Anne Auperin

Institut de Cancérologie Gustave Roussy, Île-de-France, France

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Publications (129)618.68 Total impact

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    ABSTRACT: To evaluate the survival outcomes of percutaneous thermal ablation (RFA + microwaves) for patients presenting N0 non-small-cell lung cancer (NSCLC) ineligible for surgery.
    Cardiovascular and interventional radiology. 11/2014;
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    ABSTRACT: Purpose This study examines the role of 18F-labeled fluorodeoxyglucose positron emission tomography (FDG-PET) in the implementation of involved-node radiation therapy (INRT) in patients treated for clinical stages (CS) I/II supradiaphragmatic Hodgkin lymphoma (HL). Methods and Material Patients with untreated CS I/II HL enrolled in the randomized EORTC/LYSA/FIL Intergroup H10 trial and participating in a real-time prospective quality assurance program were prospectively included in this study. Data were electronically obtained from 18 French cancer centers. All patients underwent APET-computed tomography (PET-CT) and a post-chemotherapy planning CT scanning. The pre-chemotherapy gross tumor volume (GTV) and the postchemotherapy clinical target volume (CTV) were first delineated on CT only by the radiation oncologist. The planning PET was then co-registered, and the delineated volumes were jointly analyzed by the radiation oncologist and the nuclear medicine physician. Lymph nodes undetected on CT but FDG-avid were recorded, and the previously determined GTV and CTV were modified according to FDG-PET results. Results From March 2007 to February 2010, 135 patients were included in the study. PET-CT identified at least 1 additional FDG-avid lymph node in 95 of 135 patients (70.4%; 95% confidence interval [CI]: 61.9%-77.9%) and 1 additional lymph node area in 55 of 135 patients (40.7%; 95% CI: 32.4%-49.5%). The mean increases in the GTV and CTV were 8.8% and 7.1%, respectively. The systematic addition of PET to CT led to a CTV increase in 60% of the patients. Conclusions Pre-chemotherapy FDG-PET leads to significantly better INRT delineation without necessarily increasing radiation volumes.
    International journal of radiation oncology, biology, physics 08/2014; 89(5):1047–1052. · 4.59 Impact Factor
  • 07/2014; 384(9939):233.
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    ABSTRACT: To investigate predictive factors for liver necrosis after transcatheter arterial chemoembolization (TACE) of neuroendocrine liver metastases.
    Cardiovascular and interventional radiology. 05/2014;
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    ABSTRACT: Thermal ablation techniques (radiofrequency-ablation/cryotherapy) can be indicated with a curative intent. The success rate and prognostic factors for complete treatment were analysed.
    European radiology. 05/2014;
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    ABSTRACT: This study was designed to compare the accuracy of targeting and the radiation dose of bone biopsies performed either under fluoroscopic guidance using a cone-beam CT with real-time 3D image fusion software (FP-CBCT-guidance) or under conventional computed tomography guidance (CT-guidance). Sixty-eight consecutive patients with a bone lesion were prospectively included. The bone biopsies were scheduled under FP-CBCT-guidance or under CT-guidance according to operating room availability. Thirty-four patients underwent a bone biopsy under FP-CBCT and 34 under CT-guidance. We prospectively compared the two guidance modalities for their technical success, accuracy, puncture time, and pathological success rate. Patient and physician radiation doses also were compared. All biopsies were technically successful, with both guidance modalities. Accuracy was significantly better using FP-CBCT-guidance (3 and 5 mm respectively: p = 0.003). There was no significant difference in puncture time (32 and 31 min respectively, p = 0.51) nor in pathological results (88 and 88 % of pathological success respectively, p = 1). Patient radiation doses were significantly lower with FP-CBCT (45 vs. 136 mSv, p < 0.0001). The percentage of operators who received a dose higher than 0.001 mSv (dosimeter detection dose threshold) was lower with FP-CBCT than CT-guidance (27 vs. 59 %, p = 0.01). FP-CBCT-guidance for bone biopsy is accurate and reduces patient and operator radiation doses compared with CT-guidance.
