1
|
Marret G, Temam S, Kamal M, Even C, Delord JP, Hoffmann C, Dolivet G, Malard O, Fayette J, Capitain O, Vergez S, Geoffrois L, Rolland F, Zrounba P, Laccourreye L, Saada-Bouzid E, Aide N, Bénavent V, Klijianenko J, Lamy C, Girard E, Vacher S, Masliah-Planchon J, de Koning L, Puard V, Borcoman E, Jimenez M, Bièche I, Gal J, Le Tourneau C. Randomized phase II study of preoperative afatinib in untreated head and neck cancers: predictive and pharmacodynamic biomarkers of activity. Sci Rep 2023; 13:22524. [PMID: 38110561 PMCID: PMC10728082 DOI: 10.1038/s41598-023-49887-4] [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: 07/12/2023] [Accepted: 12/13/2023] [Indexed: 12/20/2023] Open
Abstract
There is no strong and reliable predictive biomarker in head and neck squamous cell carcinoma (HNSCC) for EGFR inhibitors. We aimed to identify predictive and pharmacodynamic biomarkers of efficacy of afatinib, a pan-HER tyrosine kinase inhibitor, in a window-of-opportunity trial (NCT01415674). Multi-omics analyses were carried out on pre-treatment biopsy and surgical specimen for biological assessment of afatinib activity. Sixty-one treatment-naïve and operable HNSCC patients were randomised to afatinib 40 mg/day for 21-28 days versus no treatment. Afatinib produced a high rate of metabolic response. Responders had a higher expression of pERK1/2 (P = 0.02) and lower expressions of pHER4 (P = 0.03) and pRB1 (P = 0.002) in pre-treatment biopsy compared to non-responders. At the cellular level, responders displayed an enrichment of tumor-infiltrating B cells under afatinib (P = 0.02). At the molecular level, NF-kappa B signaling was over-represented among upregulated genes in non-responders (P < 0.001; FDR = 0.01). Although exploratory, phosphoproteomics-based biomarkers deserve further investigations as predictors of afatinib efficacy.
Collapse
Affiliation(s)
- Grégoire Marret
- Department of Drug Development and Innovation (D3i), Institut Curie, 26 Rue d'Ulm, 75005, Paris, France
| | - Stéphane Temam
- Department of Head and Neck Surgery, Gustave Roussy, Villejuif, France
| | - Maud Kamal
- Department of Drug Development and Innovation (D3i), Institut Curie, 26 Rue d'Ulm, 75005, Paris, France
| | - Caroline Even
- Head and Neck Oncology Department, Gustave Roussy, Villejuif, France
| | - Jean-Pierre Delord
- Department of Medical Oncology, Centre Claudius Régaud, Toulouse, France
| | | | - Gilles Dolivet
- Department of Head and Neck Surgery, Institut de Cancérologie de Lorraine, Nancy, France
| | - Olivier Malard
- Department of Head and Neck Surgery, Centre Hospitalier Universitaire, Nantes, France
| | - Jérôme Fayette
- Department of Medical Oncology, Centre Léon Bérard, Lyon, France
| | - Olivier Capitain
- Department of Medical Oncology, Centre Paul Papin, Angers, France
| | - Sébastien Vergez
- Department of Head and Neck Surgery, Institut Claudius Regaud, Toulouse, France
| | - Lionel Geoffrois
- Department of Medical Oncology, Institut de Cancérologie de Lorraine, Nancy, France
| | - Frédéric Rolland
- Department of Medical Oncology, Centre René Gauducheau, Nantes, France
| | - Philippe Zrounba
- Department of Head and Neck Surgery, Centre Léon Bérard, Lyon, France
| | - Laurent Laccourreye
- Department of Head and Neck Surgery, Centre Hospitalier Universitaire, Angers, France
| | - Esma Saada-Bouzid
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France
| | - Nicolas Aide
- Department of Nuclear Medicine, Centre François Baclesse, Caen, France
| | | | | | - Constance Lamy
- Department of Drug Development and Innovation (D3i), Institut Curie, 26 Rue d'Ulm, 75005, Paris, France
| | - Elodie Girard
- Bioinformatics Core Facility, INSERM U900, Mines Paris Tech, Institut Curie, Paris, France
| | | | | | - Leanne de Koning
- Department of Translational Research, Institut Curie, PSL Research University, Paris, France
| | - Vincent Puard
- Department of Translational Research, Institut Curie, PSL Research University, Paris, France
| | - Edith Borcoman
- Department of Drug Development and Innovation (D3i), Institut Curie, 26 Rue d'Ulm, 75005, Paris, France
| | | | - Ivan Bièche
- Genetics Department, Institut Curie, Paris, France
| | - Jocelyn Gal
- Department of Biostatistics, Centre Antoine Lacassagne, Nice, France
| | - Christophe Le Tourneau
- Department of Drug Development and Innovation (D3i), Institut Curie, 26 Rue d'Ulm, 75005, Paris, France.
- INSERM U900, Institut Curie, Paris-Saclay University, Paris, France.
| |
Collapse
|
2
|
Ghanem W, Qassemyar Q, Julieron M, Kolb F, Leymarie N, Moya-Plana A, Janot F, Temam S, Benmoussa N. Reconstruction of subtotal pharyngolaryngectomy using a fasciocutaneous free flap with cartilage graft: A case series of 17 patients. Head Neck 2023; 45:2335-2343. [PMID: 37482897 DOI: 10.1002/hed.27474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 07/03/2023] [Accepted: 07/12/2023] [Indexed: 07/25/2023] Open
Abstract
INTRODUCTION Subcricoid-hemilaryngopharyngectomy (SCHLP) with a reconstruction using a fasciocutaneous free flap armed with cartilage graft (FFACG) aims to avoid permanent tracheostomy while still maintaining the laryngopharyngeal functions. The purpose of this study is to report the outcome of this surgical approach. MATERIALS AND METHODS Retrospective study including 17 men operated between 2001 and 2019. Specific survival rate included death caused by cancer or SCHLP complications. Complications, functional and oncological outcomes were evaluated retrospectively. RESULTS There were no locoregional recurrences. One patient died due to inhalation pneumonia 3 years after surgery. Tracheostomy was closed in 13 patients (76.5%). Mean decannulation time was at six [1-14] months after surgery. CONCLUSION SCHPL with FFACG could avoid total pharyngolaryngectomy with good oncologic results. However, tracheotomy is extended and deglutition recovery is long with high risk of aspirations. These complications justify that such surgery should be realized only on selected patients by experienced surgical teams. Expertise of the surgical team is critical.
Collapse
Affiliation(s)
- Wahib Ghanem
- Department of Head and Neck Oncology, Gustave Roussy, Paris-Saclay University, Villejuif, France
| | - Quentin Qassemyar
- Department of Plastic Surgery, Gustave Roussy, Paris-Saclay University, Villejuif, France
| | - Morbize Julieron
- Department of Head and Neck Oncology, Gustave Roussy, Paris-Saclay University, Villejuif, France
| | - Frédéric Kolb
- Department of Plastic Surgery, Gustave Roussy, Paris-Saclay University, Villejuif, France
| | - Nicolas Leymarie
- Department of Plastic Surgery, Gustave Roussy, Paris-Saclay University, Villejuif, France
| | - Antoine Moya-Plana
- Department of Head and Neck Oncology, Gustave Roussy, Paris-Saclay University, Villejuif, France
| | - François Janot
- Department of Head and Neck Oncology, Gustave Roussy, Paris-Saclay University, Villejuif, France
| | - Stéphane Temam
- Department of Head and Neck Oncology, Gustave Roussy, Paris-Saclay University, Villejuif, France
| | - Nadia Benmoussa
- Department of Head and Neck Oncology, Gustave Roussy, Paris-Saclay University, Villejuif, France
| |
Collapse
|
3
|
Elaldi R, Gorphe P, Kolb F, Temam S, Honart JF, Benmoussa N. Swallowing outcomes over time after total pharyngolaryngectomy and free flap reconstruction. J Plast Reconstr Aesthet Surg 2023; 82:21-26. [PMID: 37148806 DOI: 10.1016/j.bjps.2023.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 09/08/2022] [Revised: 02/17/2023] [Accepted: 04/11/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND One of the challenges after total pharyngolaryngectomy (TPL) is to restore the swallowing function. The aim of this study was to compare swallowing outcomes between patients who underwent reconstruction with jejunum free flap (JFF) and other free flaps (OFFs). METHODS This retrospective study included patients who underwent TPL and free flap reconstruction. The endpoints were the evolution of swallowing outcomes during the first five years after treatment assessed by the Functional Oral Intake Scale (FOIS), and outcomes associated with complications. RESULTS One hundred and eleven patients were included, 84 patients in the JFF group and 27 in the OFF group. The patients in the OFF group experienced more chronic pharyngostoma (p = 0.001) and pharyngoesophageal stricture (p = 0.008). During the first year, a lower FOIS score tended to be associated with OFF (p = 0.137), and this result remained stable over time. CONCLUSIONS This study suggests that JFF reconstruction provides better swallowing outcomes than OFF reconstruction, stable over time.
Collapse
Affiliation(s)
- Roxane Elaldi
- Gustave Roussy, Paris-Saclay University, Department of Head and neck Oncology, Villejuif F-94805, France
| | - Philippe Gorphe
- Gustave Roussy, Paris-Saclay University, Department of Head and neck Oncology, Villejuif F-94805, France
| | - Frederic Kolb
- Gustave Roussy, Paris-Saclay University, Department of Plastic Surgery, Villejuif F-94805, France; Department of Plastic Surgery, UC San Diego, University of California, CA, USA
| | - Stéphane Temam
- Gustave Roussy, Paris-Saclay University, Department of Head and neck Oncology, Villejuif F-94805, France
| | - Jean-François Honart
- Gustave Roussy, Paris-Saclay University, Department of Plastic Surgery, Villejuif F-94805, France
| | - Nadia Benmoussa
- Gustave Roussy, Paris-Saclay University, Department of Plastic Surgery, Villejuif F-94805, France.
| |
Collapse
|
4
|
Noortman WA, Aide N, Vriens D, Arkes LS, Slump CH, Boellaard R, Goeman JJ, Deroose CM, Machiels JP, Licitra LF, Lhommel R, Alessi A, Woff E, Goffin K, Le Tourneau C, Gal J, Temam S, Delord JP, van Velden FHP, de Geus-Oei LF. Development and External Validation of a PET Radiomic Model for Prognostication of Head and Neck Cancer. Cancers (Basel) 2023; 15:2681. [PMID: 37345017 DOI: 10.3390/cancers15102681] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/30/2023] [Accepted: 05/03/2023] [Indexed: 06/23/2023] Open
Abstract
AIM To build and externally validate an [18F]FDG PET radiomic model to predict overall survival in patients with head and neck squamous cell carcinoma (HNSCC). METHODS Two multicentre datasets of patients with operable HNSCC treated with preoperative afatinib who underwent a baseline and evaluation [18F]FDG PET/CT scan were included (EORTC: n = 20, Unicancer: n = 34). Tumours were delineated, and radiomic features were extracted. Each cohort served once as a training and once as an external validation set for the prediction of overall survival. Supervised feature selection was performed using variable hunting with variable importance, selecting the top two features. A Cox proportional hazards regression model using selected radiomic features and clinical characteristics was fitted on the training dataset and validated in the external validation set. Model performances are expressed by the concordance index (C-index). RESULTS In both models, the radiomic model surpassed the clinical model with validation C-indices of 0.69 and 0.79 vs. 0.60 and 0.67, respectively. The model that combined the radiomic features and clinical variables performed best, with validation C-indices of 0.71 and 0.82. CONCLUSION Although assessed in two small but independent cohorts, an [18F]FDG-PET radiomic signature based on the evaluation scan seems promising for the prediction of overall survival for HNSSC treated with preoperative afatinib. The robustness and clinical applicability of this radiomic signature should be assessed in a larger cohort.
Collapse
Affiliation(s)
- Wyanne A Noortman
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- TechMed Centre, University of Twente, 7522 NB Enschede, The Netherlands
| | - Nicolas Aide
- Nuclear Medicine Department, Centre Hospitalier Universitaire de Caen, 14000 Caen, France
| | - Dennis Vriens
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Lisa S Arkes
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- Technical Medicine, Delft University of Technology, 2628 CD Delft, The Netherlands
| | - Cornelis H Slump
- TechMed Centre, University of Twente, 7522 NB Enschede, The Netherlands
| | - Ronald Boellaard
- Amsterdam University Medical Center, 1081 HV Amsterdam, The Netherlands
| | - Jelle J Goeman
- Department of Biomedical Data Sciences, Leiden University Medical Center, 2300 RC Leiden, The Netherlands
| | - Christophe M Deroose
- Nuclear Medicine and Molecular Imaging, Department of Imaging & Pathology, University Hospitals Leuven, KU Leuven, 3000 Leuven, Belgium
| | - Jean-Pascal Machiels
- Department of Medical Oncology, Institut Roi Albert II, Cliniques Universitaires Saint-Luc, 1200 Brussels, Belgium
- Institute for Experimental and Clinical Research (IREC, pôle MIRO), Université Catholique de Louvain (UCLouvain), 1200 Brussels, Belgium
| | - Lisa F Licitra
- Department of Head and Neck Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, University of Milan, 20133 Milan, Italy
| | - Renaud Lhommel
- Division of Nuclear Medicine, Institut de Recherche Clinique, Cliniques Universitaires Saint Luc, 1200 Brussels, Belgium
| | - Alessandra Alessi
- Department of Nuclear Medicine-PET Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | - Erwin Woff
- Nuclear Medicine Department, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (H.U.B.), 1070 Bruxelles, Belgium
| | - Karolien Goffin
- Nuclear Medicine and Molecular Imaging, Department of Imaging & Pathology, University Hospitals Leuven, KU Leuven, 3000 Leuven, Belgium
| | - Christophe Le Tourneau
- Department of Drug Development and Innovation, Institut Curie, Paris-Saclay University, 75005 Paris, France
| | - Jocelyn Gal
- Epidemiology and Biostatistics Department, Centre Antoine Lacassagne, University Côte d'Azur, 06100 Nice, France
| | - Stéphane Temam
- Department of Head and Neck Surgery Gustave Roussy, 94805 Villejuif, France
| | | | - Floris H P van Velden
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Lioe-Fee de Geus-Oei
- Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
- TechMed Centre, University of Twente, 7522 NB Enschede, The Netherlands
- Department of Radiation Science & Technology, Delft University of Technology, 2628 CD Delft, The Netherlands
| |
Collapse
|
5
|
Guerlain J, Marhic A, Casiraghi O, Lumbroso J, Garcia G, Breuskin I, Janot F, Temam S, Gorphe P, Moya-Plana A. Occult nodal metastases in T1-T2cN0 oral squamous cell carcinoma: Correlation between sentinel node positivity and completion neck dissection analysis. Oral Oncol 2023; 139:106338. [PMID: 36807087 DOI: 10.1016/j.oraloncology.2023.106338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/31/2023] [Accepted: 02/12/2023] [Indexed: 02/21/2023]
Abstract
OBJECTIVES Sentinel node procedure (SN) is a standard procedure that has shown its safety and effectiveness for T1/T2 cN0 oral squamous cell carcinoma (OSCC), with completion neck dissection (CND) for patients with positive SN. The aim of this study was to characterize the nodal involvement in a cohort of SN + OSCC. MATERIALS AND METHODS Patients with T1/T2 cN0 OSCC with positive SN with CND were included in this single-center, prospective cohort study between 2000 and 2013. RESULTS 54/301 patients had at least one positive SN. In 43/54 (80 %) cases, only the SN(s) were invaded; with only one SN involved (SN+=1) in 36/54 (67 %) cases. No predictive factors of nodal involvement in the CND were found considering the followings: SN micro/macrometastases, primary tumor's depth of invasion (DOI), perineural spread, lymphovascular involvement, primary tumor location, T stage and extranodal extension. The SN micrometastatic involvement (n = 22) was significantly associated with only one SN + CND- (p = 0.017). In the group of patients with unique micrometastatic involvement in the SN (n = 20/54), there was a higher isolated nodal recurrence free time (p = 0.017). CONCLUSION 80% of T1/T2 cN0 OSCC with positive SN had no other lymph node metastases in the CND, questioning the potential benefits of this procedure. Predictive factors such as the size of the SN metastasis need to be tested to stratify the risk of positive non-SN lymph nodes leading to a personalized treatment, lowering the therapeutic morbidity while maintaining the oncologic safety.
