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Thierry A, Barbe C, Labrousse M, Makeieff M, Merol JC, Carsin-Vu A, Truong F, Dubernard X, Brenet E. Intra-parotid facial nerve path by MRI tractography: radio-clinical comparison in parotid tumors. Eur Arch Otorhinolaryngol 2024; 281:925-934. [PMID: 37917163 DOI: 10.1007/s00405-023-08301-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 10/17/2023] [Indexed: 11/04/2023]
Abstract
PURPOSE The objective of our study was to evaluate the ability of preoperative MRI tractography to visualize and predict the path of the facial nerve with respect to an intra-parotid mass. METHODS We performed an observational bicentric study from June 2019 to August 2020. All patients older than 18 years old, treated for a parotid mass with surgical indication, without MRI contraindication and who agreed to participate in the study were enrolled prospectively. All patients underwent a cervico-facial MRI with tractographic analysis. Postprocessed tractography images of the intra-parotid facial nerve were analyzed by two expert radiologists in head and neck imaging. The intraoperative anatomical description of the facial nerve path and its relationship to the mass was performed by the surgeon during the operation, with no visibility on MRI examination results. A statistical study allowed for the description of the data collected as well as the measurement of inter-observer agreement and agreement between tractography and surgery using kappa coefficients. RESULTS Fifty-two patients were included. The facial nerve trunk and its first two divisional branches were visualized via tractography in 93.5% of cases (n = 43). The upper distal branches were visualized in 51.1% of cases (n = 23), and the lower branches were visualized in 73.3% of cases (n = 33). Agreement with the location described per-operatively was on average 82.9% for the trunk, 74.15% for the temporal branch, and 75.21% for the cervico-facial branch. CONCLUSION Fiber tractography analysis by MRI of the intra-parotid facial nerve appears to be a good test for predicting the path of the nerve over the parotid mass and could be an additional tool to guide the surgeon in the operative procedure.
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Affiliation(s)
- Axelle Thierry
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital of Reims, Reims, France
- University of Reims-Champagne Ardennes, Reims, France
- Department of Radiology, University Hospital of Reims, Reims, France
| | - Coralie Barbe
- University Department of Health Research, University of Reims Champagne Ardennes, Reims, France
- Department of Radiology, University Hospital of Reims, Reims, France
| | - Marc Labrousse
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital of Reims, Reims, France
- University of Reims-Champagne Ardennes, Reims, France
- Department of Radiology, University Hospital of Reims, Reims, France
| | - Marc Makeieff
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital of Reims, Reims, France
- University of Reims-Champagne Ardennes, Reims, France
- Department of Radiology, University Hospital of Reims, Reims, France
| | - Jean-Claude Merol
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital of Reims, Reims, France
- Department of Radiology, University Hospital of Reims, Reims, France
| | - Aline Carsin-Vu
- University Department of Health Research, University of Reims Champagne Ardennes, Reims, France
- Department of Radiology, University Hospital of Reims, Reims, France
| | - France Truong
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital of Reims, Reims, France
- University of Reims-Champagne Ardennes, Reims, France
- Department of Radiology, University Hospital of Reims, Reims, France
| | - Xavier Dubernard
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital of Reims, Reims, France
- University of Reims-Champagne Ardennes, Reims, France
- Department of Radiology, University Hospital of Reims, Reims, France
| | - Esteban Brenet
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital of Reims, Reims, France.
- University of Reims-Champagne Ardennes, Reims, France.
- Department of Radiology, University Hospital of Reims, Reims, France.
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2
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Drapier E, Brenet E, Louges MA, Merol JC, Labrousse M, Dubernard X. Assessment of peak inspiratory flow in the management of acute inspiratory dyspnoea. Eur Arch Otorhinolaryngol 2021; 279:1099-1104. [PMID: 34476594 DOI: 10.1007/s00405-021-07066-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 08/28/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Assessment of inspiratory dyspnoea associated with upper airway obstruction is based on subjective clinical and nasal fibreoptic laryngoscopy (NFL) signs. The aim of this study was to determine whether peak inspiratory flow (PIF) measurement could indicate the need for upper airway release surgery in patients with acute inspiratory dyspnoea during emergency. METHODS A retrospective single-institution study (February 2018-March 2020) of 48 patients with acute inspiratory dyspnoea and PIF measurement (Peak Flow In-Check Dial G16®-Harlow-England) was conducted. The surgical decision was based on the clinical evaluation of the patient's respiratory tolerance and NFL. RESULTS Forty-eight patients were included in this study. Thirty-five patients underwent surgery (PIF: 36 L/min), and 13 patients did not (PIF: 58 L/min) (p = 0.0009). Three of these 13 patients underwent an operation later (PIF value: 42 L/min versus 63 L/min for the 10 others [p = 0.25]). CONCLUSION PIF measurement is a quantitative, objective, inexpensive, non-invasive, and quick test that is potentially useful for general practitioners, mobile medical teams, or for ear-nose-and-throat specialists. A threshold of 42 L/min can help doctors in emergency decision making to refer patients to an ear-nose-and-throat specialist to release the upper airway and perform surgery or to choose medical monitoring for patients with emergency inspiratory dyspnoea.
