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Bachet JB, Laurent-Puig P, Meurisse A, Bouché O, Mas L, Taly V, Cohen R, Gornet JM, Artru P, Louafi S, Thirot-Bidault A, Baumgaertner I, Coriat R, Tougeron D, Lecomte T, Mary F, Aparicio T, Marthey L, Blons H, Vernerey D, Taieb J. Circulating tumour DNA at baseline for individualised prognostication in patients with chemotherapy-naïve metastatic colorectal cancer. An AGEO prospective study. Eur J Cancer 2023; 189:112934. [PMID: 37390800 DOI: 10.1016/j.ejca.2023.05.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 03/08/2023] [Revised: 05/19/2023] [Accepted: 05/27/2023] [Indexed: 07/02/2023]
Abstract
PURPOSE Baseline circulating tumour DNA (ctDNA) is a potential prognostic marker in metastatic colorectal cancer (mCRC) patients. However, few studies have compared ctDNA with the usual prognostic factors, and no ctDNA cut-off has been proposed for daily use in clinical practice. PATIENTS AND METHODS Chemotherapy-naive patients with mCRC were prospectively included. Plasma samples were collected at diagnosis and analysed centrally by both NGS and methylation digital PCR. Baseline patient and disease characteristics, treatment regimens, and secondary surgeries were collected. The restricted cubic spline method was used to define the optimal cut-off of ctDNA mutated allelic frequency (MAF). Prognostic values were assessed on overall survival (OS) using Cox models. RESULTS From July 2015 to December 2016, 412 patients were included. ctDNA was undetectable in 83 patients (20%). ctDNA was an independent prognostic marker for OS considering the whole study population. The optimal cut-off for ctDNA MAF was 20% with median OS of 16.0 and 35.8 months for patients with MAF ≥20% and<20%, respectively (hazard ratio = 0.40; 95% confidence intervals: 0.31-0.51; P < 0.0001). The independent prognostic value of ctDNA MAF at 20% was confirmed in subgroups defined by RAS/BRAF status or resectability of metastases. Combining ctDNA MAF and carcinoembryonic antigen levels allowed us to define three different prognostic groups with median OS of 14.2, 21.1, and 46.4 months (P < 0.0001). CONCLUSION ctDNA with a MAF cut-off of 20% improves prognostication of chemotherapy-naïve mCRC patients and may be useful in the future for individualised therapeutic decisions and as a stratification factor in clinical trials. TRIAL REGISTRATION Clinicaltrials.gov, NCT02502656.
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Affiliation(s)
- Jean-Baptiste Bachet
- Department of Hepato-gastroenterology, Groupe Hospitalier Pitié Salpêtrière, Paris, France; AGEO (Association des Gastroentérologues Oncologues), Paris, France; Sorbonne Universités, UPMC Université, Paris 06, France; Centre de Recherche des Cordeliers, INSERM, CNRS SNC 5096, Sorbonne Université, Université Paris Cité, Paris, France
| | - Pierre Laurent-Puig
- Centre de Recherche des Cordeliers, INSERM, CNRS SNC 5096, Sorbonne Université, Université Paris Cité, Paris, France; Institut du cancer Paris CARPEM, AP-HP, Hopital européen Georges Pompidou, Paris, France.
| | - Aurelia Meurisse
- Methodology and Quality of Life Unit in Oncology, University Hospital of Besançon, Besançon, France; INSERM, EFS BFC, UMR1098, RIGHT, University of Franche-Comté, Besançon, France
| | - Olivier Bouché
- AGEO (Association des Gastroentérologues Oncologues), Paris, France; Department of Hepato-Gastroenterology, CHU Reims, Reims, France
| | - Léo Mas
- Department of Hepato-gastroenterology, Groupe Hospitalier Pitié Salpêtrière, Paris, France; AGEO (Association des Gastroentérologues Oncologues), Paris, France
| | - Valérie Taly
- Centre de Recherche des Cordeliers, INSERM, CNRS SNC 5096, Sorbonne Université, Université Paris Cité, Paris, France
| | - Romain Cohen
- AGEO (Association des Gastroentérologues Oncologues), Paris, France; Sorbonne Universités, UPMC Université, Paris 06, France; Department of Oncology, Hôpital Saint-Antoine, Paris, France
| | - Jean-Marc Gornet
- AGEO (Association des Gastroentérologues Oncologues), Paris, France; Department of Gastroenterology, Hôpital Saint-Louis, Paris, France
| | - Pascal Artru
- AGEO (Association des Gastroentérologues Oncologues), Paris, France; Department of Gastroenterology, Ramsay Hôpital Privé Jean Mermoz, Lyon, France
| | - Samy Louafi
- AGEO (Association des Gastroentérologues Oncologues), Paris, France; Department of Gastroenterology, Centre Hospitalier Sud Francilien, Corbeil-Essonnes, France; Department of Gastroenterology, Groupe Hospitalier Nord Essonne, Longjumeau, France
| | - Anne Thirot-Bidault
- AGEO (Association des Gastroentérologues Oncologues), Paris, France; Department of Gastroenterology, Hôpital Kremlin Bicêtre, Le Kremlin-Bicêtre, France
| | - Isabelle Baumgaertner
- AGEO (Association des Gastroentérologues Oncologues), Paris, France; Department of Oncology, Hôpital Henri Mondor, Créteil, France
| | - Romain Coriat
- AGEO (Association des Gastroentérologues Oncologues), Paris, France; Department of Gastroenterology, Hôpital Cochin, Université Paris Cité, Paris, France
| | - David Tougeron
- AGEO (Association des Gastroentérologues Oncologues), Paris, France; Department of Gastroenterology and Hepatology, Centre Hospitalo-universitaire de Poitiers, Poitiers, France
| | - Thierry Lecomte
- AGEO (Association des Gastroentérologues Oncologues), Paris, France; Department of Gastroenterology, Hepatology and Digestive Oncology, Centre Hospitalo-universitaire de Tours, Tours, France
| | - Florence Mary
- AGEO (Association des Gastroentérologues Oncologues), Paris, France; Department of Gastroenterology, Hôpital Avicenne, Bobigny, France
| | - Thomas Aparicio
- AGEO (Association des Gastroentérologues Oncologues), Paris, France; Department of Gastroenterology, Hôpital Saint-Louis, Paris, France; Department of Gastroenterology, Hôpital Antoine Béclère, Clamart, France
| | - Lysiane Marthey
- AGEO (Association des Gastroentérologues Oncologues), Paris, France; Department of Biochemistry, Hôpital Européen Georges Pompidou, Paris, France
| | - Hélène Blons
- Centre de Recherche des Cordeliers, INSERM, CNRS SNC 5096, Sorbonne Université, Université Paris Cité, Paris, France; Institut du cancer Paris CARPEM, AP-HP, Hopital européen Georges Pompidou, Paris, France
| | - Dewy Vernerey
- Methodology and Quality of Life Unit in Oncology, University Hospital of Besançon, Besançon, France; INSERM, EFS BFC, UMR1098, RIGHT, University of Franche-Comté, Besançon, France
| | - Julien Taieb
- AGEO (Association des Gastroentérologues Oncologues), Paris, France; Centre de Recherche des Cordeliers, INSERM, CNRS SNC 5096, Sorbonne Université, Université Paris Cité, Paris, France; Institut du cancer Paris CARPEM, AP-HP, Hopital européen Georges Pompidou, Paris, France; Department of Gastroenterology and Digestive Oncology, Hôpital Européen Georges Pompidou, Paris, France
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2
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Boyer C, Sefrioui D, Cohen R, Chautard R, Perrier M, Lebrun H, Goujon G, Hautefeuille V, Dior M, Walter T, Mary F, Manfredi S, Caroli-Bosc FX, Cervantes B, Coriat R, Deluche E, Zaanan A, Olivier R, Bouché O, Piessen G, Lecomte T, Louvet C, Michel P, Aparicio T, André T, Taieb J, Randrian V, Tougeron D. Prognosis and chemosensitivity of non-colorectal alimentary tract cancers with microsatellite instability. Dig Liver Dis 2023; 55:123-130. [PMID: 35397988 DOI: 10.1016/j.dld.2022.03.011] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 03/12/2022] [Accepted: 03/18/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND Data on outcomes of microsatellite instable and/or mismatch repair deficient (dMMR/MSI) digestive non-colorectal tumors are limited. AIMS To evaluate overall survival (OS) of patients with dMMR/MSI digestive non-colorectal tumor. METHODS All consecutive patients with a dMMR/MSI digestive non-colorectal tumor were included in this French retrospective multicenter study. RESULTS One hundred and sixteen patients were included with a mean age of 63.6 years and 32.6% with a Lynch syndrome. Most tumors were oesophago-gastric (54.3%) or small bowel (32.8%) adenocarcinomas and at a localized stage at diagnosis (86.7%). In patients with localized tumors and R0 resection, median OS was 134.0 ± 64.2 months. Median disease-free survival (DFS) was 100.3 ± 65.7 months. Considering oesophago-gastric tumors, median DFS was improved when chemotherapy was added to surgery (not reached versus 22.8 ± 10.0 months, p = 0.03). In patients with advanced tumors treated by chemotherapy, median OS was 14.2 ± 1.9 months and median progression-free survival was 7.4 ± 1.6 months. CONCLUSION dMMR/MSI digestive non-colorectal tumors are mostly diagnosed at a non-metastatic stage with a good prognosis. Advanced dMMR/MSI digestive non-colorectal tumors have a poor prognosis with standard chemotherapy.
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Affiliation(s)
- Claire Boyer
- Hepato-Gastroenterology Department, Poitiers University Hospital, University of Poitiers, 2 rue de la Milétrie, Poitiers 86000, France
| | - David Sefrioui
- Department of Hepatogastroenterology, Normandie Univ, UNIROUEN, Inserm U1245, IRON group, Rouen University Hospital, Rouen 76000, France
| | - Romain Cohen
- Medical Oncology Department, Assistance Publique-Hôpitaux de Pari, Saint Antoine Hospital, Sorbonne University, Paris 75012, France
| | - Romain Chautard
- Department of Hepato-Gastroenterology and Digestive Oncology, Tours University hospital, Tours 37000, France
| | - Marine Perrier
- Department of Hepato-Gastroenterology and Digestive Oncology, Robert-Debré University Hospital, Reims 51000, France
| | - Hugo Lebrun
- Department of Digestive and Oncological Surgery, Claude Huriez University Hospital, Lille University, Lille 59000, France
| | - Gael Goujon
- Gastroenterology Department, Bichat Hospital, Paris 75018, France
| | - Vincent Hautefeuille
- Department of Hepato-Gastroenterology and Digestive Oncology, Hôpital Sud, Amiens 80000, France
| | - Marie Dior
- Department of Hepato-Gastroenterology and Digestive Oncology, Louis Mourier Hospital, Colombes 92700, France
| | - Thomas Walter
- Department of Digestive Oncology, Edouard Herriot Hospital, Lyon 69000, France
| | - Florence Mary
- Gastroenterology Department, Avicenne Hospital, Bobigny 93000, France
| | - Silvain Manfredi
- Department of Hepato-Gastroenterology and Digestive Oncology, Dijon University hospital, Dijon 21000, France
| | - Francois-Xavier Caroli-Bosc
- Department of Hepato-Gastroenterology and Digestive Oncology, Angers University hospital, Angers 49000, France
| | - Baptiste Cervantes
- Department of Medical Oncology, Institut Mutualiste Montsouris, Paris 75014, France
| | - Romain Coriat
- Department of Hepato-Gastroenterology and Digestive Oncology, Cochin Hospital, Paris 75014, France
| | - Elise Deluche
- Department of Medical Oncology, Limoges University Hospital, Limoges 87000, France
| | - Aziz Zaanan
- Department of Gastroenterology and Digestive Oncology, Assistance Publique-Hôpitaux de Paris, European Georges Pompidou Hospital, Paris, 75015, France
| | - Raphael Olivier
- Hepato-Gastroenterology Department, Poitiers University Hospital, University of Poitiers, 2 rue de la Milétrie, Poitiers 86000, France
| | - Olivier Bouché
- Department of Hepato-Gastroenterology and Digestive Oncology, Robert-Debré University Hospital, Reims 51000, France
| | - Guillaume Piessen
- Department of Digestive and Oncological Surgery, Claude Huriez University Hospital, Lille University, Lille 59000, France
| | - Thierry Lecomte
- Department of Hepato-Gastroenterology and Digestive Oncology, Tours University hospital, Tours 37000, France
| | - Christophe Louvet
- Department of Medical Oncology, Institut Mutualiste Montsouris, Paris 75014, France
| | - Pierre Michel
- Department of Hepatogastroenterology, Normandie Univ, UNIROUEN, Inserm U1245, IRON group, Rouen University Hospital, Rouen 76000, France
| | - Thomas Aparicio
- Gastroenterology and Digestive Oncology Department, Assistance Publique-Hôpitaux de Paris, Saint Louis Hospital, Paris University, Paris 75010, France
| | - Thierry André
- Medical Oncology Department, Assistance Publique-Hôpitaux de Pari, Saint Antoine Hospital, Sorbonne University, Paris 75012, France
| | - Julien Taieb
- Department of Gastroenterology and Digestive Oncology, Assistance Publique-Hôpitaux de Paris, European Georges Pompidou Hospital, Paris, 75015, France
| | - Violaine Randrian
- Hepato-Gastroenterology Department, Poitiers University Hospital, University of Poitiers, 2 rue de la Milétrie, Poitiers 86000, France
| | - David Tougeron
- Hepato-Gastroenterology Department, Poitiers University Hospital, University of Poitiers, 2 rue de la Milétrie, Poitiers 86000, France.
