1
|
Mouawad C, Bardier A, Wagner M, Doat S, Djelil D, Fawaz J, Pocard M. Active surveillance for low-grade appendiceal mucinous neoplasm (LAMN). Pleura Peritoneum 2024; 9:31-37. [PMID: 38558872 PMCID: PMC10980982 DOI: 10.1515/pp-2023-0032] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 11/30/2023] [Indexed: 04/04/2024] Open
Abstract
Objectives Due to the scarcity of low-grade appendiceal mucinous neoplasm (LAMN), there is an absence of systematized guidelines concerning its management, especially after incidental finding on an appendiceal specimen. In this study, we evaluate the active surveillance (AS) strategy adopted for a series of patients diagnosed with LAMN on resection specimens who were considered to have a low risk of pseudomyxoma progression. Methods Thirty patients were included between April 2014 and July 2021, with a female majority and a median follow-up period of 3.1 years. The inclusion criteria were as follows: LAMN diagnosis on appendiceal specimens, confirmed in an expert center, limited extra-appendiceal mucin resected and localized around the appendix, normal biology (CEA, CA199, CA125) and normal abdominopelvic MRI. AS included physical exam (trocar scar), biology and MRI, 6 months postoperatively, then yearly for 10 years. Results As an initial surgery, 77 % had an appendectomy as their initial intervention, 17 % had a cecectomy, and 6 % had a right colectomy. After follow-up, 87 % of patients showed no sign of disease progression by MRI, while 13 % progressed to PMP. MRI performed in the first postoperative year predicted the disease prognosis in 97 % of patients. Conclusions The AS strategy, based on MRI, is a valid option after incidental LAMN diagnosis.
Collapse
Affiliation(s)
- Christian Mouawad
- Department of Digestive, Hepatobiliary and Liver Transplantation Surgery, AP-HP, Hôpital de la Pitié-Salpêtrière, Paris, France
- Université Paris Cité, INSERM, U1275 CAP Paris-Tech, Paris, France
| | - Armelle Bardier
- Department of Pathology, AP-HP, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Mathilde Wagner
- Department of Radiology, AP-HP, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Solène Doat
- Department of Gastroenterology, AP-HP, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Dahbia Djelil
- Department of Digestive, Hepatobiliary and Liver Transplantation Surgery, AP-HP, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Jade Fawaz
- Department of Digestive, Hepatobiliary and Liver Transplantation Surgery, AP-HP, Hôpital de la Pitié-Salpêtrière, Paris, France
- Université Paris Cité, INSERM, U1275 CAP Paris-Tech, Paris, France
| | - Marc Pocard
- Department of Digestive, Hepatobiliary and Liver Transplantation Surgery, AP-HP, Hôpital de la Pitié-Salpêtrière, Paris, France
- Université Paris Cité, INSERM, U1275 CAP Paris-Tech, Paris, France
| |
Collapse
|
2
|
Leiritz E, Rezai J, Wagner M, Bardier A, Therwath A, Pocard M. Appendiceal adenocarcinoma, diagnosed after acute perforated appendicitis: Potential contribution of HIPEC. Eur J Surg Oncol 2024; 50:107959. [PMID: 38340494 DOI: 10.1016/j.ejso.2024.107959] [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: 08/29/2023] [Revised: 11/23/2023] [Accepted: 01/08/2024] [Indexed: 02/12/2024]
Abstract
INTRODUCTION Treatment of peritoneal metastasis from appendicular adenocarcinoma consists of cyto-reductive surgery (CRS) and Hyperthermic IntraPEritoneal Chemotherapy (HIPEC). In case of acute appendicular syndrome (AAS) the tumor is likely to be perforated. In that case, there is no treatment recommendation. We propose CRS and HIPEC. MATERIALS AND METHOD We listed 21 consecutive patients who were addressed for discovery of appendiceal adenocarcinoma. The emergency surgery was performed in a primary-care hospital. We evaluated the therapeutic algorithms, per operative decision, survival and recurrent rate. RESULTS Among the 21 patients, 4 patients were diagnosed as synchronous appendicular peritoneal metastasis, and underwent CRS and HIPEC. The other 17 patients with diagnosis of adenocarcinoma on anatomopathological samples, without peritoneal metastasis during appendectomy, were addressed. Between them 2 patients were denied CRS. Among the 15 operated patients, 8 patients had no peritoneal metastasis discovery during surgery, and therefore underwent prophylactic CRS and HIPEC. Peritoneal metastasis were discovered for the other 7 patients, who also underwent CRS and HIPEC. For the prophylactic group, the recurrence rate is 12,5 %, overall survival (OS) is 100 %. The rate of grade III-IV surgical complications after CRS and HIPEC was 36 % among the 19 patients who underwent surgery. CONCLUSION In case of appendectomy in emergency situations for perforated adenocarcinoma, half of the patients may have peritoneal metastasis. In case of non-identified peritoneal metastasis during CRS, performing a prophylactic HIPEC seems to be associated with an encouraging rate of peritoneal disease free situation at 5 years.
Collapse
Affiliation(s)
- Elsa Leiritz
- Department of Digestive, Hepatobiliary Surgery and Liver Transplantation, Pitié-Salpêtrière Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.
| | - Jérémy Rezai
- Department of Gastroenterology and Digestive Oncology, Pitié-Salpêtrière Hospital, Sorbonne University, UPMC University, Paris, France
| | - Mathilde Wagner
- Department of Radiology Diagnosis, Pitié-Salpêtrière Hospital, Sorbonne University, UPMC University, Paris, France
| | - Armelle Bardier
- Department of Pathology, Pitié-Salpêtrière Hospital, Sorbonne University, UPMC University, Paris, France
| | - Amu Therwath
- Université Paris Cité, INSERM, U1275 CAP Paris-Tech, F-75010, Paris, France
| | - Marc Pocard
- Department of Digestive, Hepatobiliary Surgery and Liver Transplantation, Pitié-Salpêtrière Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France; Université Paris Cité, INSERM, U1275 CAP Paris-Tech, F-75010, Paris, France.
| |
Collapse
|
3
|
Leiritz E, Rezai J, Bardier A, Wagner M, Pocard M. Appendiceal adenocarcinoma, diagnosed after acute perforated appendicitis : potential contribution of CHIP for 22 patients. European Journal of Surgical Oncology 2023. [DOI: 10.1016/j.ejso.2022.11.203] [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: 02/23/2023]
|
4
|
Bres C, Voron T, Benhaim L, Bergeat D, Parc Y, Karoui M, Genser L, Péré G, Demma JA, Bacoeur-Ouzillou O, Lebreton G, Thereaux J, Gronnier C, Dartigues P, Svrcek M, Bouzillé G, Bardier A, Brunac AC, Roche B, Darcha C, Bazille C, Doucet L, Belleannee G, Lejeune S, Buisine MP, Renaud F, Nuytens F, Benusiglio PR, Veziant J, Eveno C, Piessen G. Management of Pathogenic CDH1 Variant Carriers within the FREGAT Network: A multicentric Retrospective Study. Ann Surg 2022; 276:830-837. [PMID: 35856494 DOI: 10.1097/sla.0000000000005626] [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: 11/25/2022]
Abstract
OBJECTIVE To describe the management of pathogenic CDH1 variant carriers (pCDH1vc) within the FREGAT (FRench Eso-GAsTric tumor) network. Primary objective focused on clinical outcomes and pathological findings, Secondary objective was to identify risk factor predicting postoperative morbidity (POM). SUMMARY BACKGROUND DATA Prophylactic Total Gastrectomy (PTG) remains the recommended option for gastric cancer risk management in pCDH1vc with however endoscopic surveillance as an alternative. METHODS A retrospective observational multicenter study was carried out between 2003 and 2021. Data were reported as median [interquartile range] or as counts (proportion). Usual tests were used for univariate analysis. Risk factors of overall and severe POM (i.e. Clavien-Dindo grade 3 or more) were identified with a binary logistic regression. RESULTS 99 patients including 14 index cases were reported from 11 centers. Median survival among index cases was 12.0[7.6-16.4] months with most of them having peritoneal carcinomatosis at diagnosis (71.4%). Among the remaining 85 patients, 77 underwent a PTG (median age 34.6 [23.7 - 46.2], ASA score 1: 75%) mostly via a minimally-invasive approach (51.9%). POM rate was 37.7% including 20.8% of severe POM, with age≥ 40 years and low volume centers as predictors (P=0.030 and P=0.038). After PTG, the cancer rate on specimen was 54.5% (n=42, all pT1a) of which 59.5% had no cancer detected on preoperative endoscopy (n=25). CONCLUSION Among pCDH1vc, index cases carry a dismal prognosis. The risk of cancer among patients undergoing PTG remained high and unpredictable and has to be balanced with the morbidity and functional consequence of PTG.
