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Illac C. [Histoseminar. Tumoral peritoneal biopsies. Case No. 4]. Ann Pathol 2024:S0242-6498(24)00073-7. [PMID: 38632011 DOI: 10.1016/j.annpat.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 03/11/2024] [Accepted: 03/15/2024] [Indexed: 04/19/2024]
Affiliation(s)
- Claire Illac
- Département d'anatomie et cytologie pathologiques, IUCT-Oncopole, 1, avenue Irène Joliot-Curie, 31000 Toulouse, France.
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Del M, Illac C, Morisseau M, Angeles MA, Ducassou A, Betrian S, Bataillon G, Ferron G, Chantalat E, Gabiache E, Martinez A. Intraepithelial tumor-infiltrating lymphocytes shape loco-regional PET/CT spread of locally advanced cervical cancer. Int J Gynecol Cancer 2024; 34:490-496. [PMID: 38471676 DOI: 10.1136/ijgc-2023-004677] [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] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Data suggest an association between positron emission tomography/CT (PET/CT) metabolic metrics and tumor microenvironment in several malignancies, and a potential role of PET/CT to monitor response to immunotherapy. OBJECTIVE To evaluate the correlation between tumor loco-regional extension and tumor-infiltrating lymphocyte infiltration in locally advanced cervical cancer prior to concurrent chemo-radiotherapy.The secondary objective was to assess the association between tumor-infiltrating lymphocytes and PET/CT metabolic metrics. METHODS Patients with locally advanced cervical cancer and negative para-aortic extensions on PET/CT were included. Two senior nuclear medicine physicians specializing in gynecologic oncology reviewed all PET/CT exams, and extracted tumor maximum standardized uptake value, metabolic tumor volume, and total lesion glycolysis, as well as pelvic lymph node involvement. One senior gynecologic oncology pathologist assessed intraepithelial tumor-infiltrating lymphocytes and stromal tumor-infiltrating lymphocytes. Intraepithelial tumor-infiltrating lymphocytes were categorized following previous studies as <1% and >1%. The cut-off for stromal tumor-infiltrating lymphocytes was chosen empirically: intermediate <60% and high >60%. RESULTS 86 patients were included. Intraepithelial tumor-infiltrating lymphocytes were not significantly associated with tumor metabolic metrics. Intraepithelial tumor-infiltrating lymphocytes were not significantly associated with maximum standard uptake value (p=0.16), or metabolic tumor volume (p=0.19). Tumors with <1% intraepithelial tumor-infiltrating lymphocytes score were associated with a higher MRI tumor size (≥ median) (63.3% vs 39.3%, p=0.04). Patients with pelvic lymph node uptake were significantly more frequent in patients with high stromal tumor-infiltrating lymphocytes score (≥60%) (61.5% vs 31.7%, p=0.009). CONCLUSIONS Poor or absent intraepithelial tumor-infiltrating lymphocytes were associated with more advanced disease at diagnosis and larger tumor size. Tumor-infiltrating lymphocytes were not associated with tumor metabolic activity. Intraepithelial and stroma tumor-infiltrating lymphocytes are not redundant and should be assessed separately. Further work is needed to evaluate the association between tumor metabolic profile and immune populations, including different T-cell subtypes for patient selection for immunotherapy strategies.
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Affiliation(s)
- Mathilde Del
- Department of Surgical Oncology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
| | - Claire Illac
- Department of Pathology, Institut Claudius Regaud, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
| | - Mathilde Morisseau
- Department of Biostatistics, Institut Claudius Regaud, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
| | - Martina Aida Angeles
- Department of Surgical Oncology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
| | - Anne Ducassou
- Radiation Oncology and Brachytherapy Department, Institut Universitaire du Cancer de Toulouse - Oncopole, Institut Claudius Regaud, Toulouse, France
| | - Sarah Betrian
- Department of Medical Oncology, Institut Universitaire du Cancer de Toulouse, Toulouse, France
| | - Guillaume Bataillon
- Department of Anatomopathology, Toulouse University Cancer Institute, Toulouse, France
| | - Gwenael Ferron
- Department of Surgical Oncology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
- Team 19, ONCOSARC - Oncogenesis of Sarcomas, Cancer Research Center of Toulouse (CRCT) - INSERM UMR 1037, Toulouse, France
| | - Elodie Chantalat
- Department of Surgical Oncology, University Hospital Centre Toulouse IUC Oncopole CHU Division, Toulouse, France
| | - Erwan Gabiache
- Department of Nuclear Medicine, Cancer University Institute Toulouse Oncopole, Toulouse, France
| | - Alejandra Martinez
- Department of Surgical Oncology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
- Team 1, Tumor Immunology and Immunotherapy, Cancer Research Center of Toulouse (CRCT) - INSERM UMR 1037, Toulouse, France
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Benzerdjeb N, Dartigues P, Illac C, Valmary-Degano S. [Histoseminar peritoneal biopsies - Introduction]. Ann Pathol 2024:S0242-6498(24)00035-X. [PMID: 38418290 DOI: 10.1016/j.annpat.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 03/01/2024]
Affiliation(s)
- Nazim Benzerdjeb
- Centre hospitalier Lyon Sud, HCL, université de Lyon I, 69000, Lyon, France
| | | | - Claire Illac
- Institut universitaire du cancer, oncopole, 31000 Toulouse, France
| | - Séverine Valmary-Degano
- Service d'anatomie pathologique, Inserm U1209, CNRS UMR5309, IAB, CHU de Grenoble Alpes, université de Grenoble Alpes, 38000 Grenoble, France.
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Navarro AS, Angeles MA, Illac C, Boulet B, Ferron G, Martinez A. Effect of medical treatments in disseminated peritoneal leiomyomatosis: a case report. J Surg Case Rep 2022; 2022:rjac166. [PMID: 35702263 PMCID: PMC9187347 DOI: 10.1093/jscr/rjac166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/19/2021] [Accepted: 03/27/2022] [Indexed: 11/12/2022] Open
Abstract
Abstract
Disseminated peritoneal leiomyomatosis (DPL) is a rare gynecologic disease involving multifocal proliferation of myomas. The pathogenesis remains unclear. Although there is no standard treatment, medical therapies have attempted to suppress estrogen levels by using gonadotrophin-releasing hormone agonist and aromatase inhibitor (AI) therapy with differing degrees of success. Surgery is also an option in symptomatic patients, and in the event of partial or no response to medical treatments. We report a case of DPL in a young woman with a previous history of myomectomy. She was treated sequentially with ulipristal acetate and AI.
