1
|
Cosset T, Tonnerre D, Gorphe P, Dupret-Bories A, Dufour X, Carsuzaa F. Free-flap reconstruction methods in head-and-neck oncologic surgery: A CROSS practice survey of members of the French GETTEC Head-and-Neck Tumor Study Group. Eur Ann Otorhinolaryngol Head Neck Dis 2024:S1879-7296(24)00053-X. [PMID: 38658260 DOI: 10.1016/j.anorl.2024.04.002] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
OBJECTIVE To survey practices concerning the use of anticoagulants and antiplatelets in microvascular free-flap reconstruction following oncological surgery of the head and neck. METHODS A survey of practices was carried out between September 2022 and March 2023. An online questionnaire was sent to members of the French GETTEC Head-and-Neck Tumor Study Group in all French centers practicing head-and-neck cancer surgery with reconstruction using microvascular free-flaps. The questionnaire asked surgeons about their practices regarding the use of intra- and postoperative anticoagulants and antiplatelets, preoperative management of comorbidities, and prevention of postoperative complications. RESULTS Sixty-one percent of the 38 respondents (23/38) used intraoperative intravenous heparin injection, associated to flap irrigation with heparin for 76% of surgeons (29/38) and/or a heparin solution bath for 37% (14/38). Postoperative anticoagulation was used by 95% of surgeons (36/38), and antiplatelets by 40% (15/38). Postoperatively, 40% (15/38) carried out monitoring using an implantable micro-Doppler probe, associated to analysis of clinical characteristics of the flap. CONCLUSION Reconstructive surgery using microvascular free-flaps involves numerous factors that can influence success. Prospective studies, particularly concerning the management of anticoagulants, could enable a national consensus on methods for free-flap reconstruction.
Collapse
Affiliation(s)
- T Cosset
- Service ORL, chirurgie cervicofaciale et audiophonologie, centre hospitalier universitaire de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France
| | - D Tonnerre
- Service ORL, chirurgie cervicofaciale et audiophonologie, centre hospitalier universitaire de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France
| | - P Gorphe
- Département d'ORL et de chirurgie cervicofaciale, Gustave-Roussy, 114, rue Édouard-Vaillant, 94805 Villejuif, France
| | - A Dupret-Bories
- Service ORL et chirurgie cervicofaciale et audiophonologie, IUCT Oncopole, 1, avenue Irène-Joliot-Curie, 31100 Toulouse, France
| | - X Dufour
- Service ORL, chirurgie cervicofaciale et audiophonologie, centre hospitalier universitaire de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France
| | - F Carsuzaa
- Service ORL, chirurgie cervicofaciale et audiophonologie, centre hospitalier universitaire de Poitiers, 2, rue de la Milétrie, 86000 Poitiers, France.
| |
Collapse
|
2
|
Culié D, Schiappa R, Pace-Loscos T, Guelfucci B, Vergez S, Garrel R, Fakhry N, Dassonville O, Poissonnet G, Lallemant B, Sudaka A, Saada-Bouzid E, Benezery K, Temam S, Gorphe P, Chamorey E, Bozec A. Enteral Nutrition during Radiotherapy for Oropharyngeal Cancers: Prevalence and Prognostic Factors Based on HPV Status (A GETTEC Study). J Clin Med 2023; 12:jcm12093169. [PMID: 37176609 PMCID: PMC10179627 DOI: 10.3390/jcm12093169] [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: 03/23/2023] [Revised: 04/19/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023] Open
Abstract
Nutritional support during radiotherapy is crucial to tolerating and completing oropharyngeal squamous cell carcinoma (OPSCC) treatment. The impact of HPV status on nutritional support is debated. The objective was to evaluate the rate of Reactive Feeding Tube (RFT) use and determine its prognostic factors during definitive radiotherapy for OPSCC. All OPSCC patients treated from 2009 to 2014 were included in this multicentric retrospective study. The impact of tumor p16 status on the risk of RFT was assessed through multivariate analyses. Among the 543 patients, 103 patients required an RFT (19.0%). The use of RFT differed between centers (5% to 32.4%). In multivariate analysis, only tongue base involvement and concurrent chemotherapy were significantly associated with RFT (OR = 2.18 and 3.7, respectively). Tongue base involvement and concomitant chemotherapy were prognostic factors for RFT. HPV status was not a prognostic factor for enteral nutrition during radiotherapy for OPSCC.
Collapse
Affiliation(s)
- Dorian Culié
- Antoine Lacassagne Centre, University Institute of the Face and Neck, Côte d'Azur University, 06000 Nice, France
- Antoine Lacassagne Centre, Department of Epidemiology, Biostatistics and Health Data, Côte d'Azur University, 06000 Nice, France
| | - Renaud Schiappa
- Antoine Lacassagne Centre, Department of Epidemiology, Biostatistics and Health Data, Côte d'Azur University, 06000 Nice, France
| | - Tanguy Pace-Loscos
- Antoine Lacassagne Centre, Department of Epidemiology, Biostatistics and Health Data, Côte d'Azur University, 06000 Nice, France
| | - Bruno Guelfucci
- Department of Otorhinolaryngology and Head and Neck Surgery, Sainte Musse Hospital, 83100 Toulon, France
| | - Sebastien Vergez
- Department of Otorhinolaryngology and Head and Neck Surgery, Cancer University Institute of Toulouse, 31100 Toulouse, France
| | - Renaud Garrel
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Montpellier, 34295 Montpellier, France
| | - Nicolas Fakhry
- Department of Otorhinolaryngology and Head and Neck Surgery, Public Assistance-Hospitals of Marseille, 13005 Marseille, France
| | - Olivier Dassonville
- Antoine Lacassagne Centre, University Institute of the Face and Neck, Côte d'Azur University, 06000 Nice, France
| | - Gilles Poissonnet
- Antoine Lacassagne Centre, University Institute of the Face and Neck, Côte d'Azur University, 06000 Nice, France
| | - Benjamin Lallemant
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Nîmes, 30900 Nîmes, France
| | - Anne Sudaka
- Antoine Lacassagne Centre, Department of Pathology, Côte d'Azur University, 06000 Nice, France
| | - Esma Saada-Bouzid
- Antoine Lacassagne Centre, Department of Medical Oncology, Côte d'Azur University, 06000 Nice, France
| | - Karen Benezery
- Antoine Lacassagne Centre, Department of Radiotherapy, Côte d'Azur University, 06000 Nice, France
| | - Stephane Temam
- Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, 94805 Villejuif, France
| | - Phillipe Gorphe
- Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, 94805 Villejuif, France
| | - Emmanuel Chamorey
- Antoine Lacassagne Centre, Department of Epidemiology, Biostatistics and Health Data, Côte d'Azur University, 06000 Nice, France
| | - Alexandre Bozec
- Antoine Lacassagne Centre, University Institute of the Face and Neck, Côte d'Azur University, 06000 Nice, France
| |
Collapse
|
3
|
Guerlain J, Marhic A, Casiraghi O, Lumbroso J, Garcia G, Breuskin I, Janot F, Temam S, Gorphe P, Moya-Plana A. Occult nodal metastases in T1-T2cN0 oral squamous cell carcinoma: Correlation between sentinel node positivity and completion neck dissection analysis. Oral Oncol 2023; 139:106338. [PMID: 36807087 DOI: 10.1016/j.oraloncology.2023.106338] [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: 12/01/2022] [Revised: 01/31/2023] [Accepted: 02/12/2023] [Indexed: 02/21/2023]
Abstract
OBJECTIVES Sentinel node procedure (SN) is a standard procedure that has shown its safety and effectiveness for T1/T2 cN0 oral squamous cell carcinoma (OSCC), with completion neck dissection (CND) for patients with positive SN. The aim of this study was to characterize the nodal involvement in a cohort of SN + OSCC. MATERIALS AND METHODS Patients with T1/T2 cN0 OSCC with positive SN with CND were included in this single-center, prospective cohort study between 2000 and 2013. RESULTS 54/301 patients had at least one positive SN. In 43/54 (80 %) cases, only the SN(s) were invaded; with only one SN involved (SN+=1) in 36/54 (67 %) cases. No predictive factors of nodal involvement in the CND were found considering the followings: SN micro/macrometastases, primary tumor's depth of invasion (DOI), perineural spread, lymphovascular involvement, primary tumor location, T stage and extranodal extension. The SN micrometastatic involvement (n = 22) was significantly associated with only one SN + CND- (p = 0.017). In the group of patients with unique micrometastatic involvement in the SN (n = 20/54), there was a higher isolated nodal recurrence free time (p = 0.017). CONCLUSION 80% of T1/T2 cN0 OSCC with positive SN had no other lymph node metastases in the CND, questioning the potential benefits of this procedure. Predictive factors such as the size of the SN metastasis need to be tested to stratify the risk of positive non-SN lymph nodes leading to a personalized treatment, lowering the therapeutic morbidity while maintaining the oncologic safety.