Collapse
Affiliation(s)
- Capucine Bres
- Department of Digestive and Oncological Surgery, Claude Huriez Hospital, Chu Lille (France)
| | - Thibault Voron
- Department of Digestive Surgery, Sorbonne Université, Hôpital Saint-Antoine, APHP, Paris, France
| | - Leonor Benhaim
- Department of Digestive Surgery, Gustave Roussy, Villejuif (France)
| | - Damien Bergeat
- Department of Digestive Surgery, Chu Rennes, Rennes (France)
| | - Yann Parc
- Department of Digestive Surgery, Sorbonne Université, Hôpital Saint-Antoine, APHP, Paris, France
| | - Mehdi Karoui
- Department of Digestive Surgery, Georges Pompidou European Hospital, APHP, Paris (France)
| | - Laurent Genser
- Department of Digestive Surgery, Sorbonne Université, Hôpital Pitié-Salpétrière, APHP, Paris (France)
| | - Guillaume Péré
- Department of Digestive Surgery, Chu Toulouse, Toulouse (France)
| | | | | | - Gil Lebreton
- Department of Digestive Surgery, Chu Caen, Caen (France)
| | | | | | | | - Magali Svrcek
- Department of Pathology, Sorbonne Université, Hôpital Saint Antoine, APHP, Paris (France)
| | | | - Armelle Bardier
- Department of Pathology, Sorbonne Université, Hôpital Pitié-Salpétrière, APHP, Paris (France)
| | - Anne Cécile Brunac
- Department of Pathology, Institut Universitaire du Cancer-Oncopole de Toulouse; Centre Hospitalier Universitaire (CHU), Toulouse, France
| | - Brigitte Roche
- Department of Pathology, Chu Saint Louis, APHP, Paris (France)
| | - Claude Darcha
- Department of Pathology, Chu Clermont Ferrand, Clermont Ferrand (France)
| | | | | | | | | | - Marie Pierre Buisine
- Department of Molecular Oncogenetics, Chu Lille - Lille (France).,Univ. Lille, CNRS, Inserm, CHU Lille, UMR9020-U1277 - CANTHER - Cancer Heterogeneity Plasticity and Resistance to Therapies, F-59000 Lille, France
| | - Florence Renaud
- Univ. Lille, CNRS, Inserm, CHU Lille, UMR9020-U1277 - CANTHER - Cancer Heterogeneity Plasticity and Resistance to Therapies, F-59000 Lille, France.,Department of Pathology, Centre Biologie Pathologie, Chu Lille - Lille (France)
| | - Frederiek Nuytens
- Department of Digestive and Hepatobiliary/Pancreatic surgery, AZ Groeninge hospital, Kortrijk, Belgium
| | - Patrick R Benusiglio
- Department of Digestive Surgery, Sorbonne Université, Hôpital Saint-Antoine, APHP, Paris, France.,UF d'Oncogénétique Clinique, Département de Génétique Médicale et Institut Universitaire de Cancérologie, Sorbonne Université, Hôpital Pitié-Salpêtrière, AP-HP, Paris (France)
| | - Julie Veziant
- Department of Digestive and Oncological Surgery, Claude Huriez Hospital, Chu Lille (France)
| | - Clarisse Eveno
- Department of Digestive and Oncological Surgery, Claude Huriez Hospital, Chu Lille (France).,Univ. Lille, CNRS, Inserm, CHU Lille, UMR9020-U1277 - CANTHER - Cancer Heterogeneity Plasticity and Resistance to Therapies, F-59000 Lille, France
| | - Guillaume Piessen
- Department of Digestive and Oncological Surgery, Claude Huriez Hospital, Chu Lille (France).,Univ. Lille, CNRS, Inserm, CHU Lille, UMR9020-U1277 - CANTHER - Cancer Heterogeneity Plasticity and Resistance to Therapies, F-59000 Lille, France
| |
Collapse
|
5
|
Cohen R, Hain E, Buhard O, Guilloux A, Bardier A, Kaci R, Bertheau P, Renaud F, Bibeau F, Fléjou JF, André T, Svrcek M, Duval A. Association of Primary Resistance to Immune Checkpoint Inhibitors in Metastatic Colorectal Cancer With Misdiagnosis of Microsatellite Instability or Mismatch Repair Deficiency Status. JAMA Oncol 2020; 5:551-555. [PMID: 30452494 DOI: 10.1001/jamaoncol.2018.4942] [Citation(s) in RCA: 149] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Primary resistance to immune checkpoint inhibitors is observed in 10% to 40% of patients with metastatic colorectal cancer (mCRC) displaying microsatellite instability (MSI) or defective mismatch repair (dMMR). Objective To investigate possible mechanisms underlying primary resistance to immune checkpoint inhibitors of mCRC displaying MSI or dMMR. Design, Setting, and Participants This post hoc analysis of a single-center, prospective cohort included 38 patients with mCRC diagnosed as MSI or dMMR by local laboratories and entered into trials of immune checkpoint inhibitors between January 1, 2015, and December 31, 2016. The accuracy of MSI or dMMR status was also assessed in a retrospective cohort comprising 93 cases of mCRC that were diagnosed as MSI or dMMR between January 1, 1998, and December 31, 2016, in 6 French hospitals. Primary resistance of mCRC was defined as progressive disease according to Response Evaluation Criteria in Solid Tumors criteria, 6 to 8 weeks after initiation of immune checkpoint inhibitors, without pseudo-progression. All tumor samples were reassessed for dMMR status using immunohistochemistry with antibodies directed against MLH1, MSH2, MSH6, and PMS2, and for MSI using polymerase chain reaction with pentaplex markers and with the HSP110 T17 (HT17) repeat. Main Outcomes and Measures The primary outcome was positive predictive value. Results Among the 38 patients (15 women and 23 men; mean [SD] age, 55.6 [13.7] years) in the study with mCRC displaying MSI or dMMR, primary resistance to immune checkpoint inhibitors was observed in 5 individuals (13%). Reassessment of the status of MSI or dMMR revealed that 3 (60%) of these 5 resistant tumors were microsatellite stable or displayed proficient mismatch repair. The positive predictive value of MSI or dMMR status assessed by local laboratories was therefore 92.1% (95% CI, 78.5%-98.0%). In the retrospective cohort of 93 patients (44 women and 49 men; mean [SD] age, 56.8 [18.3] years) without immune checkpoint inhibitor treatment, misdiagnosis of the MSI or dMMR status by local assessment was 10% (n = 9), with a positive predictive value of 90.3% (95% CI, 82.4%-95.0%). Testing for MSI with the HT17 assay confirmed the MSI or dMMR status in 2 of 4 cases showing discrepant results between immunohistochemistry and pentaplex polymerase chain reaction (ie, dMMR but microsatellite stable). Conclusions and Relevance Primary resistance of mCRC displaying MSI or dMMR to immune checkpoint inhibitors is due mainly to misdiagnosis of their MSI or dMMR status. Larger studies are required to confirm these findings. Microsatellite instability or dMMR status should be tested routinely using both immunohistochemistry and polymerase chain reaction methods prior to treatment with immune checkpoint inhibitors.
Collapse
Affiliation(s)
- Romain Cohen
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche Scientifique 938 and Site de Recherche Intégré contre le Cancer, Cancer United Research Associating Medicine University and Society, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Sorbonne Université, Paris, France.,Department of Medical Oncology, Assistance Publique des Hôpitaux de Paris, Hôpital Saint-Antoine, Sorbonne Université, Paris, France
| | - Elisabeth Hain
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche Scientifique 938 and Site de Recherche Intégré contre le Cancer, Cancer United Research Associating Medicine University and Society, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Sorbonne Université, Paris, France
| | - Olivier Buhard
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche Scientifique 938 and Site de Recherche Intégré contre le Cancer, Cancer United Research Associating Medicine University and Society, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Sorbonne Université, Paris, France
| | - Agathe Guilloux
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche Scientifique 938 and Site de Recherche Intégré contre le Cancer, Cancer United Research Associating Medicine University and Society, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Sorbonne Université, Paris, France
| | - Armelle Bardier
- Department of Pathology, Assistance Publique des Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Sorbonne Université, Paris, France
| | - Rachid Kaci
- Department of Pathology, Assistance Publique des Hôpitaux de Paris, Hôpital Lariboisière, Paris, France
| | - Philippe Bertheau
- Department of Pathology, Assistance Publique des Hôpitaux de Paris, Hôpital Saint-Louis, Sorbonne Université, Paris, France
| | - Florence Renaud
- Université Lille, Unité Mixte de Recherche Scientifique 1172 e Jean-Pierre Aubert Research Centre e Jean-Pierre Aubert Research Center, Lille, France.,Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche Scientifique 1172, Team "Mucins, Epithelial Differentiation and Carcinogenesis," Lille, France.,Centre Hospitalier Universitaire Lille, Institut de Pathologie, Lille, France
| | - Frédéric Bibeau
- Department of Pathology, Institut du Cancer de Montpellier, Montpellier, France
| | - Jean-François Fléjou
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche Scientifique 938 and Site de Recherche Intégré contre le Cancer, Cancer United Research Associating Medicine University and Society, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Sorbonne Université, Paris, France.,Department of Pathology, Sorbonne Université, Assistance Publique des Hôpitaux de Paris, Hôpital Saint-Antoine, Paris, France
| | - Thierry André
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche Scientifique 938 and Site de Recherche Intégré contre le Cancer, Cancer United Research Associating Medicine University and Society, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Sorbonne Université, Paris, France.,Department of Medical Oncology, Assistance Publique des Hôpitaux de Paris, Hôpital Saint-Antoine, Sorbonne Université, Paris, France
| | - Magali Svrcek
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche Scientifique 938 and Site de Recherche Intégré contre le Cancer, Cancer United Research Associating Medicine University and Society, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Sorbonne Université, Paris, France.,Department of Pathology, Sorbonne Université, Assistance Publique des Hôpitaux de Paris, Hôpital Saint-Antoine, Paris, France
| | - Alex Duval
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche Scientifique 938 and Site de Recherche Intégré contre le Cancer, Cancer United Research Associating Medicine University and Society, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Sorbonne Université, Paris, France
| |
Collapse
|
6
|
Manceau G, Margot N, Augustin J, Bardier A, Simon JM, Bachet JB, Spano JP, Maingon P, Vaillant JC, Karoui M. YpN0 rectal cancer patients with sterilized lymph nodes after neoadjuvant chemoradiotherapy are of greater risk of recurrence. Dig Liver Dis 2020; 52:214-220. [PMID: 31427089 DOI: 10.1016/j.dld.2019.07.013] [Citation(s) in RCA: 3] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 07/13/2019] [Accepted: 07/17/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Indication for adjuvant chemotherapy in ypN0 rectal cancer patients after chemoradiotherapy (CRT) is debated. The clinical significance of the presence of sterilized lymph nodes (LNS) in ypN0 patients remains to be determined. AIMS To assess the prognostic value of LNS in ypN0 rectal cancers after neoadjuvant CRT. METHODS From 2006-2016, 235 patients underwent TME surgery for non-metastatic mid-low rectal cancer after CRT. A lymph node was considered sterilized if there were signs of treatment response (fibrosis, necrosis or mucus) without residual tumor cells. RESULTS 180 patients (77%) were classified ypN0 and 55 (23%) ypN+. LNS was present in 20 patients (9%). In ypN0 patients, 5-year OS was similar between patients with and without LNS. In contrast, 5-year DFS was significantly lower in ypN0/LNS + patients (58% vs. 78%, p = 0.043) and was similar to those staged ypN+. In multivariate analysis, two factors were independent predictors of DFS: mesorectal grading (OR = 3.14; 95%CI: 1.10-8.34; p = 0.033) and the presence of LNS (OR = 3.93, 95% CI: 1.06-11.81, p = 0.042) CONCLUSION: The presence of LNS in ypN0 rectal cancer after neoadjuvant CRT is associated with an increased risk of recurrence and may be taken into account for the discussion of adjuvant chemotherapy.
