1
|
Dubray-Vautrin A, Chappey C, Taouachi R, Ghanem W, Choussy O. Upper Aerodigestive Tract Endoscopy Combining Rigid Laryngoscopy and Flexible Endoscopy. Surg Innov 2024:15533506241238870. [PMID: 38448034 DOI: 10.1177/15533506241238870] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
Upper Aerodigestive Tract Endoscopy (UATE) is recommended for initial examination of head and neck squamous cell carcinomas. Reducing delay of initial examination must be a challenge to manage head and neck cancers. We hereby describe the technic combining UATE and flexible endoscopy in a unique general anesthesia with overview of hypopharyngeal, larygeal, tracheal, esophageal, nasopharyngeal sub sites in a unique procedure with system of magnificense and to perform percutaneous gastrostomy during the same time before initiation of therapy.
Collapse
Affiliation(s)
- Antoine Dubray-Vautrin
- Department of Oto-Rhino-Laryngology, Head & Neck Surgery, Institut Curie, Paris, France
- Departement of Oto-Rhino-Laryngology, Head & Neck Surgery, Institut Curie, Saint-Cloud, France
| | - Christian Chappey
- Departement of Oto-Rhino-Laryngology, Head & Neck Surgery, Institut Curie, Saint-Cloud, France
| | - Rabah Taouachi
- Departement of Oto-Rhino-Laryngology, Head & Neck Surgery, Institut Curie, Saint-Cloud, France
| | - Wahib Ghanem
- Department of Oto-Rhino-Laryngology, Head & Neck Surgery, Institut Curie, Paris, France
| | - Olivier Choussy
- Department of Oto-Rhino-Laryngology, Head & Neck Surgery, Institut Curie, Paris, France
- Departement of Oto-Rhino-Laryngology, Head & Neck Surgery, Institut Curie, Saint-Cloud, France
| |
Collapse
|
2
|
Klijanienko J, Masliah-Planchon J, Choussy O, Rougier G, Vautrin AD, Lesnik M, Badois N, Ghanem W, Klos J, Tourneau CL, Marret G, Barnhill R, El-Naggar AK. Is Primary Poorly Differentiated Sarcomatoid Malignancy of the Parotid Gland Sarcomatoid Undifferentiated/Dedifferentiated Melanoma ? Report of three unusual cases diagnosed by fine needle aspiration combined with histological, immunohistochemical and molecular analyses. Acta Cytol 2024:000538070. [PMID: 38437817 DOI: 10.1159/000538070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/26/2024] [Indexed: 03/06/2024]
Abstract
INTRODUCTION Poorly differentiated primary sarcomatoid parotid malignancies are extremely rare. These tumors have not been consistently studied by morphology, immunohistochemistry or molecular techniques. CASE PRESENTATION We report three unusual cases of parotid gland poorly-differentiated sarcomatoid malignancy investigated by fine needle aspiration and studied histologically, by immunohistochemistry and molecular investigations. Aspirates showed poorly specific polymorphous sarcomatoid malignancy in all cases. Histologically, all cases were polymorphous high-grade malignancies, additionally one case showed epithelial structures and was finally classified as salivary carcinosarcoma. Immunohistochemistry showed classical melanocytic markers negativity but positivity for PRAME, CD10, WT1 in all three tumors and for CD56 in two tumors, which can potentially be supportive of melanocytic origin. Although not entirely specific, molecular characterization also suggested the melanocytic lineage of these tumors. CONCLUSION Although rare, primary malignant melanoma of salivary gland was already described, but undifferentiated/dedifferentiated amelanotic forms are unknown in this localization up today. Further case reports of similar presentations are required to confirm the unequivocal primary origin of these obscure neoplasms in the parotid gland.
Collapse
|
3
|
Tawa P, Lesnik M, Hoffmann C, Dubray-Vautrin A, Ghanem W, Rougier G, Choussy O, Badois N. Safety and reliability of the internal jugular vein for venous anastomoses in head and neck oncological reconstruction: A retrospective study. J Craniomaxillofac Surg 2024; 52:170-174. [PMID: 38142170 DOI: 10.1016/j.jcms.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/06/2023] [Accepted: 10/05/2023] [Indexed: 12/25/2023] Open
Abstract
This study aimed to assess the efficacy of utilizing the internal jugular vein (IJV) as the primary recipient site for venous anastomoses in head and neck oncological reconstruction. Patients who underwent a free flap reconstruction of the head and neck were retrospectively included. Venous anastomoses were preferentially performed less than 1 cm from the IJV, either end-to-side (EtS) on the IJV, or end-to-end (EtE) on the origin of the thyrolingofacial venous (TLF) trunk. When the pedicle length was insufficient to reach the IJV, anastomoses were performed EtE to a size-matched cervical vein. Of the 246 venous anastomoses, 216 (87.8%) were performed less than 1 cm from the IJV, including 150 EtS on the IJV (61.0%), and 66 EtE on the TLF trunk (26.8%). Thirty veins (12.1%) were anastomosed EtE on other cervical veins more than 1 cm from the IJV. Two venous thromboses occurred (0.9%) and were successfully managed after revision surgery. There was no evidence of an increased thrombosis rate in high-risk or pre-irradiated patients. These findings suggest that the internal jugular vein is safe and reliable as a first-choice recipient vessel for free flap transfers in head and neck oncological reconstruction.
Collapse
Affiliation(s)
- Pierre Tawa
- Department of Head and Neck Surgical Oncology, PSL University, Institut Curie, Paris, France.
| | - Maria Lesnik
- Department of Head and Neck Surgical Oncology, PSL University, Institut Curie, Paris, France
| | - Caroline Hoffmann
- Department of Head and Neck Surgical Oncology, PSL University, Institut Curie, Paris, France
| | - Antoine Dubray-Vautrin
- Department of Head and Neck Surgical Oncology, PSL University, Institut Curie, Paris, France
| | - Wahib Ghanem
- Department of Head and Neck Surgical Oncology, PSL University, Institut Curie, Paris, France
| | - Guillaume Rougier
- Department of Head and Neck Surgical Oncology, PSL University, Institut Curie, Paris, France
| | - Olivier Choussy
- Department of Head and Neck Surgical Oncology, PSL University, Institut Curie, Paris, France
| | - Nathalie Badois
- Department of Head and Neck Surgical Oncology, PSL University, Institut Curie, Paris, France
| |
Collapse
|
4
|
Kowalewski A, Tissot H, Jehanno N, Bakuła Zalewska E, Choussy O, Lesnik M, Badois N, Rougier G, Klijanienko J. Fine needle aspiration as a diagnostic modality for Warthin tumors identified as fluorodeoxyglucose positron emission tomography/computed tomography-positive. Diagn Cytopathol 2024; 52:116-122. [PMID: 37991130 DOI: 10.1002/dc.25255] [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: 08/17/2023] [Revised: 09/27/2023] [Accepted: 11/08/2023] [Indexed: 11/23/2023]
Abstract
Limited evidence exists regarding the 2-deoxy-2-[fluorine-18]-fluoro-D-glucose (FDG) avidity of Warthin tumors, the second most common benign parotid gland tumor. This study aims to clarify this aspect by analyzing patients who underwent FDG positron emission tomography/computed tomography (PET/CT) and quantifying tumor standardized uptake values (SUV). Medical records of 29 patients with fine needle aspiration (FNA)-confirmed Warthin tumors who underwent FDG-PET/CT near the diagnosis of Warthin tumor were reviewed. Key parameters included cancer history, cytologic diagnosis of Warthin tumor, maximum SUV on FDG PET/CT, and tumor localization. Among the cohort, 18 males and 11 females (average age: 67.9 years) were included. Most patients had malignant neoplasms (lung, head and neck, breast, others). One patient had synchronous liver cancer. Three individuals had bilateral Warthin tumors, and three had bifocal tumors, resulting in 35 tumors for analysis. Tumors were located in the parotid gland (28) and vicinity (7). SUVmax for the Warthin tumors ranged from 3.6 to 26.8, with an average SUVmax of 10.1. Warthin tumors exhibit significant and variable FDG accumulation, exceeding expectations and mimicking high-grade malignancies. Awareness of this phenomenon is crucial for accurate staging and timely management. In cases of positive FDG PET/CT uptake in periparotid, perimandibular, and upper jugular areas, FNA is recommended to avoid misinterpretation or delays in management.
Collapse
Affiliation(s)
- Adam Kowalewski
- Department of Pathology, Institut Curie, Paris, France
- Department of Clinical Pathomorphology, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | - Hubert Tissot
- Department of Nuclear Medicine, Institut Curie, Paris, France
| | - Nina Jehanno
- Department of Nuclear Medicine, Institut Curie, Paris, France
| | - Elwira Bakuła Zalewska
- Department of Pathology, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Olivier Choussy
- Department of Head and Neck Surgery, Institut Curie, Paris, France
| | - Maria Lesnik
- Department of Head and Neck Surgery, Institut Curie, Paris, France
| | - Nathalie Badois
- Department of Head and Neck Surgery, Institut Curie, Paris, France
| | | | | |
Collapse
|
5
|
Dubray-Vautrin A, Ghanem W, Bozec L, Gonin J, Choussy O. Head and neck INI1-deficient carcinoma without primary: a case report. J Med Case Rep 2023; 17:479. [PMID: 37974295 PMCID: PMC10655450 DOI: 10.1186/s13256-023-04214-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/13/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND SMARCB1, also known as INI1, is a member of a large protein complex involved in chromatin remodeling and thus the regulation of gene expression. It is located on chromosome 22q11.2. SMARCB1 tumors have been found in various locations, including the sinonasal region, gastrointestinal tract, central nervous system (in atypical teratoid and rhabdoid tumors), and perirenal region (in malignant rhabdoid tumors) in both adults and children. CASE PRESENTATION We describe here the first case in the literature of an INI1-deficient neck carcinoma without a primary tumor managed with surgical therapy and neck dissection in a young Caucasian woman of 29 years old, followed by chemotherapy before radiotherapy, with regional control after 18 months of follow-up. Histologic analysis showed an undifferentiated carcinoma without glandular or epidermoid differentiation. Biomolecular analysis of the tumor revealed a homozygous deletion of the SMARCB1 gene on RNA sequencing. CONCLUSION Research of INI1 deletion should be performed for undifferentiated carcinoma of young patients because of possibilities of molecular therapies such as autophagy inhibitors or proteasome inhibitors could be used in clinical trials.
Collapse
Affiliation(s)
- Antoine Dubray-Vautrin
- Department of Oto-Rhino-Laryngology, Head & Neck Surgery, Institut Curie, 26 Rue D'Ulm, 75005, Paris, France.
| | - Wahib Ghanem
- Department of Oto-Rhino-Laryngology, Head & Neck Surgery, Institut Curie, 26 Rue D'Ulm, 75005, Paris, France
| | - Laurence Bozec
- Department of Oncology, Institut Curie, Saint Cloud, France
| | - Julie Gonin
- Departement of Pathology, Institut Curie, Saint-Cloud, France
| | - Olivier Choussy
- Department of Oto-Rhino-Laryngology, Head & Neck Surgery, Institut Curie, 26 Rue D'Ulm, 75005, Paris, France
| |
Collapse
|
6
|
Beddok A, Maynadier X, Krhili S, Ala Eddine C, Champion L, Chilles A, Goudjil F, Zefkili S, Amessis M, Choussy O, Le Tourneau C, Buvat I, Créhange G, Carton M, Calugaru V. Predictors of toxicity after curative reirradiation with intensity modulated radiotherapy or proton therapy for recurrent head and neck carcinoma: new dose constraints for pharyngeal constrictors muscles and oral cavity. Strahlenther Onkol 2023; 199:901-909. [PMID: 37256301 DOI: 10.1007/s00066-023-02080-y] [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: 12/16/2022] [Accepted: 03/26/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND Our study aims to identify predictive factors of moderate to severe (grade ≥ 2) late toxicity after reirradiation (reRT) of recurrent head and neck carcinoma (HNC) and explore the correlations between dose organs at risk (OAR) and grade ≥ 2 toxicity. MATERIAL AND METHODS Between 09/2007 and 09/2019, 55 patients were re-irradiated with IMRT or proton therapy with curative intent for advanced HNC. Our study included all patients for whom data from the first and second irradiations were available. Co-variables, including interval to reRT, size of re-irradiated PTV, and dose to OAR, were analyzed as potential predictors for developing moderate to severe long-term toxicity with death as a competing risk. Receiver-operator characteristics (ROC) analysis assessed the association between dose/volume parameters and the risk of toxicity. RESULTS Twenty-three patients participated in our study. After a median follow-up of 41 months, 65% of the patients experienced grade ≥ 2 late toxicity. The average dose to pharyngeal constrictor muscles (PCM) at the time of reRT showed an association with the risk of grade ≥ 2 dysphagia: AUC = 0.78 (95% CI: 0.53-1), optimal cut-off value = 36.7 Gy (sensitivity 62%/specificity 100%). The average dose to the oral cavity at the time of reRT showed an association with the risk of grade ≥ 2 dysgeusia: AUC = 0.96 (0.89-1), optimal cut-off value = 20.5 Gy (sensitivity 100%/specificity 88%). CONCLUSION Our analysis depicted an association between the dose to OAR and the risk of developing moderate to severe dysphagia and dysgeusia and proposed new dose constraints for PCM (36.7 Gy) and oral cavity (20.5 Gy).
Collapse
Affiliation(s)
- Arnaud Beddok
- Radiation Oncology Department, Institut Curie, PSL Research University, 25 rue d'Ulm, 75005, Paris/Orsay, France.
