·2), with a posterior probability of absolute risk difference greater than 0 of 48·9%. At day 14, 25 (37%) patients in the sarilumab and 26 (34%) patients in the usual care group needed ventilation or died, (median posterior hazard ratio [HR] 1·10; 90% CrI 0·69–1·74) with a posterior probability HR greater than 1 of 37·4%. Serious adverse events occurred in 27 (40%) patients in the sarilumab group and 28 (37%) patients in the usual care group (p=0·73). Interpretation Sarilumab treatment did not improve early outcomes in patients with moderate-to-severe COVID-19 pneumonia. Further studies are warranted to evaluate the effect of sarilumab on long-term survival. Funding Assistance publique—Hôpitaux de Paris
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Cazzato RL, Hubelé F, De Marini P, Ouvrard E, Salvadori J, Addeo P, Garnon J, Kurtz JE, Greget M, Mertz L, Goichot B, Gangi A, Imperiale A. Liver-Directed Therapy for Neuroendocrine Metastases: From Interventional Radiology to Nuclear Medicine Procedures. Cancers (Basel) 2021; 13:cancers13246368. [PMID: 34944988 PMCID: PMC8699378 DOI: 10.3390/cancers13246368] [Citation(s) in RCA: 9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/16/2021] [Accepted: 12/17/2021] [Indexed: 12/25/2022] Open
Abstract
Neuroendocrine neoplasms (NENs) are rare and heterogeneous epithelial tumors most commonly arising from the gastroenteropancreatic (GEP) system. GEP-NENs account for approximately 60% of all NENs, and the small intestine and pancreas represent two most common sites of primary tumor development. Approximately 80% of metastatic patients have secondary liver lesions, and in approximately 50% of patients, the liver is the only metastatic site. The therapeutic strategy depends on the degree of hepatic metastatic invasion, ranging from liver surgery or percutaneous ablation to palliative treatments to reduce both tumor volume and secretion. In patients with grade 1 and 2 NENs, locoregional nonsurgical treatments of liver metastases mainly include percutaneous ablation and endovascular treatments, targeting few or multiple hepatic metastases, respectively. In the present work, we provide a narrative review of the current knowledge on liver-directed therapy for metastasis treatment, including both interventional radiology procedures and nuclear medicine options in NEN patients, taking into account the patient clinical context and both the strengths and limitations of each modality.
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Affiliation(s)
- Roberto Luigi Cazzato
- Interventional Radiology, University Hospitals of Strasbourg, Strasbourg University, 67000 Strasbourg, France; (R.L.C.); (P.D.M.); (J.G.); (M.G.); (A.G.)
- Oncology, Institut de Cancérologie de Strasbourg Europe (ICANS), Strasbourg University, 67200 Strasbourg, France;
| | - Fabrice Hubelé
- Nuclear Medicine and Molecular Imaging, Institut de Cancérologie de Strasbourg Europe (ICANS), University Hospitals of Strasbourg, Strasbourg University, 67200 Strasbourg, France; (F.H.); (E.O.)
| | - Pierre De Marini
- Interventional Radiology, University Hospitals of Strasbourg, Strasbourg University, 67000 Strasbourg, France; (R.L.C.); (P.D.M.); (J.G.); (M.G.); (A.G.)
| | - Eric Ouvrard
- Nuclear Medicine and Molecular Imaging, Institut de Cancérologie de Strasbourg Europe (ICANS), University Hospitals of Strasbourg, Strasbourg University, 67200 Strasbourg, France; (F.H.); (E.O.)
| | - Julien Salvadori
- Radiophysics, Institut de Cancérologie de Strasbourg Europe (ICANS), 67200 Strasbourg, France;
| | - Pietro Addeo
- Hepato-Pancreato-Biliary Surgery and Liver Transplantation, University Hospitals of Strasbourg, 67200 Strasbourg, France;
| | - Julien Garnon
- Interventional Radiology, University Hospitals of Strasbourg, Strasbourg University, 67000 Strasbourg, France; (R.L.C.); (P.D.M.); (J.G.); (M.G.); (A.G.)
| | - Jean-Emmanuel Kurtz
- Oncology, Institut de Cancérologie de Strasbourg Europe (ICANS), Strasbourg University, 67200 Strasbourg, France;
| | - Michel Greget
- Interventional Radiology, University Hospitals of Strasbourg, Strasbourg University, 67000 Strasbourg, France; (R.L.C.); (P.D.M.); (J.G.); (M.G.); (A.G.)
| | - Luc Mertz
- Radiophysics, University Hospitals of Strasbourg, 67000 Strasbourg, France;
| | - Bernard Goichot
- Internal Medicine, Diabetes and Metabolic Disorders, University Hospitals of Strasbourg, Strasbourg University, 67200 Strasbourg, France;
| | - Afshin Gangi
- Interventional Radiology, University Hospitals of Strasbourg, Strasbourg University, 67000 Strasbourg, France; (R.L.C.); (P.D.M.); (J.G.); (M.G.); (A.G.)
- School of Biomedical Engineering and Imaging Science, King’s College London, Strand, London WC2R 2LS, UK
| | - Alessio Imperiale
- Nuclear Medicine and Molecular Imaging, Institut de Cancérologie de Strasbourg Europe (ICANS), University Hospitals of Strasbourg, Strasbourg University, 67200 Strasbourg, France; (F.H.); (E.O.)
- Molecular Imaging—DRHIM, IPHC, UMR 7178, CNRS/Unistra, 67037 Strasbourg, France
- Correspondence: ; Tel.: +33-3-68-76-74-48; Fax: +33-3-68-76-72-56
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Brugel M, Walter T, Goichot B, Smith D, Lepage C, Do Cao C, Hautefeuille V, Rebours V, Cadiot G, de Mestier L. Efficacy of treatments for VIPoma: A GTE multicentric series. Pancreatology 2021; 21:1531-1539. [PMID: 34404601 DOI: 10.1016/j.pan.2021.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/28/2021] [Accepted: 08/04/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Vasoactive intestinal peptide-secreting tumor (VIPoma) is a very rare, life-threatening, functioning pancreatic neuroendocrine tumor (pNET). The efficacy of antitumor therapies against functioning symptoms and tumor burden have been poorly described in VIPoma. OBJECTIVE Describe the impact of treatments on the secretory syndrome, tumor burden and survival in patients with VIPoma. METHODS We retrospectively reviewed the records of patients with VIPoma treated in seven French expert centers between 1990 and 2016. Diagnostic of VIPoma was reassessed using strict criteria. We evaluated the antisecretory efficacy (>50 % decrease of daily bowel movements), and antitumor efficacy (RECIST 1.1) of all treatments received. RESULTS Twenty-two patients were included. pNETs were mostly metastatic (77 %) and classified as grade 2 (83 %). Median follow-up was 78.2 months. Surgical excision of nonmetastatic VIPoma effectively controlled the secretory syndrome. Although 4/5 patients had metastatic recurrences, all patients were alive after median post-operative follow-up of 171 months. Among the 87 treatments received for metastatic VIPoma, curative-intent surgery (n = 14), somatostatin analogs alone (n = 11), chemotherapy (n = 23), transarterial liver embolization (TALE) (n = 14), everolimus (n = 10) and sunitinib (n = 7) achieved, respectively, 100 %, 67 %, 83 %, 50 %, 20 % and 100 % antisecretory efficacy. The 5-year OS rate was 63.6 %, with pejorative impact of higher Ki-67 index (P = 0.045) and higher plasma VIP concentration (P = 0.025). CONCLUSIONS Surgical resection of localized VIPoma is effective but rarely curative. For metastatic VIPoma, curative-intent surgery, chemotherapy and sunitinib are the therapeutic options that best combined antitumor and antisecretory efficacies.
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Affiliation(s)
- Mathias Brugel
- Department of Hepato-Gastroenterology and Digestive Oncology, Robert-Debré Hospital and Reims-Champagne-Ardenne University, Reims, France.
| | - Thomas Walter
- Department of Digestive Oncology, ENETS Centre of Excellence, Hospices Civils de Lyon, Lyon, France
| | - Bernard Goichot
- Department of Internal Medicine, Endocrinology & Nutrition, Hôpital Hautepierre, Strasbourg University Hospital, France
| | - Denis Smith
- Department of Hepato-Gastroenterology and Digestive Oncology, Haut-Lévêque Hospital, Bordeaux University Hospital, Pessac, France
| | - Côme Lepage
- Department of Hepato-Gastroenterology and Digestive Oncology, Dijon University Hospital, Dijon, France
| | - Christine Do Cao
- Department of Endocrinology, Hôpital Claude-Huriez, Lille University Hospital, Lille, France
| | - Vincent Hautefeuille
- Department of Hepato-Gastroenterology and Digestive Oncology, Amiens University Hospital, Amiens, France
| | - Vinciane Rebours
- Department of Gastroenterology-Pancreatology, ENETS Centre of Excellence, Hôpital Beaujon and Université de Paris Nord, Clichy, France
| | - Guillaume Cadiot
- Department of Hepato-Gastroenterology and Digestive Oncology, Robert-Debré Hospital and Reims-Champagne-Ardenne University, Reims, France
| | - Louis de Mestier
- Department of Gastroenterology-Pancreatology, ENETS Centre of Excellence, Hôpital Beaujon and Université de Paris Nord, Clichy, France
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17
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Le Bras M, Leclerc H, Rousseau O, Goudet P, Cuny T, Castinetti F, Bauters C, Chanson P, Tabarin A, Gaujoux S, Christin-Maitre S, Ruszniewski P, Borson-Chazot F, Guilhem I, Caron P, Goichot B, Beckers A, Delemer B, Raingeard I, Vergès B, Smati S, Wargny M, Cariou B, Hadjadj S. Pituitary adenoma in patients with multiple endocrine neoplasia type 1: a cohort study. Eur J Endocrinol 2021; 185:863-873. [PMID: 34636744 DOI: 10.1530/eje-21-0630] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 10/07/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Pituitary adenoma (PA) is one of the three major components of multiple endocrine neoplasia type 1 (MEN1). Recent studies have suggested that MEN1-associated PAs are less aggressive than initially estimated. We propose an analysis of the outcome of PAs with a standard of care treatment in a nationwide cohort of MEN1 patients. DESIGN Retrospective observational nationwide cohort study using the MEN1 patient registry from the French Group of Endocrine Tumours (GTE). METHODS The GTE database population consists of 1435 patients with MEN1. This analysis focused on 551 patients recruited after 2000 with at least 3 years of follow-up. The study outcome was tumour progression of PA defined by an increase in Hardy classification (HC) during follow-up according to referring physician regular reports. RESULTS Among 551 MEN1 patients (index and related), 202 (36.7%) had PA, with 114 (56.4%) diagnosed by MEN1-related screening. PAs were defined according to HC as microadenoma (grade I) in 117 cases (57.9%), macroadenoma in 59 (29.2%) with 20 HC grade II and 39 HC grades III-IV and unspecified in 26 (12.8%). They were prolactinomas in 92 cases (45.5%) and non-secreting in 73 (36.1%). After a median follow-up of 3 years among the 137 patients with HC grades I-II, 4 patients (2.9%) presented tumour progression. CONCLUSION PAs in patients with MEN1 are less aggressive than previously thought. Tumour progression is rare with a standard of care monitoring and treatment, especially in related patients who mostly present non-secreting microadenoma. MRI monitoring for asymptomatic MEN1 patients should be reduced accordingly.