    CardioVascular and Interventional Radiology 03/2014; · 2.09 Impact Factor
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    ABSTRACT: The peritoneum is one of the most frequent sites of recurrent gastric carcinoma after curative treatment, despite the administration of pre- and/or postoperative systemic chemotherapy. Indeed, the prognosis of peritoneal carcinomatosis from gastric carcinoma continues to be poor, with a median survival of less than one year with systemic chemotherapy. Whereas the prognosis of peritoneal carcinomatosis from colorectal cancer has changed with the development of locally administered hyperthermic intraperitoneal chemotherapy (HIPEC), survival results following carcinomatosis from gastric cancer remain disappointing, yielding a 5-year survival rate of less than 20%. Innovative surgical therapies such as intraperitoneal immunotherapy therefore need to be developed for the immediate postoperative period after complete cytoreductive surgery. In a recent randomised study, a clinical effect was obtained after intraperitoneal infusion of catumaxomab in patients with malignant ascites, notably from gastric carcinoma. Catumaxomab, a nonhumanized chimeric antibody, is characterized by its unique ability to bind to three different types of cells: tumour cells expressing the epithelial cell adhesion molecule (EpCAM), T lymphocytes (CD3) and also accessory cells (Fcgamma receptor). Because the peritoneum is an immunocompetent organ and up to 90% of gastric carcinomas express EpCAM, intraperitoneal infusion of catumaxomab after complete resection of all macroscopic disease (as defined in the treatment of carcinomatosis from colorectal cancer) could therefore efficiently treat microscopic residual disease.Methods/design: The aim of this randomized phase II study is to assess 2-year overall survival after complete resection of limited carcinomatosis synchronous with gastric carcinoma, followed by an intraperitoneal infusion of catumaxomab with different total doses administered in each of the 2 arms. Close monitoring of peri-opertive mortality, morbidity and early surgical re-intervention will be done with stopping rules. Besides this analysis, translational research will be conducted to determine immunological markers of catumaxomab efficacy and to correlate these markers with clinical efficacy.
    BMC Cancer 03/2014; 14(1):148. · 3.33 Impact Factor
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    ABSTRACT: Study Design. Retrospective assessment of risk factors using univariate and multivariate analysisObjective. To retrospectively evaluate risk factors for cement leakage (CL), including vascular (vCL) and cortical (cCL) leakages, in percutaneous vertebroplasty of spinal metastasis.Summary of Background Data. Complications of vertebroplasty for spine metastasis are rare but related to extra-vertebral cement leakage i.e. pulmonary embolism and medullary compression. Better understanding of the risk factors for vascular and cortical types of cement leakage is necessary in order to prevent these complications.Methods. 56 cancer patients (30 women, 26 men; age 56 ± 12 years), 81 vertebrae were treated in 58 sessions under fluoroscopy or CT fluoroscopy guidance. Leakage rates were reported. The following items were assessed for occurrence of CL, vCL and cCL: primary tumour site, prior radiotherapy or local tumour ablation or embolization, appearance on CT, cortical osteolytic destruction, vertebral collapse, operator's experience, guidance modality, cement filling.Results. CL, vCL and cCL rates were 53, 25 and 32%. History of prior treatment correlated with a decrease in CL (p = 0.018). vCL decreased when lung was the primary tumour site (p = 0.036), in osteolytic vertebrae (p = 0.033) or when there was a vertebral collapse (p = 0.037). cCL correlated with operator's experience (p = 0.021) and vertebral collapse (p<0.001). Superior discal cCL correlated with superior endplate cortical destruction (p = 0.012). While History of prior treatment appeared as an independent protective factor (OR = 0.24, 95% CI, O.087 - 0.7, p = 0.001), vertebral collapse was isolated as a risk factor for cCL (OR = 32, 95% CI, 6.7 - 161, p = 0.001).Conclusion. Risk factors for cCL and vCL are distinct. Vertebral collapse and cortical destruction are risk factors for cCL. History of prior treatment is a protective factor for CL.