Collapse
Affiliation(s)
- J Guerlain
- Head & Neck Oncology Department, Gustave Roussy Cancer Campus, Grand Paris, France.
| | - A Marhic
- Head & Neck Oncology Department, Gustave Roussy Cancer Campus, Grand Paris, France
| | - O Casiraghi
- Department of Pathology, Gustave Roussy Cancer Campus, Grand Paris, France
| | - J Lumbroso
- Nuclear Medicine Department, Gustave Roussy Cancer Campus, Grand Paris, France
| | - G Garcia
- Department of Medical Imaging, Gustave Roussy Cancer Campus, Grand Paris, France
| | - I Breuskin
- Head & Neck Oncology Department, Gustave Roussy Cancer Campus, Grand Paris, France
| | - F Janot
- Head & Neck Oncology Department, Gustave Roussy Cancer Campus, Grand Paris, France
| | - S Temam
- Head & Neck Oncology Department, Gustave Roussy Cancer Campus, Grand Paris, France
| | - P Gorphe
- Head & Neck Oncology Department, Gustave Roussy Cancer Campus, Grand Paris, France
| | - A Moya-Plana
- Head & Neck Oncology Department, Gustave Roussy Cancer Campus, Grand Paris, France
| |
Collapse
|
6
|
Obongo Anga R, Abbaci M, Guerlain J, Breuskin I, Casiraghi O, Marhic A, Benmoussa-Rebibo N, de Kermadec H, Moya-Plana A, Temam S, Gorphe P, Hartl DM. Intraoperative Autofluorescence Imaging for Parathyroid Gland Identification during Total Laryngectomy with Thyroidectomy. Cancers (Basel) 2023; 15:cancers15030875. [PMID: 36765832 PMCID: PMC9913419 DOI: 10.3390/cancers15030875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/08/2022] [Accepted: 01/28/2023] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE Hypoparathyroidism is a known complication of total laryngectomy, although parathyroid preservation and/or reimplantation are not routine. Autofluorescence is a new technique for identifying parathyroid glands intraoperatively. The aim of this study was to evaluate the feasibility of autofluorescence in this context. MATERIALS AND METHODS A retrospective study of patients undergoing total laryngectomy/pharyngectomy with concomitant thyroidectomy using the Fluobeam® (Fluoptics, Grenoble, France) and frozen section of a parathyroid fragment in case of reimplantation. The rates of identification using autofluorescence, reimplantation, and hypoparathyroidism were evaluated. RESULTS Eighteen patients (16 males, median age 67) underwent total laryngectomy/pharyngectomy with total thyroidectomy (n = 12) or hemithyroidectomy (n = 6). A median of 2 parathyroid glands were identified per patient. Ninety-two percent were identified by autofluorescence before visualisation. All parathyroids were reimplanted due to devascularization. Temporary hypoparathyroidism occurred in nine patients, and was permanent in one patient. After 34 months of median follow-up (range 1-49), no tumor recurrence was observed in the reimplantation sites. CONCLUSIONS To our knowledge, this is the largest study to evaluate autofluorescence during total laryngectomy with thyroidectomy. No tumor recurrence occurred in the sites of parathyroid reimplantation.
Collapse
Affiliation(s)
- Raïs Obongo Anga
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, 94805 Villejuif, France
- Department of Head and Neck Cancer and ENT Surgery, Henri Becquerel Cancer Center, 76038 Rouen, France
| | - Muriel Abbaci
- Plateforme d’Imagerie et de Cytométrie, UMS AMMICa, Gustave-Roussy Cancer Campus—Grand Paris, Université Paris-Saclay, 94805 Villejuif, France; Laboratoire d’Imagerie Biomédicale Multimodale Paris Saclay, Université Paris-Saclay, CEA, CNRS, Inserm, 91401 Orsay, France
| | - Joanne Guerlain
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, 94805 Villejuif, France
| | - Ingrid Breuskin
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, 94805 Villejuif, France
| | - Odile Casiraghi
- Department of Pathology, Gustave Roussy Cancer Campus, 94805 Villejuif, France
| | - Alix Marhic
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, 94805 Villejuif, France
| | - Nadia Benmoussa-Rebibo
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, 94805 Villejuif, France
| | - Héloïse de Kermadec
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, 94805 Villejuif, France
| | - Antoine Moya-Plana
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, 94805 Villejuif, France
| | - Stéphane Temam
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, 94805 Villejuif, France
| | - Philippe Gorphe
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, 94805 Villejuif, France
| | - Dana M. Hartl
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, 94805 Villejuif, France
- Correspondence:
| |
Collapse
|
7
|
Dong W, Volk A, Djaroum M, Girot C, Balleyguier C, Lebon V, Garcia G, Ammari S, Temam S, Gorphe P, Wei L, Pitre-Champagnat S, Lassau N, Bidault F. Influence of Different Measurement Methods of Arterial Input Function on Quantitative Dynamic Contrast-Enhanced MRI Parameters in Head and Neck Cancer. J Magn Reson Imaging 2022. [PMID: 36269053 DOI: 10.1002/jmri.28486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 10/04/2022] [Accepted: 10/06/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Head and neck cancer (HNC) is the sixth most prevalent cancer worldwide. Dynamic contrast-enhanced MRI (DCE-MRI) helps in diagnosis and prognosis. Quantitative DCE-MRI requires an arterial input function (AIF), which affects the values of pharmacokinetic parameters (PKP). PURPOSE To evaluate influence of four individual AIF measurement methods on quantitative DCE-MRI parameters values (Ktrans , ve , kep , and vp ), for HNC and muscle. STUDY TYPE Prospective. POPULATION A total of 34 HNC patients (23 males, 11 females, age range 24-91) FIELD STRENGTH/SEQUENCE: A 3 T; 3D SPGR gradient echo sequence with partial saturation of inflowing spins. ASSESSMENT Four AIF methods were applied: automatic AIF (AIFa) with up to 50 voxels selected from the whole FOV, manual AIF (AIFm) with four voxels selected from the internal carotid artery, both conditions without (Mc-) or with (Mc+) motion correction. Comparison endpoints were peak AIF values, PKP values in tumor and muscle, and tumor/muscle PKP ratios. STATISTICAL TESTS Nonparametric Friedman test for multiple comparisons. Nonparametric Wilcoxon test, without and with Benjamini Hochberg correction, for pairwise comparison of AIF peak values and PKP values for tumor, muscle and tumor/muscle ratio, P value ≤ 0.05 was considered statistically significant. RESULTS Peak AIF values differed significantly for all AIF methods, with mean AIFmMc+ peaks being up to 66.4% higher than those for AIFaMc+. Almost all PKP values were significantly higher for AIFa in both, tumor and muscle, up to 76% for mean Ktrans values. Motion correction effect was smaller. Considering tumor/muscle parameter ratios, most differences were not significant (0.068 ≤ Wilcoxon P value ≤ 0.8). DATA CONCLUSION We observed important differences in PKP values when using either AIFa or AIFm, consequently choice of a standardized AIF method is mandatory for DCE-MRI on HNC. From the study findings, AIFm and inflow compensation are recommended. The use of the tumor/muscle PKP ratio should be of interest for multicenter studies. EVIDENCE LEVEL 2 TECHNICAL EFFICACY: Stage 1.
Collapse
Affiliation(s)
- Wanxin Dong
- Multimodal Biomedical Imaging Laboratory (BioMaps), Paris-Saclay University, Inserm (UMR1281), CNRS (UMR9011), CEA, France
| | - Andreas Volk
- Multimodal Biomedical Imaging Laboratory (BioMaps), Paris-Saclay University, Inserm (UMR1281), CNRS (UMR9011), CEA, France
| | - Meriem Djaroum
- Multimodal Biomedical Imaging Laboratory (BioMaps), Paris-Saclay University, Inserm (UMR1281), CNRS (UMR9011), CEA, France
| | - Charly Girot
- Multimodal Biomedical Imaging Laboratory (BioMaps), Paris-Saclay University, Inserm (UMR1281), CNRS (UMR9011), CEA, France
| | - Corinne Balleyguier
- Multimodal Biomedical Imaging Laboratory (BioMaps), Paris-Saclay University, Inserm (UMR1281), CNRS (UMR9011), CEA, France.,Department of Medical Imaging, Gustave Roussy Cancer Campus, Paris-Saclay University, Villejuif, France
| | - Vincent Lebon
- Multimodal Biomedical Imaging Laboratory (BioMaps), Paris-Saclay University, Inserm (UMR1281), CNRS (UMR9011), CEA, France
| | - Gabriel Garcia
- Department of Medical Imaging, Gustave Roussy Cancer Campus, Paris-Saclay University, Villejuif, France
| | - Samy Ammari
- Multimodal Biomedical Imaging Laboratory (BioMaps), Paris-Saclay University, Inserm (UMR1281), CNRS (UMR9011), CEA, France.,Department of Medical Imaging, Gustave Roussy Cancer Campus, Paris-Saclay University, Villejuif, France
| | - Stéphane Temam
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, Paris-Saclay University, Villejuif, France
| | - Philippe Gorphe
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, Paris-Saclay University, Villejuif, France
| | - Lecong Wei
- Multimodal Biomedical Imaging Laboratory (BioMaps), Paris-Saclay University, Inserm (UMR1281), CNRS (UMR9011), CEA, France
| | - Stéphanie Pitre-Champagnat
- Multimodal Biomedical Imaging Laboratory (BioMaps), Paris-Saclay University, Inserm (UMR1281), CNRS (UMR9011), CEA, France
| | - Nathalie Lassau
- Multimodal Biomedical Imaging Laboratory (BioMaps), Paris-Saclay University, Inserm (UMR1281), CNRS (UMR9011), CEA, France.,Department of Medical Imaging, Gustave Roussy Cancer Campus, Paris-Saclay University, Villejuif, France
| | - François Bidault
- Multimodal Biomedical Imaging Laboratory (BioMaps), Paris-Saclay University, Inserm (UMR1281), CNRS (UMR9011), CEA, France.,Department of Medical Imaging, Gustave Roussy Cancer Campus, Paris-Saclay University, Villejuif, France
| |
Collapse
|
8
|
Gorphe P, Blanchard P, Garcia GCTE, Classe M, Even C, Temam S, Breuskin I. 2011-2021 rising prevalence of HPV infection among oropharyngeal carcinoma in France. BMC Cancer 2022; 22:1000. [PMID: 36127667 PMCID: PMC9490895 DOI: 10.1186/s12885-022-10091-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 09/13/2022] [Indexed: 11/21/2022] Open
Abstract
Background The objective of our study was to investigate changes over the past decade in patient age and the prevalence of HPV in the population of patients with oropharyngeal carcinoma (OPC) treated at our center. Methods We performed a retrospective cohort study of patients treated at our cancer center for OPC between 2011 and 2021. Tissue biopsies were assessed for HPV status based on p16 staining for all patients. Results There were 1,365 treated patients. The proportion of p16-positive patients increased from 43% in 2011 to 57.3% in 2021 (p = 0.01). The sex ratio was 3.6 M/1F for p16-positive and 3.7 M/1F for p16-negative patients (p = 0.94). The mean age increased from 60.2 y in 2011 to 63.6 y in 2021. The mean ages were 61.9 y for p16-positive and 61.7 y for p16-negative patients (p = 0.71), but there was a broader age distribution for the p16-positive patients (p = 0.03). The proportion of patients older than 70 y increased from 11% in 2011 to 28.2% in 2021, and this aging was similar between p16-positive (30.7% in 2021) and p16-negative (26.3% in 2021) patients. The 2-year and 5-year OS rates were 73.7% and 56.5% for the entire cohort. p16-positive patients had 2-year and 5-year OS rates of 86.8% and 77.4%, respectively, whereas p16-negative patients had 2-year and 5-year OS rates of 63.9% and 40.5%. Conclusions Assessment of the change over the past decade in the population of patients with OPC at our center showed that HPV-positive OPC now appear to have overtaken HPV-negative cases in France, with 57.3% in 2021, and showed significant aging, with almost thirty percent of patients now older than 70 years. Those combined changes emphasize some of the challenges to be addressed in future OPC management.