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Affiliation(s)
- Emeline Drapier
- Department of Oto-Rhino-Laryngology, University Hospital of Reims, Rue du Général Koenig, 51100, Reims, France
| | - Esteban Brenet
- Department of Oto-Rhino-Laryngology, University Hospital of Reims, Rue du Général Koenig, 51100, Reims, France
| | - Marie-Anne Louges
- Department of Oto-Rhino-Laryngology, University Hospital of Reims, Rue du Général Koenig, 51100, Reims, France
| | - Jean-Claude Merol
- Department of Oto-Rhino-Laryngology, University Hospital of Reims, Rue du Général Koenig, 51100, Reims, France
| | - Marc Labrousse
- Department of Oto-Rhino-Laryngology, University Hospital of Reims, Rue du Général Koenig, 51100, Reims, France
| | - Xavier Dubernard
- Department of Oto-Rhino-Laryngology, University Hospital of Reims, Rue du Général Koenig, 51100, Reims, France.
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Dahan LS, Giorgi R, Vergez S, Le Taillandier de Gabory L, Costes-Martineau V, Herman P, Poissonnet G, Mauvais O, Malard O, Garrel R, Uro-Coste E, Barry B, Bach C, Chevalier D, Mouawad F, Merol JC, Bastit V, Thariat J, Gilain L, Dufour X, Righini CA, Moya-Plana A, Even C, Radulesco T, Michel J, Baujat B, Fakhry N, Albert S, Andry G, Babin E, Bach C, Badet JM, Badoual C, Baglin A, Banal A, Barry B, Baudin E, Baujat B, Bensadoun R, Bertolus C, Bessède JP, Blanchard D, Borel C, Bozorg-Grayeli A, Breheret R, Breton P, Brugel L, Calais G, Casiraghi O, Cassagnau E, Castillo L, Ceruse P, Chabolle F, Chevalier D, Chobaut J, Choussy O, Cosmidis A, Coste A, Costes V, Crampette L, Darrouzet V, Demez P, Dessi P, Devauchelle B, Dolivet G, Dubrulle F, Duflo S, Dufour X, Faivre S, Fakhry N, Ferron C, Floret F, de Gabory L, Garrel R, Geoffrois L, Gilain L, Giovanni A, Girod A, Guerrier B, Hans S, Herman P, Hofman P, Housset M, Jankowski R, Jegoux F, Juliéron M, Kaminsky MC, Kolb F, St Guily JL, Laccoureye L, Lallemant B, Lang P, Lartigau E, Lavieille JP, Lefevre M, Leroy X, Malard O, Massip F, Mauvais O, Merol JC, Michel J, Mom T, Morinière S, de Monès E, Moulin G, Noel G, Poissonnet G, Prades JM, Radulesco T, de Raucourt D, Reyt E, Righini C, Robin YM, Rolland F, Ruhin B, Sarroul N, Schultz P, Serrano E, Sterkers O, Strunski V, Sudaka A, Tassart M, Testelin S, Thariat J, Timochenko A, Toussaint B, Coste EU, Valette G, Van den Abbeele T, Varoquaux A, Veillon F, Vergez S, Wassef M. Mucoepidermoid carcinoma of salivary glands: A French Network of Rare Head and Neck Tumors (REFCOR) prospective study of 292 cases. Eur J Surg Oncol 2021; 47:1376-1383. [DOI: 10.1016/j.ejso.2020.11.123] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 10/31/2020] [Accepted: 11/13/2020] [Indexed: 12/18/2022] Open
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Brenet E, Philouze P, Schiffler C, Pommier P, Crozes C, Benzerdjeb N, Monchet E, Boulagnon-Rombi C, Ton Van J, Podeur F, Servagi-Vernat S, Liem X, Merol JC, Ceruse P, Serre AA, Chabaud S, Julieron M, Deneuve S. Influence of postoperative radiotherapy target volumes in unilateral head and neck carcinoma of unknown primary: A multicentric study using propensity score. Radiother Oncol 2021; 160:1-8. [PMID: 33845043 DOI: 10.1016/j.radonc.2021.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/22/2021] [Accepted: 04/01/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare the impact of two radiation modalities on loco-regional control, survival and tumour emergence, after node dissection for an unilateral head and neck carcinoma of unknown primary (HNCUP). MATERIALS AND METHODS This is a multicentric retrospective study of 138 patients with unilateral HNCUP treated between 2002 and 2017. The absence of primary tumour was assessed by a systematic panendoscopy and positron emission tomography. Neck dissection was initially performed for all patients. Radiation Therapy was delivered on ipsilateral lymph node areas in 62 cases (44%: UL-RT group) and on bilateral lymph node areas and the entire pharyngeal mucosa in 77 cases (56%: COMP-RT group). Impact of radiation modalities on locoregional control and overall survival was assessed using propensity score matching method in order to balance baseline characteristics between the two groups. RESULTS The population included 80.4% men, 80.4% smokers, 32.6% P16 positive tumours and 71.0% extracapsular extension. After a median follow-up of 5 years, the locoregional control rate was 80.3% in the UL-RT group and 75.3% in the COMP-RT group (p = 0.688). The corresponding rate of contralateral lymph node recurrence was 0% versus 2.6% (p = 0.503) and the rate of tumour emergence was 11.5% versus 9.1% (p = 0.778). No significant difference was observed between the UL-RT and the COMP-RT groups for overall survival (p = 0.9516), specific survival (p = 0.4837) or tumour emergence (p = 0.9034). CONCLUSION UL-RT seems to provide similar outcomes as COMP-RT in unilateral HNCUP post-operative management.