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Affiliation(s)
- Anne-Sophie Navarro
- Department of Surgical Oncology , Institut Claudius Regaud–Institut Universitaire du Cancer de Toulouse (IUCT), Oncopole, Toulouse, France
| | - Martina Aida Angeles
- Department of Surgical Oncology , Institut Claudius Regaud–Institut Universitaire du Cancer de Toulouse (IUCT), Oncopole, Toulouse, France
| | - Claire Illac
- Department of Pathology , Institut Claudius Regaud–Institut Universitaire du Cancer de Toulouse (IUCT), Oncopole, Toulouse, France
| | - Bérénice Boulet
- Department of Radiology , Institut Claudius Regaud–Institut Universitaire du Cancer de Toulouse (IUCT), Oncopole, Toulouse, France
| | - Gwenael Ferron
- Department of Pathology , Institut Claudius Regaud–Institut Universitaire du Cancer de Toulouse (IUCT), Oncopole, Toulouse, France
| | - Alejandra Martinez
- Department of Pathology , Institut Claudius Regaud–Institut Universitaire du Cancer de Toulouse (IUCT), Oncopole, Toulouse, France
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Gomez-Brouchet A, Illac C, Ledoux A, Fortin PY, de Barros S, Vabre C, Despas F, Peries S, Casaroli C, Bouvier C, Aubert S, de Pinieux G, Larousserie F, Galmiche L, Talmont F, Pitson S, Maddelein ML, Cuvillier O. Sphingosine Kinase-1 Is Overexpressed and Correlates with Hypoxia in Osteosarcoma: Relationship with Clinicopathological Parameters. Cancers (Basel) 2022; 14:cancers14030499. [PMID: 35158767 PMCID: PMC8833796 DOI: 10.3390/cancers14030499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/14/2022] [Accepted: 01/16/2022] [Indexed: 11/16/2022] Open
Abstract
The Sphingosine kinase-1/Sphingosine 1-Phosphate (SphK1/S1P) signaling pathway is overexpressed in various cancers, and is instrumental for the adaptation to hypoxia in a number of solid tumor models, but no data are available in osteosarcoma. Here we report that SphK1 and the S1P1 receptor are involved in HIF-1α accumulation in hypoxic osteosarcoma cells. FTY720 (Fingolimod), which targets SphK1 and S1P1, prevented HIF-1α accumulation, and also inhibited cell proliferation in both normoxia and hypoxia unlike conventional chemotherapy. In human biopsies, a significant increase of SphK1 activity was observed in cancer compared with normal bones. In all sets of TMA samples (130 cases of osteosarcoma), immunohistochemical analysis showed the hypoxic marker GLUT-1, SphK1 and S1P1 were expressed in tumors. SphK1 correlated with the GLUT-1 suggesting that SphK1 is overexpressed and correlates with intratumoral hypoxia. No correlation was found between GLUT-1 or SphK1 and response to chemotherapy, but a statistical difference was found with increased S1P1 expression in patients with poor response in long bone osteosarcomas. Importantly, multivariate analyses showed that GLUT-1 was associated with an increased risk of death in flat bone, whereas SphK1 and S1P1 were associated with an increased risk of death in long bones.
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Affiliation(s)
- Anne Gomez-Brouchet
- CNRS, Institut de Pharmacologie et de Biologie Structurale, 31077 Toulouse, France; (C.I.); (A.L.); (P.-Y.F.); (F.T.); (M.-L.M.)
- Université de Toulouse, UPS, 31400 Toulouse, France
- Département d’Anatomie et Cytologie Pathologies, Institut Universitaire du Cancer de Toulouse–Oncopôle (IUCT-O), 31059 Toulouse, France
- Cancer Biobank, Institut Universitaire du Cancer de Toulouse–Oncopôle (IUCT-O), 31059 Toulouse, France;
- Correspondence: (A.G.-B.); (O.C.)
| | - Claire Illac
- CNRS, Institut de Pharmacologie et de Biologie Structurale, 31077 Toulouse, France; (C.I.); (A.L.); (P.-Y.F.); (F.T.); (M.-L.M.)
- Université de Toulouse, UPS, 31400 Toulouse, France
- Département d’Anatomie et Cytologie Pathologies, Institut Universitaire du Cancer de Toulouse–Oncopôle (IUCT-O), 31059 Toulouse, France
| | - Adeline Ledoux
- CNRS, Institut de Pharmacologie et de Biologie Structurale, 31077 Toulouse, France; (C.I.); (A.L.); (P.-Y.F.); (F.T.); (M.-L.M.)
- Université de Toulouse, UPS, 31400 Toulouse, France
| | - Pierre-Yves Fortin
- CNRS, Institut de Pharmacologie et de Biologie Structurale, 31077 Toulouse, France; (C.I.); (A.L.); (P.-Y.F.); (F.T.); (M.-L.M.)
- Université de Toulouse, UPS, 31400 Toulouse, France
| | - Sandra de Barros
- Service de Pharmacologie Clinique, Hôpitaux de Toulouse, 31300 Toulouse, France; (S.d.B.); (C.V.); (F.D.); (S.P.)
| | - Clémentine Vabre
- Service de Pharmacologie Clinique, Hôpitaux de Toulouse, 31300 Toulouse, France; (S.d.B.); (C.V.); (F.D.); (S.P.)
| | - Fabien Despas
- Service de Pharmacologie Clinique, Hôpitaux de Toulouse, 31300 Toulouse, France; (S.d.B.); (C.V.); (F.D.); (S.P.)
| | - Sophie Peries
- Service de Pharmacologie Clinique, Hôpitaux de Toulouse, 31300 Toulouse, France; (S.d.B.); (C.V.); (F.D.); (S.P.)
| | - Christelle Casaroli
- Cancer Biobank, Institut Universitaire du Cancer de Toulouse–Oncopôle (IUCT-O), 31059 Toulouse, France;
| | - Corinne Bouvier
- Department of Pathology, CHU la Timone, 13005 Marseille, France;
| | | | | | - Frédérique Larousserie
- Department of Pathology, AP-HP, Hôpital Cochin, Universiteé Paris Descartes, 75014 Paris, France;
| | - Louise Galmiche
- Centre Hospitalier Universitaire de Nantes Hôtel Dieu, 44000 Nantes, France;
| | - Franck Talmont
- CNRS, Institut de Pharmacologie et de Biologie Structurale, 31077 Toulouse, France; (C.I.); (A.L.); (P.-Y.F.); (F.T.); (M.-L.M.)