Collapse
Affiliation(s)
- Philippe Gorphe
- Department of Head and Neck Oncology, Gustave Roussy, University Paris Saclay, 114 rue Edouard Vaillant, 94800, Villejuif, France.
| | - Pierre Blanchard
- Department of Radiation Oncology, Gustave Roussy, University Paris Saclay, Villejuif, France
| | - Gabriel C T E Garcia
- Department of Radiology, Gustave Roussy, University Paris Saclay, Villejuif, France
| | - Marion Classe
- Department of Pathology, Gustave Roussy, University Paris Saclay, Villejuif, France
| | - Caroline Even
- Department of Head and Neck Oncology, Gustave Roussy, University Paris Saclay, 114 rue Edouard Vaillant, 94800, Villejuif, France
| | - Stéphane Temam
- Department of Head and Neck Oncology, Gustave Roussy, University Paris Saclay, 114 rue Edouard Vaillant, 94800, Villejuif, France
| | - Ingrid Breuskin
- Department of Head and Neck Oncology, Gustave Roussy, University Paris Saclay, 114 rue Edouard Vaillant, 94800, Villejuif, France
| |
Collapse
|
9
|
Marret G, Kamal M, Gal J, Temam S, Klijianenko J, Delord JP, Hoffmann C, Dolivet G, Malard O, Fayette J, Capitain O, Even C, Vergez S, Geoffrois L, Rolland F, Zrounba P, Laccourreye L, Guigay J, Aide N, Bénavent V, Lamy C, Girard E, Jimenez M, Bièche I, Tourneau CL. Abstract 1237: Randomized phase II trial of pre-operative afatinib in non-metastatic head and neck squamous cell carcinoma patients: Identification of predictive biomarkers of response. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-1237] [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: 11/16/2022]
Abstract
Abstract
Background: Epidermal growth factor receptor (EGFR) inhibitors, including monoclonal antibodies and tyrosine kinase inhibitors, have limited efficacy in head and neck squamous cell carcinoma (HNSCC) patients. In the randomized phase II PREDICTOR trial, we aimed at identifying predictive and pharmacodynamics biomarkers of 2-4 weeks afatinib (an irreversible pan-HER inhibitor) versus no treatment in the pre-operative setting (NCT01415674). We previously reported a 59% metabolic response rate on PET imaging in the afatinib arm. We report here the evaluation of predictive genomic and transcriptomic biomarkers of afatinib efficacy.
Patients and Methods: All patients (41 in the afatinib arm and 20 in the no treatment arm) underwent a pre-treatment biopsy. We performed targeted DNA sequencing using an in-house NGS panel of 571 genes on baseline biopsies from 56 patients, and RNA-sequencing (RNAseq) in 54 patients. In the afatinib arm, 26 patients had paired pre- and post-treatment tumor samples. DNA and RNA alterations were correlated with metabolic response to afatinib using PET imaging, as well as overall survival (OS).
Results: Most frequent molecular alterations, including known activating mutations and/or focal amplifications for oncogenes or homozygous deletions and inactivating mutations for tumor suppressor genes, involved genome integrity (TP53 [70%]), cell cycle (CCND1 [38%], CDKN2A [32%], CDKN2B [14%]), senescence (TERT [23%]), Wnt signaling (NOTCH1 [16%]), and the PI3K pathway (PIK3CA [14%]). In the afatinib arm, metabolic response was observed in 1 out of 7 patients (14%) and in 19 out of 28 patients (68%) in the Wnt altered and unaltered groups (p = 0.03, fisher exact test), respectively. In the whole cohort of patients, homozygous deletions of both CDKN2A and CDKN2B correlated with shorter OS, with 6-year survival of 22% in the CDKN2A/B altered group and 70% in the CDKN2A/B wild-type group (p = 0.004; log-rank test). In the afatinib treated patients, using a generalized linear mixed model with a patient as random effect and a quasi-binomial family, the ratio of B cells expression levels in the post-treated versus pre-treated samples was significantly higher in responder as compared to non-responder patients (p = 0.001).
Conclusions: Wnt signaling pathway alterations and treatment-related dynamic changes in B cells proportions were identified as predictive and pharmacodynamics biomarkers of afatinib efficacy. CDKN2A/B homozygous deletions were associated with a poor prognosis in HNSCC patients treated with upfront surgery.
Citation Format: Grégoire Marret, Maud Kamal, Jocelyn Gal, Stéphane Temam, Jerzy Klijianenko, Jean-Pierre Delord, Caroline Hoffmann, Gilles Dolivet, Olivier Malard, Jerôme Fayette, Olivier Capitain, Caroline Even, Sébastien Vergez, Lionel Geoffrois, Frédéric Rolland, Philippe Zrounba, Laurent Laccourreye, Joël Guigay, Nicolas Aide, Valérie Bénavent, Constance Lamy, Elodie Girard, Marta Jimenez, Ivan Bièche, Christophe Le Tourneau. Randomized phase II trial of pre-operative afatinib in non-metastatic head and neck squamous cell carcinoma patients: Identification of predictive biomarkers of response [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1237.
Collapse
Affiliation(s)
- Grégoire Marret
- 1Institut Curie, Paris-Saclay University, Paris & Saint-Cloud, France
| | - Maud Kamal
- 1Institut Curie, Paris-Saclay University, Paris & Saint-Cloud, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Constance Lamy
- 1Institut Curie, Paris-Saclay University, Paris & Saint-Cloud, France
| | | | | | | | | |
Collapse
|
10
|
Moya-Plana A, Tselikas L, Lambotte O, Temam S, De Baere T, Deutsch E, Barlesi F, Blanchard P, Levy A. Postgraduate oncology educational shifts during the COVID-19 pandemic: results of faculty and medical student surveys. ESMO Open 2022; 7:100451. [PMID: 35427841 PMCID: PMC8888032 DOI: 10.1016/j.esmoop.2022.100451] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/08/2022] [Accepted: 02/22/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has disrupted clinical practice, research and teaching. During peaks, virtual courses were implemented but these changes are poorly described, especially for oncology postgraduate students and faculty teachers. PATIENTS AND METHODS We administered two surveys from June 2021 to October 2021 to students and faculty teachers (250 and 80 responses, respectively) who registered at Gustave Roussy School of Cancer Sciences (Université Paris-Saclay) during 3 consecutive university years (October 2018 to October 2021), where a major shift to e-learning was associated with COVID-19 pandemic. RESULTS Most students were female (53%), attending physicians (50%), aged 30-39 years (54%) and 2020-2021 (66.4%) was the main year of training. Most faculty teachers were male (58%), aged 40-50 years (44%) and had participated in training for at least 3 years (83%). More than half of the students received 100% virtual training [55% versus 45% face-to-face/mixed teaching modalities; online (84%) versus remote teaching (16%)]. Only 34% of students declared >80% 'active listening' and only 16% of teachers considered e-learning to be more suitable (compared with face-to-face) for postgraduate education. Virtual teaching decreased student-teacher interactions as compared with mixed/face-to-face (lessons were sufficiently interactive for 54% students if virtual only teaching versus for 71% if other teaching modalities; P = 0.009). Teachers stated that virtual learning did not lead to any improvements in terms of attendance (68%), interaction (74%) and quality of teaching (68%). However, most faculty (76%) acknowledged that partial e-learning training should be maintained outside the pandemic, if it represents ≤50% of the whole teaching (teachers: 79% versus student: 66%; P = 0.04). CONCLUSIONS COVID-19 accelerated the transition toward novel practices. Students and faculty teachers agreed on the need for future mixed (≤50% e-learning) teaching modalities. Adequate formation and the use of codified best newer virtual practices are required.
Collapse
Affiliation(s)
- A Moya-Plana
- Department of Head and Neck Oncology, Gustave Roussy, Villejuif, France; Université Paris-Saclay, INSERM U981, Villejuif, France; Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France.
| | - L Tselikas
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France; Interventional Radiology, Department of Surgery and Anesthesiology, Gustave Roussy, Villejuif, France; Université Paris-Saclay, INSERM 1428 CIC Biotheris, Villejuif, France.
| | - O Lambotte
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France; Université Paris-Saclay, AP-HP, Hôpital Bicêtre, Clinical Immunology Department, Le Kremlin Bicêtre, France; Université Paris-Saclay, Inserm, CEA, Center for Immunology of Viral, Auto-immune, Hematological and Bacterial Diseases (IDMIT/IMVA-HB), UMR1184, Le Kremlin Bicêtre, France
| | - S Temam
- Department of Head and Neck Oncology, Gustave Roussy, Villejuif, France
| | - T De Baere
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France; Interventional Radiology, Department of Surgery and Anesthesiology, Gustave Roussy, Villejuif, France
| | - E Deutsch
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France; Department of Radiation Oncology, Gustave Roussy, Villejuif, France; Université Paris-Saclay, INSERM U1030, Molecular Radiotherapy, Villejuif, France
| | - F Barlesi
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France; Department of Medical Oncology, Gustave Roussy, Villejuif, France; Aix Marseille University, CNRS, INSERM, CRCM, Marseille, France
| | - P Blanchard
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France; Department of Radiation Oncology, Gustave Roussy, Villejuif, France
| | - A Levy
- Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France; Department of Radiation Oncology, Gustave Roussy, Villejuif, France; Université Paris-Saclay, INSERM U1030, Molecular Radiotherapy, Villejuif, France.
| |
Collapse
|
11
|
Gorphe P, Classe M, Ammari S, Garcia G, Even C, Casiraghi O, Breuskin I, Tao Y, Temam S, Blanchard P, Moya-Plana A. Patterns of disease events and causes of death in patients with HPV-positive versus HPV-negative oropharyngeal carcinoma. Radiother Oncol 2022; 168:40-45. [DOI: 10.1016/j.radonc.2022.01.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/13/2022] [Accepted: 01/16/2022] [Indexed: 01/27/2023]
|
12
|
Gorphe P, Moya-Plana A, Guerlain J, Tao Y, Nguyen F, Breuskin I, Blanchard P, Temam S. Disease-free time stratification in locally recurrent head and neck carcinoma after definitive radiotherapy or chemoradiotherapy. Eur Arch Otorhinolaryngol 2021; 279:3063-3069. [PMID: 34648050 DOI: 10.1007/s00405-021-07116-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 09/30/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE There is no standard definition of disease-free interval before local recurrence after treatment in head and neck carcinoma (HNSCC). We evaluated an easy-to-use stratification and its association with survival in a large cohort of patients. METHODS We performed a retrospective cohort analysis of prognostic variables in 325 HNSCC patients with a local recurrence after definitive radiotherapy or concurrent chemoradiotherapy. Endpoints were overall survival (OS) and post-recurrence survival (PRS). RESULTS Variables associated with the survival were the patient age (OS p < 0.0001, PRS p < 0.0001), the initial disease stage (OS p = 0.24, PRS p = 0.0358), localization (OS p = 0.012, PRS p = 0.0002), a complete initial response to treatment (OS p < 0.0001, PRS p = 0.019), synchronous regional or distant metastatic disease (OS p = 0.0094, PRS p < 0.0001), a salvage surgery (OS p < 0.0001, PRS p < 0.0001) and time to recurrence (OS p = 0.0002, PRS p = 0.0029). Time to recurrence could be stratified between specific prognostic time categories that comprised disease persistence, early recurrence (< 12 months), standard recurrence (12 months-5 years) and late recurrence (> 5 years). CONCLUSION In HNSCC patients, time to local recurrence is a prognostic variable that can be defined using an easy-to-use stratification.
Collapse
Affiliation(s)
- Philippe Gorphe
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, 114 Rue Edouard Vaillant, 94800, Villejuif, France.
| | - Antoine Moya-Plana
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, 114 Rue Edouard Vaillant, 94800, Villejuif, France
| | - Joanne Guerlain
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, 114 Rue Edouard Vaillant, 94800, Villejuif, France
| | - Yungan Tao
- Department of Radiotherapy, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - France Nguyen
- Department of Radiotherapy, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - Ingrid Breuskin
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, 114 Rue Edouard Vaillant, 94800, Villejuif, France
| | - Pierre Blanchard
- Department of Radiotherapy, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - Stéphane Temam
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, 114 Rue Edouard Vaillant, 94800, Villejuif, France
| |
Collapse
|
13
|
Gorphe P, Temam S, Moya-Plana A, Leymarie N, Kolb F, Bout-Roumazeilles A, Qassemyar Q, Benmoussa N, Honart JF. Indications and Clinical Outcomes of Transoral Robotic Surgery and Free Flap Reconstruction. Cancers (Basel) 2021; 13:cancers13112831. [PMID: 34204149 PMCID: PMC8201082 DOI: 10.3390/cancers13112831] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/02/2021] [Accepted: 06/03/2021] [Indexed: 12/21/2022] Open
Abstract
We reviewed the indications, peroperative feasibility, and postoperative clinical outcomes of our first 50 consecutive patients who underwent free flap reconstruction after TORS for complex pharyngeal defects at our institution. We analyzed indications according to previous radiotherapy, the size of the resection, and the transoral exposure of critical structures. We reviewed surgical data, postoperative complications, and functional outcomes comprising tracheostomy and alimentation management. Indications were upfront surgery (34%), a second primary surgery after radiotherapy (28%), or salvage surgery after chemoradiotherapy failure (38%). Localizations were the tongue base (44%), tonsillar fossa (28%), pharyngeal wall (22%), and soft palate (6%). T-classifications were T1 (6%), T2 (52%), T3 (20%), and T4 (22%). The mean length of the surgery was 574 min. Two patients were intraoperatively converted to a conventional approach at the beginning of the learning curve. In conclusion, TORS and free flap reconstruction in complex situations were associated with low rates of postoperative complications and satisfactory functional outcomes. They were, however, associated with a renewed learning curve.
Collapse
Affiliation(s)
- Philippe Gorphe
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, 94800 Villejuif, France; (S.T.); (A.M.-P.); (N.B.)