- Institut Curie, PSL Research University, University Paris Saclay, Inserm LITO, 91898, Orsay, France.
| | - Xavier Maynadier
- Biometry Unit, Institut Curie, PSL Research University, Paris, France
| | - Samar Krhili
- Radiation Oncology Department, Institut Curie, PSL Research University, 25 rue d'Ulm, 75005, Paris/Orsay, France
| | | | - Laurence Champion
- Institut Curie, PSL Research University, University Paris Saclay, Inserm LITO, 91898, Orsay, France
- Department of Nuclear Medicine, Institut Curie, Saint-Cloud, France
| | - Anne Chilles
- Radiation Oncology Department, Institut Curie, PSL Research University, 25 rue d'Ulm, 75005, Paris/Orsay, France
| | - Farid Goudjil
- Radiation Oncology Department, Institut Curie, PSL Research University, 25 rue d'Ulm, 75005, Paris/Orsay, France
| | - Sofia Zefkili
- Radiation Oncology Department, Institut Curie, PSL Research University, 25 rue d'Ulm, 75005, Paris/Orsay, France
| | - Malika Amessis
- Radiation Oncology Department, Institut Curie, PSL Research University, 25 rue d'Ulm, 75005, Paris/Orsay, France
| | - Olivier Choussy
- Department of Head and Neck Surgery, Institut Curie, Paris, France
| | - Christophe Le Tourneau
- Department of Drug Development and Innovation (D3i), INSERM U900 Research unit, Paris-Saclay University, Institut Curie, Paris, France
| | - Irene Buvat
- Institut Curie, PSL Research University, University Paris Saclay, Inserm LITO, 91898, Orsay, France
| | - Gilles Créhange
- Radiation Oncology Department, Institut Curie, PSL Research University, 25 rue d'Ulm, 75005, Paris/Orsay, France
- Institut Curie, PSL Research University, University Paris Saclay, Inserm LITO, 91898, Orsay, France
| | - Matthieu Carton
- Biometry Unit, Institut Curie, PSL Research University, Paris, France
| | - Valentin Calugaru
- Radiation Oncology Department, Institut Curie, PSL Research University, 25 rue d'Ulm, 75005, Paris/Orsay, France
| |
Collapse
|
7
|
Mahé M, Beddok A, Goudjil F, Ala Eddine C, Bolle S, Champion L, Feuvret L, Herman P, Zefkili S, Choussy O, Le Tourneau C, Dendale R, Buvat I, Sauvaget E, Créhange G, Calugaru V. Curative high-dose reirradiation for patients with recurrent head and neck adenoid cystic carcinomas: outcomes and analysis of patterns of failure. Int J Radiat Biol 2023; 100:79-86. [PMID: 37526368 DOI: 10.1080/09553002.2023.2242934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 07/19/2023] [Accepted: 07/25/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND To investigate the outcomes of patients who underwent curative reirradiation (reRT), with intensity-modulated radiation therapy (IMRT) or proton therapy (PT) for unresectable recurrent or second primary head and neck adenoid cystic carcinoma (HNACC). METHODS Ten patients, mostly KPS 90%, were reirradiated (3/10 with IMRT and 7/10 with PT) at a median maximum dose to the CTV of 64.2 Gy from July 2011 to November 2021. Locations at the time of reRT were mainly the sinus (4/10) and the salivary glands (including the parotid and submandibular gland, 3/10). CTCAEv5 was used to assess acute and late toxicities. Follow-up was the time between the end of reRT and the date of last news. RESULTS The median time between the two irradiations was 53.5 months (IQR: 18-84). After a median follow-up of 26 months (range, 12.5-51.8 months), six patients had developed a locoregional recurrence (LR), of which four occurred within the previously irradiated volume. Two and three-year locoregional failure-free survival (LFFS) and overall survival (OS) were 55.6% [95%CI: 31-99.7%], and 41% [18.5-94%] and 66.7% [42-100%] and 44.4% [21.4-92.3%], respectively. LFFS and OS were significantly better in the subgroup of sinus tumors (p = .013) and the subgroup of patients re-irradiated more than two years after the first course of irradiation (p = .01). Seven patients had impairments before the start of reRT, including hearing impairment (3/10) and facial nerve impairment (3/10). The most severe late toxicities were brain necrosis (2/10), osteoradionecrosis (1/10) and vision decreased (1/10). CONCLUSION Curative reRT for HNACC is possible for selected cases, but the LR rate in the irradiated field and the risk of severe toxicity remain high. Improved selection criteria and more carefully defined target volumes may improve outcome in these patients. A further study including larger cohort of patients would be useful to confirm these results.
Collapse
Affiliation(s)
- Mathilde Mahé
- Radiation Oncology Department. Paris/Saint-Cloud/Orsay, Institut Curie. PSL Research University, Paris, France
| | - Arnaud Beddok
- Radiation Oncology Department. Paris/Saint-Cloud/Orsay, Institut Curie. PSL Research University, Paris, France
- Institut Curie. PSL Research University. University Paris Saclay. Inserm LITO U1288 Orsay, Paris, France
| | - Farid Goudjil
- Radiation Oncology Department. Paris/Saint-Cloud/Orsay, Institut Curie. PSL Research University, Paris, France
| | | | - Stéphanie Bolle
- Department of Radiation Oncology, Gustave Roussy Campus, Villejuif, France
| | | | - Loïc Feuvret
- Department of Radiation Therapy, East Group Hospital. Hospices Civils de Lyon, Lyon, France
| | - Philippe Herman
- Department of Head and Neck Surgery, Lariboisière Hospital. APHP. Nord. Université Paris Cité, Paris, France
| | - Sofia Zefkili
- Radiation Oncology Department. Paris/Saint-Cloud/Orsay, Institut Curie. PSL Research University, Paris, France
| | - Olivier Choussy
- Department of Head and Neck Surgery. Institut Curie, Paris/Saint-Cloud, France
| | - Christophe Le Tourneau
- Department of Drug Development and Innovation (D3i), INSERM U900 Research unit. Paris-Saclay University. Institut Curie, Paris, France
| | - Remi Dendale
- Radiation Oncology Department. Paris/Saint-Cloud/Orsay, Institut Curie. PSL Research University, Paris, France
| | - Irene Buvat
- Institut Curie. PSL Research University. University Paris Saclay. Inserm LITO U1288 Orsay, Paris, France
| | - Elisabeth Sauvaget
- Department of Head and Neck Surgery, Saint-Joseph Hospital, Paris, France
| | - Gilles Créhange
- Radiation Oncology Department. Paris/Saint-Cloud/Orsay, Institut Curie. PSL Research University, Paris, France
| | - Valentin Calugaru
- Radiation Oncology Department. Paris/Saint-Cloud/Orsay, Institut Curie. PSL Research University, Paris, France
| |
Collapse
|
8
|
Mavrikios A, Goudjil F, Beddok A, Zefkili S, Bolle S, Feuvret L, Le Tourneau C, Choussy O, Sauvaget E, Herman P, Dendale R, Calugaru V. Proton therapy and/or helical tomotherapy for locally advanced sinonasal skull base adenoid cystic carcinoma: Focus on experience of the Institut Curie and review of literature. Head Neck 2023. [PMID: 37097003 DOI: 10.1002/hed.27371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 03/20/2023] [Accepted: 04/04/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Sinonasal adenoid cystic carcinomas (SNACC) have high propensity for skull base (SB) infiltration. Unresectability or incomplete surgical resection in such cases make radiotherapy treatment paramount. Curative dose escalation is challenging because of adjacent organs at risk, especially in locally advanced cases. METHODS Eighteen patients that had locally advanced SB SNACC with unresectable or incomplete surgical resection treated by proton therapy and/or helical tomotherapy at Institut Curie between 3/2010 and 8/2020 were retrospectively included. RESULTS After median follow-up of 52 months, 5-year OS, LRRFS, DMFS, DFS rates were, respectively, 47% (95%CI: 26-83), 50% (95%CI: 36-88), 39% (95%CI: 26-81), 33% (95%CI: 22-73). One patient had grade 4 late optic nerve disorder. Eight patients had grade 3 late toxicity including mainly hearing impairments. CONCLUSION Proton therapy and helical tomotherapy are effective and safe methods for curative dose escalation of locally advanced SB SNACC, which are a poor prognosis subgroup. Available literature suggests carbon-ion therapy could be an efficient alternative.
Collapse
Affiliation(s)
| | - Farid Goudjil
- Proton Therapy Center, Institut Curie, Orsay, France
| | - Arnaud Beddok
- Proton Therapy Center, Institut Curie, Orsay, France
| | - Sofia Zefkili
- Department of Radiation Oncology, Institut Curie, Paris, France
| | - Stéphanie Bolle
- Proton Therapy Center, Institut Curie, Orsay, France
- Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France
| | - Loic Feuvret
- Department of Radiation Oncology, East Group Hospital, Wertheimer Hospital, Hospices Civils de Lyon, Bron, France
| | - Christophe Le Tourneau
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris, France
- INSERM U900 Research Unit, Institut Curie, Saint-Cloud, France
- Paris-Saclay University, Paris, France
| | - Olivier Choussy
- Department of Head and Neck Surgery, Institut Curie, Paris, France
| | - Elisabeth Sauvaget
- Department of Head and Neck Surgery, Hôpital Saint-Joseph, Paris, France
| | - Philippe Herman
- Department of Head and Neck Surgery, Hôpital Lariboisière, Paris, France
| | - Rémi Dendale
- Proton Therapy Center, Institut Curie, Orsay, France
| | - Valentin Calugaru
- Department of Radiation Oncology, Institut Curie, Paris, France
- Proton Therapy Center, Institut Curie, Orsay, France
| |
Collapse
|
9
|
Chartier J, Beddok A, Cao KI, Feuvret L, Herman P, Bolle S, Goudjil F, Sauvaget E, Choussy O, Dendale R, Calugaru V. Protontherapy to maintain local control of head and neck paragangliomas. Acta Oncol 2023; 62:400-403. [PMID: 37074028 DOI: 10.1080/0284186x.2023.2201686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Affiliation(s)
- Julie Chartier
- Department of Radiation-Oncology, Proton Therapy Center of Orsay (CPO), Institut Curie, Orsay, France
- Department of Radiation-Oncology, Institut Curie, Paris, France
| | - Arnaud Beddok
- Department of Radiation-Oncology, Proton Therapy Center of Orsay (CPO), Institut Curie, Orsay, France
- Department of Radiation-Oncology, Institut Curie, Paris, France
| | - Kim I Cao
- Department of Radiation-Oncology, Proton Therapy Center of Orsay (CPO), Institut Curie, Orsay, France
- Department of Radiation-Oncology, Institut Curie, Paris, France
| | - Loïc Feuvret
- Department of Radiation-Oncology, Proton Therapy Center of Orsay (CPO), Institut Curie, Orsay, France
- Department of Radiotherapy, Pitie-Salpetriere University Hospital (APHP), Paris, France
| | - Philippe Herman
- Department of Head and Neck Surgery, Lariboisiere Hospital, Paris, France
| | - Stéphanie Bolle
- Department of Radiation-Oncology, Proton Therapy Center of Orsay (CPO), Institut Curie, Orsay, France
- Department of Radiation-Oncology, Gustave-Roussy Cancer Campus, Villejuif, France
| | - Farid Goudjil
- Department of Radiation-Oncology, Proton Therapy Center of Orsay (CPO), Institut Curie, Orsay, France
| | | | | | - Rémi Dendale
- Department of Radiation-Oncology, Proton Therapy Center of Orsay (CPO), Institut Curie, Orsay, France
- Department of Radiation-Oncology, Institut Curie, Paris, France
| | - Valentin Calugaru
- Department of Radiation-Oncology, Proton Therapy Center of Orsay (CPO), Institut Curie, Orsay, France
- Department of Radiation-Oncology, Institut Curie, Paris, France
| |
Collapse
|
10
|
Marret G, Lamy C, Vacher S, Séné M, Ahmanache L, Courtois L, Beiano ZE, Klijanienko J, Martinat C, Servant N, Kamoun C, Chérif LL, Bronzini T, Balsat C, Laes JF, Prévot A, Sauvage S, Lienard M, Martin E, Genin B, Badois N, Lesnik M, Dubray-Vautrin A, Choussy O, Ghanem W, Taouachi R, Planchon JM, Bièche I, Kamal M, Tourneau CL. Abstract 3363: Spatial and longitudinal tumor heterogeneity in head and neck squamous cell carcinoma patients treated with primary surgery. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-3363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Abstract
Introduction: Cell-free tumor DNA (ctDNA) is an emerging biomarker in head and neck squamous cell carcinoma (HNSCC) for disease staging, patients’ recurrence risk stratification and early detection of relapse. We aimed to compare variants identified in ctDNA versus surgical tumor specimen, and to study the evolution of the mutational landscape of ctDNA over time in HNSCC.
Patients and Method: Forty-one HNSCC patients treated with curative-intent primary surgery from SCANDARE cohort (NCT03017573) were evaluated for longitudinal ctDNA-based NGS. Overall, 28 patients were treated with adjuvant (chemo)radiotherapy, and 31 experienced recurrence. Formalin-fixed paraffin-embedded tumor tissues at surgery were available for 41 patients. Serial contributive ctDNA were retrieved from all 41 patients at the date of surgery, 36 patients within 19 weeks after surgery, 20 patients at six months after surgery, and 22 patients at recurrence. Tissue DNA was personalized detected with a custom NGS panel of 571 genes (DRAGON) and ctDNA was sequenced using another personalized dedicated NGS panel including up to 15 genes (OncoFOLLOW).
Results: Most frequently mutated genes in tissue included TP53 (15.9%), FAT1 (6.7%), NOTCH1 (5.5%) and PIK3CA (4.3%) with similar allelic ratio to ctDNA at baseline surgery. Higher prevalence of KRAS and TP53 mutations was found in ctDNA at recurrence in comparison with ctDNA and tissue, respectively, at baseline surgery (KRAS: 6.3% versus 1.6% and 0.6%; TP53: 31.2% versus 21.1% and 15.9%). Additional variants in NRAS, HRAS, TP53, JAK2 and SDHA were detected in 6 patients in ctDNA at surgery and were not found in tissue, suggesting spatial intratumor heterogeneity. Twenty-three/36 patients (64%) had detected ctDNA within 19 weeks after surgery among whom, 17/23 patients (74%) had disease recurrence. Eleven/20 patients (including 10 with adjuvant treatment) had detected ctDNA at six months after surgery among whom 6 patients (55%) had disease recurrence. Fifteen/22 patients (68%) had detected ctDNA at recurrence. Emerging pathogenic variants were found in patients with detected ctDNA after surgery (n=7/23; 30%), at six months after surgery (n=1/11; 9%) and at recurrence (n=4/15; 27%).
Conclusion: Our study suggests spatial and longitudinal tumor heterogeneity and reports emerging mutations in ctDNA over time in HNSCC. Prognostic significance characterization of the ctDNA dominant clone allele frequency is ongoing.