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Affiliation(s)
- Esteban Brenet
- Head and Neck Surgery Department, Centre Hospitalo Universitaire Reims, France
| | - Pierre Philouze
- Head and Neck Surgery Department, Centre Hospitalo Universitaire Lyon Sud, France
| | | | - Pascal Pommier
- Radiotherapy Department, Centre Léon Bérard, Lyon, France
| | - Carole Crozes
- Pathological Anatomy Department, Centre Léon Bérard, Lyon, France
| | - Nazim Benzerdjeb
- Pathological Anatomy Department, Centre Hospitalo Universitaire Lyon Sud, France
| | - Elodie Monchet
- Head and Neck Surgery Department, Centre Oscar Lambret, Lille, France
| | | | - Jean Ton Van
- Head and Neck Department, Centre Oscar Lambret, Lille, France
| | - Fabien Podeur
- Oncologic Surgery Department, Centre Léon Bérard, Lyon, France
| | | | - Xavier Liem
- Radiotherapy Department, Centre Oscar Lambret, Lille, France
| | - Jean-Claude Merol
- Head and Neck Department, Centre hospilato Universitaire Reims, France
| | - Philippe Ceruse
- Head and Neck Surgery Department, Centre Hospitalo Universitaire Lyon Sud, France
| | | | - Sylvie Chabaud
- Biostatistics Department, Centre Léon Bérard, Lyon, France
| | - Morbize Julieron
- Head and Neck Surgery Department, Centre Oscar Lambret, Lille, France
| | - Sophie Deneuve
- Oncologic Surgery Department, Centre Léon Bérard, Lyon, France.
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5
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Saloner Dahan L, Giorgi R, Garrel R, Le Taillandier de Gabory L, Costes-Martineau V, Herman P, Poissonnet G, Mauvais O, Malard O, Vergez S, Uro-Coste E, Barry B, Bach C, Chevalier D, Mouawad F, Merol JC, Bastit V, Thariat J, Gilain L, Dufour X, Righini CA, Dessi P, Michel J, Radulesco T, Even C, Baujat B, Fakhry N. Management of cN0 low-grade mucoepidermoid carcinomas of salivary glands: Prospective multicentre study of 152 cases of the French Network of Rare Head and Neck Tumors (REFCOR). Clin Otolaryngol 2020; 45:926-931. [PMID: 32569444 DOI: 10.1111/coa.13600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 05/28/2020] [Accepted: 06/14/2020] [Indexed: 02/01/2023]
Affiliation(s)
- Laurie Saloner Dahan
- Service d'ORL et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire La Conception, Marseille, France.,Aix Marseille Univ, Marseille, France.,REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France
| | - Roch Giorgi
- Aix Marseille Univ, Marseille, France.,Faculté des Sciences Médicales et Paramédicales, SESSTIM, Marseille, France.,BIOSTIC, Hôpital de la Timone, Marseille, France
| | - Renaud Garrel
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL et Chirurgie cervico-faciale, CHU de Montpellier, Montpellier, France
| | - Ludovic Le Taillandier de Gabory
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL et Chirurgie cervico-faciale, CHU de Bordeaux, Bordeaux, France
| | - Valérie Costes-Martineau
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'Anatomie Pathologique, CHU de Montpellier, Montpellier, France
| | - Philippe Herman
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL Chirurgie maxillo-faciale et plastique, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Gilles Poissonnet
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL et chirurgie cervico-faciale, Centre Antoine Lacassagne, Institut Universitaire de la face et du cou, Nice, France
| | - Olivier Mauvais
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL Chirurgie cervico-faciale, Audiophoniatrie, CHU de Besançon, Besancon, France
| | - Olivier Malard
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL et chirurgie cervico-faciale, CHU de Nantes, Nantes, France
| | - Sébastien Vergez
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL et chirurgie cervico-faciale, CHU de Toulouse/Oncopôle, Toulouse, France
| | - Emmanuelle Uro-Coste
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'Anatomie et Cytologie Pathologiques, Institut Universitaire du Cancer-Oncopole, Toulouse, France
| | - Béatrix Barry
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL et chirurgie cervico-faciale, CHU Paris Nord-Val de Seine, Hôpital Xavier Bichat-Claude Bernard, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Christine Bach
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL et chirurgie de la face et du cou, Hôpital Foch, Suresnes, France
| | - Dominique Chevalier
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL et chirurgie cervico-faciale, CHU de Lille, Lille, France
| | - Francois Mouawad
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL et chirurgie cervico-faciale, CHU de Lille, Lille, France
| | - Jean-Claude Merol
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL et chirurgie cervico-faciale, CHU de reims, Reims, France
| | - Vianney Bastit
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL et chirurgie cervico-faciale, Centre François Baclesse, Caen, France
| | - Juliette Thariat
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL et chirurgie cervico-faciale, Centre François Baclesse, Caen, France
| | - Laurent Gilain
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL et chirurgie cervico-faciale, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Xavier Dufour
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL et chirurgie cervico-faciale, CHU de Poitiers, Poitiers, France
| | - Christian-Adrien Righini
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL et chirurgie cervico-faciale, CHU de Grenoble, Grenoble, France
| | - Patrick Dessi
- Service d'ORL et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire La Conception, Marseille, France.,Aix Marseille Univ, Marseille, France.,REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France
| | - Justin Michel
- Service d'ORL et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire La Conception, Marseille, France.,Aix Marseille Univ, Marseille, France.,REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France
| | - Thomas Radulesco
