Gilles Houvenaeghel, Alexandre de Nonneville, Monique Cohen, Frédéric Viret, Sandrine Rua, Laura Sabiani, Max Buttarelli, Emmanuelle Charaffe, Audrey Monneur, Aurélie Jalaguier-Coudray, Marie Bannier, Renaud Sabatier, Anthony Gonçalves
We examined characteristics trends in early breast cancer patients receiving neoadjuvant chemotherapy (NAC) over a 16-year period. Our primary objective was to analyze variations in tumor stage and subtype over time. Secondary objectives included analyses of type of surgery and pathological response, from January 2005 to May 2021, 1623 patients receiving NAC were identified. Three periods were determined: 2005-2009 (P1), 2010-2014 (P2), 2015-2021 (P3). Correlations between periods and patient features with cT stage, pathological breast and axillary node response, pathological complete response (pCR), and type of surgery were assessed in univariate and multivariate analyses. We observed a significant increase in cT0-1 and N0 stages with periods (from 6.8% at P1 to 21.2% at P3, and from 43.2% at P1 to 55.9% at P3, respectively) and in the proportion of HER2+ and triple negative (TN) subtypes. In a multivariate analysis, a decrease of cT2-3-4 tumors during P3 was observed for HER2+ (OR:0.174; p=0.004) and TN tumors (OR:0.287; p=0.042). In-breast pCR and pCR were observed in 40.8% and 34.4% of all patients, respectively, with strong association with tumor subtypes, but not with tumor size in multivariate analysis (37.0% pCR for cT0-1 tumors, 36.4% for cT2 tumors, 29.1% for cT3 tumors (cT0-1 versus cT≥2; p=0.222)). pCR was negatively associated with cN1 stage (OR:1.499; p<0.001 for cN1 patients compared to cN0). We observed an increase in the proportion of small cT0-1 and N0 stages treated with NAC, especially in HER2+ and TN subtypes. No significant impact of tumor size on pCR rates was found.
{"title":"Neoadjuvant Chemotherapy for Breast Cancer: Evolution of Clinical Practice in a French Cancer Center Over 16 Years and Pathologic Response Rates According to Tumor Subtypes and Clinical Tumor Size: Retrospective Cohort Study.","authors":"Gilles Houvenaeghel, Alexandre de Nonneville, Monique Cohen, Frédéric Viret, Sandrine Rua, Laura Sabiani, Max Buttarelli, Emmanuelle Charaffe, Audrey Monneur, Aurélie Jalaguier-Coudray, Marie Bannier, Renaud Sabatier, Anthony Gonçalves","doi":"10.26502/jsr.10020251","DOIUrl":"https://doi.org/10.26502/jsr.10020251","url":null,"abstract":"<p><p>We examined characteristics trends in early breast cancer patients receiving neoadjuvant chemotherapy (NAC) over a 16-year period. Our primary objective was to analyze variations in tumor stage and subtype over time. Secondary objectives included analyses of type of surgery and pathological response, from January 2005 to May 2021, 1623 patients receiving NAC were identified. Three periods were determined: 2005-2009 (P1), 2010-2014 (P2), 2015-2021 (P3). Correlations between periods and patient features with cT stage, pathological breast and axillary node response, pathological complete response (pCR), and type of surgery were assessed in univariate and multivariate analyses. We observed a significant increase in cT0-1 and N0 stages with periods (from 6.8% at P1 to 21.2% at P3, and from 43.2% at P1 to 55.9% at P3, respectively) and in the proportion of HER2+ and triple negative (TN) subtypes. In a multivariate analysis, a decrease of cT2-3-4 tumors during P3 was observed for HER2+ (OR:0.174; p=0.004) and TN tumors (OR:0.287; p=0.042). In-breast pCR and pCR were observed in 40.8% and 34.4% of all patients, respectively, with strong association with tumor subtypes, but not with tumor size in multivariate analysis (37.0% pCR for cT0-1 tumors, 36.4% for cT2 tumors, 29.1% for cT3 tumors (cT0-1 versus cT≥2; p=0.222)). pCR was negatively associated with cN1 stage (OR:1.499; p<0.001 for cN1 patients compared to cN0). We observed an increase in the proportion of small cT0-1 and N0 stages treated with NAC, especially in HER2+ and TN subtypes. No significant impact of tumor size on pCR rates was found.</p>","PeriodicalId":73961,"journal":{"name":"Journal of surgery and research","volume":"5 3","pages":"511-525"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9879000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10646830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jeremi Bedard Ginchereau, M. Bellavance, Anthonie Hamel, Nicolas Tassé, S. Drolet
Impact of the SARS-COV2 on Surgical Treatment of Acute Appendicitis: A Retrospective Cohort Multi-Centre Study. Abstract Background Since the pandemic begun, in March 2020, several observational studies attempted to demonstrate the impact of the pandemic on the management of acute appendicitis. As a result, the surgical management of acute appendicitis is still undefined.
