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Salin G, Corpechot C, Ouazana S, Dong C, Becq A, Lemoinne S, Ben Belkacem K, Leenhardt R, Chaput U, Chazouillères O, Kirchgesner J, Camus M. Endoscopic features of low-phospholipid-associated cholelithiasis syndrome: A retrospective cohort study. Clin Res Hepatol Gastroenterol 2024; 48:102324. [PMID: 38527568 DOI: 10.1016/j.clinre.2024.102324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 03/17/2024] [Accepted: 03/23/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND AND OBJECTIVE LPAC (low phospholipid-associated cholelithiasis) syndrome is a rare genetic form of cholelithiasis. ERCP (endoscopic retrograde cholangiopancreatography) is often used to remove gallstones in the bile duct. No published data is available on the role of ERCP in LPAC syndrome. PATIENTS AND METHODS In this retrospective cohort study, we included patients diagnosed with LPAC syndrome in a single tertiary referral center between 2009 and 2021. Our aim was to assess the frequency, indications, modalities, results, and complications of ERCP, as well as predictive factors for ERCP, in LPAC syndrome. Independent factors associated with ERCP occurrence were identified using a multivariable Cox regression analysis. RESULTS ERCP was required in 31.2 % of the 269 patients included for analysis. Among patients who required ERCPs, 78.6 % had the procedure before diagnosis (i.e., starting UDCA). Most common indications were choledocholithiasis (53.6 %) and acute cholangitis (29.5 %). Post ERCP pancreatitis, perforation and bleeding rates were 7.2 %, 2.6 %, and 1.3 %, respectively. Age and history of cholelithiasis in first-degree relatives were associated with a higher risk of ERCP (Hazard-ratio [HR]=1.30 [95 %confidence-interval [CI] 1.04-1.62] and HR=1.88 [95 %CI 1.15-3.07] respectively). Female gender and UDCA intake ≥ 1 year were associated with a lower risk of ERCP (HR=0.49 [95 %CI 0.29-0.82] and HR=0.44 [95 %CI 0.22-0.90] respectively). Median follow-up was 10.8 years. CONCLUSION One-third of patients with LPAC syndrome undergo sphincterotomy. However, most procedures are performed before diagnosis and UDCA is associated with a lower risk of endoscopic procedure. Earlier diagnosis and treatment with UDCA may further reduce the need for ERCP in patients with LPAC syndrome.
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Affiliation(s)
- G Salin
- Sorbonne University, Hepatogastroenterology - Endoscopy unit, Saint-Antoine Hospital and Research Center, Assistance Publique - Hopitaux de Paris, Paris, France.
| | - C Corpechot
- Sorbonne University, Reference center for Inflammatory Biliary Diseases and Autoimmune Hepatitis, ERN Rare-Liver, Saint-Antoine Hospital and Research Center, Assistance Publique - Hopitaux de Paris, Paris, France; French National Cohort of Patients with LPAC syndrome RaDiCo-COLPAC, RaDiCo, Inserm U933, Armand Trousseau Hospital, Paris, France
| | - S Ouazana
- Sorbonne University, Hepatogastroenterology - Endoscopy unit, Saint-Antoine Hospital and Research Center, Assistance Publique - Hopitaux de Paris, Paris, France
| | - C Dong
- Sorbonne University, Reference center for Inflammatory Biliary Diseases and Autoimmune Hepatitis, ERN Rare-Liver, Saint-Antoine Hospital and Research Center, Assistance Publique - Hopitaux de Paris, Paris, France; French National Cohort of Patients with LPAC syndrome RaDiCo-COLPAC, RaDiCo, Inserm U933, Armand Trousseau Hospital, Paris, France
| | - A Becq
- Paris-Est Creteil University, Department of Gastroenterology, Henri Mondor Hospital, Assistance Publique - Hopitaux de Paris, Paris, France
| | - S Lemoinne
- Sorbonne University, Reference center for Inflammatory Biliary Diseases and Autoimmune Hepatitis, ERN Rare-Liver, Saint-Antoine Hospital and Research Center, Assistance Publique - Hopitaux de Paris, Paris, France; French National Cohort of Patients with LPAC syndrome RaDiCo-COLPAC, RaDiCo, Inserm U933, Armand Trousseau Hospital, Paris, France
| | - K Ben Belkacem
- Sorbonne University, Reference center for Inflammatory Biliary Diseases and Autoimmune Hepatitis, ERN Rare-Liver, Saint-Antoine Hospital and Research Center, Assistance Publique - Hopitaux de Paris, Paris, France; French National Cohort of Patients with LPAC syndrome RaDiCo-COLPAC, RaDiCo, Inserm U933, Armand Trousseau Hospital, Paris, France
| | - R Leenhardt
- Sorbonne University, Hepatogastroenterology - Endoscopy unit, Saint-Antoine Hospital and Research Center, Assistance Publique - Hopitaux de Paris, Paris, France
| | - U Chaput
- Sorbonne University, Hepatogastroenterology - Endoscopy unit, Saint-Antoine Hospital and Research Center, Assistance Publique - Hopitaux de Paris, Paris, France
| | - O Chazouillères
- Sorbonne University, Reference center for Inflammatory Biliary Diseases and Autoimmune Hepatitis, ERN Rare-Liver, Saint-Antoine Hospital and Research Center, Assistance Publique - Hopitaux de Paris, Paris, France; French National Cohort of Patients with LPAC syndrome RaDiCo-COLPAC, RaDiCo, Inserm U933, Armand Trousseau Hospital, Paris, France
| | - J Kirchgesner
- Sorbonne University, Department of Gastroenterology, Saint-Antoine Hospital and Research Center, Assistance Publique - Hopitaux de Paris, Paris, France
| | - M Camus
- Sorbonne University, Hepatogastroenterology - Endoscopy unit, Saint-Antoine Hospital and Research Center, Assistance Publique - Hopitaux de Paris, Paris, France
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2
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Heredia A, Walbaum B, Vidal M, Itriago L, Camus M, Dominguez F, Manzor M, Martínez R, Murature G, Muñiz S, Navarro M, Guerra C, Merino T, Medina L, Ibañez C, Ramirez K, Acevedo F, Sánchez C. Suboptimal use of ovarian function suppression in very young women with early breast cancer: a real-world data study. Breast Cancer Res Treat 2024; 203:173-179. [PMID: 37733187 DOI: 10.1007/s10549-023-07117-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 08/24/2023] [Indexed: 09/22/2023]
Abstract
PURPOSE The incidence of breast cancer in young women (BCYW) has increased in recent decades. Malignant disease in this subset is characterized by its aggressiveness and poor prognosis. Ovarian function suppression (OFS) in these patients improves survival especially in hormone receptor-positive (HR +) cases. The Regan Composite Risk (RCR) is a prognostic tool to identify high-risk HR + BC candidates for OFS. Our study sought to characterize a Chilean cohort of early HR + BCYW assessing the use of OFS and its related prognosis and the utility of RCR in our patients. METHODS This was a retrospective population cohort study that included ≤ 35-year-old early HR + /human epidermal growth factor receptor 2 -negative (HER2-) BC patients treated between 2001 and 2021. Analysis included clinical-pathological characteristics, treatment strategies, and survival. Also, we evaluated the association between RCR and survival. RESULTS A total of 143 patients were included into our study, representing 2.9% of all early BC cases in our registry. Median age was 31 years old (range: 19-35). Most patients (93%) received endocrine therapy (ET). Of these, 18% received OFS. No survival differences were observed among treatment strategies. Median RCR score for patients treated with CT plus ET was significantly higher vs. ET alone (2.95 vs. 1.91; p = 0.0001). Conversely, patients treated with tamoxifen alone had significantly lower RCR scores vs. OFS (2.72 vs. 3.14; p = 0.04). Higher RCR scores were associated with poorer overall survival. CONCLUSION Less than 20% of very young women with early HR + /HER2-BC in our cohort received OFS, in most cases, this involved surgical oophorectomy. RCR score was higher in patients that underwent CT and OFS and was associated with survival, regardless of treatment. We confirm the RCR score as a valuable prognostic tool to identify high-risk BC patients who could benefit from OFS.
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Affiliation(s)
- Ana Heredia
- Departamento de Hematología-Oncología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile
- Unidad de Oncología Hospital Herminda Martín, Chillán, Chile
| | - Benjamín Walbaum
- Departamento de Hematología-Oncología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile
- Fundación ChileSinCáncer, Santiago, Chile
- Oncología Médica, Hospital Dr. Sótero del Río, Santiago, Chile
| | - María Vidal
- Translational Genomics and Targeted Therapeutics in Solid Tumors Lab - IDIBAPS, Hospital Clinic Barcelona, Universidad de Barcelona, Barcelona, España
| | - Laura Itriago
- Departamento de Hematología-Oncología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile
| | - Mauricio Camus
- Departamento de Cirugía Oncológica, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francisco Dominguez
- Departamento de Cirugía Oncológica, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Manuel Manzor
- Cirugía Oncológica, Hospital Dr. Sótero del Río, Santiago, Chile
| | - Raúl Martínez
- Cirugía Oncológica, Hospital Dr. Sótero del Río, Santiago, Chile
| | - Geraldine Murature
- Cirugía Oncológica, Hospital Dra. Eloísa Díaz La Florida, Santiago, Chile
| | - Sabrina Muñiz
- Departamento de Hematología-Oncología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile
| | - Marisel Navarro
- Cirugía Oncológica, Hospital Dr. Sótero del Río, Santiago, Chile
| | - Constanza Guerra
- Cirugía Oncológica, Hospital Dr. Sótero del Río, Santiago, Chile
| | - Tomas Merino
- Departamento de Hematología-Oncología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile
| | - Lidia Medina
- Departamento de Hematología-Oncología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile
| | - Carolina Ibañez
- Departamento de Hematología-Oncología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile
| | - Karol Ramirez
- Departamento de Hematología-Oncología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile
- Fundación ChileSinCáncer, Santiago, Chile
- Oncología Médica, Hospital Dr. Sótero del Río, Santiago, Chile
| | - Francisco Acevedo
- Departamento de Hematología-Oncología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile
| | - César Sánchez
- Departamento de Hematología-Oncología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile.
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Olmos R, Domínguez JM, Vargas-Salas S, Mosso L, Fardella CE, González G, Baudrand R, Guarda F, Valenzuela F, Arteaga E, Forenzano P, Nilo F, Lustig N, Martínez A, López JM, Cruz F, Loyola S, Leon A, Droppelmann N, Montero P, Domínguez F, Camus M, Solar A, Zoroquiain P, Roa JC, Muñoz E, Bruce E, Gajardo R, Miranda G, Riquelme F, Mena N, González HE. ThyroidPrint®: clinical utility for indeterminate thyroid cytology. Endocr Relat Cancer 2023; 30:e220409. [PMID: 37671897 PMCID: PMC10563504 DOI: 10.1530/erc-22-0409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 09/06/2023] [Indexed: 09/07/2023]
Abstract
Molecular testing contributes to improving the diagnosis of indeterminate thyroid nodules (ITNs). ThyroidPrint® is a ten-gene classifier aimed to rule out malignancy in ITN. Post-validation studies are necessary to determine the real-world clinical benefit of ThyroidPrint® in patients with ITN. A single-center, prospective, noninterventional clinical utility study was performed, analyzing the impact of ThyroidPrint® in the physicians' clinical decisions for ITN. Demographics, nodule characteristics, benign call rates (BCRs), and surgical outcomes were measured. Histopathological data were collected from surgical biopsies of resected nodules. Of 1272 fine-needle aspirations, 109 (8.6%) were Bethesda III and 135 (10.6%) were Bethesda IV. Molecular testing was performed in 155 of 244 ITN (63.5%), of which 104 were classified as benign (BCR of 67.1%). After a median follow-up of 15 months, 103 of 104 (99.0%) patients with a benign ThyroidPrint® remained under surveillance and one patient underwent surgery which was a follicular adenoma. Surgery was performed in all 51 patients with a suspicious for malignancy as per ThyroidPrint® result and in 56 patients who did not undergo testing, with a rate of malignancy of 70.6% and 32.1%, respectively. A higher BCR was observed in follicular lesion of undetermined significance (87%) compared to atypia of undetermined significance (58%) (P < 0.05). False-positive cases included four benign follicular nodules and six follicular and four oncocytic adenomas. Our results show that, physicians chose active surveillance instead of diagnostic surgery in all patients with a benign ThyroidPrint® result, reducing the need for diagnostic surgery in 67% of patients with preoperative diagnosis of ITN.
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Affiliation(s)
- Roberto Olmos
- Department of Endocrinology, School of Medicine Pontificia Universidad Católica de Chile
| | - José Miguel Domínguez
- Department of Endocrinology, School of Medicine Pontificia Universidad Católica de Chile
| | - Sergio Vargas-Salas
- Department of Surgical Oncology, School of Medicine Pontificia Universidad Católica de Chile
| | - Lorena Mosso
- Department of Endocrinology, School of Medicine Pontificia Universidad Católica de Chile
| | - Carlos E Fardella
- Department of Endocrinology, School of Medicine Pontificia Universidad Católica de Chile
| | - Gilberto González
- Department of Endocrinology, School of Medicine Pontificia Universidad Católica de Chile
| | - René Baudrand
- Department of Endocrinology, School of Medicine Pontificia Universidad Católica de Chile
| | - Francisco Guarda
- Department of Endocrinology, School of Medicine Pontificia Universidad Católica de Chile
| | - Felipe Valenzuela
- Department of Endocrinology, School of Medicine Pontificia Universidad Católica de Chile
| | - Eugenio Arteaga
- Department of Endocrinology, School of Medicine Pontificia Universidad Católica de Chile
| | - Pablo Forenzano
- Department of Endocrinology, School of Medicine Pontificia Universidad Católica de Chile
| | - Flavia Nilo
- Department of Endocrinology, School of Medicine Pontificia Universidad Católica de Chile
| | - Nicole Lustig
- Department of Endocrinology, School of Medicine Pontificia Universidad Católica de Chile
| | - Alejandra Martínez
- Department of Endocrinology, School of Medicine Pontificia Universidad Católica de Chile
| | - José M López
- Department of Endocrinology, School of Medicine Pontificia Universidad Católica de Chile
| | - Francisco Cruz
- Department of Radiology, School of Medicine Pontificia Universidad Católica de Chile
| | - Soledad Loyola
- Department of Radiology, School of Medicine Pontificia Universidad Católica de Chile
| | - Augusto Leon
- Department of Surgical Oncology, School of Medicine Pontificia Universidad Católica de Chile
| | - Nicolás Droppelmann
- Department of Surgical Oncology, School of Medicine Pontificia Universidad Católica de Chile
| | - Pablo Montero
- Department of Surgical Oncology, School of Medicine Pontificia Universidad Católica de Chile
| | - Francisco Domínguez
- Department of Surgical Oncology, School of Medicine Pontificia Universidad Católica de Chile
| | - Mauricio Camus
- Department of Surgical Oncology, School of Medicine Pontificia Universidad Católica de Chile
| | - Antonieta Solar
- Department of Anatomic Pathology, School of Medicine Pontificia Universidad Católica de Chile
| | - Pablo Zoroquiain
- Department of Anatomic Pathology, School of Medicine Pontificia Universidad Católica de Chile
| | - Juan Carlos Roa
- Department of Anatomic Pathology, School of Medicine Pontificia Universidad Católica de Chile
| | - Estefanía Muñoz
- Department of Surgical Oncology, School of Medicine Pontificia Universidad Católica de Chile
| | - Elsa Bruce
- Department of Surgical Oncology, School of Medicine Pontificia Universidad Católica de Chile
| | - Rossio Gajardo
- Department of Surgical Oncology, School of Medicine Pontificia Universidad Católica de Chile
| | - Giovanna Miranda
- Department of Surgical Oncology, School of Medicine Pontificia Universidad Católica de Chile
| | - Francisco Riquelme
- Department of Surgical Oncology, School of Medicine Pontificia Universidad Católica de Chile
| | - Natalia Mena
- Department of Surgical Oncology, School of Medicine Pontificia Universidad Católica de Chile
| | - Hernán E González
- Department of Surgical Oncology, School of Medicine Pontificia Universidad Católica de Chile
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Guilloux A, Blaise L, Simon D, Leenhardt R, Camus M, Chaput U. Endoscopic ultrasound-guided glue injection for refractory bleeding from gastric varices: A safe and effective therapeutic option (with video). Clin Res Hepatol Gastroenterol 2023; 47:102208. [PMID: 37696415 DOI: 10.1016/j.clinre.2023.102208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 09/05/2023] [Accepted: 09/08/2023] [Indexed: 09/13/2023]
Affiliation(s)
- A Guilloux
- Centre d'Endoscopie Digestive, Hôpital Saint-Antoine, APHP, Sorbonne Université, 184 rue du Faubourg Saint Antoine, Paris 75012, France
| | - L Blaise
- Service d'Hépatologie, Hôpital Avicenne, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance-Publique Hôpitaux de Paris, Bobigny, France
| | - D Simon
- Centre d'Endoscopie Digestive, Hôpital Saint-Antoine, APHP, Sorbonne Université, 184 rue du Faubourg Saint Antoine, Paris 75012, France
| | - R Leenhardt
- Centre d'Endoscopie Digestive, Hôpital Saint-Antoine, APHP, Sorbonne Université, 184 rue du Faubourg Saint Antoine, Paris 75012, France
| | - M Camus
- Centre d'Endoscopie Digestive, Hôpital Saint-Antoine, APHP, Sorbonne Université, 184 rue du Faubourg Saint Antoine, Paris 75012, France
| | - U Chaput
- Centre d'Endoscopie Digestive, Hôpital Saint-Antoine, APHP, Sorbonne Université, 184 rue du Faubourg Saint Antoine, Paris 75012, France.