- Service d'ORL et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire La Conception, Marseille, France.,Aix Marseille Univ, Marseille, France.,REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France
| | - Caroline Even
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'Oncologie médicale tête et cou, Institut Gustave Roussy, Villejuif, France
| | - Bertrand Baujat
- REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France.,Service d'ORL et Chirurgie Cervico-faciale, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Nicolas Fakhry
- Service d'ORL et Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire La Conception, Marseille, France.,Aix Marseille Univ, Marseille, France.,REFCOR (Réseau d'Expertise Français sur les Cancers ORL Rares), Paris, France
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Brenet E, Barbe C, Hoeffel C, Dubernard X, Merol JC, Fath L, Servagi-Vernat S, Labrousse M. Predictive Value of Early Post-Treatment Diffusion-Weighted MRI for Recurrence or Tumor Progression of Head and Neck Squamous Cell Carcinoma Treated with Chemo-Radiotherapy. Cancers (Basel) 2020; 12:cancers12051234. [PMID: 32422975 PMCID: PMC7281260 DOI: 10.3390/cancers12051234] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/04/2020] [Accepted: 05/10/2020] [Indexed: 12/14/2022] Open
Abstract
Aims: To investigate the predictive capacity of early post-treatment diffusion-weighted magnetic resonance imaging (MRI) for recurrence or tumor progression in patients with no tumor residue after chemo-radiotherapy (CRT) for head and neck squamous cell carcinoma, and, to assess the predictive capacity of pre-treatment diffusion-weighted MRI for persistent tumor residue post-CRT. Materials and Method: A single center cohort study was performed in one French hospital. All patients with squamous cell carcinoma receiving CRT (no surgical indication) were included. Two diffusion-weighted MRI were performed: one within 8 days before CRT and one 3 months after completing CRT with determination of median tumor apparent diffusion coefficient (ADC). Main outcome: The primary endpoint was progression-free survival. Results: 59 patients were included prior to CRT and 46 (78.0%) completed CRT. A post-CRT tumor residue was found in 19/46 (41.3%) patients. In univariate analysis, initial ADC was significantly lower in patients with residue post CRT (0.56 ± 0.11 versus 0.79 ± 0.13; p < 0.001). When initial ADC was dichotomized at the median, initial ADC lower than 0.7 was significantly more frequent in patients with residue post CRT (73.7% versus 11.1%, p < 0.0001). In multivariate analysis, only initial ADC lower than 0.7 was significantly associated with tumor residue (OR = 22.6; IC [4.9–103.6], p < 0.0001). Among 26 patients without tumor residue after CRT and followed up until 12 months, 6 (23.1%) presented recurrence or progression. Only univariate analysis was performed due to a small number of events. The only factor significantly associated with disease progression or early recurrence was the delta ADC (p = 0.0009). When ADC variation was dichotomized at the median, patients with ADC variation greater than 0.7 had time of disease-free survival significantly longer than patients with ADC variation lower than 0.7 (377.5 [286–402] days versus 253 [198–370], p < 0.0001). Conclusion and relevance: Diffusion-weighted MRI could be a technique that enables differentiation of patients with high potential for early recurrence for whom intensive post-CRT monitoring is mandatory. Prospective studies with more inclusions would be necessary to validate our results.
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Affiliation(s)
- Esteban Brenet
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Robert Debré University Hospital, 51100 Reims, France; (X.D.); (J.-C.M.); (M.L.)
- Correspondence:
| | - Coralie Barbe
- Clinical Research Unit, Robert Debré University Hospital, 51100 Reims, France;
| | - Christine Hoeffel
- Department of Radiology, Robert Debré University Hospital, 51100 Reims, France;
| | - Xavier Dubernard
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Robert Debré University Hospital, 51100 Reims, France; (X.D.); (J.-C.M.); (M.L.)
| | - Jean-Claude Merol
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Robert Debré University Hospital, 51100 Reims, France; (X.D.); (J.-C.M.); (M.L.)
| | - Léa Fath
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital of Strasbourg, 67000 Strasbourg, France;
| | | | - Marc Labrousse
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Robert Debré University Hospital, 51100 Reims, France; (X.D.); (J.-C.M.); (M.L.)
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7
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Le Guevelou J, Lebars S, Kammerer E, de Gabory L, Vergez S, Janot F, Baujat B, Righini C, Jegoux F, Dufour X, Merol JC, Mauvais O, Lasne-Cardon A, Selleret L, Thariat J. Head and neck cancer during pregnancy. Head Neck 2019; 41:3719-3732. [PMID: 31329334 DOI: 10.1002/hed.25877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 06/28/2019] [Accepted: 07/03/2019] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND The incidence of cancer during pregnancy is low but is slightly increasing. Data on incidence and etiology of head and neck (HN) cancers in pregnant women are rare. We evaluated the frequency, tumor type, associated factors, and specific biomarkers in HN cancers occurring in pregnant (and peripartum) women. METHODS A systematic literature search was performed on PubMed, for any HN tumor site occurring in pregnant women. RESULTS Sixty cases of HN cancers occurring during pregnancy were identified. Most of them were oral cavity cancers. Relationships with oncogenic viruses, hormonal disturbance, and shift in maternal immunity profile were identified. CONCLUSION Carcinogenesis of HN cancers in pregnant women may be led by different cancer type-specific hallmarks. Relevance of these etiological factors with respect to treatments and birth control recommendations is being investigated by the REFCOR in an ambispective study.