    Spine 12/2013; · 2.16 Impact Factor
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    ABSTRACT: Beyond cancer-cell intrinsic factors, the immune status of the host has a prognostic impact on cancer patients and influences the effects of conventional chemotherapies. Metastatic melanoma (MM) is intrinsically immunogenic, thereby facilitating the search for immune biomarkers of clinical responses to cytotoxic agents. Here we show that a multi-tyrosine kinase inhibitor, sorafenib, upregulates IL-15Rα in vitro and in vivo in melanoma patients, and in conjunction with NKG2D ligands, contributes to the Th1 polarization and accumulation of peripheral CD4(+)NKG2D(+)T cells. Hence, the increase of blood CD4(+)NKG2D(+)T cells after two cycles of sorafenib (combined with temozolomide) was associated with prolonged survival in a prospective phase 1/2 trial enrolling 63 MM patients who did not receive vemurafenib nor immune checkpoint blocking antibodies. In contrast, in MM treated with classical treatment modalities, this CD4(+)NKG2D(+) subset failed to correlate with prognosis. These findings indicate that sorafenib may be used as an "adjuvant" molecule capable of inducing or restoring IL-15Rα/IL-15 in tumors expressing MICA/B and on circulating monocytes of responding patients, hereby contributing to the bioactivity of NKG2D(+) Th1 cells.
    Cancer Research 11/2013; · 9.28 Impact Factor
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    ABSTRACT: Head and neck cancers are the fifth among the most common cancers in France. Two thirds of cases occur at an advanced stage. For advanced disease, progression-free survival, despite undeniable progress, remains below 50% at three years. The last 20 years have been marked by the necessity to identify situations where less intense surgery and/or radiotherapy and/or chemotherapy is possible without jeopardizing the prognosis, and situations where a therapeutic intensification is necessary and results in a gain in survival while better preserving function with less toxicity. French cooperative groups gathering radiation oncologists (GORTEC), surgeons (GETTEC) and medical oncologists or physicians involved in the management of systemic treatments in head and neck cancers (GERCOR) are now belonging to the INCa-labelled Intergroup ORL to deal with the challenges of head and neck cancers.
    Bulletin du cancer 10/2013; · 0.61 Impact Factor
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    ABSTRACT: HPV-related oropharyngeal squamous cell carcinomas clearly represent a growing entity in the head and neck with distinct carcinogenesis, clinico-pathological presentation and survival profile. We aimed to compare the HPV prevalence rates and clinico-pathological correlations obtained with three distinct commonly used HPV detection methods. p16-immunohistochemistry (IHC), HPV DNA viral load by real-time PCR (qPCR), and HPV genotyping by a reverse hybridization-based line probe assay (INNO-LiPA) were performed on pretreatment formalin-fixed paraffin-embedded tumor samples from 46 patients treated for single primary oropharyngeal carcinomas. Twenty-eight patients (61%) had a p16 overexpression in IHC. Twenty-nine patients (63%) harbored HPV DNA on qPCR. Thirty-four patients (74%) harbored HPV DNA on INNO-LiPA. The concordance analysis revealed a good agreement between both HPV DNA detection methods (κ=0.65); when both tests were positive, the depicted HPV subtypes were always concordant (HPV16 in 27 cases, HPV18 in 1 case). Agreement was moderate between IHC and qPCR (κ=0.59) and fair between IHC and INNO-LiPA (κ=0.22). Certain highly sensitive methods are able to detect the mere presence of HPV without any carcinogenetic involvement while other more specific tests provide proof of viral transcriptional activity and thus evidence of clinically relevant infections. The use of a stepwise approach allows reducing false positives; p16-immunostaining seems to be an excellent screening test and in situ hybridization may overcome some of the PCR limitations.
    American journal of otolaryngology 10/2013; · 0.77 Impact Factor
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    ABSTRACT: Describe the epidemiology, clinical profiles and outcomes associated with head and neck (H&N) involvement in children/adolescents with B-cell non-Hodgkin lymphoma (B-NHL). Analysis of children/adolescents with H&N B-NHL prospectively enrolled in the SFOP LMB-89 trial (July 1989-June 1996). One hundred and twelve of 561 patients (20%) had H&N involvement. The mean age of the patients was 8.4 years. Murphy staging differed between the H&N patients and the others (P < 0.0001): 9% versus 5% of the patients presented with stage I disease, 36% versus 11% presented with stage II disease, 12% versus 59% presented with stage III disease, 17% versus 10% with stage IV disease and 27% versus 16% with B-AL. Twenty-nine H&N patients (26%) had CNS involvement at diagnosis versus 8.5% in the group without H&N involvement (P < 0.0001). Patients were treated according to the LMB89 protocol: 3 H&N patients were allocated to group A, 70 to group B and 39 to group C. Ninety-seven percent of H&N patients achieved CR and event-free and overall survival at 4 years was 95.5% (5 deaths in patients with CNS disease). On multivariate analysis, EFS was significantly better in H&N patients than in non-H&N patients (P = 0.021), but not OS (P = 0.11). The H&N site is the second most common location for B-NHL at diagnosis and is more frequently associated with disseminated disease and CNS involvement than other sites. However, outcomes are no worse for these patients than for the rest of the population. Pediatr Blood Cancer © 2013 Wiley Periodicals, Inc.