- Correspondence:
| | - Stéphane Temam
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, 94800 Villejuif, France; (S.T.); (A.M.-P.); (N.B.)
| | - Antoine Moya-Plana
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, 94800 Villejuif, France; (S.T.); (A.M.-P.); (N.B.)
| | - Nicolas Leymarie
- Department of Plastic and Reconstructive Surgery, Gustave Roussy Institute, University Paris-Saclay, 94800 Villejuif, France; (N.L.); (A.B.-R.); (J.-F.H.)
| | - Frédéric Kolb
- Plastic and Reconstructive Surgery, UC San Diego, University of California, La Jolla, CA 92121, USA;
| | - Apolline Bout-Roumazeilles
- Department of Plastic and Reconstructive Surgery, Gustave Roussy Institute, University Paris-Saclay, 94800 Villejuif, France; (N.L.); (A.B.-R.); (J.-F.H.)
| | - Quentin Qassemyar
- Department of Plastic Surgery, Tenon Hospital, AP-HP, 75020 Paris, France;
| | - Nadia Benmoussa
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, 94800 Villejuif, France; (S.T.); (A.M.-P.); (N.B.)
| | - Jean-François Honart
- Department of Plastic and Reconstructive Surgery, Gustave Roussy Institute, University Paris-Saclay, 94800 Villejuif, France; (N.L.); (A.B.-R.); (J.-F.H.)
| |
Collapse
|
14
|
Petit C, Lacas B, Pignon JP, Le QT, Grégoire V, Grau C, Hackshaw A, Zackrisson B, Parmar MKB, Lee JW, Ghi MG, Sanguineti G, Temam S, Cheugoua-Zanetsie M, O'Sullivan B, Posner MR, Vokes EE, Cruz Hernandez JJ, Szutkowski Z, Lartigau E, Budach V, Suwiński R, Poulsen M, Kumar S, Ghosh Laskar S, Mazeron JJ, Jeremic B, Simes J, Zhong LP, Overgaard J, Fortpied C, Torres-Saavedra P, Bourhis J, Aupérin A, Blanchard P. Chemotherapy and radiotherapy in locally advanced head and neck cancer: an individual patient data network meta-analysis. Lancet Oncol 2021; 22:727-736. [PMID: 33862002 DOI: 10.1016/s1470-2045(21)00076-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 02/01/2021] [Accepted: 02/02/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Randomised, controlled trials and meta-analyses have shown the survival benefit of concomitant chemoradiotherapy or hyperfractionated radiotherapy in the treatment of locally advanced head and neck cancer. However, the relative efficacy of these treatments is unknown. We aimed to determine whether one treatment was superior to the other. METHODS We did a frequentist network meta-analysis based on individual patient data of meta-analyses evaluating the role of chemotherapy (Meta-Analysis of Chemotherapy in Head and Neck Cancer [MACH-NC]) and of altered fractionation radiotherapy (Meta-Analysis of Radiotherapy in Carcinomas of Head and Neck [MARCH]). Randomised, controlled trials that enrolled patients with non-metastatic head and neck squamous cell cancer between Jan 1, 1980, and Dec 31, 2016, were included. We used a two-step random-effects approach, and the log-rank test, stratified by trial to compare treatments, with locoregional therapy as the reference. Overall survival was the primary endpoint. The global Cochran Q statistic was used to assess homogeneity and consistency and P score to rank treatments (higher scores indicate more effective therapies). FINDINGS 115 randomised, controlled trials, which enrolled patients between Jan 1, 1980, and April 30, 2012, yielded 154 comparisons (28 978 patients with 19 253 deaths and 20 579 progression events). Treatments were grouped into 16 modalities, for which 35 types of direct comparisons were available. Median follow-up based on all trials was 6·6 years (IQR 5·0-9·4). Hyperfractionated radiotherapy with concomitant chemotherapy (HFCRT) was ranked as the best treatment for overall survival (P score 97%; hazard ratio 0·63 [95% CI 0·51-0·77] compared with locoregional therapy). The hazard ratio of HFCRT compared with locoregional therapy with concomitant chemoradiotherapy with platinum-based chemotherapy (CLRTP) was 0·82 (95% CI 0·66-1·01) for overall survival. The superiority of HFCRT was robust to sensitivity analyses. Three other modalities of treatment had a better P score, but not a significantly better HR, for overall survival than CLRTP (P score 78%): induction chemotherapy with taxane, cisplatin, and fluorouracil followed by locoregional therapy (ICTaxPF-LRT; 89%), accelerated radiotherapy with concomitant chemotherapy (82%), and ICTaxPF followed by CLRT (80%). INTERPRETATION The results of this network meta-analysis suggest that further intensifying chemoradiotherapy, using HFCRT or ICTaxPF-CLRT, could improve outcomes over chemoradiotherapy for the treatment of locally advanced head and neck cancer. FUNDINGS French Institut National du Cancer, French Ligue Nationale Contre le Cancer, and Fondation ARC.
Collapse
Affiliation(s)
- Claire Petit
- Service de Biostatistique et d'Epidémiologie, Gustave Roussy, Oncostat U1018, Ligue Contre le Cancer, INSERM, Université Paris-Saclay, Villejuif, France; Department of Radiation Oncology, Gustave Roussy Cancer Campus, Université Paris-Sud, Université Paris-Saclay, F-94805 Villejuif, France; Groupe d'Oncologie Radiothérapie Tête Et Cou, Tours, France
| | - Benjamin Lacas
- Service de Biostatistique et d'Epidémiologie, Gustave Roussy, Oncostat U1018, Ligue Contre le Cancer, INSERM, Université Paris-Saclay, Villejuif, France; Groupe d'Oncologie Radiothérapie Tête Et Cou, Tours, France
| | - Jean-Pierre Pignon
- Service de Biostatistique et d'Epidémiologie, Gustave Roussy, Oncostat U1018, Ligue Contre le Cancer, INSERM, Université Paris-Saclay, Villejuif, France; Groupe d'Oncologie Radiothérapie Tête Et Cou, Tours, France
| | - Quynh Thu Le
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA, USA
| | | | - Cai Grau
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Allan Hackshaw
- Cancer Research UK and University College London Cancer Trials Centre, Cancer Institute, University College London Hospital, London, UK
| | - Björn Zackrisson
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden
| | - Mahesh K B Parmar
- Medical Research Council Clinical Trials Unit, University College London, London, UK
| | - Ju-Whei Lee
- ECOG-ACRIN Biostatistics Center, Dana Farber Cancer Institute, Boston, MA, USA
| | - Maria Grazia Ghi
- Oncology Unit 2, Veneto Institute of Oncology-IRCCS, Padua, Italy
| | - Giuseppe Sanguineti
- Department of Radiation Oncology, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Stéphane Temam
- Service de Cancérologie Cervico-faciale, Gustave Roussy, Université Paris-Saclay, F-94805 Villejuif, France
| | - Maurice Cheugoua-Zanetsie
- Service de Biostatistique et d'Epidémiologie, Gustave Roussy, Oncostat U1018, Ligue Contre le Cancer, INSERM, Université Paris-Saclay, Villejuif, France
| | - Brian O'Sullivan
- Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Marshall R Posner
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Everett E Vokes
- Section of Hematology-Oncology, The University of Chicago Medical Center, Chicago, IL, USA
| | | | - Zbigniew Szutkowski
- Department of Radiotherapy, Cancer Center, Marie Curie-Sklodowska Memorial Institute, Warsaw, Poland
| | - Eric Lartigau
- Department of Radiotherapy, Centre Oscar Lambret, Lille, France
| | - Volker Budach
- Department of Radiation Oncology, Charité Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Rafal Suwiński
- Radiotherapy and Chemotherapy Clinic and Teaching Hospital, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Michael Poulsen
- Radiation Oncology Services, Mater Centre, Brisbane, QLD, Australia
| | - Shaleen Kumar
- Department of Radiotherapy, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Sarbani Ghosh Laskar
- Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
| | | | | | - John Simes
- NHMRC Clinical Trials Center, Camperdown, NSW, Australia
| | - Lai-Ping Zhong
- Department of Oral and Maxillofacial-Head and Neck Oncology, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jens Overgaard
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Pedro Torres-Saavedra
- NRG Oncology Statistics and Data Management Center, American College of Radiology, Philadelphia, PA, USA
| | - Jean Bourhis
- Groupe d'Oncologie Radiothérapie Tête Et Cou, Tours, France; Department of Radiotherapy, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Anne Aupérin
- Service de Biostatistique et d'Epidémiologie, Gustave Roussy, Oncostat U1018, Ligue Contre le Cancer, INSERM, Université Paris-Saclay, Villejuif, France; Groupe d'Oncologie Radiothérapie Tête Et Cou, Tours, France
| | - Pierre Blanchard
- Service de Biostatistique et d'Epidémiologie, Gustave Roussy, Oncostat U1018, Ligue Contre le Cancer, INSERM, Université Paris-Saclay, Villejuif, France; Department of Radiation Oncology, Gustave Roussy Cancer Campus, Université Paris-Sud, Université Paris-Saclay, F-94805 Villejuif, France; Groupe d'Oncologie Radiothérapie Tête Et Cou, Tours, France.
| | | |
Collapse
|
15
|
Moya-Plana A, Mangin D, Blanchard P, Obongo R, Casiraghi O, Bidault F, Temam S, Robert C, Gorphe P. Prognostic value and therapeutic implications of nodal involvement in head and neck mucosal melanoma. Head Neck 2021; 43:2325-2331. [PMID: 33783056 DOI: 10.1002/hed.26694] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 03/16/2021] [Accepted: 03/16/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The prognostic significance of nodal involvement is not well established in head and neck mucosal melanoma (HNMM). METHODS A retrospective, monocentric study was performed on 96 patients with HNMM treated between 2000 and 2017. RESULTS At diagnosis, seventeen patients (17.8%) were cN1, with a higher risk for HNMM arising from the oral cavity (p = 0.01). cN status had no prognostic value in patients with nonmetastatic resectable HNMM. No occult nodal metastasis was observed in the cN0 patients after a nodal dissection (ND). The nodal recurrence rate was similar in the cN1 and the cN0 patients. No isolated nodal recurrences were noted. Among the patients who underwent a ND, no benefit of this procedure was noted. CONCLUSIONS cN1 status is not a prognostic factor in patients with resectable HNMM. Elective ND should not be systematically performed in cN0 HNMM.
Collapse
Affiliation(s)
- Antoine Moya-Plana
- Department of Head & Neck Surgery, Gustave Roussy Cancer Campus, Villejuif, France.,Inserm U981, Melanoma Group, Gustave Roussy Cancer Campus, Villejuif, France
| | - David Mangin
- Department of Head & Neck Surgery, Gustave Roussy Cancer Campus, Villejuif, France
| | - Pierre Blanchard
- Department of Onco-Radiotherapy, Gustave Roussy Cancer Campus, Villejuif, France
| | - Rais Obongo
- Department of Head & Neck Surgery, Gustave Roussy Cancer Campus, Villejuif, France
| | - Odile Casiraghi
- Department of Pathology, Gustave Roussy Cancer Campus, Villejuif, France
| | - François Bidault
- Department of Radiology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Stéphane Temam
- Department of Head & Neck Surgery, Gustave Roussy Cancer Campus, Villejuif, France
| | - Caroline Robert
- Inserm U981, Melanoma Group, Gustave Roussy Cancer Campus, Villejuif, France.,Department of Onco-Dermatology, Gustave Roussy Cancer Campus-Université Paris-Saclay, Villejuif, France
| | - Philippe Gorphe
- Department of Head & Neck Surgery, Gustave Roussy Cancer Campus, Villejuif, France
| |
Collapse
|
16
|
El Ayachy R, Sun R, Ka K, Laville A, Duhamel AS, Tailleur A, Dumas I, Bockel S, Espenel S, Blanchard P, Tao Y, Temam S, Moya-Plana A, Haie-Meder C, Chargari C. Pulsed Dose Rate Brachytherapy of Lip Carcinoma: Clinical Outcome and Quality of Life Analysis. Cancers (Basel) 2021; 13:cancers13061387. [PMID: 33808535 PMCID: PMC8003123 DOI: 10.3390/cancers13061387] [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: 01/10/2021] [Revised: 03/09/2021] [Accepted: 03/15/2021] [Indexed: 01/04/2023] Open
Abstract
Simple Summary Lip cancer accounts for 25–30% of all oral cancers, with 23,000 new cases per year in the world. Carcinomas of the lip can be successfully treated with different methods: surgery, external beam radiotherapy (EBRT) and brachytherapy. The choice of the treatment depends on the tumor size, location and expected functional and esthetic results with each option, but also depends on treatment type accessibility. There are no randomized studies comparing these different treatment strategies. In this article, we investigated the complications and outcomes of patients treated with interstitial pulsed dose rate brachytherapy in our institution. Abstract Purpose: Lip carcinoma represents one of the most common types of head and neck cancer. Brachytherapy is a highly effective therapeutic option for all stages of lip cancers. We report our experience of pulsed dose rate brachytherapy (PDR) as treatment of lip carcinoma. Methods and Materials: this retrospective single center study included all consecutive patients treated for a lip PDR brachytherapy in our institution from 2010 to 2019. The toxicities and outcomes of the patients were reported, and a retrospective quality of life assessment was conducted by phone interviews (FACT H&N). Results: From October 2010 to December 2019, 38 patients were treated in our institution for a lip carcinoma by PDR brachytherapy. The median age was 73, and the majority of patients presented T1-T2 tumors (79%). The median total dose was 70.14 Gy (range: 60–85 Gy). With a mean follow-up of 35.4 months, two patients (5.6%) presented local failure, and seven patients (19%) had lymph node progression. The Kaplan–Meier estimated probability of local failure was 7.2% (95% CI: 0.84–1) at two and four years. All patients encountered radiomucitis grade II or higher. The rate of late toxicities was low: three patients (8.3%) had grade II fibrosis, and one patient had grade II chronic pain. All patients would highly recommend the treatment. The median FACT H&N total score was 127 out of 148, and the median FACT H&N Trial Outcome Index was 84. Conclusions: This study confirms that an excellent local control rate is achieved with PDR brachytherapy as treatment of lip carcinoma, with very limited late side effects and satisfactory functional outcomes. A multimodal approach should help to improve regional control.
Collapse
Affiliation(s)
- Radouane El Ayachy
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
| | - Roger Sun
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
| | - Kanta Ka
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
| | - Adrien Laville
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
| | - Anne-Sophie Duhamel
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
| | - Anne Tailleur
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
| | - Isabelle Dumas
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
| | - Sophie Bockel
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
| | - Sophie Espenel
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
| | - Pierre Blanchard
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
| | - Yungan Tao
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
| | - Stéphane Temam
- Head and Neck Surgery Department, Gustave Roussy, 94800 Villejuif, France; (S.T.); (A.M.-P.)
| | - Antoine Moya-Plana
- Head and Neck Surgery Department, Gustave Roussy, 94800 Villejuif, France; (S.T.); (A.M.-P.)
| | - Christine Haie-Meder
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
- Centre de Cancérologie, Département d’Oncologie Radiothérapie, Charlebourg la Défense, 92250 La Garenne Colombes, France
| | - Cyrus Chargari
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France; (R.E.A.); (R.S.); (K.K.); (A.L.); (A.-S.D.); (A.T.); (I.D.); (S.B.); (S.E.); (P.B.); (Y.T.); (C.H.-M.)
