Pick Topic
Review Topic
List Experts
Examine Expert
Save Expert
  Site Guide ··   
Pancreatic Neoplasms: HELP
Articles by Romain Coriat
Based on 27 articles published since 2010
(Why 27 articles?)
||||

Between 2010 and 2020, R. Coriat wrote the following 27 articles about Pancreatic Neoplasms.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Editorial [Cystic lesion of the pancreas… The epidemic in yet not under control!] 2019

Gaujoux, Sébastien / Coriat, Romain. ·AP-HP, hôpital Cochin, service de chirurgie pancréatique et endocrinienne, 75014 Paris, France; Université Paris Descartes, 75006 Paris, France. Electronic address: sebastien.gaujoux@aphp.fr. · Université Paris Descartes, 75006 Paris, France; AP-HP, hôpital Cochin, service de gastroentérologie, d'endoscopie et d'oncologie digestive, 75014 Paris, France. ·Presse Med · Pubmed #31303373.

ABSTRACT: -- No abstract --

2 Review Surgical management of pancreatic neuroendocrine tumors: an introduction. 2019

Hain, Elisabeth / Sindayigaya, Rémy / Fawaz, Jade / Gharios, Joseph / Bouteloup, Gaspard / Soyer, Philippe / Bertherat, Jérôme / Prat, Frédéric / Terris, Benoit / Coriat, Romain / Gaujoux, Sébastien. ·Department of Digestive, Hepato-biliary and Endocrine Surgery, Cochin Hospital, APHP, Paris, France. · Facultéde Médecine Paris Descartes, Université Paris Descartes, Sorbonne Paris Cité, Paris, France. · Department of Radiology, Cochin Hospital, APHP, Paris, France. · Department of Endocrinology, Cochin Hospital, APHP, Paris, France. · Department of Gastroenterology, Cochin Hospital, APHP, Paris, France. · Department of Pathology, Cochin Hospital, APHP, Paris, France. ·Expert Rev Anticancer Ther · Pubmed #31825691.

ABSTRACT:

3 Review Pre- and intraoperative diagnostic requirements, benefits and risks of minimally invasive and robotic surgery for neuroendocrine tumors of the pancreas. 2019

Gharios, Joseph / Hain, Elisabeth / Dohan, Anthony / Prat, Fréderic / Terris, Benoit / Bertherat, Jérôme / Coriat, Romain / Dousset, Bertrand / Gaujoux, Sébastien. ·Department of Digestive, Hepato-biliary and Endocrine Surgery, Referral Center for Rare Adrenal Diseases, Cochin Hospital, APHP, Paris, France. · Faculté de Médecine Paris Descartes, Université Paris Descartes, Sorbonne Paris Cité, France; Department of Radiology, Cochin Hospital, APHP, Paris, France. · Faculté de Médecine Paris Descartes, Université Paris Descartes, Sorbonne Paris Cité, France; Department of Gastroenterology, Cochin Hospital, APHP, Paris, France. · Faculté de Médecine Paris Descartes, Université Paris Descartes, Sorbonne Paris Cité, France; Department of Pathology, Cochin Hospital, APHP, Paris, France. · Faculté de Médecine Paris Descartes, Université Paris Descartes, Sorbonne Paris Cité, France; Department of Endocrinology, Cochin Hospital, Referral Center for Rare Adrenal Diseases, Cochin Hospital, APHP, Paris, France. · Department of Digestive, Hepato-biliary and Endocrine Surgery, Referral Center for Rare Adrenal Diseases, Cochin Hospital, APHP, Paris, France; Faculté de Médecine Paris Descartes, Université Paris Descartes, Sorbonne Paris Cité, France. · Department of Digestive, Hepato-biliary and Endocrine Surgery, Referral Center for Rare Adrenal Diseases, Cochin Hospital, APHP, Paris, France; Faculté de Médecine Paris Descartes, Université Paris Descartes, Sorbonne Paris Cité, France. Electronic address: sebastien.gaujoux@aphp.fr. ·Best Pract Res Clin Endocrinol Metab · Pubmed #31351817.

ABSTRACT: Pancreatic neuroendocrine tumours (PanNET) are rare tumours, accounting for 1%-2% of all pancreatic neoplasms. These tumors are classified as functioning neuroendocrine tumours (F-PanNETs) or non-functioning (NF-PanNETs) depends on whether the tumour is associated with clinical hormonal hypersecretion syndrome or not. In the last decades, diagnosis of PanNETs has increased significantly due to the widespread of cross-sectional imaging. Whenever possible, surgery is the cornerstone of PanNETs management and the only curative option for these patients. Indeed, after R0 resection, the 5-year overall survival rate is around 90-100% for low grade lesions but significantly drops after incomplete resections. Compared to standard resections, pancreatic sparing surgery, i.e. enucleation and central pancreatectomy, significantly decreased the risk of pancreatic insufficiency. It should be performed in patients with good general condition and normal pancreatic function to limit the operative risk and enhance the benefit of surgery. Nowadays, due to many known advantages of minimally invasive surgery, there is an ongoing trend towards laparoscopic and robotic pancreatic surgery. The aim of this study is to describe the pre- and intraoperative diagnostic requirements for the management of PanNETs and the benefits and risks of minimally invasive surgery including laparoscopic and robotic approach in view of the recent literature.

4 Review Pancreatic cancer surgical management. 2019

Jeune, Florence / Coriat, Romain / Prat, Frédéric / Dousset, Bertrand / Vaillant, Jean-Christophe / Gaujoux, Sébastien. ·AP-HP, Pierre-and-Marie-Curie university, Paris VI, Pitié-Salpêtrière hospital, department of hepatobiliary surgery, pancreatic surgery and liver transplantation, 75651 Paris cedex, France. Electronic address: florence.jeune@hotmail.fr. · AP-HP, Paris V, Paris Descartes faculty of medecine, Cochin hopsital, department of gastroenterology and oncology, 75014 Paris, France. · AP-HP, Paris V, Paris Descartes faculty of medicine, Cochin hospital, department of digestive, hepatobiliary and pancreatic surgery, 75014 Paris, France. · AP-HP, Pierre-and-Marie-Curie university, Paris VI, Pitié-Salpêtrière hospital, department of hepatobiliary surgery, pancreatic surgery and liver transplantation, 75651 Paris cedex, France. ·Presse Med · Pubmed #30905395.

ABSTRACT: Pancreatic ductal adenocarcinoma (PDAC) remains a dismal prognosis and surgery is the only chance for cure. However, only few of the patients have localized tumor eligible for curative complete resection. Preoperative management and well-staging of the disease are the cornerstone for appropriate surgery and major issues to define the best therapeutic strategy. This review focuses on the surgical and optimal perioperative management of PDAC and summarizes updates data on the subject.

5 Review Gastroenteropancreatic Well-Differentiated Grade 3 Neuroendocrine Tumors: Review and Position Statement. 2016

Coriat, Romain / Walter, Thomas / Terris, Benoît / Couvelard, Anne / Ruszniewski, Philippe. ·Department of Gastroenterology, Cochin Teaching Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France romain.coriat@cch.aphp.fr. · Hospices Civils de Lyon, Hôpital Edouard Herriot, Service d'Oncologie Digestive, Lyon Cedex 03, France Université Claude Bernard Lyon 1, Université de Lyon, , Lyon, France. · Department of Pathology, Cochin Teaching Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France. · Department of Pathology, Bichat Hospital, Assistance Publique-Hôpitaux de Paris, Départements Hospitalo Universitaires, Paris, France Department of Gastroenterology and Pancreatology, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Départements Hospitalo Universitaires, Clichy, France. · Université Paris Diderot, Sorbonne Paris Cité, Paris, France Department of Gastroenterology and Pancreatology, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, Départements Hospitalo Universitaires, Clichy, France. ·Oncologist · Pubmed #27401895.