    Pediatric Blood & Cancer 08/2013; · 2.35 Impact Factor
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    ABSTRACT: To prospectively compare electromagnetic needle tracking (EMT) and freehand ultrasound (US)-guided liver biopsies. Among 60 consecutive US-guided liver biopsies performed by staff radiologists (senior operators) and residents (junior operators), 30 were performed freehand and 30 with EMT. Needle placement time, numbers of needle punctures and pullbacks, and subjective scores of procedure difficulty were compared by χ(2) or Student t test. Diagnostic success rates, defined by the procurement of an adequate histopathologic specimen, were 96.6% for freehand biopsy and 100% with EMT. Needle placement time was significantly lower for EMT (mean ± standard deviation, 45.8 s ± 48.1) than for freehand procedures (143.2 s ± 122.1; P < .01). In the freehand group, needle placement times were 179.6 seconds ± 133.3 for junior operators and 106.8 seconds ± 101.3 for senior operators (P = .15). In the EMT group, needle placement times were 49.2 seconds ± 55 for junior operators and 42.5 seconds ± 41.2 for senior operators (P = .53). The number of needle pullbacks was significantly lower for senior operators (1.2 ± 0.80) compared with junior operators (2.4 ± 1.4) in the freehand group (P = .01), with no significant difference (junior, 0.47 ± 0.92; senior, 0.67 ± 0.72; P = .24) in the EMT group. The postprocedural difficulty score was lower in the EMT group (1.5 ± 0.7) than in the freehand group (2.1 ± 1.1; P = .02). Needle placement time and number of needle pullbacks were lower in the EMT group, even after taking into account tumor size and depth and operator experience. The EMT procedure shortens needle placement time and reduces the number of needle pullbacks needed for redirection, regardless of operator experience.
    Journal of vascular and interventional radiology: JVIR 07/2013; · 1.81 Impact Factor
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    ABSTRACT: Background:The aim of our study was to evaluate the prognostic role of immunological microenvironnement in stage II-III CRC patients.Methods:We constructed a tissue microarray from 196 consecutive patients with stage II-III CRC and compared CD3, CD4, CD8, CD57, CD68, CXCL9/MIG, CXCL13, and PPARγ immunoreactivity in tumour samples and their matched non-tumour tissue. We assessed their association with relapse-free survival (RFS; primary endpoint) and overall survival (OS) in multivariate Cox models.Results:Low densities of CD57+ and CD68+ tumour-infiltrating cells (TIC) independently predicted worse outcomes. A prognostic score combining CD57 (+, > vs -, 2 cells per spot) and CD68 (+, >0 vs -, =0 cells per spot) TIC density discriminated CRC patients at low (CD68+/CD57+), intermediate (CD68+/CD57-), or high (CD68-/CD57-) risk, with hazard ratios for the intermediate-risk and high-risk groups of 2.7 (95% confidence interval (CI): 1.3-5.8) and 9.0 (3.2-25.4) for RFS, and 2.5 (1.2-5.1) and 10.6 (3.8-29.2) for OS, respectively, as compared with the low-risk group. Corresponding 5-year survival rates (95% CI) in the low-, moderate- and high-risk groups were 84% (71-91), 65% (54-74), and 12% (2-47), respectively, for RFS, and 91% (80-96), 76% (66-84), and 25% (7-59), respectively, for OS.Conclusion:Tumour CD57+ and CD68+ TIC density assessment independently predicts survival in patients with stage II-III CRC. If validated, our score based on a quick, inexpensive, and well-established method such as point counting on diagnostic tissue sections could be used routinely as a prognostic tool in CRC patients.British Journal of Cancer advance online publication, 18 July 2013; doi:10.1038/bjc.2013.362
    British Journal of Cancer 07/2013; · 5.08 Impact Factor
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    ABSTRACT: BACKGROUND: Human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (SCC) is associated with favorable survival. The purpose of this study was to evaluate the prevalence and prognostic significance of the HPV infection through both the p16 expression status and the oncogenic HPV DNA viral load. METHODS: A retrospective chart review was conducted on all patients treated for oropharyngeal SCC between January 2007 and June 2009. P16 expression status by immunohistochemistry and HPV DNA viral load by quantitative polymerase chain reaction (qPCR) were evaluated on routine pretreatment tumor samples. RESULTS: One hundred thirty-three patients (94 men and 39 women) were included in the study. Mean age was 59 years. One hundred twenty-two lesions (92%) were localized to lymphoid areas. Sixty-seven patients (50%) were p16+, and 87 patients (65%) harbored HPV DNA. The p16+/HPV DNA+ profile (48%) was associated with the most favorable prognosis. HPV16 was responsible for the majority of the infections (89%). CONCLUSION: HPV is common among oropharyngeal SCC in France, and acts as an independent prognostic factor. © 2013 Wiley Periodicals, Inc. Head Neck, 2013.