Citation Format: Grégoire Marret, Constance Lamy, Sophie Vacher, Mathieu Séné, Ladidi Ahmanache, Laura Courtois, Zakhia El Beiano, Jerzy Klijanienko, Charlotte Martinat, Nicolas Servant, Choumouss Kamoun, Linda Larbi Chérif, Thierry Bronzini, Cédric Balsat, Jean-François Laes, Aubray Prévot, Sébastien Sauvage, Maxime Lienard, Emmanuel Martin, Bérengère Genin, Nathalie Badois, Maria Lesnik, Antoine Dubray-Vautrin, Olivier Choussy, Wahib Ghanem, Rabah Taouachi, Julien Masliah Planchon, Ivan Bièche, Maud Kamal, Christophe Le Tourneau. Spatial and longitudinal tumor heterogeneity in head and neck squamous cell carcinoma patients treated with primary surgery [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 3363.
Collapse
|
11
|
Beddok A, Saint‐Martin C, Krhili S, Eddine CA, Champion L, Chilles A, Goudjil F, Zefkili S, Amessis M, Peurien D, Choussy O, le Tourneau C, Dendale R, Buvat I, Créhange G, Calugaru V. Curative high‐dose reirradiation for patients with recurrent head and neck squamous cell carcinoma using IMRT or proton therapy: Outcomes and analysis of patterns of failure. Head Neck 2022; 44:2452-2464. [DOI: 10.1002/hed.27153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 06/27/2022] [Accepted: 07/07/2022] [Indexed: 12/23/2022] Open
Affiliation(s)
- Arnaud Beddok
- PSL Research University, Radiation Oncology Department Institut Curie Paris/Orsay France
- PSL Research University, University Paris Saclay, Inserm LITO U1288 Institut Curie Orsay France
| | | | - Samar Krhili
- PSL Research University, Radiation Oncology Department Institut Curie Paris/Orsay France
| | | | | | - Anne Chilles
- PSL Research University, Radiation Oncology Department Institut Curie Paris/Orsay France
| | - Farid Goudjil
- PSL Research University, Radiation Oncology Department Institut Curie Paris/Orsay France
| | - Sofia Zefkili
- PSL Research University, Radiation Oncology Department Institut Curie Paris/Orsay France
| | - Malika Amessis
- PSL Research University, Radiation Oncology Department Institut Curie Paris/Orsay France
| | - Dominique Peurien
- PSL Research University, Radiation Oncology Department Institut Curie Paris/Orsay France
| | - Olivier Choussy
- Department of Head and Neck Surgery Institut Curie Paris France
| | - Christophe le Tourneau
- Department of Drug Development and Innovation (D3i), INSERM U900 Research unit Paris‐Saclay University. Institut Curie Paris France
| | - Remi Dendale
- PSL Research University, Radiation Oncology Department Institut Curie Paris/Orsay France
| | - Irene Buvat
- PSL Research University, University Paris Saclay, Inserm LITO U1288 Institut Curie Orsay France
| | - Gilles Créhange
- PSL Research University, Radiation Oncology Department Institut Curie Paris/Orsay France
| | - Valentin Calugaru
- PSL Research University, Radiation Oncology Department Institut Curie Paris/Orsay France
| |
Collapse
|
12
|
Choussy O, Choussy O, Viault N, Ghanem W, Dubray Vautrin A, Lamer C. A New Device for Managing Refractory Epistaxis in ICU Patients with COVID-19. Surg Case Rep 2021. [DOI: 10.31487/j.scr.2021.09.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Epistaxis is a common and a well-known symptom. Nasal packing is an effective treatment in most cases [1]. The COVID-19 disease treatment includes conventional or high flow nasal oxygen therapy and systemic anticoagulation [2]. Patients in intensive care unit may require therapeutic anticoagulation for venous thromboembolism, hyperinflammatory status, extracorporeal membrane oxygenation (ECMO) and multiple other pathologies. The use of therapeutic anticoagulation increases risk of nose bleeding, and its management may be challenging. CAVI-T (Figures 1 & 2) is a new asymmetrical low-pressure balloon that have shown promising results to control epistaxis in emergency. We report herein the management of severe epistaxis in two COVID-19 patients admitted to ICU for severe respiratory failure.
Collapse
|
13
|
Le Tourneau C, Calugaru V, Takacsi-Nagy Z, Liem X, Papai Z, Moreno V, Braña I, Salas S, Poissonnet G, Calvo E, Doger B, Choussy O, Mirabel X, Krhili S, Bernois K, Fakhry N, Wong Hee Kam S, Borcoman E, Hoffmann C. OC-0515 NBTXR3 activated by radiotherapy in cisplatin-ineligible locally advanced HNSCC patients. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06941-3] [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: 11/25/2022]
|
14
|
Moreira A, Poulet A, Masliah-Planchon J, Lecerf C, Vacher S, Larbi Chérif L, Dupain C, Marret G, Girard E, Syx L, Hoffmann C, Jeannot E, Klijanienko J, Guillou I, Mariani O, Dubray-Vautrin A, Badois N, Lesnik M, Choussy O, Calugaru V, Borcoman E, Baulande S, Legoix P, Albaud B, Servant N, Bieche I, Le Tourneau C, Kamal M. Prognostic value of tumor mutational burden in patients with oral cavity squamous cell carcinoma treated with upfront surgery. ESMO Open 2021; 6:100178. [PMID: 34118772 PMCID: PMC8207209 DOI: 10.1016/j.esmoop.2021.100178] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 04/19/2021] [Accepted: 05/17/2021] [Indexed: 12/25/2022] Open
Abstract
Background Oral cavity is the most prevalent site of head and neck squamous cell carcinomas (HNSCCs). Most often diagnosed at a locally advanced stage, treatment is multimodal with surgery as the cornerstone. The aim of this study was to explore the molecular landscape of a homogenous cohort of oral cavity squamous cell carcinomas (OCSCCs), and to assess the prognostic value of tumor mutational burden (TMB), along with classical molecular and clinical parameters. Patients and methods One hundred and fifty-one consecutive patients with OCSCC treated with upfront surgery at the Institut Curie were analyzed. Sequencing of tumor DNA from frozen specimens was carried out using an in-house targeted next-generation sequencing panel (571 genes). The impact of molecular alterations and TMB on disease-free survival (DFS) and overall survival (OS) was evaluated in univariate and multivariate analyses. Results Pathological tumor stage, extranodal spread, vascular emboli, and perineural invasion were associated with both DFS and OS. TP53 was the most mutated gene (71%). Other frequent molecular alterations included the TERT promoter (50%), CDKN2A (25%), FAT1 (17%), PIK3CA (14%), and NOTCH1 (15%) genes. Transforming growth factor-β pathway alterations (4%) were associated with poor OS (P = 0.01) and DFS (P = 0.02) in univariate and multivariate analyses. High TMB was associated with prolonged OS (P = 0.01 and P = 0.02, in the highest 10% and 20% TMB values, respectively), but not with DFS. Correlation of TMB with OS remained significant in multivariate analysis (P = 0.01 and P = 0.005 in the highest 10% and 20% TMB values, respectively). Pathological tumor stage combined with high TMB was associated with good prognosis. Conclusion Our results suggest that a high TMB is associated with a favorable prognosis in patients with OCSCC treated with upfront surgery. High TMB is associated with a favorable prognosis in patients with OCSCC treated with upfront surgery Pathological tumor stage combined with high TMB is associated with good prognosis TP53 was the most mutated gene (71%). Other frequent molecular alterations included the TERT promoter (50%) TGFβ pathway alterations were associated with poor outcomes, although it was only observed in 4% of the patients
Collapse
Affiliation(s)
- A Moreira
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris and Saint-Cloud, France
| | - A Poulet
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris and Saint-Cloud, France
| | - J Masliah-Planchon
- Department of Genetics, Institut Curie, PSL Research University, Paris, France
| | - C Lecerf
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris and Saint-Cloud, France
| | - S Vacher
- Department of Genetics, Institut Curie, PSL Research University, Paris, France
| | - L Larbi Chérif
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris and Saint-Cloud, France
| | - C Dupain
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris and Saint-Cloud, France
| | - G Marret
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris and Saint-Cloud, France
| | - E Girard
- INSERM U900 Research Unit, Institut Curie, Paris and Saint-Cloud, France
| | - L Syx
- INSERM U900 Research Unit, Institut Curie, Paris and Saint-Cloud, France
| | - C Hoffmann
- INSERM U932 Research Unit, Institut Curie, PSL Research University, Paris, France; Department of Oncologic Surgery, Institut Curie, PSL Research University, Paris, France
| | - E Jeannot
- Department of Genetics, Institut Curie, PSL Research University, Paris, France; Department of Pathology, Institut Curie, PSL Research University, Paris, France
| | - J Klijanienko
- Department of Pathology, Institut Curie, PSL Research University, Paris, France
| | - I Guillou
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris and Saint-Cloud, France
| | - O Mariani
- Department of Pathology, Institut Curie, PSL Research University, Paris, France
| | - A Dubray-Vautrin
- Department of Oncologic Surgery, Institut Curie, PSL Research University, Paris, France
| | - N Badois
- Department of Oncologic Surgery, Institut Curie, PSL Research University, Paris, France
| | - M Lesnik
- Department of Oncologic Surgery, Institut Curie, PSL Research University, Paris, France
| | - O Choussy
- Department of Oncologic Surgery, Institut Curie, PSL Research University, Paris, France
| | - V Calugaru
- Department of Oncologic Radiotherapy, Institut Curie, PSL Research University, Paris, France
| | - E Borcoman
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris and Saint-Cloud, France
| | - S Baulande
- Institut Curie Genomics of Excellence (ICGex) Platform, PSL Research University, Paris, France
| | - P Legoix
- Institut Curie Genomics of Excellence (ICGex) Platform, PSL Research University, Paris, France
| | - B Albaud
- Institut Curie Genomics of Excellence (ICGex) Platform, PSL Research University, Paris, France
| | - N Servant
- INSERM U900 Research Unit, Institut Curie, Paris and Saint-Cloud, France
| | - I Bieche
- Department of Genetics, Institut Curie, PSL Research University, Paris, France; INSERM U1016, Paris Descartes University, Faculty of Pharmaceutical and Biological Sciences, Paris, France
| | - C Le Tourneau
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris and Saint-Cloud, France; INSERM U900 Research Unit, Institut Curie, Paris and Saint-Cloud, France; Paris-Saclay University, Paris, France
| | - M Kamal
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris and Saint-Cloud, France.
| |
Collapse
|
15
|
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
|
16
|
Le Tourneau C, Calugaru V, Takacsi-Nagy Z, Liem X, Papai Z, Fijuth J, Moreno V, Giralt J, Salas S, Poissonnet G, Calvo E, Doger B, Choussy O, Mirabel X, Krhili S, Bernois K, Fakhry N, Wong-Hee-Kam S, Borcoman E, Hoffmann C. Phase I study of functionalized hafnium oxide nanoparticles (NBTXR3) activated by radiotherapy in cisplatin-ineligible locally advanced HNSCC patients. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.6051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6051 Background: The non-surgical standard of care (SOC) for the treatment of locally advanced head and neck squamous cell carcinoma (LA HNSCC) patients is concurrent chemoradiation with high dose cisplatin or cetuximab in case of contra-indication to cisplatin. However elderly patients, and those with poor performance status, comorbidities, and/or intolerance, may not benefit from these SOC treatments and represent a high unmet need. New approaches are thus needed to improve clinical outcomes without adding toxicity. NBTXR3, a novel radioenhancer, composed of functionalized hafnium oxide nanoparticles, is injected once intratumorally and activated by radiotherapy (RT).NBTXR3 increases the RT energy deposit inside tumor cells and subsequently increases tumor cell death compared to RT alone, while sparing healthy tissues. We present here the results of the dose expansion part of the phase I study evaluating NBTXR3 plus intensity modulated radiation therapy (IMRT) in this population. Methods: Patients with stage III-IVA or T3/T4 (AJCC/UICC TNM staging system 8th ed.) HNSCC of the oropharynx or oral cavity, ineligible to cisplatin or cetuximab and amenable for RT, received a single intratumoral injection of NBTXR3 and IMRT (70 Gy in 35 fractions /7 weeks). A classical 3 + 3 dose escalation design has tested four doses of NBTXR3, equivalent to 5, 10, 15, and 22% of baseline theoretical tumor volume. The RP2D established as 22% of baseline tumor volume is further tested in the dose expansion part. The primary endpoints of the dose expansion part are objective response rate (ORR) and complete response rate (CRR) of the primary tumor, by imaging according to RECIST 1.1. Safety is also evaluated. Results: As of August 13, 2020, 43 patients have been treated in the phase I dose expansion part. The median age was 70.7 years old (range: 50.7- 89.9), 70% of patients had cardiac disorder risk, 44% had gastrointestinal disorder risk and 44% metabolic and nutrition disorder risk. The median tumor volume was 42.8 mL (range: 1.3 - 222.3). At a median time of 7.8 months after NBTXR3 injection, the ORR of the primary lesion was 83.9% and the CRR 67.7% in the evaluable population for efficacy (N = 31). Three patients (7%) experienced at least one serious adverse event (AE) related to the injection procedure and/or NBTXR3 which represented less than 1% of all reported AEs. RT-related toxicity was as expected with IMRT. Three deaths due to AEs related to RT and other causes were reported. The recruitment is ongoing and updated efficacy and safety results will be presented. Conclusions: NBTXR3 intratumoral administration followed by IMRT may represent an option in elderly patients or patients with multiple comorbidities with LA-HNSCC who have limited therapeutic options. NBTXR3 activated by RT showed promising anti-tumor efficacy, supporting further evaluation in a phase III randomized trial. Clinical trial information: NCT01946867.