ABSTRACT: : In 2010, the World Health Organization (WHO) classification of neuroendocrine neoplasms was reviewed and validated the crucial role of the proliferative rate. According to the WHO classification 2010, gastroenteropancreatic neuroendocrine neoplasms are classified as well-differentiated neuroendocrine tumors (NETs) of grade 1 or 2 in up to 84%, or poorly differentiated neuroendocrine carcinomas in 6%-8%. Neuroendocrine carcinomas are of grade G. Recently, a proportion of neuroendocrine tumors presenting a number of mitoses or a Ki-67 index higher than 20% and a well-differentiated morphology have been identified, calling for a new category, well-differentiated grade 3 NET (NET G-3). Studies that have reported the characteristics of neuroendocrine neoplasms have identified more well-differentiated NET G-3 than neuroendocrine carcinomas. The main localizations of NET G-3 are the pancreas, stomach, and colon. Treatment for NET G-3 is not standardized and is balanced between G-1/2 neuroendocrine tumor and neuroendocrine carcinoma treatments. In nonmetastatic neuroendocrine tumors, the European and American guidelines recommended a surgical resection for localized neuroendocrine neoplasm, irrespective of the tumor grading. In NET G-3, chemotherapy is the benchmark if the main treatment goal is reduction of the tumor mass, particularly if it would allow a secondary surgery. In the present work, we review the epidemiology and make recommendations for the management of NET G-3. IMPLICATIONS FOR PRACTICE: Neuroendocrine tumors presenting a number of mitoses or a Ki-67 index higher than 20% and a well-differentiated morphology have been identified and named well-differentiated grade 3 neuroendocrine tumors (NET G-3). The main localizations of NET G-3 are the pancreas, stomach, and colon. The prognosis is worse than that for NET G-2. In nonmetastatic NET G-3, surgery appeared to be the first option. The chemotherapy regimen in pancreatic NET G-3 should be in line with that implemented in NET G-1/2 when the Ki-67 index is below 55% and should be in line with that implemented for neuroendocrine carcinoma when Ki-67 is above 55%.

6 Review [Management of gastrinoma]. 2016

Hain, Elisabeth / Coriat, Romain / Dousset, Bertrand / Gaujoux, Sébastien. ·AP-HP, hôpital Cochin, service de chirurgie digestive hépato-biliaire et endocrienne, Paris, France. · AP-HP, hôpital Cochin, service de gastroentérologie, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Université Paris Descartes, 12, rue de l'École-de-Médecine, 75006 Paris, France. · AP-HP, hôpital Cochin, service de chirurgie digestive hépato-biliaire et endocrienne, Paris, France; Université Paris Descartes, 12, rue de l'École-de-Médecine, 75006 Paris, France. · AP-HP, hôpital Cochin, service de chirurgie digestive hépato-biliaire et endocrienne, Paris, France; Université Paris Descartes, 12, rue de l'École-de-Médecine, 75006 Paris, France. Electronic address: sebastien.gaujoux@aphp.fr. ·Presse Med · Pubmed #27262229.

ABSTRACT: Gastrinoma is a very rare tumor leading to gastrin hypersecretion and characterised by Zollinger-Ellisson syndrome (ZES) i.e. severe gastric and duodenal ulceration and profuse diarrhea. This disease can be sporadic or familial within a multiple endocrine neoplasia type 1 (MEN-1) syndrome. Diagnosis is based on hypergastrinemia/hypercholrhydria. Tumors are usually located in the duodeno-pancreas. Preoperative tumor location by CT, echoendoscopy and fibroscopy is not always possible because of the small size of the lesion that are frequently multiple. The aim of gastrinoma treatment is 1/to control the hormonal hypersecretion 2/to remove the neoplasm when it is possible. Surgery is the only chance to cure. Gastrinoma is a slow-growing tumor, and overall survival is good with a median survival above 10years and a 5-year survival above 80 % in surgically resected patients. Recurrence is frequent, a biochemical recurrence is observed in 65 % of cases and morphological recurrence in 40 % of patients at 2years. Metastases are associated with a dismal prognosis.

7 Review [Management of metabolic disorders induced by everolimus in patients with differentiated neuroendocrine tumors: expert proposals]. 2014

Lombard-Bohas, Catherine / Cariou, Bertrand / Vergès, Bruno / Coriat, Romain / N'guyen, Thierry / François, Eric / Hammel, Pascal / Niccoli, Patricia / Hentic, Olivia. ·Hospices civils de Lyon, Pavillon H, hôpital E-Herriot, service d'oncologie médicale, place d'Arsonval, 69437 Lyon cedex 03, France. · CHU Nantes, clinique d'endocrinologie, 44093 Nantes cedex 1, France. · CHU de Dijon, hôpital du Bocage, service endocrinologie, diabétologie, 14, rue Paul-Gaffarel, 21000 Dijon, France. · Hôpital Cochin, service de gastroentérologie, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France. · CHRU, hôpital Jean Minjoz, service d'Oncologie, 2, boulevard Fleming, 25030 Besançon, France. · Centre Antoine Lacassagne, 33, avenue Valombrose, 06189 Nice, France. · Hôpital Beaujon, service de gastroentérologie-pancréatologie (PMAD), 100, boulevard du Général-Leclerc, 92118 Clichy, France. · CHU de La Timone, 254, rue Saint-Pierre, 13385 Marseille cedex, France. ·Bull Cancer · Pubmed #24557872.

ABSTRACT: Medical management of pancreatic neuroendocrine tumors has recently been improved by new molecules of which the mTOR inhibitor everolimus. If digestive neuroendocrine tumors are rare, the incidence is in constant increase and the prevalence in digestive cancers put them right behind colorectal cancers. Everolimus has demonstrated efficacy in unresectable and progressive pancreatic neuroendocrine tumors, by doubling the median progression free survival (11 versus 4.6 months), with a median time of exposure to everolimus of nine months. Everolimus is generally maintained until progression or intolerance and some patients are treated during several years. Potential metabolic disorders induced by everolimus (dyslipidemia, hyperglycemia) in patients with life expectancy of several years, justify monitoring of these parameters and accurate treatment management algorithm. These will avoid worsening patient's prognostic, but also prematurely discontinue potentially effective treatment or contraindicate other therapeutic weapons, in a pathology in which there are multiple therapeutic options in metastatic phase. We propose a standard practice in terms of initial assessment, monitoring, care threshold, and therapeutic objectives to manage metabolic disorders, fitted to our patients with advanced pancreatic neuroendocrine tumors.

8 Review [Neuroendocrine pancreatic tumors and helpfulness of targeted therapies]. 2013

Vaysse, Thibaut / Coriat, Romain / Perkins, Géraldine / Dhooge, Marion / Brezault, Catherine / Chaussade, Stanislas. ·CHU de Cochin Port-Royal, service de gastro-entérologue, 75014 Paris, France. ·Presse Med · Pubmed #23009947.

ABSTRACT: The neuroendocrine pancreatic tumors are rare tumors, but their incidence is constantly rising. Even if the management of these tumors has to be surgical as soon as possible, the disease is most often metastatic at the stage of the diagnostic. The prognostic and the therapeutic options differ from pancreatic adenocarcinoma. Available treatments have evolved over the last years with recent publications of studies that bring to light the benefits of targeted therapies in this pathology. This has resulted in modifications of both practices and either French and international guidelines. Therefore, we focus on the management of the grade 1 and grade 2 well-differentiated neuroendocrine pancreatic tumors as classified in new WHO classification of neuroendocrine neoplasms published in 2010.