Collapse
Affiliation(s)
- J Guerlain
- Head & Neck Oncology Department, Gustave Roussy Cancer Campus, Grand Paris, France.
| | - A Marhic
- Head & Neck Oncology Department, Gustave Roussy Cancer Campus, Grand Paris, France
| | - O Casiraghi
- Department of Pathology, Gustave Roussy Cancer Campus, Grand Paris, France
| | - J Lumbroso
- Nuclear Medicine Department, Gustave Roussy Cancer Campus, Grand Paris, France
| | - G Garcia
- Department of Medical Imaging, Gustave Roussy Cancer Campus, Grand Paris, France
| | - I Breuskin
- Head & Neck Oncology Department, Gustave Roussy Cancer Campus, Grand Paris, France
| | - F Janot
- Head & Neck Oncology Department, Gustave Roussy Cancer Campus, Grand Paris, France
| | - S Temam
- Head & Neck Oncology Department, Gustave Roussy Cancer Campus, Grand Paris, France
| | - P Gorphe
- Head & Neck Oncology Department, Gustave Roussy Cancer Campus, Grand Paris, France
| | - A Moya-Plana
- Head & Neck Oncology Department, Gustave Roussy Cancer Campus, Grand Paris, France
| |
Collapse
|
4
|
Milliet F, Bozec A, Schiappa R, Viotti J, Modesto A, Dassonville O, Poissonnet G, Guelfucci B, Bizeau A, Vergez S, Dupret-Bories A, Garrel R, Fakhry N, Santini L, Lallemant B, Chambon G, Sudaka A, Peyrade F, Saada-Bouzid E, Benezery K, Jourdan-Soulier F, Chapel F, Sophie Ramay A, Roger P, Galissier T, Coste V, Ben Lakdar A, Guerlain J, Temam S, Mirghani H, Gorphe P, Chamorey E, Culié D. Metachronous second primary neoplasia in oropharyngeal cancer patients: Impact of tumor HPV status. A GETTEC multicentric study. Oral Oncol 2021; 122:105503. [PMID: 34500315 DOI: 10.1016/j.oraloncology.2021.105503] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 08/02/2021] [Accepted: 08/18/2021] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Patients with oropharyngeal squamous cell carcinoma (OPSCC) display a significant risk to develop a metachronous second primary neoplasia (MSPN). HPV and non-HPV-related OPSCC are 2 distinct entities with biological, clinical and prognostic differences. The aims of our study were to analyze the impact of tumor HPV status and other relevant clinical factors, such as tobacco and/or alcohol (T/A) consumption, on the risk and distribution of MSPN in OPSCC patients and to assess the impact of MSPN on patient survival. MATERIAL AND METHODS All OPSCC patients treated from 2009 to 2014 were included in this multicentric retrospective study. P16 immunohistochemical expression was used as a surrogate maker of tumor HPV status. The impact of tumor p16 status on the risk of MSPN was assessed in uni- and multivariate analyses. Overall survival (OS) was determined by Kaplan-Meier analysis. RESULTS Among the 1291 patients included in this study, 138 (10.7%) displayed a MSPN which was preferentially located in the head and neck area (H&N), lung and esophagus. Multivariate analyses showed that p16- tumor status (p = 0.003), T/A consumption (p = 0.005) and soft palate tumor site (p = 0.009) were significantly associated with a higher risk of MSPN. We found no impact of p16 tumor status on the median time between index OPSCC diagnosis and MSPN development, but a higher proportion of MSPN arising outside the H&N, lung and esophagus was found in p16 + than in p16- patients. MSPN development had an unfavorable impact (p = 0.04) on OS only in the p16 + patient group. CONCLUSION P16 tumor status and T/A consumption were the main predictive factors of MSPN in OPSCC patients. This study provides crucial results with a view to tailoring global management and follow-up of OPSCC patients.
Collapse
Affiliation(s)
- Florent Milliet
- Department of Otorhinolaryngology, University Hospital of Nice, France
| | - Alexandre Bozec
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Renaud Schiappa
- Department of Statistics, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Julien Viotti
- Department of Statistics, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Anouchka Modesto
- Department of Radiotherapy, Cancer University Institute of Toulouse, Toulouse, France
| | - Olivier Dassonville
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Gilles Poissonnet
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Bruno Guelfucci
- Department of Otorhinolaryngology and Head and Neck Surgery, Sainte Musse Hospital, Toulon, France
| | - Alain Bizeau
- Department of Otorhinolaryngology and Head and Neck Surgery, Sainte Musse Hospital, Toulon, France
| | - Sebastien Vergez
- Department of Otorhinolaryngology and Head and Neck Surgery, Cancer University Institute of Toulouse, Toulouse, France
| | - Agnes Dupret-Bories
- Department of Otorhinolaryngology and Head and Neck Surgery, Cancer University Institute of Toulouse, Toulouse, France
| | - Renaud Garrel
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Montpellier, Montpellier, France
| | - Nicolas Fakhry
- Department of Otorhinolaryngology and Head and Neck Surgery, Public Assistance - Hospitals of Marseille, Marseille, France
| | - Laure Santini
- Department of Otorhinolaryngology and Head and Neck Surgery, Public Assistance - Hospitals of Marseille, Marseille, France
| | - Benjamin Lallemant
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Nîmes, Nîmes, France
| | - Guillaume Chambon
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Nîmes, Nîmes, France
| | - Anne Sudaka
- Department of Pathology, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Frederic Peyrade
- Department of Medical Oncology, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Esma Saada-Bouzid
- Department of Medical Oncology, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Karen Benezery
- Department of Radiotherapy, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | | | | | - Anne Sophie Ramay
- Department of Pathology, University Hospital of Nîmes, Nîmes, France
| | - Pascal Roger
- Department of Pathology, University Hospital of Nîmes, Nîmes, France
| | - Thibault Galissier
- Department of Pathology, Cancer University Institute of Toulouse, Toulouse, France
| | - Valérie Coste
- Department of Pathology, University Hospital of Montpellier, Montpellier, France
| | - Aicha Ben Lakdar
- Department of Pathology, Gustave Roussy Institute, Villejuif, France
| | - Joanne Guerlain
- Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
| | - Stephane Temam
- Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
| | - Haitham Mirghani
- Otolaryngology and Head and Neck Surgery Department, European Hospital Georges Pompidou, APHP, Paris, France
| | - Phillipe Gorphe
- Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
| | - Emmanuel Chamorey
- Department of Statistics, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Dorian Culié
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France.