Collapse
Affiliation(s)
- Gilles Manceau
- Department of Digestive and Hepato-Pancreato-Biliary Surgery, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital, Paris, France
| | - Nicolas Margot
- Department of Digestive and Hepato-Pancreato-Biliary Surgery, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital, Paris, France
| | - Jeremy Augustin
- Department of Pathology, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital, Paris, France
| | - Armelle Bardier
- Department of Pathology, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital, Paris, France
| | - Jean-Marc Simon
- Department of Radiotherapy, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital, Paris, France
| | - Jean-Baptiste Bachet
- Department of Hepato-Gastroenterology and Digestive Oncology, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital, Paris, France
| | - Jean-Philippe Spano
- Department of Medical Oncology, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital, Paris, France
| | - Philippe Maingon
- Department of Radiotherapy, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital, Paris, France
| | - Jean-Christophe Vaillant
- Department of Digestive and Hepato-Pancreato-Biliary Surgery, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital, Paris, France
| | - Mehdi Karoui
- Department of Digestive and Hepato-Pancreato-Biliary Surgery, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital, Paris, France.
| |
Collapse
|
7
|
Desbuissons G, Izzedine H, Bardier A, Dubreuil O, Vaillant JC, Frochot V, Mercadal L. Oxalate nephropathy is a major cause of kidney injury in surgically treated pancreatic adenocarcinoma patients. Clin Kidney J 2019; 12:821-828. [PMID: 31807294 PMCID: PMC6885689 DOI: 10.1093/ckj/sfz015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Indexed: 12/03/2022] Open
Abstract
Background Despite new therapeutics, the prognosis for pancreatic cancer remains poor. Pancreatic surgery is a therapeutic option in non-metastatic forms. The consequences for renal function are poorly described. Methods Patients who underwent surgery for pancreatic cancer between 1 January 2010 and 1 January 2017 and who experienced kidney biopsy in the Pitié-Salpêtrière Hospital were analysed. Results Two hundred and ninety-four patients had pancreatic surgery during the period of analysis and five of them had a kidney biopsy (mean ± SD 20 months ±13.6 months after surgery) during the post-operative follow-up. Among these patients, three exhibited oxalate nephropathy (ON), indicating that the prevalence of ON in patients with pancreatectomy is at least 1%. ON may be insidious, with chronic renal failure without urinary abnormalities. All patients had a high oxalate-to-creatinine ratio in urine sample. Renal function improved after specific management of ON in two patients. Pancreaticoduodenectomy may represent a higher risk of ON than left pancreatectomy. Conclusion Although rare and underestimated, ON appears to be a real risk after pancreatic resection. Early detection may preserve renal function.
Collapse
Affiliation(s)
- Geoffroy Desbuissons
- Nephrology Department, Pitié-Salpêtrière University Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France.,Division of Nephrology, RAMSAY-Générale de Santé, Hôpital privé de l'Ouest Parisien, Trappes, France
| | - Hassan Izzedine
- Nephrology Department, Pitié-Salpêtrière University Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France.,Division of Oncology, RAMSAY-Générale de Santé, Hôpital Privé Les Peupliers, Paris, France
| | - Armelle Bardier
- Pathology Department, Pitié-Salpêtrière University Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Olivier Dubreuil
- Oncology Department, Pitié-Salpêtrière University Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Jean Christophe Vaillant
- Department of Hepato Pancreato Biliary Surgery, Pitié-Salpêtrière University Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Vincent Frochot
- Physiology Unit, Tenon University Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Lucile Mercadal
- Nephrology Department, Pitié-Salpêtrière University Hospital, Assistance Publique des Hôpitaux de Paris, Paris, France
| |
Collapse
|
8
|
Raffenne J, Nicolle R, Puleo F, Le Corre D, Boyez C, Marechal R, Emile JF, Demetter P, Bardier A, Laurent-Puig P, de Mestier L, Paradis V, Couvelard A, VanLathem JL, MacKey JR, Bachet JB, Svrcek M, Cros J. hENT1 Testing in Pancreatic Ductal Adenocarcinoma: Are We Ready? A Multimodal Evaluation of hENT1 Status. Cancers (Basel) 2019; 11:cancers11111808. [PMID: 31752123 PMCID: PMC6896053 DOI: 10.3390/cancers11111808] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 11/05/2019] [Accepted: 11/13/2019] [Indexed: 02/06/2023] Open
Abstract
Gemcitabine is still one of the standard chemotherapy regimens for pancreatic ductal adenocarcinoma (PDAC). Gemcitabine uptake into tumor cells is mainly through the human equilibrative nucleoside transport 1 (hENT1). It was therefore proposed as a potential predictive biomarker of gemcitabine efficacy but reports are conflicting, with an important heterogeneity in methods to assess hENT1 expression. A multicenter cohort of 471 patients with a resected PDAC was used to assess simultaneously the predictive value of the 2 best described hENT1 antibodies (10D7G2 and SP120). Three additional antibodies and the predictive value of hENT1 mRNA were also tested on 251 and 302 patients, respectively. hENT1 expression was assessed in 54 patients with matched primary tumors and metastases samples. The 10D7G2 clone was the only hENT1 antibody whose high expression was associated with a prolonged progression free survival and overall survival in patients who received adjuvant gemcitabine. hENT1 mRNA level was also predictive of gemcitabine benefit. hENT1 status was concordant in 83% of the cases with the best concordance in synchronous metastases. The 10D7G2 clone has the best predictive value of gemcitabine benefit in PDAC patients. Since it is not commercially available, hENT1 mRNA level could represent an alternative to assess hENT1 status.
Collapse
Affiliation(s)
- Jerome Raffenne
- Institut national de la santé et de la recherche médicale (INSERM) U1149, Inflammation research center, Beaujon’s Hospital, 92110 Clichy, France; (J.R.); (C.B.); (V.P.); (A.C.)
| | - Remy Nicolle
- Programme Cartes d’Identité des Tumeurs (CIT), Ligue Nationale Contre Le Cancer, 75013 Paris, France;
| | - Francesco Puleo
- Gastroenterology Department, CHIREC Delta Hospital, 1160 Brussels, Belgium; (F.P.); (R.M.)
| | - Delphine Le Corre
- Sorbonne Paris Cité, Paris Descartes University, Georges Pompidou European Hospital, 75015 Paris, France; (D.L.C.); (P.L.-P.)
| | - Camille Boyez
- Institut national de la santé et de la recherche médicale (INSERM) U1149, Inflammation research center, Beaujon’s Hospital, 92110 Clichy, France; (J.R.); (C.B.); (V.P.); (A.C.)
| | - Raphael Marechal
- Gastroenterology Department, CHIREC Delta Hospital, 1160 Brussels, Belgium; (F.P.); (R.M.)
| | - Jean François Emile
- Department of Pathology, Ambroise Paré Hospital, 92100 Boulogne-Billancourt, France;
| | - Peter Demetter
- Department of Pathology, Erasme Hospital, 1000 Brussels, Belgium;
| | - Armelle Bardier
- Department of Pathology, Pitié-Salpetriére Hospital, 75013 Paris, France;
| | - Pierre Laurent-Puig
- Sorbonne Paris Cité, Paris Descartes University, Georges Pompidou European Hospital, 75015 Paris, France; (D.L.C.); (P.L.-P.)
| | - Louis de Mestier
- Department of Gastroenterology, Beaujon Hospital–Paris University, 92110 Clichy, France;
| | - Valerie Paradis
- Institut national de la santé et de la recherche médicale (INSERM) U1149, Inflammation research center, Beaujon’s Hospital, 92110 Clichy, France; (J.R.); (C.B.); (V.P.); (A.C.)