- Université de Toulouse, UPS, 31400 Toulouse, France
| | - Stuart Pitson
- Centre for Cancer Biology, University of South Australia and SA Pathology, Adelaide, SA 5000, Australia;
| | - Marie-Lise Maddelein
- CNRS, Institut de Pharmacologie et de Biologie Structurale, 31077 Toulouse, France; (C.I.); (A.L.); (P.-Y.F.); (F.T.); (M.-L.M.)
- Université de Toulouse, UPS, 31400 Toulouse, France
| | - Olivier Cuvillier
- CNRS, Institut de Pharmacologie et de Biologie Structurale, 31077 Toulouse, France; (C.I.); (A.L.); (P.-Y.F.); (F.T.); (M.-L.M.)
- Université de Toulouse, UPS, 31400 Toulouse, France
- Correspondence: (A.G.-B.); (O.C.)
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Angeles MA, Cabarrou B, Gil-Moreno A, Pérez-Benavente A, Spagnolo E, Rychlik A, Martínez-Gómez C, Guyon F, Zapardiel I, Querleu D, Illac C, Migliorelli F, Bétrian S, Ferron G, Hernández A, Martinez A. Effect of tumor burden and radical surgery on survival difference between upfront, early interval or delayed cytoreductive surgery in ovarian cancer. J Gynecol Oncol 2021; 32:e78. [PMID: 34431252 PMCID: PMC8550927 DOI: 10.3802/jgo.2021.32.e78] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 03/15/2021] [Revised: 06/02/2021] [Accepted: 06/15/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE We sought to evaluate the impact on survival of tumor burden and surgical complexity in relation to the number of cycles of neoadjuvant chemotherapy (NACT) in patients with advanced ovarian cancer (OC) with minimal (CC-1) or no residual disease (CC-0). METHODS This retrospective study included patients with International Federation of Gynaecology and Obstetrics IIIC-IV stage OC who underwent debulking surgery at 4 high-volume institutions between January 2008 and December 2015. We assessed the overall survival (OS) of primary debulking surgery (PDS group), early interval debulking surgery after 3-4 cycles of NACT (early IDS group) and delayed debulking surgery after 6 cycles (DDS group) with CC-0 or CC-1 according to peritoneal cancer index (PCI) and Aletti score. RESULTS Five hundred forty-nine women were included: 175 (31.9%) had PDS, 224 (40.8%) early IDS and 150 (27.3%) DDS. Regardless of Aletti score, median OS after PDS was significantly higher than after early IDS or DDS, but the survival difference was higher in women with an Aletti score <8. Among patients with PCI ≤10, median OS after PDS was significantly higher than after early IDS or DDS. In women with PCI >10, there were no differences between PDS and early IDS, but DDS was associated with decreased OS. CONCLUSION The benefit of complete PDS compared with NACT was maximal in patients with a low complexity score. In patients with low tumor burden, there was a survival benefit of PDS over early IDS or DDS. In women with high tumor load, DDS impaired the oncological outcome.
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Affiliation(s)
- Martina Aida Angeles
- Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole (IUCT-Oncopole), Toulouse, France
| | - Bastien Cabarrou
- Biostatistics Unit, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole (IUCT-Oncopole), Toulouse, France
| | - Antonio Gil-Moreno
- Department of Gynaecological Oncology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Asunción Pérez-Benavente
- Department of Gynaecological Oncology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Emanuela Spagnolo
- Gynecologic Oncology Unit, La Paz University Hospital, Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - Agnieszka Rychlik
- Department of Gynaecologic Oncology, Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Carlos Martínez-Gómez
- Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole (IUCT-Oncopole), Toulouse, France.,INSERM CRCT 1, Toulouse, France
| | - Frédéric Guyon
- Department of Surgical Oncology, Institut Bergonié, Bordeaux, France
| | - Ignacio Zapardiel
- Gynecologic Oncology Unit, La Paz University Hospital, Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - Denis Querleu
- Honorary Professor of the University of Toulouse, France
| | - Claire Illac
- Department of Anatomopathology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole (IUCT-Oncopole), Toulouse, France
| | - Federico Migliorelli
- Department of Gynaecology and Obstetrics, Centre Hospitalier Intercommunal des Vallées de l'Ariège, St Jean de Verges, France
| | - Sarah Bétrian
- Department of Medical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole (IUCT-Oncopole), Toulouse, France
| | - Gwénaël Ferron
- Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole (IUCT-Oncopole), Toulouse, France.,INSERM CRCT 19, Toulouse, France
| | - Alicia Hernández
- Gynecologic Oncology Unit, La Paz University Hospital, Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - Alejandra Martinez
- Department of Surgical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse Oncopole (IUCT-Oncopole), Toulouse, France.,INSERM CRCT 1, Toulouse, France.
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Navarro AS, Angeles MA, Migliorelli F, Illac C, Martínez-Gómez C, Leray H, Betrian S, Chantalat E, Tanguy Le Gac Y, Motton S, Querleu D, Ferron G, Gabiache E, Martinez A. Comparison of SPECT-CT with intraoperative mapping in cervical and uterine malignancies. Int J Gynecol Cancer 2021; 31:679-685. [PMID: 33649157 DOI: 10.1136/ijgc-2020-002198] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 02/06/2021] [Accepted: 02/16/2021] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION The objective was to evaluate whether hybrid imaging combining single photon emission tomography with computed tomography (SPECT/CT) provides additional clinical value for dectection of sentinel lymph nodes (SLNs) compared with intraoperative combined mapping in uterine and cervical malignancies. METHODS This was a retrospective study of prospectively collected data from patients with stages IA-IB2 cervical cancer (International Federation of Gynecology and Obstetrics (FIGO) 2018) or stage I endometrial cancer, who underwent preoperative SPECT/CT for SLN detection. All included patients had dual injection of technetium-99m (99mTc) with patent blue or indocyanine green. RESULTS A total of 171 patients were included with 468 SLNs detected during surgery: 146/171 patients (85.4%) had both radiotracer and blue injection whereas 25/171 patients (14.6%) had radiotracer and indocyanine green injected. The overall detection rate was 95.3%. The detection rate of SLN mapping was 74.9% for SPECT/CT, 90.6% for 99mTc, 91.8% for blue dye, and 100% for indocyanine green. Bilateral drainage was found in 140 patients (81.9%), detected by 99mTc in 105 patients (61.4%), by blue in 99 patients (67.3%), by indocyanine green in 23 patients (92%), and by SPECT/CT in 62 patients (36.4%). Atypical SLN locations were identified by SPECT/CT in 64 patients (37.4%), by 99mTc in 28 patients (16.4%), by blue in 17 patients (9.9%), and by indocyanine green in 8 patients (4.7%). Sensitivity and negative predictive value of SLN biopsy to detect lymph node metastasis using dual injection of different intraoperative combined techniques were 88.9% and 97.5%, respectively. CONCLUSION SPECT/CT enhanced topographic delineation of SLN and more accurately identified drainage to atypical locations. Fluorescent SLN mapping using indocyanine green offered the highest SLN detection rate. When indocyanine green was used, SPECT/CT did not increase SLN detection, and did not add further information to improve lymph node localization and removal.