| |
Collapse
|
5
|
Bouaoud J, Benmoussa N, Hennocq Q, Honart JF, Breuskin I, Gorphe P, Casiraghi O, Classe M, Blanchard P, Janot F, Kolb F, Leymarie N, Temam S, Moya-Plana A. Locally advanced nasal pyramid squamous cell carcinoma: our 15 years' experience in a series of 35 total rhinectomies. Rhinology 2021; 58:638-640. [PMID: 33006589 DOI: 10.4193/rhin20.381] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- J Bouaoud
- Department of Head and Neck Surgical Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France; Department of Plastic and Reconstructive Surgery, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - N Benmoussa
- Department of Head and Neck Surgical Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - Q Hennocq
- Department of Head and Neck Surgical Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - J-F Honart
- Department of Plastic and Reconstructive Surgery, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - I Breuskin
- Department of Head and Neck Surgical Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - P Gorphe
- Department of Head and Neck Surgical Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - O Casiraghi
- Department of Pathology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - M Classe
- Department of Pathology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - P Blanchard
- Department of Radiation Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - F Janot
- Department of Head and Neck Surgical Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - F Kolb
- Department of Plastic and Reconstructive Surgery, Gustave Roussy Institute, University Paris-Saclay, Villejuif,France
| | - N Leymarie
- Department of Plastic and Reconstructive Surgery, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - S Temam
- Department of Head and Neck Surgical Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - A Moya-Plana
- Department of Head and Neck Surgical Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| |
Collapse
|
6
|
Marhic A, Guerlain J, Benmoussa N, Breuskin I, Honart JF, Janot F, Moya-Plana A, Temam S, Gorphe P. Replacement of lip-split mandibulotomy by pull-through approach for T3-4 oral carcinomas. Int J Oral Maxillofac Surg 2021; 50:1123-1130. [PMID: 33414034 DOI: 10.1016/j.ijom.2020.10.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/06/2020] [Accepted: 10/29/2020] [Indexed: 11/19/2022]
Abstract
At the study hospital, the lip-split mandibulotomy (LSM) has progressively been replaced by a pull-through (PT) approach. This study compared the outcomes of the LSM and PT approaches in a series of 192 patients with T3-T4a oral tongue and floor of the mouth squamous cell carcinoma treated over the two last decades. No difference in margin status (P = 0.254), rate of early complications (local infections) (P = 0.867), haematoma/haemorrhage (P = 0.221), delayed wound healing (P = 0.438), re-operation (P = 0.083), or Clavien-Dindo classification (P= 0.5281) was found. The LSM approach was associated with a higher rate of late complications such as pseudarthrosis (14.5% vs 0.9%; OR 17.89, P = 0.0005) and trismus (35% vs 13.8%; OR 3.32, P = 0.025), and a trend towards a higher rate of fistulas (24.6% vs 13.1%; OR 2.16, P = 0.088). The quality of life of long-term survivors (median 132 months) was similar in the two groups, with a mean QLQC30 score of 59.7 (P = 0.099) and mean MDADI score of 57.4 (P = 0.213). The 5-year local control rate was 86.4% in the PT group and 86.2% in the LSM group (P = 0.878), while the 5-year overall survival rates were 50.0% and 48.3%, respectively (P = 0.68). In our experience, replacement of LSM by a PT approach in oral carcinoma was associated with decreased rates of late complications such as pseudarthrosis, fistula, and trismus, without any difference in oncological outcomes.
Collapse
Affiliation(s)
- A Marhic
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - J Guerlain
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - N Benmoussa
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - I Breuskin
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - J-F Honart
- Department of Plastic and Reconstructive Surgery, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - F Janot
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - A Moya-Plana
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - S Temam
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - P Gorphe
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France.
| |
Collapse
|
7
|
Culié D, Schiappa R, Modesto A, Viotti J, Chamorey E, Dassonville O, Poissonnet G, Bizeau A, Vergez S, Dupret-Bories A, Fakhry N, Santini L, Lallemant B, Chambon G, Sudaka A, Peyrade F, Saada-Bouzid E, Benezery K, Jourdan-Soulier F, Chapel F, Ramay AS, Roger P, Galissier T, Coste V, Ben Lakdar A, Guerlain J, Mirghani H, Gorphe P, Guelfucci B, Garrel R, Temam S, Bozec A. Upfront surgery or definitive radiotherapy for p16+ oropharyngeal cancer. A GETTEC multicentric study. Eur J Surg Oncol 2021; 47:1389-1397. [PMID: 33390333 DOI: 10.1016/j.ejso.2020.12.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/25/2020] [Accepted: 12/15/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The aim of this study was to assess the impact of the initial therapeutic strategy on oncologic outcomes in patients with HPV-positive OPSCC. METHODS All p16-positive OPSCCs treated from 2009 to 2014 in 7 centers were retrospectively included and classified according to the therapeutic strategy: surgical strategy (surgery ± adjuvant radiotherapy and chemotherapy) vs. non-surgical strategy (definitive radiotherapy ± chemotherapy). Univariate, multivariate propensity score matching analyses were performed to compare overall (OS), disease-specific (DSS) and recurrence-free survival (RFS). RESULTS 382 patients were included (surgical group: 144; non-surgical group: 238). Five-year OS, DSS and RFS were 89.2, 96.8 and 83.9% in the surgical group and 84.2, 87.1 and 70.4% in the non-surgical group, respectively. These differences were statistically significant for DSS and RFS after multivariate analysis, but only for RFS after propensity score matching analysis. CONCLUSION In p16+ OPSCC patients, upfront surgery results in higher RFS than definitive radiotherapy ± chemotherapy but does not impact OS.