- Department of Pathology, Beaujon-Bichat Hospital–Paris University, 92110 Clichy, France
| | - Anne Couvelard
- Institut national de la santé et de la recherche médicale (INSERM) U1149, Inflammation research center, Beaujon’s Hospital, 92110 Clichy, France; (J.R.); (C.B.); (V.P.); (A.C.)
- Department of Pathology, Beaujon-Bichat Hospital–Paris University, 92110 Clichy, France
| | - Jean Luc VanLathem
- Department of Gastroenterology and medical oncology, Erasme Hospital, 1000 Brussels, Belgium;
| | - John R. MacKey
- Medical Oncoloy Cross Cancer Institute, Edmonton, AB T6G 1Z2, Canada;
| | - Jean-Baptiste Bachet
- Department of Gastroenterology, Pitié-Salpetrière Hospital, Sorbonne Universités, UPMC Université, 75013 Paris, France;
| | - Magali Svrcek
- Dpt of Pathology, Saint Antoine Hospital, 75012 Paris, France;
| | - Jerome Cros
- Institut national de la santé et de la recherche médicale (INSERM) U1149, Inflammation research center, Beaujon’s Hospital, 92110 Clichy, France; (J.R.); (C.B.); (V.P.); (A.C.)
- Department of Pathology, Beaujon-Bichat Hospital–Paris University, 92110 Clichy, France
- Correspondence:
| |
Collapse
|
9
|
Perkins G, Svrcek M, Bouchet-Doumenq C, Voron T, Colussi O, Debove C, Merabtene F, Dumont S, Sauvanet A, Hammel P, Cros J, André T, Bachet JB, Bardier A, Douard R, Meatchi T, Peschaud F, Emile JF, Cojean-Zelek I, Laurent-Puig P, Taieb J. Can we classify ampullary tumours better? Clinical, pathological and molecular features. Results of an AGEO study. Br J Cancer 2019; 120:697-702. [PMID: 30837681 PMCID: PMC6462032 DOI: 10.1038/s41416-019-0415-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 02/05/2019] [Accepted: 02/13/2019] [Indexed: 12/11/2022] Open
Abstract
Background Ampullary adenocarcinoma (AA) originates from either intestinal (INT) or pancreaticobiliary (PB) epithelium. Different prognostic factors of recurrence have been identified in previous studies. Methods In 91 AA patients of the AGEO retrospective multicentre cohort, we evaluated the centrally reviewed morphological classification, panel markers of Ang et al. including CK7, CK20, MUC1, MUC2 and CDX2, the 50-gene panel mutational analysis, and the clinicopathological AGEO prognostic score. Results Forty-three (47%) of the 91 tumours were Ang-INT, 29 (32%) were Ang-PB, 18 (20%) were ambiguous (Ang-AMB) and one could not be classified. Among these 90 tumours, 68.7% of INT tumours were Ang-INT and 78.2% of PB tumours were Ang-PB. MUC5AC expression was detected in 32.5% of the 86 evaluable cases. Among 71 tumours, KRAS, TP53, APC and PIK3CA were the most frequently mutated genes. The KRAS mutation was significantly more frequent in the PB subtype. In multivariate analysis, only AGEO prognostic score and tumour subtype were associated with relapse-free survival. Only AGEO prognostic score was associated with overall survival. Conclusions Mutational analysis and MUC5AC expression provide no additional value in the prognostic evaluation of AA patients. Ang et al. classification and the AGEO prognostic score were confirmed as a strong prognosticator for disease recurrence.
Collapse
Affiliation(s)
- Geraldine Perkins
- Sorbonne Paris - Cité, Paris Descartes University, Department of Gastroenterology and GI Oncology, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.,Centre de Recherche UMR-S 1147, Médecine Personnalisée, Pharmacogénomique, Optimisation Thérapeutique, Institut National de la Santé et de la Recherche Médicale, Paris, France
| | - Magali Svrcek
- Sorbonne-Université, Department of Pathology, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.,INSERM, UMR S 938, Sorbonne-Université, Université Pierre et Marie Curie - Paris 6, Paris, France
| | - Cecile Bouchet-Doumenq
- Centre de Recherche UMR-S 1147, Médecine Personnalisée, Pharmacogénomique, Optimisation Thérapeutique, Institut National de la Santé et de la Recherche Médicale, Paris, France.,Department of Gastrointestinal Surgery, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Thibault Voron
- Department of Gastrointestinal Surgery, Saint Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Orianne Colussi
- Sorbonne Paris - Cité, Paris Descartes University, Department of Gastroenterology and GI Oncology, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Clotilde Debove
- Department of Gastrointestinal Surgery, Saint Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Fatiha Merabtene
- INSERM, UMR S 938, Sorbonne-Université, Université Pierre et Marie Curie - Paris 6, Paris, France
| | - Sylvie Dumont
- INSERM, UMR S 938, Sorbonne-Université, Université Pierre et Marie Curie - Paris 6, Paris, France
| | - Alain Sauvanet
- Department of Digestive Surgery, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Pascal Hammel
- Department of Digestive Oncology, Beaujon University Hospital, Assistance Publique-Hôpitaux de Paris, Clichy, France.,Centre de Recherche sur l'Inflammation (CRI), INSERM UMR 1149, University of Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Jerome Cros
- Centre de Recherche sur l'Inflammation (CRI), INSERM UMR 1149, University of Paris Diderot, Sorbonne Paris Cité, Paris, France.,Department of Pathology, Beaujon University Hospital, Assistance Publique-Hôpitaux de Paris, Clichy, France
| | - Thierry André
- Sorbonne-Université, and department of Medical Oncology, Saint Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jean-Baptiste Bachet
- Centre de Recherche UMR-S 1147, Médecine Personnalisée, Pharmacogénomique, Optimisation Thérapeutique, Institut National de la Santé et de la Recherche Médicale, Paris, France.,Department of Hepato-Gastroenterology, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Armelle Bardier
- Surgical Pathology Department, Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Richard Douard
- Paris Descartes University, Department of Digestive Surgery, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Tchao Meatchi
- Paris Descartes University, Department of Pathology, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Frederique Peschaud
- Department of Surgery and Oncology, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt, France
| | - Jean-Francois Emile
- Department of Pathology, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne-Billancourt, France.,EA4340, Biomarqueurs en Cancérologie et Onco-Hématologie, UVSQ, Paris-Saclay University, Boulogne-Billancourt, France
| | | | - Pierre Laurent-Puig
- Centre de Recherche UMR-S 1147, Médecine Personnalisée, Pharmacogénomique, Optimisation Thérapeutique, Institut National de la Santé et de la Recherche Médicale, Paris, France
| | - Julien Taieb
- Sorbonne Paris - Cité, Paris Descartes University, Department of Gastroenterology and GI Oncology, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
| |
Collapse
|
10
|
Cohen R, Hain E, Buhard O, Guilloux A, Bardier A, Kaci R, Bertheau P, Renaud F, Bibeau F, Fléjou JF, André T, Svrcek M, Duval A. Assessment of local clinical practice for testing of mismatch repair deficiency in metastatic colorectal cancer: The need for new diagnostic guidelines prior to immunotherapy. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.083] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
11
|
Manceau G, Mori A, Bardier A, Augustin J, Breton S, Vaillant JC, Karoui M. Lymph node metastases in splenic flexure colon cancer: Is subtotal colectomy warranted? J Surg Oncol 2018; 118:1027-1033. [PMID: 30212600 DOI: 10.1002/jso.25169] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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: 05/15/2018] [Accepted: 06/28/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND OBJECTIVES Tumors of the splenic flexure (TSF) can be associated with metastatic lymph nodes (LN) along the left colic pedicle, but also along the superior mesenteric vessels. We aimed to detail the anatomical distribution of metastatic LNs in patients undergoing elective subtotal colectomy for TSF. METHOD Between 2000 and 2016, 65 patients were included. At pathological analysis, LNs were classified into two groups: locoregional LN (along the left colic artery) and distant LN (along the middle colic, right colic, and ileocolic arteries). RESULTS The median number of LNs examined was 20. Eighteen patients (27%) were pN+. Among them, six (33% of pN+ patients and 9% of the series) had at least one positive distant LN. All these patients had a positive distant LN along the right colic artery. These patients had a significantly advanced stage and more positive LNs than the others (stage III-IV: 100% vs 22%, P = 0.0009 and 6 [3-15] vs 0 [0-15], P < 0.0001, respectively). The presence of synchronous metastases was predictor of metastatic distant LNs (P = 0.042). CONCLUSION Elective subtotal colectomy for TSF allows to discover distant positive LNs in nearly 10% of patients. For those having TSF and synchronous metastatic disease enable to resection, subtotal colectomy should be recommended.