9 Clinical Trial Clinical and Biomarker Evaluations of Sunitinib in Patients with Grade 3 Digestive Neuroendocrine Neoplasms. 2018

Pellat, Anna / Dreyer, Chantal / Couffignal, Camille / Walter, Thomas / Lombard-Bohas, Catherine / Niccoli, Patricia / Seitz, Jean François / Hentic, Olivia / André, Thierry / Coriat, Romain / Faivre, Sandrine / Zappa, Magaly / Ruszniewski, Philippe / Pote, Nicolas / Couvelard, Anne / Raymond, Eric. ·Medical Oncology, Hôpital Saint Antoine, AP-HP, Paris, France. · Biostatistics, Hôpital Bichat, AP-HP, Paris, France. · Gastroenterology, Hôpital Edouard Herriot, Lyon, France. · Medical Oncology, Hôpital Edouard Herriot, Lyon, France. · Medical Oncology, Hôpital La Timone, Marseille, France. · Gastroenterology and Digestive Oncology, Hôpital La Timone, Marseille, France. · Gastroenterology, Hôpital Beaujon, AP-HP, Clichy, France. · Gastroenterology and Digestive Oncology, Hôpital Cochin, AP-HP, Sorbonne Paris Cité, Paris, France. · Medical Oncology, Hôpital Beaujon, AP-HP, Paris, France. · Radiology, Hôpital Beaujon, AP-HP, Clichy, France. · Department of Pathology Beaujon-Bichat, AP-HP, DHU UNITY, Clichy, France. · Medical Oncology, Hôpital Saint Joseph, AP-HP, Paris, France. ·Neuroendocrinology · Pubmed #29518779.

ABSTRACT: BACKGROUND/AIMS: Angiogenesis is extensively developed in well-differentiated pancreatic neuroendocrine tumours (PanNET) where sunitinib was shown to prolong progression-free survival, leading to nationwide approval. However, clinical experience in patients with grade 3 gastroenteropancreatic neuroendocrine neoplasms (GEPNEN-G3) remains limited. This prospective phase II trial evaluated potential predictive biomarkers of sunitinib activity in patients with advanced GEPNEN-G3. METHODS: Sunitinib was given at a dose of 37.5 mg/day as a continuous daily dosing until progression or unacceptable toxicity. Evaluation of activity was based on RECIST1.1. Safety was evaluated according to NCI-CTCAE v4. Pharmacokinetics of sunitinib and its main active metabolite SU12662 were evaluated. All tumour samples were reviewed histologically for tumour differentiation. PDGFRβ, carbonic anhydrase 9, Ki-67, VEGFR2, and p-AKT were quantified using immunohistochemistry and their expression correlated with response by RECIST1.1. RESULTS: Thirty-one patients were included and 26 had available histological tissue. Six and 20 patients presented well-differentiated tumours (NET-G3) and neuroendocrine carcinoma (NEC), respectively. Eighteen patients responded to sunitinib (4 experienced partial responses and 14 tumour stabilization). A high p-AKT expression correlated with lower response to sunitinib (OR 0.94, 95% CI 0.89-0.99, p = 0.04). Safety and PK exposure to sunitinib and SU12662 in these patients were consistent with that reported in PanNET. CONCLUSION: Sunitinib showed evidence of activity in patients with GEPNEN-G3 with expected toxicity profile. In the NET-G3 and NEC groups, 4/6 and 11/20 patients were responders, respectively. High p-AKT expression predicted a lower response to sunitinib. Our study allowed the identification of a potential biomarker of resistance/sensitivity to sunitinib in aggressive GEPNEN-G3.

10 Clinical Trial Evaluating bevacizumab in combination with FOLFIRI after the failure of platinum-etoposide regimen in patients with advanced poorly differentiated neuroendocrine carcinoma: The PRODIGE 41-BEVANEC randomized phase II study. 2018

Walter, Thomas / Malka, David / Hentic, Olivia / Lombard-Bohas, Catherine / Le Malicot, Karine / Smith, Denis / Ferru, Aurélie / Assenat, Eric / Cadiot, Guillaume / Lievre, Astrid / Kurtz, Jean-Emmanuel / Dahan, Laetitia / Dubreuil, Olivier / Hautefeuille, Vincent / Lepere, Céline / Gangloff, Alice / Elhajbi, Farid / Coriat, Romain / Roquin, Guillaume / Bouarioua, Nadia / Granger, Victoire / Scoazec, Jean-Yves / Lepage, Côme. ·Department of Medical Oncology, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France. Electronic address: thomas.walter@chu-lyon.fr. · Gastrointestinal Oncology Department, Gustave Roussy Institute, Villejuif, France. · Gastroenterology-Pancreatology Department, Beaujon Hospital, PMAD, Clichy, France. · Department of Medical Oncology, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France. · Fédération Francophone de Cancérologie Digestive, Dijon, France. · Hepatogastroenterology and Digestive Oncology Department, Haut-Lévèque, University Hospital of Bordeaux, Pessac, France. · Pôle régional de cancérologie, University Hospital of Poitiers, Poitiers, France. · Medical Oncology Department, University Hospital St Eloi, Montpellier, France. · Department of Hepatogastroenterology and Digestive Oncology, Robert Debré Hospital, University Hospital of Reims, Reims, France. · Service des maladies de l'appareil digestif, University Hospital of Pontchaillou, Rennes, France. · Oncology Department, Nouvel Hospital Civil, University Hospital of Strasbourg, Strasbourg, France. · Digestive Oncology Department, University Hospital Timone, Marseille, France. · Hepatogastroenterology and Digestive Oncology Department, Pitié Salpêtrière Hospital, Paris, France. · Gastroenterology and Digestive Oncology, Amiens University Hospital, Amiens, France. · European Georges Pompidou Hospital, Paris, France. · Gastroenterology Department, University Hospital of Rouen, Rouen, France. · Oncology Department, Oscar Lambret Center, Lille, France. · Gastroenterology Department, Cochin Hospital, Paris, France. · Gastroenterology & Digestive Oncology, University Hospital of Angers, Angers, France. · Service de gastroentérologie et oncologie digestive, hôpital Nord, Saint Priest en Jarez, France. · Hepatogastroenterology Department, Michallon Hospital, University Hospital of Grenoble, Grenoble, France. · Gustave Roussy Cancer Campus, Department of Surgical and Molecular Pathology, Villejuif Cedex, France; Université Paris Saclay, Université Paris Sud XI, Faculté de Médecine de Bicêtre, Le Kremlin-Bicêtre, France. · Gastrointestinal Oncology Department, Gustave Roussy Institute, Villejuif, France; Gastroenterology & Digestive Oncology, University Hospital Le Bocage, Dijon, France. ·Dig Liver Dis · Pubmed #29258812.

ABSTRACT: INTRODUCTION: Patients with gastroenteropancreatic (GEP), metastatic or locally advanced, non-resectable, grade 3 poorly-differentiated neuroendocrine carcinoma (NEC) are treated with cisplatin (or carboplatin)-etoposide in first-line palliative chemotherapy (CT1). However, nearly all patients will develop resistance and there is no standard second-line treatment. AIM: PRODIGE 41-BEVANEC is an academic randomized, phase II study designed to evaluate the efficacy of bevacizumab in combination with FOLFIRI after failure of CT1 in unknown primary NEC and GEP-NEC. MATERIALS AND METHODS: The main eligibility criteria are age ≥18 years, metastatic (synchronous or metachronous) or locally advanced, non-resectable, grade 3 GEP-NEC, and documented progressive disease during or after CT1 therapy. RESULTS: A total of 124 patients will be randomly assigned (1:1) to receive either 5 mg/kg bevacizumab with FOLFIRI, or FOLFIRI alone, every 14 days until disease progression or unacceptable toxicity. The hypothesis is to demonstrate a 6-month overall survival for at least 50% of the patients in bevacizumab arm versus 35% in the control arm (FOLFIRI alone). Secondary endpoints are objective response, response duration, progression-free survival, toxicity, and biochemical response. CONCLUSION: The study is currently opened in France (NCT02820857). The first patient was randomized on September 6, 2017.

