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Papers by Anne et Guy Jouret - Mourin
Cancers
Background: The prognostic value of Immunoscore was evaluated in Stage II/III colon cancer (CC) p... more Background: The prognostic value of Immunoscore was evaluated in Stage II/III colon cancer (CC) patients, but it remains unclear in Stage I/II, and in early-stage subgroups at risk. An international Society for Immunotherapy of Cancer (SITC) study evaluated the pre-defined consensus Immunoscore in tumors from 1885 AJCC/UICC-TNM Stage I/II CC patients from Canada/USA (Cohort 1) and Europe/Asia (Cohort 2). METHODS: Digital-pathology is used to quantify the densities of CD3+ and CD8+ T-lymphocyte in the center of tumor (CT) and the invasive margin (IM). The time to recurrence (TTR) was the primary endpoint. Secondary endpoints were disease-free survival (DFS), overall survival (OS), prognosis in Stage I, Stage II, Stage II-high-risk, and microsatellite-stable (MSS) patients. RESULTS: High-Immunoscore presented with the lowest risk of recurrence in both cohorts. In Stage I/II, recurrence-free rates at 5 years were 78.4% (95%-CI, 74.4–82.6), 88.1% (95%-CI, 85.7–90.4), 93.4% (95%-CI, 91.1...
Cancers
BACKGROUND: In this study, we evaluated the prognostic value of Immunoscore in patients with stag... more BACKGROUND: In this study, we evaluated the prognostic value of Immunoscore in patients with stage I–III colon cancer (CC) in the Asian population. These patients were originally included in an international study led by the Society for Immunotherapy of Cancer (SITC) on 2681 patients with AJCC/UICC-TNM stages I–III CC. METHODS: CD3+ and cytotoxic CD8+ T-lymphocyte densities were quantified in the tumor and invasive margin by digital pathology. The association of Immunoscore with prognosis was evaluated for time to recurrence (TTR), disease-free survival (DFS), and overall survival (OS). RESULTS: Immunoscore stratified Asian patients (n = 423) into different risk categories and was not impacted by age. Recurrence-free rates at 3 years were 78.5%, 85.2%, and 98.3% for a Low, Intermediate, and High Immunoscore, respectively (HR[Low-vs-High] = 7.26 (95% CI 1.75−30.19); p = 0.0064). A High Immunoscore showed a significant association with prolonged TTR, OS, and DFS (p < 0.05). In Cox ...
Cancers, 2022
Retrospective studies reported that preoperative oxaliplatin-based chemotherapy increased patholo... more Retrospective studies reported that preoperative oxaliplatin-based chemotherapy increased pathological response (PR) in patients resected for colorectal liver metastases (CRLM). This multicenter prospective randomized (1/1) phase II trial evaluated PR on resected CRLM after preoperative mFOLFOX6 (arm A) or FOLFIRI (arm B) + bevacizumab. The primary endpoint was the major pathological response rate (MPRR), defined as the percentage of patients presenting CRLMs with mean tumor regression grade (TRG) < 3. Secondary endpoints included safety, progression-free survival (PFS) and overall survival (OS). Out of 65 patients, 57 patients (28 and 29 in arm A/B) were resected for CRLM (one patient with lung metastases). Clinical and treatment characteristics were similar in both arms. One-month postoperative complications were 39.3%/31.0% in arm A/B (p = 0.585). MPRR and complete PR were 32.1%/20.7% (p = 0.379) and 14.3%/0.0% (p = 0.052) in arm A/B, respectively. PFS and OS were not differen...