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Lapeyre-Prost A, Perkins G, Vallee M, Pozet A, Tougeron D, Maillet M, Locher C, Dreanic J, Legoux JL, Lièvre A, Lecaille C, Sabate JM, Mary F, Bonnetain F, Jaulmes-Bouillot H, Behal F, Landi B, Taieb J. Chemotherapy use in end-of-life digestive cancer patients: a retrospective AGEO observational study. Clin Res Hepatol Gastroenterol 2021; 45:101709. [PMID: 33930588 DOI: 10.1016/j.clinre.2021.101709] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 04/05/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND The use of chemotherapy (CT) near the end-of-life (EOL) is an important issue in oncology since it could degrade quality of life. CT near EOL is still poorly studied, with no dedicated study in gastrointestinal (GI) cancer patients. AIM To analyze in GI cancer patients the factors associated with the use of CT within 3- and 1-month before patients' death. METHODS AND PARTICIPANTS All consecutive patients who died from a GI cancer in 10 French tertiary care hospitals during 2014 were included in this retrospective study. Clinical, demographical and biological data were collected and compared between patients receiving or not CT within 3- and 1-month before death. Variables associated with overall survival (OS) was also determined using of univariate and multivariate analyses with a Cox model. RESULTS Four hundred and thirty-seven patients with a metastatic GI cancer were included in this study. Among them, 293 pts (67.0%) received CT within 3-months before death, and 121 pts (27.7%) received CT within 1-month before death. Patients receiving CT within 3-months before death were significantly younger (median age: 65.5 vs 72.8 years, p < 0.0001), with a better PS (PS 0 or 1: 53.9 vs 29.3%, p < 0.0001) and a higher albumin level (median: 32.8 vs 31.0 g/L, p = 0.048). Similar results were found for CT within 1 month before death. Palliative care team intervention was less frequent in patients who received CT in their last month of life (39.7% vs 51.3%, p = 0.02). In multivariate analysis, median OS from diagnosis was shorter in the group receiving CT within 1-month before death (HR = 0.59; 95% CI [0.48-0.74]). CONCLUSION In GI-cancer patients, CT is administered within 3- and 1-month before death, in two and one third of patients, respectively. Patients receiving CT within 1-month before death, had more aggressive disease with poor OS. Palliative care team intervention was associated with less administration of CT in the last month of life. These results highlight the need to better anticipate the time to stop CT treatment in the end-of-life and the importance of an active collaboration between oncology and palliative care teams.
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Affiliation(s)
- Alexandra Lapeyre-Prost
- Université de Paris, Department of Gastroenterology and GI Oncology, Georges Pompidou European Hospital, AP-HP, Paris, France
| | - Geraldine Perkins
- Université de Paris, Department of Gastroenterology and GI Oncology, Georges Pompidou European Hospital, AP-HP, Paris, France
| | - Marie Vallee
- Oncology Department, Poitiers University Hospital, Poitiers, France
| | - Astrid Pozet
- Methodology and Quality of Life in Oncology Unit, INSERM U1098, University Hospital of Besançon, Besançon, France
| | - David Tougeron
- Gastroenterology Department, Poitiers University Hospital, Poitiers, France
| | - Marianne Maillet
- Department of Gastroenterology, St-Louis Hospital, AP-HP, Paris, France
| | - Christophe Locher
- Department of Gastroenterology, General Hospital of Meaux, Meaux, France
| | - Johann Dreanic
- Department of Gastroenterology, Cochin Hospital, AP-HP, Paris, France
| | - Jean-Louis Legoux
- Department of Gastroenterology and Digestive Oncology, Centre Hospitalier Regional, Orléans, France
| | - Astrid Lièvre
- Department of Medical Oncology, Institut Curie, Hôpital René Huguenin, Saint-Cloud, France; Department of Gastroenterology, Rennes University Hospital, Rennes 1 University, Rennes, France
| | - Cedric Lecaille
- Department of Gastroenterology, Polyclinique Bordeaux Nord Aquitaine, Bordeaux, France
| | - Jean-Marc Sabate
- Department of Gastroenterology, Louis Mourier Hospital, AP-HP, Colombes, France
| | - Florence Mary
- Gastroenterology and Digestive Oncology, CHU Avicenne, AP-HP, Bobigny, France
| | - Franck Bonnetain
- Methodology and Quality of Life in Oncology Unit, INSERM U1098, University Hospital of Besançon, Besançon, France
| | | | - Florence Behal
- Palliative Care Unit, Georges Pompidou European Hospital, AP-HP, Paris, France
| | - Bruno Landi
- Université de Paris, Department of Gastroenterology and GI Oncology, Georges Pompidou European Hospital, AP-HP, Paris, France
| | - Julien Taieb
- Université de Paris, Department of Gastroenterology and GI Oncology, Georges Pompidou European Hospital, AP-HP, Paris, France.
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4
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Bouchoucha M, Deutsch D, Uong P, Mary F, Sabate JM, Benamouzig R. Characteristics of patients with overlap functional gastrointestinal disorders. J Gastroenterol Hepatol 2021; 36:2171-2179. [PMID: 33555092 DOI: 10.1111/jgh.15438] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/25/2021] [Accepted: 02/05/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIM Functional gastrointestinal disorders (FGIDs) are frequently overlapped. The present study was designed to (i) search the clinical differences between patients with single FGID and overlap FGIDs and (ii) define the most common FGIDs associations to identify homogenous subgroups of patients. METHODS A total of 3555 outpatients with FGID filled out the Rome III adult diagnostic questionnaire, Bristol stool form, and four 10-point Likert scales to report the severity of constipation, diarrhea, bloating, and abdominal pain. An unsupervised algorithm was used to estimate the number of groups directly from the data. A classification tree separated patients into different subgroups, according to FGIDs. Multinomial logistic regression was used to characterize the groups of patients with overlap disorders. RESULTS Patients reported 3.3 ± 1.9 FGIDs (range 1-10, median = 3); 736 reported only one FGID, while 2819 reported more than one FGID (3.8 ± 1.7). Patients with single FGID had higher body mass index (P < 0.001), never report irritable bowel syndrome (IBS), and rarely report fecal incontinence and anorectal pain (< 1% for each disorder). The non-supervised clustering of the 2819 patients with overlap FGIDs divided this population into 23 groups, including five groups associated with only one disorder (IBS-diarrhea, dysphagia, functional constipation, levator ani syndrome, and IBS-unspecified). Ten groups were related to two overlap disorders and eight groups to three or more disorders. Three disorders were not explicitly associated with a given group: IBS-mixed, proctalgia fugax, and nonspecific anorectal pain. CONCLUSION Patients with FGID mostly report overlap disorders in a limited number of associations, each significantly associated with a few disorders.
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Affiliation(s)
- Michel Bouchoucha
- Department of Physiology, Université René Descartes, Paris V, Paris, France.,Department of Gastroenterology, Hôpital Avicenne, Bobigny, France
| | - David Deutsch
- Department of Gastroenterology, Hôpital Avicenne, Bobigny, France
| | - Panha Uong
- Department of Gastroenterology, Hôpital Avicenne, Bobigny, France
| | - Florence Mary
- Department of Gastroenterology, Hôpital Avicenne, Bobigny, France
| | - Jean-Marc Sabate
- Department of Gastroenterology, Hôpital Avicenne, Bobigny, France
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5
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Tran-Minh ML, Lehmann-Che J, Lambert J, Theou-Anton N, Poté N, Dior M, Mary F, Goujon G, Gardair C, Schischmanoff O, Kaci R, Cucherousset N, Bertheau P, Couvelard A, Aparicio T. Prevalence and prognosis of microsatellite instability in oesogastric adenocarcinoma, NORDICAP 16-01. Clin Res Hepatol Gastroenterol 2021; 45:101691. [PMID: 33852952 DOI: 10.1016/j.clinre.2021.101691] [Citation(s) in RCA: 6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 03/03/2021] [Accepted: 03/23/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND The prevalence and prognosis association of microsatellite instability (MSI) in oesogastric junction and gastric adenocarcinoma (OGC) have been reported with conflicting results. METHODS Patients with OGC from 2010 to 2015 were enrolled in this retrospective multicenter study. MSI was determined by genotyping. MLH1 promoter methylation and BRAFV600E mutation were screened in the MSI tumors. RESULTS Among 315 tumors analyzed, 39 (12.4%) were of the MSI phenotype. Compared to MSS tumors, MSI tumors were more frequent in patients >70 years (17% vs 9%, p=0.048) and in gastric antral primary (20% versus 5% in junction tumor and 12% in fundus tumor. Among 29 MSI tumors analyzed, 28 had a loss of MLH1 protein expression and 27 had MLH1 promotor hypermethylation. None had a BRAF V600E mutation. The 4-year cumulative incidence of recurrence for patients with resected tumor was significantly lower in dMMR tumors versus pMMR tumors (17% versus 47%, p=0.01). For the patients with unresectable tumor the median overall survival was 11 months in MSS group and 14 months in MSI group (p=0.24). CONCLUSION MSI prevalence in OGC was 12.4%, associated with antral localization and advanced age. Patients with MSI tumors had a lower cumulative incidence of recurrence after surgery. MSI phenotype was mainly associated with loss of MLH1 protein expression, MLH1 promotor hypermethylation and had no BRAFV600E mutation.
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Affiliation(s)
- My-Linh Tran-Minh
- Service de gastro entérologie, Hôpital Saint Louis, AP-HP, Paris, France.
| | | | - Jerôme Lambert
- Service de biostatistique et information médicale, Hôpital Saint Louis, AP-HP, Paris, France
| | | | - Nicolas Poté
- Service de pathologie, Hôpital Bichat, AP-HP, Paris, France
| | - Marie Dior
- Service de gastro entérologie, Hôpital Louis Mourier, AP-HP, Colombes, France
| | - Florence Mary
- Service de gastro entérologie, Hôpital Avicenne, AP-HP, Bobigny, France
| | - Gael Goujon
- Service de gastro entérologie, Hôpital Bichat, AP-HP, Paris, France
| | | | - Olivier Schischmanoff
- Laboratoire de biochimie et biologie moléculaire, Hôpital Avicenne, AP-HP, Bobigny, France
| | - Rachid Kaci
- Service de pathologie, Hôpital Lariboisière, AP-HP, Paris, France
| | | | | | - Anne Couvelard
- Service de pathologie, Hôpital Bichat, AP-HP, Paris, France
| | - Thomas Aparicio
- Service de gastro entérologie, Hôpital Saint Louis, AP-HP, Paris, France
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6
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Aparicio T, Cozic N, de la Fouchardière C, Meriaux E, Plaza J, Mineur L, Guimbaud R, Samalin E, Mary F, Lecomte T, Gomez-Roca C, Haineaux PA, Gratet A, Selves J, Menu Y, Colignon N, Johnson L, Legrand F, Vassal G. The Activity of Crizotinib in Chemo-Refractory MET-Amplified Esophageal and Gastric Adenocarcinomas: Results from the AcSé-Crizotinib Program. Target Oncol 2021; 16:381-388. [PMID: 33847874 PMCID: PMC8105218 DOI: 10.1007/s11523-021-00811-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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] [Accepted: 03/20/2021] [Indexed: 12/03/2022]
Abstract
Background The AcSé-crizotinib program provides extensive screening of crizotinib-targeted genomic alteration in several malignancies. We here report the results in patients with esogastric MET-amplified adenocarcinomas. Objective The objective of the study was to evaluate the efficacy and tolerability of crizotinib in patients with pretreated esogastric MET-amplified adenocarcinoma who have no alternative treatment options. Patients and Methods MET expression was evaluated by fluorescence in situ hybridization in tumor samples with immunohistochemistry scores ≥ 2+. Patients with chemo-refractory tumors showing ≥ 6 MET copies were eligible for crizotinib 250 mg twice daily. The primary efficacy outcome was the objective response rate after two cycles of crizotinib. Results MET was prospectively analyzed in 570 esogastric adenocarcinomas. Amplifications were found in 35/570 adenocarcinomas (29/523 gastric and 6/47 esophageal). Nine patients were treated with crizotinib. The objective response rate after two cycles was 33.3% (95% CI 7.5–70), the best overall response rate was 55.6% (95% CI 21.2–86.3), with median progression-free survival of 3.2 months (95% CI 1.0–5.4), and overall survival of 8.1 months (95% CI 1.7–24.6). Safety was consistent with that previously reported for crizotinib. Conclusions Large-scale screening for MET-amplified esogastric adenocarcinomas is feasible. MET amplification was observed in 5.5% of gastric and 12.8% of esophageal adenocarcinomas. Crizotinib shows encouraging results in selected patients. Thus, c-MET inhibition for MET-amplified tumors deserves further evaluation. Trial Registration Number NCT02034981. Date of Registration 14 January 2014.