11 Article Computed tomography features of acinar cell carcinoma of the pancreas. 2020

Barat, M / Dohan, A / Gaujoux, S / Hoeffel, C / Jornet, D / Oudjit, A / Coriat, R / Barret, M / Terris, B / Soyer, P. ·Department of Radiology, Hôpital Cochin, AP-HP, 75014 Paris, France; Université de Paris, Descartes-Paris 5, 75006 Paris, France. Electronic address: maxime.barat@aphp.fr. · Department of Radiology, Hôpital Cochin, AP-HP, 75014 Paris, France; Université de Paris, Descartes-Paris 5, 75006 Paris, France. · Université de Paris, Descartes-Paris 5, 75006 Paris, France; Department of Abdominal Surgery, Hôpital Cochin, AP-HP, 75014 Paris, France. · Department of Radiology, Hôpital Robert Debré, 51092 Reims, France. · Department of Radiology, Hôpital Cochin, AP-HP, 75014 Paris, France. · Université de Paris, Descartes-Paris 5, 75006 Paris, France; Department of Gastroenterology, Hôpital Cochin, AP-HP, 75014 Paris, France. · Université de Paris, Descartes-Paris 5, 75006 Paris, France; Department of Pathology, Hôpital Cochin, AP-HP, 75014 Paris, France. ·Diagn Interv Imaging · Pubmed #32146131.

ABSTRACT: PURPOSE: To report the computed tomography (CT) features of pancreatic acinar cell carcinoma (ACC) and identify CT features that may help discriminate between pancreatic ACC and pancreatic ductal adenocarcinoma (PDA). MATERIALS AND METHODS: The CT examinations of 20 patients (13 men, 7 women; mean age, 66.5±10.7 [SD] years; range: 51-88 years) with 20 histopathologically proven pancreatic ACC were reviewed. CT images were analyzed qualitatively and quantitatively and compared to those obtained in 20 patients with PDA. Comparisons were performed using univariate analysis with a conditional logistic regression model. RESULTS: Pancreatic ACC presented as an enhancing (20/20; 100%), oval (15/20; 75%), well-delineated (14/20; 70%) and purely solid (13/20; 65%) pancreatic mass with a mean diameter of 52.6±28.0 (SD) mm (range: 24-120mm) in association with visible lymph nodes (14/20; 70%). At univariate analysis, well-defined margins (Odds ratio [OR], 7.00; P=0.005), nondilated bile ducts (OR, 9.00; P=0.007), visible lymph nodes (OR, 4.33; P=0.028) and adjacent organ involvement (OR, 5.67; P=0.02) were the most discriminating CT features to differentiate pancreatic ACC from PDA. When present, lymph nodes were larger in patients with pancreatic ACC (14±4.8 [SD]; range: 7-25mm) than in those with PDA (8.8±4.1 [SD]; range: 5-15mm) (P=0.039). CONCLUSION: On CT, pancreatic ACC presents as an enhancing, predominantly oval and purely solid pancreatic mass that most frequently present with no bile duct dilatation, no visible lymph nodes, no adjacent organ involvement and larger visible lymph nodes compared to PDA.

12 Article McCune Albright syndrome is a genetic predisposition to intraductal papillary and mucinous neoplasms of the pancreas associated pancreatic cancer in relation with GNAS somatic mutation - a case report. 2019

Gaujoux, Sébastien / Pasmant, Eric / Silve, Caroline / Mehsen-Cetre, Nadia / Coriat, Romain / Rouquette, Alexandre / Douset, Bertrand / Prat, Frédéric / Leroy, Karen. ·Department of Digestive, Hepato-biliary and Pancreatic Surgery, Cochin Hospital, APHP. · Faculté de Médecine Paris Descartes, Université Paris Descartes, Sorbonne Paris Cité. · INSERM Unité 1016, Centre National de la Recherche Scientifique Unité Mixte de Recherche 8104, Institut Cochin. · Service de Génétique et Biologie Moléculaires, Hôpital Cochin. · EA7331, Université Paris Descartes. · INSERM U1169, Hôpital Bicêtre. · Centre de Référence des Maladies Rares du Métabolisme du Calcium et du Phosphore / Filière OSCAR. · Service de Rhumatologie CHU Bordeaux-Tripode. · Department of Gastroenterology, Cochin Hospital, APHP. · Department of Pathology, Cochin Hospital, APHP, Paris, France. ·Medicine (Baltimore) · Pubmed #31852070.

ABSTRACT: RATIONALE: Intraductal papillary and mucinous neoplasms of the pancreas (IPMN) are preneoplastic lesions diagnosed with an increasing incidence. Recently, several groups have described, in up to 70% of IPMN, activating mutations of the G-protein alpha stimulatory sub-unit (Gsα subunit) gene (GNAS). GNAS-activating somatic, post-zygotic, mutations are also associated with McCune-Albright syndrome (MCAS) characterized by fibrous dysplasia, precocious puberty, and café-au-lait spots. PATIENT CONCERNS: We herein report a patient with McCune Albright Syndrome that presented with malignant IPMN and underwent pancreatic resection. DIAGNOSES AND INTERVENTIONS: Leucocyte and duodenum juice DNA analysis, endoscopically collected from secretin-stimulated pancreatic juice revealed the same (GNAS) activating mutation also found in the invasive pancreatic colloid adenocarcinoma arising from intestinal subtype IPMN. OUTCOMES: Thirty months after surgery, the patient was alive with recurrence (bone only metastasis). LESSONS: In this observation, we show that MCAS should be view as a new genetic predisposition to IPMN associated pancreatic cancer, and consequently a targeted screening in this high-risk population might be proposed.

13 Article Aggressive gastro-entero-pancreatic neoplasms. 2019

Coriat, Romain. ·Gastroenterology, digestive oncology unit, université Paris-Descartes, AP-HP, 27, rue du faubourg Saint-Jacques, 75014 Paris, France. Electronic address: romain.coriat@aphp.fr. ·Ann Endocrinol (Paris) · Pubmed #31064660.

ABSTRACT: -- No abstract --

14 Article How Does Chemoradiotherapy Following Induction FOLFIRINOX Improve the Results in Resected Borderline or Locally Advanced Pancreatic Adenocarcinoma? An AGEO-FRENCH Multicentric Cohort. 2019