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Affiliation(s)
| | | | | | - Ludovic de Gabory
- Service de Chirurgie ORL, Centre Hospitalier Universitaire Pellegrin, Bordeaux, France
| | - Sebastien Vergez
- Service de Chirurgie ORL, Centre Hospitalier Universitaire Rangueil-Larrey, Toulouse, France
| | - François Janot
- Service de Chirurgie ORL, Centre Gustave Roussy, Villejuif, France
| | - Bertrand Baujat
- Service de Chirurgie ORL, Hopital Tenon, Université Paris-Est, Paris, France
| | - Christian Righini
- Service de Chirurgie ORL, Centre Hospitalier Universitaire de Grenoble, Grenoble, France
| | - Franck Jegoux
- Service de Chirurgie ORL, Centre Hospitalier Universitaire Pontchaillou, Rennes, France
| | - Xavier Dufour
- Service de Chirurgie ORL, Centre Hospitalier Universitaire de Poitiers, Poitiers, France
| | - Jean-Claude Merol
- Service de Chirurgie ORL, Centre Hospitalier Universitaire de Reims, Reims, France
| | - Olivier Mauvais
- Service de Chirurgie ORL, Centre Hospitalier Universitaire de Besançon, Besançon, France
| | - Audrey Lasne-Cardon
- Service de Chirurgie ORL Centre François Baclesse, Normandie Université-Unicaen, Caen, France
| | - Lise Selleret
- Service de Gynécologie Obstetrique, Hopital Tenon, Paris, France
| | - Juliette Thariat
- Service de Radiothérapie, Centre François Baclesse, Caen, France
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8
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Bozec A, Demez P, Gal J, Chamorey E, Louis MY, Blanchard D, De Raucourt D, Merol JC, Brenet E, Dassonville O, Poissonnet G, Santini J, Peyrade F, Benezery K, Lesnik M, Berta E, Ransy P, Babin E. Long-term quality of life and psycho-social outcomes after oropharyngeal cancer surgery and radial forearm free-flap reconstruction: A GETTEC prospective multicentric study. Surg Oncol 2017; 27:23-30. [PMID: 29549900 DOI: 10.1016/j.suronc.2017.11.005] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [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: 07/19/2017] [Revised: 10/25/2017] [Accepted: 11/22/2017] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To assess long-term quality of life (QoL) and psycho-social outcomes, and to determine their predictive factors after oropharyngeal cancer (OPC) surgery and radial forearm free-flap (RFFF) reconstruction. METHODS Patients who had undergone OPC surgery and RFFF reconstruction who were still alive and disease-free at least 1 year after surgery were enrolled in this prospective multicentric study. Patients completed the European Organization for Research and Treatment of Cancer (EORTC) Core (QLQ-C30) and Head and Neck Cancer (QLQ-H&N35) QoL questionnaires, the Voice Handicap Index (VHI-10) questionnaire and the Hospital Anxiety and Depression Scale (HADS). The level of dysphagia was evaluated using the Dysphagia Handicap Index (DHI) and the Dysphagia Outcomes and Severity Scale (DOSS). Predictive factors of these clinical outcomes were determined in univariate and multivariate analysis. RESULTS A total of 58 patients were included in this study. Long-term QoL and functioning scales scores were well-preserved (all superior to 70%). Main persistent symptoms were fatigue, reduced sexuality and oral function-related disorders (swallowing, teeth, salivary and mouth-opening problems). HADS anxiety and depression scores were 7.2 and 5.4, respectively. Twenty-one (36%) patients presented an anxiodepressive disorder (HADS global score ≥ 15). Among the 21 patients who were still working before surgery, 11 (52%) had returned to work at the time of our study. The HADS global score (p < 0.001) was the main predictor of QoL, VHI-10 and DOSS scores. CONCLUSIONS Psychological distress is the main determinant of long-term QoL and is therefore of critical importance in the multidisciplinary management of OPC patients.
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Affiliation(s)
- Alexandre Bozec
- Institut Universitaire de la Face et du Cou, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France.
| | - Pierre Demez
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Liège, Belgium
| | - Jocelyn Gal
- Department of Statistics, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France
| | - Emmanuel Chamorey
- Department of Statistics, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France
| | - Marie-Yolande Louis
- Department of Maxillo-facial and Head and Neck Surgery, Centre François-Baclesse, Caen, France
| | - David Blanchard
- Department of Maxillo-facial and Head and Neck Surgery, Centre François-Baclesse, Caen, France
| | - Dominique De Raucourt
- Department of Maxillo-facial and Head and Neck Surgery, Centre François-Baclesse, Caen, France
| | - Jean-Claude Merol
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Reims, France
| | - Esteban Brenet
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Reims, France
| | - Olivier Dassonville
- Institut Universitaire de la Face et du Cou, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France
| | - Gilles Poissonnet
- Institut Universitaire de la Face et du Cou, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France
| | - José Santini
- Institut Universitaire de la Face et du Cou, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France
| | - Frédéric Peyrade
- Department of Medical Oncology, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France
| | - Karen Benezery
- Department of Radiotherapy, Centre Antoine Lacassagne, Université Côte d'Azur, Nice, France
| | - Maria Lesnik
- Department of Otorhinolaryngology and Head and Neck Surgery, Institut Curie, Paris, France
| | - Etienne Berta
- Department of Otorhinolaryngology and Head and Neck Surgery, Hospital of Annecy, France
| | - Pierre Ransy
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Liège, Belgium
| | - Emmanuel Babin
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Caen, France
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9
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Abstract
Orbital tumors are a rather frequent pathology. Their diagnosis and treatment may be difficult. They can be benign or malignant. All the tissues of the orbit can give rise to a tumor, resulting in their large number. Among the benign tumors, we have meningiomas and cavernous hemangiomas, and for the malignant tumors, lymphomas, metastasis, ENT tumors and lacrimal gland tumors in the adult. Usually the signs are nonspecific, with proptosis, oculomotor disturbance, inflammatory signs, pain and sometimes a mass. Imaging (CT, MRI and color Doppler ultrasound) shows the tumor, its location, extent and possible metastases. Biopsy and anatomic and cytopathologic examination confirm the type of benign or malignant tumor. Based on these three elements: clinical appearance, imaging and histology, the tumor will be treated, usually by a surgical approach according to the recommendations of a multidisciplinary tumor conference. Radiation therapy and chemotherapy may supplement the treatment.
