Cyril Touboul

• MD, PhD
• Chef de service at Hôpital Tenon (Hôpitaux Universitaires Est Parisien)

To define the risk factors of post-operative voiding dysfunction according to the type of surgical procedure performed. A systematic review through PubMed, the Cochrane Library, and Web of Science databases was performed. The Medical Subject Headings terms aimed for English articles about colorectal endometriosis surgery and voiding dysfunction pub...

Surgery for deep endometriosis with colorectal involvement is an option after medical treatment failure. Over the past decade, robotic laparoscopy has emerged as an alternative to conventional laparoscopy. We aimed to evaluate surgical outcomes of robotic versus conventional laparoscopy for discoid excision and segmental resection. From 2019 to 202...

In light of the rising number of patients referred for magnetic resonance imaging (MRI) due to suspected endometriosis and the high expectations of these patients, there is a need for new imaging guidelines to optimally protocol and indicate MRI and transvaginal ultrasonography (TVUS) examinations. This is crucial for accurately addressing the inqu...

Eighteen to 35% of adnexal masses remain non-classified following ultrasonography, leading to unnecessary surgeries and inappropriate management. This finding led to the conclusion that ultrasonography was insufficient to accurately assess adnexal masses and that a standardized MRI criteria could improve these patients’ management. The aim of this...

Objective To evaluate the outcomes associated with each therapeutic option for patients diagnosed with interstitial pregnancy (IP). Methods We conducted a multicentric retrospective cohort study within the departments of Gynecology and Obstetrics involved in the Francogent research group. Women treated for an interstitial pregnancy between January...

Objectives Obesity is known to be both a major risk factor for endometrial cancer and associated with surgical complexity. Therefore, the management of patients with obesity is a challenge for surgeons and oncologists. The aim of this study is to assess the adherence to European Society of Gynaecological Oncology (ESGO) guidelines in morbidly obese...

Objectives: We studied a post operative classification of surgical complexity in endometriosis. Study design: Retrospective monocentric observational study was conducted between January 2001 to December 2019 and included 764 women with DE that underwent surgery. We retrospectively graded surgical complexity through operative reports according to...

BACKGROUND: The discovery of a saliva-based micro–ribonucleic acid (miRNA) signature for endometriosis in 2022 opened up new perspectives for early and noninvasive diagnosis of the disease. The 109-miRNA saliva signature is the product of miRNA biomarkers and artificial intelligence (AI) modeling. We designed a multicenter study to provide external...

e15156 Background: Oncotype DX recurrence score is a predictive assay clinically used to estimate the risk of distant recurrence for patients with hormone receptor positive (HR+) early breast cancer (EBC) and to predict the benefit of adjuvant chemotherapy, based on molecular factors of the tumor itself. This retrospective study examines the factor...

Background The aim of this study was to analyze postoperative consumption of analgesics during hospitalization following colorectal surgery for endometriosis. Methods We conducted a retrospective study at Tenon University Hospital, Paris, France from February 2019 to December 2021. Results One hundred sixty-two patients underwent colorectal surge...

Objective To compare survival and morbidity rates between primary cytoreductive surgery (pCRS) and interval cytoreductive surgery (iCRS) for epithelial ovarian cancer (EOC), using a propensity score. Design We conducted a propensity score‐matched cohort study, using data from the FRANCOGYN cohort. Setting Retrospective, multicentre study of data...

Cervical cancer (CC) is the fourth cancer in women and is the leading cause of cancer death in 42 countries. Lymph node metastasis is a determinant prognostic factor, as underlined in the latest FIGO classification. However, assessment of lymph node status remains difficult, despite the progress of imaging such as PET-CT and MRI. In the specific se...

Importance: Preoperative mapping of deep pelvic endometriosis (DPE) is crucial as surgery can be complex and the quality of preoperative information is key. Objective: To evaluate the Deep Pelvic Endometriosis Index (dPEI) magnetic resonance imaging (MRI) score in a multicenter cohort. Design, setting, and participants: In this cohort study, t...

Purpose: To retrospectively evaluate the pain-free survival of percutaneous image-guided cryoablation of symptomatic extraperitoneal endometriosis (EE). Material and methods: From 2017 to 2022, cryoablation of EE was performed at a single institution for 42 consecutive patients (median age: 37 years [interquartile range: 33 - 39.5]) on a total o...

Simple Summary Ovarian cancer is the most lethal gynecologic cancer since it is often diagnosed at advanced stages. Current tools for diagnosis are currently insufficient and include physical examination, ultrasound and pelvic magnetic resonance imaging, as well as algorithms combining thoraco-abdomino-pelvic scans and blood markers. In this contex...