Collapse
Affiliation(s)
- Gilles Manceau
- Department of Digestive and Hepato-Pancreato-Biliary Surgery, Assistance Publique, Hôpitaux de Paris, Pitié-Salpêtrière Hospital, University Institute of Cancerology (Paris VI), Medicine Sorbonne University, France
| | - Arnaud Mori
- Department of Digestive and Hepato-Pancreato-Biliary Surgery, Assistance Publique, Hôpitaux de Paris, Pitié-Salpêtrière Hospital, University Institute of Cancerology (Paris VI), Medicine Sorbonne University, France
| | - Armelle Bardier
- Department of Pathology, Assistance Publique, Hôpitaux de Paris, Pitié-Salpêtrière Hospital, University Institute of Cancerology (Paris VI), Medicine Sorbonne University, France
| | - Jeremy Augustin
- Department of Pathology, Assistance Publique, Hôpitaux de Paris, Pitié-Salpêtrière Hospital, University Institute of Cancerology (Paris VI), Medicine Sorbonne University, France
| | - Sylvie Breton
- Department of Digestive and Hepato-Pancreato-Biliary Surgery, Assistance Publique, Hôpitaux de Paris, Pitié-Salpêtrière Hospital, University Institute of Cancerology (Paris VI), Medicine Sorbonne University, France
| | - Jean-Christophe Vaillant
- Department of Digestive and Hepato-Pancreato-Biliary Surgery, Assistance Publique, Hôpitaux de Paris, Pitié-Salpêtrière Hospital, University Institute of Cancerology (Paris VI), Medicine Sorbonne University, France
| | - Mehdi Karoui
- Department of Digestive and Hepato-Pancreato-Biliary Surgery, Assistance Publique, Hôpitaux de Paris, Pitié-Salpêtrière Hospital, University Institute of Cancerology (Paris VI), Medicine Sorbonne University, France
| |
Collapse
|
12
|
Eyraud D, Granger B, Bardier A, Loncar Y, Gottrand G, Le Naour G, Siksik JM, Vaillant JC, Klatzmann D, Puybasset L, Charlotte F, Augustin J. Immunological environment in colorectal cancer: a computer-aided morphometric study of whole slide digital images derived from tissue microarray. Pathology 2018; 50:607-612. [PMID: 30166125 DOI: 10.1016/j.pathol.2018.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 04/10/2018] [Accepted: 04/20/2018] [Indexed: 12/13/2022]
Abstract
Cancer research has moved from investigating tumour cells to including analysis of the tumour microenvironment as well. The aim of this study was to assess the cellular infiltrate of colorectal cancer (CRC) using computer-aided analysis of whole slide digital image derived from tissue microarray (TMA). TMA slides from 31 CRC patients were immunostained for forkhead box protein 3 (FOXP3) and immunomodulatory enzyme indoleamine 2,3-dioxygenase (IDO) at four sites: centre (C) and invasive front (F) of the tumour, proximal non-metastatic draining lymph node (N-), tumour-draining lymph node with metastasis (N+) and healthy mucosa at 10 cm from the cancer (M). We analysed the proportion of IDO+ tissue areas in the lamina propria or in the non-epithelial area of the lymph node and in epithelial cells in each site. The normal mucosa of patients operated on for benign disease was also analysed. The proportion (%) of FOXP3+ tissue area in C, F, N-, N+ and M were 2.3 ± 1.8, 2.6 ± 2.9, 6.0 ± 2.9, 14.2 ± 5.8 and 1.2 ± 0.8 (p < 0.001). The proportion (%) of IDO+ tissue area in the lamina propria of C, F, N-, N+ and M were 1.6 ± 3.1, 1.1 ± 1.3, 3.4 ± 2.5, 9.1 ± 8.5 and 6.7 ± 5.4 (p < 0.001). IDO+ tissue area in the lamina propria was not significantly different between healthy mucosa of patients with cancer than without (1.8 ± 3 vs 1.1 ± 0.95). The proportion of IDO positive tissue area in the epithelium was significantly higher in healthy mucosa of patients with cancer than without (5.4 ± 13.8 vs 2.1 ± 2.4). The FOXP3+ tissue area was increased in healthy mucosa of CRC patients in comparison with healthy mucosa of patients with colorectal resection for disease other than cancer: 1.20 ± 1.81 versus 0.81 ± 0.51 (p < 0.05). The proportion of IDO+ tissue area in lymph node (N-) was correlated with the proportion of FOXP3+ tissue area in tumour area (r = 0.44, p < 0.01). TMA technique permits simultaneous analysis of FOXP3+ and IDO+ cells at different sites including tumour, draining non-metastatic lymph node, metastatic lymph node and normal mucosa.
Collapse
Affiliation(s)
- Daniel Eyraud
- Département d'Anesthésie-Réanimation, Hôpital Pitié-Salpêtrière, Paris, France; Service d'Anatomie Pathologique, UIMAP, Hôpital Pitié-Salpêtrière, Paris, France; Service de Biothérapies, UPMC, CNRS 7211, INSERM 959, Hôpital Pitié-Salpêtrière, Paris, France.
| | - Benjamin Granger
- Département de Biostatistiques, de Santé Publique et d'Information Médicale, Hôpital Pitié-Salpêtrière, Paris, France
| | - Armelle Bardier
- Service d'Anatomie Pathologique, UIMAP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Yann Loncar
- Département d'Anesthésie-Réanimation, Hôpital Pitié-Salpêtrière, Paris, France
| | - GaËlle Gottrand
- Service de Biothérapies, UPMC, CNRS 7211, INSERM 959, Hôpital Pitié-Salpêtrière, Paris, France
| | - Gilles Le Naour
- Service d'Anatomie Pathologique, UIMAP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Jean-Michel Siksik
- Service de Chirurgie Digestive et de Transplantation Hépatique, Hôpital Pitié-Salpêtrière, Paris, France
| | - Jean-Christophe Vaillant
- Service de Chirurgie Digestive et de Transplantation Hépatique, Hôpital Pitié-Salpêtrière, Paris, France
| | - David Klatzmann
- Service de Biothérapies, UPMC, CNRS 7211, INSERM 959, Hôpital Pitié-Salpêtrière, Paris, France
| | - Louis Puybasset
- Département d'Anesthésie-Réanimation, Hôpital Pitié-Salpêtrière, Paris, France
| | - Frederic Charlotte
- Service d'Anatomie Pathologique, UIMAP, Hôpital Pitié-Salpêtrière, Paris, France
| | - Jeremy Augustin
- Service d'Anatomie Pathologique, UIMAP, Hôpital Pitié-Salpêtrière, Paris, France
| |
Collapse
|
13
|
Cohen R, Buhard O, Cervera P, Hain E, Dumont S, Bardier A, Bachet JB, Gornet JM, Lopez-Trabada D, Dumont S, Kaci R, Bertheau P, Renaud F, Bibeau F, Parc Y, Vernerey D, Duval A, Svrcek M, André T. Clinical and molecular characterisation of hereditary and sporadic metastatic colorectal cancers harbouring microsatellite instability/DNA mismatch repair deficiency. Eur J Cancer 2017; 86:266-274. [PMID: 29055842 DOI: 10.1016/j.ejca.2017.09.022] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [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: 07/04/2017] [Revised: 09/05/2017] [Accepted: 09/14/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Patients treated with chemotherapy for microsatellite unstable (MSI) and/or mismatch repair deficient (dMMR) cancer metastatic colorectal cancer (mCRC) exhibit poor prognosis. We aimed to evaluate the relevance of distinguishing sporadic from Lynch syndrome (LS)-like mCRCs. PATIENTS AND METHODS MSI/dMMR mCRC patients were retrospectively identified in six French hospitals. Tumour samples were screened for MSI, dMMR, RAS/RAF mutations and MLH1 methylation. Sporadic cases were molecularly defined as those displaying MLH1/PMS2 loss of expression with BRAFV600E and/or MLH1 hypermethylation and no MMR germline mutation. RESULTS Among 129 MSI/dMMR mCRC patients, 81 (63%) were LS-like and 48 (37%) had sporadic tumours; 22% of MLH1/PMS2-negative mCRCs would have been misclassified using an algorithm based on local medical records (age, Amsterdam II criteria, BRAF and MMR statuses when locally tested), compared to a systematical assessment of MMR, BRAF and MLH1 methylation statuses. In univariate analysis, parameters associated with better overall survival were age (P < 0.0001), metastatic resection (P = 0.001) and LS-like mCRC (P = 0.01), but not BRAFV600E. In multivariate analysis, age (hazard ratio (HR) = 3.19, P = 0.01) and metastatic resection (HR = 4.2, P = 0.001) were associated with overall survival, but not LS. LS-like patients were associated with more frequent liver involvement, metastatic resection and better disease-free survival after metastasectomy (HR = 0.28, P = 0.01). Median progression-free survival of first-line chemotherapy was similar between the two groups (4.2 and 4.2 months; P = 0.44). CONCLUSIONS LS-like and sporadic MSI/dMMR mCRCs display distinct natural histories. MMR, BRAF mutation and MLH1 methylation testing should be mandatory to differentiate LS-like and sporadic MSI/dMMR mCRC, to determine in particular whether immune checkpoint inhibitors efficacy differs in these two populations.