{"title":"Impact of the SARS-COV2 on Surgical Treatment of Acute Appendicitis: A Retrospective Cohort Multi-Centre Study","authors":"Jeremi Bedard Ginchereau, M. Bellavance, Anthonie Hamel, Nicolas Tassé, S. Drolet","doi":"10.26502/jsr.10020221","DOIUrl":"https://doi.org/10.26502/jsr.10020221","url":null,"abstract":"Impact of the SARS-COV2 on Surgical Treatment of Acute Appendicitis: A Retrospective Cohort Multi-Centre Study. Abstract Background Since the pandemic begun, in March 2020, several observational studies attempted to demonstrate the impact of the pandemic on the management of acute appendicitis. As a result, the surgical management of acute appendicitis is still undefined.","PeriodicalId":73961,"journal":{"name":"Journal of surgery and research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76356278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lymphangioleiomyomatosis (LAM) is a rare disease frequently (often) occurs in women of childbearing age. It is a multi-systemic disorder characterized by the proliferation, metastasis, and infiltration of smooth muscle cells in the lung and other tissues. We will report a case of a patient diagnosed with LAM who presented with chylothorax after hysterectomy of broad ligament. of etiology of this but the this the this We will a case of a patient diagnosed with LAM who presented with chylothorax after broad ligament developed dyspnea after surgical treatment. Chest CT found bilateral pleural effusion and multiple cystic lesions in both lungs. The pleural fluid Chyle test was positive, subsequent postoperative pathology confirmed LAM. The patient was treated by Sirolimus with Ideal therapeutic effect. However the presence of chylothorax after adnexal occupying resection has not been reported. Conclusions The pathogenesis of LAM is not completely clear, but the clinical manifestations of this patient seem to confirm the hypothesis that LAM originates from the female reproductive system. LAM should be considered in the differential diagnosis of female reproductive system tumors, we suggested to improve chest CT before surgery to be vigilant against the possibility of LAM if multiple cystic changes occur in pulmonary.
{"title":"Chylothorax after Excision of The Right Broad Ligament Mass of The Uterus was Diagnosed Lymphangiomyomatosis A Case Report and Literature Review","authors":"Liwan Dai, Tao Chen, Jinxing Wu","doi":"10.26502/jsr.10020233","DOIUrl":"https://doi.org/10.26502/jsr.10020233","url":null,"abstract":"Lymphangioleiomyomatosis (LAM) is a rare disease frequently (often) occurs in women of childbearing age. It is a multi-systemic disorder characterized by the proliferation, metastasis, and infiltration of smooth muscle cells in the lung and other tissues. We will report a case of a patient diagnosed with LAM who presented with chylothorax after hysterectomy of broad ligament. of etiology of this but the this the this We will a case of a patient diagnosed with LAM who presented with chylothorax after broad ligament developed dyspnea after surgical treatment. Chest CT found bilateral pleural effusion and multiple cystic lesions in both lungs. The pleural fluid Chyle test was positive, subsequent postoperative pathology confirmed LAM. The patient was treated by Sirolimus with Ideal therapeutic effect. However the presence of chylothorax after adnexal occupying resection has not been reported. Conclusions The pathogenesis of LAM is not completely clear, but the clinical manifestations of this patient seem to confirm the hypothesis that LAM originates from the female reproductive system. LAM should be considered in the differential diagnosis of female reproductive system tumors, we suggested to improve chest CT before surgery to be vigilant against the possibility of LAM if multiple cystic changes occur in pulmonary.","PeriodicalId":73961,"journal":{"name":"Journal of surgery and research","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87921319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Girish Bakhshi, A. Dutt, Sushrut Baligar, R. V., Chettubattina Ravi Teja, Sampada V. Joshi, Madhulika Jha
{"title":"Retroperitoneal Sarcoma Mimicking a Testicular Malignancy","authors":"Girish Bakhshi, A. Dutt, Sushrut Baligar, R. V., Chettubattina Ravi Teja, Sampada V. Joshi, Madhulika Jha","doi":"10.26502/jsr.10020211","DOIUrl":"https://doi.org/10.26502/jsr.10020211","url":null,"abstract":"","PeriodicalId":73961,"journal":{"name":"Journal of surgery and research","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84671947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Spontaneous Pneumothorax in Post COVID-19 Patients - A Case Series","authors":"G. Wadhawan, Konark Thakkar, Ravdeep Singh","doi":"10.26502/jsr.10020200","DOIUrl":"https://doi.org/10.26502/jsr.10020200","url":null,"abstract":"","PeriodicalId":73961,"journal":{"name":"Journal of surgery and research","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74244953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Sabiani, S. Knight, G. Blache, C. Jauffret, M. Buttarelli, E. Lambaudie, G. Houvenaeghel