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Affiliation(s)
- Thomas Aparicio
- Gastroenterology and Digestive Oncology Department, Hôpital Saint Louis, APHP, Université de Paris, 1 Avenue Claude Vellefaux, 75010, Paris, France.
| | - Nathalie Cozic
- Department of Biostatistics and Epidemiology, Gustave Roussy, University Paris-Saclay, Villejuif, France.,Oncostat U1018, Inserm, University Paris-Saclay, Labeled Ligue Contre le Cancer, Villejuif, France
| | - Christelle de la Fouchardière
- Medical Oncology Department, Centre Léon Bérard, Lyon, France.,Cancer Research Center of Lyon, UMR INSERM 1052, CNRS 5286, 69373, Lyon, France
| | - Emeline Meriaux
- Institut du Cancer de l'Ouest-Centre René Gauducheau, Saint Herblain, France
| | - Jérome Plaza
- Hopitaux Privés de Metz-Hôpital Belle Isle, Metz, France
| | - Laurent Mineur
- Institut du cancer Sainte-Catherine Avignon Provence, Avignon, France
| | | | - Emmanuelle Samalin
- Medical Oncology Department, Institut du Cancer de Montpellier, Université de Montpellier, Montpellier, France
| | - Florence Mary
- Gastroenterology and Digestive Oncology, Hôpital Avicenne, AP-HP, Bobigny, France
| | - Thierry Lecomte
- Gastroenterology and Digestive Oncology, Tours University Hospital, UMR INSERM 1069, Université de Tours, Tours, France
| | - Carlos Gomez-Roca
- Institut Claudius Regaud, Toulouse, France.,IUCT-Oncopole, Toulouse, France
| | | | | | | | - Yves Menu
- Hôpital Saint Antoine, APHP, Paris, France
| | | | | | - Frédéric Legrand
- Department of Clinical Research, Institut National du Cancer, Boulogne Billancourt, France
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Lapeyre-Prost A, Pernot S, Sigrand J, Le Malicot K, Mary F, Aparicio T, Dahan L, Caroli-Bosc FX, Lecomte T, Doat S, Marthey L, Desrame J, Lepage C, Taieb J. Aflibercept in Combination With FOLFIRI as First-line Chemotherapy in Patients With Metastatic Colorectal Cancer (mCRC): A Phase II Study (FFCD 1302). Clin Colorectal Cancer 2020; 19:285-290. [DOI: 10.1016/j.clcc.2020.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 06/03/2020] [Accepted: 06/08/2020] [Indexed: 01/18/2023]
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Bouchoucha M, Devroede G, Rompteaux P, Mary F, Bejou B, Benamouzig R. Clinical, Physiological, and Psychological Correlates of the Improvement of Defecation during Menses in Women with Functional Gastrointestinal Disorders. Visc Med 2020; 36:487-493. [PMID: 33447605 PMCID: PMC7768094 DOI: 10.1159/000504184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 10/16/2019] [Indexed: 08/30/2023] Open
Abstract
BACKGROUND/AIMS Little is known about the improvement in defecation frequently reported by women around menses. We aimed to describe clinical, physiological, and psychological correlates of this improvement in those with functional bowel disorders. PATIENTS AND METHODS We recruited 478 consecutive premenopausal adult females with no indication of gynecologic or psychiatric disease, who were attending an outpatient functional bowel disorders clinic. Patients completed a Rome III questionnaire, psychological evaluation stool form, and a 10-point Likert scale for constipation, diarrhea, bloating, and abdominal pain. These patients underwent physiological tests, anorectal manometry, and colonic transit time and were classified according to the presence or the absence of improvement in defecation during menses. The reverse selection procedure was used for model selection during multivariate logistic regression where statistically significant variables (p < 0.01) remained in the adjusted model. RESULTS Ninety-seven patients (20%) reported easier defecation during menstruation. These patients were younger (p < 0.001) but had similar body mass indices and psychological profiles as the other patients. Clinically, they only reported more frequent irritable bowel syndrome (IBS) with constipation (p = 0.007), with harder stools (p = 0.005) and delayed left colon transit time (p = 0.002). No anorectal manometric parameter was different between the 2 groups. CONCLUSION Improvement of constipation during menses is mainly associated with younger age and constipation-IBS phenotype and not with functional constipation.
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Affiliation(s)
- Michel Bouchoucha
- Université Paris V René Descartes, Paris, France
- Service de Gastroentérologie, Hôpital Avicenne, Bobigny, France
| | - Ghislain Devroede
- Département de Chirurgie, Faculté de Médecine, Université de Sherbrooke, CHUS-Hôtel-Dieu, Sherbrooke, Québec, Canada
| | | | - Florence Mary
- Service de Gastroentérologie, Hôpital Avicenne, Bobigny, France
| | - Bakhtiar Bejou
- Service de Gastroentérologie, Hôpital Avicenne, Bobigny, France
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Bouchoucha M, Devroede G, Girault-Lidvan N, Hejnar M, Mary F, Benamouzig R. Psychological profiles of irritable bowel syndrome patients with different phenotypes. Intest Res 2020; 18:459-468. [PMID: 33131233 PMCID: PMC7609389 DOI: 10.5217/ir.2019.09171] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 05/30/2020] [Accepted: 06/04/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND/AIMS Abnormal psychological profiles are frequently found in patients with functional gastrointestinal disorders (FGIDs). The present study aimed to evaluate the psychological profiles of FGID patients with irritable bowel syndrome (IBS), and IBS phenotypes. METHODS In 608 FGID patients, including 235 with IBS, have filled a Rome III questionnaire and the French version of the Minnesota Multiphasic Personality Inventory 2. Data analysis was performed using univariate analysis and multivariate logistic regression. RESULTS This study shows that IBS patients have abnormal psychological profiles with more significant symptom exaggeration and decreased test defensiveness than non-IBS patients. They have a significantly higher score for all clinical scales. Logistic regression analysis showed in IBS patients a decrease of body mass index (P= 0.002), and test defensiveness score K (P= 0.001) and an increase of Hypochondriasis (P< 0.001) and Masculinity-Femininity scale (P= 0.018). By comparison with non-IBS patients, IBS-constipation, IBS-diarrhea, and mixed IBS patients have increased Hypochondriasis value and Depression score, mixed IBS patients have higher Psychasthenia score and higher Hypomania score. No item was significantly different in the IBS-unspecified group. CONCLUSIONS This study shows that IBS patients have different psychological profiles than other FGID patients and that psychological characteristics are associated with IBS phenotypes except for patients with unsubtyped IBS.
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Affiliation(s)
- Michel Bouchoucha
- Department of Physiology, University René Descartes, Paris, France
- Department of Gastroenterology, Avicenne Hospital, Bobigny, France
| | - Ghislain Devroede
- Department of Surgical, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, QC, Canada
| | - Noëlle Girault-Lidvan
- Psychological Institute, Laboratory of Psychopathology and Health Processes (EA 4057), University René Descartes, Paris, France
| | - Maria Hejnar
- Psychiatry and Psychopathology Unit, Avicenne Hospital, Bobigny, France
| | - Florence Mary
- Department of Gastroenterology, Avicenne Hospital, Bobigny, France
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10
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Soualy A, Deutsch D, Benallaoua M, Ait-Omar A, Mary F, Helfen S, Boubaya M, Levy V, Benamouzig R. Effect of chemoprevention by low-dose aspirin of new or recurrent colorectal adenomas in patients with Lynch syndrome (AAS-Lynch): study protocol for a multicenter, double-blind, placebo-controlled randomized controlled trial. Trials 2020; 21:764. [PMID: 32887653 PMCID: PMC7487877 DOI: 10.1186/s13063-020-04674-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 08/12/2020] [Indexed: 12/21/2022] Open
Abstract
Abstract Lynch syndrome (LS) is the most common cause of inherited colorectal cancer (CRC) and confers a high lifetime risk of CRC estimated to be up to 60%. Colonoscopy is recommended every 2 years in LS patients above the 20–25-year-old age bracket, and every year when colonic neoplasia has been detected. Efficient chemoprevention has the potential to represent a cost-effective intervention in these high-risk patients and could allow a delay in colonoscopy surveillance. Several epidemiological studies have shown that regular use of low dose aspirin is associated with a 20 to 30% reduction in the risk of sporadic colonic adenomas and colorectal cancer regardless of family risk. However, in recent large randomized trials in specific populations, aspirin use showed no protection for colorectal cancer. A prospective randomized CAPP-2 trial evaluated the effect of aspirin use in LS patients. The primary analysis of this trial showed no significant decrease in CRC in LS patients under daily aspirin. However, a preplanned secondary analysis after an extended follow-up showed a significant reduced risk of CRC in the aspirin group in the per-protocol analysis. The real effect and clinical benefit of aspirin are still to be consolidated in this population. The AAS-Lynch trial—a prospective, multicentric, double-blind, placebo-controlled, randomized clinical trial—was designed to investigate if daily aspirin therapy, at a dose of 100 or 300 mg, would decrease the occurrence or recurrence of colorectal adenomas in patients under 75 years of age, compared with placebo. Trial registration ClinicalTrials.gov NCT02813824. Registered on 27 June 2016. The trial was prospectively registered.
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Affiliation(s)
- Adil Soualy
- Service de Gastroentérologie, Hôpital Avicenne, Université Paris 13, 125 Rue de Stalingrad, 93000, Bobigny, France
| | - David Deutsch
- Service de Gastroentérologie, Hôpital Avicenne, Université Paris 13, 125 Rue de Stalingrad, 93000, Bobigny, France
| | - Mourad Benallaoua
- Service de Gastroentérologie, Hôpital Avicenne, Université Paris 13, 125 Rue de Stalingrad, 93000, Bobigny, France
| | - Amal Ait-Omar
- Service de Gastroentérologie, Hôpital Avicenne, Université Paris 13, 125 Rue de Stalingrad, 93000, Bobigny, France
| | - Florence Mary
- Service de Gastroentérologie, Hôpital Avicenne, Université Paris 13, 125 Rue de Stalingrad, 93000, Bobigny, France
| | - Sabine Helfen
- Unité de Recherche Clinique, Hôpital Avicenne, Bobigny, France
| | | | - Vincent Levy
- Unité de Recherche Clinique, Hôpital Avicenne, Bobigny, France
| | - Robert Benamouzig
- Service de Gastroentérologie, Hôpital Avicenne, Université Paris 13, 125 Rue de Stalingrad, 93000, Bobigny, France.
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11
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Bachet JB, Bouché O, Taieb J, Dubreuil O, Garcia ML, Meurisse A, Normand C, Gornet JM, Artru P, Louafi S, Bonnetain F, Thirot-Bidault A, Baumgaertner I, Coriat R, Tougeron D, Lecomte T, Mary F, Aparicio T, Marthey L, Taly V, Blons H, Vernerey D, Laurent-Puig P. RAS mutation analysis in circulating tumor DNA from patients with metastatic colorectal cancer: the AGEO RASANC prospective multicenter study. Ann Oncol 2019; 29:1211-1219. [PMID: 29438522 DOI: 10.1093/annonc/mdy061] [Citation(s) in RCA: 108] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background RAS mutations are currently sought for in tumor samples, which takes a median of almost 3 weeks in western European countries. This creates problems in clinical situations that require urgent treatment and for inclusion in therapeutic trials that need RAS status for randomization. Analysis of circulating tumor DNA might help to shorten the time required to determine RAS mutational status before anti-epidermal growth factor receptor antibody therapy for metastatic colorectal cancer. Here we compared plasma with tissue RAS analysis in a large prospective multicenter cohort. Patients and methods Plasma samples were collected prospectively from chemotherapy-naive patients and analyzed centrally by next-generation sequencing (NGS) with the colon lung cancer V2 Ampliseq panel and by methylation digital PCR (WIF1 and NPY genes). Tumoral RAS status was determined locally, in parallel, according to routine practice. For a minimal κ coefficient of 0.7, reflecting acceptable concordance (precision ± 0.07), with an estimated 5% of non-exploitable data, 425 subjects were necessary. Results From July 2015 to December 2016, 425 patients were enrolled. For the 412 patients with available paired plasma and tumor samples, the κ coefficient was 0.71 [95% confidence interval (CI), 0.64-0.77] and accuracy was 85.2% (95% CI, 81.4% to 88.5%). In the 329 patients with detectable ctDNA (at least one mutation or one methylated biomarker), the κ coefficient was 0.89 (95% CI, 0.84-0.94) and accuracy was 94.8% (95% CI, 91.9% to 97.0%). The absence of liver metastases was the main clinical factor associated with inconclusive circulating tumor DNA results [odds ratio = 0.11 (95% CI, 0.06-0.21)]. In patients with liver metastases, accuracy was 93.5% with NGS alone and 97% with NGS plus the methylated biomarkers. Conclusion This prospective trial demonstrates excellent concordance between RAS status in plasma and tumor tissue from patients with colorectal cancer and liver metastases, thus validating plasma testing for routine RAS mutation analysis in these patients. Clinical Trial registration Clinicaltrials.gov, NCT02502656.