Collapse
Affiliation(s)
- Dorian Culié
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France.
| | - Renaud Schiappa
- Department of Statistics, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France
| | - Anouchka Modesto
- Department of Radiotherapy, Cancer University Institute of Toulouse, Toulouse, France
| | - Julien Viotti
- Department of Statistics, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France
| | - Emmanuel Chamorey
- Department of Statistics, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France
| | - Olivier Dassonville
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France
| | - Gilles Poissonnet
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France
| | - Alain Bizeau
- Department of Otorhinolaryngology and Head and Neck Surgery, Sainte Musse Hospital, Toulon, France
| | - Sebastien Vergez
- Department of Otorhinolaryngology and Head and Neck Surgery, Cancer University Institute of Toulouse, Toulouse, France
| | - Agnes Dupret-Bories
- Department of Otorhinolaryngology and Head and Neck Surgery, Cancer University Institute of Toulouse, Toulouse, France
| | - Nicolas Fakhry
- Department of Otorhinolaryngology and Head and Neck Surgery, Public Assistance - Hospitals of Marseille, Marseille, France
| | - Laure Santini
- Department of Otorhinolaryngology and Head and Neck Surgery, Public Assistance - Hospitals of Marseille, Marseille, France
| | - Benjamin Lallemant
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Nîmes, Nîmes, France
| | - Guillaume Chambon
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Nîmes, Nîmes, France
| | - Anne Sudaka
- Department of Pathology, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France
| | - Frederic Peyrade
- Department of Medical Oncology, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France
| | - Esma Saada-Bouzid
- Department of Medical Oncology, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France
| | - Karen Benezery
- Department of Radiotherapy, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France
| | | | | | - Anne Sophie Ramay
- Department of Pathology, University Hospital of Nîmes, Nîmes, France
| | - Pascal Roger
- Department of Pathology, University Hospital of Nîmes, Nîmes, France
| | - Thibault Galissier
- Department of Pathology, Cancer University Institute of Toulouse, Toulouse, France
| | - Valérie Coste
- Department of Pathology, University Hospital of Montpellier, Montpellier, France
| | - Aicha Ben Lakdar
- Department of Pathology, Gustave Roussy Institute, Villejuif, France
| | - Joanne Guerlain
- Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
| | - Haitham Mirghani
- Department of Otorhinolaryngology and Head and Neck Surgery, European Hospital Georges Pompidou, Paris, France
| | - Phillipe Gorphe
- Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
| | - Bruno Guelfucci
- Department of Otorhinolaryngology and Head and Neck Surgery, Sainte Musse Hospital, Toulon, France
| | - Renaud Garrel
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Montpellier, Montpellier, France
| | - Stephane Temam
- Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
| | - Alexandre Bozec
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France
| |
Collapse
|
8
|
Culié D, Lisan Q, Leroy C, Modesto A, Schiappa R, Chamorey E, Dassonville O, Poissonnet G, Guelfucci B, Bizeau A, Vergez S, Dupret-Bories A, Garrel R, Fakhry N, Santini L, Lallemant B, Chambon G, Sudaka A, Peyrade F, Saada-Bouzid E, Benezery K, Jourdan-Soulier F, Chapel F, Ramay AS, Roger P, Galissier T, Coste V, Lakdar AB, Temam S, Gorphe P, Guerlain J, Bozec A, Mirghani H. Oropharyngeal cancer: First relapse description and prognostic factor of salvage treatment according to p16 status, a GETTEC multicentric study. Eur J Cancer 2020; 143:168-177. [PMID: 33333482 DOI: 10.1016/j.ejca.2020.10.034] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 10/21/2020] [Accepted: 10/29/2020] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Although Human Papilloma Virus (HPV)-driven oropharyngeal cancer (OPC) prognosis is significantly better than that of other head and neck cancers, up to 25% of cases will recur within 5 years. Data on the pattern of disease recurrence and efficiency of salvage treatment are still sparse. MATERIAL AND METHOD Observational study of all recurrent OPCs diagnosed, following a curative intent treatment, in seven French centers from 2009 to 2014. p16 Immunohistochemistry was used to determine HPV status. Clinical characteristics, distribution of recurrence site, and treatment modalities were compared by HPV tumor status. Overall survival was examined using Kaplan-Meier and multivariate Cox regression modeling. RESULTS 350 recurrent OPC patients (246 p16-negative and 104 p16-positive patients). The site of recurrence was more frequently locoregional for p16-negative patients (65.4% versus 52.9% in p16-positive patients) and metastatic for p16-positive patients (47.1% versus 34.6% in p16-patients, p = 0.03). Time from diagnosis to recurrence did not differ between p16-positive and p16-negative patients (12 and 9.6 months, respectively, p-value = 0.2), as the main site of distant metastasis (all p-values ≥0.10). Overall and relapse-free survival following the first recurrence did not differ according to p16 status (p-values from log-rank 0.30 and 0.40, respectively). In multivariate analysis, prognosis factors for overall survival in p16-negative patients were distant metastasis (HR 2.11, 95% CI 1.30-3.43) and concurrent local and regional recurrences (HR 2.20, 95% CI 1.24-3.88). CONCLUSION With the exception of the initial site of recurrence, the pattern of disease relapse and the efficiency of salvage treatment are not different between p16-positive and negative OPCs.
Collapse
Affiliation(s)
- Dorian Culié
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France.