- INSERM1030 Radiothérapie Moléculaire et Innovations Thérapeutiques, Université Paris-Saclay, 94800 Villejuif, France
- Correspondence:
| |
Collapse
|
17
|
Even C, Sagaon Teyssier L, Pointreau Y, Temam S, Huguet F, Geoffrois L, Schwarzinger M. Factors associated with under-reporting of head and neck squamous cell carcinoma in cause-of-death records: A comparative study of two national databases in France from 2008 to 2012. PLoS One 2021; 16:e0246252. [PMID: 33534860 PMCID: PMC7857613 DOI: 10.1371/journal.pone.0246252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 01/18/2021] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To date, no study has evaluated the detection rate of head and neck squamous cell carcinoma (HNSCC) in cause-of-death records in Europe. Our objectives were to compare the number of deaths attributable to HNSCC from two national databases in France and to identify factors associated with under-reporting of HNSCC in cause-of-death records. METHODS The national hospital discharge database and the national underlying cause-of-death records were compared for all HNSCC-attributable deaths in adult patients from 2008 to 2012 in France. Factors associated with under-reporting of HNSCC in cause-of-death records were assessed using multivariate Poisson regression. RESULTS A total of 41,503 in-hospital deaths were attributable to HNSCC as compared to 25,647 deaths reported in national UCoD records (a detection rate of 62%). Demographics at death were similar in both databases with respect to gender (83% men), age (54% premature deaths at 25-64 years), and geographic distribution. In multivariate Poisson regression, under-reporting of HNSCC in cause-of-death records significantly increased in 2012 compared to 2010 (+7%) and was independently associated with a primary HNSCC site other than the larynx, a former primary or second synchronous cancer other than HNSCC, distant metastasis, palliative care, and death in hospitals other than comprehensive cancer care centers. The main study results were robust in a sensitivity analysis which also took into account deaths outside hospital (overall, 51,129 HNSCC-attributable deaths; a detection rate of 50%). For the year 2012, the age-standardized mortality rate for HNSCC derived from underlying cause-of-death records was less than half that derived from hospital discharge summaries (14.7 compared to 34.1 per 100,000 for men and 2.7 compared to 6.2 per 100,000 for women). CONCLUSION HNSCC is largely under-reported in cause-of-death records. This study documents the value of national hospital discharge databases as a complement to death certificates for ascertaining cancer deaths.
Collapse
Affiliation(s)
- Caroline Even
- Department of Surgical & Medical Head & Neck Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Luis Sagaon Teyssier
- Aix Marseille Univ, INSERM, IRD, SESSTIM, Marseille, France
- Translational Health Economics Network (THEN), Paris, France
| | - Yoann Pointreau
- Department of Radiation Oncology, ILC- Institut inter-régionaL de Cancérologie, Centre Jean Bernard-Clinique Victor Hugo, Le Mans, France
| | - Stéphane Temam
- Department of Surgical & Medical Head & Neck Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Florence Huguet
- Department of Radiation Oncology, Hôpital Tenon, AP-HP, Paris, France
| | - Lionnel Geoffrois
- Department of Medical Oncology, Institut de cancérologie de Lorraine – Alexis Vautrin, Vandoeuvre Les Nancy, France
| | | | | |
Collapse
|
18
|
Guerlain J, Haroun F, Voicu A, Honoré C, Griscelli F, Temam S, Benmoussa N, Gorphe P, de Baere T, Ammari S, Garcia G, Balleyguier C, Rimareix F, Gouy S, Sitbon P, Gachot B, Breuskin I, Suria S, Moya-Plana A. Cancer surgery during the COVID-19 pandemic: The experience of a comprehensive cancer center performing preoperative screening by RT-PCR and chest CT scan. J Surg Oncol 2021; 123:815-822. [PMID: 33524172 DOI: 10.1002/jso.26335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 11/30/2020] [Accepted: 11/30/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND AND OBJECTIVES During the worldwide pandemic of coronavirus disease 2019 (COVID-19), oncological procedures considered to be urgent could not be delayed, and a specific procedure was required to continue surgical activity. The objective was to assess the efficacy of our preoperative screening algorithm. METHODS This observational retrospective study was performed between the 25th of March and the 12th of May 2020 in a comprehensive cancer center in France. Patients undergoing elective oncologic surgery were tested by preoperative nasopharyngeal reverse-transcription polymerase chain reaction (RT-PCR) that could be associated with a chest computerized tomography (CT) scan. RESULTS Of the 510 screening tests (in 477 patients), only 5% (15/477) were positive for COVID-19 in 24 patients (18 RT-PCR+ and 7 CT scan+/RT-PCR-). Four patients were ultimately false positives based on the CT scan. In total, only 4.2% (20/477) of the patients were COVID-19+. The positivity rate decreased with time after the containment measures were implemented (from 7.4% to 0.8%). In the COVID-19+ group, 20% of the patients had postoperative pulmonary complications, whereas this was the case for 5% of the patients in the COVID-19 group. CONCLUSIONS Maintaining secure surgical activity is achievable and paramount in oncology care, even during the COVID-19 pandemic, with appropriate screening based on preoperative RT-PCR.
Collapse
Affiliation(s)
- Joanne Guerlain
- Surgical and Interventional Department, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Fabienne Haroun
- Surgical and Interventional Department, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Alexandra Voicu
- Surgical and Interventional Department, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Charles Honoré
- Surgical and Interventional Department, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Franck Griscelli
- Department of Laboratory Medicine and Pathology, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Stéphane Temam
- Surgical and Interventional Department, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Nadia Benmoussa
- Surgical and Interventional Department, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Philippe Gorphe
- Surgical and Interventional Department, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Thierry de Baere
- Surgical and Interventional Department, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Samy Ammari
- Department of Medical Imaging, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Gabriel Garcia
- Department of Medical Imaging, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Corinne Balleyguier
- Department of Medical Imaging, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Françoise Rimareix
- Surgical and Interventional Department, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Sébastien Gouy
- Surgical and Interventional Department, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Philippe Sitbon
- Surgical and Interventional Department, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Bertrand Gachot
- Infectious Diseases Unit, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Ingrid Breuskin
- Surgical and Interventional Department, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Stéphanie Suria
- Surgical and Interventional Department, Paris-Saclay University, Gustave Roussy, Villejuif, France
| | - Antoine Moya-Plana
- Surgical and Interventional Department, Paris-Saclay University, Gustave Roussy, Villejuif, France
| |
Collapse
|
19
|
Bouaoud J, Benmoussa N, Hennocq Q, Honart JF, Breuskin I, Gorphe P, Casiraghi O, Classe M, Blanchard P, Janot F, Kolb F, Leymarie N, Temam S, Moya-Plana A. Locally advanced nasal pyramid squamous cell carcinoma: our 15 years' experience in a series of 35 total rhinectomies. Rhinology 2021; 58:638-640. [PMID: 33006589 DOI: 10.4193/rhin20.381] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- J Bouaoud
- Department of Head and Neck Surgical Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France; Department of Plastic and Reconstructive Surgery, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - N Benmoussa
- Department of Head and Neck Surgical Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - Q Hennocq
- Department of Head and Neck Surgical Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - J-F Honart
- Department of Plastic and Reconstructive Surgery, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - I Breuskin
- Department of Head and Neck Surgical Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - P Gorphe
- Department of Head and Neck Surgical Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - O Casiraghi
- Department of Pathology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - M Classe
- Department of Pathology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - P Blanchard
- Department of Radiation Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - F Janot
- Department of Head and Neck Surgical Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - F Kolb
- Department of Plastic and Reconstructive Surgery, Gustave Roussy Institute, University Paris-Saclay, Villejuif,France
| | - N Leymarie
- Department of Plastic and Reconstructive Surgery, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - S Temam
- Department of Head and Neck Surgical Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - A Moya-Plana
- Department of Head and Neck Surgical Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| |
Collapse
|
20
|
Damiani M, Mercante G, Abdellaoui M, Guerlain J, Moya-Plana A, Casiraghi O, Temam S, Tao Y, Gorphe P. Prognostic Features in Intermediate-Size Supraglottic Tumors Treated With Open Supraglottic Laryngectomy. Laryngoscope 2021; 131:E1980-E1986. [PMID: 33399237 DOI: 10.1002/lary.29367] [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: 11/06/2020] [Revised: 12/09/2020] [Accepted: 12/23/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVES/HYPOTHESIS We investigated growth patterns and pathological features in intermediate-size laryngeal carcinoma amenable to supraglottic laryngectomy. STUDY DESIGN Retrospective cohort study. METHODS We reviewed patients who underwent an open partial horizontal laryngectomy (OPHL) type I. We analyzed pathological data, tumor sizes, overall survival, disease-specific survival, local control, and laryngeal preservation. Results were stratified between three groups: group I comprised patients with endolaryngeal carcinoma, group II comprised patients with anterior epilaryngeal carcinoma who underwent an OPHL type I + base of tongue (BOT), group III comprised patients with lateral epilaryngeal carcinoma who underwent an OPHL type I + pyriform sinus (PIR). RESULTS Sixty-eight patients were analyzed. The 5-year rates of overall survival, disease-specific survival, local control, and laryngeal preservation were 68.4%, 83.7%, 91.6%, and 98.3%, respectively. The tumor sizes at pathological examination were similar between the three groups (mean 27 mm, P = .80) and were associated with pathological features, notably pre-epiglottic space (PES) invasion (24.9 mm vs. 32.2 mm, P = .01), occult invaded lymph nodes (22.6 mm vs. 29.9 mm, P = .03), and trends for margins status (26.5 mm vs. 29.3 mm, P = .45). The risks of PES invasion, occult lymph nodes, and positive margins, respectively, predominated in group I (41.7%), group II (56.3%), and group III (23.3%). CONCLUSION In intermediate-size tumors amenable to supraglottic laryngectomy, pathological features are associated with tumor size according to group stratification based on tumor location. LEVEL OF EVIDENCE 4 Laryngoscope, 131:E1980-E1986, 2021.
Collapse
Affiliation(s)
- Marialessia Damiani
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - Giuseppe Mercante
- Humanitas Clinical and Research Center - IRCCS, Rozzano, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Mohammed Abdellaoui
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - Joanne Guerlain
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - Antoine Moya-Plana
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - Odile Casiraghi
- Department of Pathology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - Stéphane Temam
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - Yungan Tao
- Department of Radiotherapy, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - Philippe Gorphe
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| |
Collapse
|
21
|
Marhic A, Guerlain J, Benmoussa N, Breuskin I, Honart JF, Janot F, Moya-Plana A, Temam S, Gorphe P. Replacement of lip-split mandibulotomy by pull-through approach for T3-4 oral carcinomas. Int J Oral Maxillofac Surg 2021; 50:1123-1130. [PMID: 33414034 DOI: 10.1016/j.ijom.2020.10.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/06/2020] [Accepted: 10/29/2020] [Indexed: 11/19/2022]
Abstract
At the study hospital, the lip-split mandibulotomy (LSM) has progressively been replaced by a pull-through (PT) approach. This study compared the outcomes of the LSM and PT approaches in a series of 192 patients with T3-T4a oral tongue and floor of the mouth squamous cell carcinoma treated over the two last decades. No difference in margin status (P = 0.254), rate of early complications (local infections) (P = 0.867), haematoma/haemorrhage (P = 0.221), delayed wound healing (P = 0.438), re-operation (P = 0.083), or Clavien-Dindo classification (P= 0.5281) was found. The LSM approach was associated with a higher rate of late complications such as pseudarthrosis (14.5% vs 0.9%; OR 17.89, P = 0.0005) and trismus (35% vs 13.8%; OR 3.32, P = 0.025), and a trend towards a higher rate of fistulas (24.6% vs 13.1%; OR 2.16, P = 0.088). The quality of life of long-term survivors (median 132 months) was similar in the two groups, with a mean QLQC30 score of 59.7 (P = 0.099) and mean MDADI score of 57.4 (P = 0.213). The 5-year local control rate was 86.4% in the PT group and 86.2% in the LSM group (P = 0.878), while the 5-year overall survival rates were 50.0% and 48.3%, respectively (P = 0.68). In our experience, replacement of LSM by a PT approach in oral carcinoma was associated with decreased rates of late complications such as pseudarthrosis, fistula, and trismus, without any difference in oncological outcomes.
Collapse
Affiliation(s)
- A Marhic
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - J Guerlain
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - N Benmoussa
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - I Breuskin
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - J-F Honart
- Department of Plastic and Reconstructive Surgery, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - F Janot
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - A Moya-Plana
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - S Temam
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France
| | - P Gorphe
- Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, Villejuif, France.
| |
Collapse
|
22
|
Mangialardi ML, Honart JF, Qassemyar Q, Guyon A, Li SS, Benmoussa N, Beldarida V, Temam S, Kolb F. Reconstruction of Extensive Composite Parotid Region Oncologic Defects with Immediate Facial Nerve Reconstruction Using a Chimeric Scapulodorsal Vascularized Nerve Free Flap. J Reconstr Microsurg 2020; 37:282-291. [PMID: 33142333 DOI: 10.1055/s-0040-1719050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Cancer involving the parotid gland region may originates from parotid parenchyma itself or from locoregional organs and in rare cases, the facial nerve (FN) has to be sacrificed during tumor resection. In these cases, cancer extension often goes beyond the parotid compartment and requires extensive local resection responsible for complex multitissular defects. The goals of reconstruction may be summarized in the following two components: (1) restoration of the volumetric tissue defect and (2) FN reconstruction. The aim of this study is to describe our surgical technique and our cosmetic results using the chimeric scapulodorsal vascularized nerve (SDVN) flap to reconstruct extensive maxillofacial defects associated with FN sacrifice. METHODS All patients undergone an extensive maxillofacial resection with FN sacrifice and primarily reconstructed with a SDVN flap were included. We classified the maxillofacial defects into six groups based on the type of resection. Intraoperative data including flap composition, topography of FN injury, length of nerve gap, and number of nervous anastomosis were recorded. RESULTS Twenty-nine patients were included. Mean follow-up was 38.7 months. The harvested flaps included the SDVN combined with different components according to the defect group. A satisfactory volumetric restoration was obtained in 93% of cases. The mean number of distal nervous anastomosis was 4.5. The length of the vascularized grafted nerve ranged from 7 to 10 cm. CONCLUSION This is largest series presented in literature on primary FN reconstruction utilizing a vascularized nerve graft. We believe that the chimeric SDVN flap should be highly considered for these cases due to its versatility. The surgeon is able to use single donor site available soft and hard tissues components along with a vascular motor nerve graft, which offers a great length and number of distal branches, and easily matches with the extracranial FN trunk and its peripheral ramifications.