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5
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Flateau C, Pitsch A, Cornaglia C, Picque M, de Pontfarcy A, Leroy P, Jault T, Thach C, Camus M, Dolveck F, Diamantis S. Management of imported malaria in the emergency department: Adequacy compared to guidelines, and impact of the SARS-CoV-2 pandemic. Infect Dis Now 2023; 53:104672. [PMID: 36773811 PMCID: PMC9912039 DOI: 10.1016/j.idnow.2023.104672] [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: 11/14/2022] [Revised: 01/13/2023] [Accepted: 02/03/2023] [Indexed: 02/12/2023]
Abstract
OBJECTIVES Adequacy of imported malaria management with respect to guidelines in emergency departments (ED) is low. We aimed to identify factors associated with this non-compliance, and a potential impact of the SARS-CoV-2 pandemic. PATIENTS AND METHODS Patients presenting with imported malaria at the ED of the hospital of Melun (France), from January 1, 2017 to February 14, 2022 were retrospectively included. RESULTS Among 205 adults and 25 children, biological criteria of severity were fully assessed in 10% of cases; lactates (40%) and blood pH (21%) levels were the main missing variables. Of 74 patients (32%) with severe malaria, 13 were misclassified as uncomplicated malaria. The choice and dosage of treatment were adequate in 85% and 92% of cases, respectively. Treatment conformity was lower in severe malaria cases than in non-severe malaria cases (OR 0.15 [95% CI 0.07-0.31]), with oral treatment in 17 patients with severe malaria; conformity was higher in the intensive care unit (OR 4.10 [95% CI 1.21-13.95]). Patients with severe malaria were more likely to start treatment within 6hours than patients with uncomplicated malaria (OR 1.97 [95% CI 1.08-3.43]), as were patients infected by P.falciparum compared to other species (OR 4.63 [95% CI 1.03-20.90]). Consulting during the SARS-CoV-2 pandemic was the only organizational factor associated with a lower probability of adequate management (OR 0.42 [95% CI 0.23-0.75]). CONCLUSION Initial evaluation of malaria severity and time to treatment administration could be improved. These have been adversely impacted by the SARS-CoV-2 pandemic.
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Affiliation(s)
- C. Flateau
- Service des maladies infectieuses, Groupe hospitalier Sud Ile de France, 270 avenue Marc Jacquet, 77 000 Melun, France,Corresponding author at: Service des maladies infectieuses, Groupe hospitalier Sud Ile de France, 270 avenue Marc Jacquet, 77 000 Melun, France. Fax: + 33 1 81 74 18 12
| | - A. Pitsch
- Laboratoire de biologie médicale, Groupe hospitalier Sud Ile de France, 270 avenue Marc Jacquet, 77 000 Melun, France
| | - C. Cornaglia
- Service d’accueil des urgences, Groupe hospitalier Sud Ile de France, 270 avenue Marc Jacquet, 77 000 Melun, France
| | - M. Picque
- Laboratoire de biologie médicale, Groupe hospitalier Sud Ile de France, 270 avenue Marc Jacquet, 77 000 Melun, France
| | - A. de Pontfarcy
- Service des maladies infectieuses, Groupe hospitalier Sud Ile de France, 270 avenue Marc Jacquet, 77 000 Melun, France
| | - P. Leroy
- Service des maladies infectieuses, Groupe hospitalier Sud Ile de France, 270 avenue Marc Jacquet, 77 000 Melun, France
| | - T. Jault
- Service de gynécologie-obstétrique, Groupe hospitalier Sud Ile de France, 270 avenue Marc Jacquet, 77 000 Melun, France
| | - C. Thach
- Service de pédiatrie, Groupe hospitalier Sud Ile de France, 270 avenue Marc Jacquet, 77 000 Melun, France
| | - M. Camus
- Pharmacie hospitalière, Groupe hospitalier Sud Ile de France, 270 avenue Marc Jacquet, 77 000 Melun, France
| | - F. Dolveck
- Service d’accueil des urgences, Groupe hospitalier Sud Ile de France, 270 avenue Marc Jacquet, 77 000 Melun, France
| | - S. Diamantis
- Service des maladies infectieuses, Groupe hospitalier Sud Ile de France, 270 avenue Marc Jacquet, 77 000 Melun, France
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6
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Acevedo F, Walbaum B, Camus M, Manzor M, Muñiz S, Medina L, Petric M, Reyes P, Domínguez F, Puschel K, Merino T, Bravo ML, Pinto MP, Ibáñez C, Hughes K, Sánchez C. Access disparities and underutilization of germline genetic testing in Chilean breast cancer patients. Breast Cancer Res Treat 2023; 199:363-370. [PMID: 36988750 DOI: 10.1007/s10549-023-06909-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 03/04/2023] [Indexed: 03/30/2023]
Abstract
PURPOSE Latin American reports on genetic cancer risk assessments are scarce. In Chile, current breast cancer (BC) guidelines do not define strategies for germline genetic testing. Our study sought to quantify the disparities in access to genetic testing in Chilean BC patients, according to international standards and their clinical characteristics to explore improvement strategies. METHODS Retrospective analysis of invasive BC databases including patients treated in a Public Hospital (PH) and in an Academic Private Center (AC) in Santiago, Chile between 2012 and 2021. RESULTS Of 5438 BC patients, 3955 had enough data for National Comprehensive Cancer Network (NCCN) categorization. From these, 1911 (48.3%) fulfilled NCCN criteria for germline testing, of whom, 300 were tested for germline mutations and 268 with multigene panels. A total of 65 pathogenic variants were found in this subset. As expected, BRCA1/2 mutations were the most frequent (17.7%). Access to genetic testing was higher in AC versus PH (19.6% vs. 10.3%, p = 0.0001). Other variables associated with germline genetic testing were BC diagnosis after 2018, being 45 years old or younger at diagnosis, BC family history (FH), FH of ovarian cancer, non-metastatic disease, and triple-negative subtype. CONCLUSION In our cohort, 15% of BC patients who met NCCN criteria for germline testing were effectively tested. This percentage was even lower at the PH. Current recommendations encourage universal genetic testing for BC patients; however, our findings suggest that Chile is far from reaching such a goal and national guidelines in this regard are urgently needed. To our knowledge, this is the first study of its kind in Chile and Latin America.
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Affiliation(s)
- Francisco Acevedo
- Departamento de Hematología-Oncología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, 8330077, Santiago, Chile
- Fundación Chile Sin Cáncer, Santiago, Chile
| | - Benjamín Walbaum
- Departamento de Hematología-Oncología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, 8330077, Santiago, Chile
- Fundación Chile Sin Cáncer, Santiago, Chile
| | - Mauricio Camus
- Departamento de Cirugía Oncológica, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Manuel Manzor
- Cirugía Oncológica, Hospital Dr. Sótero del Río, Santiago, Chile
| | - Sabrina Muñiz
- Departamento de Hematología-Oncología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, 8330077, Santiago, Chile
| | - Lidia Medina
- Centro de Cáncer, Red de Salud UC Christus, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Militza Petric
- Cirugía Oncológica, Hospital Gustavo Fricke, Valparaíso, Chile
| | - Paula Reyes
- Departamento de Hematología-Oncología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, 8330077, Santiago, Chile
| | - Francisco Domínguez
- Departamento de Cirugía Oncológica, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Klaus Puschel
- Departamento de Medicina Familiar, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Tomas Merino
- Departamento de Hematología-Oncología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, 8330077, Santiago, Chile
| | - M Loreto Bravo
- Support Team for Oncological Research and Medicine (STORM), Providencia, Santiago, Chile
| | - Mauricio P Pinto
- Support Team for Oncological Research and Medicine (STORM), Providencia, Santiago, Chile
| | - Carolina Ibáñez
- Departamento de Hematología-Oncología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, 8330077, Santiago, Chile
| | - Kevin Hughes
- Division of Oncologic & Endocrine Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - César Sánchez
- Departamento de Hematología-Oncología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, 8330077, Santiago, Chile.
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Walbaum B, ACEVEDO FRANCISCO, Bauerle C, Camus M, Manzor M, Martinez R, Veglia P, Navarro M, Guerra C, Dominguez F, Merino T, Medina L, SÁNCHEZ CÉSAR. Abstract P3-03-19: Real-world data of clinical characteristics, risk factors and outcomes of Chilean triple-negative breast cancer patients. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p3-03-19] [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: 03/06/2023]
Abstract
Abstract
Background: triple-negative breast cancer (TNBC) is associated with hereditary and environmental risk factors plus an overall worse prognosis compared to other Breast Cancer (BC) subtypes. While TNBC risk factors, prevalence, clinical characteristics and prognosis may vary throughout different populations, limited data on Latin American patients forces clinical decisions to be based predominantly on data coming from non-Hispanic women. To obtain local epidemiological information, regarding risk factors and clinical outcomes, we analysed the largest Chilean BC registry.
Methods: we conducted a retrospective population-cohort study involving females with any stage TNBC, treated at a community hospital (mid-low income) and at an academic private hospital (high income), between the years 2010 and 2021. Risk factors, reason for consultation, clinical and pathological characteristics and prognosis were separately analysed for both TNBC and non-TNBC subgroups. Univariate and multivariate analyses were performed to identify prognostic factors for survival on TNBC patients.
Results: From 5,806 patients, 647 (11.2%) were identified as TNBC. Compared to non-TNBC patients, women were younger (median age 55.2 vs. 57.2, p=0.0001), with 15.8% of TNBC patients having been diagnosed before the age of 40 compared to 9.6% in non-TNBC (p= 0.0001). TNBC had a significantly lower screen-detected cancer rate (14.5% vs. 31.6% p= 0.0001) and worse stage at diagnosis. No differences were seen between patients seen at a community hospital and private centre, for both TNBC rate and stage. Other risk factors such as parity, age at first gestation, menarche, hormone therapy replacement and obesity showed no significant differences between TNBC and no-TNBC patients (table 1). With a median follow up of 57 months, 5-year overall survival (OS) and BC specific death were significantly shorter for TNBC compared to non-TNBC (76.4% vs 88.1% and 78.9% vs 91.2%, respectively; p=0.0001) (table 2). In the multivariate analysis, TN subtype (HR=2.3, p=0.0001), stage (HR=2.05 for stage II vs stage I, HR=7.04 for stage III vs. stage I, p=0.0001), lower income (HR= 1.64, p=0.0001), and non-screened detected BC (HR=1.32, p=0.03) were all associated with worse overall survival (table 3).
Conclusion: This is the first study focusing on TNBC characteristics in Chilean BC patients and to our knowledge, the largest performed in a Latin American population. We identified a lower proportion of TNBC patients when compared with data reported from other LA groups and worldwide, a very low screen detected cancer rate and as expected significantly lower TNBC survival rate compared to non-TNBC women. While TNBC patients were younger compared to the non-TNBC group, this age difference was marginal compared to other reported studies. Community hospital patients (with mid-low income) were associated with lower survival rates for both all-cause mortality and BC specific survival, regardless of a similar stage distribution at diagnosis. Reflecting an underlying interaction between social and biological factors that needs to be addressed.
Table 1. Patient characteristics: Triple-negative versus noN-triple negative breast cancer BMI: Body mass index; FH: Family history * Difference is statistically significant.
Table 2. Survival comparison in triple-negative versus non-triple negative breast cancer * Difference is statistically significant.
Table 3. Cox Regression Multivariate analysis * Difference is statistically significant.
Citation Format: Benjamin Walbaum, FRANCISCO ACEVEDO, Catherine Bauerle, Mauricio Camus, Manuel Manzor, Raul Martinez, Paulina Veglia, Marisel Navarro, Constanza Guerra, Francisco Dominguez, Tomas Merino, Lidia Medina, CÉSAR SÁNCHEZ. Real-world data of clinical characteristics, risk factors and outcomes of Chilean triple-negative breast cancer patients [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P3-03-19.
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ACEVEDO FRANCISCO, Walbaum B, Medina L, Merino T, Bauerle C, Camus M, Leon A, Manzor M, Veglia P, Martinez R, Guerra C, Navarro M, Dominguez F, SÁNCHEZ CÉSAR. Abstract P1-11-17: The real-world outcome of human epidermal growth factor type-2 positive breast cancer patients receiving neoadjuvant therapy with or without pertuzumab. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p1-11-17] [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: 03/06/2023]
Abstract
Abstract
Background Standard treatment in early HER2 positive BC involves the use of neoadjuvant chemotherapy (NACT) with Trastuzumab (T) plus Pertuzumab (P). Dual blockade increases pathological complete response (pCR) and improves disease free survival (DFS). However, Chilean public health system does not include P use in the NACT schedule, while private insurers only provide partial coverage. Here, we aim to compare pCR, Distant DFS (DDFS) and site of recurrence in HER2 positive BC patients treated in the neoadjuvant setting with the use of T with or without P, in the largest BC Chilean registry. Methods We conducted a retrospective population-cohort study involving females with stage I-III HER2 positive BC treated with NACT in a public and academic private centre between 2012 to 2021. CT regimens for comparison included anthracyclines, taxanes, T and P. pCR was defined as the absence of residual invasive disease in the breast and in the axillary lymph nodes (ypT0/is N0) at the completion of the NACT. DDFS was measured from the time of diagnosis to the event or lost to follow-up. We performed Cox regression analysis to identify factors associated with prognosis and a logistic regression to identify factors related to the first metastasis site. Results 372 patients with HER2 positive BC were included. Median age was 51 years (24 – 79), 57.5% were classified as Hormone Receptor positive (HR), and 4.5% were stage I, 48.2% stage II and 47.3% stage III. 65.8% were treated in a Public Hospital (PH) and 34.2% in an Academic Private Centre (AC). 85.2% received both anthracyclines and taxanes, 10.0% only taxanes and 4.8% only anthracyclines-based CT. 55 patients (14.8%) received both T and P, while 3.3% did not receive any HER2 directed therapy as NA treatment. Median T doses before surgery were 6 (1 – 12). pCR rate was 46.5% which varied according to HR expression: 61.0% in HR-positive BC vs. 36.2% in HR-negative disease (p=0.0001). pCR according to treatment were as follows: no-T no-P 22.2%, only-T 49.4%, both T-P 60.0% (p=0.02). We found no difference in pCR rate between anthracycline and non-anthracycline based CT (49.1% vs. 45.9%, p=0.72). With a median follow-up of 36 months, DDFS at 3 and 5 years differed regarding pathological response: 94.8% vs. 77.1% and 86.3% vs. 69.1% (p=0.0006), for pCR and non-pCR group, respectively. In a multivariate analysis, stage III vs. I-II (HR 2.5, p=0.005), non-pCR vs. pCR (HR 2.6, p=0.01) and not receiving NA anti-HER2 treatment (HR 2.6, p=0.01) were associated with higher risk of distant metastasis. Regarding recurrence, 7 out of 198 non-pCR tumors and 6 out of 174 pCR tumors presented brain metastasis (BM) as the first site of distant recurrence(p=0.96). In contrast, visceral metastasis (VM) as the first site of recurrence, were more frequent in non-pCR (21/198) than pCR patients (3/174, p=0.001). In a multivariate analysis, the only factor associated with BM was stage III (HR 5.8 vs stage I-II, p=0.02) and with VM was not achieving pCR (HR 6.3, p=0.02) and not using T nor P (HR 5.1, p=0.008). Conclusion The use of anti-HER2 treatment in a NA scheme is critical in HER2 positive disease. Although P is associated with increased pCR, we found no survival benefit with its use. Retrospective analysis, few events, post-surgical treatment might have influenced these results. Achieving pCR is associated with better prognosis by reducing distant recurrence but not BM. New strategies are needed to prevent the occurrence of this event.
Citation Format: FRANCISCO ACEVEDO, Benjamin Walbaum, Lidia Medina, Tomas Merino, Catherine Bauerle, Mauricio Camus, Augusto Leon, Manuel Manzor, Paulina Veglia, Raul Martinez, Constanza Guerra, Marisel Navarro, Francisco Dominguez, CÉSAR SÁNCHEZ. The real-world outcome of human epidermal growth factor type-2 positive breast cancer patients receiving neoadjuvant therapy with or without pertuzumab [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P1-11-17.
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Adriaenssens T, Van Vaerenbergh I, Reis M, Van Landuyt L, Verheyen G, Debrucker M, Camus M, Platteau P, De Vos M, Coucke W, Vanhecke E, Rosenthal A, Smitz J. P-251 Cumulus cell analysis as a non-invasive oocyte selection strategy to reduce the number of oocytes/embryos cultured and increase pregnancy rates. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.241] [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: 11/12/2022] Open
Abstract
Abstract
Study question
Can non-invasive gene expression analysis of cumulus cells (CC) improve efficiency in ART by prioritizing oocytes for further culture and fresh single embryo transfer?
Summary answer
CC analysis can be used for the selective processing of oocytes. This may reduce culture work and improve the outcome in ICSI elective SETs (eSET).
What is known already
In an interventional, blinded, prospective cohort study (Van Vaerenbergh et al. 2021), 113 patients underwent a fresh Day3 eSET with embryos ranked and transferred based on morphology and CC gene expression (Aurora Test), while 520 control patients underwent a Day3 eSET without the Aurora Test. This resulted in a significant higher clinical pregnancy of 61% in the patients with eSET based on CC ranking applied on good morphology embryos, compared to 29% in the controls with eSET based on embryo morphology only. Live birth rate was also significantly increased, while time-to-pregnancy was significantly reduced with 3 transfer cycles.
Study design, size, duration
In a retrospective analysis, in a subset of patients with at least 6 growing follicles and at least five 2PN oocytes (n = 80), it was investigated whether the Aurora Test, used to select transferrable Day3-embryos, could also be applied to select oocytes on Day0/1. The effect of processing only the three highest ranked oocytes (based on the Aurora Test) on embryo development and clinical pregnancy was studied compared to processing all oocytes.