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Affiliation(s)
- A Ducasse
- Hôpital Robert-Debré, CHRU de Reims, avenue du M.L.-Koenig, 51092 Reims, France.
| | - J C Merol
- Hôpital Robert-Debré, CHRU de Reims, avenue du M.L.-Koenig, 51092 Reims, France
| | - F Bonnet
- Hôpital Robert-Debré, CHRU de Reims, avenue du M.L.-Koenig, 51092 Reims, France
| | - F Litré
- Hôpital Maison-Blanche, CHRU de Reims, 51092 Reims, France
| | - C Arndt
- Hôpital Robert-Debré, CHRU de Reims, avenue du M.L.-Koenig, 51092 Reims, France
| | - I Larré
- Hôpital Robert-Debré, CHRU de Reims, avenue du M.L.-Koenig, 51092 Reims, France
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10
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Dubernard X, Dabakuyo S, Ouedraogo S, Amroun K, Kere D, Nasser T, Deguelte S, Pochart JM, Merol JC, Makeieff M, Chays A, Schvartz C. Prophylactic neck dissection for low-risk differentiated thyroid cancers: Risk-benefit analysis. Head Neck 2016; 38:1091-6. [PMID: 26873677 DOI: 10.1002/hed.24402] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2015] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The benefit of neck dissection is the subject of debate in differentiated thyroid cancer (DTC). We analyze the risk-benefit of neck dissection for low-risk DTC without detectable lymph nodes. METHODS We conducted a retrospective study from 1983 to 2003; which included 295 patients without detectable lymph nodes who were treated by thyroidectomy with (C+) or without (C-) neck dissection. All patients had iodine131 therapy. We compared the frequency of remission, disease progression, and permanent complications between groups. RESULTS Two hundred twelve patients comprised the C+ group, and 83 patients the C- group. Respectively for C+ versus C-, remission rates were 92% versus 89.2% (p = .40), and progressive disease observed was 3.3% versus 7.2% (p = .10). Permanent hypoparathyroidism occurred in 15.1% in C+ versus 3.6% in C- (p = .006). CONCLUSION The risk-benefit analysis of neck dissection in patients with low-risk DTC shows no benefit in terms of complete remission or occurrence of progression. However, risk of complications seems to be higher in patients with neck dissection. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1091-1096, 2016.
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Affiliation(s)
- Xavier Dubernard
- Thyroïde Marne-Ardennes Register, CLCC Institut Jean Godinot, Reims, France.,Otolaryngology Department, Centre Hospitalier Robert Debré, Reims, France
| | - Sandrine Dabakuyo
- Thyroïde Marne-Ardennes Register, CLCC Institut Jean Godinot, Reims, France
| | | | - Koceila Amroun
- General Surgery Department, CLCC Institut Jean Godinot, Reims, France
| | - David Kere
- General Surgery Department, CLCC Institut Jean Godinot, Reims, France
| | - Talal Nasser
- Otolaryngology Department, Polyclinique de Courlancy, Reims, France
| | - Sophie Deguelte
- General Surgery Department, Centre Hospitalier Robert Debré, Reims, France
| | - Jean-Marie Pochart
- Thyroïde Marne-Ardennes Register, CLCC Institut Jean Godinot, Reims, France
| | - Jean-Claude Merol
- Otolaryngology Department, Centre Hospitalier Robert Debré, Reims, France
| | - Marc Makeieff
- Otolaryngology Department, Centre Hospitalier Robert Debré, Reims, France
| | - André Chays
- Otolaryngology Department, Centre Hospitalier Robert Debré, Reims, France
| | - Claire Schvartz
- Thyroïde Marne-Ardennes Register, CLCC Institut Jean Godinot, Reims, France
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11
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Huguenin A, Lorot A, Zachar D, Dudez O, Mzabi A, Dupuis E, Lehrter V, Merol JC, Villena I, Depaquit J, Toubas D. Matrix-assisted laser desorption ionization-time of flight identification of Schizophyllum commune: perspectives on the review by Chowdhary et al. Med Mycol 2015; 53:896-7. [PMID: 26472778 DOI: 10.1093/mmy/myv031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Antoine Huguenin
- Laboratoire de Parasitologie Mycologie, CHU de Reims, Université Reims Champagne Ardenne, Hôpital Maison Blanche, 45 rue Cognacq Jay, 51092 Reims cedex, France
| | - Aurélie Lorot
- Service d'ORL et de Chirurgie Cervico-Faciale, CHU de Reims, Hopital Robert Debré, 45 rue Cognacq Jay, 51092 Reims cedex, France
| | - Dominique Zachar
- Laboratoire central d'Anatomie et de Cytologie pathologiques, CHU de Reims, Hôpital Robert-Debré, Université Reims Champagne-Ardenne, rue du Général-Koenig, 51100 Reims cedex, France
| | - Oriane Dudez
- Laboratoire central d'Anatomie et de Cytologie pathologiques, CHU de Reims, Hôpital Robert-Debré, Université Reims Champagne-Ardenne, rue du Général-Koenig, 51100 Reims cedex, France
| | - Alexandre Mzabi
- Laboratoire de Parasitologie Mycologie, CHU de Reims, Université Reims Champagne Ardenne, Hôpital Maison Blanche, 45 rue Cognacq Jay, 51092 Reims cedex, France EA 3800, Université Reims Champagne-Ardenne, France
| | - Emilie Dupuis
- Laboratoire de Parasitologie Mycologie, CHU de Reims, Université Reims Champagne Ardenne, Hôpital Maison Blanche, 45 rue Cognacq Jay, 51092 Reims cedex, France EA 3800, Université Reims Champagne-Ardenne, France
| | - Véronique Lehrter
- Université Reims Champagne-Ardenne, ANSES, EA4688 - USC 'transmission vectorielle et épidémiosurveillance de maladies parasitaires (VECPAR)', SFR Cap Santé, Faculté de Pharmacie, 51 rue Cognacq-Jay, 51096 Reims, France