Collapse
Affiliation(s)
| | | | | | | | - Zsuzsanna Papai
- State Health Center, Hungarian Defense Forces, Oncology Department, Budapest, Hungary
| | | | - Victor Moreno
- START Madrid-FJD, Fundación Jiménez Díaz Hospital, Madrid, Spain
| | - Jordi Giralt
- Vall d'Hebron University Hospital, Barcelona, Spain
| | - Sébastien Salas
- CEPCM Assistance Publique des Hôpitaux de Marseille, Aix-Marseille Université, Marseille, France
| | | | | | - Bernard Doger
- Hospital Universitario Fundacion Jimenez Diaz - START Madrid, Madrid, Spain
| | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Garrel R, Poissonnet G, Moyà Plana A, Fakhry N, Dolivet G, Lallemant B, Sarini J, Vergez S, Guelfucci B, Choussy O, Bastit V, Richard F, Costes V, Landais P, Perriard F, Daures JP, de Verbizier D, Favier V, de Boutray M. Equivalence Randomized Trial to Compare Treatment on the Basis of Sentinel Node Biopsy Versus Neck Node Dissection in Operable T1-T2N0 Oral and Oropharyngeal Cancer. J Clin Oncol 2020; 38:4010-4018. [PMID: 33052754 DOI: 10.1200/jco.20.01661] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
PURPOSE Sentinel node (SN) biopsy is accurate in operable oral and oropharyngeal cT1-T2N0 cancer (OC), but, to our knowledge, the oncologic equivalence of SN biopsy and neck lymph node dissection (ND; standard treatment) has never been evaluated. METHODS In this phase III multicenter trial, 307 patients with OC were randomly assigned to (1) the ND arm or (2) the SN arm (experimental arm: biopsy alone if negative, or followed by ND if positive, during primary tumor surgery). The primary outcome was neck node recurrence-free survival (RFS) at 2 years. Secondary outcomes were 5-year neck node RFS, 2- and 5-year disease-specific survival (DSS), and overall survival (OS). Other outcomes were hospital stay length, neck and shoulder morbidity, and number of physiotherapy prescriptions during the 2 years after surgery. RESULTS Data on 279 patients (139 ND and 140 SN) could be analyzed. Neck node RFS was 89.6% (95% CI, 0.83% to 0.94%) at 2 years in the ND arm and 90.7% (95% CI, 0.84% to 0.95%) in the SN arm, confirming the equivalence with P < .01. The 5-year RFS and the 2- and 5-year DSS and OS were not significantly different between arms. The median hospital stay length was 8 days in the ND arm and 7 days in the SN arm (P < .01). The functional outcomes were significantly worse in the ND arm until 6 months after surgery. CONCLUSION This study demonstrated the oncologic equivalence of the SN and ND approaches, with lower morbidity in the SN arm during the first 6 months after surgery, thus establishing SN as the standard of care in OC.
Collapse
Affiliation(s)
- Renaud Garrel
- Head Neck Surgery Department, Montpellier University Hospital Center, Montpellier, France
| | - Gilles Poissonnet
- Head Neck Surgery Department, Antoine Lacassagne Center, Nice, France
| | - Antoine Moyà Plana
- Head Neck Surgery Department, Institut Gustave Roussy, Villejuif, France
| | - Nicolas Fakhry
- Head Neck Surgery Department, Marseille University Hospital Center, Marseille, France
| | - Gilles Dolivet
- Head Neck Surgery Department, Alexis Vautrin Center, Vandœuvre-lès-Nancy, France
| | - Benjamin Lallemant
- Head Neck Surgery Department, Nîmes University Hospital Center, Nîmes, France
| | - Jérôme Sarini
- Head Neck Surgery Department, Toulouse Oncopole, Toulouse, France
| | - Sebastien Vergez
- Head Neck Surgery Department, Toulouse Oncopole, Toulouse, France
| | - Bruno Guelfucci
- Head Neck Surgery Department, Toulon Hospital Center, Toulon, France
| | - Olivier Choussy
- Head Neck Surgery Department, Curie Institute, Paris, France
| | - Vianney Bastit
- Head Neck Surgery Department, François Baclesse Center, Caen, France
| | - Fanny Richard
- Head Neck Surgery Department, Montpellier University Hospital Center, Montpellier, France
| | - Valérie Costes
- Pathology Department, Montpellier University Hospital Center, Montpellier, France
| | - Paul Landais
- Clinical Research University Institute, UPRES EA 2415, Montpellier, France
| | - Françoise Perriard
- Clinical Research University Institute, UPRES EA 2415, Montpellier, France
| | - Jean Pierre Daures
- Clinical Research University Institute, UPRES EA 2415, Montpellier, France
| | - Delphine de Verbizier
- Nuclear Medicine Department, Montpellier University Hospital Center, Montpellier, France
| | - Valentin Favier
- Head Neck Surgery Department, Montpellier University Hospital Center, Montpellier, France
| | - Marie de Boutray
- Head Neck Surgery Department, Montpellier University Hospital Center, Montpellier, France
| |
Collapse
|
18
|
Le Tourneau C, Calugaru V, Borcoman E, Moreno V, Calvo E, Liem X, Salas S, Doger B, Choussy O, Lesnik M, Mirabel X, Badois N, Krhili S, Blomkvist J, Fakhry N, Wong-Hee-Kam S, Hoffmann C. Phase I trial of hafnium oxide nanoparticles activated by radiotherapy in cisplatin-ineligible locally advanced HNSCC patients. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.6573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
6573 Background: The standard of care non-surgical approach for locally advanced head and neck squamous cell carcinoma (LA HNSCC) patients (pts) is concurrent chemoradiation with high dose cisplatin or cetuximab in case of contra-indication. Older age is a contra-indication to cisplatin, and cetuximab might not improve survival in older pts. It is therefore urgently needed to develop new treatment options for elderly pts with LA HNSCC. NBTXR3 are hafnium oxide nanoparticles that can enhance the efficacy of radiotherapy (RT) by increasing locally the deposited dose. In this phase I clinical trial we aimed to evaluate the feasibility and safety of NBTXR3 administered as intratumoral (IT) injection prior to RT in LA HNSCC elderly pts. Methods: Pts with stage III-IV LA HNSCC of the oropharynx or oral cavity ineligible for platinum-based chemoradiation received a single IT injection of NBTXR3 into a selected primary tumor and intensity modulated RT (IMRT; 70 Gy/35 fractions/7 weeks) [NCT01946867]. A 3+3 dose escalation design, tested NBTXR3 dose levels equivalent to 5, 10, 15, and 22% of baseline tumor volume, followed by a dose expansion at the Recommended Phase II Dose (RP2D). Primary endpoints included RP2D determination, and early dose limiting toxicities (DLT). NBTXR3 intratumoral bioavailability and anti-tumor activity (RECIST 1.1) were also evaluated. Results: Enrollment was completed at all dose escalation levels: 5% (3 pts), 10% (3 pts), 15% (5 pts), and 22% (8 pts). No early DLT or SAE related to NBTXR3 or injection were observed. The median follow-up from NBTXR3 administration is 7.6 months. One AE (Grade 1) related to NBTXR3 and four AEs (Grade 1-2) related to the injection were observed. RT-related toxicity was as expected with IMRT. CT-scan assessment showed a good dispersion of NBTXR3 throughout the injected tumor and not in surrounding healthy tissues. The RP2D was determined to be 22%. Preliminary efficacy was evaluated in pts who received the intended dose of NBTXR3 and RT. A complete response of the injected lesion was observed in 9/13 (69%) evaluable pts at doses ≥10% (2 unconfirmed) and an overall complete response in 5/13 (38%) evaluable pts at doses ≥10%. Preliminary safety and efficacy data of the dose expansion cohort at the RP2D will also be presented. Conclusions: NBTXR3 activated by RT was well tolerated at all tested doses and demonstrated promising preliminary anti-tumor activity. Recruitment is ongoing in the dose expansion cohort. These results demonstrate that further testing of NBTXR3 in this population is warranted. Clinical trial information: NCT01946867 .
Collapse
Affiliation(s)
| | | | | | - Victor Moreno
- START Madrid-FJD, Fundación Jiménez Díaz University Hospital, Madrid, Spain
| | | | | | - Sebastien Salas
- CEPCM Assistance Publique des Hôpitaux de Marseille, Marseille, France
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Hoffmann C, Vacher S, Sirven P, Lecerf C, Massenet L, Moreira A, Surun A, Schnitzler A, Klijanienko J, Mariani O, Jeannot E, Badois N, Lesnik M, Choussy O, Le Tourneau C, Guillot-Delost M, Kamal M, Bieche I, Soumelis V. MMP2 as an independent prognostic stratifier in oral cavity cancers. Oncoimmunology 2020; 9:1754094. [PMID: 32934875 PMCID: PMC7466851 DOI: 10.1080/2162402x.2020.1754094] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 08/15/2019] [Accepted: 03/25/2020] [Indexed: 12/16/2022] Open
Abstract
Background Around 25% of oral cavity squamous cell carcinoma (OCSCC) are not controlled by the standard of care, but there is currently no validated biomarker to identify those patients. Our objective was to determine a robust biomarker for severe OCSCC, using a biology-driven strategy. Patients and methods Tumor and juxtatumor secretome were analyzed in a prospective discovery cohort of 37 OCSCC treated by primary surgery. Independent biomarker validation was performed by RTqPCR in a retrospective cohort of 145 patients with similar clinical features. An 18-gene signature (18 G) predictive of the response to PD-1 blockade was evaluated in the same cohort. Results Among 29 deregulated molecules identified in a secretome analysis, including chemokines, cytokines, growth factors, and molecules related to tumor growth and tissue remodeling, only soluble MMP2 was a prognostic biomarker. In our validation cohort, high levels of MMP2 and CD276, and low levels of CXCL10 and STAT1 mRNA were associated with poor prognosis in univariate analysis (Kaplan-Meier). MMP2 (p = .001) and extra-nodal extension (ENE) (p = .006) were independent biomarkers of disease-specific survival (DSS) in multivariate analysis and defined prognostic groups with 5-year DSS ranging from 36% (MMP2highENE+) to 88% (MMP2lowENE-). The expression of 18 G was similar in the different prognostic groups, suggesting comparable responsiveness to anti-PD-1. Conclusion High levels of MMP2 were an independent and validated prognostic biomarker, surpassing other molecules of a large panel of the tumor and immune-related processes, which may be used to select poor prognosis patients for intensified neoadjuvant or adjuvant regimens.
Collapse
Affiliation(s)
- Caroline Hoffmann
- Paris Sciences and Letters (PSL) University, Paris, France
- INSERM U932 Research Unit, Immunity and Cancer, Paris, France
- Department of Surgical Oncology, Institut Curie, Paris & Saint-Cloud, France
| | - Sophie Vacher
- Paris Sciences and Letters (PSL) University, Paris, France
- Department of Genetics, Institut Curie, Paris, France
| | - Philémon Sirven
- Paris Sciences and Letters (PSL) University, Paris, France
- INSERM U932 Research Unit, Immunity and Cancer, Paris, France
| | - Charlotte Lecerf
- Paris Sciences and Letters (PSL) University, Paris, France
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris & Saint-Cloud, France
| | - Lucile Massenet
- Paris Sciences and Letters (PSL) University, Paris, France
- INSERM U932 Research Unit, Immunity and Cancer, Paris, France
| | - Aurélie Moreira
- Paris Sciences and Letters (PSL) University, Paris, France
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris & Saint-Cloud, France
| | - Aurore Surun
- SIREDO Cancer Center (Care, Innovation and Research in Pediatric, Adolescents and Young Adults Oncology), Institut Curie, Paris, France
- Paris Descartes University, Paris, France
| | - Anne Schnitzler
- Paris Sciences and Letters (PSL) University, Paris, France
- Department of Genetics, Institut Curie, Paris, France
| | - Jerzy Klijanienko
- Paris Sciences and Letters (PSL) University, Paris, France
- Department of Pathology, Institut Curie, Paris, France
| | - Odette Mariani
- Paris Sciences and Letters (PSL) University, Paris, France
- Department of Pathology, Institut Curie, Paris, France
- Biological Resources Center, Institut Curie, Paris, France
| | - Emmanuelle Jeannot
- Paris Sciences and Letters (PSL) University, Paris, France
- Department of Pathology, Institut Curie, Paris, France
| | - Nathalie Badois
- Paris Sciences and Letters (PSL) University, Paris, France
- Department of Surgical Oncology, Institut Curie, Paris & Saint-Cloud, France
| | - Maria Lesnik
- Paris Sciences and Letters (PSL) University, Paris, France
- Department of Surgical Oncology, Institut Curie, Paris & Saint-Cloud, France
| | - Olivier Choussy
- Paris Sciences and Letters (PSL) University, Paris, France
- Department of Surgical Oncology, Institut Curie, Paris & Saint-Cloud, France
| | - Christophe Le Tourneau
- Paris Sciences and Letters (PSL) University, Paris, France
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris & Saint-Cloud, France
- INSERM U900 Research Unit, Saint-Cloud, France
| | - Maude Guillot-Delost
- Paris Sciences and Letters (PSL) University, Paris, France
- INSERM U932 Research Unit, Immunity and Cancer, Paris, France
- Center of Clinical Investigation, CIC IGR-Curie, Paris, France
| | - Maud Kamal
- Paris Sciences and Letters (PSL) University, Paris, France
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris & Saint-Cloud, France
| | - Ivan Bieche
- Paris Sciences and Letters (PSL) University, Paris, France
- Department of Genetics, Institut Curie, Paris, France
- Faculty of Pharmaceutical and Biological Sciences, INSERM U1016 Research Unit, Paris Descartes University, Paris, France
| | - Vassili Soumelis
- Paris Sciences and Letters (PSL) University, Paris, France
- INSERM U932 Research Unit, Immunity and Cancer, Paris, France
- Clinical Immunology Department, Institut Curie, Paris, France
| |
Collapse
|
20
|
Badois N, Bauër P, Cheron M, Hoffmann C, Nicodeme M, Choussy O, Lesnik M, Poitrine FC, Fromantin I. Acellular fish skin matrix on thin-skin graft donor sites: a preliminary study. J Wound Care 2020; 28:624-628. [PMID: 31513492 DOI: 10.12968/jowc.2019.28.9.624] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Surgery for head and neck cancer often requires free flap reconstructions, whose harvesting site often requires a thin-skin graft. Wounds from the thin-skin donor site are comparable to an intermediate or deep second-degree burn. This is uncomfortable and can lead to complications such as a long healing time, local infections and pain. Since they are reproducible, these wounds may serve as a model for an objective assessment of new healing medical devices. The acellular fish skin matrix is a new medical device designed to improve healing quality and time. METHODS We compared the outcomes between standard procedure and the use of this matrix placed on the split-thickness skin graft (STSG) donor site, in patients operated on in our centre for radial forearm free flap reconstruction for head and neck wounds. RESULTS There were 21 patients included. The healing time was halved when using the acellular fish skin matrix, from 68 to 32 days on average. Acellular fish skin matrix reduced pain levels and local infection. The visual analogue pain scale (VAS) was ≥3 at five days (p=0.0034) and infection rate reduced from 60% to 0% (p=0.0039). CONCLUSION These results are extremely encouraging. However, it is important to take into account the relatively high cost of this matrix for its future indications. A larger study including an overall cost estimation and an assessment on different wound types would be interesting, to better target the indications of the acellular fish skin matrix.