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Affiliation(s)
| | - Martina Aida Angeles
- Department of Surgical Oncology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
| | - Federico Migliorelli
- Centre Hospitalier Intercommunal des Vallées de l'Ariège, St Jean de Verges, GE, France
| | - Claire Illac
- Department of Pathology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, Languedoc-Roussillon-Midi, France
| | - Carlos Martínez-Gómez
- Department of Surgical Oncology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
| | - Hélène Leray
- Department of Surgical Oncology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
| | - Sarah Betrian
- Department of Medical Oncology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, Languedoc-Roussillon-Midi, France
| | - Elodie Chantalat
- Centre Hospitalier Universitaire de Toulouse, Toulouse, Midi-Pyrénées, France
| | - Yann Tanguy Le Gac
- Centre Hospitalier Universitaire de Toulouse, Toulouse, Midi-Pyrénées, France
| | - Stephanie Motton
- Centre Hospitalier Universitaire de Toulouse, Toulouse, Midi-Pyrénées, France
| | | | - Gwenael Ferron
- Department of Surgical Oncology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
| | - Erwan Gabiache
- Department of Nuclear Medicine, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, Languedoc-Roussillon-Midi, France
| | - Alejandra Martinez
- Department of Surgical Oncology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
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Weyl A, Illac C, Delchier MC, Suc B, Cuellar E, Chantalat E. Splenic lesion mimicking breast metastasis: The first description of splenic parenchymal endometriosis. Journal of Endometriosis and Pelvic Pain Disorders 2020. [DOI: 10.1177/2284026520960846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction: Splenic parenchymal endometriosis has never been described to date. We report here the case of real parenchymal endometriosis of the spleen. Case description: In this case, a 54-year-old female patient presented a histologically proven metastatic recurrence of breast cancer in the internal breast chain. The CT-scan also detected a large cystic structure developed from the spleen, but non-suspected to be metastasis. The patient was treated with chemotherapy (paclitaxel) and a combination of targeted therapies (everolimus and trastuzumab). While a complete radiological and biological response was noted at 2 months, the splenic cyst gradually decreased over the years. When targeted therapies were stopped, a reincrease of the splenic lesion and de novo significant hypermetabolism of the splenic parenchyma on 18F-FDG PET scan were observed. A splenectomy was finally performed and revealed splenic parenchymal endometriosis. Conclusion: This case once again highlights the complexity of endometriosis disease, from a pathophysiological point of view, but also the difficulties of radiological characterisation, and diagnostic management.
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Affiliation(s)
- Ariane Weyl
- Department of Gynecologic surgery, University Hospital of Toulouse Rangueil, Toulouse, France
| | - Claire Illac
- Department of Pathology, Institut Universitaire du cancer de Toulouse Oncopole, Toulouse, France
| | | | - Bertrand Suc
- Department of Visceral Surgery, University Hospital of Toulouse Rangueil, Toulouse, France
| | - Emmanuel Cuellar
- Department of Visceral Surgery, University Hospital of Toulouse Rangueil, Toulouse, France
| | - Elodie Chantalat
- Department of Gynecologic surgery, University Hospital of Toulouse Rangueil, Toulouse, France
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Weyl A, Illac C, Lusque A, Leray H, Vaysse C, Martinez A, Chantalat E, Motton S. Prognostic value of lymphovascular space invasion in early-stage cervical cancer. Int J Gynecol Cancer 2020; 30:1493-1499. [PMID: 32565486 DOI: 10.1136/ijgc-2020-001274] [Citation(s) in RCA: 8] [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: 02/13/2020] [Revised: 05/16/2020] [Accepted: 05/19/2020] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Few prognostic factors likely to influence therapeutic management of early-stage cervical cancer are currently recognized. The objective of this study was to determine the prognostic value of lymphovascular space invasion (LVSI) in overall survival of patients with early-stage cervical cancer. METHODS This is a retrospective study of patients treated for early-stage cervical cancer between January 1996 and December 2013 at Toulouse University Hospital and the Cancer Center Claudius Regaud Institute. Patients were included if they had FIGO 2018 stage IA1, IA2, IB1/2, or IIA1 cervical cancer. All patients had to have had surgery (conization, radical hysterectomy, or radical trachelectomy). The presence of LVSI was evaluated in the initial anatomic pathology reports of the excised tissue. The presence of LVSI was defined by the presence of epithelial tumor cells in the lumen of vessels, lined by endothelial cells. If the data were missing, the slides were reviewed by an expert pathologist. Comparative analyses of patient populations with and without LVSI invasion were performed, as well as analyses of overall and disease-free survival. RESULTS A total of 158 patients were included in the analysis. Seventy-two (45.6%) patients had LVSI. More patients with LVSI received external radiotherapy in addition to standard treatment than patients without LVSI (53% vs 14%, p<0.0001). The overall survival of patients with LVSI (89.8%) was similar to that of patients without LVSI (91.5%) (p=0.39). For patients without lymph node involvement but with LVSI, disease-free survival at 5 years tended to be higher among those treated with external radiotherapy in addition to standard treatments (92.6% vs 79.8%, difference not tested due to the small number of events). CONCLUSION Patients with early-stage cervical cancer with LVSI received external radiotherapy more often, and therefore had an overall survival at 5 years identical to patients without LVSI.