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Affiliation(s)
- Maelle Le Bras
- CHU de Nantes PHU2 Institut du Thorax et du Système Nerveux, Service d'Endocrinologie, Diabétologie et Nutrition, Nantes, France
| | - Hélène Leclerc
- Centre Hospitalier de La Roche sur Yon, Department of Endocrinology and Diabetology, La Roche sur Yon, France
| | - Olivia Rousseau
- INSERM CIC 1413, Clinique des Données, CHU de Nantes, Nantes, France
| | - Pierre Goudet
- University Hospital Dijon, Endocrine Surgery, Hôpital du Bocage, Dijon, France
| | - Thomas Cuny
- Department of Endocrinology, Hopital de la Conception, Marseille, France
| | - Frederic Castinetti
- Aix-Marseille Université, Assistance-Publique-Hôpitaux de Marseille, Centre de Référence des Maladies Rares d'Origine Hypophysaire, Department of endocrinology, Marseille, France
| | | | - Philippe Chanson
- Assistance Publique-Hôpitaux de Paris, Endocrinology, Le Kremlin-Bicêtre, Île-de-France, France
| | - Antoine Tabarin
- Department of Endocrinology, Hôpital Haut Lévêque-CHU de Bordeaux, Pessac, France
| | | | | | - Philippe Ruszniewski
- Department of Gastroenterology and Pancreatology, Université Paris Diderot, Sorbonne Paris Cité, Beaujon Hospital, Paris Clichy, France
| | - Francoise Borson-Chazot
- Hospices Civils de Lyon, Fédération d'Endocrinologie Groupement Hospitalier Est, Lyon, France
| | - Isabelle Guilhem
- Centre Hospitalier Universitaire de Rennes, Hôpital Sud, Service d'Endocrinologie-Diabétologie-Nutrition, Rennes, France
| | - Philippe Caron
- CHU Toulouse, Endocrinology and Metabolic diseases, Service d'Endocrinologie, Toulouse, France
| | - Bernard Goichot
- Hôpital de Hautepierre, Service de Medecine Interne et Nutrition, Strasbourg Cedex, France
| | - Albert Beckers
- CHU de Liège, Service d'Endocrinologie, Domaine Univeritaire du Sart-Tilman, Liège, Belgium
| | - Brigitte Delemer
- Hôpital Robert-Debré, CHU de Reims, Service Endocrinologie, Reims, France
| | | | - Bruno Vergès
- CHU Dijon, Hôpital du Bocage, Endocrinologie, Diabétologie, Dijon, France
| | - Sarra Smati
- CHU de Nantes PHU2 Institut du Thorax et du Système Nerveux, Service d'Endocrinologie, Diabétologie et Nutrition, Nantes, France
- UNIV Nantes, CNRS, INSERM, CHU Nantes, l'Institut du Thorax, Nantes, France
| | - Matthieu Wargny
- CHU de Nantes PHU2 Institut du Thorax et du Système Nerveux, Service d'Endocrinologie, Diabétologie et Nutrition, Nantes, France
- UNIV Nantes, CNRS, INSERM, CHU Nantes, l'Institut du Thorax, Nantes, France
| | - Bertrand Cariou
- CHU de Nantes PHU2 Institut du Thorax et du Système Nerveux, Service d'Endocrinologie, Diabétologie et Nutrition, Nantes, France
- UNIV Nantes, CNRS, INSERM, CHU Nantes, l'Institut du Thorax, Nantes, France
| | - Samy Hadjadj
- CHU de Nantes PHU2 Institut du Thorax et du Système Nerveux, Service d'Endocrinologie, Diabétologie et Nutrition, Nantes, France
- UNIV Nantes, CNRS, INSERM, CHU Nantes, l'Institut du Thorax, Nantes, France
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18
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Carapito R, Li R, Helms J, Carapito C, Gujja S, Rolli V, Guimaraes R, Malagon-Lopez J, Spinnhirny P, Lederle A, Mohseninia R, Hirschler A, Muller L, Bastard P, Gervais A, Zhang Q, Danion F, Ruch Y, Schenck M, Collange O, Chamaraux-Tran TN, Molitor A, Pichot A, Bernard A, Tahar O, Bibi-Triki S, Wu H, Paul N, Mayeur S, Larnicol A, Laumond G, Frappier J, Schmidt S, Hanauer A, Macquin C, Stemmelen T, Simons M, Mariette X, Hermine O, Fafi-Kremer S, Goichot B, Drenou B, Kuteifan K, Pottecher J, Mertes PM, Kailasan S, Aman MJ, Pin E, Nilsson P, Thomas A, Viari A, Sanlaville D, Schneider F, Sibilia J, Tharaux PL, Casanova JL, Hansmann Y, Lidar D, Radosavljevic M, Gulcher JR, Meziani F, Moog C, Chittenden TW, Bahram S. Identification of driver genes for critical forms of COVID-19 in a deeply phenotyped young patient cohort. Sci Transl Med 2021; 14:eabj7521. [PMID: 34698500 DOI: 10.1126/scitranslmed.abj7521] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
[Figure: see text].
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Affiliation(s)
- Raphael Carapito
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Service d'Immunologie Biologique, Plateau Technique de Biologie, Pôle de Biologie, Nouvel Hôpital Civil; 67091 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Richard Li
- Genuity AI Research Institute, Genuity Science; Boston, MA 02114, USA
| | - Julie Helms
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France.,Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg; 67091 Strasbourg, France
| | - Christine Carapito
- Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France.,Laboratoire de Spectrométrie de Masse BioOrganique, Université de Strasbourg, CNRS, IPHC, UMR 7178; 67000, Strasbourg, France
| | - Sharvari Gujja
- Genuity AI Research Institute, Genuity Science; Boston, MA 02114, USA
| | - Véronique Rolli
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Service d'Immunologie Biologique, Plateau Technique de Biologie, Pôle de Biologie, Nouvel Hôpital Civil; 67091 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Raony Guimaraes
- Genuity AI Research Institute, Genuity Science; Boston, MA 02114, USA
| | | | - Perrine Spinnhirny
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Alexandre Lederle
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Razieh Mohseninia
- Center for Quantum Information Science and Technology, University of Southern California; Los Angeles, 90089-0484 CA, USA
| | - Aurélie Hirschler
- Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France.,Laboratoire de Spectrométrie de Masse BioOrganique, Université de Strasbourg, CNRS, IPHC, UMR 7178; 67000, Strasbourg, France
| | - Leslie Muller
- Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France.,Laboratoire de Spectrométrie de Masse BioOrganique, Université de Strasbourg, CNRS, IPHC, UMR 7178; 67000, Strasbourg, France
| | - Paul Bastard
- St Giles laboratory of human genetics of infectious diseases, Rockefeller Branch, The Rockefeller University; New York, NY 10065, USA.,Laboratory of human genetics of infectious diseases, Necker Branch, INSERM, Necker Hospital for Sick Children; 75015 Paris, France.,University of Paris, Imagine Institute; 75015 Paris, France
| | - Adrian Gervais
- Laboratory of human genetics of infectious diseases, Necker Branch, INSERM, Necker Hospital for Sick Children; 75015 Paris, France.,University of Paris, Imagine Institute; 75015 Paris, France
| | - Qian Zhang
- St Giles laboratory of human genetics of infectious diseases, Rockefeller Branch, The Rockefeller University; New York, NY 10065, USA.,Laboratory of human genetics of infectious diseases, Necker Branch, INSERM, Necker Hospital for Sick Children; 75015 Paris, France.,University of Paris, Imagine Institute; 75015 Paris, France
| | - François Danion
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France.,Department of Infectious and Tropical Diseases, Hôpitaux Universitaires de Strasbourg; 67091 Strasbourg, France
| | - Yvon Ruch
- Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France.,Department of Infectious and Tropical Diseases, Hôpitaux Universitaires de Strasbourg; 67091 Strasbourg, France
| | - Maleka Schenck
- Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France.,Service de Médecine Intensive-Réanimation, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg; Avenue Molière, 67200 Strasbourg, France
| | - Olivier Collange
- Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France.,Service d'Anesthésie-Réanimation et Médecine Péri-Opératoire, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg; 67000 Strasbourg, France
| | - Thiên-Nga Chamaraux-Tran
- Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France.,Service d'Anesthésie-Réanimation et Médecine Péri-Opératoire, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg; 67200 Strasbourg Cedex, France
| | - Anne Molitor
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Angélique Pichot
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Alice Bernard
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Ouria Tahar
- Service d'Immunologie Biologique, Plateau Technique de Biologie, Pôle de Biologie, Nouvel Hôpital Civil; 67091 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Sabrina Bibi-Triki
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Haiguo Wu
- Genuity AI Research Institute, Genuity Science; Boston, MA 02114, USA
| | - Nicodème Paul
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Sylvain Mayeur
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Annabel Larnicol
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Géraldine Laumond
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Julia Frappier
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Sylvie Schmidt
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Antoine Hanauer
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Cécile Macquin
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Tristan Stemmelen
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Service d'Immunologie Biologique, Plateau Technique de Biologie, Pôle de Biologie, Nouvel Hôpital Civil; 67091 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Michael Simons
- Yale Cardiovascular Research Center, Departments of Medicine and Cell Biology, Yale University School of Medicine; New Haven, CT 06511, USA
| | - Xavier Mariette
- Department of Rheumatology, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris; 94270 Paris, France.,Université Paris-Saclay, INSERM UMR_S 1184; 94270 Le Kremlin Bicêtre, France
| | - Olivier Hermine
- University of Paris, Imagine Institute; 75015 Paris, France.,Department of Hematology, INSERM UMR_S 1153, Imagine Institute, Necker Hospital, University of Paris, Assistance Publique-Hôpitaux de Paris, 75015 Paris, France
| | - Samira Fafi-Kremer
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France.,Department of Virology, Hôpitaux Universitaires de Strasbourg; 67091 Strasbourg, France
| | - Bernard Goichot
- Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France.,Service de Médecine Interne, Endocrinologie et Nutrition, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg; 67200 Strasbourg, France
| | - Bernard Drenou
- Département d'Hématologie, Groupe Hospitalier de la région Mulhouse Sud Alsace; 68100 Mulhouse, France
| | - Khaldoun Kuteifan
- Service de Réanimation Médicale, Groupe Hospitalier de la région Mulhouse Sud Alsace; 68100 Mulhouse, France
| | - Julien Pottecher
- Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France.,Service d'Anesthésie-Réanimation et Médecine Péri-Opératoire, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg; 67200 Strasbourg Cedex, France
| | - Paul-Michel Mertes
- Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France.,Service d'Anesthésie-Réanimation et Médecine Péri-Opératoire, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg; 67000 Strasbourg, France
| | | | - M Javad Aman
- Integrated BioTherapeutics, Inc.; Rockville, MD 20850, USA
| | - Elisa Pin
- Division of Affinity Proteomics, Department of Protein Science, KTH Royal Institute of Technology, SciLifeLab; Stockholm, SE-171 21, Sweden
| | - Peter Nilsson
- Division of Affinity Proteomics, Department of Protein Science, KTH Royal Institute of Technology, SciLifeLab; Stockholm, SE-171 21, Sweden
| | | | | | | | - Francis Schneider
- Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France.,Service de Médecine Intensive-Réanimation, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg; Avenue Molière, 67200 Strasbourg, France
| | - Jean Sibilia
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France.,Service de Rhumatologie, Centre National de Référence des Maladies Auto-immunes Systémiques Rares Est Sud-Ouest, Hôpitaux Universitaires de Strasbourg; 67200 Strasbourg, France
| | - Pierre-Louis Tharaux
- INSERM (Institut de la Santé et de la Recherche Médicale), Université de Paris, Paris Cardiovascular Center-PARCC; 75015 Paris, France
| | - Jean-Laurent Casanova
- St Giles laboratory of human genetics of infectious diseases, Rockefeller Branch, The Rockefeller University; New York, NY 10065, USA.,Laboratory of human genetics of infectious diseases, Necker Branch, INSERM, Necker Hospital for Sick Children; 75015 Paris, France.,University of Paris, Imagine Institute; 75015 Paris, France.,Howard Hughes Medical Institute; New York, NY 10065, USA
| | - Yves Hansmann
- Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France.,Department of Infectious and Tropical Diseases, Hôpitaux Universitaires de Strasbourg; 67091 Strasbourg, France
| | - Daniel Lidar
- Center for Quantum Information Science and Technology, University of Southern California; Los Angeles, 90089-0484 CA, USA.,Department of Electrical and Computer Engineering, Department of Chemistry, Department of Physics and Astronomy, University of Southern California; Los Angeles, CA 90089, USA
| | - Mirjana Radosavljevic
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Service d'Immunologie Biologique, Plateau Technique de Biologie, Pôle de Biologie, Nouvel Hôpital Civil; 67091 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Jeffrey R Gulcher
- Genuity AI Research Institute, Genuity Science; Boston, MA 02114, USA
| | - Ferhat Meziani
- Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France.,Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg; 67091 Strasbourg, France
| | - Christiane Moog
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
| | - Thomas W Chittenden
- Genuity AI Research Institute, Genuity Science; Boston, MA 02114, USA.,Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School; Boston, MA 02115, USA
| | - Seiamak Bahram
- Laboratoire d'ImmunoRhumatologie Moléculaire, plateforme GENOMAX, INSERM UMR_S 1109, Faculté de Médecine, Institut Thématique Interdisciplinaire (ITI) de Médecine de Précision de Strasbourg, Transplantex NG, Université de Strasbourg; 67085 Strasbourg, France.,Service d'Immunologie Biologique, Plateau Technique de Biologie, Pôle de Biologie, Nouvel Hôpital Civil; 67091 Strasbourg, France.,Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche d'Immunologie et d'Hématologie; 67085, Strasbourg, France
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Baudin E, Goichot B, Berruti A, Hadoux J, Moalla S, Laboureau S, Noelting S, De La Fouchardière C, Kienitz T, Deutschbein T, Zovato S, Amar L, Tabarin A, Timmers H, Niccoli P, Attard M. Essai randomisé en double aveugle du Sunitinib dans les phéochromocytomes et paragangliomes malins (PPGM) : résultats de l’étude internationale FIRSTMAPPP. Annales d'Endocrinologie 2021. [DOI: 10.1016/j.ando.2021.07.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Chibbaro S, Signorelli F, Milani D, Cebula H, Scibilia A, Bozzi MT, Messina R, Zaed I, Todeschi J, Ollivier I, Mallereau CH, Dannhoff G, Romano A, Cammarota F, Servadei F, Pop R, Baloglu S, Lasio GB, Luca F, Goichot B, Proust F, Ganau M. Primary Endoscopic Endonasal Management of Giant Pituitary Adenomas: Outcome and Pitfalls from a Large Prospective Multicenter Experience. Cancers (Basel) 2021; 13:cancers13143603. [PMID: 34298816 PMCID: PMC8304085 DOI: 10.3390/cancers13143603] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 06/22/2021] [Accepted: 07/10/2021] [Indexed: 11/30/2022] Open
Abstract
Simple Summary Giant pituitary adenomas are highly invasive tumors whose treatment is challenging. Surgery is their management mainstay. However, there is no consensus about the type of approach. Open transcranial, microscopic, and endoscopic trans-sphenoidal approaches have all been employed, alone or in combination. Extended endoscopic endonasal techniques may represent a versatile and safe one-stage approach. Our research aimed at evaluating prospectively their applicability, effectiveness, and safety in a multicenter series, to acquire further evidence toward its use in the treatment of those challenging lesions. Ninety-six patients were recruited and followed-up for 52.4 months on average. Most of them (81.2%) presented with visual deficits and >50% had various degrees of adenohypophysis insufficiency. Resection of at least 75% of initial volume was achieved in all cases, with 98.7% visual improvement, >50% endocrine deficit recovery and a permanent complication rate of 4.2%, indicating extended endoscopic endonasal approaches as a valuable treatment option. Abstract Purpose: To evaluate factors influencing clinical and radiological outcome of extended endoscopic endonasal transtuberculum/transplanum approach (EEA-TTP) for giant pituitary adenomas (GPAs). Methods: We recruited prospectively all consecutive GPAs patients undergoing EEA-TTP between 2015 and 2019 in 5 neurosurgical centers. Preoperative clinical and radiologic features, visual and hormonal outcomes, extent of resection (EoR), complications and recurrence rates were recorded and analyzed. Results: Of 1169 patients treated for pituitary adenoma, 96 (8.2%) had GPAs. Seventy-eight (81.2%) patients had visual impairment, 12 (12.5%) had headaches, 3 (3.1%) had drowsiness due to hydrocephalus, and 53 (55.2%) had anterior pituitary insufficiency. EoR was gross or near-total in 46 (47.9%) and subtotal in 50 (52.1%) patients. Incomplete resection was associated with lateral suprasellar, intraventricular and/or cavernous sinus extension and with firm/fibrous consistence. At the last follow-up, all but one patient (77, 98.7%) with visual deficits improved. Headache improved in 8 (88.9%) and anterior pituitary function recovered in 27 (50.9%) patients. Recurrence rate was 16.7%, with 32 months mean recurrence-free survival. Conclusions: EEA-TTP is a valid option for GPAs and seems to provide better outcomes, lower rate of complications and higher EoR compared to one- or multi-stage microscopic, non-extended endoscopic transsphenoidal, and transcranial resections.