    Head & Neck 06/2013; · 2.83 Impact Factor
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    ABSTRACT: BACKGROUND: Sinonasal cancers are rare and associated with a poor prognosis. The aim of this study was to report our experience and analyze the risk factors for oncologic failures. METHODS: A retrospective review of 156 consecutive patients treated with curative intent for sinonasal malignancy between 1995 and 2005 at tertiary cancer center was performed. Demographic, clinical, morphological and pathological parameters were correlated with oncologic outcomes. RESULTS: Complete response was obtained for 134 patients. Sixty-eight patients relapsed among which 51 had local recurrence. Nine of these 51 patients (17.6%) underwent successful salvage therapy. Five years local failure and overall survival rates were 50.0% and 61.1%. Maxillary sinus tumors, intracranial invasion and N>0 stage at initial diagnosis were significantly and independently associated with local failure and survival in multivariant analysis. CONCLUSION: Local control following initial treatment is primordial to optimizing outcomes due to the poor results of salvage therapy. Head Neck, 2013.
    Head & Neck 04/2013; · 2.83 Impact Factor
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    ABSTRACT: PURPOSE: This study was designed to assess the role of radiofrequency ablation (RFA) in the multimodality management of gastrointestinal stromal tumors (GIST) in patients undergoing targeted tyrosine kinase inhibitor therapy (TKI) for liver metastases. METHODS: Outcomes of 17 patients who underwent liver RFA for 27 metastatic GIST after TKI therapy, from January 2004 to March 2012, were retrospectively analyzed. Mean maximum tumor diameter was 2.5 ± 1 cm (range 0.9-4.5 cm). In seven patients (group A), RFA of all residual tumors was performed, with curative intent, and TKI therapy was discontinued. In five patients (group B), RFA of all residual tumors was performed upon achieving the best morphological response with TKI therapy, which was maintained after RFA. In another five patients (group C), RFA was performed on individual liver metastases which were progressive under TKI therapy. RESULTS: All 27 targeted tumors were completely ablated, without local recurrence during the mean follow-up period of 49 months. No major complications occurred. Two minor complications were reported (11 %). Only two patients (both in group C) died at 20 and 48 months. Two-year progression-free survival (PFS) after RFA was 29 % in group A, 75 % in group B, and 20 % in group C. CONCLUSIONS: RFA in patients, previously treated with TKI, is feasible and safe. Our data suggest that RFA is a useful therapeutic option in patients with metastatic GIST and should be performed at the time of best clinical response with patient maintained under TKI after the procedure.