Collapse
Affiliation(s)
- Nathalie Badois
- 1 Unit, Department of Head and Neck surgical oncology, Institut Curie, Paris, France.,2 University PSL, Paris, France
| | - Pierre Bauër
- 2 University PSL, Paris, France.,3 Research and Wound Care Unit, Institut Curie, Paris, France
| | - Maxime Cheron
- 2 University PSL, Paris, France.,3 Research and Wound Care Unit, Institut Curie, Paris, France
| | - Caroline Hoffmann
- 1 Unit, Department of Head and Neck surgical oncology, Institut Curie, Paris, France.,2 University PSL, Paris, France
| | - Marguerite Nicodeme
- 2 University PSL, Paris, France.,3 Research and Wound Care Unit, Institut Curie, Paris, France
| | - Olivier Choussy
- 1 Unit, Department of Head and Neck surgical oncology, Institut Curie, Paris, France.,2 University PSL, Paris, France
| | - Maria Lesnik
- 1 Unit, Department of Head and Neck surgical oncology, Institut Curie, Paris, France.,2 University PSL, Paris, France
| | - Florence Canoui Poitrine
- 4 Paris-Est University (UPEC), DHU A-TVB, IMRB, EA 7376 CEpiA (Clinical Epidemiology And Ageing Unit), F-94000, Créteil, France.,5 APHP, Henri-Mondor Hospital, Public Health Department, F-94000, Créteil, France
| | - Isabelle Fromantin
- 3 Research and Wound Care Unit, Institut Curie, Paris, France.,4 Paris-Est University (UPEC), DHU A-TVB, IMRB, EA 7376 CEpiA (Clinical Epidemiology And Ageing Unit), F-94000, Créteil, France
| |
Collapse
|
21
|
Rougier G, Seguin-Givelet A, D'Honneur G, Choussy O. Anesthetic tracheal wound before total thyroidectomy and lymphadenectomy surgical procedure. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 137:441-442. [PMID: 32197938 DOI: 10.1016/j.anorl.2020.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 01/20/2020] [Accepted: 02/03/2020] [Indexed: 11/18/2022]
Affiliation(s)
- G Rougier
- Head and neck Oncologic surgery department, Curie Institute, PSL Research University, 26, rue d'Ulm, 75005, Paris, France.
| | - A Seguin-Givelet
- Thoracic surgery department, Montsouris Institute, 75014, Paris, France
| | - G D'Honneur
- Anesthetic department, Curie Institute, PSL Research University, 75005, Paris, France
| | - O Choussy
- Head and neck Oncologic surgery department, Curie Institute, PSL Research University, 26, rue d'Ulm, 75005, Paris, France
| |
Collapse
|
22
|
Hoffmann C, Surun A, Noel F, Michea P, Grandclaudon M, Faucheux L, Sirven P, Klijanienko J, Badois N, Lesnik M, Choussy O, Kamal M, Lecerf C, Le Tourneau C, Guillot-Delost M, Soumelis V. Use of PD-L1 and ICOSL to discriminate innate and adaptive dendritic cells in the head and neck cancer microenvironment. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.e14184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e14184 Background: Inflamed head and neck squamous cell carcinomas (HNSCC), have a better prognosis independently of the treatment modalities, and have an increased response rate to PD(L)1 blockade. Dendritic cells (DC) infiltration is associated to T cell infiltration and DC are critical in the immune response to cancer, but little is known on HNSCC infiltrating DC. The objectives were to determine the differences between DC infiltrating inflamed vs non inflamed tumors, to understand which mechanisms modulate DC phenotypes and which are the associated functions. Methods: 22 untreated HNSCC were characterized by flow cytometry for their immune infiltrate. RNA sequencing of sorted tumor infiltrating myeloid subsets and blood DC were analyzed for differentially expressed genes. The TMod database (Grandclaudon et al.), testing the effect of various stimuli on DC and subsequently on co-cultured T cells, was used to decipher DC and T cell modulation. Results: The level of CD3 infiltration was positively associated to the level of DC infiltration and PDL1 expression on myeloid cells, and negatively to the level neutrophils and of ICOSL expression on myeloid cells. PDL1high ICOSLneg DC from inflamed tumors were matched with the “innate DC” phenotype described in vitro, highly efficient at secreting cytokines and chemokines but poorly activating naïve CD4 T cells. DC from non-inflamed tumor resembled immature medium DC. A third type of DC, “adaptive DC”, expressing high levels of ICOSL and low of PDL1, poorly efficient at cytokine and chemokine secretion, but highly efficient at activating T cells is was described in vitro, but not found in tumors. RNAseq analysis confirmed this innate polarization and highlighted that those cells present a mature and NFkB activated phenotype. Conclusions: Inflamed HNSCC contain stimuli able to induce the recruitment and the differentiation of DC into mature, NFkB activated “innate” DC, highly efficient at secreting cytokines and chemokines but poorly activating naïve CD4 T cells. These data partly explain the superiority of CPS over TPS for the prediction of response to PD(L)1 blockade. More importantly, the stimuli identified here may be used as adjuvants to induce this DC « innate » maturation in non-inflamed tumors, but should only be used in combination with anti-PD(L)1 immunotherapy.
Collapse
Affiliation(s)
| | - Aurore Surun
- SIREDO Oncology Center, Institut Curie, Paris, France
| | | | | | | | | | | | | | | | | | | | | | - Charlotte Lecerf
- Department of Drug Development and Innovation, Institut Curie, Paris, France
| | | | | | | |
Collapse
|
23
|
Gajdzis P, Laé M, Choussy O, Lavigne M, Klijanienko J. Fine‐needle aspiration features of ossifying fibromyxoid tumor in the breast: A case report and literature review. Diagn Cytopathol 2019; 47:711-715. [DOI: 10.1002/dc.24168] [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] [Received: 11/28/2018] [Revised: 01/07/2019] [Accepted: 02/22/2019] [Indexed: 11/06/2022]
Affiliation(s)
- Pawel Gajdzis
- Department of Pathomorphology and Oncological CytologyWroclaw Medical University Wroclaw Poland
- PathologyInstitut Curie Paris France
| | - Marick Laé
- PathologyInstitut Curie Paris France
- PathologyCentre Henri Becquerel Rouen France
| | | | | | | |
Collapse
|
24
|
Chabrillac E, Morinière S, Jegoux F, Blanchard D, Choussy O, Hans S, Vergez S. Transoral robotic resection of benign tumors of the upper aerodigestive tract: Experience of the French group of GETTEC. Head Neck 2018; 40:2043-2049. [PMID: 29697873 DOI: 10.1002/hed.25197] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 03/13/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The purpose of this study was to assess the current use of transoral robotic surgery (TORS) in benign tumors of the upper aerodigestive tract through a case series and a literature review. METHODS This multicentric retrospective study was conducted in 6 French centers between November 2009 and July 2017. RESULTS Twenty-one patients had a TORS resection of a tumor at varied locations with differing histopathologic characteristics. The mean postoperative hospital stay was 6.1 days. Eight patients had nasogastric tubes, which were removed after a mean of 5.6 days. Two patients had a prophylactic tracheostomy for an average of 5.5 days. A third tracheostomy was performed secondarily for postoperative bleeding. No recurrences were observed during the 2-year follow-up. CONCLUSION This technique caused few complications and resulted in short hospitalization, with satisfactory functional and recurrence outcomes. However, the risk of bleeding and edema must be considered, and the need for a tracheostomy must be approached wisely.
Collapse
Affiliation(s)
- Emilien Chabrillac
- Department of Ear, Nose, and Throat - Head and Neck Surgery, Toulouse University Hospital, Hôpital Larrey, Toulouse, France
- Department of Surgery, University Cancer Institute Toulouse, Toulouse, France
| | - Sylvain Morinière
- Department of Ear, Nose, and Throat - Head and Neck Surgery, Tours University Hospital, Cedex, France
| | - Franck Jegoux
- Department of Ear, Nose, and Throat - Head and Neck Surgery, Rennes University Hospital, Rennes, France
| | - David Blanchard
- Department of Ear, Nose, and Throat - Head and Neck Surgery, Institut Curie Hospital, Paris, France
| | - Olivier Choussy
- Department of Ear, Nose, and Throat - Head and Neck Surgery, Rouen University Hospital, Rouen, France
| | - Stéphane Hans
- Department of Ear, Nose, and Throat - Head and Neck Surgery, Toulouse University Hospital, Hôpital Larrey, Toulouse, France
- Department of Surgery, University Cancer Institute Toulouse, Toulouse, France
| | - Sébastien Vergez
- Department of Ear, Nose, and Throat - Head and Neck Surgery, Georges Pompidou European Hospital, Paris, France
| |
Collapse
|
25
|
de Gabory L, Verillaud B, Rumeau C, Herman P, Jankowski R, Michel J, de Kermadec H, Coste A, Mortuaire G, Righini C, Reyt E, Choussy O, Trévillot V, Crampette L, Serrano E, Tsaranazy A, Bastier PL, Vergez S. Multicenter assessment of exclusive endoscopic endonasal approach for the treatment of 53 olfactory neuroblastomas. Head Neck 2018; 40:1000-1007. [PMID: 29356209 DOI: 10.1002/hed.25064] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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: 06/21/2017] [Revised: 09/22/2017] [Accepted: 11/28/2017] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Given the particularities of olfactory neuroblastoma (ONB) and the lack of studies on the subject, a multicenter collaborative study was conducted to assess treatment strategy. METHODS Fifty-three patients with ONB were included from the French Rare Head and Neck Cancer Expert Network (REFCOR) database: 16T1, 8T2, 19T3, and 10T4. All cases were treated endoscopically with skull base removal and repair in 26 cases (49%) and without external craniotomy. RESULTS The overall survival (OS) and disease-free survival (DFS) rates at 5 years were 87% and 71%, respectively, with mean follow-up of 45.4 ± 26.5 months. The complication rate was 18.8% with 4 cases of meningitis. Pathological analysis showed positive margins in 26.8%, notably on the dura-mater and periorbita, without impairment of OS or DFS. Forty-eight patients received adjuvant radiotherapy on T ± N. Ten patients had a recurrence (18.9%). Six patients died of their disease. Prophylactic neck irradiation seemed to reduce the recurrence rate. CONCLUSION Exclusively endoscopic treatment proved efficient and reliable in a large controlled series.
Collapse
Affiliation(s)
- Ludovic de Gabory
- Otorhinolaryngology, Head and Neck Surgery Department, University Hospital Pellegrin, Bordeaux, France
| | - Benjamin Verillaud
- Otorhinolaryngology, Head and Neck Surgery Department, University Hospital Lariboisière, Paris, France
| | - Cécile Rumeau
- Otorhinolaryngology, Head and Neck Surgery Department, University Hospital of Nancy, France
| | - Philippe Herman
- Otorhinolaryngology, Head and Neck Surgery Department, University Hospital Lariboisière, Paris, France
| | - Roger Jankowski
- Otorhinolaryngology, Head and Neck Surgery Department, University Hospital of Nancy, France
| | - Justin Michel
- Otorhinolaryngology, Head and Neck Surgery Department, University Hospital, Marseille, France
| | - Héloïse de Kermadec
- Otorhinolaryngology, Head and Neck Surgery Department, University Hospital Creteil, France
| | - André Coste
- Otorhinolaryngology, Head and Neck Surgery Department, University Hospital Creteil, France
| | - Geoffrey Mortuaire
- Otorhinolaryngology, Head and Neck Surgery Department, University Hospital Charles Nicolle, Lille, France
| | - Christian Righini
- Otorhinolaryngology, Head and Neck Surgery Department, University Hospital Grenoble, France
| | - Emile Reyt
- Otorhinolaryngology, Head and Neck Surgery Department, University Hospital Grenoble, France
| | - Olivier Choussy
- Otorhinolaryngology, Head and Neck Surgery Department, University Hospital Charles Nicolle, Rouen, France
| | - Vincent Trévillot
- Otorhinolaryngology, Head and Neck Surgery Department, University Hospital Guy de Chauliac, Montpellier, France
| | - Louis Crampette
- Otorhinolaryngology, Head and Neck Surgery Department, University Hospital Guy de Chauliac, Montpellier, France
| | - Elie Serrano
- Otorhinolaryngology, Head and Neck Surgery Department, University Hospital Rangueil-Larrey, Toulouse, France
| | | | - Pierre-Louis Bastier
- Otorhinolaryngology, Head and Neck Surgery Department, University Hospital Pellegrin, Bordeaux, France
| | - Sebastien Vergez
- Otorhinolaryngology, Head and Neck Surgery Department, University Hospital Rangueil-Larrey, Toulouse, France
| |
Collapse
|
26
|
Fiaux-Camous D, Chevret S, Oker N, Turri-Zanoni M, Lombardi D, Choussy O, Duprez F, Jorissen M, de Gabory L, Malard O, Herman P, Nicolai P, Castelnuovo P, Verillaud B. Prognostic value of the seventh AJCC/UICC TNM classification of intestinal-type ethmoid adenocarcinoma: Systematic review and risk prediction model. Head Neck 2017; 39:668-678. [PMID: 28067974 DOI: 10.1002/hed.24663] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2016] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND The purpose of this study was to propose a prognostic classification of intestinal-type adenocarcinoma (ITAC) based on literature search and prognostic modeling of cohort data. METHODS We first conducted a literature search to assess the homogeneity of the reported estimates of 5-year survival and to identify the influence of T classification. We then pooled prospective data from 3 large French and Italian series to predict time to all-cause mortality. The sample was randomly split to derive and then to validate the proposed prognostic model. RESULTS Literature analysis confirmed the heterogeneity in 5-year survival rates, partly explained in subsets of homogeneous T-values. The sample included 223 patients, randomly separated into a derivation (n = 141) and a validation set (n = 82). Invasion of the sphenoid lateral and/or posterior walls and dura/cerebral invasion were systematically associated with a poor survival. CONCLUSION The incorporation of the invasion of the sphenoid lateral or posterior walls should be considered for ITAC management and prognostication. © 2017 Wiley Periodicals, Inc. Head Neck 39: 668-678, 2017.