Purpose: The purpose of this retrospective study was to demonstrate the validity of early enhancement criteria on ultrafast magnetic resonance imaging (MRI) sequence to predict malignancy in a large population, and the benefit of diffusion-weighted imaging (DWI) to improve the performance of breast MRI. Material and methods: Women who underwent...

Simple Summary The identification of prognostic factors is important to improve the management of patients with ovarian cancer (OC). The staging classification of OC was revised in 2014 and 2018 by the FIGO (International Federation of Gynecology and Obstetrics) Gynecological Oncology Committee and dichotomizes stages IV into stage IVA and IVB. The...

Introduction: We aimed to describe management and survival of patients with endometrial cancer (EC) ≥80 years to identify poor prognosis criteria. Methods: We collected clinical, histologic, surgical and follow-up data for patients with EC ≥ 80 years included in a multicenter French cohort (FRANCOGYN) who underwent primary surgical treatment fro...

Objective: To evaluate a saliva diagnostic test (Endotest®) for endometriosis compared with the conventional algorithm. Design: A cost-effectiveness analysis with a decision-tree model based on literature data SETTING: France. Population: Women with chronic pelvic pain. Methods: Strategy I represents the French algorithm as the comparator. F...

Objectives: To assess the ability of Physical Examination (PE), Transvaginal Ultrasonography (TVUS), and Magnetic Resonance Imaging (MRI) alone and combined to diagnose Deep Infiltrating Endometriosis (DIE). Design: We retrospectively queried our pelvic MRI database to identify women who underwent PE, TVUS, and pelvic MRI for DIE up to 12 months...

Ovarian cancer (OC) is a heterogeneous disease characterized by its late diagnosis (FIGO stages III and IV) and the importance of abdominal metastases often observed at diagnosis. Detached ovarian cancer cells (OCCs) float in ascites and form multicellular spheroids. Here, we developed endothelial cell (EC)-based 3D spheroids to better represent in...

Breast cancer in women is the second most common cancer and the fifth leading cause of cancer death worldwide. Although earlier diagnosis and detection of breast cancer has resulted in lower mortality rates, further advances in prevention, detection, and treatment are needed to improve outcomes and survival for women with breast cancer as well as t...

Purpose The purpose of this consensus article was to develop guidelines by a focused panel of experts to elaborate a lexicon of image interpretation, and a standardized region-based reporting of deep infiltrating endometriosis (DIE) with magnetic resonance imaging (MRI). Materials and methods Evidence-based data and expert opinion were combined us...

Introduction/Background Evaluation of the management by first brachytherapy followed by enlarged hysterectomy (Wertheim type) compared to enlarged surgery alone (Wertheim type) for the treatment of IB2 cervical cancer. Methodology Data from women with histologically proven FIGO stage IB2 cervical cancer treated between April 1996 and December 2016...

Introduction/Background While obesity is associated with a higher risk of mortality in several cancers, this relationship is equivocal in ovarian cancer. Some studies show a significant impact of this comorbidity on both incidence and survival. However, other studies do not show a significant difference in survival and recurrence-free survival. The...

Objective: The aim of the present study was to evaluate evolution and prognosis of mucinous ovarian carcinomas (mOC), with respect to the two invasive patterns: expansile and infiltrative invasion. Methods: This was a descriptive, retrospective, multicenter study conducted in 13 French centres from 1st January 2001 to 31st December 2019. All patien...

Objective To evaluate the potential impact of the latest ESGO guidelines for endometrial cancer with molecular classification on the management strategy in a French cohort. Methods All patients treated between January 1st, 2014 and December 31, 2020 for an endometrial cancer at the Centre Hospitalier Intercommunal de Créteil (CHIC, FRANCE) were se...

Research question : We aimed to design and validate a saliva-based miRNA signature for endometriosis-associated infertility by analyzing the human miRNome. Design The prospective ENDOmiARN study (NCT04728152) included 200 saliva samples obtained between January and June 2021 from women with pelvic pain suggestive of endometriosis. All patients und...

Objective Parametrial involvement (PI) in endometriosis is poorly defined resulting in an underestimation of its impact during surgical excision. The aim of our study was to assess the surgical complications associated with parametrectomy during surgery for endometriosis. Our secondary objective was to compare the surgical complications rates of a...

Endometriosis, defined by the presence of endometrium-like tissue outside the uterus, affects 2–10% of the female population, i.e., around 190 million women, worldwide. The aim of the prospective ENDO-miRNA study was to develop a bioinformatics approach for microRNA-sequencing analysis of 200 saliva samples for miRNAome expression and to test its d...