| | - Quentin Lisan
- Department of Head and Neck Surgery, Georges Pompidou European Hospital, Paris, France; INSERM UMR970, Department of Epidemiology, Paris, France
| | - Charlotte Leroy
- Department of Otorhinolaryngology, Lariboisière Hospital, Paris, France
| | - Anouchka Modesto
- Department of Radiotherapy, Cancer University Institute of Toulouse, Toulouse, France
| | - Renaud Schiappa
- Department of Head and Neck Surgery, Georges Pompidou European Hospital, Paris, France; INSERM UMR970, Department of Epidemiology, Paris, France
| | - Emmanuel Chamorey
- Department of Head and Neck Surgery, Georges Pompidou European Hospital, Paris, France; INSERM UMR970, Department of Epidemiology, Paris, France
| | - Olivier Dassonville
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France
| | - Gilles Poissonnet
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France
| | - Bruno Guelfucci
- Department of Otorhinolaryngology and Head and Neck Surgery, Sainte Musse Hospital, Toulon, France
| | - Alain Bizeau
- Department of Otorhinolaryngology and Head and Neck Surgery, Sainte Musse Hospital, Toulon, France
| | - Sebastien Vergez
- Department of Otorhinolaryngology and Head and Neck Surgery, Cancer University Institute of Toulouse, Toulouse, France
| | - Agnes Dupret-Bories
- Department of Otorhinolaryngology and Head and Neck Surgery, Cancer University Institute of Toulouse, Toulouse, France
| | - Renaud Garrel
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Montpellier, Montpellier, France
| | - Nicolas Fakhry
- Department of Otorhinolaryngology and Head and Neck Surgery, Public Assistance - Hospitals of Marseille, Marseille, France
| | - Laure Santini
- Department of Otorhinolaryngology and Head and Neck Surgery, Public Assistance - Hospitals of Marseille, Marseille, France
| | - Benjamin Lallemant
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Nîmes, Nîmes, France
| | - Guillaume Chambon
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Nîmes, Nîmes, France
| | - Anne Sudaka
- Department of Pathology, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France
| | - Frederic Peyrade
- Department of Medical Oncology, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France
| | - Esma Saada-Bouzid
- Department of Medical Oncology, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France
| | - Karen Benezery
- Department of Radiotherapy, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France
| | | | | | - Anne Sophie Ramay
- Department of Pathology, University Hospital of Nîmes, Nîmes, France
| | - Pascal Roger
- Department of Pathology, University Hospital of Nîmes, Nîmes, France
| | - Thibault Galissier
- Department of Pathology, Cancer University Institute of Toulouse, Toulouse, France
| | - Valérie Coste
- Department of Pathology, University Hospital of Montpellier, Montpellier, France
| | - Aicha B Lakdar
- Department of Pathology, Gustave Roussy Institute, Villejuif, France
| | - Stephane Temam
- Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
| | - Phillipe Gorphe
- Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
| | - Joanne Guerlain
- Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
| | - Alexandre Bozec
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte D'Azur University, Nice, France
| | - Haitham Mirghani
- Department of Head and Neck Surgery, Georges Pompidou European Hospital, Paris, France
| |
Collapse
|
9
|
Milliet F, Bozec A, Schiappa R, Viotti J, Modesto A, Dassonville O, Poissonnet G, Guelfucci B, Bizeau A, Vergez S, Dupret-Bories A, Garrel R, Fakhry N, Santini L, Lallemant B, Chambon G, Sudaka A, Peyrade F, Saada-Bouzid E, Benezery K, Jourdan-Soulier F, Chapel F, Sophie Ramay A, Roger P, Galissier T, Coste V, Ben Lakdar A, Guerlain J, Temam S, Mirghani H, Gorphe P, Chamorey E, Culié D. Synchronous primary neoplasia in patients with oropharyngeal cancer: Impact of tumor HPV status. A GETTEC multicentric study. Oral Oncol 2020; 112:105041. [PMID: 33129057 DOI: 10.1016/j.oraloncology.2020.105041] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/28/2020] [Accepted: 10/04/2020] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Patients with oropharyngeal squamous cell carcinoma (OPSCC) display a significant risk of synchronous primary neoplasia (SPN) which could impact their management. The aims of this study were to evaluate the risk and distribution of SPN in OPSCC patients according to their HPV (p16) status, the predictive factors of SPN and the impact of SPN on therapeutic strategy and oncologic outcomes. MATERIAL AND METHODS All OPSCC patients treated from 2009 to 2014 were included in this multicentric retrospective study. Univariate analyses were conducted using Chi-2 and Fisher exact tests. For multivariate analyses, all variables associated with a p ≤ 0.10 in univariate analysis were included in logistic regression models. RESULTS Among the 1291 patients included in this study, 75 (5.8%) displayed a SPN which was preferentially located in the upper aerodigestive tract, lung and esophagus. Comorbidity level (p = 0.03), alcohol (p = 0.005) and tobacco (p = 0.01) consumptions, and p16 tumor status (p < 0.0001) were significant predictors of SPN. In multivariate analysis, p16+ status was significantly associated with a lower risk of SPN (OR = 0.251, IC95% [0.133;0.474]). Patients with a SPN were more frequently referred for non-curative treatment (p = 0.02). In patients treated with curative intent, there was no impact of SPN on the therapeutic strategy (surgical vs. non-surgical treatment). We observed no overall survival differences between patients with or without SPN. CONCLUSION P16 tumor status is the main predictive factor of SPN in OPSCC patients. This study provides crucial results which should help adapt the initial work-up and the global management of OPSCC patients.
Collapse
Affiliation(s)
- Florent Milliet
- Department of Otorhinolaryngology, University Hospital of Nice, France
| | - Alexandre Bozec
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Renaud Schiappa
- Department of Statistics, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Julien Viotti
- Department of Statistics, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Anouchka Modesto
- Department of Radiotherapy, Cancer University Institute of Toulouse, Toulouse, France
| | - Olivier Dassonville
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Gilles Poissonnet
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Bruno Guelfucci
- Department of Otorhinolaryngology and Head and Neck Surgery, Sainte Musse Hospital, Toulon, France
| | - Alain Bizeau
- Department of Otorhinolaryngology and Head and Neck Surgery, Sainte Musse Hospital, Toulon, France
| | - Sebastien Vergez
- Department of Otorhinolaryngology and Head and Neck Surgery, Cancer University Institute of Toulouse, Toulouse, France
| | - Agnes Dupret-Bories
- Department of Otorhinolaryngology and Head and Neck Surgery, Cancer University Institute of Toulouse, Toulouse, France
| | - Renaud Garrel
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Montpellier, Montpellier, France
| | - Nicolas Fakhry
- Department of Otorhinolaryngology and Head and Neck Surgery, Public Assistance - Hospitals of Marseille, Marseille, France
| | - Laure Santini
- Department of Otorhinolaryngology and Head and Neck Surgery, Public Assistance - Hospitals of Marseille, Marseille, France
| | - Benjamin Lallemant
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Nîmes, Nîmes, France
| | - Guillaume Chambon
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Nîmes, Nîmes, France
| | - Anne Sudaka
- Department of Pathology, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Frederic Peyrade
- Department of Medical Oncology, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Esma Saada-Bouzid
- Department of Medical Oncology, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Karen Benezery
- Department of Radiotherapy, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | | | | | - Anne Sophie Ramay
- Department of Pathology, University Hospital of Nîmes, Nîmes, France
| | - Pascal Roger
- Department of Pathology, University Hospital of Nîmes, Nîmes, France
| | - Thibault Galissier
- Department of Pathology, Cancer University Institute of Toulouse, Toulouse, France
| | - Valérie Coste
- Department of Pathology, University Hospital of Montpellier, Montpellier, France
| | - Aicha Ben Lakdar
- Department of Pathology, Gustave Roussy Institute, Villejuif, France
| | - Joanne Guerlain
- Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
| | - Stephane Temam
- Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
| | - Haitham Mirghani
- Department of Head and Neck Surgery, European Georges Pompidou Hospital, APHP, Paris, France
| | - Phillipe Gorphe
- Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
| | - Emmanuel Chamorey
- Department of Statistics, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Dorian Culié
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France.