Collapse
Affiliation(s)
| | - Sylvie Chevret
- Biostatistics and Clinical Epidemiology (ECSTRA) Team, UMR 1153 Inserm, Paris Diderot University, Saint-Louis Hospital, AP-HP, Paris, France
| | - Natalie Oker
- Ear, Nose, and Throat Department, Lariboisière University Hospital, Paris, France
| | | | - Davide Lombardi
- Department of Otorhinolaryngology, University of Brescia, Brescia, Italy
| | - Olivier Choussy
- Ear, Nose, and Throat Department, Rouen University Hospital, Rouen, France
| | - Frederic Duprez
- Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium
| | - Marc Jorissen
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Ludovic de Gabory
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Bordeaux, F-X Michelet Center, Bordeaux Cedex, France
| | - Olivier Malard
- Ear, Nose, and Throat Department, CHU Hôtel-Dieu, Nantes, France
| | - Philippe Herman
- Ear, Nose, and Throat Department, Lariboisière University Hospital, Paris, France
| | - Piero Nicolai
- Department of Otorhinolaryngology, University of Brescia, Brescia, Italy
| | - Paolo Castelnuovo
- Department of Otorhinolaryngology, Insubria University, Varese, Italy
| | - Benjamin Verillaud
- Ear, Nose, and Throat Department, Lariboisière University Hospital, Paris, France
| |
Collapse
|
27
|
Roussel LM, Micault E, Peyronnet D, Blanchard D, Guarnieri S, Choussy O, Géry B, Béquignon A, Joubert C, Parienti JJ, Babin E. Intensive nutritional care for patients treated with radiotherapy in head and neck cancer: a randomized study and meta-analysis. Eur Arch Otorhinolaryngol 2016; 274:977-987. [DOI: 10.1007/s00405-016-4278-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Accepted: 08/19/2016] [Indexed: 11/30/2022]
|
28
|
Halimi C, Barry B, De Raucourt D, Choussy O, Dessard-Diana B, Hans S, Lafarge D. Guidelines of the French Society of Otorhinolaryngology (SFORL), short version. Diagnosis of local recurrence and metachronous locations in head and neck oncology. Eur Ann Otorhinolaryngol Head Neck Dis 2015; 132:287-90. [DOI: 10.1016/j.anorl.2015.07.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
29
|
Meccariello G, Deganello A, Choussy O, Gallo O, Vitali D, De Raucourt D, Georgalas C. Endoscopic nasal versus open approach for the management of sinonasal adenocarcinoma: A pooled-analysis of 1826 patients. Head Neck 2015; 38 Suppl 1:E2267-74. [DOI: 10.1002/hed.24182] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2015] [Indexed: 11/05/2022] Open
Affiliation(s)
- Giuseppe Meccariello
- Academic Clinic of Otolaryngology and Head and Neck surgery, Department of Surgery and Translational Medicine; University of Florence; Florence Italy
| | - Alberto Deganello
- Academic Clinic of Otolaryngology and Head and Neck surgery, Department of Surgery and Translational Medicine; University of Florence; Florence Italy
| | | | - Oreste Gallo
- Academic Clinic of Otolaryngology and Head and Neck surgery, Department of Surgery and Translational Medicine; University of Florence; Florence Italy
| | - Daniele Vitali
- Academic Clinic of Otolaryngology and Head and Neck surgery, Department of Surgery and Translational Medicine; University of Florence; Florence Italy
| | | | - Christos Georgalas
- Endoscopic Skull Base Center, Department of Otorhinolaryngology, Academic Medical Center; University of Amsterdam; Amsterdam The Netherlands
| |
Collapse
|
30
|
Blanchard D, Barry B, De Raucourt D, Choussy O, Dessard-Diana B, Hans S, Lafarge D. Guidelines update: Post-treatment follow-up of adult head and neck squamous cell carcinoma: Screening for metastasis and metachronous esophageal and bronchial locations. Eur Ann Otorhinolaryngol Head Neck Dis 2015; 132:217-21. [DOI: 10.1016/j.anorl.2015.07.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
|
31
|
Cuny F, Babin E, Lacau-Saint-Guily J, Baujat B, Bensadoun R, Bozec A, Chevalier D, Choussy O, Deneuve S, Fakhry N, Guigay J, Makeieff M, Merol JC, Mouawad F, Pavillet J, Rebiere C, Righini C, Sostras MC, Tournaille M, Vergez S. French Society of ENT (SFORL) guidelines for care pathway organization in head and neck oncology (short version). Early management of head and neck cancer. Eur Ann Otorhinolaryngol Head Neck Dis 2015; 132:205-8. [PMID: 26183548 DOI: 10.1016/j.anorl.2015.06.007] [Citation(s) in RCA: 6] [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] [Indexed: 10/23/2022]
Abstract
Early management in oncology is based on coordination and high-quality exchange between the various health-care partners. The present guidelines are based on a literature search with levels of evidence. Treatment waiting time can be optimized by performing assessment as early as possible (Expert opinion), to limit the interval (ideally, less than 4 weeks) between first consultation and data collection. In the first specialist consultation, diagnostic work-up should be scheduled and the data required for management should be determined (Grade B). Work-up may be conducted on a day-care basis or with conventional admission (Expert opinion). The patient's medico-social context should be taken into account from the outset, with social work involvement whenever necessary (Expert opinion). Pain and nutritional management should be planned for (Grade A) and realistic therapeutic education be provided (Expert opinion). Community-hospital teamwork for supportive care should be optimized (Expert opinion). Management should be early and multidisciplinary, to shorten delay between diagnosis and treatment initiation.
Collapse
Affiliation(s)
- F Cuny
- Inserm U1086 cancers et prévention, service d'ORL et chirurgie cervico-faciale, CHU, avenue de la Côte-de-Nacre, 14000 Caen, France.
| | - E Babin
- Inserm U1086 cancers et prévention, service d'ORL et chirurgie cervico-faciale, CHU, avenue de la Côte-de-Nacre, 14000 Caen, France
| | | | - B Baujat
- Service d'ORL, hôpital Tenon, 4, rue de la Chine, 75018 Paris, France
| | - R Bensadoun
- Service de radiothérapie, centre Antoine-Lacassagne, 33, avenue Valombrose, 06100 Nice, France
| | - A Bozec
- Service d'ORL et chirurgie cervico-faciale, centre Antoine-Lacassagne, 33, avenue Valombrose, 06100 Nice, France
| | - D Chevalier
- Service d'ORL et chirurgie cervico-faciale, hôpital Claude-Huriez, CHRU, rue Michel Polonovski, 59037 Lille cedex, France
| | - O Choussy
- Service d'ORL et chirurgie cervico-faciale, hôpital Charles-Nicolle, 1, rue de Germont, 76000 Rouen, France
| | - S Deneuve
- Service d'ORL et chirurgie cervico-faciale, CRLCC centre Léon-Bérard, 28, promenade Léa-et-Napoléon-Bullukian, 69008 Lyon, France
| | - N Fakhry
- Service d'ORL et de chirurgie cervico-faciale, hôpital de la Conception, CHU, 147, boulevard Baille, 13005 Marseille, France
| | - J Guigay
- Unité de cancérologie médicale en cancérologie cervico-faciale, centre Antoine-Lacassagne, 33, avenue Valombrose, 06100 Nice, France
| | - M Makeieff
- Service d'ORL et chirurgie cervico-faciale, hopital Robert-Debré, CHU, avenue du Général-Koenig, 51100 Reims, France
| | - J-C Merol
- Service d'ORL et chirurgie cervico-faciale, hopital Robert-Debré, CHU, avenue du Général-Koenig, 51100 Reims, France
| | - F Mouawad
- Service d'ORL et chirurgie cervico-faciale, hôpital Claude-Huriez, CHRU, rue Michel Polonovski, 59037 Lille cedex, France
| | - J Pavillet
- Service d'oncologie médicale, CHU de Grenoble, avenue Maquis-du-Grésivaudan, 38700 La Tronche, France
| | - C Rebiere
- Service social, CHU, avenue de la Côte-de-Nacre, 14000 Caen, France
| | - C Righini
- Clinique universitaire d'ORL, pôle TCCR, CHU de Grenoble Site Nord, Pavillon Dauphiné, 38043 Grenoble cedex, France
| | - M-C Sostras
- Service social, hôpital Tenon, 4, rue de la Chine, 75018 Paris, France
| | - M Tournaille
- Service social, CLCC François-Baclesse, avenue du Général-Harris, 14000 Caen, France
| | - S Vergez
- Service d'ORL et chirurgie cervico-faciale, pôle voies respiratoires, hôpital Larrey, 24, chemin de Pouvourville, 31400 Toulouse, France
| | | |
Collapse
|
32
|
Deneuve S, Babin E, Lacau-St-Guily J, Baujat B, Bensadoun RJ, Bozec A, Chevalier D, Choussy O, Cuny F, Fakhry N, Guigay J, Makeieff M, Merol JC, Mouawad F, Pavillet J, Rebiere C, Righini CA, Sostras MC, Tournaille M, Vergez S. Guidelines (short version) of the French Otorhinolaryngology - Head and Neck Surgery Society (SFORL) on patient pathway organization in ENT: The therapeutic decision-making process. Eur Ann Otorhinolaryngol Head Neck Dis 2015; 132:213-5. [PMID: 26139415 DOI: 10.1016/j.anorl.2015.06.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The authors present the guidelines of the French Otorhinolaryngology - Head and Neck Surgery Society (SFORL) for patient pathway organization in head and neck cancer, and in particular for multidisciplinary team meetings. The present article concerns the therapeutic decision-making process. METHODS A multidisciplinary work group was entrusted with a review of the scientific literature on the above topic. Guidelines were drawn up, based on the articles retrieved and the group members' individual experience. They were then read over by an editorial group independent of the work group. The final version was established in a coordination meeting. The guidelines were graded as A, B, C or expert opinion, by decreasing level of evidence. RESULTS It is recommended that: an organ specialist should contribute to all multidisciplinary meetings on head and neck cancer; all members of the multidisciplinary meeting should have specific knowledge in head and neck cancer; any referring physician who does not follow the multidisciplinary meeting's advice should justify that decision; there should be sufficient time to prepare, discuss and sum up the cases dealt with in the multidisciplinary team meeting.
Collapse
Affiliation(s)
- S Deneuve
- Département de chirurgie oncologique, centre de lutte contre le cancer Léon-Bérard, 28, rue Laennec, 69008 Lyon, France.
| | - E Babin
- Service d'ORL, CHU, avenue de la Côte-de-Nacre, 14000 Caen, France
| | - J Lacau-St-Guily
- Service d'ORL, hôpital Tenon, 4, rue de la Chine, 75018 Paris, France
| | - B Baujat
- Service d'ORL, hôpital Tenon, 4, rue de la Chine, 75018 Paris, France
| | - R-J Bensadoun
- Service d'oncologie et de radiothérapie, centre de Haute Énergie, 10, boulevard Pasteur, 06000 Nice, France
| | - A Bozec
- Service d'ORL, institut universitaire de la face et du cou, 31, avenue Valombrose, 06100 Nice, France
| | - D Chevalier
- Service d'ORL, hôpital Claude-Huriez, rue Michel Polonovski, 59037 Lille cedex, France
| | - O Choussy
- Service d'ORL, hôpital Charles-Nicolle, 1, rue de Germont, 76000 Rouen, France
| | - F Cuny
- Service d'ORL, CHU, avenue de la Côte-de-Nacre, 14000 Caen, France
| | - N Fakhry
- Service d'ORL et de chirurgie cervico-faciale, hôpital de la Conception, CHU, 147, boulevard Baille, 13005 Marseille, France
| | - J Guigay
- Service d'oncologie médicale, institut universitaire de la face et du cou, 31, avenue Valombrose, 06100 Nice, France
| | - M Makeieff
- Service d'ORL, hopital Robert-Debré, avenue du Général-Koenig, 51100 Reims, France
| | - J-C Merol
- Service d'ORL, hopital Robert-Debré, avenue du Général-Koenig, 51100 Reims, France
| | - F Mouawad
- Service d'ORL, hôpital Claude-Huriez, rue Michel Polonovski, 59037 Lille cedex, France
| | - J Pavillet
- Service d'oncologue médicale, CHU, 38043 Grenoble, France
| | - C Rebiere
- Service social, CHU, 14000 Caen, France
| | - C-A Righini
- Service d'ORL, hôpital Nord Michalon, BP 217, 38043 Grenoble cedex, France
| | - M-C Sostras
- Service social, hôpital Tenon, 4, rue de la Chine, 75018 Paris, France
| | - M Tournaille
- Service social, CLCC François-Baclesse, 3, avenue du Général-Harris, 14000 Caen, France
| | - S Vergez
- Service d'ORL, hôpital Larrey, 24, chemin de Pouvourville, TSA 30030, 31059 Toulouse cedex 9, France
| |
Collapse
|
33
|
Bon-Mardion N, De Raucourt D, Babin E, Rame JP, Dehesdin D, Choussy O. Cervical lymph node metastases and T1 squamous cell carcinoma of the lips. B-ENT 2015; 11:89-93. [PMID: 26563007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
OBJECTIVE The occurrence of cervical lymph node metastasis is a major prognostic factor for head and neck squamous cell carcinoma (SCC) of the lip. This study focuses on patients with T1 stage tumours,in order to describe the prevalence of metastatic lymphadenopathies. METHODS A multicenter retrospective study was performed in three tertiary care referral centers and included 59 patients surgically treated for T1 stage SCC of the lips from January 1996 to December 2006. This surgical treatment concerned the tumour, with cervical neck dissection when lymph node metastasis was suspected. RESULTS Cervical lymph node metastasis was found and histologically proven in 7 patients (11.9% of the cases, pN+ group; 95% confidence interval, 3.6 to 20.2%) during follow-up, never at the time of diagnosis. Metastasis appeared 13.3 ± 7.9 months (min. 5.3 months, max. 29.1 months) after the initial treatment and involved the IB level in all cases. Tumour progression was significantly longer in the pN+ group compared to patients with no lymph node metastases (sN-group). The pN+ group also had a significantly higher proportion of poorly or moderately differentiated tumours, and a significant decrease in overall survival, disease-free survival, and disease-specific survival. CONCLUSION Lymph node metastasis occurs in roughly 12% of T1 stage SCC of the lips, and the management of neck lymph node areas is necessary. A randomized trial is needed to determine the proportion of occult lymph node metastases in T1N0 patients and the impact of this therapeutic procedure on survival.