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Affiliation(s)
- J B Bachet
- Sorbonne Universités, UPMC Université, Paris; Université Sorbonne Paris Cité, INSERM UMR-S1147 MEPPOT, CNRS SNC5014, Centre Universitaire des Saints-Pères, Equipe Labellisée Ligue Nationale Contre le Cancer, Paris; Department of Hepato-Gastroenterology, Groupe Hospitalier Pitié Salpêtrière, Paris; AGEO (Association des Gastroentérologues Oncologues), Paris
| | - O Bouché
- AGEO (Association des Gastroentérologues Oncologues), Paris; Department of Hepato-Gastroenterology, Hôpital Robert Debré, Reims
| | - J Taieb
- AGEO (Association des Gastroentérologues Oncologues), Paris; Department of Digestive Oncology, Hôpital Européen Georges Pompidou, Paris
| | - O Dubreuil
- Department of Hepato-Gastroenterology, Groupe Hospitalier Pitié Salpêtrière, Paris; AGEO (Association des Gastroentérologues Oncologues), Paris
| | - M L Garcia
- AGEO (Association des Gastroentérologues Oncologues), Paris; Department of Oncology, Hôpital Saint-Antoine, Paris
| | - A Meurisse
- Department of Methodology and Quality of Life in Oncology, INSERM UMR 1098, Hôpital Universitaire de Besancon, Besancon
| | - C Normand
- Université Sorbonne Paris Cité, INSERM UMR-S1147 MEPPOT, CNRS SNC5014, Centre Universitaire des Saints-Pères, Equipe Labellisée Ligue Nationale Contre le Cancer, Paris
| | - J M Gornet
- AGEO (Association des Gastroentérologues Oncologues), Paris; Department of Gastroenterology, Hôpital Saint-Louis, Paris
| | - P Artru
- AGEO (Association des Gastroentérologues Oncologues), Paris; Department of Gastroenterology, Hôpital Privé Jean Mermoz, Lyon
| | - S Louafi
- AGEO (Association des Gastroentérologues Oncologues), Paris; Department of Gastroenterology, Centre Hospitalier Sud Francilien, Corbeil-Essonnes; Department of Gastroenterology, Groupe Hospitalier Nord Essonne, Longjumeau
| | - F Bonnetain
- Department of Methodology and Quality of Life in Oncology, INSERM UMR 1098, Hôpital Universitaire de Besancon, Besancon
| | - A Thirot-Bidault
- AGEO (Association des Gastroentérologues Oncologues), Paris; Department of Gastroenterology, Hôpital Kremlin Bicêtre, Le Kremlin-Bicêtre
| | - I Baumgaertner
- AGEO (Association des Gastroentérologues Oncologues), Paris; Department of Oncology, Hôpital Henri Mondor, Créteil
| | - R Coriat
- AGEO (Association des Gastroentérologues Oncologues), Paris; Department of Gastroenterology, Hôpital Cochin, Paris
| | - D Tougeron
- AGEO (Association des Gastroentérologues Oncologues), Paris; Depatment of Gastroenterology, Centre Hospitalo-Universitaire de Poitiers, Poitiers
| | - T Lecomte
- AGEO (Association des Gastroentérologues Oncologues), Paris; Department of Gastroenterology, Centre Hospitalo-Universitaire de Tours, Tours
| | - F Mary
- AGEO (Association des Gastroentérologues Oncologues), Paris; Department of Gastroenterology, Hôpital Avicenne, Bobigny
| | - T Aparicio
- AGEO (Association des Gastroentérologues Oncologues), Paris; Department of Gastroenterology, Hôpital Saint-Louis, Paris; Department of Gastroenterology, Hôpital Avicenne, Bobigny
| | - L Marthey
- AGEO (Association des Gastroentérologues Oncologues), Paris; Depatment of Gastroenterology, Hôpital Antoine Béclère, Clamart
| | - V Taly
- Université Sorbonne Paris Cité, INSERM UMR-S1147 MEPPOT, CNRS SNC5014, Centre Universitaire des Saints-Pères, Equipe Labellisée Ligue Nationale Contre le Cancer, Paris
| | - H Blons
- Université Sorbonne Paris Cité, INSERM UMR-S1147 MEPPOT, CNRS SNC5014, Centre Universitaire des Saints-Pères, Equipe Labellisée Ligue Nationale Contre le Cancer, Paris; Department of Biochemistry, Hôpital Européen Georges Pompidou, Paris, France
| | - D Vernerey
- Department of Methodology and Quality of Life in Oncology, INSERM UMR 1098, Hôpital Universitaire de Besancon, Besancon
| | - P Laurent-Puig
- Université Sorbonne Paris Cité, INSERM UMR-S1147 MEPPOT, CNRS SNC5014, Centre Universitaire des Saints-Pères, Equipe Labellisée Ligue Nationale Contre le Cancer, Paris.
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Sportes A, Catajar N, Charles S, Bejou B, Mary F, Sabaté JM, Le Mab G, Benamouzig R. Invitation letter with a standardized form is a reliable tool to exclude increased risk patients from organized fecal immunological testing-based colorectal cancer screening program. Dig Liver Dis 2018; 50:1339-1342. [PMID: 29571900 DOI: 10.1016/j.dld.2018.02.008] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 02/11/2018] [Accepted: 02/12/2018] [Indexed: 12/11/2022]
Abstract
In Europe, screening guidelines for colorectal cancer (CRC) recommend colonoscopy for high-risk patients and fecal immunological testing (FIT) for the standard-risk group. Currently, there is not any validated screening tool to exclude high-risk patients. The aim of the study is to evaluate the validity of exclusion and evaluate the follow-up of patients identified as increased risk for CRC. In this retrospective study using a prospective database, patients at increased risk were identified using the standardized form and then excluded from the FIT screening invitation. A specific questionnaire was sent to all patients at increased risk in order to confirm the reason for the exclusion and evaluate their follow-up. Among 220 695 eligible individuals, 16 693 (7.5%) were excluded after being characterized at increased risk using the standardized form. The questionnaire was sent to these 16.693 excluded patients and completed by 5076 (30.7%) patients. Validity of exclusion was confirmed in 92% of cases. Endoscopic follow-up was in agreement with guideline in 89% of persons at increased risk (inflammatory bowel disease 93%, personal history of CCR 92%, of colonic polyps 82%, family history of CRC 77%). This study suggests that the standardized form is a reliable tool to correctly exclude from the screening program 92% of patients at increased risk for CRC.
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Affiliation(s)
- Adrien Sportes
- Gastroenterology Unit, Bobigny, France; Departmental Committee of Cancers (93), Bondy, France.
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13
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Lapeyre-Prost A, Pernot S, Sigrand J, Mary F, Le Malicot K, Aparicio T, Dahan L, Caroli-Bosc FX, Lecomte T, Racine Doat S, Marthey L, Desrame J, Lepage C, Taieb J. Aflibercept in combination with irinotecan, fluorouracil and leucovorin (FOLFIRI) as first-line chemotherapy in metastatic colorectal cancer (mCRC) patients: A phase II multicentric study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Aparicio T, Cozic N, De La Fouchardiere C, Meriaux E, Plaza JE, Mineur L, Guimbaud R, Samalin E, Mary F, Lecomte T, Gomez-Roca CA, Haineaux PA, Gratet A, Selves J, Menu Y, Colignon N, Mahier - Ait Oukhatar C, Legrand F, Vassal G. The activity of crizotinib in chemo-refractory MET-amplified esogastric adenocarcinomas: Results from the AcSé-crizotinib program. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.4054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Thomas Aparicio
- Department of Gastroenterology, Saint Louis Hospital, Paris, France
| | - Nathalie Cozic
- Biostatistics Unit, Gustave Roussy Cancer Campus, Villejuif, France
| | | | | | | | | | | | - Emmanuelle Samalin
- Institut du Cancer de Montpellier (ICM), Univ Montpellier, Montpellier, France
| | | | | | | | | | | | | | - Yves Menu
- Hôpitaux Universitaires Est Parisien - APHP - Hôpital Saint Antoine, Paris, France
| | - Nikias Colignon
- Hôpitaux Universitaires Est Parisien - APHP - Hôpital Saint Antoine, Paris, France
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Mary F, Moesseler A, Khodorova N, Foucault-Simonin A, Benamouzig R, Tomé D, Gregory PC, Gaudichon C. Metabolic markers of protein maldigestion after a 15N test meal in minipigs with pancreatic exocrine insufficiency. Am J Physiol Gastrointest Liver Physiol 2018; 314:G223-G230. [PMID: 29074486 DOI: 10.1152/ajpgi.00218.2017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The effect of pancreatic exocrine insufficiency (PEI) on protein malabsorption is little documented, partly due to methodological barriers. We aimed to validate biomarkers of protein malabsorption using a 15N test meal in a minipig model of PEI. Six pancreatic duct-ligated minipigs were used as a model of PEI and four nonoperated animals as a control. All animals were equipped with an ileocecal reentrant cannula. Minipigs were given a test meal containing [15N]casein. The PEI animals repeated the test three times, in the absence of any pancreatic enzymes, or after pancreatic substitution at two levels [ A or B: 7,500 or 75,000 (lipase) and 388 or 3881 (protease) FIP U]. Ileal chyme, urine, and blood were collected postprandially. Nitrogen and 15N were measured in digestive and metabolic pools. We obtained a gradient of ileal protein digestibility from 29 ± 11% in PEI to 89 ± 6% in the controls and a dose- dependent response of enzymes. Insulin and gastric inhibitory polypeptide secretions were decreased by PEI, an effect that was counteracted with the enzymes at level B. The total recovery of 15N in urinary urea and plasma proteins was 14 ± 5.1% in the control group and decreased to 5.5 ± 2.1% by PEI. It was dose dependently restored by the treatment. Both 15N recovery in plasma and urine were correlated to protein digestibility. We confirm that the 15N transfer in those pools is a sensitive marker of protein malabsorption. Nevertheless, an optimization of the test meal conditions would be necessary in the view of implementing a clinical test. NEW & NOTEWORTHY We designed an intervention study to create a gradient of ileal protein digestibility in minipigs with pancreatic exocrine insufficiency and to validate reliable metabolic markers using a 15N oral meal test. 15N recovery in plasma proteins and to a higher extent in urine was sensitive to protein malabsorption. This test is minimally invasive and could be used to reveal protein malabsorption in patients.
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Affiliation(s)
- Florence Mary
- UMR PNCA, AgroParisTech, INRA, Université Paris Saclay , Paris , France
| | - Anne Moesseler
- Institute for Animal Nutrition, University of Veterinary Medicine Hannover, Foundation , Hanover , Germany
| | - Nadezda Khodorova
- UMR PNCA, AgroParisTech, INRA, Université Paris Saclay , Paris , France
| | | | - Robert Benamouzig
- UMR PNCA, AgroParisTech, INRA, Université Paris Saclay , Paris , France
| | - Daniel Tomé
- UMR PNCA, AgroParisTech, INRA, Université Paris Saclay , Paris , France
| | | | - Claire Gaudichon
- UMR PNCA, AgroParisTech, INRA, Université Paris Saclay , Paris , France
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Bouchoucha M, Mary F, Bon C, Bejou B, Airinei G, Benamouzig R. Sleep quality and functional gastrointestinal disorders. A psychological issue. J Dig Dis 2018; 19:84-92. [PMID: 29316246 DOI: 10.1111/1751-2980.12577] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [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: 05/31/2017] [Revised: 09/04/2017] [Accepted: 01/04/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Sleep disorders are often associated with functional gastrointestinal disorders (FGIDs). This study aims to evaluate the association of sleep disorders with specific FGIDs and to assess the related importance of psychological disorders. METHODS We included 1009 consecutive patients with FGIDs (70.9% females). The patients completed a Rome III questionnaire and after a psychological evaluation on anxiety and depression they were classified according to their sleep disorders using a 7-point grading scale: Groups 1-3, drowsiness (severe, moderate, mild); Group 4, no change; Groups 5-7, insomnia (mild, moderate, severe). Multinomial logistic regression using sleep group as a dependent variable with no sleep change as reference and body mass index, FGIDs, anxiety and depression as independent variables were used for statistical analysis. RESULTS Altogether 667 (66.1%) patients reported changes in sleep disorders, of whom 487 (48.3%) had decreased sleep and 180 (17.8%) had increased sleep while 342 (33.9%) reported no change. Depression was lower in patients with no change in sleep pattern and increased with the severity of their sleep disorder (P < 0.001). State-anxiety is associated with moderate drowsiness (P = 0.024), while trait anxiety is associated with mild insomnia (P = 0.048). FGIDs associated with sleep disorders included chest pain, epigastric pain syndrome, irritable bowel syndrome with constipation, diarrhea, bloating, fecal incontinence and proctalgia fugax. CONCLUSION Sleep disorders are associated with FGIDs, especially in the presence of depressive symptoms.
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Affiliation(s)
- Michel Bouchoucha
- Department of Physiology, Paris V René Descartes University, Paris, France.,Department of Gastroenterology, Avicenne Hospital, Bobigny, France
| | - Florence Mary
- Department of Gastroenterology, Avicenne Hospital, Bobigny, France
| | - Cyriaque Bon
- Department of Gastroenterology, Avicenne Hospital, Bobigny, France
| | - Bakhtiar Bejou
- Department of Gastroenterology, Avicenne Hospital, Bobigny, France
| | - Gheorghe Airinei
- Department of Gastroenterology, Avicenne Hospital, Bobigny, France
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Fysekidis M, Bouchoucha M, Mary F, Airinei G, Bon C, Benamouzig R. Change of appetite in patients with functional digestive disorder. Association with psychological disorders: A cross-sectional study. J Gastroenterol Hepatol 2018; 33:195-202. [PMID: 28556178 DOI: 10.1111/jgh.13836] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 03/06/2017] [Revised: 05/19/2017] [Accepted: 05/22/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS Changes in appetite are a frequent complaint in patients with functional gastrointestinal disorders (FGIDs). The aims of this study are to evaluate whether the changes in appetite are associated with specific FGIDs and to explore associations of these changes with symptoms of anxiety or depression. METHODS This study included 1009 consecutive FGID patients (71% female), aged 48.9 years who all filled out a Rome III questionnaire for the evaluation of FGIDs, submitted to a psychological evaluation of symptoms of anxiety, and completed the Beck Depression Inventory questionnaire. The patients were classified according to their appetite change using a 7-point grading scale and split into three groups: those with appetite loss, those with no change in appetite, and those with increased appetite. RESULTS Among the 1009, 496 patients (49%) reported a change in appetite, of which 332 (33%) patients reported a decrease in appetite and 164 (16%) patients reported an increase in appetite. Appetite was not affected in 51% of patients. Changes in appetite depended on gender, body mass index and psychometric evaluation scores. Increased appetite did not have specific FGIDs associations, while decreased appetite was associated with esophageal, gastroduodenal, bowel, and anorectal symptoms. The presence of depressive symptoms was also a predictor for the majority of FGIDs in decreased appetite, while anxiety trait was significant for globus and dysphagia. CONCLUSIONS Decreased appetite was associated with FGIDs, especially in the presence of depressive symptoms. A reduced appetite would help to predict psychological disorders associated with FGIDs. FINANCIAL DISCLOSURE None declared. LEGAL REGISTRATION This study was a registered study in the French National Drug Agency (ANSM, Agence Nationale de Securité du Medicamentet des produits de santé, Study Number 2016-A01120-51). COMPETING INTERESTS Michel Bouchoucha, Marinos Fysekidis, Florence Mary, Gheorghe Airinei, Cyriaque Bon, and Robert Benamouzig have no competitive interests.