Because of the peak incidence of cervical cancer between the ages of 35 and 44 and the increasing age of first pregnancy, the issue of fertility preservation in cases of early-stage cervical cancer in women in this reproductive age category arises. Early-stage cervical cancer patients have a good prognosis and are surgically treated in cases of mil...

Objective To assess the surgical management and survival of severely obese patients with high-risk endometrial cancer. Materials and Methods Data from 269 patients with high-risk endometrial cancer who were treated between 2001 and 2018 were collected from a multicenter database (11 centers). We classified the patients according to their BMI and c...

The aim of our study was to describe the bioinformatics approach to analyze miRNome with Next Generation Sequencing (NGS) of 200 plasma samples from patients with and without endometriosis. Patients were prospectively included in the ENDO-miRNA study that selected patients with pelvic pain suggestive of endometriosis. miRNA sequencing was performed...

Background This study compares morbidity and mortality associated with retroperitoneal and transperitoneal para-aortic lymphadenectomy (PAAL) for pretherapeutic nodal staging of locally advanced cervical cancers (FIGO IB3–IVA). Methods Pre-, per- and postoperative data of patients treated for locally advanced stage cervical cancer between 1999 and...

Results from studies reporting the optimal stimulation duration of IVF-ICSI cycles are inconsistent. The aim of this study was to determine whether, in the presence of early ovulation-triggering criteria, prolonged ovarian stimulation modified the chances of a live birth. This cross-sectional study included 312 women presenting triggering criteria...

Our objective was to evaluate postoperative pain and opioid consumption in patients undergoing hysterectomy by low-impact laparoscopy and compare these parameters with conventional laparoscopy. We conducted a prospective study in two French gynecological surgery departments from May 2017 to January 2018. The primary endpoint was the intensity of po...

Endometriosis, characterized by endometrial-like tissue outside the uterus, is thought to affect 2–10% of women of reproductive age: representing about 190 million women worldwide. Numerous studies have evaluated the diagnostic value of blood biomarkers but with disappointing results. Thus, the gold standard for diagnosing endometriosis remains lap...

Background & Aims Predicting the risk of early limiting toxicity (ELT) is major challenge for the clinician seeking an effective, safe treatment for older patients with cancer. The Cancer and Aging Research Group (CARG) and CRASH (Chemotherapy Risk Assessment Scale for High-Age Patients) toxicity scores were designed to predict chemotherapy-related...

Background Between 8% and 56% of pure ductal carcinoma in situ are upstaged to microinvasive or invasive carcinoma on definitive pathological examination. The first objective of this study was to perform a comprehensive review of the literature on factors associated with increased risk of pre-operative underestimation. The second objective was to p...

Summary background data Vulvar carcinoma is a rare disease accounting for 3%–5% of all gynaecological cancers. Although surgery is the standard treatment at an early stage, the outcomes are highly correlated with clear resection margins. Therefore, surgical defects can be important and require reconstruction. The aim of this study was to evaluate v...

Background: Our objective was to evaluate surgical outcomes of robotic compared to conventional laparoscopy for colorectal surgery for endometriosis. Methods: We conducted a prospective cohort study comparing robotic to conventional laparoscopy for colorectal endometriosis during an 18-month period. We included 61 patients in the robotic group a...

Background: Endometriosis diagnosis constitutes a considerable economic burden for the healthcare system with diagnostic tools often inconclusive with insufficient accuracy. We sought to analyze the human miRNAome to define a saliva-based diagnostic miRNA signature for endometriosis. Methods: We performed a prospective ENDO-miRNA study involving...

Endometriosis—a systemic and chronic condition occurring in women of childbearing age—is a highly enigmatic disease with unresolved questions. While multiple biomarkers, genomic analysis, questionnaires, and imaging techniques have been advocated as screening and triage tests for endometriosis to replace diagnostic laparoscopy, none have been imple...

The pathophysiology of endometriosis remains poorly understood. The aim of the present study was to investigate functions and pathways associated with the various miRNAs differentially expressed in patients with endometriosis. Plasma samples of the 200 patients from the prospective “ENDO-miRNA” study were analyzed and all known human miRNAs were se...

Introduction Triple-negative (TN) breast cancer represents one third of pregnancy-associated breast cancers (PABC). The aims of the current study were to describe oncological and obstetrical outcomes of patients with TN-PABC and to compare their prognosis with TN-non-PABC patients using a propensity score. Materials and methods Between January 200...