Collapse
|
34
|
Crampon F, Eliezer M, Choussy O, Hardy H, Trost O. A pathognomonic CT of the parotid gland. ACTA ACUST UNITED AC 2014; 116:e1-2. [PMID: 25458593 DOI: 10.1016/j.revsto.2014.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 10/06/2014] [Indexed: 10/24/2022]
Affiliation(s)
- F Crampon
- Department of oral and maxillofacial surgery and multidisciplinary federation of cervicomaxillofacial oncology, university hospital of Rouen, Charles-Nicolle hospital, 1, rue de Germont, 76031 Rouen, France
| | - M Eliezer
- Department of radiology, university hospital of Rouen, Charles-Nicolle hospital, 1, rue de Germont, 76031 Rouen, France
| | - O Choussy
- Department of oral and maxillofacial surgery and multidisciplinary federation of cervicomaxillofacial oncology, university hospital of Rouen, Charles-Nicolle hospital, 1, rue de Germont, 76031 Rouen, France
| | - H Hardy
- Department of oral and maxillofacial surgery and multidisciplinary federation of cervicomaxillofacial oncology, university hospital of Rouen, Charles-Nicolle hospital, 1, rue de Germont, 76031 Rouen, France
| | - O Trost
- Department of oral and maxillofacial surgery and multidisciplinary federation of cervicomaxillofacial oncology, university hospital of Rouen, Charles-Nicolle hospital, 1, rue de Germont, 76031 Rouen, France.
| |
Collapse
|
35
|
Zakzouk A, Hammad F, Langlois O, Aziz M, Marie JP, Choussy O. Malignant triton tumour of the sinonasal tract: Case report and literature review. Int J Surg Case Rep 2014; 5:608-12. [PMID: 25123649 PMCID: PMC4200876 DOI: 10.1016/j.ijscr.2014.07.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Accepted: 07/15/2014] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION The objective is to report a rare tumour of the sinonasal tract and conduct a literature review. Malignant triton tumour is a subtype of malignant schwannoma with rhabdomyoblastic differentiation. It is a very rare tumour, with only 15 reported cases involving the sinonasal region. PRESENTATION OF CASE Forty-seven years old female presented with a right-sided epistaxis, progressive right sided nasal obstruction and anosmia and a visible mass in the right nasal cavity. Imaging studies showed a mass extending from the piriform aperture to the nasopharynx in contact with the dura and the orbital content. The mass was biopsied and the result was consistent with malignant triton tumour. The patient refused the surgery at first so chemotherapy with MAID protocol was started. After the fourth course of chemotherapy the treatment was stopped due to patient intolerance and a thrombosis of the jugular vein. Patient then underwent surgery with frontal craniotomy and dural excision, endoscopic control was done at the end to insure a complete removal. The patient received Radiotherapy in the postoperative period (56 Greys). At 5 years of follow up the patient is doing fine with no signs of recurrence and normal ophthalmological findings. DISCUSSION Sixteen cases, including our case, have been reported to date in the literature. The mean age at presentation is 61 years. None of cases were associated with neurofibromatosis type 1. Eight patients were reported to be alive 5 years post-treatment, and 2 patients were reported to have died of the disease. The prognosis for triton tumours in the sinonasal tract is better than that for triton tumours in other locations. CONCLUSION Malignant triton tumour is a rare malignancy of the sinonasal tract. Otolaryngologists should be aware of this disease. The optimal treatment should include radical resection of the tumour.
Collapse
Affiliation(s)
| | - Fahad Hammad
- Department of Neurosurgery, University Hospital of Rouen, France
| | - Olivier Langlois
- Department of Neurosurgery, University Hospital of Rouen, France
| | - Moutaz Aziz
- Department of Histo-Pathology, University Hospital of Rouen, France
| | - Jean-Paul Marie
- Department of Otolaryngology, University Hospital of Rouen, France
| | - Olivier Choussy
- Department of Otolaryngology, University Hospital of Rouen, France
| |
Collapse
|
36
|
Bouchetemblé P, Heathcote K, Tollard E, Choussy O, Dehesdin D, Marie JP. Intralabyrinthine schwannomas: a case series with discussion of the diagnosis and management. Otol Neurotol 2014; 34:944-51. [PMID: 23598704 DOI: 10.1097/mao.0b013e31828687f2] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE By extracting cases of intralabyrinthine schwannomas (ILS) from the sum of all vestibular schwannomas, we aim to identify and analyze unique features of its presentation. This allows us to refine the management protocol of this rare condition. DESIGN This is a retrospective study of all patients seen in the Department of Otorhinolaryngology-Head and Neck Surgery, Rouen University Hospital, with either ILS or ILS with intracanalicular extension (ILS-IAC) between 2001 and 2011. A literature search was performed and results combined to draw conclusions on management strategies. METHOD Three patients with ILS and 6 patients with ILS-IAC were identified. We retrieved data on age, sex, symptoms, audiometry, imaging, and management. Pure tone audiometry and speech discrimination score were assessed and hearing classification recorded. Facial nerve function and vestibular function were documented throughout. The diagnostic and surveillance imaging (MRI with or without CT) were reviewed. RESULTS The average age at presentation was 62.8 years and the sex ratio was (male: female) 4:5. An ipsilateral hearing loss was observed in all patients. Eight of 9 patients had tinnitus at presentation, 2 had rotatory vertigo, and 1 patient had a facial palsy and hemifacial spasm. In 2 cases, the labyrinthine extension was initially missed. The patient presenting with a large tumor and facial palsy was operated on without delay. The others underwent MRI surveillance, with 4 requiring surgery at a later stage. No postoperative facial palsies were encountered other than the one that had been present preoperatively. CONCLUSION Frequency of ILS is underestimated because of poor diagnostic criteria. These tumors have often been described as having features, which resemble Ménière's disease, which is not found in our series. In the absence of tumor progression or disabling symptoms, their management is surveillance/medical, and when surgery is considered, facial paralysis and recurrence rates seem low. The treatment of IAC-ILS differs from that of ILS.
Collapse
Affiliation(s)
- Pierre Bouchetemblé
- Department of Otolaryngology-Head and Neck Surgery, Rouen University Hospital, Rouen, France
| | | | | | | | | | | |
Collapse
|
37
|
Clatot F, Gouérant S, Mareschal S, Cornic M, Berghian A, Choussy O, El Ouakif F, François A, Bénard M, Ruminy P, Picquenot JM, Jardin F. The gene expression profile of inflammatory, hypoxic and metabolic genes predicts the metastatic spread of human head and neck squamous cell carcinoma. Oral Oncol 2014; 50:200-7. [PMID: 24387976 DOI: 10.1016/j.oraloncology.2013.12.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 11/06/2013] [Accepted: 12/09/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To assess the prognostic value of the expression profile of the main genes implicated in hypoxia, glucose and lactate metabolism, inflammation, angiogenesis and extracellular matrix interactions for the metastatic spread of head and neck squamous cell carcinoma. PATIENTS AND METHODS Using a high-throughput qRT-PCR, we performed an unsupervised clustering analysis based on the expression of 42 genes for 61 patients. Usual prognostic factors and clustering analysis results were related to metastasis free survival. RESULTS With a median follow-up of 48months, 19 patients died from a metastatic evolution of their head and neck squamous cell carcinoma and one from a local recurrence. The unsupervised clustering analysis distinguished two groups of genes that were related to metastatic evolution. A capsular rupture (p=0.005) and the "cluster CXCL12 low" (p=0.002) were found to be independent prognostic factors for metastasis free survival. Using a Linear Predictive Score methodology, we established a 9-gene model (VHL, PTGER4, HK1, SLC16A4, DLL4, CXCL12, CXCR4, PTGER3 and CA9) that was capable of classifying the samples into the 2 clusters with 90% accuracy. CONCLUSION In this cohort, our clustering analysis underlined the independent prognostic value of the expression of a panel of genes involved in hypoxia and tumor environment. It allowed us to define a 9-gene model which can be applied routinely to classify newly diagnosed head and neck squamous cell carcinoma. If confirmed by an independent prospective study, this approach may help future clinical management of these aggressive tumors.
Collapse
Affiliation(s)
- Florian Clatot
- Department of Medical Oncology, Centre Henri Becquerel, IRON, Rouen, France; INSERM U918, Centre Henri Becquerel, IRIB, Rouen, France.
| | - Sophie Gouérant
- Department of Medical Oncology, Centre Henri Becquerel, IRON, Rouen, France; Department of Medical Oncology, Centre François Baclesse, Caen, France
| | | | - Marie Cornic
- Department of Pathology, Centre Henri Becquerel, Rouen, France
| | - Anca Berghian
- Department of Pathology, Centre Henri Becquerel, Rouen, France
| | - Olivier Choussy
- Department of Head and Neck Surgery, Hospital Charles Nicolle, Rouen, France
| | - Faissal El Ouakif
- Department of Head and Neck Surgery, Centre Henri Becquerel, Rouen, France
| | - Arnaud François
- Department of Pathology, Hospital Charles Nicolle, Rouen, France
| | - Magalie Bénard
- PRIMACEN, the Cell Imaging Platform of Normandy, IRIB, Faculty of Sciences, University of Rouen, Mont-Saint-Aignan, France
| | | | - Jean-Michel Picquenot
- INSERM U918, Centre Henri Becquerel, IRIB, Rouen, France; Department of Pathology, Centre Henri Becquerel, Rouen, France
| | - Fabrice Jardin
- INSERM U918, Centre Henri Becquerel, IRIB, Rouen, France
| |
Collapse
|
38
|
Vergez S, du Mayne MD, Coste A, Gallet P, Jankowski R, Dufour X, Righini C, Reyt E, Choussy O, Serrano E, Crampette L, Debry C, de Gabory L. Multicenter study to assess endoscopic resection of 159 sinonasal adenocarcinomas. Ann Surg Oncol 2013; 21:1384-90. [PMID: 24264517 DOI: 10.1245/s10434-013-3385-8] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Indexed: 11/18/2022]
Abstract
PURPOSE This study was designed to assess the efficacy and morbidity of the endoscopic endonasal approach for the treatment of sinonasal adenocarcinomas. METHODS This was a retrospective, multicenter study of nine French tertiary referral centers, including untreated patients. All patients were operated by an endoscopic approach. Tumors were classified according to the UICC 2002. Demographic, therapeutic, histological, morbidity data, and the course of the disease were recorded. Survival rates were obtained using the Kaplan-Meier method. RESULTS A total of 159 patients were included with a mean age of 69 years. There were 19T1, 62T2 (1M1), 36T3 (1N1), 26T4a, and 16T4b (1N2a-1N2c). The mean duration of hospitalization was 4.4 days. The histologic outcomes showed that the olfactory cleft, the posterior and anterior ethmoid sinus, and the sphenoid, maxillary, and frontal sinuses were invaded in 95, 64, 55, 19, 7, and 3 % of cases, respectively. Histologic margins were positive in 17 % (1T1, 4T2, 3T3, 2T4a, and 8T4b). In total, 130 patients received adjuvant radiotherapy on the primary tumor site (58 Gy), 24 cases were not irradiated, and 5 refused treatment. The mean follow-up was 32.5 ± 24 months. The complication rate was 19 %: 6 epistaxis, 3 meningitis, 6 CSF leaks, 2 dacryocystitis, and 8 septoplasties. The recurrence rate was 17.6 % (28 cases) within 23 ± 21 months. Eleven patients underwent a second surgical procedure. Nine patients died of their disease (3T2, 2T3, 4T4b). The global and disease-specific, recurrence-free survival rate at 3 years was 74 and 84 % respectively. CONCLUSIONS The endoscopic approach seems to be efficient to remove sinonasal adenocarcinoma with low morbidity.
Collapse
Affiliation(s)
- Sebastien Vergez
- Otorhinolaryngology, Head and Neck Surgery Department, University Hospital Rangueil-Larrey, Toulouse, France
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Zoghlami A, Roussel F, Sabourin JC, Kuhn JM, Marie JP, Dehesdin D, Choussy O. BRAF mutation in papillary thyroid carcinoma: predictive value for long-term prognosis and radioiodine sensitivity. Eur Ann Otorhinolaryngol Head Neck Dis 2013; 131:7-13. [PMID: 23845288 DOI: 10.1016/j.anorl.2013.01.004] [Citation(s) in RCA: 19] [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] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Revised: 12/04/2012] [Accepted: 01/14/2013] [Indexed: 01/17/2023]
Abstract
OBJECTIVES BRAF pV600E mutation is the most common oncogenic event and the most specific mutation for papillary thyroid carcinoma (PTC). Many studies over the last decade have shown a direct relationship between BRAF mutation and aggressive tumour characteristics, resulting in poor prognosis. However, several recent studies have suggested that BRAF mutation is not associated with poor prognosis of PTC. The present study was designed to evaluate the association between BRAF mutation with clinicopathological factors and tumour recurrence. MATERIAL AND METHODS In this retrospective study, BRAF mutation status was examined by direct sequencing on paraffin-embedded tumour specimens from 46 patients undergoing surgery for PTC in our institution from 1985 to 2000. The relationship between BRAF mutation and gender, advanced age, extrathyroid extension, multifocal tumour, cervical lymph node metastasis, tumour size and advanced pT stage of PTC and its predictive role for the risk of tumour recurrence were investigated with a median follow-up of 10.1 (±6.5)years. RESULTS BRAF mutation was detected in 20 of the 46 patients (43.5%) included in the study. No statistically significant correlation was demonstrated between the presence of BRAF mutation and the various clinicopathological factors studied. No significant difference in tumour recurrence rate or radioiodine sensitivity was observed between the two subgroups: mutant BRAF and wild-type BRAF. CONCLUSION Although BRAF mutation appears to play a role in local tumour progression, it is not a risk factor for poor prognosis or tumour recurrence in PTC.