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Affiliation(s)
- Salvatore Chibbaro
- Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France; (S.C.); (H.C.); (A.S.); (M.T.B.); (I.Z.); (J.T.); (I.O.); (C.H.M.); (G.D.); (F.C.); (R.P.); (S.B.); (F.P.); (M.G.)
| | - Francesco Signorelli
- Neurosurgery Unit, Department of Basic Medical Sciences, Neurosciences, Sense Organs, University “Aldo Moro”, 70124 Bari, Italy;
- Correspondence: ; Tel.: +39-0805592900
| | - Davide Milani
- Neurosurgery Unit, Humanitas Research Hospital, 20089 Milano, Italy; (D.M.); (F.S.); (G.B.L.)
| | - Helene Cebula
- Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France; (S.C.); (H.C.); (A.S.); (M.T.B.); (I.Z.); (J.T.); (I.O.); (C.H.M.); (G.D.); (F.C.); (R.P.); (S.B.); (F.P.); (M.G.)
| | - Antonino Scibilia
- Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France; (S.C.); (H.C.); (A.S.); (M.T.B.); (I.Z.); (J.T.); (I.O.); (C.H.M.); (G.D.); (F.C.); (R.P.); (S.B.); (F.P.); (M.G.)
| | - Maria Teresa Bozzi
- Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France; (S.C.); (H.C.); (A.S.); (M.T.B.); (I.Z.); (J.T.); (I.O.); (C.H.M.); (G.D.); (F.C.); (R.P.); (S.B.); (F.P.); (M.G.)
| | - Raffaella Messina
- Neurosurgery Unit, Department of Basic Medical Sciences, Neurosciences, Sense Organs, University “Aldo Moro”, 70124 Bari, Italy;
| | - Ismail Zaed
- Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France; (S.C.); (H.C.); (A.S.); (M.T.B.); (I.Z.); (J.T.); (I.O.); (C.H.M.); (G.D.); (F.C.); (R.P.); (S.B.); (F.P.); (M.G.)
- Neurosurgery Unit, Humanitas Research Hospital, 20089 Milano, Italy; (D.M.); (F.S.); (G.B.L.)
| | - Julien Todeschi
- Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France; (S.C.); (H.C.); (A.S.); (M.T.B.); (I.Z.); (J.T.); (I.O.); (C.H.M.); (G.D.); (F.C.); (R.P.); (S.B.); (F.P.); (M.G.)
| | - Irene Ollivier
- Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France; (S.C.); (H.C.); (A.S.); (M.T.B.); (I.Z.); (J.T.); (I.O.); (C.H.M.); (G.D.); (F.C.); (R.P.); (S.B.); (F.P.); (M.G.)
| | - Charles Henry Mallereau
- Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France; (S.C.); (H.C.); (A.S.); (M.T.B.); (I.Z.); (J.T.); (I.O.); (C.H.M.); (G.D.); (F.C.); (R.P.); (S.B.); (F.P.); (M.G.)
| | - Guillaume Dannhoff
- Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France; (S.C.); (H.C.); (A.S.); (M.T.B.); (I.Z.); (J.T.); (I.O.); (C.H.M.); (G.D.); (F.C.); (R.P.); (S.B.); (F.P.); (M.G.)
| | - Antonio Romano
- Neurosurgery Department, Parma and Reggio Emilia Hospital, University of Parma, 43126 Parma, Italy;
| | - Francesco Cammarota
- Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France; (S.C.); (H.C.); (A.S.); (M.T.B.); (I.Z.); (J.T.); (I.O.); (C.H.M.); (G.D.); (F.C.); (R.P.); (S.B.); (F.P.); (M.G.)
| | - Franco Servadei
- Neurosurgery Unit, Humanitas Research Hospital, 20089 Milano, Italy; (D.M.); (F.S.); (G.B.L.)
| | - Raoul Pop
- Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France; (S.C.); (H.C.); (A.S.); (M.T.B.); (I.Z.); (J.T.); (I.O.); (C.H.M.); (G.D.); (F.C.); (R.P.); (S.B.); (F.P.); (M.G.)
| | - Seyyid Baloglu
- Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France; (S.C.); (H.C.); (A.S.); (M.T.B.); (I.Z.); (J.T.); (I.O.); (C.H.M.); (G.D.); (F.C.); (R.P.); (S.B.); (F.P.); (M.G.)
| | - Giovanni Battista Lasio
- Neurosurgery Unit, Humanitas Research Hospital, 20089 Milano, Italy; (D.M.); (F.S.); (G.B.L.)
| | - Florina Luca
- Endocrinology Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France; (F.L.); (B.G.)
| | - Bernard Goichot
- Endocrinology Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France; (F.L.); (B.G.)
| | - Francois Proust
- Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France; (S.C.); (H.C.); (A.S.); (M.T.B.); (I.Z.); (J.T.); (I.O.); (C.H.M.); (G.D.); (F.C.); (R.P.); (S.B.); (F.P.); (M.G.)
| | - Mario Ganau
- Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France; (S.C.); (H.C.); (A.S.); (M.T.B.); (I.Z.); (J.T.); (I.O.); (C.H.M.); (G.D.); (F.C.); (R.P.); (S.B.); (F.P.); (M.G.)
- Neurosurgery Department, Oxford University Hospital, Oxford OX3 9DU, UK
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21
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Greuez C, Argemi X, Giorgiutti S, Goichot B, Hannedouche T, Kaltenbach G, Lefebvre N, Lenormand C, Lescuyer S, Moulin B, Rondeau-Lutz M, Schmitt E, Sibilia J, Imperiale A, Andres E. Fièvre et syndrome inflammatoire inexpliqué chez le sujet âgé, impact thérapeutique de la TEP-TDM au 18F-FDG. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.03.267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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de Mestier L, Savagner F, Brixi H, Do Cao C, Dominguez-Tinajero S, Roquin G, Goichot B, Hentic O, Dubreuil O, Hautefeuille V, Walter T, Cadiot G. Plasmatic and Urinary 5-Hydroxyindolacetic Acid Measurements in Patients With Midgut Neuroendocrine Tumors: A GTE Study. J Clin Endocrinol Metab 2021; 106:e1673-e1682. [PMID: 33382891 DOI: 10.1210/clinem/dgaa924] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Indexed: 11/19/2022]
Abstract
CONTEXT Although 24-hour urinary 5-hydroxyindolacetic acid (24u5HIAA) is a key biomarker in midgut neuroendocrine tumors (NETs), it may be inaccurate and inconvenient. OBJECTIVE We compared the diagnostic performances of 24u5HIAA, overnight urinary 5HIAA (Ou5HIAA), and plasmatic 5HIAA (p5HIAA) in midgut NETs. METHODS This prospective, multicenter study included 80 patients with metastatic midgut NETs and 17 control patients with irritable bowel syndrome. 24u5HIAA, Ou5HIAA, and p5HIAA were measured in urine and plasma collected on 2 consecutive days following a specific recommended diet. Reproducibility of the biomarkers was evaluated by the Spearman test. Diagnostic performance was assessed by the area under the receiver operating characteristic curve (AUROC). Correlations with the main clinical features and declared observance to the specific diet were assessed using AUROC and logistic regression models. RESULTS The reproducibility of 24u5HIAA, Ou5HIAA, and p5HIAA were excellent (ρ = 0.916; 0.897; 0.978, respectively, P < .001) with significant discrimination between patients and controls (AUROC = 0.795, P < .001; 0.757, P = .001; 0.717, P = .005, respectively). All 3 markers were correlated with the presence of carcinoid syndrome (AUROC = 0.702, P = .006; 0.701, P = .006; 0.697, P = .007, respectively), carcinoid heart disease (AUROC = 0.896; 0.887; 0.923, P < .001, respectively, P < .001), and liver metastatic involvement greater than 30% (AUROC = 0.827; 0.807; 0.849, P < .001, respectively, P < .001), independent from other traditional prognostic factors. Biomarker levels were similar between patients with optimal or suboptimal diet observance. CONCLUSION Ou5HIAA and p5HIAA could be used as more convenient alternatives to 24u5HIAA in patients with metastatic midgut NETs. Prospective long-term studies with repeated dosages are needed.