| | - Jean-Claude Merol
- Service d'ORL et de Chirurgie Cervico-Faciale, CHU de Reims, Hopital Robert Debré, 45 rue Cognacq Jay, 51092 Reims cedex, France
| | - Isabelle Villena
- Laboratoire de Parasitologie Mycologie, CHU de Reims, Université Reims Champagne Ardenne, Hôpital Maison Blanche, 45 rue Cognacq Jay, 51092 Reims cedex, France EA 3800, Université Reims Champagne-Ardenne, France
| | - Jérôme Depaquit
- Laboratoire de Parasitologie Mycologie, CHU de Reims, Université Reims Champagne Ardenne, Hôpital Maison Blanche, 45 rue Cognacq Jay, 51092 Reims cedex, France Université Reims Champagne-Ardenne, ANSES, EA4688 - USC 'transmission vectorielle et épidémiosurveillance de maladies parasitaires (VECPAR)', SFR Cap Santé, Faculté de Pharmacie, 51 rue Cognacq-Jay, 51096 Reims, France
| | - Dominique Toubas
- Laboratoire de Parasitologie Mycologie, CHU de Reims, Université Reims Champagne Ardenne, Hôpital Maison Blanche, 45 rue Cognacq Jay, 51092 Reims cedex, France Equipe MéDIAN, Unité MEDyC CNRS UMR 7369, Université de Reims Champagne-Ardenne, France
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12
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Perotin JM, Jeanfaivre T, Thibout Y, Jouneau S, Lena H, Dutau H, Ramon P, Lorut C, Noppen M, Vergnon JM, Vallerand H, Merol JC, Marquette CH, Lebargy F, Deslee G. Endoscopic management of idiopathic tracheal stenosis. Ann Thorac Surg 2011; 92:297-301. [PMID: 21718860 DOI: 10.1016/j.athoracsur.2011.03.129] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2011] [Revised: 03/22/2011] [Accepted: 03/28/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND Idiopathic tracheal stenosis (ITS) is a rare condition representing a difficult therapeutic challenge. Endoscopic management is a therapeutic option but long-term results are not established. The aim of this retrospective multicenter study was to analyze long-term outcome after endoscopic management of ITS. METHODS Nine institutions involved in interventional bronchoscopy were contacted and asked to identify ITS endoscopically treated. A standard form was used to report the main characteristics and long-term outcome after endoscopic management. RESULTS Twenty-three patients, 96% women, aged 45±16 years, were endoscopically treated for ITS. Time between first symptoms and diagnosis was 19±18 months. Bronchoscopy showed a weblike (61%) or complex (39%) stenosis, located in the upper part of the trachea, mainly in the cricoid area. Endoscopic treatment included mechanical dilation only (52%) or associated with laser or electrocoagulation (30%) and stent placement (18%). All procedures were efficient. The follow-up after endoscopic management was 41±34 months. The ITS recurrence occurred in 30% at 6 months, 59% at 2 years, and 87% at 5 years, with a delay of 14±16 months. The treatment of recurrence (n=13) included endoscopic management in 12 cases. CONCLUSIONS Endoscopic management of ITS provides a safe and efficient therapeutic option but late recurrences are frequent and require long-term follow-up.
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Affiliation(s)
- Jeanne-Marie Perotin
- Department of Respiratory Medicine, INSERM UMRS 903, University Hospital of Reims, Reims, France
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13
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Maillard S, Jovenin N, Cauchois A, Froissart D, Merol JC, Chays A, Nguyen TD. Radiothérapie postopératoire des cancers laryngés classés N0. Cancer Radiother 2005; 9:285-92. [PMID: 16168697 DOI: 10.1016/j.canrad.2005.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2004] [Revised: 04/29/2005] [Accepted: 05/16/2005] [Indexed: 10/25/2022]
Abstract
PURPOSE A retrospective study to re-assess the indications for postoperative radiation therapy in squamous cell carcinoma of the larynx staged N0 after gross resection. PATIENTS AND METHODS Between January 1975 and December 2000, 166 patients with squamous cell carcinoma of the larynx were treated by total laryngectomy with or without neck dissection. Surgery was completed by external radiotherapy delivering 45 to 65 Gy to the tumour bed and 45 to 50 Gy to cervical lymphatic chains. Minimal follow-up was 36 months and median follow-up was 98 months. RESULTS The rate of nodal recurrence was 6% (median time for relapse was 9 months). The survival rates at 1, 2, 3 and 5 years were 93.5, 84, 80 and 69% respectively, with a 8 year 3 month median survival. The univariate analysis showed 4 parameters, which significantly increased the risk of local recurrence: the medical necessity for immediate tracheotomy, the subglottic involvement, the involvement of the whole larynx and the presence of lymphatic embols in the neck dissection. There was no statistically significant difference between the patients with or without a neck dissection. Fifty-nine secondary cancers were observed, 15 of them occurring in the head and neck area. The late complications consisted of cervical subcutaneous fibrosis (7%), oesophageal stricture (4%), oeso-tracheal fistula (l%), hypothyroidism (3%), bone necrosis (1%). CONCLUSION Prophylactic cervical radiotherapy in laryngeal cancers resulted in 6% cervical node recurrence rate. This value may represent the maximal rate to accept if one would favour new therapeutic strategies based on restricted indications for radiotherapy.