Purpose: Pelvic exenteration (PE) for locally advanced gynecological cancer or local recurrence is in some cases the only option. Because of the impact of this major surgery, our objective was to identify prognostic factors in order to establish an operative prognostic score. Methods: Patients were characterized by age, type of PE (anterior, posterior, total, atypical, preservation of pelvic floor and perineal excision, extended or not to other structures), indication, curative or palliative surgery and prior radiation therapy. Results: Over 30 years, 277 patients were included. 3 and 5-years overall survival was 36.8% and 32.3%. The rate of non curative resection was significantly correlated with posterior PE (OR: 2.29), tumors extending to the lateral pelvic wall (OR: 2.91), PE requiring enlargement (OR: 2.61) and lack of radiotherapy or <45 Gy (OR: 1.73). In multivariate analysis, factors significantly impacting survival were: total PE (HR: 2.04, p <0.0001), extended PE (HR: 1.56, p=0.017) and lack of radiotherapy or <45 Gy (HR: 1.40; p=0.033). Based on these factors, we created 4 different groups in order to establish a pre and post-operative prognostic score. Overall 5-years survival for each group was respectively 48.7%, 29.0%, 28.7% and 14.8% (p <0.0001). A preoperative high score was a strong negative predictive predictor of overall survival (HR=3.01, p <0.0001). Conclusion: These scores could help to predict overall survival and help decide when to perform this surgery.
{"title":"Operative Prognostic Scores for Pelvic Exenterations for Gynecological Cancer: When Should we Operate?","authors":"L. Sabiani, S. Knight, G. Blache, C. Jauffret, M. Buttarelli, E. Lambaudie, G. Houvenaeghel","doi":"10.26502/jsr.10020241","DOIUrl":"https://doi.org/10.26502/jsr.10020241","url":null,"abstract":"Purpose: Pelvic exenteration (PE) for locally advanced gynecological cancer or local recurrence is in some cases the only option. Because of the impact of this major surgery, our objective was to identify prognostic factors in order to establish an operative prognostic score. Methods: Patients were characterized by age, type of PE (anterior, posterior, total, atypical, preservation of pelvic floor and perineal excision, extended or not to other structures), indication, curative or palliative surgery and prior radiation therapy. Results: Over 30 years, 277 patients were included. 3 and 5-years overall survival was 36.8% and 32.3%. The rate of non curative resection was significantly correlated with posterior PE (OR: 2.29), tumors extending to the lateral pelvic wall (OR: 2.91), PE requiring enlargement (OR: 2.61) and lack of radiotherapy or <45 Gy (OR: 1.73). In multivariate analysis, factors significantly impacting survival were: total PE (HR: 2.04, p <0.0001), extended PE (HR: 1.56, p=0.017) and lack of radiotherapy or <45 Gy (HR: 1.40; p=0.033). Based on these factors, we created 4 different groups in order to establish a pre and post-operative prognostic score. Overall 5-years survival for each group was respectively 48.7%, 29.0%, 28.7% and 14.8% (p <0.0001). A preoperative high score was a strong negative predictive predictor of overall survival (HR=3.01, p <0.0001). Conclusion: These scores could help to predict overall survival and help decide when to perform this surgery.","PeriodicalId":73961,"journal":{"name":"Journal of surgery and research","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82414743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This article presents the case of a patient with a large maxillary radicular cyst. After apicoectomy of involved teeth and excision of the cyst, the bone defect was reconstructed with biomaterial made of concentrated bone marrow aspirate mixed with xenograft. Complete surgical procedure has been described and presented as well as steps of aspirating the bone marrow from anterior iliac crest and subsequent processing of the aspirate. Authors also provide long term follow-up, which shows healing and remodeling of both soft and hard tissues. Results of this method are very promising although using bone marrow as a source of mesenchymal stem cells seems challenging in everyday practice. More research must be done to determine whether or not peripheral blood and PRF could be the accessible source of mesenchymal stem cells with competing clinical results.