Participants/materials, setting, methods
Patients included in this single centre study had their first or second GnRH-antagonist ICSI cycle, were younger than 40y, had normal BMI, were stimulated with HP-hMG and scheduled for Day3 eSET. Two-sided statistical analysis (p < 0,05) was performed between a strategy of processing only the top 3 Aurora ranked oocytes, according to CC gene expression, and a strategy of processing all available oocytes.
Main results and the role of chance
On average, 8 MII oocytes were obtained per patient and the average fertilization rate was 83%. In total, 407 good quality embryos (GQE) on Day3 were generated from these 80 patients when utilising all 639 oocytes. Processing the three top-ranked oocytes only (240/639 oocytes) would have reduced the number of embryos to 169 GQE and would have resulted in 2.1 GQE on average on Day3 per patient; 75/80 (94%) patients would have had a fresh Day3 transfer resulting in a 63% clinical pregnancy rate. Processing all 639 available 2PN oocytes (standard of care) resulted in a fresh Day3 transfer in all 80 patients and a similar 64% clinical pregnancy rate (ns). However, 399 more oocytes would need to be processed. The strategy of restricting the number of oocytes to be processed would not have compromised cumulative cycle outcome. Considering all subsequent freeze/thawing cycles the cumulative clinical pregnancy rate calculated per all 80 patients would increase to 90%.
Limitations, reasons for caution
The limitation of this approach is that the Aurora Test requires individual oocyte denudation and individual oocyte vitrification. Secondly, this new strategy should be validated in a prospective study.
Wider implications of the findings
By applying this oocyte selection strategy patients would benefit from a high pregnancy rate in the fresh transfer cycle, while the lab would see reduction in embryo culture work, because freeze/thawing cycles and culture of embryos with lower competence would be prevented.
Trial registration number
NA
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Affiliation(s)
| | | | - M Reis
- Fertiga, Fertiga , Jette- Brussels, Belgium
| | | | - G Verheyen
- UZBrussel, Brussels IVF , Brussels, Belgium
| | | | - M Camus
- UZBrussel, Brussels IVF , Brussels, Belgium
| | - P Platteau
- UZBrussel, Brussels IVF , Brussels, Belgium
| | - M De Vos
- UZBrussel, Brussels IVF , Brussels, Belgium
| | - W Coucke
- Sciensano, Quality of Laboratories- , Brussels, Belgium
| | - E Vanhecke
- Fertiga, Fertiga , Jette- Brussels, Belgium
| | | | - J Smitz
- Fertiga, Fertiga , Jette- Brussels, Belgium
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Seror R, Baron G, Camus M, Cornec D, Perrodeau E, Bowman SJ, Bombardieri M, Bootsma H, Gottenberg JE, Fisher B, Hueber W, van Roon J, Devauchelle-Pensec V, Gergely P, Mariette X, Porcher R. OP0286 DEVELOPMENT AND PRELIMINARY VALIDATION OF THE SJÖGREN’S TOOL FOR ASSESSING RESPONSE (STAR): A CONSENSUAL COMPOSITE SCORE FOR ASSESSING TREATMENT EFFECT IN PRIMARY SJÖGREN’S SYNDROME. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundToday, there are still no DMARDs licensed for primary Sjögren Syndrome (pSS) patients. Among the explanations, are the limitations of current outcome measures used as primary endpoints: e.g; high placebo response rate, evaluation of either symptoms or systemic activity, and important features not being assessed. The NECESSITY consortium (https://www.necessity-h2020.eu/), including pSS experts from academia, pharmaceutical industry and patient groups formed to develop a new composite responder index, the Sjögren’s Tool for Assessing Response (STAR) that solve the issues of current outcome measures in pSS and is intended for use in clinical trials as an efficacy endpoint.ObjectivesTo develop a composite responder index in primary Sjögren’s syndrome (pSS): the STAR.MethodsTo develop the STAR, the NECESSITY consortium used data-driven methods, based on 9 randomized controlled trials (RCTs), and consensus techniques, involving 78 experts and 20 patients. Based on reanalysis of rituximab trials (TRACTISS and TEARS) and literature review, the Delphi panel identified a core set of domains to include in the STAR, with their respective outcome measures. STAR options combining these domains were designed and proposed to the panel to select and improve them. For each STAR option, sensitivity to change was estimated by the C-index (derived from Effect size) in all 9 RCTs. Delphi rounds were run for selecting STAR among these options. The Delphi panel also voted to classify trials as positive, negative or “in between” in regards to primary but also key secondary endpoints. For the options remaining before the final vote, meta-analyses of the RCTs were performed separately for positive and “in between” trials together, and for negative trials.ResultsThe Delphi panel identified 5 core domains (systemic activity, patient symptoms, lachrymal gland function, salivary gland function and biological parameters), and 227 STAR options, combining these domains, were selected to be tested for sensitivity to change. After two Delphi rounds, meta-analyses of the 20 remaining options were performed. The candidate STAR was selected by a final vote based on metrological properties and clinical relevance. In positive/in between trials, candidate STAR detected a difference between arms (OR 3.29, 95%-CI [2.07;5.22], whereas it did not in negative trials (OR 1.53, 95%-CI [0.81;2.91]).ConclusionThe candidate STAR is a composite responder index, including in a single tool all main disease features, and is designed for use as a primary endpoint in pSS RCTs. Its rigorous and consensual development process ensures its face and content validity. The candidate STAR showed good sensitivity and specificity to change. The candidate STAR will be prospectively validated in a dedicated three arms RCT of the NECESSITY consortium that will evaluate combination of synthetic DMARDs (hydroxychloroquine + lefunomide or hydroxychloroquine + mycophenolate vs placebo). We encourage the use of STAR in any ongoing and future trials.Table 1.Candidate STARDomainPointDefinition of responseSystemic activity3Decrease of clinESSDAI ≥ 3Patient reported outcome3Decrease of ESSPRI ≥ 1 point or ≥ 15%Lachrymal gland function1Schirmer:If abnormal score at baseline: increase ≥ 5 mm from baselineIf normal score at baseline: no change to abnormalOrOcular Staining Score:If abnormal score at baseline: decrease ≥ 2 points from baselineIf normal score at baseline: no change to abnormalSalivary gland function1Unstimulated Whole Salivary Flow:If score > 0 at baseline: increase ≥ 25% from baselineIf score is 0 at baseline: any increase from baselineorUltrasound:Decrease ≥ 25% in total Hocevar score from baselineBiological1Serum IgG levels: decrease ≥ 10%orRheumatoid Factor levels: decrease ≥ 25%Candidate STAR responder≥ 5 pointsESSDAI: EULAR Sjögren syndrome disease activity index; ESSPRI: EULAR Sjögren syndrome patient reported index; IgG: Immunoglobulin G;AcknowledgementsNECESSITY WP5 STAR development participants: Suzanne Arends (University Medical Center Groningen, Department of Rheumatology and Clinical Immunology, Groningen 9700 RB, Netherlands), Francesca Barone (Centre for Translational Inflammation Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK), Albin Björk (Division of Rheumatology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden), Coralie Bouillot (Association Française du Gougerot Sjögren et des Syndromes Secs, France), Guillermo Carvajal Alegria (University of Brest, Inserm, CHU de Brest, LBAI, UMR1227, Brest, France; Service de Rhumatologie, Centre de Référence Maladies Autoimmunes Rares CERAINO, CHU Cavale Blanche, Brest, France), Wen-Hung Chen (GlaxoSmithKline, Research Triangle Park, North Carolina, USA), Kenneth Clark (GlaxoSmithKline Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire SG1 2NY, United Kingdom), Konstantina Delli (Department of Oral and Maxillofacial Surgery, University Medical Center Groningen (UMCG), University of Groningen, The Netherlands), Salvatore de Vita (Rheumatology Clinic, University Hospital of Udine, Italy), Liseth de Wolff (University Medical Center Groningen, Department of Rheumatology and Clinical Immunology, Groningen 9700 RB, Netherlands), Jennifer Evans (Novartis Pharmaceuticals corporation USA), Stéphanie Galtier (Institut de Recherches Internationales Servier (IRIS), Suresnes Cedex, France), Saviana Gandolfo (Rheumatology Clinic, Department of Medical area, University of Udine, ASUFC, 33100 Udine, Italy), Mickael Guedj (Institut de Recherches Internationales Servier (IRIS), Suresnes Cedex, France), Dewi Guellec (CHU de Brest, Service de Rhumatologie, Inserm, CIC 1412, Brest, France), Safae Hamkour (Center of Translational Immunology, Department of Immunology, University Medical Center Utrecht, Utrecht 3584 GA, Netherlands), Dominik Hartl (Novartis Institutes for BioMedical Research, Basel, Switzerland), Malin Jonsson (Section for Oral and Maxillofacial Radiology, Department of Clinical Dentistry, Faculty of Medicine and Dentistry, University of Bergen, Norway), Roland Jonsson (Broegelmann Research Laboratory, Department of Clinical Science, University of Bergen, Department of Rheumatology, Haukeland University Hospital, Bergen, Norway), Frans Kroese (University Medical Center Groningen, Department of Rheumatology and Clinical Immunology, Groningen 9700 RB, Netherlands), Aike Albert Kruize (University Medical Center Utrecht, Department Rheumatology and Clinical Immunology, Utrecht, Netherlands), Laurence Laigle (Institut de Recherches Internationales Servier (IRIS), Suresnes Cedex, France), Véronique Le Guern (AP-HP, Hôpital Cochin, Centre de référence maladies auto-immunes et systémiques rares, service de médecine interne, Paris, France), Wen-Lin Luo (Department of Biometrics and Statistical Science, Novartis Pharmaceuticals, East Hanover, New Jersey), Esther Mossel (University Medical Center Groningen, Department of Rheumatology and Clinical Immunology, Groningen 9700 RB, Netherlands), Wan-Fai Ng (Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne NE2 4HH, UK), Gaëtane Nocturne (Department of Rheumatology, Université Paris-Saclay, INSERM U1184: Centre for Immunology of Viral Infections and Autoimmune Diseases, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin Bicêtre, Paris, France), Marleen Nys (Global Biometric Sciences, Bristol Myers Squibb, Braine L’Alleud, Belgium), Roald Omdal (Clinical Immunology Unit, Department of Internal Medicine, Stavanger University Hospital, PO Box 8100, 4068, Stavanger, Norway), Jacques-Olivier Pers (LBAI, UMR1227, University of Brest, Inserm, Brest, France and CHU de Brest, Brest, France), Maggy Pincemin (Association Française du Gougerot Sjögren et des Syndromes Secs, France), Manel Ramos-Casals (Department of Autoimmune Diseases, Hospital Clinic de Barcelona Institut Clinic de Medicinai Dermatologia, Barcelona, Catalunya, Spain), Philippe Ravaud (Centre d’Epidémiologie Clinique, Hôpital Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France), Neelanjana Ray (Global Drug Development - Immunology, Bristol Myers Squibb Company, Princeton, New Jersey, USA), Alain Saraux (HU de Brest, Service de Rhumatologie, Univ Brest, Inserm, UMR1227, Lymphocytes B et Autoimmunité, Univ Brest, Inserm, LabEx IGO, Brest, France), Athanasios Tzioufas (Rheumatology Clinic, Department of Medical area, University of Udine, ASUFC, 33100 Udine, Italy), Gwenny Verstappen (University Medical Center Groningen, Department of Rheumatology and Clinical Immunology, Groningen 9700 RB, Netherlands), Arjan Vissink, Marie Wahren-Herlenius (Division of Rheumatology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden). We thank the following experts: Esen Karamursel Akpek, Alan Baer, Chiara Baldini, Elena Bartoloni, Marí-Alfonso Begona, Johan Brun, Vatinee Bunya, Laurent Chiche, Troy Daniels, Paul Emery, Robert Fox, Roberto Giacomelli, John Gonzales, John Greenspan, Robert Moots, Susumu Nishiyama, Elizabeth Price, Christophe Richez, Caroline Shiboski, Roser Solans Laque, Muthiah Srinivasan, Peter Olsson, Tsutomu Takeuchi, Frederick Vivino, Paraskevi Voulgari, Daniel Wallace, Ava Wu, Wen Zhang. We thank the anonymous patients from the NECESSITY Patient Advisory Group and the Sjögren Foundation for their valuable contribution to the Delphi process. We thank EW StClair and AN Baer who generated the baminercept data and made them publicly available.Disclosure of InterestsRaphaèle Seror Consultant of: GlaxoSmithKline, Boehringer, Janssen and Novartis, Grant/research support from: GlaxoSmithKline and Amgen, Gabriel Baron: None declared, Marine Camus: None declared, Divi Cornec Consultant of: GlaxoSmithKline, Bristol Myers Squibb, Janssen, Amgen, Pfizer and Roche, Elodie Perrodeau: None declared, Simon J. Bowman Consultant of: Abbvie, Astra Zeneca, Galapagos and Novartis Pharmaceuticals, Michele Bombardieri Consultant of: UCB, Amgen/Medimmune, Janssen, and GlaxoSmithKline, Grant/research support from: Amgen/Medimmune, Janssen, and GlaxoSmithKline, Hendrika Bootsma: None declared, Jacques-Eric Gottenberg Consultant of: AbbVie, Bristol Myers Squibb, Eli Lilly, Galapagos, Gilead, Pfizer, Roche, Sanofi, Novartis, MSD, CSL-Behring and Genzyme, Grant/research support from: Bristol Myers Squibb, Benjamin Fisher Speakers bureau: Bristol Myers Squibb and Novartis, Consultant of: Novartis, Bristol Myers Squibb, Janssen and Servier, Grant/research support from: Servier, Galapagos and Janssen, Wolfgang Hueber Shareholder of: Novartis Pharma, Employee of: Novartis Pharma, Joel van Roon: None declared, Valerie Devauchelle-Pensec: None declared, Peter Gergely Shareholder of: Novartis Pharma, Employee of: Novartis Pharma, Xavier Mariette Consultant of: Bristol Myers Squibb, Galapagos, GlaxoSmithKline, Janssen, Novartis, Pfizer and UCB, Grant/research support from: Ose Pharmaceuticals, Raphaël Porcher: None declared
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Canteros D, Walbaum B, Córdova-Delgado M, Torrealba A, Reyes C, Navarro ME, Razmilic D, Camus M, Dominguez F, Navarrete O, Pinto MP, Pizarro G, Acevedo F, Sánchez C. Contrast-enhanced mammography predicts pathological response after neoadjuvant chemotherapy in locally advanced breast cancer. Ecancermedicalscience 2022; 16:1396. [PMID: 35919242 PMCID: PMC9300406 DOI: 10.3332/ecancer.2022.1396] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction Recently, contrast-enhanced mammography (CEM) has emerged as a reliable alternative to breast magnetic resonance imaging (MRI) for the assessment of pathological response in breast cancer patients. Our study sought to determine the diagnostic accuracy of CEM to predict pathological complete response (pCR) in patients who received neoadjuvant chemotherapy (NACT). Methods We retrieved the medical records of patients who underwent NACT at our institution. Using post-surgery pCR, morphological evidence and CEM enhancement tumours were classified as follows: 1) radiologic complete response (rCR); 2) functional radiological complete response (frCR); and 3) non-complete response. Initially, we used multivariate analyses adjusted by clinical variables and frCR or rCR to determine which variables affected pathological response. Then, CEM diagnostic accuracy to discriminate pCR was assessed using receiver operating characteristic curves in univariate and multivariate models including either frCR or rCR. Results A total of 48 patients were included in our study. Most patients (68.7%) were hormone receptor (HR)+ and 41.6% (20) of the patients achieved pCR. Using univariate logistic regression analyses we found that HR status, HER2 status, rCR and frCR had a significant impact on CEM diagnostic accuracy. Exploratory analyses found that CEM sensitivity was higher for HR− tumours. Multivariate logistic regression analyses found 60% sensitivity, 92.9% specificity and 79.2% accuracy in a model that included clinical variables and rCR. Conclusion CEM is a reliable alternative to high-cost, time-consuming breast MRI that predicts pCR in patients undergoing NACT; CEM diagnostic accuracy was higher among patients who harboured HR− tumours.
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Affiliation(s)
- Daniel Canteros
- Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
| | - Benjamin Walbaum
- Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
| | - Miguel Córdova-Delgado
- Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
| | - Andrés Torrealba
- Department of Surgical Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
| | - Constanza Reyes
- Department of Radiology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
| | - María Elena Navarro
- Department of Radiology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
| | - Dravna Razmilic
- Department of Radiology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
| | - Mauricio Camus
- Department of Surgical Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
| | - Francisco Dominguez
- Department of Surgical Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
| | - Orieta Navarrete
- Department of Pathology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
| | - Mauricio P Pinto
- Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
| | - Gonzalo Pizarro
- Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
| | - Francisco Acevedo
- Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
| | - César Sánchez
- Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago 8330024, Chile
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Walbaum B, Puschel K, Medina L, Merino T, Camus M, Razmilic D, Navarro ME, Dominguez F, Cordova-Delgado M, Pinto MP, Acevedo F, Sánchez C. Screen-detected breast cancer is associated with better prognosis and survival compared to self-detected/symptomatic cases in a Chilean cohort of female patients. Breast Cancer Res Treat 2021; 189:561-569. [PMID: 34244869 DOI: 10.1007/s10549-021-06317-1] [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: 03/12/2021] [Accepted: 06/26/2021] [Indexed: 11/12/2022]
Abstract
PURPOSE The implementation of national breast cancer (BC) screening programs in Latin America has been rather inconsistent. Instead, most countries have opted for "opportunistic" mammogram screenings on the population at risk. Our study assessed and compared epidemiological, clinical factors, and survival rates associated with BC detected by screening (SDBC) or self-detected/symptomatic (non-SDBC) in Chilean female patients. METHODS Registry-based cohort study that included non-metastatic BC (stage I/II/III) patients diagnosed between 1993 and 2020, from a public hospital (PH) and a private university cancer center (PC). Epidemiological and clinical data were obtained from medical records. RESULTS A total of 4559 patients were included. Most patients (55%; n = 2507) came from PH and were diagnosed by signs/symptoms (non-SDBC; n = 3132, 68.6%); these patients displayed poorer overall (OS) and invasive disease-free survival (iDFS) compared to SDBC. Importantly, the proportion of stage I and "luminal" BC (HR + /HER2 -) were significantly higher in SDBC vs. non-SDBC. Finally, using a stage/subset-stratified age/insurance-adjusted model, we found that non-SDBC cases are at a higher risk of death (HR:1.75; p < 0.001). In contrast, patients with PC health insurance have a lower risk of death (HR: 0.60; p < 0.001). CONCLUSION We confirm previous studies that report better prognosis/survival on SDBC patients. This is probably due to a higher proportion of stage I and luminal-A cases versus non-SDBC. In turn, the survival benefit observed in patients with PC health insurance might be attributed to a larger proportion of SDBC. Our data support the implementation of a systematic BC screening program in Chile to improve patient prognosis and survival rates.