Introduction : Peritoneal carcinomatosis (PC) of colorectal origin remains the most advanced form... more Introduction : Peritoneal carcinomatosis (PC) of colorectal origin remains the most advanced form of colorectal cancer and is still associated with poor outcome. Cytoreducive surgery (CRS) and hyperthermic intra-peritoneal chemotherapy (HIPEC) has deeply modified patients’ prognosis. Aim : This study aims to review our results of CRS and HIPEC based on Oxaliplatin and using a closed abdomen technique as treatment of peritonela carcinomatosis of colorectal origin. Beside oncologic outcome, this study examines the long term quality of life (QoL) of patients treated by CRS and HIPEC. Methods : This is a retrospective monocentric study based on consecutive patients presenting colorectal cancer with perioneal carcinomatosis and treated by CRS and HIPEC. Demographic, operative, post-operative and pathological data have been collected. Long term oncological results have been computed and quality of life has been evaluated using the EORTC QLQ C-30 and GIQLI questionnaires. Results : Between October 2007 and December 2015, 82 patients have undergone 92 HIPEC, of which 70 patients underwent 75 CS with Oxaliplatin HIPEC using a closed abdomen technique. Among the 38 patients alive at the time of the study, 34 had not benefited from a redo-HIPEC after December 31, 2015.Of the 82 patients operated between October 2007 and December 2015, 10 (10.9%) received prophylactic HIPEC. There were 44 women and 38 men with a median age of 60 (18-77). Twenty-one patients (32.6%) had synchronous resecable liver metastases. The median level of carcinoembryonic antigen was 2,7 ng / mL. The CC-0 and CC-1 resection scores were obtained for 75 (87.2%) and 10 (11.6%) procedures, respectively. The median index of peritoneal carcinomatosis (PCI) was 6 (0 to 30). Twenty-two patients (23.9%) had a Dindo-Clavien complication> 2 and the postoperative mortality was 1,6%. The median follow-up time is 35 months. Twenty-seven patients (29.3%) received neoadjuvant chemotherapy and 48 (53.3%) received adjuvant chemotherapy. Twelve patients (13.0%) had isolated recurrence of CP and 35 patients (38.0%) presented distant metastases. Overall survival (OS) and 5-year survival without recurrence (DFS) were 45.7% and 8.7%, respectively. The deterioration of the quality of life in the long term is related to the presence of an invasion and to the occurrence of distal recurrences. The EORTC and GIQLI questionnaires showed a high incidence and intensity of diarrhea. Conclusions : HIPEC with Oxaliplatin using a closed abdomen technique to treat CP of colorectal origin offers acceptable oncological results. This treatment strategy should therefore be considered for all patients with peritoneal carcinomatosis, while ensuring that patients live not only longer but also enjoy a good quality of life
Journal of Clinical Oncology, 2020
PURPOSE The purpose of this study was to evaluate the prognostic value of Immunoscore in patients... more PURPOSE The purpose of this study was to evaluate the prognostic value of Immunoscore in patients with stage III colon cancer (CC) and to analyze its association with the effect of chemotherapy on time to recurrence (TTR). METHODS An international study led by the Society for Immunotherapy of Cancer evaluated the predefined consensus Immunoscore in 763 patients with American Joint Committee on Cancer/Union for International Cancer Control TNM stage III CC from cohort 1 (Canada/United States) and cohort 2 (Europe/Asia). CD3+ and cytotoxic CD8+ T lymphocyte densities were quantified in the tumor and invasive margin by digital pathology. The primary end point was TTR. Secondary end points were overall survival (OS), disease-free survival (DFS), prognosis in microsatellite stable (MSS) status, and predictive value of efficacy of chemotherapy. RESULTS Patients with a high Immunoscore presented with the lowest risk of recurrence, in both cohorts. Recurrence-free rates at 3 years were 56.9...
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 2016
Nodal stage is a strong prognostic factor of oncological outcome of rectal cancer. To compensate ... more Nodal stage is a strong prognostic factor of oncological outcome of rectal cancer. To compensate for the variation in total number of harvested nodes, calculation of the lymph node ratio (LNR) has been advocated. The aim of the study was to compare the impact, on the long-term oncological outcome, of the LNR with other predictive factors, including the quality of total mesorectal excision (TME) and the state of the circumferential resection margin. Consecutive patients having elective surgery for nonmetastatic rectal cancer were extracted from a prospectively maintained database. Retrospective uni- and multivariate analyses were performed based on patient-, surgical- and tumour-related factors. The prognostic value of the LNR on overall survival (OS) and on overall recurrence-free survival (ORFS) was assessed and a cut-off value was determined. From 1998 to 2013, out of 456 patients, 357 with nonmetastatic disease were operated on for rectal cancer. Neoadjuvant radiochemotherapy was...