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Affiliation(s)
- Louis de Mestier
- Université de Paris, Department of Gastroenterology-Pancreatology, ENETS Centre of Excellence, Hôpital Beaujon (APHP), Clichy, France
| | - Frédérique Savagner
- Biochemistry and Genetic Laboratory, Federative Institute of Biology, Hôpital Purpan and Université Toulouse III Paul Sabatier, Inserm, Toulouse, France
| | - Hedia Brixi
- Department of Hepato-Gastroenterology and Digestive Oncology, Hôpital Robert Debré and Université Reims-Champagne-Ardenne, Reims, France
| | - Christine Do Cao
- Department of Endocrinology, Hôpital Claude Huriez, Centre Hospitalo-Universitaire de Lille, Lille, France
| | - Sophie Dominguez-Tinajero
- Department of Onco-Hematology, Hôpitaux Catholiques de Lille, Université Catholique de Lille, Lille, France
| | - Guillaume Roquin
- Department of Hepato-Gastroenterology and Digestive Oncology, Centre Hospitalo-Universitaire d'Angers, Angers, France
| | - Bernard Goichot
- Department of Internal Medicine, Endocrinology & Nutrition, Hôpital Hautepierre, Hôpitaux Universitaires, Strasbourg, France
| | - Olivia Hentic
- Université de Paris, Department of Gastroenterology-Pancreatology, ENETS Centre of Excellence, Hôpital Beaujon (APHP), Clichy, France
| | - Olivier Dubreuil
- Department of Digestive Oncology, Hôpital La Pitié Salpétrière (APHP), Paris, France
| | - Vincent Hautefeuille
- Department of Hepato-Gastroenterology and Digestive Oncology, Centre Hospitalo-Universitaire d'Amiens, Amiens, France
| | - Thomas Walter
- Department of Digestive Oncology, ENETS Centre of Excellence, Hospices Civils de Lyon, Lyon, France
| | - Guillaume Cadiot
- Department of Hepato-Gastroenterology and Digestive Oncology, Hôpital Robert Debré and Université Reims-Champagne-Ardenne, Reims, France
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Addeo P, Bertin JB, Imperiale A, Averous G, Terrone A, Goichot B, Bachellier P. Outcomes of Simultaneous Resection of Small Bowel Neuroendocrine Tumors with Synchronous Liver Metastases. World J Surg 2021; 44:2377-2384. [PMID: 32179974 DOI: 10.1007/s00268-020-05467-5] [Citation(s) in RCA: 9] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND This study evaluated the short- and long-term outcomes of synchronous resection of liver metastases (LM) from small bowel neuroendocrine tumors (SB-NET). METHODS A retrospective review of patients undergoing resection for LMs from SB-NETs from January 1997 and December 2018 was performed. RESULTS There were 44 patients with synchronous SB-NET and LMs. Perioperative and 90-day mortality values were zero, and the morbidity rate was 27%. The median overall survival (OS) was 128.4 months (CI 95% 74.0-161.5 months) with 1-, 3-, 5-, and 10-year survival rates of 100%, 83%, 79%, and 60%, respectively. Not achieving surgical treatment for LM was the unique independent factor for survival (HR 6.50; CI 95% 1.54-27.28; p = 0.01) in patients with unresected LMs having OS and 10-year survival rates (42 months, 33%) versus patients undergoing liver resection (152 months, 66%)(p = 0.0008). The recurrence rate was 81.8% and associated with longer OS and 5-year survival rates when limited to the liver [223 months (61%) vs 94 months (87%)]. CONCLUSIONS Simultaneous resection of SB-NETs with synchronous LMs was safe and associated with considerable long-term survival even in the presence of bilobar disease. However, recurrence after resection was common (81%) but associated with longer survival rates when limited to the liver.
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Affiliation(s)
- Pietro Addeo
- Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, 1, Avenue Molière, 67098, Strasbourg, France.
| | - Jean-Baptiste Bertin
- Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, 1, Avenue Molière, 67098, Strasbourg, France
| | - Alessio Imperiale
- Biophysics and Nuclear Medicine, University Hospitals of Strasbourg, Strasbourg, France
- Faculty of Medicine, FMTS, University of Strasbourg, Strasbourg, France
- Molecular Imaging-DRHIM, IPHC, UMR 7178, CNRS/Unistra, Strasbourg, France
| | - Gerlinde Averous
- Faculty of Medicine, FMTS, University of Strasbourg, Strasbourg, France
- Pathology, University Hospitals of Strasbourg, Strasbourg, France
| | - Alfonso Terrone
- Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, 1, Avenue Molière, 67098, Strasbourg, France
| | - Bernard Goichot
- Internal Medicine, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - Philippe Bachellier
- Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, 1, Avenue Molière, 67098, Strasbourg, France
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Ouvrard E, Chevalier E, Addeo P, Sahakian N, Detour J, Goichot B, Bachellier P, Karcher G, Taïeb D, Imperiale A. Intraindividual comparison of 18 F-FDOPA and 68 Ga-DOTATOC PET/CT detection rate for metastatic assessment in patients with ileal neuroendocrine tumours. Clin Endocrinol (Oxf) 2021; 94:66-73. [PMID: 32790887 DOI: 10.1111/cen.14312] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/01/2020] [Accepted: 08/08/2020] [Indexed: 02/03/2023]
Abstract
INTRODUCTION In patients with ileal neuroendocrine tumours (ileal NETs), head-to-head evaluation of diagnostic performances of 68 Ga-DOTA-peptides and 18 F-fluorodihydroxyphenylalanine (18 F-FDOPA) positron emission tomography/computed tomography (PET/CT) has been performed in only few small patients' cohorts. The aim of this retrospective study was to compare 68 Ga-DOTATOC and 18 F-FDOPA PET/CT for metastatic disease assessment in a homogeneous large series of patients with well-differentiated ileal NETs. METHODS All patients with ileal NETs who underwent both 18 F-FDOPA and 68 Ga-DOTATOC PET/CT within a 3-month period and no therapeutic change between the two studies were retrospectively included. The detection rates of both modalities were calculated using per-patient, per-region and per-lesion analyses. RESULTS Forty one patients with ileal NETs were evaluated. 18 F-FDOPA and 68 Ga-DOTATOC showed similar detection rates according to per-patient (97% for both) and per-region analyses (94% for 18 F-FDOPA vs 88% for 68 Ga-DOTATOC, P = .35). For a total of 605 positive lesions, 458 (76%) were detected by both modalities, 122 (20%) exclusively by 18 F-FDOPA PET/CT, and 25 (4%) by 68 Ga-DOTATOC PET/CT only. In a per-lesion analysis, 18 F-FDOPA PET/CT performed better than 68 Ga-DOTATOC PET/CT (overall detection rates of 96% vs 80%; P < .001). 18 F-FDOPA PET/CT detected significantly more metastases than 68 Ga-DOTATOC PET/CT in the liver, peritoneum, abdominal and supra-diaphragmatic lymph nodes. CONCLUSION 18 F-FDOPA PET/CT seems not inferior than 68 Ga-DOTATOC PET/CT for the delineation of metastatic spread of ileal NETs. Therefore, according to local expertise and technical availability, 18 F-FDOPA should be considered as a valid clinical diagnostic option for exhaustive metastatic assessment in patients with ileal NETs. Obviously, 68 Ga-DOTATOC PET/CT remains mandatory for PRRT assessment. Further comparative studies are needed to determine the optimal approach in various clinical scenarios such as preoperative staging and primary tumour detection.
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Affiliation(s)
- Eric Ouvrard
- Nuclear Medicine and Molecular Imaging, ICANS, University Hospitals of Strasbourg, Strasbourg, France
| | | | - Pietro Addeo
- Hepato-Pancreato-Biliary Surgery and Liver transplantation, University Hospitals of Strasbourg, University of Strasbourg, Strasbourg, France
| | - Nicolas Sahakian
- Nuclear Medicine, La Timone University Hospital, Aix-Marseille University, Marseille, France
| | - Julien Detour
- Radiopharmacy, University Hospitals of Strasbourg, Strasbourg, France
| | - Bernard Goichot
- Internal Medicine, Diabetes and Metabolic Disorders, University Hospitals of Strasbourg, Strasbourg University, Strasbourg, France
| | - Philippe Bachellier
- Hepato-Pancreato-Biliary Surgery and Liver transplantation, University Hospitals of Strasbourg, University of Strasbourg, Strasbourg, France
| | - Gilles Karcher
- Nuclear Medicine, University Hospital of Nancy, Nancy, France
| | - David Taïeb
- Nuclear Medicine, La Timone University Hospital, Aix-Marseille University, Marseille, France
- European Center for Research in Medical Imaging, Aix-Marseille University, Marseille, France
| | - Alessio Imperiale
- Nuclear Medicine and Molecular Imaging, ICANS, University Hospitals of Strasbourg, Strasbourg, France
- Faculty of Medicine, University of Strasbourg, Strasbourg, France
- Molecular Imaging - DRHIM, IPHC, UMR 7178, CNRS/Unistra, Strasbourg, France
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Trimaille A, Curtiaud A, Marchandot B, Matsushita K, Sato C, Leonard-Lorant I, Sattler L, Grunebaum L, Ohana M, Von Hunolstein J, Andres E, Goichot B, Danion F, Kaeuffer C, Poindron V, Ohlmann P, Jesel L, Morel O. Venous thromboembolism in non-critically ill patients with COVID-19 infection. Archives of Cardiovascular Diseases Supplements 2021. [PMCID: PMC7803092 DOI: 10.1016/j.acvdsp.2020.10.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Background Systemic coagulation activation and thrombotic complications are frequent among critically ill patients with COVID-19. Limited data are available in non-intensive care unit (ICU) patients. Purpose To determine the incidence, risk factors and prognosis of venous thromboembolism (VTE) in non-ICU COVID-19 patients. Methods We studied consecutive COVID-19 patients admitted to general ward at Strasbourg Hospital, France (25.02.2020–19.04.2020). The primary outcome was any VTE complication. The secondary outcome was the composite of death or transfer to ICU. Results Among the 289 patients included (62.2 ± 17.0 years, 59.2% male), VTE occurred in 49 (17.0%). Padua prediction score for VTE was similar between VTE and non-VTE patients. VTE imaging tests were performed in 100 (34.6%) patients and VTE diagnosed in median 7 (3–11) days after admission. On-admission, time from symptom onset to admission (OR 1.07, CI 95% [1.00–1.16], P = 0.045), Improve score (OR 1.37, [1.02–1.83], P = 0.032), leukocyte count (OR 1.16, [1.06–1.27], P = 0.001) and lack of thromboprophylaxis (OR 27.85, CI 95% [9.35–82.95], P < 0.001) were independent predictors of VTE. The incidence of the composite of death or ICU transfer was 31.0% and more frequent among patients with VTE (47.9% vs. 27.9%, P = 0.01). Fever (OR 5.37, CI 95% [1.44–19.97], P = 0.012), VTE (OR 3.44, CI 95% [1.63–7.25], P = 0.001), lymphopenia (OR 0.32, 95% CI [0.15–0.71]; P = 0.005) and extent of COVID-19 evaluated by chest CT severity (OR 1.56, 95% CI [1.12–2.16]; P = 0.007) were independently associated with in-hospital death or transfer to ICU (Table 1, Fig. 1). Conclusions The 17.0% incidence of VTE in non-ICU patients with COVID-19 was associated with worse outcomes. Given the high incidence of VTE in ward patients, there is an urgent need to investigate the optimal anticoagulation regimen.
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Zulfiqar A, Lorenzo N, Mourot-Cottet R, Goichot B, Maloisel F, Tebacher M, Andres E. Neutropénie sévère et agranulocytose induites par les antithyroïdiens de synthèse : à propos de 30 cas issus d’un centre de référence. Rev Med Interne 2020. [DOI: 10.1016/j.revmed.2020.10.298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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27
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Addeo P, Julliard O, Imperiale A, Goichot B, Bachellier P. Middle-segment preserving pancreatectomy for multifocal neuroendocrine pancreatic tumors. Surg Oncol 2020; 35:466-467. [DOI: 10.1016/j.suronc.2020.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 08/30/2020] [Accepted: 10/02/2020] [Indexed: 11/29/2022]
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28
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Bachelot A, Goichot B. [36th Congress of the French Society of Endocrinology. SFE Marseille 2020]. Ann Endocrinol (Paris) 2020; 81:127. [PMID: 32838954 DOI: 10.1016/j.ando.2020.07.001] [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] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Anne Bachelot
- Service endocrinologie et médecine de la reproduction, hôpital Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
| | - Bernard Goichot
- Service de médecine interne, nutrition et endocrinologie, hôpitaux universitaires de Strasbourg, 1, avenue Molière, 67098 Strasbourg cedex, France.
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29
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Trimaille A, Curtiaud A, Marchandot B, Matsushita K, Sato C, Leonard-Lorant I, Sattler L, Grunebaum L, Ohana M, Von Hunolstein JJ, Andres E, Goichot B, Danion F, Kaeuffer C, Poindron V, Ohlmann P, Jesel L, Morel O. Venous thromboembolism in non-critically ill patients with COVID-19 infection. Thromb Res 2020; 193:166-169. [PMID: 32707275 PMCID: PMC7367026 DOI: 10.1016/j.thromres.2020.07.033] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/11/2020] [Accepted: 07/15/2020] [Indexed: 01/30/2023]
Abstract
Venous thromboembolism (VTE) is a frequent complication in COVID-19 patients. Single-center study of COVID-19 patients admitted to general ward. 17.0% of patients with VTE Lack of thromboprophylaxis and leukocytosis were independent risk factors of VTE. VTE is independently associated with worse in-hospital outcomes.