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Affiliation(s)
- Benjamin Walbaum
- Department of Hematology-Oncology, Faculty of Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile
| | - Klaus Puschel
- Department of Family Medicine, School of Medicine. Pontificia, Universidad Católica de Chile, Santiago, Chile
| | - Lidia Medina
- Centro de Cáncer, Red de Salud UC Christus. Pontificia, Universidad Católica de Chile, Santiago, Chile
| | - Tomas Merino
- Department of Hematology-Oncology, Faculty of Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile
| | - Mauricio Camus
- Department of Surgical Oncology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Dravna Razmilic
- Department of Radiology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Maria Elena Navarro
- Department of Radiology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francisco Dominguez
- Department of Surgical Oncology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Miguel Cordova-Delgado
- Department of Hematology-Oncology, Faculty of Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile
| | - Mauricio P Pinto
- Department of Hematology-Oncology, Faculty of Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile
| | - Francisco Acevedo
- Department of Hematology-Oncology, Faculty of Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile.
| | - César Sánchez
- Department of Hematology-Oncology, Faculty of Medicine, School of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile.
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Mackens S, Stubbe A, Santos-Ribeiro S, Van Landuyt L, Racca A, Roelens C, Camus M, De Vos M, van de Vijver A, Tournaye H, Blockeel C. To trigger or not to trigger ovulation in a natural cycle for frozen embryo transfer: a randomized controlled trial. Hum Reprod 2021; 35:1073-1081. [PMID: 32395750 DOI: 10.1093/humrep/deaa026] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 02/03/2020] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Is the clinical pregnancy rate (CPR) following a frozen embryo transfer (FET) in a natural cycle (NC) higher after spontaneous ovulation than after triggered ovulation [natural cycle frozen embryo transfer (NC-FET) versus modified NC-FET]? SUMMARY ANSWER The CPR did not vary significantly between the two FET preparation protocols. WHAT IS KNOWN ALREADY Although the use of FET is continuously increasing, the most optimal endometrial preparation protocol is still under debate. For transfer in the NC specifically, conflicting results have been reported in terms of the outcome following spontaneous or triggered ovulation. STUDY DESIGN, SIZE, DURATION In a tertiary hospital setting, subjects were randomized with a 1:1 allocation into two groups between January 2014 and January 2019. Patients in group A underwent an NC-FET, while in group B, a modified NC-FET was performed with a subcutaneous hCG injection to trigger ovulation. In neither group was additional luteal phase support administered. All embryos were vitrified-warmed on Day 3 and transferred on Day 4 of embryonic development. The primary outcome was CPR at 7 weeks. All patients were followed further until 10 weeks of gestation when the ongoing pregnancy rate (OPR) was defined by the observation of foetal cardiac activity on ultrasound scan. Other secondary outcomes included biochemical pregnancy rate, early pregnancy loss and the number of visits, blood samples and ultrasonographic examinations prior to FET. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 260 patients (130 per study arm) were randomized, of whom 12 withdrew consent after study arm allocation. A total of 3 women conceived spontaneously before initiating the study cycle and 16 did not start for personal or medical reasons. Of the 229 actually commencing monitoring for the study FET cycle, 7 patients needed to be switched to a hormonal replacement treatment protocol due to the absence of follicular development, 12 had no embryo available for transfer after warming and 37 had a spontaneous LH surge before the ovulation trigger could be administered, although they were allocated to group B. Given the above, an intention-to-treat (ITT) analysis was performed taking into account 248 patients (125 in group A and 123 in group B), as well as a per protocol (PP) analysis on a subset of 173 patients (110 in group A and 63 in group B). MAIN RESULTS AND THE ROLE OF CHANCE Demographic features were evenly distributed between the study groups, as were the relevant fresh and frozen ET cycle characteristics. According to the ITT analysis, the CPR and OPR in group A (33.6% and 27.2%, respectively) and group B (29.3% and 24.4%, respectively) did not vary significantly [relative risk (RR) 0.87, 95% CI (0.60;1.26), P = 0.46 and RR 0.90, 95% CI (0.59;1.37), P = 0.61, respectively]. Biochemical pregnancy rate and early pregnancy loss were also found to be not statistically significantly different between the groups. In contrast, more clinic visits and blood samplings for cycle monitoring were required in the NC-FET group (4.05 ± 1.39) compared with the modified NC-FET group (3.03 ± 1.16, P = <0.001), while the number of ultrasound scans performed were comparable (1.70 ± 0.88 in group A versus 1.62 ± 1.04 in group B). The additional PP analysis was in line with the ITT results: CPR in group A was 36.4% versus 38.1% in group B [RR 1.05, 95% CI (0.70;1.56), P = 0.82]. LIMITATIONS, REASONS FOR CAUTION The results are limited by the high drop-out rate for the PP analysis in the modified NC-FET group as more than one-third of the subjects allocated to this group ovulated spontaneously before ovulation triggering. Nonetheless, this issue is inherent to routine clinical practice and is an important observation of an event that can only be avoided by performing a very extensive monitoring that limits the practical advantages associated with modified NC-FET. Furthermore, although this is the largest randomized controlled trial (RCT) investigating this specific research question so far, a higher sample size would allow smaller differences in clinical outcome to be detected, since currently they may be left undetected. WIDER IMPLICATIONS OF THE FINDINGS This RCT adds new high-quality evidence to the existing controversial literature concerning the performance of NC-FET versus modified NC-FET. Based on our results showing no statistically significant differences in clinical outcomes between the protocols, the treatment choice may be made according to the patient's and treating physician's preferences. However, the modified NC-FET strategy reduces the need for hormonal monitoring and may therefore be considered a more patient-friendly and potentially cost-effective approach. STUDY FUNDING/COMPETING INTEREST(S) No specific funding was available for this study. None of the authors have a conflict of interest to declare with regard to this study. TRIAL REGISTRATION NUMBER NCT02145819. TRIAL REGISTRATION DATE 8 January 2014. DATE OF FIRST PATIENT’S ENROLMENT 21 January 2014.
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Affiliation(s)
- S Mackens
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090 Brussels, Belgium.,Research Group Reproduction and Immunology (REIM), Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090 Brussels, Belgium
| | - A Stubbe
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090 Brussels, Belgium
| | - S Santos-Ribeiro
- Valencian Institute of Infertility Reproductive Medicine Associates (IVI-RMA) Lisboa, Avenida Infante Dom Henrique 333 H 1-9, 1800-282 Lisbon, Portugal
| | - L Van Landuyt
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090 Brussels, Belgium
| | - A Racca
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090 Brussels, Belgium
| | - C Roelens
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090 Brussels, Belgium
| | - M Camus
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090 Brussels, Belgium
| | - M De Vos
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090 Brussels, Belgium
| | - A van de Vijver
- Fertiliteit, AZ Sint-Jan, Ruddershove 10, 8000 Brugge, Belgium
| | - H Tournaye
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090 Brussels, Belgium
| | - C Blockeel
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090 Brussels, Belgium
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Walbaum B, Acevedo F, Medina L, Bravo ML, Merino T, Camus M, Dominguez F, Mondaca S, Galindo H, Nervi B, Ibañez C, Madrid J, Muñiz S, Peña J, Koch É, Garrido M, Pinto MP, Sánchez C. Pathological complete response to neoadjuvant chemotherapy, but not the addition of carboplatin, is associated with improved survival in Chilean triple negative breast cancer patients: a report of real world data. Ecancermedicalscience 2021; 15:1178. [PMID: 33777171 PMCID: PMC7987491 DOI: 10.3332/ecancer.2021.1178] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Indexed: 01/12/2023] Open
Abstract
Background Breast cancer (BC) is the leading cause of cancer death for Chilean women. About 11% of cases are triple-negative (TN) BC. These are characterised by poor prognosis, higher risk of early recurrence and visceral dissemination versus other BC subtypes. Current standard treatment for early-stage non-metastatic TNBC patients consists of neoadjuvant chemotherapy (NACT) followed by surgery and radiotherapy. Pathological complete response (pCR) to NACT is associated with an increase in survival rates. In general, NACT and adjuvant regimens involve similar cytotoxic drugs. Recent studies have postulated that the use of platinum compounds in TNBC would increase response rates. However, their effects on patient survival remain uncertain. Materials and methods We retrieved and analysed medical records from a total of 156 Chilean stage I–III TNBC female patients that received NACT and compared survival rates using carboplatin (Cb)-containing versus non-Cb-containing regimens at two health cancer centres. Results Median age was 51 years (range: 24–81); 13.5% (n = 21) received Cb-containing regimens, 80.1% (n = 125) received sequential anthracyclines plus taxanes; 29.5% (n = 46) of the total group achieved pCR, 28% for the standard treatment and 35% (n = 8) for the Cb-containing group (p = 0.59). We confirmed pCR was associated with prolonged overall survival, invasive and distant disease-free survival (Log-rank p = 0.0236). But the addition of Cb was not associated with differences in survival measures (Log-rank p = 0.5216). Conclusions To the best of authors’ knowledge, this is the first report on real-world data in the Chilean population assessing the effect of Cb-containing NACT in TNBC. The authors’ results suggest no survival benefit by the addition of Cb to standard NACT. However, we confirm an increase in survival associated to pCR regardless of treatment.
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Affiliation(s)
- Benjamín Walbaum
- Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile
| | - Francisco Acevedo
- Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile
| | - Lidia Medina
- Cancer Center 'Nuestra Señora de la Esperanza', Red de Salud UC Christus, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - M Loreto Bravo
- Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile
| | - Tomas Merino
- Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile
| | - Mauricio Camus
- Department of Surgical Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francisco Dominguez
- Department of Surgical Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Sebastián Mondaca
- Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile
| | - Héctor Galindo
- Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile
| | - Bruno Nervi
- Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile
| | - Carolina Ibañez
- Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile
| | - Jorge Madrid
- Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile
| | - Sabrina Muñiz
- Complejo Asistencial Hospital Dr Sotero del Rio, Santiago, Chile
| | - José Peña
- Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile
| | - Érica Koch
- Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile
| | - Marcelo Garrido
- Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile
| | - Mauricio P Pinto
- Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile
| | - César Sánchez
- Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile
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Sánchez C, Domínguez F, Galindo H, Camus M, Oddo D, Villarroel A, Razmilic D, Peña J, Navarro ME, Medina L, Merino T, Briones J, Acevedo F. Survival rates of advanced estrogen-receptor positive breast cancer. Analysis of 211 cases. Rev Med Chil 2021; 148:1233-1238. [PMID: 33399697 DOI: 10.4067/s0034-98872020000901233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 08/14/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND About 80% of breast cancer (BC) cases express estrogen receptor (ER), which has been correlated with good prognosis and response to estrogen deprivation Aim: To characterize ER positive advanced BC (ABC) patients treated at our institution assessing the impact of clinical pre-sentation (stage IV, de novo disease at diagnosis versus systemic recurrence) and BC subtype on survival rates. MATERIAL AND METHODS We evaluated 211 ER+ advanced BC (ABC) patients, treated between 1997 and 2017. RESULTS The median overall survival (OS) was 37 months. Median OS for the period 1997/2006 and 2007/2017 were 33 and 42 months, respectively (p = 0.47). Luminal A, ABC stage IV disease at diagnosis displayed better OS rates than Luminal B stage IV tumors (100 and 32 months respectively, p < 0.01). CONCLUSIONS Clinical presentation (stage IV vs. systemic recurrence) and tumor subtype are key determinants of OS in ABC.
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Affiliation(s)
- César Sánchez
- Departamento de Hematología-Oncología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francisco Domínguez
- Departamento de Cirugía Oncológica y Maxilofacial, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Héctor Galindo
- Departamento de Hematología-Oncología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Mauricio Camus
- Departamento de Cirugía Oncológica y Maxilofacial, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - David Oddo
- Departamento de Anatomía-Patológica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Alejandra Villarroel
- Departamento de Anatomía-Patológica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Dravna Razmilic
- Departamento de Radiología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - José Peña
- Departamento de Hematología-Oncología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - María Elena Navarro
- Departamento de Radiología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Lidia Medina
- Centro de Cáncer, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Tomás Merino
- Departamento de Hematología-Oncología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Juan Briones
- Departamento de Hematología-Oncología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francisco Acevedo
- Departamento de Hematología-Oncología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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Luis Pendola G, Elizalde R, Vargas PS, Mallarino JC, González E, Parada J, Camus M, Schwartz R, Bargalló E, Freitas R, Costa MM, de Oliveira VM, Escobar P, Oller M, Viaña LF, Bambino AJ, Sarria G, Terrier F, Corrales R, Sanabria V, Agostini JCR, Chacón GV, Pérez VM, Avilés V, Galarreta J, Laviña G, Fuentes JP, de Castellanos LB, Osorio BA, Castillo H, Figueroa C. Management of non-invasive tumours, benign tumours and breast cancer during the COVID-19 pandemic: recommendations based on a Latin American survey. Ecancermedicalscience 2020; 14:1115. [PMID: 33209106 PMCID: PMC7652542 DOI: 10.3332/ecancer.2020.1115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Indexed: 11/06/2022] Open
Abstract
Introduction The COVID-19 pandemic has changed health systems across the world, both in general hospitals and in oncology institutes or centres.For cancer specialists, particularly breast cancer (BC), the COVID-19 pandemic represents a combination of challenges since the hospital resources and staff have become more limited; this has obliged oncology specialists to seek a consensus and establish which patients with BC require more urgent attention and which patients can wait until there is a better control of this pandemic. The health system in Latin America has some special characteristics; in some of the countries, there are shortages which limit access to several specialities (surgery, clinical oncology and radiotherapy) in some regions. Objective After a systematic review of the most recent literature regarding the management of BC during the COVID-19 pandemic, the main objective is to understand the position of the different Latin American Societies of Mastology in terms of available alternatives for the treatment of BC. Methods After carrying out a comprehensive and exhaustive search of the most recent guides on the management of BC during the COVID-19 pandemic, the board members of the Latin American Federation of Mastology invited, via email, different specialists, all experts in BC care, to complete an anonymous survey online.The survey was distributed between 30 and 10 May 2020. The survey included 27 questions on four topics: demographic information, consultations, imaging and treatment of BC.The questionnaire was sent and then distributed to various health specialists including breast surgeons, clinical oncologists, radiation oncologists and radiologists via the Presidents of the different Latin American Societies of Mastology in 18 countries. The results are summarised as tallies based on the number of responses to each question. Results A total of 499 responses were received. The majority of the respondents were males (275 (55.11%)); 290 participants were over 45 years (58.11%).The questionnaire presented those surveyed with three possible answers (agree, disagree and neither agree nor disagree). The results reflect that there was consensus in the majority of situations presented. Only seven questions revealed disagreement among those responding. The results are presented as recommendations. Conclusion The management of patients with BC presents unique challenges during the current world health situation produced by COVID-19 pandemic. Breast care specialists (surgical oncologists, breast care clinicians, clinical oncologists, radiation oncologists and radiologists) from 18 countries in Central and South America submitted through their responses and recommendations for the treatment of BC during the COVID-19 pandemic.