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Affiliation(s)
- Ariane Weyl
- Gynecologic Surgery, CHU Toulouse, Toulouse, Midi-Pyrénées, France
| | - Claire Illac
- Pathology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, Languedoc-Roussillon-Midi, France
| | - Amélie Lusque
- Biostatistics, Institute Claudius Regaud, Toulouse, Occitanie, France
| | - Hélène Leray
- Oncologic Surgery, Institute Claudius Regaud, Toulouse, Occitanie, France
| | - Charlotte Vaysse
- Gynecologic Surgery, CHU Toulouse, Toulouse, Midi-Pyrénées, France
| | - Alejandra Martinez
- Oncologic Surgery, Institute Claudius Regaud, Toulouse, Occitanie, France
| | - Elodie Chantalat
- Gynecologic Surgery, CHU Toulouse, Toulouse, Midi-Pyrénées, France
| | - Stephanie Motton
- Gynecologic Surgery, CHU Toulouse, Toulouse, Midi-Pyrénées, France
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10
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Balança CC, Scarlata CM, Michelas M, Devaud C, Sarradin V, Franchet C, Martinez Gomez C, Gomez-Roca C, Tosolini M, Heaugwane D, Lauzéral-Vizcaino F, Mir-Mesnier L, Féliu V, Valle C, Pont F, Ferron G, Gladieff L, Motton S, Tanguy Le Gac Y, Dupret-Bories A, Sarini J, Vairel B, Illac C, Siegfried-Vergnon A, Mery E, Fournié JJ, Vergez S, Delord JP, Rochaix P, Martinez A, Ayyoub M. Dual Relief of T-lymphocyte Proliferation and Effector Function Underlies Response to PD-1 Blockade in Epithelial Malignancies. Cancer Immunol Res 2020; 8:869-882. [PMID: 32295784 DOI: 10.1158/2326-6066.cir-19-0855] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 02/04/2020] [Accepted: 04/09/2020] [Indexed: 11/16/2022]
Abstract
Although understanding of T-cell exhaustion is widely based on mouse models, its analysis in patients with cancer could provide clues indicating tumor sensitivity to immune checkpoint blockade (ICB). Data suggest a role for costimulatory pathways, particularly CD28, in exhausted T-cell responsiveness to PD-1/PD-L1 blockade. Here, we used single-cell transcriptomic, phenotypic, and functional approaches to dissect the relation between CD8+ T-cell exhaustion, CD28 costimulation, and tumor specificity in head and neck, cervical, and ovarian cancers. We found that memory tumor-specific CD8+ T cells, but not bystander cells, sequentially express immune checkpoints once they infiltrate tumors, leading, in situ, to a functionally exhausted population. Exhausted T cells were nonetheless endowed with effector and tumor residency potential but exhibited loss of the costimulatory receptor CD28 in comparison with their circulating memory counterparts. Accordingly, PD-1 inhibition improved proliferation of circulating tumor-specific CD8+ T cells and reversed functional exhaustion of specific T cells at tumor sites. In agreement with their tumor specificity, high infiltration of tumors by exhausted cells was predictive of response to therapy and survival in ICB-treated patients with head and neck cancer. Our results showed that PD-1 blockade-mediated proliferation/reinvigoration of circulating memory T cells and local reversion of exhaustion occur concurrently to control tumors.
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Affiliation(s)
| | | | - Marie Michelas
- Cancer Research Center of Toulouse, INSERM UMR 1037, Toulouse, France
| | - Christel Devaud
- Cancer Research Center of Toulouse, INSERM UMR 1037, Toulouse, France
| | - Victor Sarradin
- Cancer Research Center of Toulouse, INSERM UMR 1037, Toulouse, France.,Department of Medical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse, Toulouse, France
| | - Camille Franchet
- Department of Pathology, Centre Hospitalier Universitaire, Institut Universitaire du Cancer de Toulouse, Toulouse, France.,Université Toulouse III Paul Sabatier, Toulouse, France
| | - Carlos Martinez Gomez
- Cancer Research Center of Toulouse, INSERM UMR 1037, Toulouse, France.,Department of Surgery, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse, Toulouse, France
| | - Carlos Gomez-Roca
- Cancer Research Center of Toulouse, INSERM UMR 1037, Toulouse, France.,Department of Medical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse, Toulouse, France
| | - Marie Tosolini
- Technological Pole and Bioinformatic Platform, Cancer Research Center of Toulouse, INSERM UMR 1037, Toulouse, France
| | - Diana Heaugwane
- Department of Pathology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse, Toulouse, France
| | - Françoise Lauzéral-Vizcaino
- Cancer Research Center of Toulouse, INSERM UMR 1037, Toulouse, France.,Université Toulouse III Paul Sabatier, Toulouse, France
| | - Lucile Mir-Mesnier
- Immune Monitoring Core Facility, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse, Toulouse, France
| | - Virginie Féliu
- Cancer Research Center of Toulouse, INSERM UMR 1037, Toulouse, France
| | - Carine Valle
- Technological Pole and Bioinformatic Platform, Cancer Research Center of Toulouse, INSERM UMR 1037, Toulouse, France
| | - Frédéric Pont
- Technological Pole and Bioinformatic Platform, Cancer Research Center of Toulouse, INSERM UMR 1037, Toulouse, France
| | - Gwénaël Ferron
- Department of Surgery, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse, Toulouse, France
| | - Laurence Gladieff
- Department of Medical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse, Toulouse, France
| | - Stéphanie Motton
- Department of Surgery, Centre Hospitalier Universitaire, Institut Universitaire du Cancer de Toulouse, Toulouse, France
| | - Yann Tanguy Le Gac
- Department of Surgery, Centre Hospitalier Universitaire, Institut Universitaire du Cancer de Toulouse, Toulouse, France
| | - Agnès Dupret-Bories
- Department of Surgery, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse, Toulouse, France
| | - Jérôme Sarini
- Department of Surgery, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse, Toulouse, France
| | - Benjamin Vairel
- Department of Surgery, Centre Hospitalier Universitaire, Institut Universitaire du Cancer de Toulouse, Toulouse, France
| | - Claire Illac
- Department of Pathology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse, Toulouse, France