Acta Endoscopica
Helicobacter pylori représente de loin la majeure partie des infections. Après une phase aiguë de... more Helicobacter pylori représente de loin la majeure partie des infections. Après une phase aiguë de courte durée, la plupart des gastrites dues à l'Helicobacter évoluent sur un mode chronique. Leurs caractéristiques histologiques principales résultent d'altérations dégénératives et régénératives épithéliales et d'une réponse cellulaire inflammatoire de la lamina propria. Les lésions peuvent être classées selon le système de Sydney (revu à Houston, 1994). La détection d'Hp repose sur des colorations spéciales telles que le Giemsa ou le Crésyl violet. L'immunocytochimie peut s'avérer utile lorsque les germes sont rares (certaines gastrites aiguës, après traitement par antibiotiques...). Un autre germe moins fréquent du groupe des Helicobacter est l'Helicobacter heilmannii qui contamine probablement l'homme à partir des animaux de compagnie ; il produit des lésions très semblables à celles d'Hp. CMV peut s'observer aussi bien chez l'individu immunocompétent qu'immunodéficient; il induit une grande variété de lésions mimant parfois une atteinte cancéreuse. Différentes mycoses peuvent se localiser à l'estomac essentiellement au niveau des tissus nécrotiques provenant des cancers ou des ulcères. Chez les patients immunodéficients, la localisation gastrique s'inscrit souvent dans un cadre plus général. Les autres germes parfois observés dans l'estomac, qu'ils soient bactériens, fungiques ou parasitaires sont extrêmement rares
Human Pathology, 1991
Ménétrier's disease is a rare form of hypertrophic or hyperplastic gastropathy, character... more Ménétrier's disease is a rare form of hypertrophic or hyperplastic gastropathy, characterized by conspicuous thickening of the gastric mucosal folds and foveolar (crypt) hyperplasia. The pathogenesis of Ménétrier's disease remains unresolved. Lymphocytic gastritis is a newly described entity which corresponds endoscopically to varioliform gastritis and is marked by T-lymphocyte infiltration of the surface epithelium and crypts. Five surgical cases and one autopsy case combining the gross and microscopic features of Ménétrier's disease and lymphocytic gastritis are presented. This unusual and hitherto previously undescribed association raises the possibility of a common pathogenesis for Ménétrier's disease and lymphocytic gastritis.
European Journal of Cancer, 2013
Gastroentérologie clinique et biologique, 1999
Gastroentérologie clinique et biologique, 1992
Cancers
Background: The prognostic value of Immunoscore was evaluated in Stage II/III colon cancer (CC) p... more Background: The prognostic value of Immunoscore was evaluated in Stage II/III colon cancer (CC) patients, but it remains unclear in Stage I/II, and in early-stage subgroups at risk. An international Society for Immunotherapy of Cancer (SITC) study evaluated the pre-defined consensus Immunoscore in tumors from 1885 AJCC/UICC-TNM Stage I/II CC patients from Canada/USA (Cohort 1) and Europe/Asia (Cohort 2). METHODS: Digital-pathology is used to quantify the densities of CD3+ and CD8+ T-lymphocyte in the center of tumor (CT) and the invasive margin (IM). The time to recurrence (TTR) was the primary endpoint. Secondary endpoints were disease-free survival (DFS), overall survival (OS), prognosis in Stage I, Stage II, Stage II-high-risk, and microsatellite-stable (MSS) patients. RESULTS: High-Immunoscore presented with the lowest risk of recurrence in both cohorts. In Stage I/II, recurrence-free rates at 5 years were 78.4% (95%-CI, 74.4–82.6), 88.1% (95%-CI, 85.7–90.4), 93.4% (95%-CI, 91.1...
Cancers
BACKGROUND: In this study, we evaluated the prognostic value of Immunoscore in patients with stag... more BACKGROUND: In this study, we evaluated the prognostic value of Immunoscore in patients with stage I–III colon cancer (CC) in the Asian population. These patients were originally included in an international study led by the Society for Immunotherapy of Cancer (SITC) on 2681 patients with AJCC/UICC-TNM stages I–III CC. METHODS: CD3+ and cytotoxic CD8+ T-lymphocyte densities were quantified in the tumor and invasive margin by digital pathology. The association of Immunoscore with prognosis was evaluated for time to recurrence (TTR), disease-free survival (DFS), and overall survival (OS). RESULTS: Immunoscore stratified Asian patients (n = 423) into different risk categories and was not impacted by age. Recurrence-free rates at 3 years were 78.5%, 85.2%, and 98.3% for a Low, Intermediate, and High Immunoscore, respectively (HR[Low-vs-High] = 7.26 (95% CI 1.75−30.19); p = 0.0064). A High Immunoscore showed a significant association with prolonged TTR, OS, and DFS (p < 0.05). In Cox ...