| |
Collapse
|
10
|
Culié D, Viotti J, Modesto A, Schiappa R, Chamorey E, Dassonville O, Poissonnet G, Guelfucci B, Bizeau A, Vergez S, Dupret-Bories A, Garrel R, Fakhry N, Santini L, Lallemant B, Chambon G, Sudaka A, Peyrade F, Saada-Bouzid E, Benezery K, Jourdan-Soulier F, Chapel F, Ramay AS, Roger P, Galissier T, Coste V, Ben Lakdar A, Guerlain J, Temam S, Mirghani H, Gorphe P, Bozec A. Upfront surgery or definitive radiotherapy for patients with p16-negative oropharyngeal squamous cell carcinoma. A GETTEC multicentric study. Eur J Surg Oncol 2020; 47:367-374. [PMID: 33004271 DOI: 10.1016/j.ejso.2020.07.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 07/13/2020] [Accepted: 07/23/2020] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Therapeutic management of oropharyngeal squamous cell carcinomas (OPSCC) is still debated. Since the role of HPV was demonstrated, few studies have focused on HPV-negative OPSCC. The aim of our study was to assess the impact of therapeutic strategy (surgical vs. non-surgical) on oncologic outcomes in patients with HPV-negative OPSCC. MATERIAL AND METHOD All p16-negative OPSCCs treated from 2009 to 2014 in 7 tertiary-care centers were included in this retrospective study and were classified according to the therapeutic strategy: surgical strategy (surgery ± adjuvant radiotherapy and chemotherapy) vs. non-surgical strategy (definitive radiotherapy ± chemotherapy). Patients not eligible for surgery (unresectable tumor, poor general-health status) were excluded. Univariate, multivariate and propensity score matching analyses were performed to compare overall (OS), disease-specific (DSS) and recurrence-free survival (RFS). RESULTS Four hundred seventy-four (474) patients were included in the study (surgical group: 196; non-surgical group: 278). Five-year OS, DSS and RFS were 76.5, 81.3 and 61.3%, respectively, in the surgical group and 49.9, 61.8 and 43.4%, respectively, in the non-surgical group. The favorable impact of primary surgical treatment on oncologic outcomes was statistically significant after multivariate analysis. This effect was more marked for locally-advanced than for early-stage tumors. Propensity score matching analysis confirmed the prognostic impact of primary surgical treatment for RFS. CONCLUSION Therapeutic strategy is an independent prognostic factor in patients with p16-negative OPSCC and primary surgical treatment is associated with improved OS, DSS and RFS. These results suggest that surgical strategy is a reliable option for advanced stage OPSCC.
Collapse
Affiliation(s)
- Dorian Culié
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France.
| | - Julien Viotti
- Department of Statistics, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Anouchka Modesto
- Department of Radiotherapy, Cancer University Institute of Toulouse, Toulouse, France
| | - Renaud Schiappa
- Department of Statistics, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Emmanuel Chamorey
- Department of Statistics, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Olivier Dassonville
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Gilles Poissonnet
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Bruno Guelfucci
- Department of Otorhinolaryngology and Head and Neck Surgery, Sainte Musse Hospital, Toulon, France
| | - Alain Bizeau
- Department of Otorhinolaryngology and Head and Neck Surgery, Sainte Musse Hospital, Toulon, France
| | - Sebastien Vergez
- Department of Otorhinolaryngology and Head and Neck Surgery, Cancer University Institute of Toulouse, Toulouse, France
| | - Agnes Dupret-Bories
- Department of Otorhinolaryngology and Head and Neck Surgery, Cancer University Institute of Toulouse, Toulouse, France
| | - Renaud Garrel
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Montpellier, Montpellier, France
| | - Nicolas Fakhry
- Department of Otorhinolaryngology and Head and Neck Surgery, Public Assistance - Hospitals of Marseille, Marseille, France
| | - Laure Santini
- Department of Otorhinolaryngology and Head and Neck Surgery, Public Assistance - Hospitals of Marseille, Marseille, France
| | - Benjamin Lallemant
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Nîmes, Nîmes, France
| | - Guillaume Chambon
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Nîmes, Nîmes, France
| | - Anne Sudaka
- Department of Pathology, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Frederic Peyrade
- Department of Medical Oncology, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Esma Saada-Bouzid
- Department of Medical Oncology, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | - Karen Benezery
- Department of Radiotherapy, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| | | | | | - Anne Sophie Ramay
- Department of Pathology, University Hospital of Nîmes, Nîmes, France
| | - Pascal Roger
- Department of Pathology, University Hospital of Nîmes, Nîmes, France
| | - Thibault Galissier
- Department of Pathology, Cancer University Institute of Toulouse, Toulouse, France
| | - Valérie Coste
- Department of Pathology, University Hospital of Montpellier, Montpellier, France
| | - Aicha Ben Lakdar
- Department of Pathology, Gustave Roussy Institute, Villejuif, France
| | - Joanne Guerlain
- Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
| | - Stephane Temam
- Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
| | - Haitham Mirghani
- Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
| | - Phillipe Gorphe
- Department of Otorhinolaryngology and Head and Neck Surgery, Gustave Roussy Institute, Villejuif, France
| | - Alexandre Bozec
- University Institute of the Face and Neck, Antoine Lacassagne Centre, Côte d'Azur University, Nice, France
| |
Collapse
|
11
|
Fanous A, Couloigner V, Gorphe P, Galmiche L, Alexandru M, Garabedian EN, Coffinet L, Blanc T, Leboulanger N, Denoyelle F. Unusual presentation of a first Branchial cleft cyst associated with an abnormal bony canal -a case report. J Otolaryngol Head Neck Surg 2020; 49:32. [PMID: 32471510 PMCID: PMC7260795 DOI: 10.1186/s40463-020-00426-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 05/08/2020] [Indexed: 12/13/2022] Open
Abstract
Background First branchial cleft anomalies are rare, accounting for only 10% of all branchial cleft anomalies. We report an even more rare and unique case of a branchial cleft cyst with features of both first and second arch derivatives. Case presentation A 6-year-old boy presented to us with a left conductive hearing loss associated with pre-tympanic keratin debris and an ipsilateral painful cervical mass. He had a past medical history of left ear surgery for presumed cholesteatoma 2 years prior and left neck abscess drainage 6 months prior. CT and MRI revealed a lesion originating in the external auditory canal and extending cervically through a bony canal located medial to the facial nerve and terminating as a parapharyngeal cyst. The complete removal was accomplished in one surgical stage consisting of three distinct steps: robotic assisted transoral resection of the pharyngeal cyst, an endaural approach and a parotidectomy approach. Conclusion We believe that our detailed description of this rare first branchial cleft cyst with pharyngeal extension, possibly a hybrid case between a first and second branchial cyst, can serve as a valuable tool to Otolaryngologists – Head and Neck Surgeons who come across a similar unusual presentations.
Collapse
Affiliation(s)
- A Fanous
- Department of Otolaryngology - Head and Neck Surgery, McGill University, Quebec, Canada.