| | - Aurore Siegfried-Vergnon
- Department of Pathology, Centre Hospitalier Universitaire, Institut Universitaire du Cancer de Toulouse, Toulouse, France
| | - Eliane Mery
- Department of Pathology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse, Toulouse, France
| | | | - Sébastien Vergez
- Université Toulouse III Paul Sabatier, Toulouse, France.,Department of Surgery, Centre Hospitalier Universitaire, Institut Universitaire du Cancer de Toulouse, Toulouse, France
| | - Jean-Pierre Delord
- Cancer Research Center of Toulouse, INSERM UMR 1037, Toulouse, France.,Department of Medical Oncology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse, Toulouse, France.,Université Toulouse III Paul Sabatier, Toulouse, France
| | - Philippe Rochaix
- Department of Pathology, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse, Toulouse, France
| | - Alejandra Martinez
- Cancer Research Center of Toulouse, INSERM UMR 1037, Toulouse, France.,Department of Surgery, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse, Toulouse, France
| | - Maha Ayyoub
- Cancer Research Center of Toulouse, INSERM UMR 1037, Toulouse, France. .,Université Toulouse III Paul Sabatier, Toulouse, France.,Immune Monitoring Core Facility, Institut Claudius Regaud, Institut Universitaire du Cancer de Toulouse, Toulouse, France
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11
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Provendier A, Angeles MA, Meyrignac O, Illac C, Ducassou A, Martínez-Gómez C, Gladieff L, Martinez A, Ferron G. Clear cell adenocarcinoma arising from the abdominal wall after cesarean section in a patient with uterine adenomyosis. J Surg Case Rep 2020; 2020:rjaa070. [PMID: 32280445 PMCID: PMC7136835 DOI: 10.1093/jscr/rjaa070] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 03/23/2020] [Indexed: 11/21/2022] Open
Abstract
Malignant transformation of abdominal wall endometriosis lesions developed in a cesarean section scar is a rare event. Patients with uterine adenomyosis but without endometriosis can also develop abdominal wall malignant carcinoma after a gynecologic surgery. The treatment of abdominal wall clear cell adenocarcinoma combines tumor surgical excision with free margins, radiotherapy and chemotherapy. We report a case of clear cell carcinoma arising from an abdominal wall cesarean section scar in a patient without history of endometriosis.
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Affiliation(s)
- Anaïs Provendier
- Department of Surgical Oncology, Institut Claudius Regaud-Institut Universitaire du Cancer de Toulouse (IUCT)-Oncopole, Toulouse, France
| | - Martina Aida Angeles
- Department of Surgical Oncology, Institut Claudius Regaud-Institut Universitaire du Cancer de Toulouse (IUCT)-Oncopole, Toulouse, France
| | - Olivier Meyrignac
- Department of Radiology, Institut Claudius Regaud-Institut Universitaire du Cancer de Toulouse (IUCT)-Oncopole, Toulouse, France
| | - Claire Illac
- Department of Anatomopathology, Institut Claudius Regaud-Institut Universitaire du Cancer de Toulouse (IUCT)-Oncopole, Toulouse, France
| | - Anne Ducassou
- Department of Radiotherapy, Institut Claudius Regaud-Institut Universitaire du Cancer de Toulouse (IUCT)-Oncopole, Toulouse, France
| | - Carlos Martínez-Gómez
- Department of Surgical Oncology, Institut Claudius Regaud-Institut Universitaire du Cancer de Toulouse (IUCT)-Oncopole, Toulouse, France.,INSERM CRCT Team 1, Tumor Immunology and Immunotherapy, Toulouse, France
| | - Laurence Gladieff
- Department of Medical Oncology, Institut Claudius Regaud-Institut Universitaire du Cancer de Toulouse (IUCT)-Oncopole, Toulouse, France
| | - Alejandra Martinez
- Department of Surgical Oncology, Institut Claudius Regaud-Institut Universitaire du Cancer de Toulouse (IUCT)-Oncopole, Toulouse, France.,INSERM CRCT Team 1, Tumor Immunology and Immunotherapy, Toulouse, France
| | - Gwénaël Ferron
- Department of Surgical Oncology, Institut Claudius Regaud-Institut Universitaire du Cancer de Toulouse (IUCT)-Oncopole, Toulouse, France.,INSERM CRCT Team 19, ONCOSARC-Oncogenesis of Sarcomas, Toulouse, France
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12
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Carrara J, Hervy B, Dabi Y, Illac C, Haddad B, Skalli D, Miailhe G, Vidal F, Touboul C, Vaysse C. Added-Value of Endometrial Biopsy in the Diagnostic and Therapeutic Strategy for Pelvic Actinomycosis. J Clin Med 2020; 9:jcm9030821. [PMID: 32197366 PMCID: PMC7141382 DOI: 10.3390/jcm9030821] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 03/06/2020] [Accepted: 03/14/2020] [Indexed: 12/02/2022] Open
Abstract
The particularity of pelvic actinomycosis lies in the difficulty of establishing the diagnosis prior to treatment. The objective of this retrospective bicentric study was to evaluate the pertinence and efficacy of the different diagnostic tools used pre- and post-treatment in a cohort of patients with pelvic actinomycosis. The following data were collected: clinical, paraclinical, type of treatment, and the outcome and pertinence of the two diagnostic methods, bacteriological or histopathological, were evaluated. Twenty-seven women were included, with a pre-treatment diagnosis proposed for 66.7% (n = 18) of them. The diagnosis was established in 13.6% (n = 3) of cases through bacteriological samples, and in 93.8% (n = 15) of cases through histopathological samples, with endometrial biopsy positive in 100% of cases. The treatment was surgical with antibiotics for 55.6% (n = 15) of patients, medical with antibiotic therapy for 40.7% (n = 11) of patients, and surgical without antibiotics for one patient. All patients achieved recovery without recurrence, with a median follow-up of 96 days (4–4339 days). Our study suggested an excellent performance of histopathological analysis, and in particular endometrial biopsy, in the diagnosis of pelvic actinomycosis. This tool allowed early diagnosis and, in some cases, the use of antibiotic therapy alone, making it possible to avoid surgery.