Pietrasz, Daniel / Turrini, Olivier / Vendrely, Véronique / Simon, Jean-Marc / Hentic, Olivia / Coriat, Romain / Portales, Fabienne / Le Roy, Bertrand / Taieb, Julien / Regenet, Nicolas / Goere, Diane / Artru, Pascal / Vaillant, Jean-Christophe / Huguet, Florence / Laurent, Christophe / Sauvanet, Alain / Delpero, Jean-Robert / Bachet, Jean Baptiste / Sa Cunha, Antonio. ·Department of Hepato-Bilio-Pancreatic Surgery, Liver Transplant Center, Paul Brousse Hospital, Université Paris-Sud, Université Paris-Saclay, Villejuif, France. daniel.pietrasz@wanadoo.fr. · Department of Digestive and Hepatobiliary Surgery, Pitié-Salpêtrière Hospital, Sorbonne University, UPMC University, Paris 06, France. daniel.pietrasz@wanadoo.fr. · Surgical Oncology Department, Institut Paoli Calmette, Marseille, France. · Departement of Radiotherapy, Hopital Haut Lévêque, CHU de Bordeaux, Pessac, France. · Radiation Oncology, Pitié-Salpêtrière Hospital, Paris, France. · Pancreato-Gastroenterology Department, Beaujon Hospital, Clichy, France. · Gastroenterology Unit, Cochin Hospital, Paris, France. · Institut du Cancer de Montpellier, Montpellier, France. · CHU Estaing, Service de Chirurgie Digestive, Université Clermont Auvergne, Clermont-Ferrand, France. · Hepatogastroenterology and Digestive Oncology Department, Georges Pompidou Hospital, Paris, France. · Department of Digestive Surgery, Nantes Hospital, Nantes, France. · Surgical Oncology Department, Gustave Roussy, Villejuif, France. · Department of Gastroenterology, Hôpital Privé Jean Mermoz, Lyon, France. · Department of Digestive and Hepatobiliary Surgery, Pitié-Salpêtrière Hospital, Sorbonne University, UPMC University, Paris 06, France. · Department of Radiation Oncology, Tenon Hospital, Hôpitaux Universitaires Est Parisien, Assistance Publique-Hôpitaux de Paris, Paris, France. · Department of Hepatobiliopancreatic Surgery and Liver Transplantation, Hôpital Haut Lévêque, CHU de Bordeaux, Pessac, France. · Department of Digestive Surgery and Transplantation, Beaujon Hospital, Clichy, France. · Gastroenterology and Digestive Oncology Department, Pitié-Salpêtrière Hospital, Sorbonne University, UPMC University, Paris, France. · Department of Hepato-Bilio-Pancreatic Surgery, Liver Transplant Center, Paul Brousse Hospital, Université Paris-Sud, Université Paris-Saclay, Villejuif, France. ·Ann Surg Oncol · Pubmed #30362063.

ABSTRACT: BACKGROUND: Patients with borderline (BR) or locally advanced (LA) pancreatic adenocarcinoma (PAC) are often treated with induction FOLFIRINOX (FLX). However, the role of additional preoperative chemoradiotherapy (CRT) is controversial. The aim of this study is to evaluate its impact in patients who underwent resection after induction FLX. PATIENTS AND METHODS: Retrospective analysis of prospective consecutive surgical BR or LA PAC patients after induction FLX in 23 French centers between November 2010 and December 2015, treated with or without preoperative additional CRT (FLX vs FLX + CRT groups). RESULTS: Two hundred three patients were included (106 BR, 97 LA PAC). Median number of FLX cycles was 6 (range 1-30); 50% (n = 102) of patients received additional CRT. Median duration between diagnosis and surgery was 5.4 and 8.7 months (P = 0.001) in the FLX and FLX + CRT group, respectively. The 90-day mortality, major complications, and pancreatic fistula rates were 4.4%, 17.7%, and 5.4%, respectively. After 45.1 months follow-up, overall survival (OS) and disease-free survival were 45.4 months and 16.2 months, respectively. Patients with additional CRT had higher R0 resection rate (89.2% vs 76.3%; P = 0.017), ypN0 rate (76.2% vs 48.5%; P < 0.001), and higher rate of pathologic major response (33.3% vs 12.9%; P = 0.001). In the FLX + CRT group, patients had lower rate of locoregional relapse (28.3% vs 50.7%; P = 0.004). Patients with additional CRT had longer OS than those receiving FLX alone (57.8 vs 35.5 months; P = 0.007). CONCLUSIONS: Pathological results and survival data argue for interest in additional CRT. Prospective studies on an intention-to-treat basis are needed to confirm these results.

15 Article Management of gastric neuro-endocrine tumours in a large French national cohort (GTE). 2017

Manfredi, Sylvain / Walter, Thomas / Baudin, Eric / Coriat, Romain / Ruszniewski, Philippe / Lecomte, Thierry / Laurenty, Anne-Pascale / Goichot, Bernard / Rohmer, Vincent / Roquin, Guillaume / Cojocarasu, Oana-Zvetlana / Lombard-Bohas, Catherine / Lepage, Côme / Morcet, Jeff / Cadiot, Guillaume. ·CHU Dijon, hepato-gastroenterology unit, University of Bourgogne Franche-Comté, INSERM, LNC UMR1231, F-21000, Dijon, France. sylvain.manfredi@chu-dijon.fr. · Département d'Oncologie Médicale, Hospices Civils de Lyon, Hôpital Edouard Herriot, 69437, Lyon, cedex 03, France. · Gustave Roussy, Département d'Oncologie Endocrinienne, 94805, Villejuif cedex, France. · Department of Gastroenterology and Digestive Oncology, Cochin Teaching Hospital, Paris Descartes University, Paris, France. · Beaujon Hospital and Paris Diderot University, Clichy, France. · CHRU de Tours, service d'Hépato-Gastroenterologie, CNRS, UMR 7292, GICC & Université Francois-Rabelais, Tours, France. · Department of Medical Oncology, Institut Claudius Regaud, Toulouse, France. · Department of Internal Medicine, Endocrinology and Nutrition, Hôpitaux Universitaires de Strasbourg, Faculté de Médecine, Université de Strasbourg, Strasbourg, France. · Service d'endocrinologie et maladies métaboliques, CHU d'Angers, 4 rue Larrey, 49100, Angers, France. · Service d'Hépato-Gastro-Entérologie, CHU Angers, Angers, France. · CH Le Mans, Le Mans, France. · CHU Dijon, hepato-gastroenterology unit, University of Bourgogne Franche-Comté, INSERM, LNC UMR1231, F-21000, Dijon, France. · CIC, Université de Rennes 1, Rennes, France. · Department of Hepato-Gastroenterology and Digestive Oncology, Robert-Debré University Hospital, Reims, France. ·Endocrine · Pubmed #28664309.

ABSTRACT: INTRODUCTION: Gastric neuro-endocrine tumours are rare. European guidelines for the management of neuro-endocrine tumours have been published in 2012. The aim of our survey was to study the management of gastric neuro-endocrine tumours registered in the national cohort. A prospective national cohort registers the Neuro-endocrine tumours in France since January 2003 (GTE network). We reviewed all the individual medical reports of gastric neuro-endocrine tumours in order to collect data on treatment. RESULTS: One hundred and ninety seven gastric neuro-endocrine tumours diagnosed between 1964 and 2013 in 20 centres were registered. For 181 cases data were considered complete for our survey. Eighty four tumours were type 1 (46.4%); five types 2 (2.8%); 52 types 3 (28.7%) and 40 types 4 (22.1%). Types 1 and 2 were first endoscopically managed in 93 and 60% of cases, respectively, whereas surgery was first done in 45 and 42%, respectively, of types 3 and 4. Systemic treatment, chemotherapy and/or somatostatin analogue, was first administered exclusively for types 3 and 4. Near 3% of types 1 and 40% of types 2 received at a time somatostatin analogue treatment. Five-year survival rates were 98.3, 100, 63.2 and 31.8% for types 1, 2, 3 and 4, respectively. CONCLUSION: The great majority of gastric neuro-endocrine tumours registered in this national cohort are treated in accordance with the current guidelines. The survival rates we reported must be interpreted with caution, because this cohort registered preferentially selected patients eligible for treatment. The registration of all the gastric neuro-endocrine tumours, in particular type 1 considered as benign and type 4 not eligible for specific anti-cancer treatment must be encouraged.

16 Article Endoscopic ultrasound-guided hepaticogastrostomy 2017

Sportes, Adrien / Camus, Marine / Greget, Michel / Leblanc, Sarah / Coriat, Romain / Hochberger, Jürgen / Chaussade, Stanislas / Grabar, Sophie / Prat, Frédéric. ·Gastroenterology Unit, Hôpital Cochin (AP-HP), University Paris Descartes, Paris, France. · Interventional Radiology Unit CHRU Strasbourg, University of Strasbourg, France. · Gastroenterology Unit, Nouvel Hôpital Civil CHRU Strasbourg, University of Strasbourg, France. · Biostatistics and Epidemiology, Hôtel Dieu (AP-HP), University Paris Descartes, Paris, France. · Gastroenterology unit, Hôpital Cochin (AP-HP), 27 Rue du Faubourg Saint-Jacques, 75014 Paris, France. ·Therap Adv Gastroenterol · Pubmed #28567118.