Collapse
Affiliation(s)
- Maria L Mangialardi
- Department of Plastic Surgery, Gustave Roussy Cancer Campus, Villejuif, France
| | - Jean-Fracois Honart
- Department of Plastic Surgery, Gustave Roussy Cancer Campus, Villejuif, France
| | - Quentin Qassemyar
- Faculty of Medicine, Sorbonne Université, Paris, France.,Department of Plastic, Reconstructive and Burn Surgery, Hopital Armand-Trousseau, Paris, France
| | - Alice Guyon
- Department of Plastic Surgery, Gustave Roussy Cancer Campus, Villejuif, France
| | - Sean S Li
- Department of Plastic Surgery, UCSD, San Diego, California
| | - Nadia Benmoussa
- Department of Head and Neck Surgery, Gustave Roussy Cancer Campus, Villejuif, France
| | - Vincent Beldarida
- Department of Head and Neck Surgery, Gustave Roussy Cancer Campus, Villejuif, France
| | - Stéphane Temam
- Department of Head and Neck Surgery, Gustave Roussy Cancer Campus, Villejuif, France
| | - Frédéric Kolb
- Department of Plastic Surgery, Gustave Roussy Cancer Campus, Villejuif, France.,Department of Plastic Surgery, UCSD, San Diego, California
| |
Collapse
|
23
|
Vercambre MN, Temam S, Billaudeau N, Kab S, Zins M. Health behaviours of education professionals: any room for improvement? A study of French employees. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.696] [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: 11/14/2022] Open
Abstract
Abstract
Background
Education professionals have a role to play in health education, both as knowledge providers and role-models. To appraise their health awareness, we compared their health behaviours to those of non-education employees.
Methods
Using inclusion data of the CONSTANCES French cohort (2012-2019) and adjusting for important confounders (sex, age, education,...), we alternately compared three indicators of risky conducts (at-risk drinking, current smoking, past year-cannabis use) and two indicators of unhealthy lifestyle (low physical activity, overweight/obesity) between education professionals (n = 14730) and a random sample of non-education employees (n = 34244). Among education professionals, we distinguished between teachers (n = 12820), school principals (n = 372), principal educational advisers (n = 189), school health professionals (n = 128), and school manual/service staff (n = 1221).
Results
Teachers were less likely than non-education employees to be at-risk drinker, to smoke, to have used cannabis in the past year and to be overweight/obese. Other non-teaching education professionals were also rather less involved in risky conducts than non-education employees. Nonetheless, school principals and principal educational advisers reported more often low physical activity and school principals and manual/service staff were more prone to overweight/obesity than non-education employees.
Conclusions
In this large nationwide sample of French employees, education professionals were rather less involved in risky conducts than other non-education employees with a similar demographic and socioeconomic profile. Yet, non-teaching education professionals showed punctually unhealthy lifestyle indicators, suggesting a window of opportunity to improve both their own health and, indirectly through role-model, that of the youth with whom they interact daily.
Key messages
Education professionals, especially teachers, appear more health-conscious than average. There may still be room for improvement toward a healthier lifestyle. In addition, the average observed may be quite far from the recommended public health target, so that any action to enhance education professional’s health behaviours will have societal benefits.
Collapse
Affiliation(s)
- M-N Vercambre
- Occupational Health Team, MGEN Foundation for Public Health, Paris, France
| | - S Temam
- Occupational Health Team, MGEN Foundation for Public Health, Paris, France
| | - N Billaudeau
- Occupational Health Team, MGEN Foundation for Public Health, Paris, France
| | - S Kab
- Population-Based Epidemiological Cohorts Unit, Inserm UMS 01, Villejuif, France
| | - M Zins
- Population-Based Epidemiological Cohorts Unit, Inserm UMS 01, Villejuif, France
- Université Paris Descartes, Faculty of Medicine, Paris, France
| |
Collapse
|
24
|
Boustani J, Ruffier A, Moya-Plana A, Tao Y, Nguyen F, Even C, Berthold C, Casiraghi O, Temam S, Blanchard P. Long-term outcomes and safety after reirradiation in locally recurrent nasopharyngeal carcinoma in a non-endemic area. Strahlenther Onkol 2020; 197:188-197. [PMID: 32514613 DOI: 10.1007/s00066-020-01647-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 05/25/2020] [Indexed: 01/22/2023]
Abstract
PURPOSE To determine outcomes and toxicities after reirradiation for locally recurrent nasopharyngeal carcinoma (rNPC) and to apply a prognostic index in a non-endemic region. METHODS We retrospectively reported progression-free survival (PFS), overall survival (OS), and treatment-related toxicities in patients treated with curative intent for locally rNPC. We applied the prognostic model for OS and grade 5 radiotherapy (RT)-related toxicities published by Li et al. and evaluated its prognostic accuracy by receiver operating characteristic (ROC) curve analysis. RESULTS Between 2005 and 2018, 33 patients were treated for rNPC in our institution. Median follow-up was 60 months. The mean time to local recurrence was 75 months. Six (18%) patients had a persistent grade 3 toxicity from a previous RT course. The median re-RT dose was 66 Gy. After re-RT, 13 patients had local failure and 3 patients had metastatic recurrence. Median PFS was 18 months with a 5-year PFS rate of 29%. Median OS was 35 months with a 5-year OS rate of 37%. Grade 3 or higher toxicities rate was 74%. There were 21% grade 5 toxicities. The median time to a grade 5 toxicity was less than 6 months following re-RT. The prognostic nomogram was not predictive for OS or grade 5 toxicities. CONCLUSION Reirradiation of rNPC is an effective treatment but is associated with a high rate of life-threatening toxicity. Stratification of patients based on their risk of developing severe toxicity is needed to select patients who will most likely benefit from re-RT.
Collapse
Affiliation(s)
- J Boustani
- Department of Radiation Oncology, Georges François Leclerc, Dijon, France.
- Department of Radiation Oncology, Gustave Roussy, 114 rue Edouard Vaillant, 94800, Villejuif, France.
| | - A Ruffier
- Department of Radiation Oncology, Gustave Roussy, 114 rue Edouard Vaillant, 94800, Villejuif, France
| | - A Moya-Plana
- Department of Head and Neck Oncology, Gustave Roussy, Villejuif, France
| | - Y Tao
- Department of Radiation Oncology, Gustave Roussy, 114 rue Edouard Vaillant, 94800, Villejuif, France
| | - F Nguyen
- Department of Radiation Oncology, Gustave Roussy, 114 rue Edouard Vaillant, 94800, Villejuif, France
| | - C Even
- Department of Head and Neck Oncology, Gustave Roussy, Villejuif, France
| | - C Berthold
- Department of Radiation Oncology, Gustave Roussy, 114 rue Edouard Vaillant, 94800, Villejuif, France
| | - O Casiraghi
- Department of Pathology, Gustave Roussy, Villejuif, France
| | - S Temam
- Department of Head and Neck Oncology, Gustave Roussy, Villejuif, France
| | - P Blanchard
- Department of Radiation Oncology, Gustave Roussy, 114 rue Edouard Vaillant, 94800, Villejuif, France
| |
Collapse
|
25
|
Fakhry N, Schultz P, Morinière S, Breuskin I, Bozec A, Vergez S, de Garbory L, Hartl D, Temam S, Lescanne E, Couloigner V, Barry B. Consensus français sur la pratique de la chirurgie oncologique ORL pendant la pandémie de COVID-19. Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale 2020. [PMCID: PMC7151435 DOI: 10.1016/j.aforl.2020.04.001] [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] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Dans le contexte de la pandémie de COVID-19, des conseils spécifiques semblent nécessaires concernant la prise en charge des patients atteints de cancers ORL. La règle est de limiter au maximum le flux de patients afin de réduire les risques de contamination par le virus SARS-Cov-2 aussi bien des patients que du personnel soignant, particulièrement exposé en ORL. L’objectif est de limiter le risque de perte de chance pour le patient et d’anticiper le flux de patients atteints de cancers à traiter à la fin de l’épidémie, en tenant compte du degré d’urgence, de la lourdeur de la chirurgie, du risque de contamination de l’équipe soignante (trachéotomie) et de la situation locale (saturation ou non de l’hôpital et des services de réanimation).
Collapse
|
26
|
Fakhry N, Schultz P, Morinière S, Breuskin I, Bozec A, Vergez S, de Garbory L, Hartl D, Temam S, Lescanne E, Couloigner V, Barry B. French consensus on management of head and neck cancer surgery during COVID-19 pandemic. Eur Ann Otorhinolaryngol Head Neck Dis 2020; 137:159-160. [PMID: 32303485 PMCID: PMC7151337 DOI: 10.1016/j.anorl.2020.04.008] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
In the context of the current pandemic, there is a need for specific advice concerning treatment of patients with Head and Neck cancers. The rule is to limit as much as possible the number of patients in order to reduce the risks of contamination by the SARS-Cov-2 virus for both patients and the caregivers, who are particularly exposed in ENT. The aim is to minimize the risk of loss of opportunity for patients and to anticipate the increased number of cancer patients to be treated at the end of the pandemic, taking into account the degree of urgency, the difficulty of the surgery, the risk of contaminating the caregivers (tracheotomy) and the local situation (whether or not the hospital and intensive care departments are overstretched).
Collapse
Affiliation(s)
- N Fakhry
- Department of otorhinolaryngology, head and neck surgery, centre hospitalier universitaire (CHU) la Conception, Aix Marseille université, Assistance publique-Hôpitaux de Marseille, Marseille, France.
| | - P Schultz
- Department of otorhinolaryngology, head and neck surgery, CHU, Strasbourg, France
| | - S Morinière
- Department of otorhinolaryngology, head and neck surgery, CHU, Tours, France
| | - I Breuskin
- Department of otorhinolaryngology, head and neck surgery, institut Gustave-Roussy, Villejuif, France
| | - A Bozec
- Department of otorhinolaryngology, head and neck surgery, centre Antoine-Lacassagne, Institut universitaire de la face et du cou, Nice, France
| | - S Vergez
- Department of otorhinolaryngology, head and neck surgery, CHU de Toulouse/Oncopôle, Toulouse, France
| | - L de Garbory
- Department of otorhinolaryngology, head and neck surgery, CHU, Bordeaux, France
| | - D Hartl
- Department of otorhinolaryngology, head and neck surgery, institut Gustave-Roussy, Villejuif, France
| | - S Temam
- Department of otorhinolaryngology, head and neck surgery, institut Gustave-Roussy, Villejuif, France
| | - E Lescanne
- Department of otorhinolaryngology, head and neck surgery, CHU, Tours, France
| | - V Couloigner
- Department of otorhinolaryngology, head and neck surgery, université Paris-Descartes, Assistance publique-Hôpitaux de Paris, Paris, France
| | - B Barry
- Department of otorhinolaryngology, head and neck surgery, hôpital Xavier Bichat-Claude Bernard, CHU Paris Nord-Val de Seine, Assistance publique-Hôpitaux de Paris, Paris, France
| |
Collapse
|
27
|
Calon T, Temam S, Vercambre-Jacquot MN. Enseignants non-titulaires dans le second degré en France : conditions de travail, bien-être professionnel et qualité de vie. ARCH MAL PROF ENVIRO 2020. [DOI: 10.1016/j.admp.2019.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
28
|
Calon T, Temam S, Vercambre-Jacquot M. Enseignants non-titulaires dans le second degré en France : conditions de travail, bien-être professionnel et qualité de vie. ARCH MAL PROF ENVIRO 2020. [DOI: 10.1016/j.admp.2019.12.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
29
|
Bedarida V, Qassemyar Q, Temam S, Janot F, Kolb F. Facial functional outcomes analysis after reconstruction by vascularized thoracodorsal nerve free flap following radical parotidectomy with facial nerve sacrifice. Head Neck 2020; 42:994-1003. [PMID: 31976612 DOI: 10.1002/hed.26076] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 12/18/2019] [Accepted: 12/31/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Parotid spread tumor may occasion wide defect with facial nerve sacrifice. We report our one time reconstruction experience of this defect using a thoracodorsal artery perforator and nerve flap (TAPN). METHODS Eight patients underwent a radical parotidectomy with facial nerve sacrifice between February 2010 and June 2016. A single time reconstruction was performed using a thoracodorsal artery perforator and nerve flap, with skin or fat paddle. The thoracodorsal nerve vascularized was harvested and used to reconstruct the facial nerve from the trunk to four until six distal branches. Patients underwent physiotherapy for 3 months at least. Facial outcomes were assessed using House-Brackmann scale and eFACE application. OUTCOMES Mean follow-up was 30 months. No complication occurred on donor site. All patients recovered a complete soft eye closure. No Frey syndrome occurred. CONCLUSION TAPN is adapted to wide and complex parotid defects.