Background The presence of lymphovascular space invasion (LVSI) is not yet included in international recommendations neither as a prognostic factor nor as a parameter for the decision to use adjuvant chemotherapy in FIGO stage I/IIa ovarian cancer (OC).Objective This study set out to evaluate the impact of LVSI on Overall Survival (OS) and Recurren...

Background The incidence of pregnancy-associated cancers has been increasing for decades. (18F)-FDG Positron Emission Tomography (PET)/Computed Tomography (CT) imaging has become a golden standard in the staging of many malignant diseases. The aims of the current study were to evaluate the feasibility, safety and impact of (18F)-FDG PET/CT performe...

Introduction : Up to 30% of couples may face secondary infertility. The impact of ectopic pregnancy, spontaneous abortion, pregnancy termination or live birth with caesarean section may impair further fertility in different ways. However, secondary infertility after physiological vaginal life childbirth has been little studied. The aim of this stud...

Objective The aim of this study was to develop a new diagnostic tool to predict lymph node metastasis (LNM) in patients with advanced epithelial ovarian cancer undergoing primary cytoreductive surgery. Materials and method The FRANCOGYN group’s multicenter retrospective ovarian cancer cohort furnished the patient population on which we developed a...

Objective The primary objective of the study was to validate the European Society for Medical Oncology (ESMO)–European Society of Gynecologic Oncology (ESGO) ovarian cancer guideline as a method of assessing quality of care, and to identify patient characteristics predictive of non-adherence to European guideline care. The secondary objectives were...

Background The aim of this study was to evaluate the impact of Lymphovascular Space Invasion (LVSI) on Overall Survival (OS) and Recurrence-Free Survival (RFS) in patients managed for high-grade serous epithelial ovarian cancer (HGSOC). Materials and methods Retrospective multicenter study by the FRANCOGYN research group between January 2001 and D...

Objectif Décrire la procédure de l’hystérectomie extrafasciale par laparoscopie pour éviter les lésions de l’uretère. Méthodes Les données ont été obtenues à partir de : – l’étude anatomique de 10 cadavres féminins frais pour mesurer la distance entre le croisement de l’uretère et de l’artère utérine et le niveau de section de la branche ascendant...

Research Question Does mild COVID-19 infection impact the ovarian reserve of women undergoing an Assisted Reproductive Technology (ART) protocol? Design We conducted a prospective observational study between June and December 2020. We included women managed in our ART unit for fertility issues by in vitro fecundation / intracytoplasmic sperm injec...

Resume Objectif : Déterminer l’intérêt ou non de la réalisation de certains gestes prophylactiques en association à une procédure chirurgicale gynécologique. Conception : Un comité de consensus de 19 experts a été constitué. Une politique de déclaration et de suivi des liens d’intérêts a été appliquée et respectée durant tout le processus de réalis...

The molecular responses to hormonal stimuli in the endometrium are modulated at the transcriptional and post-transcriptional stages. Any imbalance in cellular and molecular endometrial homeostasis may lead to gynecological disorders. MicroRNAs (miRNAs) are involved in a wide variety of physiological mechanisms and their expression patterns in the e...

Objective To provide guidelines from the French College of Obstetricians and Gynecologists (CNGOF), based on the best currently available evidence, for the prophylactic procedures associated with gynecological surgery for benign disease such as superficial endometriosis lesions and adhesions. Methods The CNGOF has decided to adopt the AGREE II and...

Background: The aim of this study was to evaluate the impact of lymphovascular space invasion (LVSI) on overall survival (OS) and recurrence-free survival (RFS) in patients managed for stage I-IIa clear cell carcinoma, mucinous, low-grade serous and low-grade endometrioid ovarian cancer MATERIAL AND METHODS: Retrospective multicentre study of the...

Background: Borderline ovarian tumors (BOTs) are tumors with a favorable prognosis but whose management by consensus is essential to limit the risk of invasive recurrence. This study aimed to conduct an inventory of surgical practices for BOT in France and to evaluate the conformity of the treatment according to the current French guidelines. Met...

To determine if the time-to-chemotherapy (TTC) after primary macroscopic complete cytoreductive surgery (CRS) influences recurrence-free survival (RFS) and overall survival (OS) in patients with epithelial ovarian cancer (EOC). We conducted an observational multicenter retrospective cohort analysis of women with EOC treated from September 2006 to N...

Pelvic and para-aortic lymphadenectomy are associated with increased risk of complications and are responsible for a significant proportion of morbidity and impaired quality of life following surgical management of pelvic malignancies. Sentinel lymph node (SLN) was developed as a trade-off between systematic and no lymphadenectomy to limit morbidit...