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Affiliation(s)
- S Maillard
- Service de radiothérapie, institut Jean-Godinot, 1, rue du Général-Koenig, 51100 Reims, France
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14
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Moutel K, Merol JC, Prevost A, Eb F, Lefebvre JF, Coninx P, Liautaud-Roger F. Prevalence of Chlamydia pneumoniae infection in squamous cell carcinoma of the head and neck. Anticancer Res 2004; 24:1207-10. [PMID: 15154648] [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: 04/29/2023]
Abstract
On the basis of epidemiological data, an association between Chlamydia pneumoniae (Cp) infection and head and neck cancer might be suggested. The aim of the present study was to detect Cp-DNA within tumour tissue specimens by a two-step polymerase chain reaction. Investigation was planned on the Fleming's procedure for early termination when initial results were extreme. So, after ten consecutive patients, only one tumour contained Cp-DNA. Hence the prevalence could be regarded as inferior to 60% (2a=b=0.08), the threshold under which a direct role of Cp in head and neck cancer development does not seem to be likely.
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Affiliation(s)
- Karinne Moutel
- Institut Jean-Godinot, Service de médecine, 1 Av du general Koenig BP 171, 51056 Reims cedex, France
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15
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Roger-Liautaud F, Gimonet D, Merol JC, Prevost A, Coninx P. New approach to pre-therapeutic prognosis in advanced squamous cell carcinoma of the head and neck. Anticancer Res 2002; 22:2419-22. [PMID: 12174937] [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: 02/26/2023]
Abstract
The Bleomycin (BLM)-induced apoptosis in peripheral blood mononuclear cells (PBMC), from patients with advanced squamous cell carcinoma of the head and neck (SCCHN), cultured in vitro with PHA, was tested as a predictive indicator of the survival time. The rates of the PBMC BLM-induced apoptosis and of the cycling-PBMCs, measured respectively after Giemsa- and Feulgen-staining were determined in 25 patients before induction chemotherapy. By using the Cox model, the survival probability was significantly and independently increased for a high percentage of PBMC BLM-induced apoptosis and a high rate of cycling PBMCs. (Chi-2(2): 10; p=0.007). Six patients, in whom both PBMC variables were simultaneouly greater than the median values, showed a median survival time as long as 60 months versus 10 months for the other 19. Conclusively, the PBMC susceptibility to BLM-induced apoptosis as well as the PBMC capability for cycling may be regarded as independent pretherapeutic prognosis factors for patients with advanced SCCHN.
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16
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Moutel K, Nasca S, Panis X, Lebrun D, Merol JC, Coninx P. Early death during initial chemotherapy of squamous cell carcinoma of the oro- or hypopharynx. Anticancer Res 1997; 17:647-51. [PMID: 9066595] [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: 02/03/2023]
Abstract
Neoadjuvant chemotherapy produces high response rates in squamous cell carcinoma of the head and neck without increasing the survival time. Furthermore authors have observed a death rate of about 5% (up to 10%) during chemotherapy. A series of patients with an oro- or hypo-pharynx cancer, were retrospectively divided into two groups on the basis of a short (< or = 2 months) or long (> or = 2 years) survival time. Clinical, tumoral and usual biological data from either group were compared. By univariate analysis, obesity index, hemoglobin, albumin concentrations and mononuclear cell counts were lower in patients with a short survival time compared with those in the other group. On the contrary, polymorphonuclear cell and platelet counts were higher. Infection appeared to be more frequent for patients with a poor prognosis without being entirely responsible for early death. By multivariate analysis, obesity index and platelet count were both independent variables associated with prognosis. These results call for further investigation of cardiac function, inflammatory, nutritional and immunological status of patients with squamous cell carcinoma of the head and neck who were given initial chemotherapy, particularly Cisplatin and Fluorouracil.
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Affiliation(s)
- K Moutel
- Institut Jean Godinot, Service de Médecine Interne Oncologique, Reims, France
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17
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Himberlin C, Merol JC, Nasca S, Panis X, Lebrun D, Desoize B, Legros M, Coninx P. Prognostic significance of routine clinical and laboratory data in advanced head and neck cancers. Anticancer Res 1996; 16:1005-10. [PMID: 8687091] [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: 02/01/2023]
Abstract
Predictive factors for toxicity and response to chemotherapy in patients with advanced head and neck cancer are seldom reported. Therefore, from a short series of patients with a histologically proven cancer, who were treated by a neo-adjuvant protocol with cisplatin and fluorouracil, routine clinical and laboratory data were investigated. ALT (alanine aminotransferase) and Hb (hemoglobin) appeared to be predictive for efficacy. By multivariate analysis (principal component analysis), these laboratory data were involved in two independent axes: one which was considered as "inflammatory" and the other as "hepatic". Initial obesity indices were associated with the former. The predictive variables for toxicity (i.e. age, serum creatinine level, weight loss and plasma cisplatin) were probably biased in this series. Nevertheless cisplatin concentration regularly increased in each cycle. Hence it was dependent on the rank of the course. According to this preliminary study, it would be of interest to conduct future investigations on acquired protein-energy malnutrition, as well as on selected soluble mediators of cellular and humoral immune response.
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Affiliation(s)
- C Himberlin
- Service de Médecine Interne Oncologique, Institut Jean-Godinot, Reims,France
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