Collapse
Affiliation(s)
- R Cohen
- Department of Medical Oncology, Hôpital Saint-Antoine, AP-HP, 184 rue du Faubourg Saint-Antoine, Paris 75012, France; INSERM, Unité Mixte de Recherche Scientifique 938, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisee par la Ligue Nationale contre le Cancer, 184 rue du Faubourg Saint-Antoine, Paris 75012, France; Sorbonne Universités, UPMC Univ Paris 06, France.
| | - O Buhard
- INSERM, Unité Mixte de Recherche Scientifique 938, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisee par la Ligue Nationale contre le Cancer, 184 rue du Faubourg Saint-Antoine, Paris 75012, France
| | - P Cervera
- INSERM, Unité Mixte de Recherche Scientifique 938, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisee par la Ligue Nationale contre le Cancer, 184 rue du Faubourg Saint-Antoine, Paris 75012, France; Sorbonne Universités, UPMC Univ Paris 06, France; Department of Pathology, Hôpital Saint-Antoine, APHP, 184 rue du Faubourg Saint-Antoine, Paris 75012, France
| | - E Hain
- INSERM, Unité Mixte de Recherche Scientifique 938, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisee par la Ligue Nationale contre le Cancer, 184 rue du Faubourg Saint-Antoine, Paris 75012, France
| | - S Dumont
- Sorbonne Universités, UPMC Univ Paris 06, France
| | - A Bardier
- Surgical Pathology Department, Hôpital Pitié Salpêtrière, Paris, France
| | - J-B Bachet
- Department of Hepato-Gastroenterology, Hôpital Pitié Salpêtrière, Paris, France
| | - J-M Gornet
- Department of Hepato-Gastroenterology, Hôpital Saint-Louis, Paris, France
| | - D Lopez-Trabada
- Department of Medical Oncology, Hôpital Saint-Antoine, AP-HP, 184 rue du Faubourg Saint-Antoine, Paris 75012, France
| | - S Dumont
- Department of Medical Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - R Kaci
- Department of Pathology, Hôpital Lariboisière, Paris, France
| | - P Bertheau
- Department of Pathology, Hôpital Saint-Louis, Paris, France
| | - F Renaud
- Univ. Lille, UMR-S 1172 - JPARC - Jean-Pierre Aubert Research Center, Lille F-59000, France; INSERM, UMR-S 1172, Team "Mucins, Epithelial Differentiation and Carcinogenesis", Lille F-59000, France; CHU Lille, Institut de Pathologie, Lille F-59000, France
| | - F Bibeau
- Department of Pathology, Institut du Cancer de Montpellier, Montpellier, France
| | - Y Parc
- INSERM, Unité Mixte de Recherche Scientifique 938, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisee par la Ligue Nationale contre le Cancer, 184 rue du Faubourg Saint-Antoine, Paris 75012, France; Sorbonne Universités, UPMC Univ Paris 06, France; Department of Surgery, Hôpital Saint-Antoine, Paris, France
| | - D Vernerey
- Methodology and Quality of Life Unit in Oncology (INSERM UMR 1098), Centre Hospital-Universitaire de Besançon, France
| | - A Duval
- INSERM, Unité Mixte de Recherche Scientifique 938, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisee par la Ligue Nationale contre le Cancer, 184 rue du Faubourg Saint-Antoine, Paris 75012, France; Sorbonne Universités, UPMC Univ Paris 06, France
| | - M Svrcek
- INSERM, Unité Mixte de Recherche Scientifique 938, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisee par la Ligue Nationale contre le Cancer, 184 rue du Faubourg Saint-Antoine, Paris 75012, France; Sorbonne Universités, UPMC Univ Paris 06, France; Department of Pathology, Hôpital Saint-Antoine, APHP, 184 rue du Faubourg Saint-Antoine, Paris 75012, France
| | - Thierry André
- Department of Medical Oncology, Hôpital Saint-Antoine, AP-HP, 184 rue du Faubourg Saint-Antoine, Paris 75012, France; INSERM, Unité Mixte de Recherche Scientifique 938, Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisee par la Ligue Nationale contre le Cancer, 184 rue du Faubourg Saint-Antoine, Paris 75012, France; Sorbonne Universités, UPMC Univ Paris 06, France
| |
Collapse
|
14
|
Karoui M, Rullier A, Mariette C, Maillard E, Bardier A, Poizat F, Luciani A, Sarran A, Legoux JL, De Chaisemartin C, Lecaille C, Bouche O, Mauvais F, Brunetti F, Prudhomme M, Seitz JF, Lepage C, Taieb J. Neoadjuvant FOLFOX 4 versus FOLFOX 4 plus cetuximab versus immediate surgery for high-risk stage II and III colon cancers: A phase II multicentre randomised controlled trial (PRODIGE 22). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
15
|
Cohen R, Hain E, Cervera P, Buhard O, Dumont S, Bardier A, Bachet JB, Gornet JM, Dumont S, Kaci R, Bertheau P, Renaud F, Bibeau F, Parc Y, Duval A, Svrcek M, Andre T. Clinical and molecular characterization of patients with metastatic colorectal cancer harbouring DNA mismatch repair deficiency. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.3563] [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
3563 Background: Prognosis of patients (pts) with metastatic colorectal cancer (mCRC) harboring microsatellite instability (MSI) is poorly characterized. We aimed to assess the clinical relevance of distinguishing sporadic (SP) from Lynch syndrome (LS)-related mismatch repair deficiency (dMMR). Methods: Pts with diagnostic of dMMR and/or MSI mCRC between 1998 and 2016 were retrospectively identified in 6 French hospitals. Tumor samples were systematically collected and screened for RAS/RAF mutations and MLH1 promotor methylation. dMMR and MSI statuses were confirmed using immunohistochemistry and Pentaplex© PCR assay. Sporadic cases were molecularly defined as those displaying MLH1 loss of expression with BRAFV600E mutation and/or MLH1 hypermethylation. Clinical data (demographic data, metastatic sites, therapeutic strategies) were recorded. Results: 129 pts, of which 48 SP and 81 LS, were included. Compared with LS, SP were associated with female (P < .001), older age at diagnostic (P < .001), proximal colon (P = 0.002), and less liver metastasis (25% vs 47%, P = .02). For initially localized CRC, median disease free survivals (DFS) were 9.1 months (m) for SP (n = 22) and 12.3 m for LS (n = 47) (hazard ratio (HR) = 0.5, 95%CI 0.28-0.90, P = .02). Median overall survivals (OS) from stage IV diagnosis were 43.9 m in the overall population, 23 m for SP and not reached for LS (HR = 0.23, 95%CI 0.10-0.52, P < .001). BRAF mutation was harbored by 29 SP tumors (60%) and did not impact OS among SP pts (P = .52). Metastatic disease was less frequently resectable for SP than LS (21% vs 56%, P < .001). Median DFS for pts with resected metastatic disease (n = 55) were respectively 6.7 and 10.5 m (HR = 0.28, 95%CI 0.10-0.73, P = .01). At the data cut-off date, 16 pts (15 LS and 1 SP) were still in complete remission. Median progression free survivals with first-line chemotherapy for pts with unresectable metastasis (n = 61) were 3.9 m for SP and 5.0 m for LS (P = .71). Conclusions: This retrospective study suggests a worse prognosis of pts with SP MSI mCRC compared to these with LS-related mCRC.