Collapse
Affiliation(s)
- A Zoghlami
- Service d'ORL et de chirurgie cervico-faciale, hôpital Charles-Nicolle, CHU, 1, rue de Germont, 76031 Rouen cedex, France
| | - F Roussel
- Service d'anatomo-pathologie, hôpital Charles-Nicolle, CHU, 1, rue de Germont, 76031 Rouen cedex, France
| | - J-C Sabourin
- Service d'anatomo-pathologie, hôpital Charles-Nicolle, CHU, 1, rue de Germont, 76031 Rouen cedex, France
| | - J-M Kuhn
- Service d'endocrinologie, hôpital Charles-Nicolle, CHU, 1, rue de Germont, 76031 Rouen cedex, France
| | - J-P Marie
- Service d'ORL et de chirurgie cervico-faciale, hôpital Charles-Nicolle, CHU, 1, rue de Germont, 76031 Rouen cedex, France
| | - D Dehesdin
- Service d'ORL et de chirurgie cervico-faciale, hôpital Charles-Nicolle, CHU, 1, rue de Germont, 76031 Rouen cedex, France
| | - O Choussy
- Service d'ORL et de chirurgie cervico-faciale, hôpital Charles-Nicolle, CHU, 1, rue de Germont, 76031 Rouen cedex, France.
| |
Collapse
|
40
|
Choussy O, Hibon R, Mardion NB, Dehesdin D. Management of voice prosthesis leakage with Blom-Singer large esophage and tracheal flange voice prostheses. Eur Ann Otorhinolaryngol Head Neck Dis 2013; 130:49-53. [DOI: 10.1016/j.anorl.2012.03.008] [Citation(s) in RCA: 11] [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] [Received: 10/13/2011] [Revised: 02/06/2012] [Accepted: 03/29/2012] [Indexed: 11/27/2022]
|
41
|
Meyer A, Delas B, Hibon R, Faure F, Dehesdin D, Choussy O. Sialendoscopy: a new diagnostic and therapeutic tool. Eur Ann Otorhinolaryngol Head Neck Dis 2012; 130:61-5. [PMID: 23273419 DOI: 10.1016/j.anorl.2012.02.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2011] [Revised: 01/27/2012] [Accepted: 02/06/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Sialendoscopy is a recently developed minimally invasive diagnostic and therapeutic procedure for the management of obstructive diseases of the salivary glands. This report describes our early experience with this new tool and compares our results with the literature data. MATERIAL AND METHODS This was a retrospective analysis of the 33 first cases treated at a teaching hospital from October 2009 to June 2011. RESULTS The success rate for diagnostic sialendoscopy was 94%. Sialolithiasis was found in 19 cases and salivary duct stenosis in 11; no canal anomaly was found in two cases. The success rate for stone removal was 79%, while treatment of strictures failed in four cases. Longer surgical experience led to shorter operating times and improved indications as well as better therapeutic outcomes. There were no complications. CONCLUSION Sialendoscopy is a safe technique that can easily be learned by surgeons familiar with endoscopic surgery. However, practical experience is needed to reduce operating times, lower failure rates and determine its precise indications.
Collapse
Affiliation(s)
- A Meyer
- Service ORL et CCF, CHU de Rouen, 1 rue de Germont, 76031 Rouen cedex, France
| | | | | | | | | | | |
Collapse
|
42
|
Thariat J, Kirova Y, Sio T, Choussy O, Vees H, Schick U, Poissonnet G, Saada E, Thyss A, Miller RC. Mucosal Kaposi sarcoma, a Rare Cancer Network study. Rare Tumors 2012; 4:e49. [PMID: 23372913 PMCID: PMC3557563 DOI: 10.4081/rt.2012.e49] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [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: 01/09/2012] [Revised: 06/20/2012] [Accepted: 07/13/2012] [Indexed: 02/02/2023] Open
Abstract
Kaposi's sarcoma (KS) most often affect the skin but occasionally affect the mucosa of different anatomic sites. The management of mucosal KS is seldom described in the literature. Data from 15 eligible patients with mucosal KS treated between 1994 and 2008 in five institutions within three countries of the Rare Cancer Network group were collected. The inclusion criteria were as follows: age >16 years, confirmed pathological diagnosis, mucosal stages I and II, and a minimum of 6 months' follow-up after treatment. Head and neck sites were the most common (66%). Eleven cases were HIV-positive. CD4 counts correlated with disease stage. Twelve patients had biopsy only while three patients underwent local resection. Radiotherapy (RT) was delivered whatever their CD4 status was. Median total radiation dose was 16.2 Gy (0–45) delivered in median 17 days (0–40) with four patients receiving no RT. Six patients underwent chemotherapy and received from 1 to 11 cycles of various regimens namely vinblastin, caelyx, bleomycine, or interferon, whatever their CD4 counts was. Five-year disease free survival were 81.6% and 75.0% in patients undergoing RT or not, respectively. Median survival was 66.9 months. Radiation-induced toxicity was at worse grade 1–2 and was manageable whatever patients' HIV status. This small series of mucosal KSs revealed that relatively low-dose RT is overall safe and efficient in HIV-positive and negative patients. Since there are distant relapses either in multicentric cutaneous or visceral forms in head and neck cases, the role of systemic treatments may be worth investigations in addition to RT of localized disease. Surgery may be used for symptomatic lesions, with caution given the risk of bleeding.
Collapse
Affiliation(s)
- Juliette Thariat
- Department of Radiation Oncology, Centre Laccasagne, Nice, France
| | | | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Drahy A, De Barros A, Lerosey Y, Choussy O, Dehesdin D, Marie JP. Acquired cholesteatoma in children: Strategies and medium-term results. Eur Ann Otorhinolaryngol Head Neck Dis 2012; 129:225-9. [DOI: 10.1016/j.anorl.2011.10.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2011] [Revised: 07/18/2011] [Accepted: 10/11/2011] [Indexed: 10/28/2022]
|
44
|
Gouerant S, Mareschal S, Picquenot J, Berghian A, Cornic M, Choussy O, Benard M, Di Fiore F, Jardin F, Clatot F. Hypoxia and Metabolism Gene Expression Profile Predicts Poor Survival in Head and Neck Carcinoma. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33588-2] [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: 11/16/2022] Open
|
45
|
Choussy O, Abramovici O, Paviot A, Lamy A, Dehesdin D, Sabourin JC. EGFR-KRAS genotyping and EGFR-CDX2 expression in sinonasal intestinal type adenocarcinomas: Toward a new targeted therapy? J Clin Oncol 2012. [DOI: 10.1200/jco.2012.30.15_suppl.5565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5565 Background: Sinonasal carcinomas are very rare tumors which are sometimes not eligible for curative surgery. Alternative therapies (i.e. conventional chemotherapies/radiotherapy) are used but with poor results. Therefore, the need for a more efficient treatment is mandatory. Aims of our study: Comparing EGFR and KRAS genetic profiles, EGFR and CDX2 phenotypes of sinonasal intestinal type adenocarcinomas (ITAC) with colorectal adenocarcinomas (CRC). Methods: 41 patients were treated in our institution between 1983 and 2007. All pathological specimens were reclassified according to the 2005 WHO classification. An immunohistochemical (IHC) study was carried out for EGFR and CDX2 expression. We were able to analyze 38 of the 41 specimens for KRAS and EGFR mutations. SNaPshot multiplex system was used to determine the presence of the most common mutations which are located in exon 18, 20 and 21 for EGFR and in exon 2 (codon 12 and13) for KRAS. Fragment analysis method was used for EGFR exon 19 deletions. Results: Thirty five of the 38 patients were classified as ITAC (33 men and 2 women). The mean age was 64.5 years. Exposure to wood work was found in 29 cases (85%). CDX2 expression was present in 31 (89%) cases of ITAC and absent in all non intestinal adenocarcinomas (3 cases). EGFR was expressed in 29 ITACs (83%) with various degrees of IHC expression: 19 (56 %) 1+, 7 (21%) 2+, and 3 with 3+ immunopositivity. No EGFR mutation was found in the whole population; 5 ITAC patients (14%) disclosed KRAS mutations. Conclusions: Histological, phenotype and genetic profiles of ITAC are very similar to those of colorectal adenocarcinoma. These results suggest that ITACs with wt KRAS could respond to anti MoAb anti-EGFR therapy in the same way as metastatic CRC. We propose that all sinonasal tumors should undergo: firstly, CDX2 IHC in order to confirm the ITAC histological subtype and then KRAS genotyping to select the wt population which could benefit from such anti EGFR targeted therapy.
Collapse
Affiliation(s)
| | | | | | - Aude Lamy
- Department of Pathology, Rouen University Hospital, Rouen, France
| | | | | |
Collapse
|
46
|
Thariat J, Hamoir M, Garrel R, Cosmidis A, Dassonville O, Janot, Righini CA, Vedrine PO, Prades JM, Lacau-Saint-Guily J, Jegoux F, Malard O, De Mones E, Benlyazid A, Bensadoun RJ, Baujat B, Merol JC, Ferron C, Scavennec C, Salvan D, Mallet Y, Moriniere S, Vergez S, Choussy O, Dollivet G, Guevara N, Ceruse P, De Raucourt D, Lallemant B, Lawson G, Lindas P, Poupart M, Duflo S, Dufour X. Management of the Neck in the Setting of Definitive Chemoradiation: Is There a Consensus? A GETTEC Study. Ann Surg Oncol 2012; 19:2311-9. [DOI: 10.1245/s10434-012-2275-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2011] [Indexed: 11/18/2022]
|
47
|
Clatot F, Picquenot JM, Choussy O, Gouérant S, Moldovan C, Schultheis D, Cornic M, François A, Blot E, Laberge-Le-Couteulx S. Intratumoural level of SDF-1 correlates with survival in head and neck squamous cell carcinoma. Oral Oncol 2011; 47:1062-8. [PMID: 21840752 DOI: 10.1016/j.oraloncology.2011.07.021] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2011] [Revised: 07/13/2011] [Accepted: 07/20/2011] [Indexed: 12/13/2022]
Abstract
The SDF-1/CXCR4 pathway has been suggested to play a role in the metastatic dissemination of various tumours. We assessed the prognostic impact of SDF-1 and CXCR4 expression in head and neck squamous cell carcinoma (HNSCC). Seventy-one HNSCC samples collected at the time of initial diagnosis were retrospectively analysed. SDF-1 and CXCR4 expression levels were measured using real-time RT-PCR and correlated to survival. After a median follow-up of 45 months, 25 patients (35%) died of cancer (group D), and 46 patients (65%) were alive or dead without evidence of HSNCC evolution (group A). The median level of CXCR4 expression was 0.33 and 0.29 in groups A and D, respectively (P=0.93), showing no correlation with recurrence or survival. By contrast, the median level of SDF-1 expression was significantly different in the A and D groups (2.41 vs 1.16, respectively, P=0.018). Using the median level as a cut-off, patients with low SDF-1 had poorer metastasis-free (P=0.026), disease-free (P=0.006) and overall specific survival rates (P=0.002). The prognostic value of SDF-1 was confirmed by a multivariate analysis. In this series of 71 HNSCC patients, the SDF-1 expression level correlated significantly with metastatic evolution and overall survival.
Collapse
Affiliation(s)
- Florian Clatot
- Department of Medical Oncology, Centre Henri Becquerel, 1 rue d'Amiens, 76038 Rouen cedex, France.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Blanchard D, Choussy O, Rame J, Bequigon A, Dehesdin D, De Raucourt D, Bardet S, Babin E. [Thyroid differenciated carcinoma in children. Study from Normandy]. Rev Laryngol Otol Rhinol (Bord) 2011; 132:197-201. [PMID: 22908540] [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: 06/01/2023]
Abstract
OBJECTIVE Definition of a strategy for the management of thyroid differenciated carcinoma in children. DESIGN AND SETTING Retrospective cohort study from the Normandy area in France. METHOD Analysis of the medical records of 13 children and adolescents (age > 15 years), presenting with thyroid differenciated carcinoma in three Normandy French hospitals from 1994 to 2006, to determine the clinical features and treatment of the disease. RESULTS X of the patients were male and y were female, with a mean age at presentation of 11 years. Most frequently symptom was solitary nodes in the thyroid gland (69%). Most frequent histological type was papillary cancer (92%). Size of tumor was > 4 cm in 23% of cases. Children had undergone surgery with total thyroidectomy, radio-iodine treatment and suppressive hormonotherapy. We observed 46% post surgery complications. All patients were alive and none developed a recurrence. CONCLUSION Thyroid differenciated carcinoma in children and adolescents were more agressif with most frequently metastasis and recurrence than thyroid differenciated carcinoma of adults. Pronostic is good with 90% of survival at 20 years. We propose a coherent plan of treatment: 1. Thyroidectomy with cervical central lymph node dissection (group VI) completed bilateral selected head neck dissection compartments (groups IIa, III, IV) if macroscopic lymph node metastases in lateral cervical compartment. 2. Postoperative radioiodine is done in all tumor > T1N0 and completed with hormonotherapy.
Collapse
Affiliation(s)
- D Blanchard
- CHU Caen, Hôpital Côte de Nacre, Service ORL et CCF, av de la Côte de Nacre, 14033 Caen cedex 9, France.
| | | | | | | | | | | | | | | |
Collapse
|
49
|
Benlyazid A, Thariat J, Temam S, Malard O, Florescu C, Choussy O, Makeieff M, Poissonnet G, Penel N, Righini C, Toussaint B, Lacau St Guily J, Vergez S, Filleron T. Postoperative Radiotherapy in Head and Neck Mucosal Melanoma. ACTA ACUST UNITED AC 2010; 136:1219-25. [DOI: 10.1001/archoto.2010.217] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
|
50
|
Delas B, Bertrand M, Babin E, Francois A, Marie JP, Dehesdin D, Choussy O. Nasolacrimal Duct Oncocytoma: An Unusual Cause of Chronic Epiphora. Ear Nose Throat J 2010. [DOI: 10.1177/014556131008900311] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Epiphora has traditionally fallen under the purview of ophthalmologists. However, owing to the development of endoscopic dacryocystorhinostomy, this condition has been increasingly observed in otolaryngologic practice. We report the case of a woman with a 4-month history of right epiphora and dacryocystitis. Nasal endoscopy revealed the presence of a tumor at the inferior meatus. Histopathologic examination of a biopsy specimen identified the tumor as an oncocytoma. Surgical excision via a lateral rhinotomy approach was performed. At 3 years postoperatively, the patient was disease-free. Lacrimal sac and nasolacrimal duct tumors are rare, but they should be considered as a possible etiology in patients with acquired epiphora because most of these tumors are malignant.
Collapse
Affiliation(s)
- Benoît Delas
- Department of Otolaryngology-Head and Neck Surgery,
Rouen University Hospital, Rouen, France
| | - Marine Bertrand
- Department of Otolaryngology-Head and Neck Surgery,
Rouen University Hospital, Rouen, France
| | - Emmanuel Babin
- Department of Otolaryngology-Head and Neck Surgery,
Rouen University Hospital, Rouen, France
| | - Arnaud Francois
- Department of Pathology, Rouen University Hospital,
Rouen, France
| | - Jean-Paul Marie
- Department of Otolaryngology-Head and Neck Surgery,
Rouen University Hospital, Rouen, France
| | - Danièle Dehesdin
- Department of Otolaryngology-Head and Neck Surgery,
Rouen University Hospital, Rouen, France
| | - Olivier Choussy
- Department of Pathology, Rouen University Hospital,
Rouen, France
| |
Collapse
|