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Affiliation(s)
- Antonin Trimaille
- Division of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France; INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, FMTS, Strasbourg, France
| | - Anaïs Curtiaud
- Division of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France
| | - Benjamin Marchandot
- Division of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France
| | - Kensuke Matsushita
- Division of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France; INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, FMTS, Strasbourg, France
| | - Chisato Sato
- Division of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France; INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, FMTS, Strasbourg, France
| | - Ian Leonard-Lorant
- Radiology Department, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France
| | - Laurent Sattler
- Department Laboratory Haematology, Center for Thrombosis and Haemostasis, Nouvel Hôpital Civil Strasbourg University Hospital, Strasbourg, France
| | - Lelia Grunebaum
- Department Laboratory Haematology, Center for Thrombosis and Haemostasis, Nouvel Hôpital Civil Strasbourg University Hospital, Strasbourg, France
| | - Mickaël Ohana
- Radiology Department, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France
| | - Jean-Jacques Von Hunolstein
- Division of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France
| | - Emmanuel Andres
- Department of Internal Medicine, Médicale B, Strasbourg University Hospital, Strasbourg, France
| | - Bernard Goichot
- Department of Internal Medicine, Diabetes and Metabolic Disorders, Strasbourg University Hospital, Strasbourg, France
| | - François Danion
- Department of Infectious Disease, Strasbourg University Hospital, Strasbourg, France
| | - Charlotte Kaeuffer
- Department of Infectious Disease, Strasbourg University Hospital, Strasbourg, France
| | - Vincent Poindron
- National Referral Center for Systemic Autoimmune Diseases, Clinical Immunology Department, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France
| | - Patrick Ohlmann
- Division of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France
| | - Laurence Jesel
- Division of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France; INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, FMTS, Strasbourg, France
| | - Olivier Morel
- Division of Cardiovascular Medicine, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France; INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, FMTS, Strasbourg, France.
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30
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Somme F, Montaz-Rosset MS, Averous G, Deur J, Goichot B, Bachellier P, Addeo P, Imperiale A. Solid pseudopapillary tumour should be part of differential diagnosis of focal pancreatic lesions with increased 18 F-FDOPA uptake. Clin Endocrinol (Oxf) 2020; 93:78-81. [PMID: 32314437 DOI: 10.1111/cen.14202] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 03/18/2020] [Accepted: 03/19/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the specificity of increased 18 F-dihydroxyphenylalanine (18 F-FDOPA) uptake in patients who underwent PET/CT for suspicion of isolated pancreatic neuroendocrine tumour (pNET). False-positive results mimicking a pNET have been investigated. MATERIAL AND METHODS Carbidopa-assisted 18 F-FDOPA PET/CT scans performed in patients with suspicion of localized pNET were retrieved. Only patients with a definitive diagnosis were retrospectively included. When available, the histopathological result after pancreatic surgery was the gold standard. In other cases, the diagnosis was based on endoscopic ultrasonography (EUS)/cytology and/or on concordant imaging results of at least two of the following: contrast-enhanced computed tomography (CE-CT), magnetic resonance imaging (MRI) and somatostatin receptor scintigraphy (SRS). RESULTS Forty-four among 731 patients were selected. Among these, 36 patients (82%) were surgically treated, revealing pNET (n = 28), solid pseudopapillary tumour (SPT) (n = 4), adenocarcinoma (n = 2), serous cystadenomas (n = 1) and solitary fibrous tumour (n = 1) cases. An additional three cases of pNET were diagnosed by EUS/cytology. In the remaining five patients, a consensus was reached on follow-up imaging results: pNET (n = 1), serous cystadenoma (n = 2) and undetermined/no pNET (n = 2). Both specificity and negative predictive value of 18 F-FDOPA PET/CT for localized pNET were 67%. Surprisingly, all four false-positive results were SPTs showing intense 18 F-FDOPA uptake and negative SRS. There was no significant difference in 18 F-FDOPA uptake intensity between PET-positive pNETs and SPTs. CONCLUSION 18 F-FDOPA PET/CT is not specific for pNET in patients with localized pancreatic lesions. SPT could mimic pNET and should be part of differential diagnosis in such a clinical situation. If these results are confirmed in a broader population, the imaging pattern 18 F-FDOPA PET-positive/SRS-negative lesions might be considered as the imaging phenotype of SPT.
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Affiliation(s)
- François Somme
- Nuclear Medicine and Molecular Imaging, ICANS - University Hospitals of Strasbourg, Strasbourg, France
| | | | - Gerlinde Averous
- Department of Pathology, University Hospital of Strasbourg, Strasbourg University, Strasbourg, France
- Faculty of Medicine, University of Strasbourg, Strasbourg, France
| | - Jeanne Deur
- Radiology, University Hospitals of Strasbourg, Strasbourg University, Strasbourg, France
| | - Bernard Goichot
- Faculty of Medicine, University of Strasbourg, Strasbourg, France
- Internal Medicine, Diabetes and Metabolic Disorders, University Hospitals of Strasbourg, Strasbourg University, Strasbourg, France
| | - Philippe Bachellier
- Faculty of Medicine, University of Strasbourg, Strasbourg, France
- Hepato-Pancreato-Biliary Surgery and Liver transplantation, University Hospitals of Strasbourg, Strasbourg University, Strasbourg, France
| | - Pietro Addeo
- Hepato-Pancreato-Biliary Surgery and Liver transplantation, University Hospitals of Strasbourg, Strasbourg University, Strasbourg, France
| | - Alessio Imperiale
- Nuclear Medicine and Molecular Imaging, ICANS - University Hospitals of Strasbourg, Strasbourg, France
- Faculty of Medicine, University of Strasbourg, Strasbourg, France
- Molecular Imaging - DRHIM, IPHC, UMR 7178, CNRS/Unistra, Strasbourg, France
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31
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Goichot B, Raverot V, Klein M, Vija Racaru L, Abeillon-du Payrat J, Lairez O, Leroy R, Cailleux A, Wolff P, Groussin L, Kaltenbach G, Caron P. Management of thyroid dysfunctions in the elderly. French Endocrine Society consensus 2019 guidelines. Short version. Ann Endocrinol (Paris) 2020; 81:511-515. [PMID: 32446837 DOI: 10.1016/j.ando.2020.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Bernard Goichot
- Service de médecine interne, endocrinologie et nutrition, hôpitaux universitaires de Strasbourg, hôpital de Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France.
| | - Véronique Raverot
- Laboratoire d'hormonologie, LBMMS, Groupement hospitalier est, hospices civils de Lyon, 69677 Bron cedex, France.
| | - Marc Klein
- Service EDN, CHU de Nancy, 54500 Vandoeuvre-les-Nancy, France.
| | - Lavinia Vija Racaru
- Service de médecine nucléaire, Institut universitaire de cancérologie de Toulouse oncopole, 31059 Toulouse, France.
| | | | - Olivier Lairez
- Fédération des services de cardiologie, CHU de Rangueil, Toulouse, France; Centre d'imagerie cardiaque, CHU de Toulouse, Toulouse, France.
| | - Remy Leroy
- Cabinet d'endocrinologie et diabétologie, 71, rue de La Louvière, 59000 Lille, France.
| | - Anne Cailleux
- Endocrinologist, clinique Mathilde, 7, boulevard de l'Europe, 76100 Rouen, France.
| | - Pierre Wolff
- Espace santé, 8, rue de Lattre de Tassigny, 69350 La Mulatiere, France.
| | - Lionel Groussin
- Inserm U1016, CNRS UMR8104, service d'endocrinologie, université de Paris, Institut Cochin, hôpital Cochin, AP-HP, 75014 Paris, France.
| | - Georges Kaltenbach
- Pôle de gériatrie, hôpitaux universitaires de Strasbourg, hôpital de la Robertsau, 67000 Strasbourg, France.
| | - Philippe Caron
- Service d'endocrinologie et maladies métaboliques, CHU de Larrey, 31059 Toulouse, France.
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32
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Goichot B, Raverot V, Klein M, Vija Racaru L, Abeillon-Du Payrat J, Lairez O, Leroy R, Cailleux A, Wolff P, Groussin L, Kaltenbach G, Caron P. Management of thyroid dysfunctions in the elderly. French Endocrine Society consensus statement 2019. Long version. Ann Endocrinol (Paris) 2020; 81:89-100. [PMID: 32416938 DOI: 10.1016/j.ando.2020.04.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Bernard Goichot
- Service de médecine interne, endocrinologie et nutrition, hôpital de Hautepierre, hôpitaux universitaires, 67098 Strasbourg cedex, France.
| | - Véronique Raverot
- Hospices civils de Lyon, groupement hospitalier Est, LBMMS, laboratoire d'hormonologie, 69677 Bron cedex, France.
| | - Marc Klein
- Service EDN, CHU de Nancy, 54500 Vandœuvre-Lès-Nancy, France.
| | - Lavinia Vija Racaru
- Service de médecine nucléaire, institut universitaire de cancérologie de Toulouse Oncopole, 31059 Toulouse, France.
| | | | - Olivier Lairez
- Fédération des services de cardiologie, centre d'imagerie cardiaque, CHU Rangueil, CHU de Toulouse, Toulouse, France.
| | - Rémy Leroy
- Cabinet d'endocrinologie et diabétologie, 71, rue de La Louvière, 59000 Lille, France.
| | - Anne Cailleux
- Clinique Mathilde, 7, boulevard de l'Europe, 76100 Rouen, France.
| | - Pierre Wolff
- Espace santé, 8, rue de Lattre de Tassigny, 69350 La Mulatière, France.
| | - Lionel Groussin
- Université de Paris, Inserm U1016, CNRS UMR8104, institut Cochin, service d'endocrinologie, AP-HP, hôpital Cochin, 75014 Paris, France.
| | - Georges Kaltenbach
- Pôle de gériatrie, hôpital de la Robertsau, hôpitaux universitaires de Strasbourg, 67000 Strasbourg, France.
| | - Philippe Caron
- Service d'endocrinologie et maladies métaboliques, CHU Larrey, 31059 Toulouse, France.
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Andrès E, Lorenzo-Villalba N, Mourot-Cottet R, Maloisel F, Tebacher M, Gottenberg JE, Goichot B, Herbrecht R, Zulfiqar AA. Severe Neutropenia and Agranulocytosis Related to Antithyroid Drugs: A Study of 30 Cases Managed in A Single Reference Center. Medicines (Basel) 2020; 7:E15. [PMID: 32204561 PMCID: PMC7151575 DOI: 10.3390/medicines7030015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 03/14/2020] [Accepted: 03/16/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND The most important series devoted to antithyroid drug-induced severe neutropenia and agranulocytosis are Japanese studies, almost specifically in relation to the intake of methimazole. The clinical data of 30 Caucasian patients followed up for antithyroid drug-induced neutropenia at a third-level hospital are reported. Methods: The data of 30 patients with idiosyncratic antithyroid drug-induced neutropenia and agranulocytosis from a cohort study on drug-induced neutropenia and agranulocytosis conducted at the University Hospital of Strasbourg (France) were retrospectively reviewed. Results: The mean patient age was 61.7 years old (range: 20-87), and the gender ratio (F/M) was 4. Several comorbidities were reported in 23 patients (76.7%), with the mean Charlson comorbidity index of 1. The causative drugs were carbimazole and benzylthiouracil, in 28 (93.3%) and 2 cases, respectively, prescribed primarily for multi-hetero-nodular goiter or thyroid nodule to 18 patients (60%). Sore throat and acute tonsillitis (40%), isolated fever (20%), septicemia (13.3%), documented pneumonia (6.7%), and septic shock (6.7%) were the main clinical features upon admission. The mean neutrophil count at nadir was 0.02 and 0 × 109/L (range: 0-0.3). Regarding the patients' hospital course: 13 cases (43.3%) worsened during hospitalization, severe sepsis was found in 26.7%, systemic inflammatory response syndrome-in 13.3%, and septic shock-in 3.3% of the cases, respectively. Broad-spectrum antibiotics were indicated for all the patients, and 21 (73.3%) of them received hematopoietic growth factors. Hematological recovery (neutrophil count ≥ 1.5 × 109/L) was seen at 8.3 days (range: 2-24), but faster in those receiving hematopoietic growth factors (4.9 days, p = 0.046). Two patients died during hospitalization, and the rest had a favorable clinical outcome. Conclusions: Antithyroid drug-induced neutropenia represents a serious complication resulting from the rates of severe infections especially in those cases severe neutropenia. In this setting, an established procedure for the management of patients seems useful or even indispensable in view of potential mortality.