Collapse
Affiliation(s)
- Vincent Bedarida
- Head & Neck Surgery Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Quentin Qassemyar
- Faculty of Medicine, Sorbonne Université, Paris, France.,Department of Plastic, Reconstructive and burn surgery, Hopital Armand-Trousseau, Paris, France
| | - Stéphane Temam
- Head & Neck Surgery Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - François Janot
- Head & Neck Surgery Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Frédéric Kolb
- Plastic and Reconstructive Surgery Department, Gustave Roussy Cancer Campus, Villejuif, France
| |
Collapse
|
30
|
Cohen E, Uppaluri R, Lee N, Westra W, Haddad R, Temam S, Le Tourneau C, Chernock R, Safina S, Tao Y, Klochikhin A, Meirovitz A, Brana I, Ge J, Swaby R, Bidadi B, Adkins D. Neoadjuvant and adjuvant pembrolizumab (pembro) plus standard of care (SOC) in patients (pts) with resectable locally advanced (LA) head and neck squamous cell carcinoma (HNSCC): The phase III KEYNOTE-689 study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz428.029] [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: 11/13/2022] Open
|
31
|
Moya-Plana A, Veyrat M, Honart JF, de Fremicourt K, Alkhashnam H, Sarfati B, Janot F, Leymarie N, Temam S, Kolb F. Reconstruction of maxillectomy and midfacial defects using latissimus dorsi-scapular free flaps in a comprehensive cancer center. Oral Oncol 2019; 99:104468. [PMID: 31678764 DOI: 10.1016/j.oraloncology.2019.104468] [Citation(s) in RCA: 5] [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: 07/15/2019] [Revised: 09/04/2019] [Accepted: 10/22/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND The standard of care for sinonasal malignancies is a large surgical resection followed by radiotherapy. Midfacial defects resulting from maxillectomy require a complex reconstruction procedure. Given their adaptability, chimeric flaps such as latissimus dorsi-scapular (LDS) free flaps appear to be a good option. MATERIAL & METHODS We performed a single-center retrospective study of consecutive patients with sinonasal cancers where a LDS free flap was used for reconstruction. We assessed the postoperative complications and the functional, aesthetic and oncologic outcomes. RESULTS Eighty-four patients were included. Primary tumors were staged as T4a in 68% of cases; 38.3% of the patients received induction chemotherapy and 82.7% received adjuvant radiotherapy. Based on our classification of midfacial and palatal defects, the majority of the patients (69%) had a type IIa with interruption of the three facial pillars. The orbital floor was removed in 55.9% of cases. The median follow-up was 45 months. Total flap necrosis with no possible revascularization occurred in 5.9% of cases. For the orbital reconstruction, a revision procedure was needed for necrosis and/or infection of the costal cartilage graft in eight cases (17%). More than 90% of the patients had no functional disorders regarding speaking, swallowing and chewing. Soft palate involvement was a prognostic factor of speech (p < 10-4) and swallowing (p = .005) disorders. Dental rehabilitation was realized in 70.2% of the patients. No severe complications were observed in the donor site, except for one seroma. CONCLUSION A LDS free flap is a reliable technique for the reconstruction of complex midfacial defects.
Collapse
Affiliation(s)
- A Moya-Plana
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France.
| | - M Veyrat
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - J F Honart
- Plastic and Reconstructive Surgery Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - K de Fremicourt
- Plastic and Reconstructive Surgery Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - H Alkhashnam
- Plastic and Reconstructive Surgery Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - B Sarfati
- Plastic and Reconstructive Surgery Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - F Janot
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - N Leymarie
- Plastic and Reconstructive Surgery Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - S Temam
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - F Kolb
- Plastic and Reconstructive Surgery Department, Gustave Roussy Cancer Campus, Villejuif, France
| |
Collapse
|
32
|
Moya-Plana A, Guerlain J, Casiraghi O, Bidault F, Grimaldi S, Breuskin I, Gorphe P, Temam S. [Sentinel lymph node biopsy in head and neck oncology]. Bull Cancer 2019; 107:653-659. [PMID: 31610909 DOI: 10.1016/j.bulcan.2019.06.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 06/23/2019] [Indexed: 02/06/2023]
Abstract
Sentinel lymph node biopsy (SLNB) has been initially developed for melanoma and breast cancers. Its application in head and neck cancers is recent, probably due to the complexity of the lymphatic drainage, the proximity between the primary tumor and the lymph nodes and the critical anatomical structures (such as the facial nerve). In onco-dermatology, SLNB is validated in head and neck surgery for melanoma with Breslow thickness up to 1mm or ulceration, Merkel carcinoma and high-risk squamous cell carcinoma. Considering the malignancies of the upper aerodigestive tract, the feasibility and oncologic safety of SLNB are now established for T1-T2N0 oral and oropharyngeal squamous cell carcinomas. Thus, it could allow patients with negative sentinel nodes to avoid an unnecessary neck dissection, leading to a decrease of morbidity with an quality of life improvement. For some primary locations (e.g., anterior floor of the mouth) with high proximity between tumor and lymph nodes, it is recommended to remove the tumor before the SLNB so as to improve the detection. New techniques of detection are currently being developed with intra-operative procedures and new tracers (such as tilmanocept), leading to a better accuracy of detection and, probably, new indications.
Collapse
Affiliation(s)
- Antoine Moya-Plana
- Université Paris-Saclay, département de cancérologie cervico-faciale, Gustave Roussy, 94805 Villejuif, France.
| | - Joanne Guerlain
- Université Paris-Saclay, département de cancérologie cervico-faciale, Gustave Roussy, 94805 Villejuif, France
| | - Odile Casiraghi
- Université Paris-Saclay, département d'anatomopathologie, Gustave Roussy, 94805 Villejuif, France
| | - François Bidault
- Université Paris-Saclay, département de radiologie, Gustave Roussy, 94805 Villejuif, France
| | - Séréna Grimaldi
- Université Paris-Saclay, département de médecine nucléaire, Gustave Roussy, 94805 Villejuif, France
| | - Ingrid Breuskin
- Université Paris-Saclay, département de cancérologie cervico-faciale, Gustave Roussy, 94805 Villejuif, France
| | - Philippe Gorphe
- Université Paris-Saclay, département de cancérologie cervico-faciale, Gustave Roussy, 94805 Villejuif, France
| | - Stéphane Temam
- Université Paris-Saclay, département de cancérologie cervico-faciale, Gustave Roussy, 94805 Villejuif, France
| |
Collapse
|
33
|
Boulate D, Kassegne T, Chenesseau J, Ammi M, Mussot S, Fabre D, Mitilian D, Crutu A, Temam S, Mercier O, Fadel E. P2.17-24 Minimally Invasive Surgery for Lung Cancer Improves Short Term Outcomes in Patients with History of Head and Neck Carcinoma. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1935] [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: 11/29/2022]
|
34
|
Baste Rotllan N, Auperin A, Iacob M, Sampetrean A, Bouguetta D, Mayache Badis L, Ferrand F, Casiraghi O, Blanchard P, Bidault F, Gorphe P, Temam S, Champiat S, Even C, Marabelle A. Immune-related adverse events (irAEs) and outcome in recurrent/metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) patients (pts) treated by immune-checkpoints inhibitors (ICI). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz252.052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
35
|
Moya-Plana A, Mangin D, Dercle L, Taouachi R, Casiraghi O, Ammari S, Nguyen F, Temam S, Robert C, Gorphe P. Risk-based stratification in head and neck mucosal melanoma. Oral Oncol 2019; 97:44-49. [PMID: 31421470 DOI: 10.1016/j.oraloncology.2019.07.026] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 07/23/2019] [Accepted: 07/26/2019] [Indexed: 01/18/2023]
Abstract
BACKGROUND Head and neck mucosal melanoma (HNMM) is a rare and aggressive disease with a high metastatic potential. Two staging systems are currently available: one specific to HNMM (mmTNM) and one specific to primary tumour sites (sccTNM). Our main objective was to assess the prognostic value of both of these classifications in order to allow accurate risk-based classification. METHODS We performed a retrospective cohort study of patients with HNMM treated consecutively between 2000 and 2017. All of the patients were restaged using the mmTNM and the sccTNM. A prognostic analysis was carried out according to both staging systems. RESULTS There were 96 patients with an HNMM in our cohort, of whom 80 underwent surgical treatment followed by radiotherapy. The median overall survival (OS) and progression-free survival (PFS) for the operated patients were 39 months (95% CI, 21.6-56.4 months) and 18 months (95% CI, 6.5-29.5 months), respectively. A paranasal sinus localization was associated with lower survival compared to a nasal cavity primary localization (p < 1 0-4). Both of the classifications correlated with OS, PFS, and distant metastasis-free survival. High-risk HNMM were characterized as T4/stage IV by the mmTNM and T3-4/stage III-IV by the sccTNM. Given the primary tumour location, both TNM classifications were suitable for risk-stratification of sinonasal mucosal melanomas. However, combining both TNM, we defined new stages mmT3A and mmT3B according to sccTNM with a more accurate risk stratification (p < 1 0-4). CONCLUSIONS Both of the classifications should be combined, in order to improve the risk-stratification of patients with HNMM.
Collapse
Affiliation(s)
- Antoine Moya-Plana
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, Villejuif, France; Inserm U981, Melanoma Group, Gustave Roussy Cancer Campus, Villejuif, France.
| | - David Mangin
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Laurent Dercle
- Radiology Department, Columbia University Medical Center, New York Presbyterian Hospital, New York, NY, USA
| | - Rabah Taouachi
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Odile Casiraghi
- Pathology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Samy Ammari
- Radiology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - France Nguyen
- Radiotherapy Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Stéphane Temam
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Caroline Robert
- Inserm U981, Melanoma Group, Gustave Roussy Cancer Campus, Villejuif, France; Onco-Dermatology Department, Gustave Roussy Cancer Campus, Villejuif, France; Université Paris-Saclay, Villejuif, France
| | - Philippe Gorphe
- Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| |
Collapse
|
36
|
Gorphe P, Bouhir S, Garcia GCTE, Alali A, Even C, Breuskin I, Tao Y, Janot F, Bidault F, Temam S. Anemia and neutrophil-to-lymphocyte ratio in laryngeal cancer treated with induction chemotherapy. Laryngoscope 2019; 130:E144-E150. [PMID: 31006874 DOI: 10.1002/lary.28021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 03/21/2019] [Accepted: 04/03/2019] [Indexed: 01/17/2023]
Abstract
OBJECTIVES/HYPOTHESIS We studied the influence of the neutrophil-to-lymphocyte ratio (NLR) and anemia on the response to induction chemotherapy (IC) and survival outcomes in laryngeal cancer patients treated with a preservation protocol. STUDY DESIGN Retrospective single-center case series. METHODS We analyzed patients with T3 laryngeal cancer treated with IC using a preservation protocol. The NLR and hemoglobin levels were assessed before treatment and after IC. The response to chemotherapy was assessed using Response Evaluation Criteria in Solid Tumours 1.1 and World Heath Organization standards. The oncological endpoints were overall survival (OS) and disease-free survival (DFS). RESULTS Sixty-eight patients were analyzed. The median NLR and hemoglobin levels before and after IC were 2.76 and 14.5 g/dL, and 2.01 and 11.6 g/dL, respectively. The NLR and anemia before treatment were not correlated, and they were not associated with the response to chemotherapy. However, an NLR > 5 and anemia before treatment were both associated with shorter OS and DFS. Notably, they were the only factors found to be significantly associated with survival outcomes. CONCLUSIONS In laryngeal cancer, patients treated with a preservation protocol, a high NLR ratio, and anemia before IC were associated with shorter survival, independently of the response to chemotherapy. LEVEL OF EVIDENCE 4 Laryngoscope, 130:E144-E150, 2020.
Collapse
Affiliation(s)
- Philippe Gorphe
- Department of Head and Neck Oncology, Gustave Roussy Institute, University of Paris-Saclay, Villejuif, France
| | - Samia Bouhir
- Department of Head and Neck Oncology, Gustave Roussy Institute, University of Paris-Saclay, Villejuif, France
| | - Gabriel C T E Garcia
- Department of Radiology, Gustave Roussy Institute, University of Paris-Saclay, Villejuif, France
| | - Abeer Alali
- Department of Head and Neck Oncology, Gustave Roussy Institute, University of Paris-Saclay, Villejuif, France
| | - Caroline Even
- Department of Head and Neck Oncology, Gustave Roussy Institute, University of Paris-Saclay, Villejuif, France
| | - Ingrid Breuskin
- Department of Head and Neck Oncology, Gustave Roussy Institute, University of Paris-Saclay, Villejuif, France
| | - Yungan Tao
- Department of Radiotherapy, Gustave Roussy Institute, University of Paris-Saclay, Villejuif, France
| | - François Janot
- Department of Head and Neck Oncology, Gustave Roussy Institute, University of Paris-Saclay, Villejuif, France
| | - François Bidault
- Department of Radiology, Gustave Roussy Institute, University of Paris-Saclay, Villejuif, France
| | - Stéphane Temam
- Department of Head and Neck Oncology, Gustave Roussy Institute, University of Paris-Saclay, Villejuif, France
| |
Collapse
|
37
|
Ou D, Adam J, Garberis I, Blanchard P, Nguyen F, Levy A, Casiraghi O, Leijenaar R, Gorphe P, Breuskin I, Janot F, Robert C, Lambin P, Temam S, Scoazec J, Deutsch E, Tao Y. OC-0586 Immunological contexture basis of a prognostic radiomics signature in head and neck cancers. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31006-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
38
|
Ruffier-Loubière A, Tao Y, NGuyen F, Moya-Plana A, Even C, Berthold C, Casiraghi O, Temam S, Blanchard P. OC-010 Local recurrence of nasopharyngeal carcinomas outcomes after reirradiation. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30176-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
39
|
Caula A, Boukhris M, Guerlain J, Tao Y, Breuskin I, Mirghani H, Temam S, Gorphe P. Correlation between the duration of locoregional control and survival in T1–T2 oropharyngeal cancer patients. Eur Arch Otorhinolaryngol 2019; 276:1161-1166. [DOI: 10.1007/s00405-019-05293-z] [Citation(s) in RCA: 4] [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] [Received: 10/25/2018] [Accepted: 01/12/2019] [Indexed: 11/28/2022]
|
40
|
Schernberg A, Canova C, Blanchard P, Gorphe P, Breuskin I, Mirghani H, Moya-Plana A, Janot F, Bidault F, Chargari C, Bellefqih S, Ruffier A, Even C, Nguyen F, Temam S, Tao Y. Prognostic factors in patients with soft palate squamous cell carcinoma. Head Neck 2019; 41:1441-1449. [PMID: 30636178 DOI: 10.1002/hed.25598] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 10/02/2018] [Accepted: 12/05/2018] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND To define the prognostic factors associated with outcome in patients with soft palate squamous cell carcinoma (SCC). METHODS Previously untreated patients with soft palate and uvula SCC treated in our institution between 1997 and 2012 were collected. The prognostic value of clinical, hematological, and treatment characteristics was examined. RESULTS We identified 156 patients, median age 58 years, with 71% drinkers, 91% smokers; 19% had synchronous cancer. Front-line treatment was chemoradiotherapy in 58 (37%), radiotherapy alone in 60 (39%), surgery in 17 (11%), and induction chemotherapy in 21 patients (14%). The 5-year actuarial overall survival (OS) and progression-free survival (PFS) were 41% and 37%, respectively. In univariate analysis, T3-T4 vs T1-T2 stage, N2-N3 vs N0-N1 stage, and neutrophil count >7 g/L were associated with worse OS and PFS (P < .05). CONCLUSION In patients with soft palate SCC, inflammation biomarkers were associated with OS.