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Affiliation(s)
- G Luis Pendola
- Ecuadorian Society of Breast Pathology (SEPAM Guayaquil Ecuador), Mastology Service, National Oncology Institute-Society to Fight Cancer, (CENONI) Comprehensive Oncology Centre, Guayaquil 090513, Ecuador
| | - Roberto Elizalde
- Argentinian Society of Mastology (SAM), Pirovano Hospital Buenos Aires, Buenos Aires, Argentina
| | - Pablo Sitic Vargas
- Bolivian Society of Mastology, Oncology Institute of East Bolivia, Santa Cruz, Bolivia
| | | | - Eduardo González
- Argentinian Society of Mastology (SAM), Ángel H Roffo Oncology Institute, University of Buenos Aires, C1053 CABA, Argentina
| | - José Parada
- Uruguayan Society of Mastology, Image Clinic Drs. Parada, Maldonado Hospital, Dr. Elbio Rivero, Cantegril Sanatorium, Punta del Este, Maldonado, Uruguay
| | - Mauricio Camus
- Chilean Society of Mastology, Clinical Hospital, Catholic Pontificia University of Chile, Chile
| | - Ricardo Schwartz
- Chilean Society of Mastology, Santiago Military Hospital, Las Condes Clinic, Chile
| | - Enrique Bargalló
- Mexican Association of Mastology, National Cancer Institute, ABC Medical Centre, Mexico
| | | | | | | | - Paula Escobar
- Chilean Society of Mastology, Santiago de Chile, Chile
| | - Miguel Oller
- Dominican Society of Surgery, Santo Domingo, Republica Dominicana
| | | | | | | | - Francisco Terrier
- Argentinian Society of Mastology, Italian de La Plata Hospital, Buenos Aires, Argentina
| | | | - Valeria Sanabria
- Paraguayan Society of Mastology, Itauguá National Hospital, Paraguay
| | | | | | | | - Verónica Avilés
- Nicaraguan Mastology Association, Vivian Pellas Hospital Managua, Managua, Nicaragua
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Fédou C, Feuillet G, Lescat O, Camus M, Burlet-Schiltz O, Klein J, Decramer S, Buffin-Meyer B, Saulnier-Blache J, Schanstra J. Identification de la Plastine-3 comme nouvel acteur du développement rénal. Nephrol Ther 2020. [DOI: 10.1016/j.nephro.2020.07.027] [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]
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Walbaum B, Acevedo F, Medina L, Bravo ML, Merino T, Camus M, Dominguez F, Mondaca S, Galindo H, Nervi B, Ibañez C, Madrid J, Peña J, Koch E, Garrido M, Pinto MP, Sánchez C. First-line endocrine therapy for advanced breast cancer. A real-world study at a Latin American university health institution. Curr Med Res Opin 2020; 36:1195-1199. [PMID: 32351137 DOI: 10.1080/03007995.2020.1763282] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Objective: Clinical guidelines recommend the use of endocrine therapy (ET) in advanced hormone receptor positive (HR+) human epidermal growth factor receptor type 2 negative (HER2-) breast cancer (BC) patients in the absence of visceral disease or ET resistance. Furthermore, studies indicate similar response and survival rates using ET or cytotoxic chemotherapy (CT).Methods: Herein, we assessed clinical characteristics, type of systemic therapy and survival rates of advanced HR + HER2-BC patients in our database.Results: A total of 172 advanced HR + HER2-BC patients were treated at our institution between 1997 and 2019. Sixty percent received first-line ET (4% received combined ET). Median age of this subset was 55 years (range: 30-86). Similarly, the median age of patients that received CT was 54 years (range: 21-83). Over time, 30% of patients received ET in the 2000-2005 period; this increased to 70% in the 2016-2019 period (p = .045). Overall survival (OS) was 97 months and 51 months for patients treated with ET or CT, respectively (p = .002).Conclusions: To the best of our knowledge this is the first study assessing the use of ET in Chilean advanced HR + HER2-BC patients. Several patients in our institution receive CT without indication. The increase in ET usage over time can be attributed to better and faster immunohistochemical detection methods for Estrogen Receptor (ER), changes in educational and government policies, and a wider variety of ET options. Finally, clinical trials have failed to demonstrate a substantial benefit of CT over ET in this setting.
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Affiliation(s)
- Benjamin Walbaum
- Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francisco Acevedo
- Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Lidia Medina
- Centro de cáncer Red Red de Salud UC Christus, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - M Loreto Bravo
- Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Tomas Merino
- Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Mauricio Camus
- Department of Surgical Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francisco Dominguez
- Department of Surgical Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Sebastian Mondaca
- Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Hector Galindo
- Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Bruno Nervi
- Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Carolina Ibañez
- Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jorge Madrid
- Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jose Peña
- Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Erica Koch
- Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Marcelo Garrido
- Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Mauricio P Pinto
- Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - César Sánchez
- Department of Hematology-Oncology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
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19
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Maiz C, Silva F, Domínguez F, Galindo H, Camus M, León A, Oddó D, Villarroel A, Razmilic D, Navarro ME, Medina L, Merino T, Vines E, Peña J, Maldonado D, Pinto MP, Acevedo F, Sánchez C. Mammography correlates to better survival rates in breast cancer patients: a 20-year experience in a University health institution. Ecancermedicalscience 2020; 14:1005. [PMID: 32104207 PMCID: PMC7039691 DOI: 10.3332/ecancer.2020.1005] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Indexed: 12/18/2022] Open
Abstract
Breast cancer (BC) is the most common malignancy in women. We retrieved medical records from >2,000 Chilean BC patients over the 1997–2018 period. The objective was to assess changes in clinical presentation or prognosis of our patients throughout these 20 years of practice. Although most variables did not display significant variations, we observed a progressive increase in stage IV BC over this period. Our data showed that tumour stage III/IV or HER2-enriched subtype tumours were associated with poorer prognosis. In contrast, we found that patients diagnosed by mammography had better overall survival. We speculate that better screenings and more sensitive imaging could explain the unexpected rise in stage IV cases. Our results support mammography screenings as an effective measure to reduce BC-related mortality.
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Affiliation(s)
- Cristóbal Maiz
- Departament of Oncological and Maxillofacial Surgery, School of Medicine, Pontificia Universidad Católica de Chile, 8330032 Santiago, Chile
| | - Fernando Silva
- Departament of Hematology and Oncology, School of Medicine, Pontificia Universidad Católica de Chile, 8330032 Santiago, Chile
| | - Francisco Domínguez
- Departament of Oncological and Maxillofacial Surgery, School of Medicine, Pontificia Universidad Católica de Chile, 8330032 Santiago, Chile
| | - Héctor Galindo
- Departament of Hematology and Oncology, School of Medicine, Pontificia Universidad Católica de Chile, 8330032 Santiago, Chile
| | - Mauricio Camus
- Departament of Oncological and Maxillofacial Surgery, School of Medicine, Pontificia Universidad Católica de Chile, 8330032 Santiago, Chile
| | - Augusto León
- Departament of Oncological and Maxillofacial Surgery, School of Medicine, Pontificia Universidad Católica de Chile, 8330032 Santiago, Chile
| | - David Oddó
- Departament of Anatomic Pathology, School of Medicine, Pontificia Universidad Católica de Chile, 8330032 Santiago, Chile
| | - Alejandra Villarroel
- Departament of Anatomic Pathology, School of Medicine, Pontificia Universidad Católica de Chile, 8330032 Santiago, Chile
| | - Dravna Razmilic
- Departament of Radiology, School of Medicine, Pontificia Universidad Católica de Chile, 8330032 Santiago, Chile
| | - María Elena Navarro
- Departament of Radiology, School of Medicine, Pontificia Universidad Católica de Chile, 8330032 Santiago, Chile
| | - Lidia Medina
- Cancer Center 'Nuestra Señora de la Esperanza', Pontificia Universidad Católica de Chile, 8330032 Santiago, Chile
| | - Tomás Merino
- Departament of Hematology and Oncology, School of Medicine, Pontificia Universidad Católica de Chile, 8330032 Santiago, Chile
| | - Eugenio Vines
- Departament of Hematology and Oncology, School of Medicine, Pontificia Universidad Católica de Chile, 8330032 Santiago, Chile
| | - José Peña
- Departament of Hematology and Oncology, School of Medicine, Pontificia Universidad Católica de Chile, 8330032 Santiago, Chile
| | - Daniela Maldonado
- Departament of Oncological and Maxillofacial Surgery, School of Medicine, Pontificia Universidad Católica de Chile, 8330032 Santiago, Chile
| | - Mauricio P Pinto
- Departament of Hematology and Oncology, School of Medicine, Pontificia Universidad Católica de Chile, 8330032 Santiago, Chile
| | - Francisco Acevedo
- Departament of Hematology and Oncology, School of Medicine, Pontificia Universidad Católica de Chile, 8330032 Santiago, Chile
| | - César Sánchez
- Departament of Hematology and Oncology, School of Medicine, Pontificia Universidad Católica de Chile, 8330032 Santiago, Chile
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20
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Leenhardt R, Camus M, Mestas JL, Jeljeli M, Abou Ali E, Chouzenoux S, Bordacahar B, Nicco C, Batteux F, Lafon C, Prat F. Ultrasound-induced Cavitation enhances the efficacy of Chemotherapy in a 3D Model of Pancreatic Ductal Adenocarcinoma with its microenvironment. Sci Rep 2019; 9:18916. [PMID: 31831785 PMCID: PMC6908636 DOI: 10.1038/s41598-019-55388-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 11/27/2019] [Indexed: 12/13/2022] Open
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is supported by a complex microenvironment whose physical contribution to chemoresistance could be overcome by ultrasound (US) therapy. This study aims to investigate the ability of US-induced inertial cavitation in association with chemotherapy to alter tumor cell viability via microenvironment disruption. For this purpose, we used a 3D-coculture PDAC model partially mimicking the tumor and its microenvironment. Coculture spheroids combining DT66066 cells isolated from KPC-transgenic mice and murine embryonic fibroblasts (iMEF) were obtained by using a magnetic nanoshuttle method. Spheroids were exposed to US with incremental inertial cavitation indexes. Conditions studied included control, gemcitabine, US-cavitation and US-cavitation + gemcitabine. Spheroid viability was assessed by the reduction of resazurin and flow cytometry. The 3D-coculture spheroid model incorporated activated fibroblasts and produced type 1-collagen, thus providing a partial miniature representation of tumors with their microenvironment. Main findings were: (a) Gemcitabine (5 μM) was significantly less cytotoxic in the presence of KPC/iMEFs spheroids compared with KPC (fibroblast-free) spheroids; (b) US-induced inertial cavitation combined with Gemcitabine significantly decreased spheroid viability compared to Gemcitabine alone; (c) both cavitation and chemotherapy affected KPC cell viability but not that of fibroblasts, confirming the protective role of the latter vis-à-vis tumor cells. Gemcitabine toxicity is enhanced when cocultured spheroids of KPC and iMEF are exposed to US-cavitation. Although the model used is only a partial representation of PDAC, this experience supports the hypothesis that US-inertial cavitation can enhance drug penetration and cytotoxicity by disrupting PDAC microenvironment.
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MESH Headings
- Animals
- Carcinoma, Pancreatic Ductal/metabolism
- Carcinoma, Pancreatic Ductal/pathology
- Carcinoma, Pancreatic Ductal/therapy
- Cell Line, Tumor
- Deoxycytidine/analogs & derivatives
- Deoxycytidine/pharmacology
- Mice
- Mice, Transgenic
- Neoplasms, Experimental/metabolism
- Neoplasms, Experimental/pathology
- Neoplasms, Experimental/therapy
- Pancreatic Neoplasms/metabolism
- Pancreatic Neoplasms/pathology
- Pancreatic Neoplasms/therapy
- Spheroids, Cellular/metabolism
- Spheroids, Cellular/pathology
- Tumor Microenvironment/drug effects
- Ultrasonic Therapy
- Gemcitabine
- Pancreatic Neoplasms
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Affiliation(s)
- R Leenhardt
- University of Paris Descartes, INSERM U1016, Cochin Institute, Paris, France
| | - M Camus
- Sorbonne University, APHP, Saint-Antoine Hospital, Paris, France
| | - J L Mestas
- LabTAU, INSERM U1032, Centre Léon Bérard, Université-Lyon 1, Lyon, 69003, Lyon, France
| | - M Jeljeli
- University of Paris Descartes, INSERM U1016, Cochin Institute, Paris, France
| | - E Abou Ali
- University of Paris Descartes, INSERM U1016, Cochin Institute, Paris, France
| | - S Chouzenoux
- University of Paris Descartes, INSERM U1016, Cochin Institute, Paris, France
| | - B Bordacahar
- University of Paris Descartes, INSERM U1016, Cochin Institute, Paris, France
| | - C Nicco
- University of Paris Descartes, INSERM U1016, Cochin Institute, Paris, France
| | - F Batteux
- University of Paris Descartes, INSERM U1016, Cochin Institute, Paris, France
| | - C Lafon
- LabTAU, INSERM U1032, Centre Léon Bérard, Université-Lyon 1, Lyon, 69003, Lyon, France
| | - F Prat
- University of Paris Descartes, INSERM U1016, Cochin Institute, Paris, France.
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21
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Rivas M, Acevedo F, Dominguez F, Galindo H, Camus M, Oddo D, Villarroel A, Razmilic D, Peña J, Munoz Medel M, Navarro ME, Perez-Sepulveda A, Medina L, Merino T, Briones J, Kalergis A, Sanchez C. The Neutrophil to Lymphocyte Ratio Predicts the Response to Neoadjuvant Chemotherapy in Luminal B Breast Cancer. Asian Pac J Cancer Prev 2019; 20:2209-2212. [PMID: 31350986 PMCID: PMC6745205 DOI: 10.31557/apjcp.2019.20.7.2209] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Indexed: 12/24/2022] Open
Abstract
Objective: Tumor response to neoadjuvant chemotherapy (NAC) in breast cancer (BC) patients is a predictor for overall survival. The aim of our study was to determine a relationship between the neutrophil to lymphocyte ratio (NLR) prior to NAC, BC subtypes and the probability of a pathologic complete response (pCR). Materials and Methods: Medical records were collected retrospectively from Centro de Cancer at Red Salud UC-Christus. Clinical data collected included peripheral blood cell counts, BC subtype at diagnosis and the pathology report of surgery after chemotherapy. Results: A total of 88 patients were analyzed. Approximately, a 25% had a pCR, and displayed a significant correlation between BC subtype and pCR (p= 0.0138 Chi2); this was more frequent in epidermal growth factor receptor type 2 (HER2) enriched subtype patients (54%). Luminal B BC patients with a pCR had significantly lower NLR levels (t test, p= 0.0181). Conclusions: HER2-enriched tumors had a higher probability of pCR. In Luminal B tumors, NLR had a statistically significant relationship with the probability of pCR. In this subtype, NLR could be a useful biomarker to predict tumor response to NAC. Further studies including other clinical parameters for systemic inflammation such as platelet counts, intratumoral NLR or body mass index could help identify patients that would get the most benefit from NAC.
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Affiliation(s)
- Mauricio Rivas
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
| | - Francisco Acevedo
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
| | - Francisco Dominguez
- Department of Oncological and Maxillofacial Surgery, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Hector Galindo
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
| | - Mauricio Camus
- Department of Oncological and Maxillofacial Surgery, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - David Oddo
- Department of Anatomy and Pathology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Alejandra Villarroel
- Department of Anatomy and Pathology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Dravna Razmilic
- Department of Radiology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Jose Peña
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
| | - Matias Munoz Medel
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
| | - Maria Elena Navarro
- Department of Radiology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Alejandra Perez-Sepulveda
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
| | - Lidia Medina
- Centro de Cancer, Red de Salud UC-CHRISTUS, Santiago, Chile
| | - Tomas Merino
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
| | - Juan Briones
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
| | - Alexis Kalergis
- Millennium Institute on Immunology and Immunotherapy, Department of Molecular Genetics and Microbiology, Faculty of Biologic Sciences, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Cesar Sanchez
- Department of Hematology and Oncology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.
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Abstract
Metastatic breast cancer (MBC) management is based on systemic treatment (ST), while the local therapy role remains controversial. We present the case of a 36-year-old woman with a diagnosis of hormone receptor-positive and human epidermal growth factor receptor type 2-positive breast cancer and isolated sternal metastasis, who received neoadjuvant ST with complete remission and later primary tumour surgery. Oligometastatic patients are a subgroup of MBC that can benefit from aggressive local therapies, even with curative intent.
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Affiliation(s)
- Catalina Vargas
- Department of Surgical Oncology, Pontificia Universidad Católica de Chile, Santiago 8331150, Chile
| | - Cristóbal Maiz
- Department of Surgical Oncology, Pontificia Universidad Católica de Chile, Santiago 8331150, Chile
| | - María Elena Navarro
- Department of Radiology, Pontificia Universidad Católica de Chile, Santiago 8331150, Chile
| | - David Oddó
- Department of Anatomical Pathology, Pontificia Universidad Católica de Chile, Santiago 8331150, Chile
| | - César Sánchez
- Department of Hematology-Oncology, Pontificia Universidad Católica de Chile, Santiago 8331150, Chile
| | - Marisa Bustos
- Departament of Oncological Radiotherapy, Pontificia Universidad Católica de Chile, Santiago 8331150, Chile
| | - Mauricio Camus
- Department of Surgical Oncology, Pontificia Universidad Católica de Chile, Santiago 8331150, Chile
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23
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Munoz-Nates F, Pourcelot P, Camus M, Ravary-Plumioen B, Hamme AV, Litaise C, Emond AL, Beaud L, Chateau H, Crevier-Denoix N. External forces and impulses applied to the hind limb of 3 jumping horses at take-off-effects of the fence’s height. Comput Methods Biomech Biomed Engin 2019. [DOI: 10.1080/10255842.2020.1715002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- F. Munoz-Nates
- Unité 957, BPLC, INRA, Ecole Nationale Vétérinaire d’Alfort, Maisons-Alfort, France
| | - P. Pourcelot
- Unité 957, BPLC, INRA, Ecole Nationale Vétérinaire d’Alfort, Maisons-Alfort, France
| | - M. Camus
- Unité 957, BPLC, INRA, Ecole Nationale Vétérinaire d’Alfort, Maisons-Alfort, France
| | - B. Ravary-Plumioen
- Unité 957, BPLC, INRA, Ecole Nationale Vétérinaire d’Alfort, Maisons-Alfort, France
| | - A. Van Hamme
- Unité 957, BPLC, INRA, Ecole Nationale Vétérinaire d’Alfort, Maisons-Alfort, France
| | - C. Litaise
- Unité 957, BPLC, INRA, Ecole Nationale Vétérinaire d’Alfort, Maisons-Alfort, France
| | - A.-L Emond
- Unité 957, BPLC, INRA, Ecole Nationale Vétérinaire d’Alfort, Maisons-Alfort, France
| | - L. Beaud
- Unité 957, BPLC, INRA, Ecole Nationale Vétérinaire d’Alfort, Maisons-Alfort, France
| | - H. Chateau
- Unité 957, BPLC, INRA, Ecole Nationale Vétérinaire d’Alfort, Maisons-Alfort, France
| | - N. Crevier-Denoix
- Unité 957, BPLC, INRA, Ecole Nationale Vétérinaire d’Alfort, Maisons-Alfort, France
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24
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Crevier-Denoix N, Munoz-Nates F, Camus M, Ravary-Plumioen B, Hamme AV, Litaise C, Emond AL, Beaud L, Denoix JM, Chateau H, Pourcelot P. Kinetics and distal limb kinematics of the forelimb of 3 jumping horses at landing after a jump: effects of the fence’s height. Comput Methods Biomech Biomed Engin 2019. [DOI: 10.1080/10255842.2020.1713506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- N. Crevier-Denoix
- Unité 957, BPLC, INRA, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - F. Munoz-Nates
- Unité 957, BPLC, INRA, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - M. Camus
- Unité 957, BPLC, INRA, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - B. Ravary-Plumioen
- Unité 957, BPLC, INRA, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - A. Van Hamme
- Unité 957, BPLC, INRA, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - C. Litaise
- Unité 957, BPLC, INRA, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - A.-L Emond
- Unité 957, BPLC, INRA, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - L. Beaud
- Unité 957, BPLC, INRA, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - J.-M Denoix
- Unité 957, BPLC, INRA, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - H. Chateau
- Unité 957, BPLC, INRA, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - P. Pourcelot
- Unité 957, BPLC, INRA, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
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25
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Carrillo M, Maturana G, Maiz C, Romero D, Domínguez F, Oddó D, Villarroel A, Razmilic D, Navarro ME, León A, Sánchez C, Camus M. Breast lesions with atypia in percutaneous biopsies, managed with surgery in the last 10 years. Ecancermedicalscience 2019; 13:923. [PMID: 31281420 PMCID: PMC6546256 DOI: 10.3332/ecancer.2019.923] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Indexed: 12/05/2022] Open
Abstract
Introduction The optimal management of breast lesions with atypia (BLA), detected in percutaneous biopsies after screening mammograms, is a controversial issue. The aim of this paper is to compare histological diagnosis by percutaneous biopsy with the results of the surgical biopsy of these lesions and to analyse the changes to clinical approach this would imply. Method A retrospective study was carried out on patients operated on between June 2007 and June 2017 with a diagnosis of BLA. One hundred and forty-seven patients were identified with a pre-operative diagnosis of flat epithelial atypia (FEA), atypical ductal hyperplasia (ADH), atypical lobular hyperplasia, lobular carcinoma in situ and other atypia. Results The average age at diagnosis of BLAs was 52 ± 9.4 years. Radiologically, the lesions presented as microcalcifications in 79%, nodules in 15.6% and other lesions 5.4%. 73.5% of these were biopsied by means of digital stereotaxis. All of the patients analysed underwent a partial mastectomy. Changes in a biologically high-risk lesion were observed in 26.5% of the surgical specimens, of which 75.5% corresponded with ADH and FEA. In the percutaneous biopsies consistent with ADH (40.1%), ductal carcinoma was discovered in 6.8% (5.1% in situ and 1.7% invasive), which implied specific, multi-disciplinary management. Of the FEAs, 84.8% required a second treatment (surgery and/or hormone therapy ± radiotherapy, depending on whether it concerned FEA 59.6%, ADH 21.2% or ductal carcinoma in situ 3.8%). Conclusion These data show the clinical relevance in the diagnosis of ADH and FEA in percutaneous biopsies. For the diagnosis of FEA in particular, the associated risk of biologically high-risk lesions and ductal carcinoma is made evident.