ABSTRACT: BACKGROUND: Percutaneous transhepatic biliary drainage (PTBD) is widely performed as a salvage procedure in patients with unresectable malignant obstruction of the common bile duct (CBD) after failed endoscopic retrograde cholangiopancreatography (ERCP) or in case of surgically altered anatomy. Endoscopic ultrasound-guided hepaticogastrostomy (EU-HGS) is a more recently introduced alternative to relieve malignant obstructive jaundice. The aim of this prospective observational study was to compare the outcome, efficacy and adverse events of EU-HGS and PTBD. METHODS: From April 2012 to August 2015, consecutive patients with malignant CBD obstruction who underwent EU-HGS or PTBD in two tertiary-care referral centers were included. The primary endpoint was the clinical success rate. Secondary endpoints were technical success, overall survival, procedure-related adverse events, incidence of adverse events, and reintervention rate. RESULTS: A total of 51 patients (EU-HGS, CONCLUSIONS: EU-HGS can be an effective and safe mini invasive-procedure alternative to PTBD, with similar success and adverse-event rates, but with lower rates of reintervention and length of hospitalization.

17 Article Poorly differentiated gastro-entero-pancreatic neuroendocrine carcinomas: Are they really heterogeneous? Insights from the FFCD-GTE national cohort. 2017

Walter, T / Tougeron, D / Baudin, E / Le Malicot, K / Lecomte, T / Malka, D / Hentic, O / Manfredi, S / Bonnet, I / Guimbaud, R / Coriat, R / Lepère, C / Desauw, C / Thirot-Bidault, A / Dahan, L / Roquin, G / Aparicio, T / Legoux, J-L / Lombard-Bohas, C / Scoazec, J-Y / Lepage, C / Cadiot, G / Anonymous2580906. ·University Hospital, Lyon, France. Electronic address: thomas.walter@chu-lyon.fr. · University Hospital, Poitiers, France. · Gustave Roussy Institute, Villejuif, France. · FFCD, Dijon, France. · Trousseau Hospital, Tours, France. · Beaujon Hospital, Clichy, France. · University Hospital, Rennes, France. · Valenciennes Hospital, Valenciennes, France. · University Hospital, Toulouse, France. · Cochin Hospital, University Paris Descartes, Paris, France. · Georges Pompidou European Hospital, University Paris-V, Paris, France. · University Hospital, Lille, France. · Hôpitalde Bicêtre, Le Kremlin Bicêtre, France. · La Timone Hospital, Marseille, France. · University Hospital, Angers, France. · Avicenne Hospital, Bobigny, France. · Hôpital de la Source, Orléans, France. · University Hospital, Lyon, France. · FFCD, Dijon, France; University Hospital, Dijon, France. · University Hospital, Reims, France. ·Eur J Cancer · Pubmed #28501762.

ABSTRACT: BACKGROUND: Diagnosis and management of poorly differentiated gastro-entero-pancreatic (GEP) neuroendocrine carcinomas (NECs) remain challenging. Recent studies suggest prognostic heterogeneity. We designed within the French Group of Endocrine Tumours a prospective cohort to gain insight in the prognostic stratification and treatment of GEP-NEC. PATIENTS AND METHODS: All patients with a diagnosis of GEP-NEC between 1st January 2010 and 31st December 2013 could be included in this national cohort. Adenoneuroendocrine tumours were excluded. RESULTS: 253 patients from 49 centres were included. Median age was 66 years. Main primary locations were pancreas (21%), colorectal (27%), oesophagus-stomach (18%); primary location was unknown in 20%. Tumours were metastatic at diagnosis in 78% of cases. Performance status (PS) at diagnosis was 0-1 in 79% of patients. Among the 147 (58%) cases reviewed by an expert pathological network, 39% were classified as small cell NEC and 61% as large cell NEC. Median Ki67 index was 75% (range, 20-100). Median overall survival was 15.6 (13.6-17.0) months. Significant adverse prognostic factors in univariate analysis were PS > 1 (hazard ratio [HR] = 2.5), metastatic disease (HR = 1.6), NSE>2 upper limit of normal [ULN]; HR = 3.2), CgA>2 ULN (HR = 1.7) and lactate dehydrogenase >2 ULN (HR = 2.1). After first-line palliative chemotherapy (CT1) with platinum-etoposide (n = 152), objective response, progression-free survival and overall survival were 50%, 6.2 and 11.6 months; they were 24%, 2.9 and 5.9, respectively, after post-CT1 FOLFIRI regimen (n = 72). CONCLUSIONS: We report a large prospective series of GEP-NEC which show the predominance of large cell type and advanced stage at diagnosis. Prognosis was found more homogeneous than previously reported, mainly impacted by PS and tumour burden.

18 Article May we challenge the ENETS guidelines in pancreatic neuroendocrine neoplasms? A quiz for French experts. 2017

Brieau, Bertrand / Coriat, Romain. ·Service de gastro-entérologie et oncologie digestive, Hôpital Cochin, Paris, France; Unité INSERM U1016, Université Paris Descartes, Sorbonne Paris Cité, Paris, France. ·Dig Liver Dis · Pubmed #28377287.

ABSTRACT: INTRODUCTION: Recent guidelines have been published by a consensus of international experts (2016 ENETS (European NeuroEndocrine Tumor Society) guidelines). Nevertheless, in case of pancreatic neuroendocrine neoplasms (panNEN) the ENETS guidelines fail to propose a unique strategy in some situations, due to the lack of high-level of evidence and the absence of formal agreement between the experts drawing up the guidelines. MATERIAL AND METHODS: A survey of 25 questions on panNEN was sent to 104 French experts challenging the guidelines. Questions focused on clinical situations in localized G-1/2 panNEN, localized G-3 panNEN, metastatic G-1/2 panNEN, and metastatic G-3 panNEN for which multiple options were proposed by the ENETS guidelines. RESULTS: Fifty-seven experts (55%) have answered the survey. 18/25 questions obtained at least 50% similar responses, allowing a "consensus" or a "position statement". Among the results, surgery of small panNEN is preferred to surveillance in young patients; the temozolomide-capecitabine combination is favored instead of streptozotocin-based chemotherapy for G-1/2 metastatic panNEN. CONCLUSION: French experts are mostly in line with the European guidelines, but some differences do exist. Whilst waiting for prospective studies, this survey helps physicians to propose standardized procedures and identifies situations where a step forward has been enabled by French experts. This questionnaire paves the way for a simplified therapeutic algorithm of panNEN.

19 Article Care pathway of patients with metastatic pancreatic cancer in daily practice in France: Results from the REPERE national survey. 2017

Hammel, Pascal / Coriat, Romain / Lledo, Gérard / de Bausset, Mariella / Selosse, Marion / Obled, Stéphane / Bonnetain, Franck. ·Beaujon Hospital (AP-HP), 100, boulevard du Général-Leclerc, 92110 Clichy, France. Electronic address: pascal.hammel@aphp.fr. · Cochin Hospital (AP-HP), 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France. · Jean-Mermoz Private Hospital, 55, avenue Jean-Mermoz, 69008 Lyon, France. · Foundation ARCAD, 151, rue du Faubourg-Saint Antoine, 75011 Paris, France. · University Regional Hospital (CHRU) of Nîmes, 30029, rue du Professeur-Robert-Debré, 30900 Nîmes, France. · Jean-Minjoz University Regional Hospital (CHRU), 3, boulevard Fleming, 25030 Besançon, France. ·Bull Cancer · Pubmed #28087054.