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Affiliation(s)
- Emmanuel Andrès
- Departments of Internal Medicine, Strasbourg University Hospitals, 67000 Strasbourg, France; (N.L.-V.); (R.M.-C.); (B.G.); (A.-A.Z.)
| | - Noel Lorenzo-Villalba
- Departments of Internal Medicine, Strasbourg University Hospitals, 67000 Strasbourg, France; (N.L.-V.); (R.M.-C.); (B.G.); (A.-A.Z.)
| | - Rachel Mourot-Cottet
- Departments of Internal Medicine, Strasbourg University Hospitals, 67000 Strasbourg, France; (N.L.-V.); (R.M.-C.); (B.G.); (A.-A.Z.)
| | - Frédéric Maloisel
- Onco-Hematology, Strasbourg University Hospitals, 67000 Strasbourg, France; (F.M.); (R.H.)
| | - Martine Tebacher
- Regional Pharmacovigilance Centre of Alsace, 67000 Strasbourg, France;
| | | | - Bernard Goichot
- Departments of Internal Medicine, Strasbourg University Hospitals, 67000 Strasbourg, France; (N.L.-V.); (R.M.-C.); (B.G.); (A.-A.Z.)
| | - Raoul Herbrecht
- Onco-Hematology, Strasbourg University Hospitals, 67000 Strasbourg, France; (F.M.); (R.H.)
| | - Abrar-Ahmad Zulfiqar
- Departments of Internal Medicine, Strasbourg University Hospitals, 67000 Strasbourg, France; (N.L.-V.); (R.M.-C.); (B.G.); (A.-A.Z.)
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Addeo P, Julliard O, Imperiale A, Goichot B, Bachellier P. Laparoscopic resection of familial interaortocaval paraganglioma. Surg Oncol 2020; 33:143-144. [PMID: 32561080 DOI: 10.1016/j.suronc.2020.02.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 02/01/2020] [Accepted: 02/17/2020] [Indexed: 01/26/2023]
Affiliation(s)
- Pietro Addeo
- Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pôle des Pathologies Digestives, Hépatiques et de La Transplantation, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France.
| | - Olivier Julliard
- Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pôle des Pathologies Digestives, Hépatiques et de La Transplantation, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - Alessio Imperiale
- Biophisic and Nuclear Medicine, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - Bernard Goichot
- Internal Medicine, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - Philippe Bachellier
- Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Pôle des Pathologies Digestives, Hépatiques et de La Transplantation, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France
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35
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Ameline A, Taquet MC, Terrade JE, Goichot B, Raul JS, Kintz P. Identification of chloramphenicol in human hair leading to a diagnosis of factitious disorder. Clin Toxicol (Phila) 2020; 58:926-930. [DOI: 10.1080/15563650.2019.1708375] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - Marie Caroline Taquet
- Service de Médecine Interne, Endocrinologie et Nutrition, Nouvel Hôpital Civil, Strasbourg, France
| | - Jean-Edouard Terrade
- Service de Médecine Interne, Endocrinologie et Nutrition, Nouvel Hôpital Civil, Strasbourg, France
| | - Bernard Goichot
- Service de Médecine Interne, Endocrinologie et Nutrition, Nouvel Hôpital Civil, Strasbourg, France
| | | | - Pascal Kintz
- Institut de Médecine Légale, Strasbourg, France
- X-Pertise Consulting, Mittelhausbergen, France
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Treglia G, Goichot B, Giovanella L, Hindié E, Jha A, Pacak K, Taïeb D, Walter T, Imperiale A. Prognostic and predictive value of nuclear imaging in endocrine oncology. Endocrine 2020; 67:9-19. [PMID: 31734779 PMCID: PMC7441826 DOI: 10.1007/s12020-019-02131-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 11/02/2019] [Indexed: 12/20/2022]
Abstract
In the last few years, the role and use of medical technologies in (neuro)endocrine oncology has greatly evolved allowing not only important diagnostic information but also prognostic stratification in different clinical situations. The terms "prognostic" and "predictive" are commonly used to describe the relationships between biomarkers and patients' clinical outcomes but have quite different meaning. The present work discusses the prognostic and predictive value of nuclear medicine imaging. It critically reviews the clinical significance and potential impact of molecular examinations on follow-up and therapeutic strategies in patients with neuroendocrine neoplasms, thyroid tumors, and adrenal malignancies.
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Affiliation(s)
- Giorgio Treglia
- Clinic of Nuclear Medicine and PET/CT Center, Imaging Institute of Southern Switzerland, Bellinzona, Switzerland
- Health Technology Assessment Unit, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Clinical Trial Unit, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Bernard Goichot
- Endocrinology and Internal Medicine Department, Hautepierre Hospital, University Hospitals of Strasbourg, Strasbourg, France
| | - Luca Giovanella
- Clinic of Nuclear Medicine and PET/CT Center, Imaging Institute of Southern Switzerland, Bellinzona, Switzerland
- University Hospital and University of Zürich, Zürich, Switzerland
| | - Elif Hindié
- Nuclear Medicine Department, Haut-Lévêque Hospital, University Hospitals of Bordeaux, University of Bordeaux, Bordeaux, France
- LabEx TRAIL, University of Bordeaux, Bordeaux, France
| | - Abhishek Jha
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Karel Pacak
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - David Taïeb
- Nuclear Medicine, La Timone University Hospital, Aix-Marseille University, Marseille, France
- European Center for Research in Medical Imaging, Aix-Marseille University, Marseille, France
| | - Thomas Walter
- Medical Oncology, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
- University of Lyon, Université Lyon 1, Lyon, France
| | - Alessio Imperiale
- Biophysics and Nuclear Medicine, Hautepierre Hospital, University Hospitals of Strasbourg, Strasbourg University/FMTS, Strasbourg, France.
- Molecular Imaging-DRHIM, IPHC, UMR 7178, CNRS/Unistra, Strasbourg, France.
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Imperiale A, Poncet G, Addeo P, Ruhland E, Roche C, Battini S, Cicek AE, Chenard MP, Hervieu V, Goichot B, Bachellier P, Walter T, Namer IJ. Metabolomics of Small Intestine Neuroendocrine Tumors and Related Hepatic Metastases. Metabolites 2019; 9:metabo9120300. [PMID: 31835679 PMCID: PMC6950539 DOI: 10.3390/metabo9120300] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 12/01/2019] [Accepted: 12/10/2019] [Indexed: 12/15/2022] Open
Abstract
To assess the metabolomic fingerprint of small intestine neuroendocrine tumors (SI-NETs) and related hepatic metastases, and to investigate the influence of the hepatic environment on SI-NETs metabolome. Ninety-four tissue samples, including 46 SI-NETs, 18 hepatic NET metastases and 30 normal SI and liver samples, were analyzed using 1H-magic angle spinning (HRMAS) NMR nuclear magnetic resonance (NMR) spectroscopy. Twenty-seven metabolites were identified and quantified. Differences between primary NETs vs. normal SI and primary NETs vs. hepatic metastases, were assessed. Network analysis was performed according to several clinical and pathological features. Succinate, glutathion, taurine, myoinositol and glycerophosphocholine characterized NETs. Normal SI specimens showed higher levels of alanine, creatine, ethanolamine and aspartate. PLS-DA revealed a continuum-like distribution among normal SI, G1-SI-NETs and G2-SI-NETs. The G2-SI-NET distribution was closer and clearly separated from normal SI tissue. Lower concentration of glucose, serine and glycine, and increased levels of choline-containing compounds, taurine, lactate and alanine, were found in SI-NETs with more aggressive tumors. Higher abundance of acetate, succinate, choline, phosphocholine, taurine, lactate and aspartate discriminated liver metastases from normal hepatic parenchyma. Higher levels of alanine, ethanolamine, glycerophosphocholine and glucose was found in hepatic metastases than in primary SI-NETs. The present work gives for the first time a snapshot of the metabolomic characteristics of SI-NETs, suggesting the existence of complex metabolic reality, maybe characteristic of different tumor evolution.
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Affiliation(s)
- Alessio Imperiale
- Biophysics and Nuclear Medicine, University Hospitals of Strasbourg, 67098 Strasbourg, France; (E.R.); (I.J.N.)
- Faculty of Medicine, University of Strasbourg, FMTS, 67000 Strasbourg, France; (M.P.C.); (B.G.); (P.B.)
- MNMS Platform, University Hospitals of Strasbourg, 67098 Strasbourg, France;
- Molecular Imaging—Institut Pluridisciplinaire Hubert Curien (IPHC), UMR 7178 – CNRS/Unistra, 67098 Strasbourg, France
- Correspondence: ; Tel.: +33-3-88-12-75-52; Fax: +33-3-88-12-81-21
| | - Gilles Poncet
- Digestive and Oncologic Surgery, Edouard-Herriot University Hospital, Claude-Bernard Lyon 1 University, 69622 Lyon, France;
| | - Pietro Addeo
- Hepato-Pancreato-Biliary Surgery and Liver transplantation, University Hospitals of Strasbourg, University of Strasbourg, 67098 Strasbourg, France;
| | - Elisa Ruhland
- Biophysics and Nuclear Medicine, University Hospitals of Strasbourg, 67098 Strasbourg, France; (E.R.); (I.J.N.)
- MNMS Platform, University Hospitals of Strasbourg, 67098 Strasbourg, France;
| | - Colette Roche
- INSERM U1052/CNRS UMR5286/University of Lyon, Cancer Research Center of Lyon, 69622 Lyon, France; (C.R.); (V.H.)
| | - Stephanie Battini
- MNMS Platform, University Hospitals of Strasbourg, 67098 Strasbourg, France;
| | - A. Ercument Cicek
- Computer Engineering Department, Bilkent University, Ankara 06800, Turkey;
| | - Marie Pierrette Chenard
- Faculty of Medicine, University of Strasbourg, FMTS, 67000 Strasbourg, France; (M.P.C.); (B.G.); (P.B.)
- Pathology, University Hospitals of Strasbourg, Strasbourg University, 67098 Strasbourg, France
| | - Valérie Hervieu
- INSERM U1052/CNRS UMR5286/University of Lyon, Cancer Research Center of Lyon, 69622 Lyon, France; (C.R.); (V.H.)
- Tissu-Tumorothèque Est (CRB-HCL, Hospices Civils de Lyon Biobank, BB-0033-00046), 69622 Lyon, France
| | - Bernard Goichot
- Faculty of Medicine, University of Strasbourg, FMTS, 67000 Strasbourg, France; (M.P.C.); (B.G.); (P.B.)
- Internal Medicine, Diabetes and Metabolic Disorders, University Hospitals of Strasbourg, Strasbourg University, 67098 Strasbourg, France
| | - Philippe Bachellier
- Faculty of Medicine, University of Strasbourg, FMTS, 67000 Strasbourg, France; (M.P.C.); (B.G.); (P.B.)
- Hepato-Pancreato-Biliary Surgery and Liver transplantation, University Hospitals of Strasbourg, University of Strasbourg, 67098 Strasbourg, France;
| | - Thomas Walter
- Medical Oncology, Edouard Herriot Hospital, Hospices Civils de Lyon, 69622 Lyon, France;
- University of Lyon, Université Lyon 1, 69622 Lyon, France
| | - Izzie Jacques Namer
- Biophysics and Nuclear Medicine, University Hospitals of Strasbourg, 67098 Strasbourg, France; (E.R.); (I.J.N.)
- Faculty of Medicine, University of Strasbourg, FMTS, 67000 Strasbourg, France; (M.P.C.); (B.G.); (P.B.)