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Affiliation(s)
- Marinos Fysekidis
- Service de Nutrition et Diabétologie, Hôpital Avicenne, Paris, France
| | - Michel Bouchoucha
- Université Paris V René Descartes, Paris, France.,Service de Gastroentérologie, Hôpital Avicenne, Paris, France
| | - Florence Mary
- Service de Gastroentérologie, Hôpital Avicenne, Paris, France
| | | | - Cyriaque Bon
- Service de Gastroentérologie, Hôpital Avicenne, Paris, France
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Bouchoucha M, Devroede G, Mary F, Bon C, Bejou B, Benamouzig R. Both men and women with functional gastrointestinal disorders suffer from a high incidence of sexual dysfunction. Clin Res Hepatol Gastroenterol 2017; 41:e93-e96. [PMID: 28601592 DOI: 10.1016/j.clinre.2017.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 04/28/2017] [Accepted: 05/05/2017] [Indexed: 02/04/2023]
Affiliation(s)
- Michel Bouchoucha
- Department of physiology, université Paris V René-Descartes, 15, rue de l'École-de-médecine, 75270 Paris cedex 06, France; Service de gastroentérologie, hôpital Avicenne, 125, rue de Stalingrad, 93009 Bobigny cedex, France.
| | - Ghislain Devroede
- Département de chirurgie, faculté de médecine, CHUS-Hôtel-Dieu, université de Sherbrooke, 580, rue Bowen-Sud, Sherbrooke, J1G2EB Quebec, Canada
| | - Florence Mary
- Service de gastroentérologie, hôpital Avicenne, 125, rue de Stalingrad, 93009 Bobigny cedex, France
| | - Cyriaque Bon
- Service de gastroentérologie, hôpital Avicenne, 125, rue de Stalingrad, 93009 Bobigny cedex, France
| | - Bakthiar Bejou
- Service de gastroentérologie, hôpital Avicenne, 125, rue de Stalingrad, 93009 Bobigny cedex, France
| | - Robert Benamouzig
- Service de gastroentérologie, hôpital Avicenne, 125, rue de Stalingrad, 93009 Bobigny cedex, France
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Lamaty G, Mary F, Roque JP. Acétylation des alcools par l’anhydride acétique en présence de N, N-diméthylamino-4 pyridine (DMAP). Influence des équilibres acido-basiques sur le mécanisme de la réaction. ACTA ACUST UNITED AC 2017. [DOI: 10.1051/jcp/1991881793] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Bachet JB, Bouche O, Taïeb J, Dubreuil O, Garcia ML, Meurisse A, Gornet JM, Artru P, Louafi S, Soularue E, Baumgaertner I, Coriat R, Tougeron D, Lecomte T, Mary F, Marthey L, Blons H, Taly V, Bonnetain F, Laurent-Puig P. RAS mutations concordance in circulating tumor DNA (ctDNA) and tissue in metastatic colorectal cancer (mCRC): RASANC, an AGEO prospective multicenter study. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.11509] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
11509 Background: RAS mutational status is required to prescribe anti-EGFR antibodies in mCRC. In comparison to molecular testing from tumor tissue, the characterization of RAS mutations in ctDNA is a promising and credible way to shorten the workflow. This study reports for the first time the performance of plasma testing in a large prospective series. Methods: Blood samples were prospectively collected before 1st line chemotherapy in mCRC patients. ctDNA was centrally assessed by NGS using the colon lung cancer V2 Ampliseq panel and by methylation digital PCR assay (WIF or NPY). Tumor tissue testing was done according to routine practice in each center. We expect a minimal kappa coefficient of 0.7 to reflect concordance. In order to have a precision of ± 0.07 with an estimated 5% of non-exploitable data 425 pts had to be included. Results were analyzed separately in the whole study population and in the subgroup of pts with ctDNA evidenced either by the presence of at least 1 mutation or by the presence of 1 methylated biomarker. Results: From 07/2015 to 12/2016, 425 patients were included, and 406 plasma samples were available for analysis. A RAS mutation was detected in 183 plasma samples (45.1%) As compared to tumor mutational status the kappa coefficient was 0.68 (95%CI: 0.61-0.75) with a concordance of 83.7%. Primary tumor removal, metachronous status, absence of liver metastases and peritoneal carcinomatosis were significantly associated with mutant RAS tumor and negative plasma status. In the subgroup of 324 samples for which ctDNA was evidenced, kappa coefficient was 0.85 (95%CI: 0.80-0.91) with a concordance of 92.9%. 23 pts had discordant results: RAS mutation in tumor tissue and not in ctDNA (15 pts, 4.6%), RAS mutation detected in ctDNA but not in tumor tissue (8 pts, 2.5%). Rectal tumor, absence of liver metastases, peritoneal carcinomatosis and tumor tissue cellularity < 10% were associated with discordant cases. Conclusions: We confirm, in this large prospective multicenter study, the high concordance rate for RAS status assessment between blood and tumor samples. This result argues for the use of blood testing in daily practice for pts with detectable ctDNA. Clinical trial information: NCT02502656.
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Affiliation(s)
| | | | - Julien Taïeb
- Hopital Européen Georges Pompidou, Paris, France
| | | | | | | | - Jean-Marc Gornet
- Department of Hepato-Gastroenterology, Saint-Louis Hospital, Paris, France
| | | | - Samy Louafi
- Centre Hospitalier de Longjumeau, Longjumeau, France
| | | | | | | | - David Tougeron
- Gastroenterology Department, Poitiers University Hospital, Poitiers, France
| | | | | | | | - Helene Blons
- Hôpital Européen Georges Pompidou, Paris, France
| | | | - Franck Bonnetain
- Methodology and Quality of Life Unit, Department of Oncology, INSERM UMR 1098, University Hospital of Besancon; French National Platform Quality of Life and Cancer, Besançon, France
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Bouchoucha M, Devroede G, Bon C, Bejou B, Mary F, Benamouzig R. Is-it possible to distinguish irritable bowel syndrome with constipation from functional constipation? Tech Coloproctol 2017; 21:125-132. [PMID: 28066860 DOI: 10.1007/s10151-016-1580-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [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: 05/31/2016] [Accepted: 12/07/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND The Rome III criteria classify patients complaining of constipation into two main groups: patients with functional constipation (FC) and patients with constipation predominant irritable bowel syndrome (IBS-C). The purpose of this study was to identify differences in the intensity of symptoms and total and segmental colonic transit time in these two types of patients. METHODS We performed a prospective evaluation of 337 outpatients consecutively referred for chronic constipation and classified according to the Rome III criteria as FC or IBS-C. They were asked to report symptom intensity, on a 10-point Likert scale, for diarrhea, constipation, bloating and abdominal pain. Stool form was reported using the Bristol scale, and colonic transit time was measured by using multiple-ingestion single-marker single-film technique. Statistical analysis was completed by a discriminant analysis. RESULTS Female gender and obstructed defecation was more frequent in IBS-C patients than in FC patients. IBS-C patients reported greater symptom intensity than FC patients, but stool form, and total and segmental colonic transit time were not different between the two groups. Multivariate logistic regression showed that only two parameters, bloating and abdominal pain, were related to the IBS-C or to the FC phenotype, and discriminant analysis showed that these two parameters were sufficient to give a correct classification of 71% of the patients. CONCLUSIONS Our study suggests that self-evaluation of abdominal pain and bloating is more helpful than colonic transit time in classifying patient as IBS-C or FC.
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Affiliation(s)
- M Bouchoucha
- Department of Physiology, Paris Descartes University, Paris, France.
- Gastroenterology Department, Avicenne Hospital Bobigny, 93009, Bobigny Cedex, France.
| | - G Devroede
- Department of Surgery, Sherbrooke University Medical School, Sherbrooke, Canada
| | - C Bon
- Gastroenterology Department, Avicenne Hospital Bobigny, 93009, Bobigny Cedex, France
| | - B Bejou
- Gastroenterology Department, Avicenne Hospital Bobigny, 93009, Bobigny Cedex, France
| | - F Mary
- Gastroenterology Department, Avicenne Hospital Bobigny, 93009, Bobigny Cedex, France
| | - R Benamouzig
- Gastroenterology Department, Avicenne Hospital Bobigny, 93009, Bobigny Cedex, France
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Mary F, Zaanan A, Boige V, Artru P, Samalin E, Coriat R, Bachet JB, Boubaya M, Benallaoua M, Tougeron D, Afchain P, Locher C, Baumgaertner I, Lecaille C, des Guetz G, Aparicio T. Perioperative chemotherapy with FOLFOX in resectable gastroesophageal adenocarcinoma in real life practice: An AGEO multicenter retrospective study. Dig Liver Dis 2016; 48:1498-1502. [PMID: 27623185 DOI: 10.1016/j.dld.2016.07.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 02/25/2016] [Revised: 06/30/2016] [Accepted: 07/21/2016] [Indexed: 12/11/2022]
Abstract
PURPOSE Perioperative chemotherapy with 5-fluorouracil and cisplatin, with or without epirubicin, improves overall survival in resectable gastroesophageal junction and gastric adenocarcinoma. The aim of this retrospective multicenter study was to evaluate the safety and efficacy of perioperative chemotherapy with a FOLFOX-based regimen. PATIENTS AND METHODS We enrolled patients with resectable gastric or gastroesophageal adenocarcinoma, who had at least 3 cycles of a pre-operative FOLFOX-based regimen. The primary end point was the feasibility of the peri-operative chemotherapy. RESULTS We enrolled 109 patients from 2007 to 2012 in 12 centres. Their median age was 66, 67% were men and 73% had gastric tumours. The median number of chemotherapy courses was 6 with a median of 4 pre-operative cycles and 2 post-operative cycles. Twenty-three patients received at least 8 cycles of chemotherapy. In univariate analysis, the Karnofsky index at inclusion was the only factor associated with 8 cycles of chemotherapy. An R0 resection was achieved in 100 patients (95.2%). CONCLUSION The FOLFOX-based perioperative regimen achieves favourable results in real life practice. The optimal number of chemotherapy cycle remains to be determined. FOLFOX regimen may be used as an alternative treatment option to a cisplatin-based regimen in resectable gastroesophageal adenocarcinoma. A prospective randomized trial is needed to confirm these results.
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Affiliation(s)
- Florence Mary
- Gastroenterology and Digestive Oncology Department, Avicenne Hospital, APHP and Université Paris 13, Sorbonne Paris Cité, Bobigny, France.
| | - Aziz Zaanan
- Gastroenterology and Digestive Oncology Department, Hôpital Européen George Pompidou, APHP, Paris, France
| | - Valérie Boige
- Digestive Oncology Department, Gustave Roussy, Villejuif, France
| | - Pascal Artru
- Gastroenterology and Digestive Oncology Department, Jean Mermoz HospitalLyon, France
| | | | - Romain Coriat
- Gastroenterology and Digestive Oncology Department, Cochin Hospital, APHP, Paris, France
| | - Jean-Baptiste Bachet
- Hepato-Gastroenterology and Digestive Oncology Department, Pitié Salpétrière Hospital, APHP, Paris, France
| | - Marouane Boubaya
- Research and Biostatistical Department, Avicenne Hospital, APHP, Bobigny, France
| | - Mourad Benallaoua
- Gastroenterology and Digestive Oncology Department, Avicenne Hospital, APHP and Université Paris 13, Sorbonne Paris Cité, Bobigny, France
| | - David Tougeron
- Hepato-Gastroenterology Department, Poitiers University Hospital, Poitiers, France
| | - Pauline Afchain
- Gastroenterology and Digestive Oncology Department, Saint Antoine Hospital, APHP, Paris, France
| | - Christophe Locher
- Hepato-Gastroenterology and Digestive Oncology Department, Meaux Hospital, Meaux, France
| | - Isabelle Baumgaertner
- Hepato-Gastroenterology and Digestive Oncology Department, Henri Mondor Hospital, APHP, Creteil, France
| | - Cédric Lecaille
- Gastroenterology and Digestive Oncology Department, Polyclinique de Bordeaux Nord, Bordeaux, France
| | | | - Thomas Aparicio
- Gastroenterology and Digestive Oncology Department, Avicenne Hospital, APHP and Université Paris 13, Sorbonne Paris Cité, Bobigny, France
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Lapeyre-Prost A, Perkins G, Vallee M, Pozet A, Tougeron D, Maillet M, Locher C, Dreanic J, Legoux J, Lievre A, Lecaille C, Sabate JM, Mary F, Bonnetain F, Jaulmes-Bouillot H, Landi B, Taieb J. End of life (EOL) chemotherapy (CT) in gastro-intestinal (GI) cancer patients (pts): A retrospective AGEO study. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw384.12] [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: 11/14/2022] Open
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Abstract
Small bowel adenocarcinomas (SBAs) are rare tumors, but their incidence is increasing. The most common primary location is the duodenum. Even though SBAs are more often sporadic, some diseases are risk factors. Early diagnosis of small bowel adenocarcinoma remains difficult, despite significant radiologic and endoscopic progress. After R0 surgical resection, the main prognostic factor is lymph node invasion. An international randomized trial (BALLAD [Benefit of Adjuvant Chemotherapy For Small Bowel Adenocarcinoma] study) will evaluate the benefit of adjuvant chemotherapy. For metastatic disease, retrospectives studies suggest that platinum-based chemotherapy is the most effective treatment. Phase II studies are ongoing to evaluate targeted therapy in metastatic SBA.