ABSTRACT: Data in the literature regarding the care pathway of pancreatic cancer patients are limited. The objective of the REPERE survey was to identify and describe the initial stages of the care pathway of pancreatic patients in the metastatic phase. From May to October 2015, 62 oncologists (ON) or gastroenterologists specialized in digestive oncology (GESDO) and 300 general practitioners (GP) completed an electronic questionnaire on the pathway of 728 patients recently diagnosed with metastatic pancreatic adenocarcinoma. Of these patients, 200 completed a questionnaire given by a specialized physician (ON/GESDO). Weight loss (65%), fatigue (53%) or anorexia (49%) were the main signs/symptoms that motivated the patients to seek medical advice. For 87% of patients, the general practitioner was the first medicine doctor they consulted. According to the respondents (patient, general practitioner or specialist), the median delay between the onset of the first symptoms and the final diagnosis of pancreatic cancer was between 41 and 65 days. This time lapse tended to decrease with associated jaundice (-15 days on average, standard deviation=8, P<0.1 NS) or with patient concerns triggered by the first symptoms (-11 days on average, standard deviation=6, P<0.05). On the contrary, the time lapse was longer (+14 days on average, standard deviation=6, P<0.05) when the general practitioner prescribed symptomatic treatment. In conclusion, diagnostic management of patients with metastatic pancreatic cancer should be accelerated with efforts to raise practitioners' awareness.

20 Article The slow-pull capillary technique increases the quality of endoscopic ultrasound fine needle biopsy samples in solid pancreatic lesions. 2016

El Haddad, Rana / Barret, Maximilien / Beuvon, Frédéric / Grabar, Sophie / Leblanc, Sarah / Terris, Benoit / Coriat, Romain / Chaussade, Stanislas / Prat, Frédéric. ·Departments of aGastroenterology bPathology cBiostatistics and Epidemiology, Cochin Hospital, Assistance Publique - Hopitaux de Paris dSchool of Medicine, Paris Descartes University, Paris, France. ·Eur J Gastroenterol Hepatol · Pubmed #27140228.

ABSTRACT: INTRODUCTION: Endoscopic ultrasound-guided sampling is used routinely for the diagnosis of solid pancreatic masses. We aimed to compare the standard suction technique with the recently described 'slow-pull' technique. PATIENTS AND METHODS: Patients with a solid pancreatic mass of more than 2 cm undergoing endoscopic ultrasound-guided fine needle biopsy with the same endoscopist using a 22 G core biopsy needle were included in the study. Patients had a first suction pass, followed by either another suction pass or a slow-pull pass. The rate of samples contributive to the diagnosis, cellularity, presence of tissue microfragments, and blood contamination were assessed and compared between each pass and each technique. RESULTS: A total of 98 patients with a lesion diameter of 33.1±10 mm were analyzed. Lesions were adenocarcinomas in 83%, neuroendocrine tumors in 6%, and benign lesions in 11% of the cases. The rate of contributive samples of the first suction pass, the slow-pull pass, and the second suction pass were 96.9, 97.9, and 90.2%, respectively (P=NS). The slow-pull capillary technique, compared with the suction technique, provided samples with better cellularity, higher proportion of representative and tumor cells, and more tissue microfragments (P=0.002, 0.0004, 0.006, and 0.005, respectively). CONCLUSION: Endoscopic ultrasound-guided fine needle biopsy sampling of solid pancreatic lesions using the slow-pull technique yielded overall outcomes similar to the standard suction technique in terms of diagnostic performance. However, the slow-pull capillary technique improved the histological quality of the samples, mainly through a higher proportion of tissue microfragments and tumor cells.

21 Article Resection of Late Pulmonary Metastases from Pancreatic Adenocarcinoma: Is Surgery an Option? 2015

Brieau, Bertrand / Barret, Maximilien / Rouquette, Alexandre / Dréanic, Johann / Brezault, Catherine / Regnard, Jean François / Coriat, Romain. ·a Department of Gastroenterology and Digestive Oncology, Cochin Teaching Hospital , Paris Descartes University , Paris , France. · b Pathology Department, Cochin Teaching Hospital , Paris Descartes University , Paris , France. · c Department of Thoracic Surgery, Cochin Teaching Hospital , Paris Descartes University , Paris , France. · d U-1016 INSERM, Paris Descartes University , Paris , France. ·Cancer Invest · Pubmed #26461032.

ABSTRACT: Patients with recurrences from pancreas adenocarcinoma have a poor survival rate despite new chemotherapy treatment options. Recurrences are mainly hepatic metastases or peritoneal dissemination and surgical treatment is not recommended. Late and single metachronous pulmonary recurrences are uncommon and may mimic primary lung carcinoma. We report two patients with late and unique pulmonary metastasis from pancreatic cancer. These two patients underwent surgical resection; three and five years later, they did not experience recurrences. Cases called for a surgical approach in late and unique pulmonary metastases from pancreatic cancer, and paved the way for a prolonged chemotherapy free period.

22 Article Nab-paclitaxel plus gemcitabine for metastatic pancreatic adenocarcinoma after Folfirinox failure: an AGEO prospective multicentre cohort. 2015

Portal, Alix / Pernot, Simon / Tougeron, David / Arbaud, Claire / Bidault, Anne Thirot / de la Fouchardière, Christelle / Hammel, Pascal / Lecomte, Thierry / Dréanic, Johann / Coriat, Romain / Bachet, Jean-Baptiste / Dubreuil, Olivier / Marthey, Lysiane / Dahan, Laetitia / Tchoundjeu, Belinda / Locher, Christophe / Lepère, Céline / Bonnetain, Franck / Taieb, Julien. ·Department of Gastroenterology and Digestive Oncology, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Descartes University, Paris, France. · Department of Gastroenterology, Poitiers University Hospital, Poitiers, France. · Methodological and Quality of Life Unit in Oncology, Quality of Life and Cancer Clinical Research Platform, Besançon University Hospital, Besançon, France. · Department of Gastroenterology, Kremlin Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Sud University, Le Kremlin Bicêtre, France. · Department of Medical Oncology, Anticancer Center Leon Berard, Lyon I university, Lyon, France. · Department of Digestive Oncology, Hospital Beaujon, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Denis Diderot University, Clichy, France. · Department of Hepato-Gastroenterology and Digestive Oncology, University Hospital of Tours, UMR CNRS 7192, François-Rabelais University, Tours, France. · Gastroenterology and Endoscopy Unit, Cochin Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris Descartes University, Sorbonne Paris Cité, Paris, France. · Department of Gastroenterology, La Pitié-Salpétrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Sorbonne University, UPMC University Paris 06, Paris, France. · Department of Hepatogastroenterology and Nutrition, Antoine-Béclère Hospital, Assistance publique-Hôpitaux de Paris (AP-HP), DHU Hepatinov, Clamart, France. · Department of Gastroenterology, University Hospital La Timone, Aix-Marseille University, Marseille, France. · Department of Gastroenterology and Digestive Oncology, Orleans Regional Hospital (CHRO), Orleans, France. · Department of Gastroenterology, Meaux Hospital, Meaux, France. ·Br J Cancer · Pubmed #26372701.