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Affiliation(s)
- Julie Carrara
- Service de Gynécologie Obstétrique, Université Paris Est, Paris XII, Hôpital Intercommunal de Créteil, 94000 Créteil, France; (J.C.); (Y.D.); (B.H.); (D.S.); (G.M.); (C.T.)
| | - Blandine Hervy
- Service de Chirurgie générale et gynécologique, Université de Toulouse, CHU de Toulouse, UPS, 31059 Toulouse, France; (B.H.); (F.V.)
| | - Yohann Dabi
- Service de Gynécologie Obstétrique, Université Paris Est, Paris XII, Hôpital Intercommunal de Créteil, 94000 Créteil, France; (J.C.); (Y.D.); (B.H.); (D.S.); (G.M.); (C.T.)
| | - Claire Illac
- Service d’Anatomie-Pathologie, Université de Toulouse, CHU de Toulouse, 31059 Toulouse, France;
| | - Bassam Haddad
- Service de Gynécologie Obstétrique, Université Paris Est, Paris XII, Hôpital Intercommunal de Créteil, 94000 Créteil, France; (J.C.); (Y.D.); (B.H.); (D.S.); (G.M.); (C.T.)
| | - Dounia Skalli
- Service de Gynécologie Obstétrique, Université Paris Est, Paris XII, Hôpital Intercommunal de Créteil, 94000 Créteil, France; (J.C.); (Y.D.); (B.H.); (D.S.); (G.M.); (C.T.)
| | - Gregoire Miailhe
- Service de Gynécologie Obstétrique, Université Paris Est, Paris XII, Hôpital Intercommunal de Créteil, 94000 Créteil, France; (J.C.); (Y.D.); (B.H.); (D.S.); (G.M.); (C.T.)
| | - Fabien Vidal
- Service de Chirurgie générale et gynécologique, Université de Toulouse, CHU de Toulouse, UPS, 31059 Toulouse, France; (B.H.); (F.V.)
| | - Cyril Touboul
- Service de Gynécologie Obstétrique, Université Paris Est, Paris XII, Hôpital Intercommunal de Créteil, 94000 Créteil, France; (J.C.); (Y.D.); (B.H.); (D.S.); (G.M.); (C.T.)
| | - Charlotte Vaysse
- Service de Chirurgie générale et gynécologique, Université de Toulouse, CHU de Toulouse, UPS, 31059 Toulouse, France; (B.H.); (F.V.)
- Correspondence: ; Tel.: +33-5-6132-2828; Fax: +33-5-3115-5318
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13
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Eychenne C, Suc B, Delchier MC, Vidal F, Rimailho J, Illac C, Breibach F, Vaysse C, Chantalat E. Hepatic pedicle endometriosis: Case report and review of the literature. J Obstet Gynaecol Res 2019; 45:2121-2127. [PMID: 31368157 DOI: 10.1111/jog.14078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 02/16/2019] [Accepted: 07/15/2019] [Indexed: 02/06/2023]
Abstract
The localization of endometriotic disease in the hepatic pedicle has never been reported to date. We report the first case of a 67-year-old postmenopausal patient having presented an endometriotic lesion in the hepatic pedicle. A surgical biopsy was needed to confirm the diagnosis after a first radiologic biopsy that concluded the presence of a mucinous cystic tumor with low-grade dysplasia. Medical treatment with aromatase inhibitors was carried out because of the inextirpable nature of the lesion. The diagnosis and therapeutic management of this rarely occurring lesion of atypical localization in a postmenopausal patient is presented here. A review of the literature on this localization could have led to a damaging surgical treatment due to the different diagnoses suggested. Management of endometriosis relies on a multidisciplinary approach that each practitioner must know how to broach with patients of all ages.
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Affiliation(s)
- Camille Eychenne
- Department of Gynecological Surgery, CHU Rangueil, Toulouse, France
| | - Bertrand Suc
- Department of Visceral Surgery, CHU Rangueil, Toulouse, France
| | | | - Fabien Vidal
- Department of Gynecological Obstetric, CHU Paule de Viguier, Toulouse, France
| | - Jacques Rimailho
- Department of Gynecological Surgery, CHU Rangueil, Toulouse, France
| | - Claire Illac
- Department of Pathology, IUCT-Oncopole, Toulouse, France
| | | | - Charlotte Vaysse
- Department of Gynecological Surgery, CHU Rangueil, Toulouse, France
| | - Elodie Chantalat
- Department of Gynecological Surgery, CHU Rangueil, Toulouse, France
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14
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Gomez-Brouchet A, Illac C, Gilhodes J, Bouvier C, Aubert S, Guinebretiere JM, Marie B, Larousserie F, Entz-Werle N, Pinieux GD, Filleron T, Minard V, Minville V, Mascard E, Gouin F, Jimenez M, Ledeley MC, Piperno-Neumann S, Brugieres L, Redini F. Abstract B29: CD163-positive tumor-associated macrophages and CD8-positive cytotoxic lymphocytes are powerful diagnostic markers for therapeutic stratification of osteosarcoma patients in the French OS 2006 trial. Clin Cancer Res 2018. [DOI: 10.1158/1557-3265.sarcomas17-b29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
The French phase 3 trial (OS 2006) testing combining zoledronate (an osteoclast inhibitor) with chemotherapy and surgery did not improve the outcome of patients with osteosarcoma. To understand this unexpected result, the presence of infiltrating immune cells was investigated in 124 biopsies of patients enrolled in the trial. The percentage of CD68/CD163 tumor-infiltrating macrophages, CD8 lymphocytes, osteoclasts, and the PD1/PDL-1 checkpoint was assessed by immunohistochemistry. M1/M2 macrophage polarization was characterized by pSTAT1/CMAF staining. The expression of these biomarkers was correlated with clinical outcome. No statistical correlations were found with response to chemotherapy. High CD163 levels (>50% of cells per core; 43.8% of patients) were associated with CMAF nuclear expression and significantly correlated with greater overall survival (p=0.0025) and with longer metastasis progression-free survival (MPFS, p=0.0315) independently of diagnosis status (p=0.002). Only a trend was observed for patients with high CD68-positive cells (p=0.0582). CD8 staining was positive in >50% of cases with a median staining of 1%. Lower CD8 levels were associated with metastatic disease at diagnosis and only the presence of CD8-positive cells significantly correlated with improved overall survival in zoledronate-treated patients (p=0.0415). PD1/PDL-1 staining was negative in >80% of cases and was not correlated to prognosis. Finally, CD163-positive TAMs and CD8-positive cells (and not the PD1/PDL-1 checkpoint) are crucial predictive biomarkers in osteosarcoma. For the first time, we described a correlation between CD8-positive cells and zometa treatment. The immunohistochemical analysis of the microenvironment in osteosarcoma patient biopsies could represent a novel tool for therapeutic stratification.