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Affiliation(s)
- Thomas Aparicio
- Gastroenterology and Digestive Oncology Unit, Avicenne Hospital, HUPSSD, APHP, Université Paris 13, Sorbonne Paris Cité, 125 rue de Stalingrad, Bobigny 93000, France.
| | - Aziz Zaanan
- Gastroenterology and Digestive Oncology Unit, Georges Pompidou Hospital, APHP, Paris Descartes University, 20 Rue Leblanc, Paris 75015, France
| | - Florence Mary
- Gastroenterology and Digestive Oncology Unit, Avicenne Hospital, HUPSSD, APHP, Université Paris 13, Sorbonne Paris Cité, 125 rue de Stalingrad, Bobigny 93000, France
| | - Pauline Afchain
- Oncology Unit, Saint Antoine Hospital, APHP, 184 Rue du Faubourg Saint-Antoine, Paris 75012, France
| | - Sylvain Manfredi
- Hepato-Gastroenterology Unit, Dijon Hospital, 14 rue Paul Gaffarel, Dijon 21079, France
| | - Thomas Ronald Jeffry Evans
- Translational Cancer Therapeutics department, The Beatson West of Scotland Cancer Centre, University of Glasgow, 1053 Great Western Road, Glasgow G12 0YN, UK
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Bouchoucha M, Devroede G, Bon C, Mary F, Bejou B, Benamouzig R. Difficult defecation in constipated patients and its relationship to colonic disorders. Int J Colorectal Dis 2016; 31:685-91. [PMID: 26861636 DOI: 10.1007/s00384-016-2528-3] [Citation(s) in RCA: 8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/02/2016] [Indexed: 02/04/2023]
Abstract
BACKGROUND The importance in constipated subjects of having difficult defecation is poorly known. According to the Rome III criteria, constipated patients are classified as having either irritable bowel syndrome with constipation or functional constipation, depending on the presence and characteristics of abdominal pain. But, the Rome III criteria also identify another group of patients, labeled as suffering from functional anorectal disorders. Within this group, two complaints are akin to being constipated, but not labeled so: having dyssynergic defecation or inadequate defecation. OBJECTIVE The aim of this study was to search for an association between difficult defecation and colonic transit abnormalities in constipated patients and, thus, shed some light on the definition of constipation according to the Rome III criteria. PATIENTS Four hundred four consecutive patients (81% female), aged 44.9 ± 16.6 years, with a BMI of 25.5 ± 6.4 kg/m(2) (mean ± SD), suffering from chronic constipation were included in the present study. After filling out a standard Rome III questionnaire, patients were classified as suffering from an irritable bowel syndrome with constipation or functional constipation. In addition, they were classified as complaining of difficult defecation or not. Patients completed the Bristol Stool Form Scale as well as visual analogue scales for constipation, bloating, and abdominal pain. The colonic transit time was measured using radiopaque markers and analyzed according to three sites: the right colon, the left colon, and the rectosigmoid area. RESULTS Difficult defecation is more frequent in patients with irritable bowel syndrome with constipation (84%) than in patients with functional constipation (68%). It is associated with an increase in constipation and abdominal pain scores on Likert scales, and a longer oroanal transit time, due to a delay in the left part of the colon. CONCLUSIONS This study demonstrates that difficult defecation is part of a more generalized colorectal dysfunction in both irritable bowel syndrome and in functional constipation patients with an overlap of symptomatology. It also demonstrates the relative inadequacy of the Rome III criteria to describe the relationship between constipation and difficult defecation.
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Affiliation(s)
- Michel Bouchoucha
- Université Paris V René Descartes, 15, rue de l'École de Médecine, 75270, Paris Cedex 06, France. .,Service de Gastroentérologie, Hôpital Avicenne, 125, rue de Stalingrad, 93009, Bobigny Cedex, France.
| | - Ghislain Devroede
- Département de Chirurgie, Faculté de Médecine, Université de Sherbrooke, Sherbrooke, Quebec, Canada.,CHUS-Hôtel-Dieu, 580 rue Bowen Sud, Sherbrooke, Quebec, J1G2EB, Canada
| | - Cyriaque Bon
- Service de Gastroentérologie, Hôpital Avicenne, 125, rue de Stalingrad, 93009, Bobigny Cedex, France
| | - Florence Mary
- Service de Gastroentérologie, Hôpital Avicenne, 125, rue de Stalingrad, 93009, Bobigny Cedex, France
| | - Baktiar Bejou
- Service de Gastroentérologie, Hôpital Avicenne, 125, rue de Stalingrad, 93009, Bobigny Cedex, France
| | - Robert Benamouzig
- Service de Gastroentérologie, Hôpital Avicenne, 125, rue de Stalingrad, 93009, Bobigny Cedex, France
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Landre T, Uzzan B, Nicolas P, Aparicio T, Zelek L, Mary F, Taleb C, Des Guetz G. Doublet chemotherapy vs. single-agent therapy with 5FU in elderly patients with metastatic colorectal cancer. a meta-analysis. Int J Colorectal Dis 2015; 30:1305-10. [PMID: 26099322 DOI: 10.1007/s00384-015-2296-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [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] [Accepted: 06/13/2015] [Indexed: 02/04/2023]
Abstract
BACKGROUND The clinical benefit of first-line doublet chemotherapy (including oxaliplatin or irinotecan) compared to single-drug therapy (5FU) in elderly patients (>70 or >75 years old) with metastatic colorectal cancer (MCRC) is controversial. Therefore, we undertook a meta-analysis of all published phase III studies. MATERIAL AND METHODS We performed a PubMed search using keywords metastatic colorectal cancer, phase III studies, oxaliplatin, irinotecan, survival. We also screened Society of Clinical Oncology (ASCO) and European Society of Medical Oncology (ESMO) proceedings. Few studies have been published corresponding to our inclusion criteria. The efficacy outcomes were overall survival (OS) and progression-free survival (PFS). Toxicity was also examined when available. Hazard ratios (HRs) with their 95 % confidence intervals (CI) were collected from the studies and pooled. By convention, HRs <1 corresponded to a better outcome for doublets. p values <0.05 were considered statistically significant. A fixed-effect model was used. We used Comprehensive Meta-Analysis Software (Biostat, Englewood, NJ, USA). RESULTS This meta-analysis (MA) included five original studies (Mitry and Venderbosch for CAIRO both assessing irinotecan, De Gramont and Seymour for FOCUS2 and Ducreux assessing oxaliplatin) and an already published MA (Folprecht) of four trials comparing FOLFIRI with 5FU (Saltz, Douillard, Köhne and Seymour). Our MA included 1225 patients (70 % men). For age, we chose a cut-off of 70 years for oxaliplatin and a cut-off of 75 years for irinotecan. The performance status (PS) score was 0-1 in about 90 % of patients except for the studies by Mitry and Seymour FOCUS2 which both included 30 % of PS2 patients. Overall, doublet chemotherapy, compared to 5FU alone, did not improve OS (HR = 1.00; CI: 0.89-1.13) but significantly improved PFS (HR = 0.82; CI: 0.72-0.93). When assessed separately, FOLFIRI and FOLFOX both significantly improved PFS (HR = 0.83; 0.68-1.00 and HR = 0.81; 0.68-0.97, respectively). The main grade 3-4 toxicities for FOLFIRI were diarrhoea, nausea, vomiting and neutropenia, which occurred significantly more often than with 5FU alone. CONCLUSION Addition of oxaliplatin or irinotecan to 5FU in metastatic CRC significantly improved PFS in elderly patients more than 70 years old but was associated with an increased risk of toxicity as shown for irinotecan.
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Affiliation(s)
- Thierry Landre
- Unité de Coordination en Onco-Gériatrie UCOG 93, APHP, René Muret Hospital, HUPSSD - Université Paris 13, Sevran, France. .,Department of Geriatric Oncology, APHP, René Muret Hospital, HUPSSD, Sevran, France.
| | - Bernard Uzzan
- Department of Pharmacology, APHP, Avicenne Hospital, HUPSSD, Bobigny, France
| | - Patrick Nicolas
- Department of Pharmacology, APHP, Avicenne Hospital, HUPSSD, Bobigny, France
| | - Thomas Aparicio
- Department of Gastroenterology and Digestive Oncology, APHP, Avicenne Hospital, HUPSSD, Université Paris 13, Sorbonne-Paris Cité, France
| | - Laurent Zelek
- Department of Clinical Oncology, APHP, Avicenne Hospital, HUPSSD, Bobigny, France
| | - Florence Mary
- Department of Gastroenterology and Digestive Oncology, APHP, Avicenne Hospital, HUPSSD, Université Paris 13, Sorbonne-Paris Cité, France
| | - Cherifa Taleb
- Unité de Coordination en Onco-Gériatrie UCOG 93, APHP, René Muret Hospital, HUPSSD - Université Paris 13, Sevran, France.,Department of Geriatric Oncology, APHP, René Muret Hospital, HUPSSD, Sevran, France
| | - Gaetan Des Guetz
- Unité de Coordination en Onco-Gériatrie UCOG 93, APHP, René Muret Hospital, HUPSSD - Université Paris 13, Sevran, France.,Department of Clinical Oncology, APHP, Avicenne Hospital, HUPSSD, Bobigny, France
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Brieau B, Dahan L, De Rycke Y, Boussaha T, Vasseur P, Tougeron D, Lecomte T, Coriat R, Bachet JB, Claudez P, Zaanan A, Soibinet P, Desrame J, Thirot-Bidault A, Trouilloud I, Mary F, Marthey L, Taieb J, Cacheux W, Lièvre A. Second-line chemotherapy for advanced biliary tract cancer after failure of the gemcitabine-platinum combination: A large multicenter study by the Association des Gastro-Entérologues Oncologues. Cancer 2015; 121:3290-7. [PMID: 26052689 DOI: 10.1002/cncr.29471] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [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: 01/21/2015] [Revised: 04/07/2015] [Accepted: 04/30/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Few data are available on second-line chemotherapy (CT2) for advanced biliary tract cancer (ABTC). The aim of this multicenter study was to describe the CT2 regimens used, the response rates, and the outcomes of patients treated with various CT2 regimens. METHODS Patients who received CT2 for ABTC at 17 French institutions after the failure of the gemcitabine-platinum combination were retrospectively studied. Progression-free survival (PFS) and overall survival (OS) were estimated with the Kaplan-Meier method. Cox models were used for multivariate analyses. RESULTS Among 603 patients who received first-line chemotherapy (CT1) for ABTC, 196 received CT2: 5-fluorouracil (5-FU) and irinotecan (n = 64), 5-FU and oxaliplatin (n = 21), 5-FU and cisplatin (n = 38), 5-FU or capecitabine (n = 40), sunitinib (n = 10), or other various regimens (n = 23). Among the 186 assessable patients, there were 22 partial responses and 70 stabilizations. After a median follow-up of 26.4 months, the median PFS and OS were 3.2 and 6.7 months, respectively. There was no significant difference in PFS or OS between CT2 regimens. Fluoropyrimidine-based doublet chemotherapy was not superior to fluoropyrimidine alone in terms of OS and PFS. In a multivariate analysis, a performance status of 0 to 1, disease control with CT1, and a carbohydrate antigen 19-9 (CA 19-9) level ≤ 400 IU/mL were significantly associated with longer PFS and OS. Grade 3 to 4 toxicity occurred in 32% of the patients. CONCLUSIONS CT2 might provide disease control for selected patients with ABTC after the failure of gemcitabine-platinum, but the prognosis remains poor. No particular regimen seems superior to others, and this calls for new treatments. A good performance status, disease control with CT1, and a low level of CA 19-9 were associated with longer survival.