{"title":"Maxillary Radicular Cyst Excision and Reconstruction with Concentrated Bone Marrow Aspirate Cells Mixed with Xenograft - Case Report with 7-Year Follow-up","authors":"R. Jadach, Karolina Osypko","doi":"10.26502/jsr.10020259","DOIUrl":"https://doi.org/10.26502/jsr.10020259","url":null,"abstract":"This article presents the case of a patient with a large maxillary radicular cyst. After apicoectomy of involved teeth and excision of the cyst, the bone defect was reconstructed with biomaterial made of concentrated bone marrow aspirate mixed with xenograft. Complete surgical procedure has been described and presented as well as steps of aspirating the bone marrow from anterior iliac crest and subsequent processing of the aspirate. Authors also provide long term follow-up, which shows healing and remodeling of both soft and hard tissues. Results of this method are very promising although using bone marrow as a source of mesenchymal stem cells seems challenging in everyday practice. More research must be done to determine whether or not peripheral blood and PRF could be the accessible source of mesenchymal stem cells with competing clinical results.","PeriodicalId":73961,"journal":{"name":"Journal of surgery and research","volume":"2004 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86262858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Charalampos Pitsilos, Theofylaktos Kyriakidis, Konstantinos Chitas, K. Ditsios
Background Carpometacarpal joint dislocations are uncommon hand injuries occurring in less than 1% of hand trauma. On routine postero-anterior view, asymmetry at the carpometacarpal joints should raise suspicion of possible subtle injury, which can be confirmed with CT scan. In literature, there is a scarcity of published cases and the optional treatment is controversial. Case report A 28-year-old man presented with dorsal dislocation of the second and third carpometacarpal joints. After initial closed reduction, the computerized tomography scan revealed residual dorsal subluxation. The patient was successfully treated with closed reduction under fluoroscopy and percutaneous pinning. In the followup full range of motion was gained and there were no recurrence or signs of degenerative changes. Conclusion Closed reduction of traumatic dorsal second and third carpometacarpal dislocation may be associated with incomplete reduction. Reduction under fluoroscopy and percutaneous pinning may be more suitable for the J Surg Res 2022; 5 (2): 346-351 DOI: 10.26502/jsr.10020227 Journal of Surgery and Research Vol. 5 No. 2 June 2022. [ISSN 2640-1002] 347 treatment of these injuries. Level of Evidence: V
{"title":"Dorsal Second and Third Carpometacarpal Joint Dislocation: A Case Report","authors":"Charalampos Pitsilos, Theofylaktos Kyriakidis, Konstantinos Chitas, K. Ditsios","doi":"10.26502/jsr.10020227","DOIUrl":"https://doi.org/10.26502/jsr.10020227","url":null,"abstract":"Background Carpometacarpal joint dislocations are uncommon hand injuries occurring in less than 1% of hand trauma. On routine postero-anterior view, asymmetry at the carpometacarpal joints should raise suspicion of possible subtle injury, which can be confirmed with CT scan. In literature, there is a scarcity of published cases and the optional treatment is controversial. Case report A 28-year-old man presented with dorsal dislocation of the second and third carpometacarpal joints. After initial closed reduction, the computerized tomography scan revealed residual dorsal subluxation. The patient was successfully treated with closed reduction under fluoroscopy and percutaneous pinning. In the followup full range of motion was gained and there were no recurrence or signs of degenerative changes. Conclusion Closed reduction of traumatic dorsal second and third carpometacarpal dislocation may be associated with incomplete reduction. Reduction under fluoroscopy and percutaneous pinning may be more suitable for the J Surg Res 2022; 5 (2): 346-351 DOI: 10.26502/jsr.10020227 Journal of Surgery and Research Vol. 5 No. 2 June 2022. [ISSN 2640-1002] 347 treatment of these injuries. Level of Evidence: V","PeriodicalId":73961,"journal":{"name":"Journal of surgery and research","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86489437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laouali Laminou, O. Habou, M. Amadou, Abba Kaka Yakoura Hadjia, Amza Abdou
{"title":"Fraser syndrome: About A Case and Review of the Literature","authors":"Laouali Laminou, O. Habou, M. Amadou, Abba Kaka Yakoura Hadjia, Amza Abdou","doi":"10.26502/jsr.10020263","DOIUrl":"https://doi.org/10.26502/jsr.10020263","url":null,"abstract":"","PeriodicalId":73961,"journal":{"name":"Journal of surgery and research","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84268958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stevens Kelly Yvonne Roger, Müller Iris, Houterman Saskia, Weyers Steven, Schoot Benedictus
{"title":"External Validation of Models to Predict Unsuccessful Endometrial Ablation: A Retrospective Study","authors":"Stevens Kelly Yvonne Roger, Müller Iris, Houterman Saskia, Weyers Steven, Schoot Benedictus","doi":"10.26502/jsr.10020232","DOIUrl":"https://doi.org/10.26502/jsr.10020232","url":null,"abstract":"","PeriodicalId":73961,"journal":{"name":"Journal of surgery and research","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89961987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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