Collapse
Affiliation(s)
- Romain Cohen
- Medical Oncology Department, Saint-Antoine Hospital, Paris, France
| | - Elisabeth Hain
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Centre de Recherche Saint-Antoine (CRSA), Paris, France
| | | | - Olivier Buhard
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Centre de Recherche Saint-Antoine (CRSA), Paris, France
| | - Sylvie Dumont
- Sorbonne Universités, UPMC Univ Paris 06, Paris, France
| | - Armelle Bardier
- Surgical Pathology Department, Pitie Salpetriere Hospital, Paris, France
| | | | | | | | - Rachid Kaci
- Pathology Department, Lariboisiere Hospital, Paris, France
| | | | | | | | - Yann Parc
- Department of Surgery, Saint-Antoine Hospital, Paris, France
| | - Alex Duval
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, Centre de Recherche Saint-Antoine (CRSA), Paris, France
| | - Magali Svrcek
- Pathology Department, Saint-Antoine Hospital, Paris, France
| | - Thierry Andre
- Medical Oncology Department, Saint-Antoine Hospital, Paris, France
| |
Collapse
|
16
|
Perkins G, Bouchet-Doumenq C, Svrcek M, Colussi O, Voron T, Sauvanet A, Hammel P, Cros J, Paye F, Andre T, Vaillant JC, Bachet JB, Bardier A, Berger A, Meatchi T, Nordlinger B, Emile JF, Cojean-Zelek I, Taieb J, Laurent-Puig P. Genomic profiling of ampullary adenocarcinoma (AA): Insights from a comparative analysis of pancreatic and intestinal adenocarcinoma and opportunities for targeted therapies use. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.4_suppl.300] [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
300 Background: Ampullary adenocarcinoma (AA) is a rare entity. AA can originate from either intestinal or pancreaticobiliary ductal epithelium, and patients are often managed as those with pancreaticobiliary carcinomas. The study objectives were the genetic profiling of AA and the identification of specific molecular profiles according to these 2 pathological types. Methods: AA patients included in the AGEO retrospective multicenter cohort who underwent surgical resection of their tumor between 1999 and 2010 were selected. Formalin-fixed, paraffin-embedded (FFPE) archival tissue blocks were collected. Next generation sequencing (NGS) using a 50 gene panel (Ion AmpliSeq Cancer panel) on tumor DNA, and immunohistochemistry (IHC) panel including CK7, CK20, MUC1, MUC2 and CDX2, on tumor sections, were performed. Results: NGS was performed on 101 tumors from 6 hospitals, with 1 technical failure. In total, the most frequent gene mutations were: KRAS (45%), TP53 (40%), APC (15%), PIK3CA (12%), SMAD4 (9%), BRAF (8%), CDKN2A (6%). No mutation was found in 21% of tumors. According to IHC, the most common histological type was intestinal (51%), followed by pancreaticobiliary type (42%) and undetermined (7%). BRAF mutation was significantly associated with intestinal type (8 vs 0, p = 0.017). According to Cosmic database, similarities of molecular profiles exist between AA with intestinal type and colorectal adenocarcinoma, and between AA with pancreaticobiliary type and pancreas adenocarcinoma, respectively. Conclusions: This study shows that AA is a heterogeneous entity and that a large proportion of AA presents a molecular profile that is more similar to that of colorectal adenocarcinoma, compared to pancreatic adenocarcinoma. This important information could be interesting to guide treatment decision in patients with this rare disease.
Collapse
Affiliation(s)
| | | | - Magali Svrcek
- Department of Pathology, Saint-Antoine Hospital, Paris, France
| | | | | | | | | | | | | | | | | | | | | | - Anne Berger
- Georges Pompidou European Hospital, Paris, France
| | | | | | | | | | - Julien Taieb
- Hopital Europeen Georges-Pompidou, Paris, France
| | | |
Collapse
|
17
|
Spano J, Gobert A, Mateescu C, Mouawad R, Bardier A, Bachet J, Dubreuilh O, Varinot J, Mitri R, Khayat D, Malouf G, Capron F. 2057 Assessment oftumor-infiltrating lymphocytes in metastatic colorectal cancer patients treated by Bevacizumab-based chemotherapy. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30980-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
18
|
Karoui M, Rullier A, Luciani A, Bonnetain F, Auriault ML, Sarran A, Monges G, Trillaud H, Le Malicot K, Leroy K, Sobhani I, Bardier A, Moreau M, Brindel I, Seitz JF, Taieb J. Neoadjuvant FOLFOX 4 versus FOLFOX 4 with Cetuximab versus immediate surgery for high-risk stage II and III colon cancers: a multicentre randomised controlled phase II trial--the PRODIGE 22--ECKINOXE trial. BMC Cancer 2015; 15:511. [PMID: 26156156 PMCID: PMC4497499 DOI: 10.1186/s12885-015-1507-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Accepted: 06/19/2015] [Indexed: 02/08/2023] Open
Abstract
Background In patients with high risk stage II and stage III colon cancer (CC), curative surgery followed by adjuvant FOLFOX-4 chemotherapy has become the standard of care. However, for 20 to 30 % of these patients, the current curative treatment strategy of surgical excision followed by adjuvant chemotherapy fails either to clear locoregional spread or to eradicate distant micrometastases, leading to disease recurrence. Preoperative chemotherapy is an attractive concept for these CCs and has the potential to impact upon both of these causes of failure. Optimum systemic therapy at the earliest possible opportunity may be more effective at eradicating distant metastases than the same treatment given after the delay and immunological stress of surgery. Added to this, shrinking the primary tumor before surgery may reduce the risk of incomplete surgical excision, and the risk of tumor cell shedding during surgery. Methods/Design PRODIGE 22 - ECKINOXE is a multicenter randomized phase II trial designed to evaluate efficacy and feasibility of two chemotherapy regimens (FOLFOX-4 alone and FOLFOX-4 + Cetuximab) in a peri-operative strategy in patients with bulky CCs. Patients with CC deemed as high risk T3, T4 and/or N2 on initial abdominopelvic CT scan are randomized to either colectomy and adjuvant chemotherapy (control arm), or 4 cycles of neoadjuvant chemotherapy with FOLFOX-4 (for RAS mutated patients). In RAS wild-type patients a third arm testing FOLFOX+ cetuximab has been added prior to colectomy. Patients in the neoadjuvant chemotherapy arms will receive postoperative treatment for 4 months (8 cycles) to complete their therapeutic schedule. The primary endpoint of the study is the histological Tumor Regression Grade (TRG) as defined by Ryan. The secondary endpoints are: treatment strategy safety (toxicity, primary tumor related complications under chemotherapy, peri-operative morbidity), disease-free and recurrence free survivals at 3 years, quality of life, carcinologic quality and completeness of the surgery, initial radiological staging and radiological response to neoadjuvant chemotherapy, and the correlation between histopathological and radiological response. Taking into account a 50 % prevalence of CC without RAS mutation, accrual of 165 patients is needed for this Phase II trial. Trial Registration NCT01675999 (ClinicalTrials.gov)
Collapse
Affiliation(s)
- Mehdi Karoui
- Assistance Publique-Hôpitaux de Paris, Pitié-Salpêtrière University Hospital, Department of Digestive and Hepato-Pancreato-Biliary Surgery, University Institute of Cancerology (Paris VI), Pierre & Marie Curie University (Paris VI), 47-83 Boulevard de l'Hôpital, 75013, Paris, France. .,FFCD (Fédération Francophone de Cancérologie Digestive), Dijon, France.
| | - Anne Rullier
- Department of Pathology, Pellegrin University Hospital, Bordeaux, France.
| | - Alain Luciani
- Assistance Publique-Hôpitaux de Paris, Department of Radiology, Henri Mondor University Hospital, Paris XII university, Créteil, France.
| | - Franck Bonnetain
- Department of Medical Oncology and public health, Centre Hospitalier Régional Universitaire Hôpital Jean Minjoz, Besançon, France.
| | - Marie-Luce Auriault
- Assistance Publique-Hôpitaux de Paris, Department of Pathology, Henri Mondor University Hospital, Créteil, France.
| | - Antony Sarran
- Department of Radiology, Institut Paoli Calmettes, Marseille, France.
| | - Geneviève Monges
- Department of Pathology, Institut Paoli Calmettes, Marseille, France.
| | - Hervé Trillaud
- Department of Radiology, St André University Hospital, Bordeaux, France.
| | - Karine Le Malicot
- FFCD (Fédération Francophone de Cancérologie Digestive), Dijon, France.
| | - Karen Leroy
- Assistance Publique-Hôpitaux de Paris, Department of Pathology, Henri Mondor University Hospital, Créteil, France.
| | - Iradj Sobhani
- Assistance Publique-Hôpitaux de Paris, Department of Gastroenterology, Henri Mondor University Hospital, Créteil, France.
| | - Armelle Bardier
- Assistance Publique-Hôpitaux de Paris, Department of Pathology, Pitié-Salpêtrière University Hospital, Paris, France.
| | - Marie Moreau
- FFCD (Fédération Francophone de Cancérologie Digestive), Dijon, France.
| | - Isabelle Brindel
- Assistance Publique-Hôpitaux de Paris, Département de la Recherche Clinique et du Développement (DRCD), Paris, France.
| | | | - Julien Taieb
- FFCD (Fédération Francophone de Cancérologie Digestive), Dijon, France. .,Assistance Publique-Hôpitaux de Paris, Department of Digestive Oncology, European Georges Pompidou - Paris Descartes University, Paris, France.