| | - V Couloigner
- Department of Pediatric Otolaryngology - Head and Neck Surgery, Hôpital Necker - Enfants Malades - Paris V University, Paris, France
| | - P Gorphe
- Department of Otolaryngology - Head and Neck Surgery, Institut Gustave Roussy, Villejuif, France
| | - L Galmiche
- Pathology Department, Hôpital Necker - Enfants Malades - Paris V University, Paris, France
| | - M Alexandru
- Department of Pediatric Otolaryngology - Head and Neck Surgery, Hôpital Necker - Enfants Malades - Paris V University, Paris, France
| | - E-N Garabedian
- Department of Pediatric Otolaryngology - Head and Neck Surgery, Hôpital Necker - Enfants Malades - Paris V University, Paris, France
| | - L Coffinet
- Department of Otolaryngology - Head and Neck Surgery, Centre Hospitalier Régional et Universitaire de Nancy, Hôpital Central, Nancy, France
| | - T Blanc
- Department of Pediatric Surgery, Hôpital Necker - Enfants Malades - Paris V University, Paris, France
| | - N Leboulanger
- Department of Pediatric Otolaryngology - Head and Neck Surgery, Hôpital Necker - Enfants Malades - Paris V University, Paris, France
| | - F Denoyelle
- Department of Pediatric Otolaryngology - Head and Neck Surgery, Hôpital Necker - Enfants Malades - Paris V University, Paris, France
| |
Collapse
|
12
|
Baste Rotllan N, Auperin A, Iacob M, Sampetrean A, Bouguetta D, Mayache Badis L, Ferrand F, Casiraghi O, Blanchard P, Bidault F, Gorphe P, Temam S, Champiat S, Even C, Marabelle A. Immune-related adverse events (irAEs) and outcome in recurrent/metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) patients (pts) treated by immune-checkpoints inhibitors (ICI). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz252.052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
13
|
Ou D, Adam J, Garberis I, Blanchard P, Nguyen F, Levy A, Casiraghi O, Leijenaar R, Gorphe P, Breuskin I, Janot F, Robert C, Lambin P, Temam S, Scoazec J, Deutsch E, Tao Y. OC-0586 Immunological contexture basis of a prognostic radiomics signature in head and neck cancers. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31006-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
14
|
Gorphe P, Jannin C. Regulatory aspects of prospective and retrospective clinical research in France in 2018. Eur Ann Otorhinolaryngol Head Neck Dis 2019; 136:103-108. [DOI: 10.1016/j.anorl.2019.02.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
15
|
Morinière S, Gorphe P, Espitalier F, Blanchard D, Fakhry N, Saroul N, Bach C, Dufour X, Fuchsmann C, Vergez S, Albert S. Assessment of swallowing function after circumferential pharyngolaryngectomy. A multicenter study by the GETTEC group. Eur Ann Otorhinolaryngol Head Neck Dis 2018; 136:3-5. [PMID: 30482707 DOI: 10.1016/j.anorl.2018.10.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Circumferential pharyngolaryngectomy is performed for advanced pharyngeal tumor or in a context of postradiation recurrence. Several free or pedicle flaps have been described for pharyngeal defect reconstruction, with choice at the surgeon's discretion. The aim of this study was to evaluate long-term swallowing function according to the type of flap used for reconstruction. MATERIAL AND METHOD A multicenter retrospective study was conducted from January to September 2016 within the French GETTEC head and neck tumor study group. All patients in remission after circumferential pharyngolaryngectomy were included and filled out the Deglutition Handicap Index (DHI) questionnaire and underwent swallowing function fiberoptic endoscopy assessment. 46 patients (39 men, 7 women) were included. Reconstruction used a tubularized forearm free flap (FFF group) in 19 cases, pectoralis major myocutaneous flap (PMMF group) in 15 cases and free jejunum flap (FJF group) in 12 cases. RESULTS Mean DHI was 24: 20 in the FFF group, 23 in the FJF group and 25 in the PMMF group, without significant differences. 27 patients had normal swallowing, 9 mixed diet, 8 liquid diet and 3 were fed by gastrostomy. On endoscopy, free flaps (FJF and FFF) were associated with significantly greater rates of normal swallowing of saliva and yogurt than in the PMMF group (P=0.04). CONCLUSION Type of flap reconstruction after circumferential pharyngolaryngectomy had no significant impact on postoperative swallowing function assessed on the self-administered DHI questionnaire.
Collapse
Affiliation(s)
- S Morinière
- Service d'ORL et de CCF, CHU Bretonneau, 2 Bd Tonnellé, 37000 Tours, France.
| | - P Gorphe
- Service d'ORL et de CCF, IGR, 94800 Villejuif, France
| | - F Espitalier
- Service d'ORL et de CCF, CHU de Nantes, Nantes, France
| | - D Blanchard
- Service d'ORL et de CCF,CHU de Caen, Caen, France
| | - N Fakhry
- Service d'ORL et de CCF, CHU de Marseille, Marseille, France
| | - N Saroul
- Service d'ORL et de CCF, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - C Bach
- Service d'ORL et de CCF, Hôpital Foch, Paris, France
| | - X Dufour
- Service d'ORL et de CCF, CHU Poitiers, Poitiers, France
| | - C Fuchsmann
- Service d'ORL et de CCF, CHU Lyon, Lyon, France
| | - S Vergez
- Service d'ORL et de CCF, CHU Toulouse, Toulouse, France
| | - S Albert
- Service d'ORL et de CCF, CHU Bichat, 75877 Paris, France
| |
Collapse
|
16
|
Carsuzaa F, Thariat J, Gorphe P, Atallah I, Cosmidis A, Thureau S, de Mones E, Servagi-Vernat S, Tonnerre D, Morinière S, Dugas A, Malard O, Pasquier F, Ashley B, Vergez S, Dufour X. Stratégies de prise en charge des tumeurs des voies aérodigestives supérieures de stade T1-T2 N3. Cancer Radiother 2018. [DOI: 10.1016/j.canrad.2018.07.019] [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]
|
17
|
Moya-Plana A, Aupérin A, Guerlain J, Gorphe P, Casiraghi O, Mamelle G, Melkane A, Lumbroso J, Janot F, Temam S. Sentinel node biopsy in early oral squamous cell carcinomas: Long-term follow-up and nodal failure analysis. Oral Oncol 2018; 82:187-194. [DOI: 10.1016/j.oraloncology.2018.05.021] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 04/20/2018] [Accepted: 05/25/2018] [Indexed: 02/06/2023]
|
18
|
Ou D, Adam J, Garberis I, Blanchard P, Nguyen F, Levy A, Casiraghi O, Gorphe P, Breuskin I, Janot F, Temam S, Scoazec J, Deutsch E, Tao Y. OC-0489: TAM and HLA class I expression in relation to HPV and clinical outcome in head and neck cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30799-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
19
|
Boros A, Blanchard P, Gorphe P, Breuskin I, Even C, Nguyen F, Deutsch E, Bidault F, Janot F, Temam S, Mirghani H, Tao Y. EP-1158: Prognostic factors and role of neck dissection in N3 head and neck cancers treated with radiotherapy. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31468-3] [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]
|
20
|
Gorphe P, Temam S, Kolb F, Qassemyar Q. Cervical-transoral robotic oropharyngectomy and thin anterolateral thigh free flap. Eur Ann Otorhinolaryngol Head Neck Dis 2018; 135:71-74. [DOI: 10.1016/j.anorl.2017.08.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
21
|
Ou D, Adam J, Garberis I, Blanchard P, Nguyen F, Levy A, Casiraghi O, Gorphe P, Breuskin I, Janot F, Temam S, Scoazec J, Deutsch E, Tao Y. OC-0400: Prognostic impact of tumor infiltrating lymphocytes and PD-L1 expression in head and neck cancers. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30842-3] [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: 12/01/2022]
|
22
|
Qassemyar Q, Aguilar P, Temam S, Kolb F, Gorphe P. [The thin ALT perforator flap for oropharyngeal robotic-assisted reconstruction]. ANN CHIR PLAST ESTH 2017; 62:1-7. [PMID: 28041765 DOI: 10.1016/j.anplas.2016.11.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 11/20/2016] [Accepted: 11/21/2016] [Indexed: 11/18/2022]
Abstract
Since a few years, the transoral robotic surgery reduced the morbidity of oropharyngeal tumors excision. Large posterior tumors can now be removed without any scar visible on the face. In this context and to respect the thinness required for reconstructions at the junction of the upper aerodigestive tract, the free radial forearm flap still remains the solution of choice. However, if the transoral robotic surgery respects the anatomy and the aesthetics of patients at the visible and social area that represents the face, the forearm flap provides visible scars on the other region of social interaction that represents the upper limb. The aim of our work was to prove the feasibility and the benefits in terms of reducing sequelae when using a thin anterolateral perforator flap harvested above the plane of the superficial fascia. We present this new original method in detail and the advantages it offers to patients after surgery.