- MNMS Platform, University Hospitals of Strasbourg, 67098 Strasbourg, France;
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Imperiale A, Averous G, Helali M, Taieb D, Pessaux P, Goichot B, Addeo P, Bachellier P. Limited role of carbidopa-assisted 18F-FDOPA PET/CT in patients with sporadic non-functional gastroduodenal neuroendocrine neoplasms. Ann Nucl Med 2019; 33:697-707. [DOI: 10.1007/s12149-019-01378-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 06/10/2019] [Indexed: 01/31/2023]
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Hescot S, Curras-Freixes M, Deutschbein T, van Berkel A, Vezzosi D, Amar L, de la Fouchardière C, Valdes N, Riccardi F, Do Cao C, Bertherat J, Goichot B, Beuschlein F, Drui D, Canu L, Niccoli P, Laboureau S, Tabarin A, Leboulleux S, Calsina B, Libé R, Faggiano A, Schlumberger M, Borson-Chazot F, Mannelli M, Gimenez-Roqueplo AP, Caron P, Timmers HJLM, Fassnacht M, Robledo M, Borget I, Baudin E. Prognosis of Malignant Pheochromocytoma and Paraganglioma (MAPP-Prono Study): A European Network for the Study of Adrenal Tumors Retrospective Study. J Clin Endocrinol Metab 2019; 104:2367-2374. [PMID: 30715419 DOI: 10.1210/jc.2018-01968] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 01/29/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Malignant pheochromocytoma and paraganglioma (MPP) are characterized by prognostic heterogeneity. Our objective was to look for prognostic parameters of overall survival (OS) in MPP patients. PATIENTS AND METHODS Retrospective multicenter study of MPP characterized by a neck-thoraco-abdomino-pelvic CT or MRI at the time of malignancy diagnosis in European centers between 1998 and 2010. RESULTS One hundred sixty-nine patients from 18 European centers were included. Main characteristics of patients with MPP were: primary pheochromocytoma in 53% of patients; tumor- or hormone-related symptoms in 57% or 58% of cases; positive plasma or urine hormones in 81% of patients; identification of a mutation in SDHB in 42% of cases. Metastatic sites included bone (64%), lymph node (40%), lung (29%), and liver (26%); mean time between initial and malignancy diagnosis was 43 months (range, 0 to 614). Median follow-up was 68 months and median survival 6.7 years. Using univariate analysis, better survival was associated with head and neck paraganglioma, age <40 years, metanephrines less than fivefold the upper limits of the normal range, and low proliferative index. In multivariate analysis, hypersecretion [hazard ratio 3.02 (1.65 to 5.55); P = 0.0004] was identified as an independent significant prognostic factor of worst OS. CONCLUSIONS Our results do not confirm SDHB mutations as a major prognostic parameter in MPP and suggest additional key molecular events involved in MPP tumor progression. Aside from SDHB mutation, the biology of aggressive MPP remains to be understood.
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Affiliation(s)
- Segolene Hescot
- Department of Nuclear Medicine and Endocrine Tumors, Gustave Roussy, Villejuif, France
| | - Maria Curras-Freixes
- Hereditary Endocrine Cancer Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Timo Deutschbein
- Department of Internal Medicine and Central Laboratory, University Hospital of Würzburg, Würzburg, Germany
| | - Anouk van Berkel
- Division of Endocrinology, Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
| | | | - Laurence Amar
- Department of Genetics, Hôpital Européen Georges Pompidou, Paris, France
- INSERM UMR970, Paris-Cardiovascular Research Center, Paris Descartes University, Paris, France
| | | | - Nuria Valdes
- Department of Endocrinology and Nutrition, University Hospital Central de Asturias, Oviedo, Spain
- Unit of Endocrinology, Nutrition, Diabetes and Obesity, Institute of Sanitary Research of Asturias, Oviedo, Spain
| | | | - Christine Do Cao
- Department of Endocrinology, Hôpital Huriez, CHR-U, Lille, France
| | | | - Bernard Goichot
- Department of Internal Medicine, Endocrinology and Nutrition, University Hospital of Strasbourg, Strasbourg, France
| | - Felix Beuschlein
- Medical Clinics and Polyclinics IV, University Hospital of Munich, Munich, Germany
- Unit of Endocrinology, Nutrition, Diabetes, University Hospital of Zurich, Zurich, Switzerland
| | - Delphine Drui
- Department of Endocrinology, L'Institut du Thorax, CHU Nantes, Nantes, France
| | - Letizia Canu
- Department of Experimental and Clinical Biomedical Sciences, "Mario Serio," University of Florence, Florence, Italy
| | - Patricia Niccoli
- Department of Oncology, Institut Paoli Calmettes, Marseille, France
| | | | | | - Sophie Leboulleux
- Department of Nuclear Medicine and Endocrine Tumors, Gustave Roussy, Villejuif, France
| | - Bruna Calsina
- Hereditary Endocrine Cancer Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Rossella Libé
- Department of Endocrinology, Hôpital Cochin, Paris, France
| | - Antongiulio Faggiano
- Division of Endocrinology, Department of Clinical Medicine and Surgery, Università Federico II, Naples, Italy
| | - Martin Schlumberger
- Department of Nuclear Medicine and Endocrine Tumors, Gustave Roussy, Villejuif, France
| | | | - Massimo Mannelli
- Department of Experimental and Clinical Biomedical Sciences, "Mario Serio," University of Florence, Florence, Italy
| | - Anne-Paule Gimenez-Roqueplo
- Department of Genetics, Hôpital Européen Georges Pompidou, Paris, France
- INSERM UMR970, Paris-Cardiovascular Research Center, Paris Descartes University, Paris, France
| | - Philippe Caron
- Department of Endocrinology, CHU Toulouse, Toulouse, France
| | - Henri J L M Timmers
- Division of Endocrinology, Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Martin Fassnacht
- Department of Internal Medicine and Central Laboratory, University Hospital of Würzburg, Würzburg, Germany
| | - Mercedes Robledo
- Hereditary Endocrine Cancer Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Isabelle Borget
- Department of Biostatistic and Epidemiology, Gustave Roussy, Villejuif, France
- University Paris-Saclay, University Paris-Sud, UVSQ, CESP ONCOSTAT, INSERM, Villejuif, France
| | - Eric Baudin
- Department of Nuclear Medicine and Endocrine Tumors, Gustave Roussy, Villejuif, France
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Buffet A, Ben Aim L, Leboulleux S, Drui D, Vezzosi D, Libé R, Ajzenberg C, Bernardeschi D, Cariou B, Chabolle F, Chabre O, Darrouzet V, Delemer B, Desailloud R, Goichot B, Esvant A, Offredo L, Herman P, Laboureau S, Lefebvre H, Pierre P, Raingeard I, Reznik Y, Sadoul JL, Hadoux J, Tabarin A, Tauveron I, Zenaty D, Favier J, Bertherat J, Baudin E, Amar L, Gimenez-Roqueplo AP. Positive Impact of Genetic Test on the Management and Outcome of Patients With Paraganglioma and/or Pheochromocytoma. J Clin Endocrinol Metab 2019; 104:1109-1118. [PMID: 30698717 DOI: 10.1210/jc.2018-02411] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 01/24/2019] [Indexed: 02/05/2023]
Abstract
CONTEXT Pheochromocytomas and paragangliomas (PPGLs) are characterized by a strong genetic component, with up to 40% of patients carrying a germline mutation in a PPGL susceptibility gene. International guidelines recommend that genetic screening be proposed to all patients with PPGL. OBJECTIVE Our objective was to evaluate how a positive genetic test impacts the management and outcome of patients with SDHx or VHL-related PPGL. DESIGN We performed a multicentric retrospective study involving 221 propositi carrying an SDHB, SDHD, SDHC, or VHL germline mutation. Patients were divided into two groups: genetic patients, who were informed of their genetic status within the year following the first PPGL diagnosis, and historic patients, who only benefited from the genetic test several years after initial PPGL diagnosis. RESULTS Genetic patients had better follow-up than historic patients, with a greater number of examinations and a reduced number of patients lost to follow-up (9.6% vs 72%, respectively). During follow-up, smaller (18.7 vs 27.6 mm; P = 0.0128) new PPGLs and metastases as well as lower metastatic spread were observed in genetic patients. Of note, these differences were reversed in the historic cohort after genetic testing. Genetic patients who developed metachronous metastases had a better 5-year survival rate than historic patients (P = 0.0127). CONCLUSION Altogether, our data suggest that early knowledge of genetic status had a positive impact on the management and clinical outcome of patients with a germline SDHx or VHL mutation.
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Affiliation(s)
- Alexandre Buffet
- Équipe Labellisée par la Ligue Contre le Cancer, INSERM, UMR970, Paris-Centre de Recherche Cardiovasculaire, Paris, France
- Service d'Endocrinologie, Hôpital Larrey, CHU de Toulouse, Toulouse, France
| | - Laurène Ben Aim
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service de Génétique, Paris, France
| | - Sophie Leboulleux
- Gustave Roussy, Université Paris-Saclay, Service de Médecine Nucléaire et Cancérologie Endocrinienne, Villejuif, France
| | - Delphine Drui
- Service d'Endocrinologie, Diabétologie et Maladies Métaboliques, L'institut du Thorax, Centre Hospitalier Universitaire de Nantes, Hôpital Nord Laënnec, Nantes, France
| | - Delphine Vezzosi
- Service d'Endocrinologie, Hôpital Larrey, CHU de Toulouse, Toulouse, France
| | - Rossella Libé
- Assistance Publique, Hôpitaux de Paris, Hôpital Cochin, Service d'Endocrinologie, Centre de Référence Maladies Rares de la Surrénale, Paris, France
| | - Christiane Ajzenberg
- Assistance Publique, Hôpitaux de Paris, Service de Médecine Interne et Endocrinologie, Hôpital Henri Mondor, Créteil, France
| | - Daniele Bernardeschi
- Assistance Publique-Hôpitaux de Paris, Hôpital Universitaire Pitié-Salpêtrière, Service d'ORL, Unité d'Otologie, Implantologie Auditive et Chirurgie de la Base du Crâne, Paris, France
| | - Bertrand Cariou
- Service d'Endocrinologie, Diabétologie et Maladies Métaboliques, L'institut du Thorax, Centre Hospitalier Universitaire de Nantes, Hôpital Nord Laënnec, Nantes, France
| | - Frédéric Chabolle
- Service d'ORL et de Chirurgie Cervico-Faciale, Hôpital Foch, Suresnes, France
| | - Olivier Chabre
- Service d'Endocrinologie, CHU de Grenoble-Alpes, La Tronche, Grenoble, France
| | - Vincent Darrouzet
- Service d'ORL et de Chirurgie Cervico-Faciale, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France
| | - Brigitte Delemer
- Service d'Endocrinologie, Hôpital Robert Debré, CHU de Reims, Reims, France
| | - Rachel Desailloud
- Service d'Endocrinologie, Hôpital Nord, CHU d'Amiens-Picardie, Amiens, France
| | - Bernard Goichot
- Service de Médecine Interne, Endocrinologie et Nutrition, Hôpitaux Universitaires de Strasbourg, Faculté de Médecine, Université de Strasbourg, Strasbourg, France
| | | | - Lucile Offredo
- Équipe Labellisée par la Ligue Contre le Cancer, INSERM, UMR970, Paris-Centre de Recherche Cardiovasculaire, Paris, France
| | - Philippe Herman
- Assistance Publique, Hôpitaux de Paris, Service ORL-CCF, Hôpital Lariboisière, Université Paris VII, AP-HP, Paris, France
| | - Sandrine Laboureau
- Service d'Endocrinologie, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - Hervé Lefebvre
- Centre Hospitalier Universitaire de Rouen, Service d'Endocrinologie, Diabète et Maladies Métaboliques, Rouen, France
| | - Peggy Pierre
- Service d'Endocrinologie, Hôpital Bretonneau, CHU de Tours, Tours, France
| | - Isabelle Raingeard
- Service d'Endocrinologie, CHU Montpellier, Hôpital Lapeyronie, Montpellier, France
| | - Yves Reznik
- Service d'Endocrinologie, CHU de Caen, Caen, France
| | - Jean-Louis Sadoul
- Service d'Endocrinologie, Hôpital de L'Archet, CHU de Nice, Nice, France
| | - Julien Hadoux
- Gustave Roussy, Université Paris-Saclay, Service de Médecine Nucléaire et Cancérologie Endocrinienne, Villejuif, France
| | - Antoine Tabarin
- Service d'Endocrinologie, Hôpital Haut-Lévêque, CHU de Bordeaux, Pessac, France
| | - Igor Tauveron
- Service d'Endocrinologie, Hôpital Gabriel Montpied, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Delphine Zenaty
- Assistance Publique-Hôpitaux de Paris, Hôpital Universitaire Robert Debré, Service d'Endocrinologie Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes Rares de la Croissance et du Développement, Paris, France
| | - Judith Favier
- Équipe Labellisée par la Ligue Contre le Cancer, INSERM, UMR970, Paris-Centre de Recherche Cardiovasculaire, Paris, France
| | - Jérôme Bertherat
- Assistance Publique, Hôpitaux de Paris, Hôpital Cochin, Service d'Endocrinologie, Centre de Référence Maladies Rares de la Surrénale, Paris, France
- Université Paris Descartes, PRES Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - Eric Baudin
- Gustave Roussy, Université Paris-Saclay, Service de Médecine Nucléaire et Cancérologie Endocrinienne, Villejuif, France
| | - Laurence Amar
- Université Paris Descartes, PRES Sorbonne Paris Cité, Faculté de Médecine, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service d'Hypertension Artérielle et Médecine Vasculaire, Paris, France
| | - Anne-Paule Gimenez-Roqueplo
- Équipe Labellisée par la Ligue Contre le Cancer, INSERM, UMR970, Paris-Centre de Recherche Cardiovasculaire, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Service de Génétique, Paris, France
- Université Paris Descartes, PRES Sorbonne Paris Cité, Faculté de Médecine, Paris, France
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Helali M, Moreau M, Le Fèvre C, Heimburger C, Bund C, Goichot B, Veillon F, Hubelé F, Charpiot A, Noel G, Imperiale A. 18F-FDOPA PET/CT Combined with MRI for Gross Tumor Volume Delineation in Patients with Skull Base Paraganglioma. Cancers (Basel) 2019; 11:cancers11010054. [PMID: 30626096 PMCID: PMC6360018 DOI: 10.3390/cancers11010054] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 12/30/2018] [Accepted: 01/02/2019] [Indexed: 11/16/2022] Open
Abstract
In this simulation study, we assessed differences in gross tumor volume (GTV) in a series of skull base paragangliomas (SBPGLs) using magnetic resonance imaging (MRI), 18F-dihydroxyphenylalanine (18F-FDOPA) combined positron emission tomography/computed tomography (PET/CT), and 18F-FDOPA PET/MRI images obtained by rigid alignment of PET and MRI. GTV was delineated in 16 patients with SBPGLs on MRI (GTVMRI), 18F-FDOPA PET/CT (GTVPET), and combined PET/MRI (GTVPET/MRI). GTVPET/MRI was the union of GTVMRI and GTVPET after visual adjustment. Three observers delineated GTVMRI and GTVPET/MRI independently. Excellent interobserver reproducibility was found for both GTVMRI and GTVPET/MRI. GTVPET and GTVMRI were not significantly different. However, there was some spatial difference between the locations of GTVMRI, GTVPET, and GTVPET/MRI. The Dice similarity coefficient median value was 0.4 between PET/CT and MRI, and 0.8 between MRI and PET/MRI. The combined use of PET/MRI produced a larger GTV than MRI alone. Nevertheless, both the target-delivered dose and organs-at-risk conservancy were respected when treatment was planned on the PET/MRI-matched data set. Future integration of 18F-FDOPA PET/CT into clinical practice will be necessary to evaluate the influence of this diagnostic modality on SBPGL therapeutic management. If the clinical utility of 18F-FDOPA PET/CT and/or PET/MRI is confirmed, GTVPET/MRI should be considered for tailored radiotherapy planning in patients with SBPGL.