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Affiliation(s)
- Mitzy Carrillo
- Department of Surgical Oncology, Pontificia Universidad Católica de Chile, Santiago, 8330024, Chile
| | - Gregorio Maturana
- School of Medicine, Pontificia Universidad Católica de Chile, Santiago, 8330024, Chile
| | - Cristóbal Maiz
- Department of Surgical Oncology, Pontificia Universidad Católica de Chile, Santiago, 8330024, Chile
| | - Diego Romero
- Oncological and Head and Neck Surgery, Hospital Sótero del Río, Santiago, 8207257, Chile
| | - Francisco Domínguez
- Department of Surgical Oncology, Pontificia Universidad Católica de Chile, Santiago, 8330024, Chile
| | - David Oddó
- Department of Anatomical Pathology, Pontificia Universidad Católica de Chile, Santiago, 8330024, Chile
| | - Alejandra Villarroel
- Department of Anatomical Pathology, Pontificia Universidad Católica de Chile, Santiago, 8330024, Chile
| | - Dravna Razmilic
- Department of Breast Radiology, Pontificia Universidad Católica de Chile, Santiago, 8330024, Chile
| | - María Elena Navarro
- Department of Breast Radiology, Pontificia Universidad Católica de Chile, Santiago, 8330024, Chile
| | - Augusto León
- Department of Surgical Oncology, Pontificia Universidad Católica de Chile, Santiago, 8330024, Chile
| | - César Sánchez
- Department of Hematology-Oncology, Pontificia Universidad Católica de Chile, Santiago, 8330024, Chile
| | - Mauricio Camus
- Department of Surgical Oncology, Pontificia Universidad Católica de Chile, Santiago, 8330024, Chile
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26
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Sánchez C, Domínguez F, Galindo H, Camus M, Oddó D, Villarroel A, Razmilic D, Navarro ME, Pérez-Sepúlveda A, Medina L, López V, Acevedo F. [Survival of patients with advanced HER2+ breast cancer. Analysis of a cancer center database]. Rev Med Chil 2019; 146:1095-1101. [PMID: 30724972 DOI: 10.4067/s0034-98872018001001095] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 10/09/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND HER2+ breast cancer (BC) subtype overexpresses the Human Epidermal growth factor Receptor type-2 (HER2) and is characterized by its aggressiveness and its high sensitivity to monoclonal antibody-based HER2-targeted therapies. AIM To assess the prognosis and evaluate the impact of novel anti-HER2 therapies on advanced HER2+ BC patients treated at our institution over the last decades. MATERIAL AND METHODS Analysis of the patient database at a cancer center of a university hospital. Information about the subtype of cancer was obtained in 2,149 of 2,724 patients in the database. Eighteen percent of the latter were HER2+. We analyzed data of 83 of these patients with advanced disease. RESULTS Median overall survival (OS) was 24 months. For patients treated between 1997-2006 median OS was 17 months and for those treated in the period 2007-2017 median OS was 32 months (p = 0.09). CONCLUSIONS A non-significant trend towards better survival in the last decade was observed. HER2+ BC overall survival has improved in our center. This can be probably attributed to the use of novel more effective anti-HER2 therapies.
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Affiliation(s)
- Cesar Sánchez
- Departamento de Hematología-Oncología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francisco Domínguez
- Departamento de Cirugía Oncológica y Maxilofacial, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Héctor Galindo
- Departamento de Hematología-Oncología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Mauricio Camus
- Departamento de Cirugía Oncológica y Maxilofacial, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - David Oddó
- Departamento de Anatomía-Patológica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Alejandra Villarroel
- Departamento de Anatomía-Patológica, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Dravna Razmilic
- Departamento de Radiología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile
| | - María Elena Navarro
- Departamento de Radiología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Chile
| | - Alejandra Pérez-Sepúlveda
- Departamento de Hematología-Oncología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Lidia Medina
- Centro de Cáncer Nuestra Señora de La Esperanza, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Valeska López
- Centro de Cáncer Nuestra Señora de La Esperanza, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francisco Acevedo
- Departamento de Hematología-Oncología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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Kadji C, Cannie MM, De Angelis R, Camus M, Klass M, Fellas S, Cecotti V, Dütemeyer V, Jani JC. Prenatal prediction of postnatal large-for-dates neonates using a simplified MRI method: comparison with conventional 2D ultrasound estimates. Ultrasound Obstet Gynecol 2018; 52:250-257. [PMID: 28508549 DOI: 10.1002/uog.17523] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 04/30/2017] [Accepted: 05/04/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To evaluate the performance of a simple semi-automated method for estimation of fetal weight (EFW) using magnetic resonance imaging (MRI) as compared with two-dimensional (2D) ultrasound (US) for the prediction of large-for-dates neonates. METHODS Data of two groups of women with singleton pregnancy between March 2011 and May 2016 were retrieved from our database and evaluated retrospectively: the first group included women who underwent US-EFW and MRI-EFW within 48 h before delivery and the second group included women who had these evaluations between 35 + 0 weeks and 37 + 6 weeks of gestation, more than 48 h before delivery. US-EFW was based on Hadlock et al. and MRI-EFW on the formula described by Baker et al. For MRI-EFW, planimetric measurement of the fetal body volume (FBV) was performed using a semi-automated method and the time required for measurement was noted. Outcome measure was the performance of MRI-EFW vs US-EFW in the prediction of large-for-dates neonates, both ≤ 48 h and > 48 h before delivery. Receiver-operating characteristics (ROC) curves for each method were compared using the DeLong method. RESULTS Of the 270 women included in the first group, 48 (17.8%) newborns had birth weight ≥ 90th centile and 30 (11.1%) ≥ 95th centile. The second group included 83 women, and nine (10.8%) newborns had birth weight ≥ 95th centile. Median time needed for FBV planimetric measurements in all 353 fetuses was 3.5 (range, 1.5-5.5) min. The area under the ROC curve (AUC) for prediction of large-for-dates neonates by prenatal MRI performed within 48 h before delivery was significantly higher than that by US (for birth weight ≥ 90th centile, difference between AUCs = 0.085, standard error (SE) = 0.020, P < 0.001; for birth weight ≥ 95th centile, difference between AUCs = 0.036, SE = 0.014, P = 0.01). Similarly, MRI-EFW was better than US-EFW in predicting birth weight ≥ 95th centile when both examinations were performed > 48 h prior to delivery (difference between AUCs = 0.077, SE = 0.039, P = 0.045). CONCLUSION MRI planimetry using our purpose-designed semi-automated method is not time-consuming. The predictive performance of MRI-EFW performed immediately prior to or remote from delivery is significantly better than that of US-EFW for the prediction of large-for-dates neonates. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- C Kadji
- Department of Obstetrics and Gynecology, University Hospital Brugmann, Brussels, Belgium
| | - M M Cannie
- Department of Radiology, University Hospital Brugmann, Brussels, Belgium
- Department of Radiology, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - R De Angelis
- Department of Radiology, University Hospital Brugmann, Brussels, Belgium
| | - M Camus
- Department of Obstetrics and Gynecology, University Hospital Brugmann, Brussels, Belgium
| | - M Klass
- Department of Obstetrics and Gynecology, University Hospital Brugmann, Brussels, Belgium
| | - S Fellas
- Department of Obstetrics and Gynecology, University Hospital Brugmann, Brussels, Belgium
| | - V Cecotti
- Department of Obstetrics and Gynecology, University Hospital Brugmann, Brussels, Belgium
| | - V Dütemeyer
- Department of Obstetrics and Gynecology, University Hospital Brugmann, Brussels, Belgium
| | - J C Jani
- Department of Obstetrics and Gynecology, University Hospital Brugmann, Brussels, Belgium
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Merino T, Ip T, Domínguez F, Acevedo F, Medina L, Villaroel A, Camus M, Vinés E, Sánchez C. Risk factors for loco-regional recurrence in breast cancer patients: a retrospective study. Oncotarget 2018; 9:30355-30362. [PMID: 30100994 PMCID: PMC6084401 DOI: 10.18632/oncotarget.25735] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 06/23/2018] [Indexed: 11/25/2022] Open
Abstract
Background Although fairly uncommon, loco-regional recurrence in breast cancer (BC) has major consequences for the patient. Several predictors for locoregional have been previously reported from large randomized clinical trials mainly from Europe & North America; data from other geographical areas are somewhat scarce. Here we performed a retrospective review of medical records in a single academic center in Chile, searching for predictors of breast tumor recurrence. Results Median patient follow up was 61 months, 5 year overall survival (OS) rate was 94.2% (95% CI 93-95.3). We found that 108 out of 2,754 (5.3%) patients had loco-regional recurrence. The 2-year loco-regional control was 98% (95% CI 97.3-98.7) and 5-year was 94% (95% CI 92.6-95.4). Univariate analysis showed a correlation between recurrence and being <50 year-old, positive surgical margins, advanced stage, subtype, and presence of LVI and omission of adjuvant radiotherapy. Only the absence of adjuvant RT was predictor of locoregional recurrence in multivariable (p< 0.001). Conclusions Our study population presents high local control of BC. Age, surgical margins, stage, molecular subtype and absence of adjuvant radiotherapy were associated with loco-regional recurrence. Prospective trials and long-term follow up are required in order to confirm these results. Materials and Methods We analyzed medical records from 2,201 BC patients at the Pontificia Universidad Católica de Chile from 1997 to 2016. Collected data included: age at diagnosis, tumor size, axillary involvement, molecular subtype, margin status, histological grade, lympho-vascular invasion (LVI) and ipsilateral recurrence.
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Affiliation(s)
- Tomás Merino
- Department of Hematology-Oncology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Teresa Ip
- Department of Hematology-Oncology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francisco Domínguez
- Department of Surgery, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francisco Acevedo
- Department of Hematology-Oncology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Lidia Medina
- Department of Hematology-Oncology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Alejandra Villaroel
- Department of Pathology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Mauricio Camus
- Department of Surgery, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Eugenio Vinés
- Department of Hematology-Oncology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - César Sánchez
- Department of Hematology-Oncology, Pontificia Universidad Católica de Chile, Santiago, Chile
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Honold F, Camus M. Prophylactic mastectomy versus surveillance for the prevention of breast cancer in women's BRCA carriers. Medwave 2018; 18:e7161. [PMID: 30052622 DOI: 10.5867/medwave.2018.04.7160] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 04/23/2018] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Women who have mutations in BRCA genes have a high risk of developing breast cancer. Therefore, multiple preventive strategies have been proposed, within which is prophylactic mastectomy. Considering physical and psychological effects of surgery, the controversy is established as to whether the preventive effect exceeds that of active vigilance. METHODS To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS We identified 13 systematic reviews including 50 studies overall. We concluded prophylactic mastectomy is associated with frequent adverse effects, but probably reduces the incidence of breast cancer and decreases mortality, in addition to being associated with high levels of satisfaction.
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Affiliation(s)
- Francisca Honold
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Proyecto Epistemonikos, Santiago, Chile
| | - Mauricio Camus
- Proyecto Epistemonikos, Santiago, Chile; Departamento de Cirugía Oncológica, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. . Address: Centro Evidencia UC, Pontificia Universidad Católica de Chile, Av. Diagonal Paraguay 476, piso 1, Santiago, Chile
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Jannot Y, Degiovanni A, Camus M. Extension of the thermal porosimetry method to high gas pressure for nanoporosimetry estimation. Rev Sci Instrum 2018; 89:044904. [PMID: 29716346 DOI: 10.1063/1.5020117] [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: 06/08/2023]
Abstract
Standard pore size determination methods like mercury porosimetry, nitrogen sorption, microscopy, or X-ray tomography are not suited to highly porous, low density, and thus very fragile materials. For this kind of materials, a method based on thermal characterization has been developed in a previous study. This method has been used with air pressure varying from 10-1 to 105 Pa for materials having a thermal conductivity less than 0.05 W m-1 K-1 at atmospheric pressure. It enables the estimation of pore size distribution between 100 nm and 1 mm. In this paper, we present a new experimental device enabling thermal conductivity measurement under gas pressure up to 106 Pa, enabling the estimation of the volume fraction of pores having a 10 nm diameter. It is also demonstrated that the main thermal conductivity models (parallel, series, Maxwell, Bruggeman, self-consistent) lead to the same estimation of the pore size distribution as the extended parallel model (EPM) presented in this paper and then used to process the experimental data. Three materials with thermal conductivities at atmospheric pressure ranging from 0.014 W m-1 K-1 to 0.04 W m-1 K-1 are studied. The thermal conductivity measurement results obtained with the three materials are presented, and the corresponding pore size distributions between 10 nm and 1 mm are presented and discussed.