Cancers, 2022
Retrospective studies reported that preoperative oxaliplatin-based chemotherapy increased patholo... more Retrospective studies reported that preoperative oxaliplatin-based chemotherapy increased pathological response (PR) in patients resected for colorectal liver metastases (CRLM). This multicenter prospective randomized (1/1) phase II trial evaluated PR on resected CRLM after preoperative mFOLFOX6 (arm A) or FOLFIRI (arm B) + bevacizumab. The primary endpoint was the major pathological response rate (MPRR), defined as the percentage of patients presenting CRLMs with mean tumor regression grade (TRG) < 3. Secondary endpoints included safety, progression-free survival (PFS) and overall survival (OS). Out of 65 patients, 57 patients (28 and 29 in arm A/B) were resected for CRLM (one patient with lung metastases). Clinical and treatment characteristics were similar in both arms. One-month postoperative complications were 39.3%/31.0% in arm A/B (p = 0.585). MPRR and complete PR were 32.1%/20.7% (p = 0.379) and 14.3%/0.0% (p = 0.052) in arm A/B, respectively. PFS and OS were not differen...
Introduction : Peritoneal carcinomatosis (PC) of colorectal origin remains the most advanced form... more Introduction : Peritoneal carcinomatosis (PC) of colorectal origin remains the most advanced form of colorectal cancer and is still associated with poor outcome. Cytoreducive surgery (CRS) and hyperthermic intra-peritoneal chemotherapy (HIPEC) has deeply modified patients’ prognosis. Aim : This study aims to review our results of CRS and HIPEC based on Oxaliplatin and using a closed abdomen technique as treatment of peritonela carcinomatosis of colorectal origin. Beside oncologic outcome, this study examines the long term quality of life (QoL) of patients treated by CRS and HIPEC. Methods : This is a retrospective monocentric study based on consecutive patients presenting colorectal cancer with perioneal carcinomatosis and treated by CRS and HIPEC. Demographic, operative, post-operative and pathological data have been collected. Long term oncological results have been computed and quality of life has been evaluated using the EORTC QLQ C-30 and GIQLI questionnaires. Results : Between October 2007 and December 2015, 82 patients have undergone 92 HIPEC, of which 70 patients underwent 75 CS with Oxaliplatin HIPEC using a closed abdomen technique. Among the 38 patients alive at the time of the study, 34 had not benefited from a redo-HIPEC after December 31, 2015.Of the 82 patients operated between October 2007 and December 2015, 10 (10.9%) received prophylactic HIPEC. There were 44 women and 38 men with a median age of 60 (18-77). Twenty-one patients (32.6%) had synchronous resecable liver metastases. The median level of carcinoembryonic antigen was 2,7 ng / mL. The CC-0 and CC-1 resection scores were obtained for 75 (87.2%) and 10 (11.6%) procedures, respectively. The median index of peritoneal carcinomatosis (PCI) was 6 (0 to 30). Twenty-two patients (23.9%) had a Dindo-Clavien complication> 2 and the postoperative mortality was 1,6%. The median follow-up time is 35 months. Twenty-seven patients (29.3%) received neoadjuvant chemotherapy and 48 (53.3%) received adjuvant chemotherapy. Twelve patients (13.0%) had isolated recurrence of CP and 35 patients (38.0%) presented distant metastases. Overall survival (OS) and 5-year survival without recurrence (DFS) were 45.7% and 8.7%, respectively. The deterioration of the quality of life in the long term is related to the presence of an invasion and to the occurrence of distal recurrences. The EORTC and GIQLI questionnaires showed a high incidence and intensity of diarrhea. Conclusions : HIPEC with Oxaliplatin using a closed abdomen technique to treat CP of colorectal origin offers acceptable oncological results. This treatment strategy should therefore be considered for all patients with peritoneal carcinomatosis, while ensuring that patients live not only longer but also enjoy a good quality of life
Journal of Clinical Oncology, 2020
PURPOSE The purpose of this study was to evaluate the prognostic value of Immunoscore in patients... more PURPOSE The purpose of this study was to evaluate the prognostic value of Immunoscore in patients with stage III colon cancer (CC) and to analyze its association with the effect of chemotherapy on time to recurrence (TTR). METHODS An international study led by the Society for Immunotherapy of Cancer evaluated the predefined consensus Immunoscore in 763 patients with American Joint Committee on Cancer/Union for International Cancer Control TNM stage III CC from cohort 1 (Canada/United States) and cohort 2 (Europe/Asia). CD3+ and cytotoxic CD8+ T lymphocyte densities were quantified in the tumor and invasive margin by digital pathology. The primary end point was TTR. Secondary end points were overall survival (OS), disease-free survival (DFS), prognosis in microsatellite stable (MSS) status, and predictive value of efficacy of chemotherapy. RESULTS Patients with a high Immunoscore presented with the lowest risk of recurrence, in both cohorts. Recurrence-free rates at 3 years were 56.9...