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Affiliation(s)
- Mehdi Helali
- Biophysics and Nuclear Medicine, University Hospitals of Strasbourg, 67098 Strasbourg, France.
| | - Matthieu Moreau
- Radiophysics, Centre Paul-Strauss, UNICANCER, 67065 Strasbourg, France.
| | - Clara Le Fèvre
- Radiotherapy, Centre Paul-Strauss, 67065 Strasbourg, France.
| | - Céline Heimburger
- Biophysics and Nuclear Medicine, University Hospitals of Strasbourg, 67098 Strasbourg, France.
- ICube, University of Strasbourg/CNRS (UMR 7357) and FMTS, Faculty of Medicine, 67000 Strasbourg, France.
| | - Caroline Bund
- Biophysics and Nuclear Medicine, University Hospitals of Strasbourg, 67098 Strasbourg, France.
- ICube, University of Strasbourg/CNRS (UMR 7357) and FMTS, Faculty of Medicine, 67000 Strasbourg, France.
| | - Bernard Goichot
- Internal Medicine, University Hospitals of Strasbourg, Strasbourg University, 67098 Strasbourg, France.
| | - Francis Veillon
- Radiology, University Hospitals of Strasbourg, Strasbourg University, 67098 Strasbourg, France.
| | - Fabrice Hubelé
- Biophysics and Nuclear Medicine, University Hospitals of Strasbourg, 67098 Strasbourg, France.
- ICube, University of Strasbourg/CNRS (UMR 7357) and FMTS, Faculty of Medicine, 67000 Strasbourg, France.
| | - Anne Charpiot
- Otolaryngology and Maxillofacial Surgery, University Hospitals of Strasbourg, 67098 Strasbourg, France.
| | - Georges Noel
- Radiotherapy, Centre Paul-Strauss, 67065 Strasbourg, France.
- Université de Strasbourg, CNRS, IPHC UMR 7178, Centre Paul Strauss, UNICANCER, 67065 Strasbourg, France.
| | - Alessio Imperiale
- Biophysics and Nuclear Medicine, University Hospitals of Strasbourg, 67098 Strasbourg, France.
- ICube, University of Strasbourg/CNRS (UMR 7357) and FMTS, Faculty of Medicine, 67000 Strasbourg, France.
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Affiliation(s)
- Pietro Addeo
- Hepato-Pancreato-Biliary Surgery and Liver transplantation, Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, 1, Avenue Molière, 6709, Strasbourg, France.
| | - Philippe Bachellier
- Hepato-Pancreato-Biliary Surgery and Liver transplantation, Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, 1, Avenue Molière, 6709, Strasbourg, France
| | - Bernard Goichot
- Internal Medicine, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France
| | - Alessio Imperiale
- Biophysics and Nuclear Medicine, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, 1, Avenue Molière, 67098, Strasbourg Cedex 09, France. .,Faculty of Medicine, ICube, University of Strasbourg/CNRS (UMR 7357) and FMTS, Strasbourg, France.
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Addeo P, Goichot B, Bachellier P. A Persistent Migrating Rash. Gastroenterology 2018; 155:e7-e8. [PMID: 29549039 DOI: 10.1053/j.gastro.2018.02.039] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 02/20/2018] [Accepted: 02/26/2018] [Indexed: 12/02/2022]
Affiliation(s)
- Pietro Addeo
- Hepato-Pancreato-Biliary Surgery and Liver transplantation, Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre, Strasbourg, France
| | - Bernard Goichot
- Department of Internal Medicine, Endocrinology and Nutrition, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Philippe Bachellier
- Hepato-Pancreato-Biliary Surgery and Liver transplantation, Pôle des Pathologies Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre, Strasbourg, France
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Goichot B, Leenhardt L, Massart C, Raverot V, Tramalloni J, Iraqi H. Diagnostic procedure in suspected Graves' disease. Ann Endocrinol (Paris) 2018; 79:608-617. [PMID: 30220410 DOI: 10.1016/j.ando.2018.08.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Diagnostic procedure in suspected Graves' disease has never been studied scientifically and actual practice seems quite variable, notably between countries. Recommendations are few and weak (expert opinion). This article presents the recommendations of an expert consensus meeting organized by the French Society of Endocrinology in 2016. In case of clinically suspected thyrotoxicosis, the first-line biological assessment is of thyroid-stimulating hormone (TSH). Free T4 and possibly free T3 assays assess biological severity and are necessary for treatment efficacy monitoring. Positive diagnosis of Graves' disease after biological confirmation of thyrotoxicosis does not always require complementary etiological examinations if clinical presentation is unambiguous, notably including extra-thyroid signs. Otherwise, first-line anti-TSH-receptor (TSH-R) antibody screening is recommended for its good intrinsic performance (sensitivity and specificity) and ease of access in France. Scintigraphy is reserved to rare cases of Graves' disease with negative antibody findings or when another etiology is suspected. Thyroid ultrasound scan may be contributive, but is not recommended in first line.
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Affiliation(s)
- Bernard Goichot
- Service de médecine interne, endocrinologie et nutrition, hôpital de Hautepierre, hôpitaux universitaires de Strasbourg, avenue Molière, 67098 Strasbourg cedex, France.
| | - Laurence Leenhardt
- Unité thyroïde tumeurs endocrines, institut E3M, hôpital Pitié-Salpêtrière, 75013 Paris, France
| | - Catherine Massart
- Service de biochimie-toxicologie, laboratoire d'hormonologie, CHU de Rennes, 35033 Rennes Cedex 09, France
| | - Véronique Raverot
- Service de biochimie et biologie moléculaire, laboratoire d'hormonologie, groupement hospitalier Est, CHU de Lyon, 69500 Bron, France
| | | | - Hinde Iraqi
- Service d'endocrinologie, CHU de Rabat, Rabat, Morocco
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Lefebvre H, Goichot B. Controversy: Pros and cons screening of corticotropic deficiency after exogenous glucocorticoid therapy. Ann Endocrinol (Paris) 2018; 79:182-183. [PMID: 29656921 DOI: 10.1016/j.ando.2018.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- H Lefebvre
- Service d'endocrinologie, diabète et maladies métaboliques, CHU de Rouen, 76031 Rouen, France.
| | - B Goichot
- Service de médecine interne, endocrinologie et nutrition, hôpitaux universitaires de Strasbourg, 67091 Strasbourg, France
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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] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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Reznik Y, Barat P, Bertherat J, Bouvattier C, Castinetti F, Chabre O, Chanson P, Cortet C, Delemer B, Goichot B, Gruson D, Guignat L, Proust-Lemoine E, Sanson MLR, Reynaud R, Boustani DS, Simon D, Tabarin A, Zenaty D. SFE/SFEDP adrenal insufficiency French consensus: Introduction and handbook. Annales d'Endocrinologie 2018; 79:1-22. [DOI: 10.1016/j.ando.2017.12.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Chabre O, Goichot B, Zenaty D, Bertherat J. Group 1. Epidemiology of primary and secondary adrenal insufficiency: Prevalence and incidence, acute adrenal insufficiency, long-term morbidity and mortality. Annales d'Endocrinologie 2017; 78:490-494. [DOI: 10.1016/j.ando.2017.10.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Chanson P, Guignat L, Goichot B, Chabre O, Boustani DS, Reynaud R, Simon D, Tabarin A, Gruson D, Reznik Y, Raffin Sanson ML. Group 2: Adrenal insufficiency: screening methods and confirmation of diagnosis. Annales d'Endocrinologie 2017; 78:495-511. [DOI: 10.1016/j.ando.2017.10.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Clere-Jehl R, Schaeffer M, Vogel T, Kiesmann M, Pasquali JL, Andres E, Bourgarit A, Goichot B. Upper and lower gastrointestinal endoscopies in patients over 85 years of age: Risk-benefit evaluation of a longitudinal cohort. Medicine (Baltimore) 2017; 96:e8439. [PMID: 29095285 PMCID: PMC5682804 DOI: 10.1097/md.0000000000008439] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
After age 85, upper and lower gastrointestinal (GI) endoscopy may be indicated in 5% to 10% of inpatients, but the risk-benefit ratio is unknown. We studied patients older than 85 years undergoing upper and lower GI endoscopy.We analyzed a retrospective cohort of inpatients older than 85 years between 2004 and 2012, all explored by upper and complete lower GI endoscopy. Initial indications, including iron deficiency anemia (IDA), other anemias, GI bleeding, weight loss, and GI symptoms, were noted, as were endoscopy or anesthesia complications, immediate endoscopic diagnosis, and the ability to modify the patients' therapeutics. Deaths and final diagnosis for initial endoscopic indication were analyzed after at least 12 months.We included 55 patients, 78% women, with a median age, reticulocyte count, hemoglobin, and ferritin levels of 87 (85-99), 56 (24-214) g/L, 8.6 (4.8-12.9) g/dL, and 56 (3-799) μg/L, respectively. IDA was the most frequent indication for endoscopy (60%; n = 33). Immediate diagnoses were found in 64% of the patients (n = 35), including 25% with GI cancers (n = 14) and 22% with gastroduodenal ulcers or erosions (n = 12). Cancer diagnosis was associated with lower reticulocyte count (45 vs. 60 G/L; P = .02). Among the 35 diagnoses, 94% (n = 33) led to modifications of the patients' therapeutics, with 29% of the patients deciding on palliative care (n = 10). No endoscopic complications lead to death. Follow-up of >12 months was available in 82% (n = 45) of the patients; among these patients, 40% (n = 27) died after an average 24 ± 18 months. Cancer diagnosis was significantly associated with less ulterior red cell transfusion (0% vs. 28%; P = .02) and fewer further investigations (6.7% vs. 40%; P = .02).Upper and complete lower GI endoscopy in patients older than 85 years appears to be safe, and enables a high rate of immediate diagnosis, with significant modifications of therapeutics. GI cancers represented more than one-third of the endoscopic diagnoses.
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Affiliation(s)
- Raphaël Clere-Jehl
- Internal Medicine, Endocrinology and Nutrition Department, Hautepierre Hospital
| | | | | | | | | | - Emmanuel Andres
- Internal Medicine Department, Civil Hospital, University Hospital of Strasbourg, Strasbourg, France
| | - Anne Bourgarit
- Internal Medicine Department, Civil Hospital, University Hospital of Strasbourg, Strasbourg, France
| | - Bernard Goichot
- Internal Medicine, Endocrinology and Nutrition Department, Hautepierre Hospital
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