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Affiliation(s)
- Y Jannot
- Université de Lorraine, LEMTA (UMR 7563), ENSEM, 2 Avenue de la Forêt de Haye, BP 90161, 54505 Vandoeuvre-lès-Nancy cedex, France
| | - A Degiovanni
- Université de Lorraine, LEMTA (UMR 7563), ENSEM, 2 Avenue de la Forêt de Haye, BP 90161, 54505 Vandoeuvre-lès-Nancy cedex, France
| | - M Camus
- Université de Lorraine, LEMTA (UMR 7563), ENSEM, 2 Avenue de la Forêt de Haye, BP 90161, 54505 Vandoeuvre-lès-Nancy cedex, France
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Racca A, Santos-Ribeiro S, De Munck N, Mackens S, Drakopoulos P, Camus M, Verheyen G, Tournaye H, Blockeel C. Impact of late-follicular phase elevated serum progesterone on cumulative live birth rates: is there a deleterious effect on embryo quality? Hum Reprod 2018; 33:860-868. [DOI: 10.1093/humrep/dey031] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 02/01/2018] [Indexed: 12/12/2022] Open
Affiliation(s)
- A Racca
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101-1090 Brussels, Belgium
- Academic Unit of Obstetrics and Gynecology, IRCCS AOU San Martino–IST, University of Genova, Largo R. Benzi 10, 16132 Genova, Italy
| | - S Santos-Ribeiro
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101-1090 Brussels, Belgium
- Department of Obstetrics, Gynaecology and Reproductive Medicine, Santa Maria University Hospital, Avenida Professor Egas Moniz, Lisbon 1649-035, Portugal
| | - N De Munck
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101-1090 Brussels, Belgium
| | - S Mackens
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101-1090 Brussels, Belgium
| | - P Drakopoulos
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101-1090 Brussels, Belgium
- Faculty of Medicine and Pharmacy, Department of Surgical and Clinical Science, Vrije Universiteit Brussel, Laarbeeklaan 101-1090 Brussels, Belgium
| | - M Camus
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101-1090 Brussels, Belgium
| | - G Verheyen
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101-1090 Brussels, Belgium
| | - H Tournaye
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101-1090 Brussels, Belgium
| | - C Blockeel
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101-1090 Brussels, Belgium
- Department of Obstetrics & Gynaecology, School of Medicine, University of Zagreb, Petrova 13, 10000 Zagreb, Croatia
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Honold F, Camus M. Prophylactic mastectomy versus surveillance for the prevention of breast cancer in women's BRCA carriers. Medwave 2018. [DOI: 10.5867/medwave.2018.01.7160] [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] Open
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Oddó D, Pulgar D, Elgueta N, Acevedo F, Razmiliz D, Navarro ME, Camus M, Merino T, Retamal I, Pérez-Sepúlveda A, Villarroel A, Galindo H, Peña J, Sánchez C. Can Histological Grade and Mitotic Index Replace Ki67 to Determine Luminal Breast Cancer Subtypes? Asian Pac J Cancer Prev 2018; 19:179-183. [PMID: 29373911 PMCID: PMC5844615 DOI: 10.22034/apjcp.2018.19.1.179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2017] [Indexed: 11/27/2022] Open
Abstract
Introduction: Breast cancer can be classified into subtypes based on immunohistochemical markers, with Ki67 expression levels being used to divide luminal BC tumors in luminal A and B subtypes; however, Ki67 is not routinely determined due to a lack of standardization. Objective: To evaluate histological grade and Eliminate: the mitotic index to determine if they can be used as an alternative method to Ki67 staining for luminal subtype definition. Methods: We evaluated estrogen receptor positive breast cancer tissue samples. Pathological analysis included determination of Ki67. A low level of Ki67 was defined as <14% positive cells. Results: We evaluated 151 breast cancer samples; 24 (15,9%) were classified as I; 74 as HG II (49%), and 53 (35,1%) as HG III. The median value for Ki67 was 13% (range: <1% - 82%) and for MI was 2 (0-12). Histological grade I tumors exhibited Ki67 values significantly lower than HG II and III tumors (Anova, Tamhane test p=0,001). A higher Ki67 value was related to a higher MI (Rho Sperman p=0,336; R2= 0,0273). ROC curve analysis determined that a MI ≥ 3 had a sensibility of 61.9% and specificity of 66.7% in predicting a high Ki67 value (≥14%) (area under the curve: 0,691; p =0,0001). A HG I tumor or HG II-III with MI ≤2, had a high probability of corresponding to a LA tumor (76,3%), as defined using Ki67 expression, while the probability of a LB subtype was higher with HG II-III and a MI ≥3 (57.4%). Global discrimination was 68.1%. Conclusions: For the LA subtype, our predictive model showed a good correlation of HG and MI with the classification based on Ki67<14%. In the LB subtype, the model showed a weak correlation; therefore Ki67 determination seems to be needed for this group of patients.
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Affiliation(s)
- David Oddó
- Department of Pathology, School of Medicine, Pontificia Universidad Católica de Chile, Chile.
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Crevier-Denoix N, Munoz-Nates F, Camus M, Ravary-Plumioen B, Denoix JM, Pourcelot P, Chateau H. Comparison of peak vertical force and vertical impulse in the inside and outside hind limbs in horses circling on a soft surface, at trot and canter. Comput Methods Biomech Biomed Engin 2017; 20:51-52. [PMID: 29088645 DOI: 10.1080/10255842.2017.1382856] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- N Crevier-Denoix
- a Unité 957, BPLC, INRA, Ecole Nationale Vétérinaire d'Alfort, Université Paris Est , 94700 , Maisons-Alfort , France
| | - F Munoz-Nates
- a Unité 957, BPLC, INRA, Ecole Nationale Vétérinaire d'Alfort, Université Paris Est , 94700 , Maisons-Alfort , France
| | - M Camus
- a Unité 957, BPLC, INRA, Ecole Nationale Vétérinaire d'Alfort, Université Paris Est , 94700 , Maisons-Alfort , France
| | - B Ravary-Plumioen
- a Unité 957, BPLC, INRA, Ecole Nationale Vétérinaire d'Alfort, Université Paris Est , 94700 , Maisons-Alfort , France
| | - J M Denoix
- b CIRALE, Unité 957, BPLC , Ecole Nationale Vétérinaire d'Alfort , 14430 , Goustranville , France
| | - P Pourcelot
- a Unité 957, BPLC, INRA, Ecole Nationale Vétérinaire d'Alfort, Université Paris Est , 94700 , Maisons-Alfort , France
| | - H Chateau
- a Unité 957, BPLC, INRA, Ecole Nationale Vétérinaire d'Alfort, Université Paris Est , 94700 , Maisons-Alfort , France
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Munoz-Nates F, Chateau H, Pourcelot P, Camus M, Ravary-Plumioen B, Denoix JM, Crevier-Denoix N. Ground reaction force and impulses of fore and hindlimbs in horses at trot on an asphalt track: effects of an inclined (uphill) compared to a flat surface. Comput Methods Biomech Biomed Engin 2017; 20:143-144. [DOI: 10.1080/10255842.2017.1382902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- F. Munoz-Nates
- Unité 957, BPLC, INRA, Ecole Nationale Vétérinaire d’Alfort, Université Paris Est, Maisons-Alfort, France
| | - H. Chateau
- Unité 957, BPLC, INRA, Ecole Nationale Vétérinaire d’Alfort, Université Paris Est, Maisons-Alfort, France
| | - P. Pourcelot
- Unité 957, BPLC, INRA, Ecole Nationale Vétérinaire d’Alfort, Université Paris Est, Maisons-Alfort, France
| | - M. Camus
- Unité 957, BPLC, INRA, Ecole Nationale Vétérinaire d’Alfort, Université Paris Est, Maisons-Alfort, France
| | - B. Ravary-Plumioen
- Unité 957, BPLC, INRA, Ecole Nationale Vétérinaire d’Alfort, Université Paris Est, Maisons-Alfort, France
| | - J. M. Denoix
- CIRALE, Unité 957, BPLC, Ecole Nationale Vétérinaire d’Alfort, Goustranville, France
| | - N. Crevier-Denoix
- Unité 957, BPLC, INRA, Ecole Nationale Vétérinaire d’Alfort, Université Paris Est, Maisons-Alfort, France
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Shotar E, Soyer P, Barat M, Dautry R, Pocard M, Placé V, Camus M, Eveno C, Barret M, Dohan A. Diagnosis of acute overt gastrointestinal bleeding with CT-angiography: Comparison of the diagnostic performance of individual acquisition phases. Diagn Interv Imaging 2017; 98:857-863. [PMID: 28754326 DOI: 10.1016/j.diii.2017.06.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 06/29/2017] [Accepted: 06/30/2017] [Indexed: 02/06/2023]
Abstract
PURPOSE To compare the respective values of arterial phase, portal venous phase and combination of phases using 64-section multidetector computed tomography (MDCT) for diagnosing acute overt gastrointestinal bleeding (AOGIB). PATIENTS AND METHODS Forty-nine patients with AOGIB were included. There were 30 men and 19 women, with a mean age of 65.4±15.6 (SD) years [range, 34-91years]. Two observers reviewed MDCT examinations in consensus for presence of active bleeding, location of bleeding site and nature of causative lesion. The different acquisition phases were reviewed independently. RESULTS AOGIB was identified in 28/49 patients (57%) with the multiphasic set, in 26/49 patients (53%) with arterial phase and in 25/49 patients (51%) with portal venous phase. Multiphasic set helped locate the bleeding site in 40/49 patients (82%). The cause was elucidated in 23/49 patients (47%) with multiphasic set. The differences between set performances were not statistically significant. Sensitivity for depicting AOGIB with the multiphasic set was 92% and specificity was 76%. CONCLUSION Multiphasic 64-section MDCT has high diagnostic performances in patients with AOGIB. Further studies with a larger population are needed to reach statistical significance and demonstrate better diagnostic performance of multiphasic MDCT in comparison with the arterial or portal phase alone.
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Affiliation(s)
- E Shotar
- Department of Body and Interventional Imaging, hôpital Lariboisière, AP-HP, 2, rue Ambroise Paré, 75475 Paris cedex 10, France
| | - P Soyer
- Université Paris 5, Sorbonne Paris Cité, rue de l'école de médecine, 75006 Paris, France; UMR Inserm 965, hôpital Lariboisière, 2, rue Amboise-Paré, 75010 Paris, France; Department of Radiologie, hôpital Cochin, AP-HP, 27, rue du Faubourg Saint-Jacques, 75014 Paris, France
| | - M Barat
- Department of Body and Interventional Imaging, hôpital Lariboisière, AP-HP, 2, rue Ambroise Paré, 75475 Paris cedex 10, France
| | - R Dautry
- Department of Body and Interventional Imaging, hôpital Lariboisière, AP-HP, 2, rue Ambroise Paré, 75475 Paris cedex 10, France
| | - M Pocard
- Université Paris 5, Sorbonne Paris Cité, rue de l'école de médecine, 75006 Paris, France; UMR Inserm 965, hôpital Lariboisière, 2, rue Amboise-Paré, 75010 Paris, France; Department of Surgical Oncology, hôpital Lariboisière, AP-HP, 2, rue Ambroise Paré, 75475 Paris cedex 10, France
| | - V Placé
- Department of Body and Interventional Imaging, hôpital Lariboisière, AP-HP, 2, rue Ambroise Paré, 75475 Paris cedex 10, France
| | - M Camus
- Department of Gastroenterology, hôpital Saint-Antoine, AP-HP, 184, rue du Faubourg Saint-Antoine, 75012 Paris, France
| | - C Eveno
- Université Paris 5, Sorbonne Paris Cité, rue de l'école de médecine, 75006 Paris, France; UMR Inserm 965, hôpital Lariboisière, 2, rue Amboise-Paré, 75010 Paris, France; Department of Surgical Oncology, hôpital Lariboisière, AP-HP, 2, rue Ambroise Paré, 75475 Paris cedex 10, France
| | - M Barret
- Department of Gastroenterology, hôpital Cochin, AP-HP, 27, rue du Faubourg Saint-Jacques, 75014 Paris, France
| | - A Dohan
- Department of Body and Interventional Imaging, hôpital Lariboisière, AP-HP, 2, rue Ambroise Paré, 75475 Paris cedex 10, France; Université Paris 5, Sorbonne Paris Cité, rue de l'école de médecine, 75006 Paris, France; UMR Inserm 965, hôpital Lariboisière, 2, rue Amboise-Paré, 75010 Paris, France.
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Mimica X, Acevedo F, Oddo D, Ibáñez C, Medina L, Kalergis A, Camus M, Sánchez C. [Neutrophil/lymphocyte ratio in complete blood count as a mortality predictor in breast cancer]. Rev Med Chil 2017; 144:691-6. [PMID: 27598486 DOI: 10.4067/s0034-98872016000600001] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Accepted: 04/06/2016] [Indexed: 11/17/2022]
Abstract
UNLABELLED The white blood cell count is one of the most sensitive markers associated with inflammation. The neutrophil/lymphocyte count ratio may be an independent factor for breast cancer mortality. AIM To assess the predictive value of the neutrophil/lymphocyte ratio for mortality in breast cancer. MATERIAL AND METHODS Review of the database of a cancer center of a University hospital. Patients with infiltrating breast cancer treated between 1997 and 2012 were selected. The pathology type and lymph node involvement were obtained from the pathology report. The expression of estrogen, progesterone and Human Epidermal Growth Factor Receptor 2 (HER2) was determined by immunohistochemistry or in situ fluorescent hybridization (FISH). The absolute peripheral neutrophil and lymphocyte counts were obtained from a complete blood count obtained at least three months before treatment. Patients were followed for a median of 61 months (range 1-171). RESULTS From 323 eligible patients, after excluding those in stage IV and those without an available complete blood count, 131 patients were analyzed (81 with negative receptors and 117 HER2 enriched). The neutrophil/lymphocyte ratio was similar in both types of tumors (2.1 and 1.91 respectively). Twenty two patients died during follow-up. Surviving patients with HER2 enriched tumors had a lower neutrophil/lymphocyte ratio than those who died (1.79 and 3.21 respectively, p < 0.01). In a multivariate analysis, including age, tumor stage and lymph node involvement as confounding factors, the neutrophil/lymphocyte ratio was still significantly associated with a risk of death with a hazard ratio of 2.56. CONCLUSIONS A high neutrophil/lymphocyte ratio in the complete blood count can be a predictor of death in breast cancer.
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Affiliation(s)
- Ximena Mimica
- Departamento de Cirugía Oncológica, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francisco Acevedo
- Departamento de Hematología-Oncología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile,
| | - David Oddo
- Departamento de Anatomía Patológica, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Carolina Ibáñez
- Departamento de Hematología-Oncología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Lidia Medina
- Departamento de Hematología-Oncología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile,
| | - Alexis Kalergis
- Facultad de Ciencias Biológicas, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Mauricio Camus
- Departamento de Cirugía Oncológica, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - César Sánchez
- Departamento de Hematología-Oncología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile,
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Alvarez C, Tapia T, Perez-Moreno E, Gajardo-Meneses P, Ruiz C, Rios M, Missarelli C, Silva M, Cruz A, Matamala L, Carvajal-Carmona L, Camus M, Carvallo P. BRCA1 and BRCA2 founder mutations account for 78% of germline carriers among hereditary breast cancer families in Chile. Oncotarget 2017; 8:74233-74243. [PMID: 29088781 PMCID: PMC5650336 DOI: 10.18632/oncotarget.18815] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 06/12/2017] [Indexed: 11/25/2022] Open
Abstract
Identifying founder mutations in BRCA1 and BRCA2 in specific populations constitute a valuable opportunity for genetic screening. Several studies from different populations have reported recurrent and/or founder mutations representing a relevant proportion of BRCA mutation carriers. In Latin America, only few founder mutations have been described. We screened 453 Chilean patients with hereditary breast cancer for mutations in BRCA1 and BRCA2. For recurrent mutations, we genotyped 11 microsatellite markers in BRCA1 and BRCA2 in order to determine a founder effect through haplotype analysis. We found a total of 25 mutations (6 novel) in 71 index patients among which, nine are present exclusively in Chilean patients. Our analysis revealed the presence of nine founder mutations, 4 in BRCA1 and 5 in BRCA2, shared by 2 to 10 unrelated families and spread in different regions of Chile. Our panel contains the highest amount of founder mutations until today and represents the highest percentage (78%) of BRCA1 and BRCA2 mutation carriers. We suggest that the dramatic reduction of Amerindian population due to smallpox and wars with Spanish conquerors, a scarce population increase during 300 years, and the geographic position of Chile constituted a favorable scenario to establish founder genetic markers in our population.
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Affiliation(s)
- Carolina Alvarez
- Department of Cell and Molecular Biology, Faculty of Biological Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Teresa Tapia
- Department of Cell and Molecular Biology, Faculty of Biological Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Elisa Perez-Moreno
- Department of Cell and Molecular Biology, Faculty of Biological Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Patricia Gajardo-Meneses
- Department of Cell and Molecular Biology, Faculty of Biological Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Catalina Ruiz
- Centro de Cáncer, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Mabel Rios
- Unidad de Patología Mamaria, Hospital Base de Valdivia, Valdivia, Chile
| | | | - Mariela Silva
- Unidad de Patología Mamaria, Hospital Base de Valdivia, Valdivia, Chile
| | - Adolfo Cruz
- Unidad de Patología Mamaria, Hospital Barros Luco Trudeau, Santiago, Chile
| | - Luis Matamala
- Unidad de Patología Mamaria, Hospital Regional de Antofagasta, Antofagasta, Chile
| | - Luis Carvajal-Carmona
- Genome Center and Department of Biochemistry and Molecular Medicine, School of Medicine, University of California, Davis, California, USA
| | - Mauricio Camus
- Centro de Cáncer, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Pilar Carvallo
- Department of Cell and Molecular Biology, Faculty of Biological Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile
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Barret M, Bordaçahar B, Beuvon F, Terris B, Camus M, Coriat R, Chaussade S, Batteux F, Prat F. Self-assembling peptide matrix for the prevention of esophageal stricture after endoscopic resection: a randomized controlled trial in a porcine model. Dis Esophagus 2017; 30:1-7. [PMID: 28375444 DOI: 10.1093/dote/dow015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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: 06/16/2016] [Accepted: 11/09/2016] [Indexed: 02/07/2023]
Abstract
Esophageal stricture formation after extensive endoscopic resection remains a major limitation of endoscopic therapy for early esophageal neoplasia. This study assessed a recently developed self-assembling peptide (SAP) matrix as a wound dressing after endoscopic resection for the prevention of esophageal stricture. Ten pigs were randomly assigned to the SAP or the control group after undergoing a 5-cm-long circumferential endoscopic submucosal dissection of the lower esophagus. Esophageal diameter on endoscopy and esophagogram, weight variation, and histological measurements of fibrosis, granulation tissue, and neoepithelium were assessed in each animal. The rate of esophageal stricture at day 14 was 40% in the SAP-treated group versus 100% in the control group (P = 0.2). Median interquartile range (IQR) esophageal diameter at day 14 was 8 mm (2.5-9) in the SAP-treated group versus 4 mm (3-4) in the control group (P = 0.13). The median (IQR) stricture indexes on esophagograms at day 14 were 0.32 (0.14-0.48) and 0.26 (0.14-0.33) in the SAP-treated and control groups, respectively (P = 0.42). Median (IQR) weight variation during the study was +0.2 (-7.4; +1.8) and -3.8 (-5.4; +0.6) in the SAP-treated and control groups, respectively (P = 0.9). Fibrosis, granulation tissue, and neoepithelium were not significantly different between the groups. The application of SAP matrix on esophageal wounds after a circumferential endoscopic submucosal dissection delayed the onset of esophageal stricture in a porcine model.