ABSTRACT: BACKGROUND: There is currently no standard second-line treatment for metastatic pancreatic adenocarcinoma (MPA), and progression-free survival is consistently <4 months in this setting. The aim of this study was to evaluate the efficacy and tolerability of Nab-paclitaxel plus gemcitabine (A+G) after Folfirinox failure in MPA. METHODS: From February 2013 to July 2014, all consecutive patients treated with A+G for histologically proven MPA after Folfirinox failure were prospectively enrolled in 12 French centres. A+G was delivered as described in the MPACT trial, until disease progression, patient refusal or unacceptable toxicity. RESULTS: Fifty-seven patients were treated with Nab-paclitaxel plus gemcitabine, for a median of 4 cycles (range 1-12). The disease control rate was 58%, with a 17.5% objective response rate. Median overall survival (OS) was 8.8 months (95% CI: 6.2-9.7) and median progression-free survival was 5.1 months (95% CI: 3.2-6.2). Since the start of first-line chemotherapy, median OS was 18 months (95% CI: 16-21). No toxic deaths occurred. Grade 3-4 toxicities were reported in 40% of patients, consisting of neutropenia (12.5%), neurotoxicity (12.5%), asthenia (9%) and thrombocytopenia (6.5%). CONCLUSIONS: A+G seems to be effective, with a manageable toxicity profile, after Folfirinox failure in patients with MPA.

23 Article Pathologic Major Response After FOLFIRINOX is Prognostic for Patients Secondary Resected for Borderline or Locally Advanced Pancreatic Adenocarcinoma: An AGEO-FRENCH, Prospective, Multicentric Cohort. 2015

Pietrasz, Daniel / Marthey, Lysiane / Wagner, Mathilde / Blanc, Jean-Frédéric / Laurent, Christophe / Turrini, Olivier / Raoul, Jean Luc / Terrebonne, Eric / Hentic, Olivia / Trouilloud, Isabelle / Coriat, Romain / Regenet, Nicolas / Innominato, Pasquale / Taieb, Julien / Cunha, Antonio Sa / Bachet, Jean Baptiste. ·Department of Digestive and Hepatobiliary Surgery, Pitié-Salpêtrière Hospital, Sorbonne University, UPMC University, Paris, France. · Hepatogastroenterology Department, Antoine Béclère Hospital, Clamart, France. · Department of Radiology, Pitié-Salpêtrière Hospital, Sorbonne University, UPMC University, Paris, France. · Hepato-Gastroenterology Department, Saint-André Hospital, Bordeaux, France. · Department of Visceral and Transplant Surgery, Saint-André Hospital, Bordeaux, France. · Surgical Oncology Department, Institut Paoli Calmette, Marseille, France. · Oncology Department, Institut Paoli Calmette, Marseille, France. · Gastroenterology and Digestive Oncology Department, Bordeaux South Hospital, Bordeaux, France. · Pancreato-Gastroenterology Department, Beaujon Hospital, Clichy, France. · Hepatogastroenterology and Digestive Oncology Department, Georges Pompidou Hospital, Paris, France. · Gastroenterology Unit, Cochin Hospital, Paris, France. · Department of Digestive Surgery, Nantes Hospital, Nantes, France. · Hematology-Oncology Department, Paul Brousse Hospital, Villejuif, France. · Liver Transplant Center, Paul Brousse Hospital, Villejuif, France. · Gastroenterology and Digestive Oncology Department, Pitié-Salpêtrière Hospital, Sorbonne University, UPMC University, Paris, France. jean-baptiste.bachet@aphp.fr. ·Ann Surg Oncol · Pubmed #26271395.

ABSTRACT: PURPOSE: In view of increased response rates and survivals in patients with metastatic pancreatic adenocarcinoma (PAC) with FOLFIRINOX, many centers proposed this regimen as induction chemotherapy for borderline (BR) or locally advanced (LA) PAC. The aim of this study was to assess surgical and oncological outcomes of patients who underwent resection after induction FOLFIRINOX therapy. METHODS: We prospectively identified surgical consecutive BR or LA PAC patients after induction FOLFIRINOX in 20 observational French centers between November 2010 and December 2013. Two independent experts retrospectively evaluated initial CT scan for central review. RESULTS: Eighty patients were included, 47 had BR and 33 had LA PAC. Median number of FOLFIRINOX cycles was 6 (range 1-30) and 65 % of patients received chemoradiation. The 30-day-mortality, major complications, and symptomatic pancreatic fistula rates were 2.5, 22.5, and 4 %, respectively. R0 resection was achieved in 84 %. After a median follow-up of 38.2 months since diagnosis, disease-free survival (DFS) was 17.16 months. The overall survival rates at 12 and 24 months were 92 and 81 %, respectively. A 26 % (n = 21) pathologic major response (pMR) rate was reached. In univariate and multivariate analysis, pMR was a prognostic factor for DFS (hazard ratio 0.33; P = 0.01 and hazard ratio 0.38; P = 0.035). CONCLUSIONS: Resection after induction FOLFIRINOX is safe and associated with similar or better outcomes as upfront surgery in patients with PAC. A pMR was observed in 26 % of cases and was prognostic of DFS. This therapeutic design should be investigated in prospective studies.

24 Article FOLFIRINOX for locally advanced pancreatic adenocarcinoma: results of an AGEO multicenter prospective observational cohort. 2015

Marthey, L / Sa-Cunha, A / Blanc, J F / Gauthier, M / Cueff, A / Francois, E / Trouilloud, I / Malka, D / Bachet, J B / Coriat, R / Terrebonne, E / De La Fouchardière, C / Manfredi, S / Solub, D / Lécaille, C / Thirot Bidault, A / Carbonnel, F / Taieb, J. ·Department of Gastroenterology, Kremlin Bicêtre Hospital, Assistance publique-Hôpitaux de Paris (AP-HP), Paris Sud University, Le Kremlin Bicêtre, France. ·Ann Surg Oncol · Pubmed #25037971.

ABSTRACT: BACKGROUND: First-line treatment with FOLFIRINOX significantly increases overall survival (OS) in patients with metastatic pancreatic adenocarcinoma (PA) compared with gemcitabine. The aim of this observational cohort was to evaluate the tolerability and efficacy of this regimen in unresectable locally advanced PA (LAPA). PATIENTS AND METHODS: From February 2010 to February 2012, all consecutive patients from 11 French centers treated by FOLFIRINOX for a histologically proven LAPA were prospectively enrolled. Unresectability was defined independently by each center's multidisciplinary staff at diagnosis. Absence of metastatic disease was confirmed by chest-abdomen-pelvis computed tomography scan. FOLFIRINOX was delivered every 2 weeks as previously reported until progressive disease, major toxicity, or consolidation treatment by radiotherapy and/or surgery. RESULTS: Seventy-seven patients were enrolled. They received a median number of five cycles (1-30). Grade 3-4 toxicities were neutropenia (11 %), nausea (9 %), diarrhea (6 %), fatigue (6 %), and anemia (1 %). Grade 2-3 sensory neuropathy occurred in 25 % of patients. No toxic death was reported and only 6 % of patients had to stop treatment because of toxicity. Disease control rate was 84 with 28 % of objective response (Response Evaluation Criteria in Solid Tumors). Seventy-five percent of patients received a consolidation therapy: 70 % had radiotherapy and 36 % underwent a surgical resection, with a curative intent. Within the whole cohort, 1-year OS rate was 77 % (95 % CI 65-86) and 1-year progression-free survival rate was 59 % (95 % CI 46-70). CONCLUSION: First-line FOLFIRINOX for LAPA seems to be effective and have a manageable toxicity profile. These promising results will have to be confirmed in a phase III randomized trial.

25 Article Early experience with a novel hemostatic powder used to treat upper GI bleeding related to malignancies or after therapeutic interventions (with videos). 2013

Leblanc, Sarah / Vienne, Ariane / Dhooge, Marion / Coriat, Romain / Chaussade, Stanislas / Prat, Frédéric. ·Gastroenterology and Endoscopy Unit, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes, Sorbonne Paris Cité, Paris, France. ·Gastrointest Endosc · Pubmed #23622976.

ABSTRACT: -- No abstract --

Next