Collapse
Affiliation(s)
- Antoine Schernberg
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Paris, France.,INSERM1030, Gustave Roussy Cancer Campus, Paris, France
| | - Charles Canova
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - Pierre Blanchard
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Paris, France.,Faculté de Médecine du Kremlin-Bicetre, Université Paris Sud, Université Paris Saclay, Paris, France
| | - Philippe Gorphe
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - Ingrid Breuskin
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - Haitham Mirghani
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - Antoine Moya-Plana
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - François Janot
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - Francois Bidault
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - Cyrus Chargari
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Paris, France.,INSERM1030, Gustave Roussy Cancer Campus, Paris, France.,French Military Health Services Academy, Paris, France.,Institut de Recherche Biomédicale des Armées, Paris, France
| | - Sara Bellefqih
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - Amandine Ruffier
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - Caroline Even
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - France Nguyen
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - Stéphane Temam
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Paris, France
| | - Yungan Tao
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Paris, France.,INSERM1030, Gustave Roussy Cancer Campus, Paris, France
| |
Collapse
|
41
|
Gorphe P, Chekkoury Idrissi Y, Tao Y, Moya-Plana A, Casiraghi O, Janot F, Blanchard P, Mirghani H, Temam S. Smoking and papillomavirus DNA in patients with p16-positive N3 oropharyngeal squamous cell carcinoma. Head Neck 2018; 41:1039-1045. [PMID: 30552841 DOI: 10.1002/hed.25523] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 08/20/2018] [Accepted: 10/05/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND We investigated the survival of patients with a p16-positive N3 oropharyngeal squamous cell carcinoma (OPSCC) and the prognostic significance of patient, tumor, and treatment characteristics. METHODS We retrospectively reviewed the data of patients treated at our Cancer Center for a p16-positive N3 OPSCC between 2003 and 2016. End points were overall survival (OS) and progression-free survival (PFS). RESULTS A total of 29 patients were included. The 5-year OS and PFS were 67.5% and 59.1%, respectively. Smoking history above 10 pack-years and the absence of human papillomavirus DNA were associated with worse OS (P = .02 and P = .03, respectively) and PFS (P = .02 and P = .02, respectively). Induction chemotherapy or radical neck dissection were not associated with different treatment outcomes. CONCLUSION Patients with an N3 p16-positive oropharyngeal cancer in our series had a 5-year OS rate of 67.5%. Smoking history and viral DNA were prognostic factors associated with survival.
Collapse
Affiliation(s)
- Philippe Gorphe
- Department of Head and Neck Oncology, Gustave Roussy Institute, Université Paris-Saclay, Villejuif, France
| | - Younes Chekkoury Idrissi
- Department of Head and Neck Oncology, Gustave Roussy Institute, Université Paris-Saclay, Villejuif, France
| | - Yungan Tao
- Department of Radiotherapy, Gustave Roussy Institute, Université Paris-Saclay, Villejuif, France
| | - Antoine Moya-Plana
- Department of Head and Neck Oncology, Gustave Roussy Institute, Université Paris-Saclay, Villejuif, France
| | - Odile Casiraghi
- Department of Pathology, Gustave Roussy Institute, Université Paris-Saclay, Villejuif, France
| | - François Janot
- Department of Head and Neck Oncology, Gustave Roussy Institute, Université Paris-Saclay, Villejuif, France
| | - Pierre Blanchard
- Department of Radiotherapy, Gustave Roussy Institute, Université Paris-Saclay, Villejuif, France
| | - Haïtham Mirghani
- Department of Head and Neck Oncology, Gustave Roussy Institute, Université Paris-Saclay, Villejuif, France
| | - Stéphane Temam
- Department of Head and Neck Oncology, Gustave Roussy Institute, Université Paris-Saclay, Villejuif, France
| |
Collapse
|
42
|
Ruffier-Loubière A, Tao Y, Nguyen F, Moya-Plana A, Even C, Berthold C, Casiraghi O, Temam S, Blanchard P. Réirradiations des carcinomes nasopharyngés en récidive locale : analyse de l’efficacité et de la toxicité sur une série de 2005 et 2018. Cancer Radiother 2018. [DOI: 10.1016/j.canrad.2018.07.013] [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: 11/29/2022]
|
43
|
Herrera Gomez R, Mezquita L, Auclin E, Saleh K, Baste Rotllan N, Iacobs M, Bursuc S, Mayache Badis L, Ferrand F, Casiraghi O, Temam S, Breuskin I, Tao Y, Besse B, Even C. Association of LIPI score with immune checkpoint inhibitors (ICI) outcomes in recurrent or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN) patients (pts). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy287.043] [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: 11/12/2022] Open
|
44
|
Fallet V, Taouachi R, Saffroy R, Ben Lakhdar A, Rabbe N, André F, Temam S, Lemoine A, Wislez M. Head and neck (HN) primary sarcomatoid carcinoma (PSC) profile by high-throughput somatic mutation profiling. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy303.043] [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: 11/12/2022] Open
|
45
|
Villepelet A, Casiraghi O, Temam S, Moya-Plana A. Ethmoid tumor and oncogenic osteomalacia: Case report and review of the literature. Eur Ann Otorhinolaryngol Head Neck Dis 2018; 135:365-369. [PMID: 30026073 DOI: 10.1016/j.anorl.2018.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Oncogenic osteomalacia is a very rare disease usually caused by a phosphaturic mesenchymal tumor, particularly the "mixed connective tissue type", secreting FGF-23 hormone. OBJECTIVE The authors report a case of ethmoid tumor associated with oncogenic osteomalacia and discuss management based on a review of the literature. CASE SUMMARY A 41-year-old woman with multiple fractures causing major disability was diagnosed with early-onset osteoporosis. CT scan followed by MRI, performed due to the concomitant presence of nasal obstruction, showed a right ethmoid tumor in contact with the dura mater and periorbital tissues, but with no signs of invasion. Endoscopic resection was performed with reconstruction of the defect of the cribriform plate by a nasoseptal flap. Nasal and bone symptoms subsequently resolved. Histological examination revealed a phosphaturic mesenchymal tumor. DISCUSSION Twelve cases of mesenchymal tumor of the ethmoid sinus associated with oncogenic osteomalacia have been reported to date. FGF-23 assay and whole-body MRI with STIR sequence are useful for the diagnosis. A very favorable outcome is observed after surgical treatment in the majority of cases.
Collapse
Affiliation(s)
- A Villepelet
- Service d'ORL et de chirurgie cervicofaciale, hôpital Tenon, Université Paris Sorbonne, Paris, Assistance Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France.
| | - O Casiraghi
- Département d'anatomopathologie, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114, rue Edouard-Vaillant, 94800 Villejuif, France
| | - S Temam
- Département de cancérologie cervicofaciale, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114, rue Edouard-Vaillant, 94800 Villejuif, France
| | - A Moya-Plana
- Département de cancérologie cervicofaciale, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114, rue Edouard-Vaillant, 94800 Villejuif, France
| |
Collapse
|
46
|
Schernberg A, Blanchard P, Chargari C, Ou D, Levy A, Gorphe P, Breuskin I, Atallah S, Caula A, Escande A, Janot F, Nguyen F, Temam S, Deutsch E, Tao Y. Leukocytosis, prognosis biomarker in locally advanced head and neck cancer patients after chemoradiotherapy. Clin Transl Radiat Oncol 2018; 12:8-15. [PMID: 30073209 PMCID: PMC6068078 DOI: 10.1016/j.ctro.2018.07.002] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 06/14/2018] [Accepted: 07/04/2018] [Indexed: 12/30/2022] Open
Abstract
Objective To study the prognostic value of leukocyte increase in a retrospective cohort of locally advanced head and neck squamous cell carcinoma (HNSCC) patients receiving definitive concurrent cisplatin and radiation. Materials and methods Clinical records of consecutive previously untreated locally advanced HNSCC patients treated in our Institution between March 2006 and October 2012 by concurrent cisplatin (100 mg/m2, every 3 weeks) and radiation (70 Gy in 7 weeks) were collected. The prognostic value of pretreatment leukocyte increase was examined, with focus on patterns of relapse and survival. Leukocytosis and neutrophilia were defined as a leukocyte count or a neutrophils count exceeding 10 and 7.5 G/L, respectively. Results We identified 193 patients, all treated with concurrent cisplatin-based chemoradiotherapy. Respectively 24% and 20% patients displayed baseline leukocytosis or neutrophilia. Mean leukocyte count were significantly more elevated in current smokers, patients with performance status (PS) >0, T4 and less in HPV + tumor. The 5-year actuarial overall survival (OS) and progression-free survival (PFS) were 56% and 51% respectively. In univariate analysis, both leukocytosis and neutrophilia were strongly associated with worse OS and PFS (p < 0.001). In multivariate analysis, N classification, HPV/p16, smoking status and leukocytosis were associated with worse OS and PFS. Patients with <3 cycles of cisplatin had worse survival. Conclusion In locally advanced HNSCC treated with concurrent cisplatin and radiation, baseline leukocytosis predicts OS and PFS. In addition with HPV status, this independent biomarker could help identifying patients with high risk of tumor relapse.
Collapse
Affiliation(s)
- Antoine Schernberg
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Pierre Blanchard
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Cyrus Chargari
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France.,INSERM1030, Gustave Roussy Cancer Campus, Villejuif France.,French Military Health Services Academy, Ecole du Val-de-Grâce, Paris, France.,Institut de Recherche Biomédicale des Armées, Bretigny-sur-Orge, France
| | - Dan Ou
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Antonin Levy
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France.,INSERM1030, Gustave Roussy Cancer Campus, Villejuif France
| | - Philippe Gorphe
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Ingrid Breuskin
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Sarah Atallah
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Alexandre Caula
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Alexandre Escande
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - François Janot
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - France Nguyen
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Stéphane Temam
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France
| | - Eric Deutsch
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France.,INSERM1030, Gustave Roussy Cancer Campus, Villejuif France.,Université Paris Sud, Université Paris Saclay, Faculté de médecine du Kremlin-Bicetre, Le Kremlin-Bicetre, France
| | - Yungan Tao
- Radiation Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France.,INSERM1030, Gustave Roussy Cancer Campus, Villejuif France
| |
Collapse
|
47
|
Moya-Plana A, Aupérin A, Guerlain J, Gorphe P, Casiraghi O, Mamelle G, Melkane A, Lumbroso J, Janot F, Temam S. Sentinel node biopsy in early oral squamous cell carcinomas: Long-term follow-up and nodal failure analysis. Oral Oncol 2018; 82:187-194. [DOI: 10.1016/j.oraloncology.2018.05.021] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 04/20/2018] [Accepted: 05/25/2018] [Indexed: 02/06/2023]
|
48
|
Semdaie D, Haroun F, Casiraghi O, Bidault F, Temam S, Janot F, Gorphe P. Laser debulking or tracheotomy in airway management prior to total laryngectomy for T4a laryngeal cancer. Eur Arch Otorhinolaryngol 2018; 275:1869-1875. [PMID: 29777295 DOI: 10.1007/s00405-018-4994-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 05/02/2018] [Indexed: 12/19/2022]
Abstract
PURPOSE Retrospective studies have shown that tracheotomy prior to total laryngectomy (TL) is associated with decreased survival. We sought to investigate whether this is due to higher local invasiveness associated with obstructive disease or whether it is the result of tracheotomy itself. METHODS We reviewed patients with a T4a (AJCC 7th edition) laryngeal squamous-cell carcinoma treated with a primary TL followed by adjuvant radiotherapy between 2001 and 2013. We compared patients who had obstructive lesions with those who had non-obstructive lesions in terms of preoperative data, pathological features, and treatment outcomes. Second, we compared tracheotomized patients with patients who underwent endoscopic laser debulking (ELD). RESULTS One hundred patients were reviewed. Thirty-seven of them required an airway intervention prior to a TL (tracheotomy n = 24/ELD n = 13). Patients with obstructive tumors had more frequently subglottic extension (p = 0.0066) and a shorter disease-free survival (DFS) (p = 0.046), due to a higher incidence of additional distant metastases. Tracheotomy was associated with a shorter DFS (p = 0.035) and more frequent perineural invasion (p = 0.0272) as compared to ELD, but not with a higher incidence of stomal recurrence. CONCLUSIONS A tracheotomy prior to a total laryngectomy is associated with decreased survival. We recommend laser debulking as the preferred treatment whenever management of an obstructive airway is required prior to a total laryngectomy.
Collapse
Affiliation(s)
- Djamil Semdaie
- Department of Head and Neck Oncology, Institute Gustave Roussy, Université Paris-Saclay, 114 rue Edouard Vaillant, 94805, Villejuif, France
| | - Fabienne Haroun
- Department of Head and Neck Oncology, Institute Gustave Roussy, Université Paris-Saclay, 114 rue Edouard Vaillant, 94805, Villejuif, France
| | - Odile Casiraghi
- Department of Pathology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - François Bidault
- Department of Radiology, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Stéphane Temam
- Department of Head and Neck Oncology, Institute Gustave Roussy, Université Paris-Saclay, 114 rue Edouard Vaillant, 94805, Villejuif, France
| | - François Janot
- Department of Head and Neck Oncology, Institute Gustave Roussy, Université Paris-Saclay, 114 rue Edouard Vaillant, 94805, Villejuif, France
| | - Philippe Gorphe
- Department of Head and Neck Oncology, Institute Gustave Roussy, Université Paris-Saclay, 114 rue Edouard Vaillant, 94805, Villejuif, France.
| |
Collapse
|
49
|
Ou D, Adam J, Garberis I, Blanchard P, Nguyen F, Levy A, Casiraghi O, Gorphe P, Breuskin I, Janot F, Temam S, Scoazec J, Deutsch E, Tao Y. OC-0489: TAM and HLA class I expression in relation to HPV and clinical outcome in head and neck cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30799-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
50
|
Boros A, Blanchard P, Gorphe P, Breuskin I, Even C, Nguyen F, Deutsch E, Bidault F, Janot F, Temam S, Mirghani H, Tao Y. EP-1158: Prognostic factors and role of neck dissection in N3 head and neck cancers treated with radiotherapy. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31468-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|