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Affiliation(s)
- M Barret
- Department of Gastroenterology, Cochin Hospital, Paris, France.,Faculté Paris Descartes, Paris, France.,Inserm Unit 1016, Paris, France
| | - B Bordaçahar
- Faculté Paris Descartes, Paris, France.,Inserm Unit 1016, Paris, France
| | - F Beuvon
- Faculté Paris Descartes, Paris, France.,Department of Pathology, Cochin Hospital, Paris, France
| | - B Terris
- Faculté Paris Descartes, Paris, France.,Department of Pathology, Cochin Hospital, Paris, France
| | - M Camus
- Department of Gastroenterology, Cochin Hospital, Paris, France.,Faculté Paris Descartes, Paris, France.,Inserm Unit 1016, Paris, France
| | - R Coriat
- Department of Gastroenterology, Cochin Hospital, Paris, France.,Faculté Paris Descartes, Paris, France.,Inserm Unit 1016, Paris, France
| | - S Chaussade
- Department of Gastroenterology, Cochin Hospital, Paris, France.,Faculté Paris Descartes, Paris, France
| | - F Batteux
- Faculté Paris Descartes, Paris, France.,Inserm Unit 1016, Paris, France.,Department of Immunology, Cochin Hospital, Paris, France
| | - F Prat
- Department of Gastroenterology, Cochin Hospital, Paris, France.,Faculté Paris Descartes, Paris, France.,Inserm Unit 1016, Paris, France
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40
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Sánchez C, Camus M, Medina L, Oddo D, Artigas R, Pérez Sepúlveda A, Domínguez F, Razmilic D, Navarro ME, Galindo H, Acevedo F. Clinico-Pathologic Subtypes of Breast Cancer Primary Tumors Are Related to Prognosis after Recurrence. Asian Pac J Cancer Prev 2016; 17:5081-5086. [PMID: 28122438 PMCID: PMC5454640 DOI: 10.22034/apjcp.2016.17.12.5081] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Background: Pathological factors, based mainly on immunohistochemistry (IHC) and histological differentiation, are mostly used to differentiate breast cancer (BC) subtypes. Our present aim was to describe the characteristics and survival of a relapsing BC patient cohort based on clinico-pathologic subtypes determined for the primary tumors. Methods: We used a clinico- pathological definition of BC subtypes based on histological grade (HG), estrogen receptor (ER), progesterone receptor (PgR), and epidermal growth factor receptor type 2 (HER2) expression assessed by IHC. We determined variables associated with loco-regional recurrence (LRR), second primaries (SP), systemic recurrence (SR) and post-recurrence survival (PRS). Results: Out of 1,702 patients, 240 (14%) had an event defined as recurrence. Those with recurrent disease were significantly younger than those without, and were initially diagnosed at more advanced stages, with larger tumors, greater lymph nodal involvement and higher HG. With a median follow up of 61 months (1-250), 4.6% of patients without recurrence and 56.6% of patients with an event defined as recurrence had died. The median PRS for the LRR group was 77 months; 75 months for those who developed a SP and 22 months for patients with an SR (p <0.0001). In SR cases, the median PRS was shorter for ER- tumors than for ER+ tumors (15 vs. 26 months, respectively; p = 0.0019, HR 0.44; CI: 0.25-0.44). Conclusions: Subtype, defined through classic histopathologic parameters determined for primary tumors, was found to eb related to type of recurrence and also to prognosis after relapse.
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Zavala V, Pérez-Moreno E, Tapia T, Camus M, Carvallo P. miR-146a and miR-638 in BRCA1-deficient triple negative breast cancer tumors, as potential biomarkers for improved overall survival. Cancer Biomark 2016; 16:99-107. [PMID: 26835710 DOI: 10.3233/cbm-150545] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Mechanisms that lead to the reduced expression of BRCA1 in triple-negative breast cancer (TNBC) tumors are not fully understood. A possible cause is overexpression of miR-146a and miR-638, which regulate BRCA1 expression in other cancers. OBJECTIVE To evaluate the expression of these microRNAs in relation to BRCA1 expression in TNBC tumors. METHODS Expression of both microRNAs was assessed by real time qPCR using Taqman microRNA assays in TNBC tumors. Results were related to protein expression of BRCA1 and patient's survival. RESULTS miR-146a and miR-638 were overexpressed in 36% and 59% of TNBC tumors, respectively. Overexpression was preeminent in BRCA1-deficient tumors and significantly associated to a better overall survival. CONCLUSION Both miRNAs are potential biomarkers for improved overall survival in patients with BRCA1-deficient TNBC tumors.
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Affiliation(s)
- Valentina Zavala
- Departamento de Biología Celular y Molecular, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Elisa Pérez-Moreno
- Departamento de Biología Celular y Molecular, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Teresa Tapia
- Departamento de Biología Celular y Molecular, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Mauricio Camus
- Centro de Cáncer, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Pilar Carvallo
- Departamento de Biología Celular y Molecular, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
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van de Vijver A, Polyzos N, Van Landuyt L, Mackens S, Stoop D, Camus M, De Vos M, Tournaye H, Blockeel C. What is the optimal duration of progesterone administration before transferring a vitrified-warmed cleavage stage embryo? A randomized controlled trial. Hum Reprod 2016; 31:1097-1104. [DOI: 10.1093/humrep/dew045] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
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43
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Alvarez C, Aravena A, Tapia T, Rozenblum E, Solís L, Corvalán A, Camus M, Alvarez M, Munroe D, Maass A, Carvallo P. Different Array CGH profiles within hereditary breast cancer tumors associated to BRCA1 expression and overall survival. BMC Cancer 2016; 16:219. [PMID: 26979459 PMCID: PMC4791866 DOI: 10.1186/s12885-016-2261-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [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: 07/15/2015] [Accepted: 03/08/2016] [Indexed: 12/20/2022] Open
Abstract
Background Array CGH analysis of breast tumors has contributed to the identification of different genomic profiles in these tumors. Loss of DNA repair by BRCA1 functional deficiency in breast cancer has been proposed as a relevant contribution to breast cancer progression for tumors with no germline mutation. Identifying the genomic alterations taking place in BRCA1 not expressing tumors will lead us to a better understanding of the cellular functions affected in this heterogeneous disease. Moreover, specific genomic alterations may contribute to the identification of potential therapeutic targets and offer a more personalized treatment to breast cancer patients. Methods Forty seven tumors from hereditary breast cancer cases, previously analyzed for BRCA1 expression, and screened for germline BRCA1 and 2 mutations, were analyzed by Array based Comparative Genomic Hybridization (aCGH) using Agilent 4x44K arrays. Overall survival was established for tumors in different clusters using Log-rank (Mantel-Cox) Test. Gene lists obtained from aCGH analysis were analyzed for Gene Ontology enrichment using GOrilla and DAVID tools. Results Genomic profiling of the tumors showed specific alterations associated to BRCA1 or 2 mutation status, and BRCA1 expression in the tumors, affecting relevant cellular processes. Similar cellular functions were found affected in BRCA1 not expressing and BRCA1 or 2 mutated tumors. Hierarchical clustering classified hereditary breast tumors in four major, groups according to the type and amount of genomic alterations, showing one group with a significantly poor overall survival (p = 0.0221). Within this cluster, deletion of PLEKHO1, GDF11, DARC, DAG1 and CD63 may be associated to the worse outcome of the patients. Conclusions These results support the fact that BRCA1 lack of expression in tumors should be used as a marker for BRCAness and to select these patients for synthetic lethality approaches such as treatment with PARP inhibitors. In addition, the identification of specific alterations in breast tumors associated with poor survival, immune response or with a BRCAness phenotype will allow the use of a more personalized treatment in these patients.
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Affiliation(s)
- Carolina Alvarez
- Department of Cellular and Molecular Biology, Faculty of Biological Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Andrés Aravena
- Mathomics, Center for Mathematical Modeling (UMI 2807 CNRS) and Center for Genome Regulation (Fondap 15090007), University of Chile, Santiago, Chile.,Department of Molecular Biology and Genetics, Faculty of Science, Istanbul University, Istanbul, 34134, Turkey
| | - Teresa Tapia
- Department of Cellular and Molecular Biology, Faculty of Biological Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Ester Rozenblum
- Laboratory of Molecular Technology Advanced Technology Program, SAIC-Frederick, Inc., National Cancer Institute-Frederick, Frederick, MD, USA
| | - Luisa Solís
- Department of Anatomo-Pathology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Alejandro Corvalán
- Department of Anatomo-Pathology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Mauricio Camus
- Cancer Center, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - David Munroe
- Laboratory of Molecular Technology Advanced Technology Program, SAIC-Frederick, Inc., National Cancer Institute-Frederick, Frederick, MD, USA
| | - Alejandro Maass
- Mathomics, Center for Mathematical Modeling (UMI 2807 CNRS) and Center for Genome Regulation (Fondap 15090007), University of Chile, Santiago, Chile.,Department of Mathematical Engineering, University of Chile, Santiago, Chile
| | - Pilar Carvallo
- Department of Cellular and Molecular Biology, Faculty of Biological Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile.
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Acevedo F, Camus M, Vial C, Panay S, Abarca M, Domínguez F, Sánchez C. [Predictive value of conventional immuno-histochemical biomarkers in breast cancer]. Rev Med Chil 2016; 143:724-32. [PMID: 26230555 DOI: 10.4067/s0034-98872015000600005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 05/08/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND Pathological complete response (pCR) after neoadjuvant chemotherapy (NCT) in breast cancer (BC) identifies patients with good prognosis. AIM To assess if the clinico-pathological subtype, determined by classic immunohistochemical (IHC) markers, is able to predict pCR and prognosis in BC patients treated with NCT. MATERIAL AND METHODS One hundred thirty three BC patients aged 24-80 years, were treated with NCT. Clinico-pathological subtype was defined based on classic IHC markers. pCR was defined as the absence of invasive neoplastic cells in the breast and lymph nodes, on final breast surgery. RESULTS pCR was achieved in 8.2% of patients, 3.5 and 19.5% in luminal and hormonal receptor (HR) negative tumors respectively (p < 0.01). Median follow-up was 72.6 months (3.5-190). Patients who achieved pCR had higher overall survival (OS) (p = 0.04). A univariate analysis revealed that size of the tumor, ratio of metastatic to examined lymph nodes and absence of HR were significant predictors of pCR. These findings were not replicated in the multivariate analyses. CONCLUSIONS Clinico-pathological subtypes were independent prognostic factors for pCR and OS in BC patients in our cohort. These findings support using classic and cheap biomarkers as a predictive tool for NCT in BC.
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Abstract
BACKGROUND Young onset breast cancer (BC) has a worse outcome as compared to in the elderly. However, some studies have shown that BC in the elderly, despite indolent features, does also cause increase in mortality. In an attempt to compare clinic-pathological characteristics, BC subtypes and survival in patients with BC presenting at extremes of age, we performed a retrospective study. MATERIALS AND METHODS Patients were either ≤40 or ≥70 years old. Subtypes were defined using immunohistochemistry and histological grade. Chi-Square test was used for evaluation of categorical variables, and Kaplan-meier and log-rank for disease-specific survival (DSS) and disease free survival (DFS) . RESULTS We analyzed 256 patients ≤40 and 366 patients ≥70. Younger patients presented with more aggressive disease, with less luminal A but more luminal B and triple negative (TN) subtype. With a median follow-up of 57.5 months, DFS at 5 years in younger patients was 72.3% vs 84.6% in the elderly (p=0.007). Luminal A and B disease presented with worse DFS in younger patients. The opposite was seen in the TN subgroup. Although we found no significant differences in DSS, older patients with TN tumors died of BC more frequently. This group also received less chemotherapy. CONCLUSIONS Young patients present with more aggressive disease, this translating into worse DFS. However, elderly patients with TN disease represent a particular subpopulation with worse DFS and DSS, suggesting that chemotherapy should not be withheld only because of age.
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Affiliation(s)
- Francisco Acevedo
- Department of Hematology-Oncology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile E-mail :
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46
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Munoz-Nates F, Chateau H, Van Hamme A, Camus M, Pauchard M, Ravary-Plumioen B, Denoix JM, Pourcelot P, Crevier-Denoix N. Accelerometric and dynamometric measurements of the impact shock of the equine forelimb and hindlimb at high speed trot on six different tracks - preliminary study in one horse. Comput Methods Biomech Biomed Engin 2015; 18 Suppl 1:2012-3. [PMID: 26247449 DOI: 10.1080/10255842.2015.1069601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- F Munoz-Nates
- a Université Paris Est, Ecole Nationale Vétérinaire d'Alfort, USC 957 BPLC , Maisons-Alfort , France.,b INRA, USC 957 BPLC , Maisons-Alfort , France
| | - H Chateau
- a Université Paris Est, Ecole Nationale Vétérinaire d'Alfort, USC 957 BPLC , Maisons-Alfort , France.,b INRA, USC 957 BPLC , Maisons-Alfort , France
| | - A Van Hamme
- a Université Paris Est, Ecole Nationale Vétérinaire d'Alfort, USC 957 BPLC , Maisons-Alfort , France.,b INRA, USC 957 BPLC , Maisons-Alfort , France
| | - M Camus
- a Université Paris Est, Ecole Nationale Vétérinaire d'Alfort, USC 957 BPLC , Maisons-Alfort , France.,b INRA, USC 957 BPLC , Maisons-Alfort , France
| | - M Pauchard
- a Université Paris Est, Ecole Nationale Vétérinaire d'Alfort, USC 957 BPLC , Maisons-Alfort , France.,b INRA, USC 957 BPLC , Maisons-Alfort , France
| | - B Ravary-Plumioen
- a Université Paris Est, Ecole Nationale Vétérinaire d'Alfort, USC 957 BPLC , Maisons-Alfort , France.,b INRA, USC 957 BPLC , Maisons-Alfort , France
| | - J-M Denoix
- a Université Paris Est, Ecole Nationale Vétérinaire d'Alfort, USC 957 BPLC , Maisons-Alfort , France.,c Université Paris Est, Ecole Nationale Vétérinaire d'Alfort, CIRALE , Goustranville , France
| | - P Pourcelot
- a Université Paris Est, Ecole Nationale Vétérinaire d'Alfort, USC 957 BPLC , Maisons-Alfort , France.,b INRA, USC 957 BPLC , Maisons-Alfort , France
| | - N Crevier-Denoix
- a Université Paris Est, Ecole Nationale Vétérinaire d'Alfort, USC 957 BPLC , Maisons-Alfort , France.,b INRA, USC 957 BPLC , Maisons-Alfort , France
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47
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Crevier-Denoix N, Munoz-Nates F, Van Hamme A, Camus M, Emond AL, Jerbi H, Ravary-Plumioen B, Chateau H, Pourcelot P. Biomechanical comparison between hybrid turf (‘AirFibr’ technology) and natural turf at landing after hurdle jumping in one horse. Comput Methods Biomech Biomed Engin 2015; 18 Suppl 1:1916-7. [DOI: 10.1080/10255842.2015.1069566] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- N. Crevier-Denoix
- Université Paris Est, Ecole Nationale Vétérinaire d’Alfort, USC 957 BPLC, Maisons-Alfort, France
- INRA, USC 957 BPLC, Maisons-Alfort, France
| | - F. Munoz-Nates
- Université Paris Est, Ecole Nationale Vétérinaire d’Alfort, USC 957 BPLC, Maisons-Alfort, France
- INRA, USC 957 BPLC, Maisons-Alfort, France
| | - A. Van Hamme
- Université Paris Est, Ecole Nationale Vétérinaire d’Alfort, USC 957 BPLC, Maisons-Alfort, France
- INRA, USC 957 BPLC, Maisons-Alfort, France
| | - M. Camus
- Université Paris Est, Ecole Nationale Vétérinaire d’Alfort, USC 957 BPLC, Maisons-Alfort, France
- INRA, USC 957 BPLC, Maisons-Alfort, France
| | - A.-L. Emond
- Université Paris Est, Ecole Nationale Vétérinaire d’Alfort, USC 957 BPLC, Maisons-Alfort, France
- INRA, USC 957 BPLC, Maisons-Alfort, France
| | - H. Jerbi
- Université Paris Est, Ecole Nationale Vétérinaire d’Alfort, USC 957 BPLC, Maisons-Alfort, France
- INRA, USC 957 BPLC, Maisons-Alfort, France
| | - B. Ravary-Plumioen
- Université Paris Est, Ecole Nationale Vétérinaire d’Alfort, USC 957 BPLC, Maisons-Alfort, France
- INRA, USC 957 BPLC, Maisons-Alfort, France
| | - H. Chateau
- Université Paris Est, Ecole Nationale Vétérinaire d’Alfort, USC 957 BPLC, Maisons-Alfort, France
- INRA, USC 957 BPLC, Maisons-Alfort, France
| | - P. Pourcelot
- Université Paris Est, Ecole Nationale Vétérinaire d’Alfort, USC 957 BPLC, Maisons-Alfort, France
- INRA, USC 957 BPLC, Maisons-Alfort, France
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Polyzos NP, Sakkas E, Vaiarelli A, Poppe K, Camus M, Tournaye H. Thyroid autoimmunity, hypothyroidism and ovarian reserve: a cross-sectional study of 5000 women based on age-specific AMH values. Hum Reprod 2015; 30:1690-6. [DOI: 10.1093/humrep/dev089] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 03/19/2015] [Indexed: 11/13/2022] Open
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49
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Barral M, Boudiaf M, Dohan A, Hoeffel C, Camus M, Pautrat K, Fishman E, Cohen S, Soyer P. MDCT of acute colitis in adults: An update in current imaging features. Diagn Interv Imaging 2015; 96:133-49. [DOI: 10.1016/j.diii.2014.04.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Petric M, Martinez S, Acevedo F, Oddo D, Artigas R, Camus M, Sanchez C. Correlation between Ki67 and Histological Grade in Breast Cancer Patients Treated with Preoperative Chemotherapy. Asian Pac J Cancer Prev 2015; 15:10277-80. [DOI: 10.7314/apjcp.2014.15.23.10277] [Citation(s) in RCA: 7] [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: 11/10/2022] Open
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