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 2016
Nodal stage is a strong prognostic factor of oncological outcome of rectal cancer. To compensate ... more Nodal stage is a strong prognostic factor of oncological outcome of rectal cancer. To compensate for the variation in total number of harvested nodes, calculation of the lymph node ratio (LNR) has been advocated. The aim of the study was to compare the impact, on the long-term oncological outcome, of the LNR with other predictive factors, including the quality of total mesorectal excision (TME) and the state of the circumferential resection margin. Consecutive patients having elective surgery for nonmetastatic rectal cancer were extracted from a prospectively maintained database. Retrospective uni- and multivariate analyses were performed based on patient-, surgical- and tumour-related factors. The prognostic value of the LNR on overall survival (OS) and on overall recurrence-free survival (ORFS) was assessed and a cut-off value was determined. From 1998 to 2013, out of 456 patients, 357 with nonmetastatic disease were operated on for rectal cancer. Neoadjuvant radiochemotherapy was...
Acta Endoscopica
Helicobacter pylori représente de loin la majeure partie des infections. Après une phase aiguë de... more Helicobacter pylori représente de loin la majeure partie des infections. Après une phase aiguë de courte durée, la plupart des gastrites dues à l'Helicobacter évoluent sur un mode chronique. Leurs caractéristiques histologiques principales résultent d'altérations dégénératives et régénératives épithéliales et d'une réponse cellulaire inflammatoire de la lamina propria. Les lésions peuvent être classées selon le système de Sydney (revu à Houston, 1994). La détection d'Hp repose sur des colorations spéciales telles que le Giemsa ou le Crésyl violet. L'immunocytochimie peut s'avérer utile lorsque les germes sont rares (certaines gastrites aiguës, après traitement par antibiotiques...). Un autre germe moins fréquent du groupe des Helicobacter est l'Helicobacter heilmannii qui contamine probablement l'homme à partir des animaux de compagnie ; il produit des lésions très semblables à celles d'Hp. CMV peut s'observer aussi bien chez l'individu immunocompétent qu'immunodéficient; il induit une grande variété de lésions mimant parfois une atteinte cancéreuse. Différentes mycoses peuvent se localiser à l'estomac essentiellement au niveau des tissus nécrotiques provenant des cancers ou des ulcères. Chez les patients immunodéficients, la localisation gastrique s'inscrit souvent dans un cadre plus général. Les autres germes parfois observés dans l'estomac, qu'ils soient bactériens, fungiques ou parasitaires sont extrêmement rares
Human Pathology, 1991
Ménétrier's disease is a rare form of hypertrophic or hyperplastic gastropathy, character... more Ménétrier's disease is a rare form of hypertrophic or hyperplastic gastropathy, characterized by conspicuous thickening of the gastric mucosal folds and foveolar (crypt) hyperplasia. The pathogenesis of Ménétrier's disease remains unresolved. Lymphocytic gastritis is a newly described entity which corresponds endoscopically to varioliform gastritis and is marked by T-lymphocyte infiltration of the surface epithelium and crypts. Five surgical cases and one autopsy case combining the gross and microscopic features of Ménétrier's disease and lymphocytic gastritis are presented. This unusual and hitherto previously undescribed association raises the possibility of a common pathogenesis for Ménétrier's disease and lymphocytic gastritis.
European Journal of Cancer, 2013
Gastroentérologie clinique et biologique, 1999
Gastroentérologie clinique et biologique, 1992