| |
Collapse
|
19
|
Maréchal R, Bachet J, Mackey JR, Demetter P, Graham K, Couvelard A, Svrcek M, Bardier A, Hammel P, Sauvanet A, Louvet C, Paye F, Rougier P, Hannoun L, Andre T, Dumontet CM, Cass CE, Salmon I, Emile J, Van Laethem J. Prediction of gemcitabine benefit after curative-intent resection of pancreatic adenocarcinoma using HENT1 and dCK protein expression. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
20
|
Chaput N, Louafi S, Bardier A, Charlotte F, Vaillant JC, Ménégaux F, Rosenzwajg M, Lemoine F, Klatzmann D, Taieb J. Identification of CD8+CD25+Foxp3+ suppressive T cells in colorectal cancer tissue. Gut 2009; 58:520-9. [PMID: 19022917 DOI: 10.1136/gut.2008.158824] [Citation(s) in RCA: 196] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The antitumoral immune response is one determinant of colorectal cancer (CRC) outcome. Recent work suggests that Foxp3(+)CD25(+)CD4(+) regulatory T cells (T4reg) might hamper effective immunosurveillance of emerging cancer cells and impede effective immune responses to established tumours. In this descriptive study, we analysed blood and tissue regulatory T cell populations in patients with CRC. METHODS Blood and tissue regulatory Foxp3(+) T cells from 40 patients with CRC were compared to regulatory Foxp3(+) T cells from normal colonic tissue and from blood of 26 healthy volunteers. Flow cytometry was used to quantify and phenotype all Foxp3(+) T cell populations. Correlations were sought with the tumour stage and with micro-invasive status. The suppressive capacity of regulatory Foxp3(+) T cells was assessed by their effect on CD4(+)CD25(-) T cell proliferation in vitro and by their capacity to inhibit cytokine production by conventional T cells. RESULTS We found a significant increase of CD8(+)CD25(+)Foxp3(+) cells (T8reg) in blood and CRC tissue; their phenotype was close to that of T4reg. T8reg cells infiltrating CRC were activated, as suggested by increased cytoxic T lymphocyte-associated antigen-4, glucocorticoid-induced tumour necrosis factor-related protein, and transforming growth factor (TGF)beta1 expression compared to T8reg from normal autologous colonic tissue. Moreover, T8reg were able to suppress CD4(+)CD25(-) T cell proliferation and Th1 cytokine production ex vivo, demonstrating that tumour-infiltrating T8reg have strong suppressive capacities. T8reg numbers correlated with the tumour stage and with micro-invasive status. Finally, interleukin 6 and TGF beta 1 synergistically induced the generation of CD8(+)CD25(+)Foxp3(+) T cells ex vivo. CONCLUSIONS We have identified a new regulatory T cell population (CD8(+)Foxp3(+)) in colorectal tumours. After isolation from cancer tissue these CD8(+)Foxp3(+) cells demonstrated strong immunosuppressive properties in vitro. These data suggest that these cells may contribute to tumoral immune escape and disease progression.
Collapse
Affiliation(s)
- N Chaput
- Département de Biothérapie, Groupe Hospitalier Pitié Salpêtrière, Paris, France
| | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Izzedine H, Boostandoot E, Spano JP, Bardier A, Khayat D. Temsirolimus-Induced Glomerulopathy. Oncology 2009; 76:170-2. [DOI: 10.1159/000201930] [Citation(s) in RCA: 13] [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: 07/11/2008] [Accepted: 08/20/2008] [Indexed: 11/19/2022]
|
22
|
Levy PP, Bardier A, Doublet JD, Sibony M. Generalized Caseview applied to prostate cancer prognosis. Annu Int Conf IEEE Eng Med Biol Soc 2009; 2008:5129-31. [PMID: 19163871 DOI: 10.1109/iembs.2008.4650368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The interpretation of results of any study using large tables with series of numbers is always difficult. Generalized Case View Method (GCm) allows translating these tables of numbers into an image. The Method identifies each informational entity in the table with a 'pixel', forming what we call an 'infoxel'. The sum of all informational entities becomes an image, the Generalized Caseview. The method consists of two steps: the first one is to define the reference frame while the second is to visualize data through the reference frame. The 'infoxels' that constitute the reference frame should be organized according to three criteria: binary, nominal and ordinal. Here this method has been applied to visualize the results of a study about prostate cancer spread. This paper exemplifies the usefulness of associating a classical statistical tool with Generalized Caseview method to solve a biomedical problem.
Collapse
Affiliation(s)
- Pierre P Levy
- Public Health Department Hôpital Tenon, Assistance Publique Hôpitaux de Paris, 4 rue de la Chine, 75970, Cedex 20, France.
| | | | | | | |
Collapse
|
23
|
Bardier A, Golmard J, Dômont J, Genestie C, Vaillant J, Taieb J, Auclerc G, Khayat D, Capron F, Spano J. Coexpression of EGFR, pEGFR, VEGF, pVEGF, PTEN, pAKT, and p21 in colorectal cancer patients can have IHC variability between metastases and primary tumours and for EGFR-targeted therapies, p21 and VEGF appear reliably as predictive factors of response. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.22074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
24
|
Bardier A, Couvidat C, Gandjbakhch I, Capron F, Brochériou I. Étude rétrospective de 421 biopsies péricardiques : expérience du Groupe Hospitalier Pitié-Salpêtrière. Ann Pathol 2006. [DOI: 10.1016/s0242-6498(06)78466-8] [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: 11/27/2022]
|
25
|
Dechaud C, Bardier A, Le Pelletier F, Gibert C, Capron F. Acanthamœbiase disséminée chez un homme de 39 ans transplanté cardiaque diagnostiquée sur une biopsie cutanée. Ann Pathol 2006. [DOI: 10.1016/s0242-6498(06)78468-1] [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: 11/28/2022]
|
26
|
Bardier A, Charlotte F, Breton S, Lucidarme O, Hannoun L, Capron F. Assises de Pathologie, Lyon, 11 et 12 mai 2006. Ann Pathol 2006. [DOI: 10.1016/s0242-6498(06)70714-3] [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: 11/30/2022]
|
27
|
Blot E, Decaudin D, Veyradier A, Bardier A, Zagame OL, Pouillart P. Cancer-related thrombotic microangiopathy secondary to Von Willebrand factor-cleaving protease deficiency. Thromb Res 2002; 106:127-30. [PMID: 12182911 DOI: 10.1016/s0049-3848(02)00095-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Cancer-related thrombotic microangiopathy (TM) is a serious complication with a short-term life-threatening prognosis. This complication shares certain similarities with thrombotic thrombocytopenic purpura and hemolytic uremic syndrome, both characterized by circulating platelet aggregates containing ultralarge multimers of Von Willebrand factor (VWF). We report a case of cancer-related thrombotic microangiopathy secondary to disseminated metastatic cancer with undetectable serum Von Willebrand factor-cleaving protease activity and no evidence of serum inhibitory antibody. A concomitant decrease of Ca 19-9 level and hemolysis was observed during chemotherapy, in parallel with normalization of Von Willebrand factor-cleaving protease activity. The role of ultralarge multimers of Von Willebrand factor in platelet aggregation in the context of metastatic disease is discussed with respect to our findings in this case of cancer-related thrombotic microangiopathy.
Collapse
Affiliation(s)
- Emmanuel Blot
- Department of Medical Oncology, Institut Curie, 26, rue d'Ulm, 75231 Paris Cedex 05, France.
| | | | | | | | | | | |
Collapse
|
28
|
Rolland M, Martinez J, Ghisolfi J, Bardier A, Dutau G. [A further case of 49 (XXXXY) karyotype. Discussion of the chromosomal mechanism of this disease]. Arch Fr Pediatr 1972; 29:565. [PMID: 4655660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
|
29
|
Bardier A, Martinez J, Andrieu P, Leloup M, Van KT. [Evaluation of Klebsiella infection in an infant hospital department]. Arch Fr Pediatr 1972; 29:449. [PMID: 5053226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|
30
|
Martinez J, Bardier A, Pasternac A. [Spasms in flexion and cardiac rhythm disorders of uncertain etiology: toxoplasmosis or Bourneville's tuberous sclerosis]. Arch Fr Pediatr 1972; 29:434. [PMID: 5053213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|
31
|
Bardier A, Martinez J, Rochiccioli P, Cathala B. [Generalized glycogenosis with angiographic appearance of obstructive cardiopathy]. Arch Fr Pediatr 1969; 26:873-87. [PMID: 4243907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
|
32
|
Bardier A, Régnier C, Barthe P, Ghisolfi J, Monnier L, Didier E. [Cystinuria in an infant (an attempt of controlling sulfoaminoacids in the diet)]. Arch Fr Pediatr 1969; 26:223. [PMID: 5375877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
|
33
|
Bardier A, Régnier C, Carrière JP, Barthe P, Chollet P, Chateauneuf R. [Gaucher's disease with hypersplenism in an infant. Splenectomy. Satisfactory evolution]. Arch Fr Pediatr 1969; 26:224. [PMID: 5385041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
|
34
|
Fessard C, Frezal J, Roy C, Martinez F, Bardier A, Lamy M. [Familial case of myasthenia in early childhood]. Arch Fr Pediatr 1968; 25:291-9. [PMID: 5670327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
|
35
|
Bardier A, Calazel P, Martinez J. [Primary endocardial fibroelastosis (personal experience)]. Arch Fr Pediatr 1967; 24:179-94. [PMID: 6032017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
|
36
|
Ruffié J, Virenque J, Bardier A, Colombies P. [Complex chromosome changes bearing on the autosomes accompanying cranio-facial abnormalities and an umbilical hernia]. C R Acad Hebd Seances Acad Sci D 1966; 262:386-9. [PMID: 4955849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|
37
|
Calazel P, Martinez J, Bardier A. [Cardiac catheterization and angiocardiography in infants]. Pediatrie 1965; 20:685-708. [PMID: 5850059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
|
38
|
Bardier A, Régnier C, Martinez J, Rochiccioli P, Petel B. [Poly-epiphyseal dysplasia in a pseudo-achondroplastic form]. Arch Fr Pediatr 1965; 22:592-4. [PMID: 5836472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
|