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Affiliation(s)
- Bertrand Brieau
- Gastroenterology and Digestive Oncology Unit, Cochin Teaching Hospital, Paris, France
| | - Laetitia Dahan
- Digestive Oncology Unit, La Timone Hospital, Marseille, France.,Faculty of Medicine-Timone, Aix-Marseille University, Marseille, France
| | - Yann De Rycke
- Public Health Department, Curie Institute, Paris, France
| | - Tarek Boussaha
- Gastroenterology Unit, Saint Antoine Hospital, Paris, France
| | - Philippe Vasseur
- Gastroenterology Unit, Poitiers Teaching Hospital, Poitiers, France.,Laboratory of Inflammation, Epithelial Tissues, and Cytokines (EA 4331), Poitiers University, Poitiers, France
| | - David Tougeron
- Gastroenterology Unit, Poitiers Teaching Hospital, Poitiers, France.,Laboratory of Inflammation, Epithelial Tissues, and Cytokines (EA 4331), Poitiers University, Poitiers, France
| | - Thierry Lecomte
- Gastroenterology Unit, Tours Teaching Hospital, Tours, France.,Faculty of Medicine, Francois Rabelais University, Tours, France
| | - Romain Coriat
- Gastroenterology and Digestive Oncology Unit, Cochin Teaching Hospital, Paris, France.,Cochin-Port Royal Faculty of Medicine, Paris Descartes University, Paris, France
| | - Jean-Baptiste Bachet
- Gastroenterology Unit, La Pitié Salpêtrière Hospital, Paris, France.,Faculty of Medicine, Pierre and Marie Curie University, Paris, France
| | - Pierre Claudez
- Gastroenterology and Hepatology Unit, Saint Etienne Teaching Hospital, North Hospital, Saint-Priest-en-Jarez, France
| | - Aziz Zaanan
- Gastroenterology and Digestive Unit, Georges Pompidou European Hospital, Paris, France.,Paris Descartes University-Sorbonne Paris Cité, Paris, France
| | | | - Jérome Desrame
- Gastroenterology Unit, Jean Mermoz Hospital, Lyon, France
| | | | | | - Florence Mary
- Gastroenterology Unit, Avicenne Hospital, Bobigny, France
| | - Lysiane Marthey
- Gastroenterology Unit, Antoine Béclère Hospital, Clamart, France
| | - Julien Taieb
- Gastroenterology and Digestive Unit, Georges Pompidou European Hospital, Paris, France.,Paris Descartes University-Sorbonne Paris Cité, Paris, France
| | - Wulfran Cacheux
- Department of Medical Oncology, Curie Institute Hospital, Paris, France
| | - Astrid Lièvre
- Department of Medical Oncology, René Huguenin Hospital, Curie Institute, Saint-Cloud, France.,Faculty of Health Sciences, Versailles Saint-Quentin-en-Yvelines University, Montigny-Le-Bretonneux, France
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Velut G, Mary F, Aflalo V, Aparicio T. Magnetic resonance imaging diffusion-weighted imaging for diagnosis of a gastric hepatoid adenocarcinoma. Dig Liver Dis 2015; 47:174. [PMID: 25249152 DOI: 10.1016/j.dld.2014.08.044] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 08/20/2014] [Accepted: 08/23/2014] [Indexed: 12/11/2022]
Affiliation(s)
- Guillaume Velut
- Gastroenterology, Avicenne Hospital, HUPSSD, APHP, University Paris 13, Sorbonne Paris Cité, Bobigny, France
| | - Florence Mary
- Gastroenterology, Avicenne Hospital, HUPSSD, APHP, University Paris 13, Sorbonne Paris Cité, Bobigny, France
| | - Vanessa Aflalo
- Radiology, Avicenne Hospital, HUPSSD, APHP, Bobigny, France
| | - Thomas Aparicio
- Gastroenterology, Avicenne Hospital, HUPSSD, APHP, University Paris 13, Sorbonne Paris Cité, Bobigny, France.
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29
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Velut G, Mary F, Wind P, Aparicio T. Adjuvant chemotherapy by FOLFOX for gastric hepatoid adenocarcinoma. Dig Liver Dis 2014; 46:1135-6. [PMID: 25179158 DOI: 10.1016/j.dld.2014.08.036] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [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: 06/19/2014] [Revised: 08/13/2014] [Accepted: 08/17/2014] [Indexed: 12/11/2022]
Affiliation(s)
- Guillaume Velut
- Gastroenterology, Avicenne Hospital, HUPSSD, APHP, University Paris 13, Sorbonne Paris Cité, Bobigny, France
| | - Florence Mary
- Gastroenterology, Avicenne Hospital, HUPSSD, APHP, University Paris 13, Sorbonne Paris Cité, Bobigny, France
| | - Philippe Wind
- Surgery, Avicenne hospital, APHP, Université Paris 13, Sorbonne Paris Cité, Bobigny, France
| | - Thomas Aparicio
- Gastroenterology, Avicenne Hospital, HUPSSD, APHP, University Paris 13, Sorbonne Paris Cité, Bobigny, France.
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30
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Aparicio T, Schischmanoff O, Poupardin C, Mary F, Soufir N, Barrat C, Bellaiche G, Boubaya M, Choudat L, Cucherousset J, DesGuetz G, Wind P, Benamouzig R. High prevalence of deficient mismatch repair phenotype and the V600E BRAF mutation in elderly patients with colorectal cancer. J Geriatr Oncol 2014; 5:384-8. [DOI: 10.1016/j.jgo.2014.08.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Revised: 07/23/2014] [Accepted: 08/14/2014] [Indexed: 01/23/2023]
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31
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Brieau B, Dahan L, De Rycke Y, Boussaha T, Vasseur P, Tougeron D, Lecomte T, Coriat R, Bachet JB, Claudez P, Zaanan A, Soibinet P, Desramé J, Thirot-Bidault A, Trouilloud I, Mary F, Locher C, Marthey L, Cacheux W, Lievre A. Second-line chemotherapy for advanced biliary tract cancer after failure of gemcitabine plus platinum: Results of an AGEO multicenter retrospective study. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.4093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Laetitia Dahan
- La Timone, Marseille University Hospital, Marseille, France
| | - Yann De Rycke
- Department of Biostatistics, Institut Curie, Paris, France
| | - Tarek Boussaha
- Hôpital Saint-Antoine - Assistance Publique Hôpitaux de Paris, Paris, France
| | | | - David Tougeron
- Department of Gastroenterology, Poitiers University Hospital, Poitiers, France
| | | | - Romain Coriat
- Cochin Teaching Hospital, AP-HP, Paris Descartes University, Paris, France
| | | | | | - Aziz Zaanan
- Department of Gastroenterology, HEGP, Paris, France
| | | | | | - Anne Thirot-Bidault
- Department of Hepato-Gastroenterology, Bicêtre Hospital, Kremlin-Bicêtre, France
| | | | | | - Christophe Locher
- Department of Hepato-Gastroenterology, Meaux Hospital, Meaux, France
| | | | | | - Astrid Lievre
- Department of Medical Oncology, Institut Curie, Saint-Cloud, France
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32
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Mary F, Zaanan A, Malka D, Artru P, Boubaya M, Samalin E, Coriat R, Bachet JB, Benallaoua M, Afchain P, Locher C, Baumgaertner I, Lecaille C, Aparicio T. Perioperative chemotherapy with FOLFOX in resectable gastroesophageal adenocarcinoma: Preliminary results of an AGEO multicentric retrospective study. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.e15018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Aziz Zaanan
- Department of Gastroenterology, HEGP, Paris, France
| | | | | | | | | | - Romain Coriat
- Cochin Teaching Hospital, AP-HP, Paris Descartes University, Paris, France
| | | | | | | | - Christophe Locher
- Department of Hepato-Gastroenterology, Meaux Hospital, Meaux, France
| | | | | | - Thomas Aparicio
- Hôpital Avicenne, Assistance Publique Hôpitaux de Paris, Bobigny, France
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33
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Mary F, Moesseler A, Gregory PC, Khodorova N, Foucault-Simonin A, Benamouzig R, Tomé D, Gaudichon C. O29 Marqueurs métaboliques de la malabsorption protéique dans un modèle de miniporc insuffisant pancréatique. NUTR CLIN METAB 2013. [DOI: 10.1016/s0985-0562(13)70301-7] [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: 11/30/2022]
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34
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Abstract
When cross-linked, beta1 integrins co-activate T cells together with a TCR-CD3 signal. Soluble anti-beta1 monoclonal antibodies, however, inhibit T cell activation. We report inhibition of early tyrosine kinases, including ZAP-70, p59(fyn), CD4-associated p56(lck) and TCR components under this condition. The tyrosine phosphatase SHP-1 is activated by engagement of beta1 integrins and is implicated in this negative regulation since no inhibition occurs in SHP-1 dominant-negative T cells. As shown by the use of Lck-deficient cells, the activation of the protein tyrosine phosphatase depends on a pool of p56(lck) that is not associated with CD4. These cross-talk events were also observed with the alpha4beta1 integrin ligand, VCAM-1. We propose that these results may be important in terms of lymphocyte circulation; while T cells migrate through the vascular endothelium, they are primed for an amplified response; as inflammation develops, a local accumulation of soluble integrin ligands may help to turn it off.
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Affiliation(s)
- F Mary
- INSERM U343 Hôpital de l'Archet, Nice, France
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35
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Vivinus-Nebot M, Ticchioni M, Mary F, Hofman P, Quaranta V, Rousselle P, Bernard A. Laminin 5 in the human thymus: control of T cell proliferation via alpha6beta4 integrins. J Cell Biol 1999; 144:563-74. [PMID: 9971749 PMCID: PMC2132916 DOI: 10.1083/jcb.144.3.563] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [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] [Subscribe] [Scholar Register] [Received: 07/27/1998] [Revised: 11/27/1998] [Indexed: 12/14/2022] Open
Abstract
Laminin 5 (alpha3beta3gamma2) distribution in the human thymus was investigated by immunofluorescence on frozen sections with anti-alpha3, -beta3, and -gamma2 mAbs. In addition to a linear staining of subcapsular basal laminae, the three mAbs give a disperse staining in the parenchyma restricted to the medullary area on a subset of stellate epithelial cells and vessel structures. We also found that laminin 5 may influence mature human thymocyte expansion; while bulk laminin and laminin 2, when cross-linked, are comitogenic with a TCR signal, cross-linked laminin 5 has no effect. By contrast, soluble laminin 5 inhibits thymocyte proliferation induced by a TCR signal. This is accompanied by a particular pattern of inhibition of early tyrosine kinases, including Zap 70 and p59(fyn) inhibition, but not overall inhibition of p56(lck). Using a mAb specific for alpha6beta4 integrins, we observed that while alpha3beta1 are known to be uniformly present on all thymocytes, alpha6beta4 expression parallels thymocyte maturation; thus a correspondence exists between laminin 5 in the thymic medulla and alpha6beta4 on mature thymocytes. Moreover, the soluble Ab against alpha6beta4 inhibits thymocyte proliferation and reproduces the same pattern of tyrosine kinase phosphorylation suggesting that alpha6beta4 is involved in laminin 5-induced modulation of T cell activation.
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Affiliation(s)
- M Vivinus-Nebot
- Institut National de la Sant¿e et de la Recherche M¿edicale, U343, Nice 06202, France
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36
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Dubau B, Hernandez V, Mary F, Malbert S, Botton A, Winnock S, Maurette P. Major abdominal surgery and complications: is air gastric tonometry predictive of outcome? Crit Care 1999; 3. [PMCID: PMC3301877 DOI: 10.1186/cc549] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- B Dubau
- Département d'Anesthésie Réanimation III, Hôspital Saint André, 1 rue Jean Burger 33075 Bordeaux Cedex, France
| | - V Hernandez
- Département d'Anesthésie Réanimation III, Hôspital Saint André, 1 rue Jean Burger 33075 Bordeaux Cedex, France
| | - F Mary
- Département d'Anesthésie Réanimation III, Hôspital Saint André, 1 rue Jean Burger 33075 Bordeaux Cedex, France
| | - S Malbert
- Département d'Anesthésie Réanimation III, Hôspital Saint André, 1 rue Jean Burger 33075 Bordeaux Cedex, France
| | - A Botton
- Département d'Anesthésie Réanimation III, Hôspital Saint André, 1 rue Jean Burger 33075 Bordeaux Cedex, France
| | - S Winnock
- Département d'Anesthésie Réanimation III, Hôspital Saint André, 1 rue Jean Burger 33075 Bordeaux Cedex, France
| | - P Maurette
- Département d'Anesthésie Réanimation III, Hôspital Saint André, 1 rue Jean Burger 33075 Bordeaux Cedex, France
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37
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Tosello AC, Mary F, Amiot M, Bernard A, Mary D. Activation of T cells via CD55: recruitment of early components of the CD3-TCR pathway is required for IL-2 secretion. J Inflamm (Lond) 1997; 48:13-27. [PMID: 9368189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
It was previously reported that the glycosylphosphatidylinositol (GPI)-anchored CD55 molecule provides a co-stimulatory signal for T lymphocytes and is constitutively associated with the Src-related kinase p56lck. The present studies were undertaken to clarify the mechanism of action of CD55 in T cells. We describe the failure of cross-linking of CD55 alone to induce both the elevation of the intracellular calcium concentration and the tyrosine phosphorylation of PLC-gamma in CD3+ Jurkat cells. By contrast, it is sufficient to induce the phosphorylation of tyrosine residues on p56lck, the TCR-zeta chain as well as ZAP-70. Surprisingly, the observed TCR-zeta and ZAP-70 tyrosine phosphorylations appear delayed compared to stimulation via CD3. Calcium ionophore A23187 in combination with cross-linked CD55 mAb initially caused an acceleration in the kinetic of these two phosphorylation events, followed by IL-2 secretion. Furthermore, transfection of the cytoplasmic domain of TCR-zeta in CD3- Jurkat cells, using a CD16-zeta chimera, demonstrates that CD55-mediated T-cell activation depends on the expression of this chain of the CD3-TCR complex.