    CardioVascular and Interventional Radiology 04/2013; · 2.09 Impact Factor
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    ABSTRACT: Mediastinal large B-cell lymphoma (MLBL) represents only 2% of mature B-cell non-Hodgkin lymphoma (B-NHL) in patients ≤18 years of age. Gene expression profiling demonstrates that MLBL in adults more closely resembles classical Hodgkin lymphoma than it does diffuse large B-cell lymphoma (DLBCL). We analyzed data from childhood and adolescent patients with Stage III MLBL (N=42) and non MLBL DLBCL (N=69) treated with Group B therapy on the FAB/LMB 96 study. Demographics of MLBL patients: M/F: 26/16; median age 15.7 yrs (12.5-19.7); LDH <2 vs. ≥2 ULN: 23:19. Six MLBL patients (14%) had <20% response to initial COP-therapy. Central pathology classification revealed approximately 50% with classical features of primary mediastinal B-cell lymphoma (PMBL). Five-year event-free survival (EFS) for Stage III MLBL and non-MLBL DLBCL groups were 66% (95% CI: 49-78%) and 85% (95% CI: 71-92%), respectively, p<0.001 (14%). The 5-year overall survival (OS) in the 42 MLBL patients was 73% (95% CI: 56-84%). MLBL in adolescent patients is associated with significantly inferior EFS compared with stage III non-MLBL DLBCL and can be of multiple histologies. Alternate treatment strategies should be investigated in the future taking into account both adult MLBL approaches and more recent biological findings in adult MLBL.
    Blood 11/2012; · 9.78 Impact Factor
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    ABSTRACT: PURPOSE: Despite high response rates, feasibility of hepatic artery infusion (HAI) is impaired by frequent malfunctions of surgically implanted catheters (SIC). The aim of this study is to analyze the incidence and the types of malfunctions affecting the SIC and the success rate of interventional revisions (IR) in restoring patency to these catheters. METHODS: In a single center, 101 consecutive patients treated with HAI through SIC over 10 years were retrospectively reviewed. The studied group (+IR) was composed of patients referred to interventional radiology for repair of catheter malfunctions. The overall patency of catheters in the +IR group was compared with the overall patency of a control group composed of patients without catheter malfunction (no IR). RESULTS: 86 patients were included with no difference in baseline characteristics between +IR (n = 40) and no IR (n = 46). There were no significant differences in overall patency between both groups (8.4 courses vs. 8.4 courses, p = 0.99). Furthermore, with an overall success rate of 72.5%, IR significantly improved the mean primary patency from 2.4 to 8.4 courses (p < 0.0001) in the +IR group. CONCLUSION: By restoring a normal patency to SIC affected by different types of malfunctions, IR improves feasibility of HAI.
    Surgical Oncology 10/2012; · 2.14 Impact Factor
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    ABSTRACT: BACKGROUND: Sinonasal cancers are rare and no high-level evidence exists to determine their optimal management. Prophylactic neck treatment issue remains controversial. The aim of this study was to analyze the pattern of neck failure and to identify any prognostic factors that may influence neck control. METHODS: A retrospective review of 155 consecutive patients treated for sinonasal malignancy, without prophylactic neck treatment, between 1995 and 2005 at tertiary cancer center was performed. Demographic, clinical, morphological and pathological parameters were correlated with oncologic outcomes. RESULTS: Eight out of 155 patients (5%) presented initially with neck node metastasis. Complete remission was obtained for 133 patients after treatment completion. During follow up, 16 out of 133 patients (12%) were affected with regional recurrence. Neck failure occurred in 8 out of 51 patients with local failure and in 8 out of 82 patients locally controlled. Isolated nodal failure was observed in 5 patients initially cN0 out of 133 (3.8%) representing 7.3% of all recurrences and 3 of them underwent successful salvage therapy. None of the tested factors were significantly associated with neck control (p>0.05). Lymph node at diagnosis time was significantly and independently associated with poor survival (p=0.0012). CONCLUSION: Isolated neck relapse, when local control is achieved, is rare and salvage treatment is effective. Routine prophylactic neck treatment has little interest. However, this approach could be profitable to few selected patients, who remain to be defined. Further investigations are needed.
    Oral Oncology 10/2012; · 2.70 Impact Factor

Publication Stats

3k Citations
618.68 Total Impact Points


  • 2002–2014
    • Institut de Cancérologie Gustave Roussy
      • • Department of Radiotherapy
      • • Department of Medical Imaging
      Île-de-France, France
  • 2012
    • Université Paris-Sud 11
      Orsay, Île-de-France, France
    • New York Medical College
      New York City, New York, United States
  • 2010
    • The Christie NHS Foundation Trust
      • Clinical Oncology
      Manchester, ENG, United Kingdom
  • 2008
    • Université Paris 13 Nord
      Île-de-France, France
    • Sheffield Children's NHS Foundation Trust
      Sheffield, England, United Kingdom
  • 2007
    • Columbia University
      New York City, New York, United States