Citation Format: Anne Gomez-Brouchet, Claire Illac, Julia Gilhodes, Corinne Bouvier, Sébastien Aubert, Jean-Marc Guinebretiere, Béatrice Marie, Frédérique Larousserie, Natacha Entz-Werle, Gonzague de Pinieux, Thomas Filleron, Véronique Minard, Vincent Minville, Eric Mascard, François Gouin, Marta Jimenez, Marie-Cécile Ledeley, Sophie Piperno-Neumann, Laurence Brugieres, Françoise Redini. CD163-positive tumor-associated macrophages and CD8-positive cytotoxic lymphocytes are powerful diagnostic markers for therapeutic stratification of osteosarcoma patients in the French OS 2006 trial [abstract]. In: Proceedings of the AACR Conference on Advances in Sarcomas: From Basic Science to Clinical Translation; May 16-19, 2017; Philadelphia, PA. Philadelphia (PA): AACR; Clin Cancer Res 2018;24(2_Suppl):Abstract nr B29.
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Affiliation(s)
| | - Claire Illac
- 1Dpt. Pathology, IUCT-Oncopole, Toulouse, France,
| | | | | | | | | | | | | | | | | | | | | | | | - Eric Mascard
- 12Dpt. Pediatric Orthopedic Surgery, Necker Hospital, Paris, France,
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15
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Gomez-Brouchet A, Illac C, Gilhodes J, Bouvier C, Aubert S, Guinebretiere JM, Marie B, Larousserie F, Entz-Werlé N, de Pinieux G, Filleron T, Minard V, Minville V, Mascard E, Gouin F, Jimenez M, Ledeley MC, Piperno-Neumann S, Brugieres L, Rédini F. CD163-positive tumor-associated macrophages and CD8-positive cytotoxic lymphocytes are powerful diagnostic markers for the therapeutic stratification of osteosarcoma patients: An immunohistochemical analysis of the biopsies fromthe French OS2006 phase 3 trial. Oncoimmunology 2017; 6:e1331193. [PMID: 28932633 DOI: 10.1080/2162402x.2017.1331193] [Citation(s) in RCA: 117] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 04/15/2017] [Accepted: 05/12/2017] [Indexed: 10/19/2022] Open
Abstract
The French phase 3 trial (OS 2006) testing zoledronic acid, an osteoclast inhibitor, with chemotherapy and surgery did not improve the outcome of patients with osteosarcoma (OS). To understand this unexpected result, the presence of infiltrating immune cells was investigated in 124 pre-therapeutic biopsies of patients enrolled in the trial. The percentage of CD68/CD163 tumor-infiltrating macrophages (TAMs), CD8+ lymphocytes, osteoclasts, and the PD1/PDL-1 checkpoint were assessed by immunohistochemistry. M1/M2 macrophage polarization was characterized by pSTAT1/CMAF staining. The expression of these biomarkers was correlated with clinical outcome. No statistical correlations were found with response to chemotherapy. High CD163 levels (>50% of cells per core; 43.8% of patients) were associated with CMAF nuclear expression and significantly correlated with better overall survival (p = 0.0025) and longer metastasis progression-free survival (MPFS, p = 0.0315) independently of metastatic status (p = 0.002). Only a trend was observed for patients with high CD68-positive cells (p = 0.0582). CD8+ staining was positive in >50% of cases with a median staining of 1%. Lower CD8+ levels were associated with metastatic disease at diagnosis and the presence of CD8-positive cells significantly correlated with improved overall survival in zoledronate-treated patients (p = 0.0415). PD1/PDL-1 staining was negative in >80% of cases and was not correlated with outcome. Finally, CD163-positive TAMs and CD8 positive cells are crucial prognostic biomarkers in OS, whereas PD1/PDL-1 checkpoint plays a minor role. For the first time, we described a correlation between CD8 positive cells and survival in zoledronate-treated patients. The immunohistochemical analysis of the microenvironment in biopsies may represent a novel tool for therapeutic stratification.
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Affiliation(s)
- Anne Gomez-Brouchet
- Department of Pathology, IUCT-Oncopole, CHU of Toulouse and University of Toulouse, Pharmacology and Structural Biology Institute, Toulouse, France
| | - Claire Illac
- Department of Pathology, IUCT-Oncopole, CHU of Toulouse and University of Toulouse, Pharmacology and Structural Biology Institute, Toulouse, France
| | - Julia Gilhodes
- Biostatistics Unit, Claudius Regaud Institut, IUCT-Oncopole, Toulouse, France
| | | | | | | | | | - Frédérique Larousserie
- AP-HP, Hôpital Cochin, Service de Pathologie and Université Paris Descartes, Paris, France
| | | | - Gonzague de Pinieux
- Department of Pathology, CHU Tours, Tours, France.,INSERM UMR1238, Université de Nantes, Nantes, France
| | - Thomas Filleron
- Biostatistics Unit, Claudius Regaud Institut, IUCT-Oncopole, Toulouse, France
| | - Véronique Minard
- Department of Children and Adolescents Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Vincent Minville
- Medical School of Rangueil, University Paul Sabatier, Toulouse, France
| | - Eric Mascard
- Department of Pediatric Orthopedic Surgery, Necker Hospital, Paris, France
| | - François Gouin
- INSERM UMR1238, Université de Nantes, Nantes, France.,Department of Orthopedic Surgery, CHU Nantes, Nantes, France
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16
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Illac C, Delisle MB, Bonnevialle P, Chiavassa-Gandois H, de Pinieux G, Gomez-Brouchet A. [Telangiectatic osteosarcoma secondary to a liposclerosing myxofibrous tumor: a case report]. Ann Pathol 2012; 32:259-62. [PMID: 23010399 DOI: 10.1016/j.annpat.2012.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Accepted: 06/21/2012] [Indexed: 11/19/2022]
Abstract
Malignant transformation of a fibrous dysplasia into an osteosarcoma is very rare. We report the case of an 84-year-old man with telangiectatic osteosarcoma of the upper femur arising in a previous fibrous dysplasia also known as liposclerosing myxofibrous tumor. The tumor was expressing the epithelial membrane antigen. This is the first described case of a malignant transformation into an osteosarcoma arising in a liposclerosing myxofibrous tumor. We discuss the main differential diagnosis with a review.
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Affiliation(s)
- Claire Illac
- Service d'anatomie pathologique et histologie-cytologie, CHU de Rangueil, 1, avenue du Professeur-Jean-Poulhès, TSA 50032, 31059 Toulouse cedex 9, France.
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