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Affiliation(s)
- A C Tosello
- Institut National de la Santé et de la Recherche Médicale INSERM U343, Hôpital de l'Archet, Nice, France
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38
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Ticchioni M, Deckert M, Mary F, Bernard G, Brown EJ, Bernard A. Integrin-associated protein (CD47) is a comitogenic molecule on CD3-activated human T cells. The Journal of Immunology 1997. [DOI: 10.4049/jimmunol.158.2.677] [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] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Abstract
IAP is a glycoprotein functionally and physically associated with some integrins, i.e., the leukocyte response integrin and the beta3 integrin chain on placenta, platelets, and polymorphonuclear cells. IAP may act as a transducer element in activation mediated via these integrins. Since IAP is present at high density on peripheral T lymphocytes we have investigated its involvement in T cell activation. We tested three mAbs against IAP, namely B6H12, BRIC126, and 2D3, which recognize two distinct epitopes. IAP cross-linking with B6H12 or BRIC126, but not 2D3, transduces costimulatory signals within highly purified CD3-activated T lymphocytes, i.e., enhancement of proliferation, CD25 expression, and IL-2 secretion, while no effect was observed upon CD2 stimulation. However, we could not observe any functional association between IAP and integrins on peripheral T cells. In an attempt to explore further the activation signal delivered by IAP, we show here that IAP cross-linking with the comitogenic B6H12 mAb induces the phosphorylation on tyrosine of several proteins, one of which is identified as p56(lck) protein tyrosine kinase. Moreover, we observed that IAP is associated with p56(lck) on PMA-activated, but not on resting, T cells. These data suggest that on T cells, IAP may be involved directly via a specific ligand in cell-matrix or cell-cell interactions. Such interactions could trigger protein tyrosine phosphorylation pathways, which play an important role in both maturation and activation of T cells.
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Affiliation(s)
- M Ticchioni
- INSERM Unit 343, Immunology Laboratory, Archet Hospital, Nice, France
| | - M Deckert
- INSERM Unit 343, Immunology Laboratory, Archet Hospital, Nice, France
| | - F Mary
- INSERM Unit 343, Immunology Laboratory, Archet Hospital, Nice, France
| | - G Bernard
- INSERM Unit 343, Immunology Laboratory, Archet Hospital, Nice, France
| | - E J Brown
- INSERM Unit 343, Immunology Laboratory, Archet Hospital, Nice, France
| | - A Bernard
- INSERM Unit 343, Immunology Laboratory, Archet Hospital, Nice, France
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39
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Ticchioni M, Deckert M, Mary F, Bernard G, Brown EJ, Bernard A. Integrin-associated protein (CD47) is a comitogenic molecule on CD3-activated human T cells. J Immunol 1997; 158:677-84. [PMID: 8992983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
IAP is a glycoprotein functionally and physically associated with some integrins, i.e., the leukocyte response integrin and the beta3 integrin chain on placenta, platelets, and polymorphonuclear cells. IAP may act as a transducer element in activation mediated via these integrins. Since IAP is present at high density on peripheral T lymphocytes we have investigated its involvement in T cell activation. We tested three mAbs against IAP, namely B6H12, BRIC126, and 2D3, which recognize two distinct epitopes. IAP cross-linking with B6H12 or BRIC126, but not 2D3, transduces costimulatory signals within highly purified CD3-activated T lymphocytes, i.e., enhancement of proliferation, CD25 expression, and IL-2 secretion, while no effect was observed upon CD2 stimulation. However, we could not observe any functional association between IAP and integrins on peripheral T cells. In an attempt to explore further the activation signal delivered by IAP, we show here that IAP cross-linking with the comitogenic B6H12 mAb induces the phosphorylation on tyrosine of several proteins, one of which is identified as p56(lck) protein tyrosine kinase. Moreover, we observed that IAP is associated with p56(lck) on PMA-activated, but not on resting, T cells. These data suggest that on T cells, IAP may be involved directly via a specific ligand in cell-matrix or cell-cell interactions. Such interactions could trigger protein tyrosine phosphorylation pathways, which play an important role in both maturation and activation of T cells.
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Affiliation(s)
- M Ticchioni
- INSERM Unit 343, Immunology Laboratory, Archet Hospital, Nice, France
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40
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Marhaba R, Mary F, Pelassy C, Stanescu AT, Aussel C, Breittmayer JP. Tyrphostin A9 inhibits calcium release-dependent phosphorylations and calcium entry via calcium release-activated channel in Jurkat T cells. J Immunol 1996; 157:1468-73. [PMID: 8759727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The mechanism by which calcium-depleted intracellular stores may trigger an external calcium influx through a calcium release-activated channel was investigated by analyzing the effects of several protein tyrosine kinase inhibitors on calcium movements in Jurkat T cells. Tyrphostin A9, an inhibitor of the kinase activity of the platelet-derived growth factor (PDGF) receptor, dramatically impaired the sustained elevation of cytosolic calcium concentration, induced by either CD3 mAbs, thapsigargin, ionomycin at low (10(-7) M) concentration, or passive depletion of intracellular stores; other tested tyrphostins, lavendustin, genistein, and compound 5 lacked significant effect. Tyrphostin A9, added during the plateau phase, was able to return cytosolic calcium to resting concentration. Likewise, it abrogated manganese entry in cells stimulated by CD3 or thapsigargin, measured by the quenching of the fluorescence of Indo-1. However, it did not measurably modify kinetics of intracellular calcium releases monitored in the absence of extracellular calcium, nor did it reverse the inhibition of phosphatidylserine that occurs as a consequence of emptying intracellular stores. Analyses of tyrosine phosphorylations demonstrated that A9 inhibited the phosphorylation of proteins, which occurred every time that internal calcium stores were depleted. These phosphorylations were not impaired by chelation of external Ca2+, nor by La3+ that inhibits calcium release-induced calcium entry. We concluded that their inhibition was not a consequence, but may be a cause, of the blockade of calcium release-activated channel by tyrphostin A9.
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Affiliation(s)
- R Marhaba
- INSERM Unit 343, l'Archet Hospital, Nice, France
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41
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Marhaba R, Mary F, Pelassy C, Stanescu AT, Aussel C, Breittmayer JP. Tyrphostin A9 inhibits calcium release-dependent phosphorylations and calcium entry via calcium release-activated channel in Jurkat T cells. The Journal of Immunology 1996. [DOI: 10.4049/jimmunol.157.4.1468] [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] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Abstract
The mechanism by which calcium-depleted intracellular stores may trigger an external calcium influx through a calcium release-activated channel was investigated by analyzing the effects of several protein tyrosine kinase inhibitors on calcium movements in Jurkat T cells. Tyrphostin A9, an inhibitor of the kinase activity of the platelet-derived growth factor (PDGF) receptor, dramatically impaired the sustained elevation of cytosolic calcium concentration, induced by either CD3 mAbs, thapsigargin, ionomycin at low (10(-7) M) concentration, or passive depletion of intracellular stores; other tested tyrphostins, lavendustin, genistein, and compound 5 lacked significant effect. Tyrphostin A9, added during the plateau phase, was able to return cytosolic calcium to resting concentration. Likewise, it abrogated manganese entry in cells stimulated by CD3 or thapsigargin, measured by the quenching of the fluorescence of Indo-1. However, it did not measurably modify kinetics of intracellular calcium releases monitored in the absence of extracellular calcium, nor did it reverse the inhibition of phosphatidylserine that occurs as a consequence of emptying intracellular stores. Analyses of tyrosine phosphorylations demonstrated that A9 inhibited the phosphorylation of proteins, which occurred every time that internal calcium stores were depleted. These phosphorylations were not impaired by chelation of external Ca2+, nor by La3+ that inhibits calcium release-induced calcium entry. We concluded that their inhibition was not a consequence, but may be a cause, of the blockade of calcium release-activated channel by tyrphostin A9.
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Affiliation(s)
- R Marhaba
- INSERM Unit 343, l'Archet Hospital, Nice, France
| | - F Mary
- INSERM Unit 343, l'Archet Hospital, Nice, France
| | - C Pelassy
- INSERM Unit 343, l'Archet Hospital, Nice, France
| | - A T Stanescu
- INSERM Unit 343, l'Archet Hospital, Nice, France
| | - C Aussel
- INSERM Unit 343, l'Archet Hospital, Nice, France
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44
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Périé C, Robic T, Duquesne I, Bringtown A, Destabeau C, Mary F, Saqué A. [Rehabilitation of coronary patients undergoing anticoagulant treatment]. Rev Infirm 1991; 41:35-7. [PMID: 1767220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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45
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Janvier G, Dugrais G, Winnock S, Vallet A, Dardel E, Mary F, Erny P, Vezon G. [Use of homologous erythrocyte concentrates. Analysis of economical factors]. Ann Fr Anesth Reanim 1991; 10:333-6. [PMID: 1928854 DOI: 10.1016/s0750-7658(05)80808-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The factors involved in reducing consumption of bank packed red cells (PRC) were studied over three one year periods (1983, 1987 and 1989) in a Department of Vascular and General Surgery. The effects of autologous blood salvage (started in 1987), associated with the management of homologous blood by a branch of the blood bank inside the operating theater suite were assessed. In 1989, intentional normovolaemic haemodilution became virtually systematic, on top of the intraoperative blood salvage, for all patients due to undergo surgery with a risk of severe blood loss. The number of surgical procedures carried out during those three years did not vary. However, in the same time, the annual consumption of homologous PRC decreased by an overall 56% (36.7% between 1983 and 1987, and 29.8% between 1987 and 1989). This decrease was mostly due to a fall in prescription in the operating theaters, and not in the wards. In the same time, albumin consumption increased sixfold. Such transfusional policies can only be carried out if there is good cooperation between the blood bank and the prescribers of blood products.
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Affiliation(s)
- G Janvier
- Département d'Anesthésie-Réanimation I, Hôpital Pellegrin-Tripode, Bordeaux
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46
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Blot A, Fraty M, Joly M, Loubere C, Mary F, Marolla M, Pengam M. [Listening to patients with AIDS]. Soins Chir 1989:38-41. [PMID: 2704917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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47
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Janvier G, Winnock S, Vallet A, Dugrais G, Stoiber H, Mary F, Dardel E. [Hemodynamic and gasometric modifications during the anesthesia recovery period in patients undergoing ventilation after surgery of the abdominal aorta]. Cah Anesthesiol 1989; 37:3-9. [PMID: 2924187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
This study was carried out on 12 patients (mean age 61) in order to assess the oxygen consumption (VO2) in the post-operative stage of an elective surgical procedure (replacement of the abdominal aorta). Anesthesia was a combination of thiopentone, pancuronium bromide and high doses of droperidol and fentanyl. Patients were kept intubated and ventilated in the post-operative period. VO2 and other related metabolic parameters as well as hemodynamic parameters were measured every 45 minutes over a period of 5 hours. A VO2 increase (127%) related to the increase in body temperature was noted. Mean VO2 for all patients during the whole period was 170 +/- 13 ml.min-1.m-2 (range: 51-411 ml.min-1.m-2). Mean value of maximal VO2 was 240 +/- 21 ml.min-1.m-2 (range: 1471-411 ml.min-1.m-2). Large dose of droperidol are shown to limit VO2 increase. In patients with shivering, the maximal value of VO2 was found during shivering. The amount of droperidol administered during anesthesia was greater in patients without shivering. VO2 increase was due to a rise in tissular O2 extraction. Cardiac index was insufficiently increased (+ 9.4%) and a certain extent of myocardial inadaptability was suspected in relation with: high blood pressure, hypovolaemia and/or myocardial effect of anesthesia agents.
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Affiliation(s)
- G Janvier
- Département d'Anesthésie-Réanimation, Hôpital Pellegrin, Bordeaux
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48
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Winnock S, Janvier G, Césarini M, Dugrais G, Vallet A, Dardel E, Mary F. [Hemodynamic changes caused by laparotomy during aorto-iliac surgery]. Ann Fr Anesth Reanim 1987; 6:471-5. [PMID: 3327391 DOI: 10.1016/s0750-7658(87)80090-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
A haemodynamic study was carried out on 53 patients undergoing elective surgery of the abdominal aorta in order to assess the haemodynamic changes consequent to abdominal manipulations prior to aortic clamping. Surgery was carried out under general anaesthesia and ventilation was controlled. The following parameters were monitored: mean arterial pressure (Pa), cardiac index (CI), systolic index (SI), systemic vascular resistances (Rsa), pulmonary vascular resistances (Rpa), heart rate (fC). Cutaneous circulation was monitored using a photoplethysmographic transducer. The following haemodynamic pattern was seen as the peritoneal cavity was opened and traction on the mesentery was applied: CI +40.7%; fC +28.61%; SI +9.85%; Rsa -39.16%; Rpa -28.43%; Pa -15.7%. The recording of the facial cutaneous photoplethysmographic wave showed an increase of 50%. In some extreme cases, a state of cardiovascular collapse with marked cutaneous erythema strongly resembling anaphylactic shock ensued. The physiopathology of these cardiovascular reactions is unclear, but the haemodynamic pattern as well as the cutaneous vasodilation suggest a stimulation of both vagal and sympathetic nervous systems and the release of vasoactive substances into the general circulation.
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Affiliation(s)
- S Winnock
- Département d'Anesthésie-Réanimation I, Hôpital Pellegrin-Tripode, Bordeaux
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Polonovski C, Zittoun R, Mary F. [Global hypocorticism. Hypoaldosteronism and pseudo-hypoaldosteronism in infants. 3 cases]. Arch Fr Pediatr 1965; 22:1061-86. [PMID: 5856506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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