Collapse
Affiliation(s)
- Q Qassemyar
- Service de chirurgie plastique et reconstructrice, Gustave-Roussy, cancer campus Grand-Paris, 114, rue Edouard-Vaillant, 94805 Villejuif, France; Département de carcinologie cervico-faciale, Gustave-Roussy, cancer campus Grand-Paris, 114, rue Edouard-Vaillant, 94805 Villejuif, France.
| | - P Aguilar
- Service de chirurgie plastique et reconstructrice, Gustave-Roussy, cancer campus Grand-Paris, 114, rue Edouard-Vaillant, 94805 Villejuif, France
| | - S Temam
- Département de carcinologie cervico-faciale, Gustave-Roussy, cancer campus Grand-Paris, 114, rue Edouard-Vaillant, 94805 Villejuif, France
| | - F Kolb
- Service de chirurgie plastique et reconstructrice, Gustave-Roussy, cancer campus Grand-Paris, 114, rue Edouard-Vaillant, 94805 Villejuif, France; Département de carcinologie cervico-faciale, Gustave-Roussy, cancer campus Grand-Paris, 114, rue Edouard-Vaillant, 94805 Villejuif, France
| | - P Gorphe
- Département de carcinologie cervico-faciale, Gustave-Roussy, cancer campus Grand-Paris, 114, rue Edouard-Vaillant, 94805 Villejuif, France
| |
Collapse
|
23
|
Gorphe P, Sarfati B, Janot F, Bourgain JL, Motamed C, Blot F, Temam S. Airway fire during tracheostomy. Eur Ann Otorhinolaryngol Head Neck Dis 2014; 131:197-9. [PMID: 24703002 DOI: 10.1016/j.anorl.2013.07.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Revised: 04/17/2013] [Accepted: 07/16/2013] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Twenty-five cases of airway fire during tracheostomy have been reported in the literature. The authors describe a case observed in their centre 3 years ago, discuss the causes and preventive management and propose guidelines for prevention of this complication. CASE REPORT A 66-year-old woman was intubated and ventilated with 100% oxygen during general anaesthesia for tracheostomy. On opening the trachea by monopolar diathermy, the oxygen present in the endotracheal tube caught fire, inducing combustion of the tube spreading to the lower airways. This airway fire was responsible for severe acute respiratory failure and the formation of multiple laryngotracheal stenoses. DISCUSSION Combustion of the endotracheal tube due to ignition of anaesthetic gases induced by the heat generated by diathermy is responsible for airway fire. These various phenomena are discussed. Prevention is based on safety measures and coordination of surgical and anaesthetic teams.
Collapse
Affiliation(s)
- P Gorphe
- Département de cancérologie cervico-faciale, institut de cancérologie Gustave-Roussy, 114, rue Edouard-Vaillant, 94800 Villejuif, France.
| | - B Sarfati
- Département de cancérologie cervico-faciale, institut de cancérologie Gustave-Roussy, 114, rue Edouard-Vaillant, 94800 Villejuif, France
| | - F Janot
- Département de cancérologie cervico-faciale, institut de cancérologie Gustave-Roussy, 114, rue Edouard-Vaillant, 94800 Villejuif, France
| | - J L Bourgain
- Service d'anesthésie, institut de cancérologie Gustave-Roussy, 94800 Villejuif, France
| | - C Motamed
- Service d'anesthésie, institut de cancérologie Gustave-Roussy, 94800 Villejuif, France
| | - F Blot
- Service d'anesthésie, institut de cancérologie Gustave-Roussy, 94800 Villejuif, France
| | - S Temam
- Département de cancérologie cervico-faciale, institut de cancérologie Gustave-Roussy, 114, rue Edouard-Vaillant, 94800 Villejuif, France
| |
Collapse
|
24
|
Hans S, Delas B, Gorphe P, Ménard M, Brasnu D. Transoral robotic surgery in head and neck cancer. Eur Ann Otorhinolaryngol Head Neck Dis 2012; 129:32-7. [DOI: 10.1016/j.anorl.2011.06.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2010] [Revised: 06/06/2011] [Accepted: 06/28/2011] [Indexed: 11/30/2022]
|
25
|
Laccourreyre O, Gorphe P, Menard MI, Cauchois R, Badoual C. [Unilateral laryngeal paralysis after intra capsular loboisthmectomy without laryngeal nerve dissection]. Rev Laryngol Otol Rhinol (Bord) 2011; 132:45-49. [PMID: 21977702] [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: 05/31/2023]
Abstract
OBJECTIVES To document the incidence, outcome and variables that increase the risk for unilateral laryngeal paralysis after loboisthmectomy performed according to the intracapsular dissection technique. MATERIALS AND METHODS A retrospective analysis of an inception cohort of 317 loboisthmectomies consecutively performed at a single institution by the same surgeon during the years 2002-2007 using the intra capsular dissection without laryngeal nerve dissection, neuromonitoring and modern hemostasis techniques (Ligasure, Ultracision). The immediate and definite rate for unilateral laryngeal nerve paralysis is documented. A statistical analysis is performed for potential relation between these events and the following variables: age, gender, comorbidity, tracheal compression and intrathoracic characteristics of the thyroid lesion, side of the loboisthmectomy, etiology of the thyroid lesion (benign, malignant, hyperthyroidy), associated thyroiditis, size of the largest resected nodule and weight of the resected lobe. RESULTS The immediate unilateral laryngeal nerve paralysis incidence was 1,2%. Recovery of motion occurred by the 1st, 3rd, 5th or 9th post operative month resulting in a 0% incidence for definitive unilateral laryngeal nerve paralysis. No significant statistical relation was noted between immediate unilateral laryngeal nerve paralysis and the variables under analysis. CONCLUSION Based on the current series and the review of the medical literature, it appears that the loboisthmectomy according to the intra capsular technique without inferior laryngeal nerve identification, in patients not previously operated, performed according to is a surgical technique whose goal is to ascent the thyroid lobe and dissect the region of the nerve penetration within the larynx by the end of the resection, does not increase the risk for transient or permanent unilateral laryngeal nerve paralysis.
Collapse
Affiliation(s)
- O Laccourreyre
- Hôpital européen Georges Pompidou, Université Paris-Descartes, Faculté de Médecine, Service ORL et CCF, 20-40 rue leblanc, 75015 Paris, France.
| | | | | | | | | |
Collapse
|