Impact of Laparoscopic Surgical Management of Deep Endometriosis on Pregnancy Rate

K

Efficacy and safety of pressurized intraperitoneal aerosol chemotherapy (PIPAC) in ovarian cancer: a systematic review of current evidence

Background: PIPAC is a recent approach for intraperitoneal chemotherapy with promising results for patients with peritoneal carcinomatosis. A systematic review was conducted to assess current evidence on the efficacy and outcomes of PIPAC in patients affected by ovarian cancer. Methods: The study adhered to the PRISMA guidelines. PubMed, Google Scholar and ClinicalTrials.gov were searched up to December 2023. Studies reporting data on patients with OC treated with PIPAC were included in the qualitative analysis. Results: Twenty-one studies and six clinical trials with 932 patients who underwent PIPAC treatment were identified. The reported first access failure was 4.9%. 89.8% of patients underwent one, 60.7% two and 40% received three or more PIPAC cycles. Pathological tumour response was objectivated in 13 studies. Intra-operative complications were reported in 11% of women and post-operative events in 11.5% with a 0.82% of procedure-related mortality. Quality of life scores have been consistently stable or improved during the treatment time. The percentage of OC patients who became amenable for cytoreductive surgery due to the good response after PIPAC treatment for palliative purposes is reported to be 2.3%. Conclusion: The results showed that PIPAC is safe and effective for palliative purposes, with a good pathological tumour response and quality of life. Future prospective studies would be needed to explore the role of this treatment in different stages of the disease, investigating a paradigm shift towards the use of PIPAC with curative intent for women who are not eligible for primary cytoreductive surgery

Development of a methodology for in vivo follow-up of hepatocellular carcinoma in hepatocyte specific Trim24-null mice treated with myo-inositol trispyrophosphate

BACKGROUND: Genetically induced hepatocellular carcinoma (HCC) models are generally used to investigate carcinogenesis pathways, but very few attempts were made to valorize them for pharmacological testing. This study describes a micro-computed tomography (micro-CT) - based methodology for the diagnostic and lifelong follow-up of HCC in the hepatocyte-specific Trim24-null mouse line. Myo-inositol trispyrophosphate (ITPP) was tested as anti-cancer drug. METHODS: Partial hepatectomy was performed in 2 months-old Trim24-null mice, in order to accelerate the carcinogenesis process. HCC diagnosis was obtained by micro-CT scan with double contrast agent: 10 μl/g Fenestra™ LC was injected intraperitoneally 6 h prior to imaging and 10 μl/g Fenestra™ VC was injected intravenously 15 min prior to imaging. Twenty three hepatocyte-specific Trim24-null mice were considered for ITPP testing (3 mg/g/week intraperitoneally during 10 months in 12 mice, versus 11 controls). Lifelong follow-up was performed using micro-CT. Comparative analysis was performed using unpaired t test with Welch correction and survival curves were compared by log-rank test. Gene expression analysis was performed using the RT q-PCR technique. RESULTS: Double contrast micro-CT scan allowed HCC diagnosis as hypodense, isodense or hyperdense nodules. Positive predictive value was 81.3 %. Negative predictive value was 83.3 %. Tumor growth could be objectified by micro-CT scan before the ITPP treatment was started, and at 3 and 9 months follow-up. Significant progression of tumor volume was demonstrated in the both groups, with no difference between groups (p > 0.05). In the ITPP group, a mild decrease in tumor doubling time was first observed (31.9 +/− 12 days, p > 0.05) followed by a significant increase (59.8 +/− 18.3 days, p = 0.008). However, tumor doubling time was not different between groups (p > 0.05). Median survival after treatment initiation was 223 days (controls) versus 296 days (ITPP group, p = 0.0027). HIF1α, VEGF, glutamine synthase, osteopontin expression levels were not significantly modified at the end of follow-up. In the ITPP group, the p53 expression profile was inversed as compared to the control group, higher in non-tumor livers than in tumors. CONCLUSION: ITPP treatment allowed for a two-month survival improvement, with better tolerance of tumor burden and apoptosis increase in non-tumor, pathological livers. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13046-016-0434-8) contains supplementary material, which is available to authorized users

Contribution of microscanner in the preclinical study of hepatic and pancreatic cancer treatments in rat

L'expérimentation animale, étape préliminaire incontournable dans la recherche pré clinique, repose essentiellement sur le petit animal. L'imagerie in vivo constitue un outil précieux qui permet l'obtention d'informations anatomiques, biochimiques, physiologiques, génétiques, pharmacologiques, etc..., tout en respectant l'intégrité cellulaire et tissulaire des animaux étudiés. Elle ouvre ainsi d'énormes perspectives scientifiques dans les domaines de la biologie du développement, de la physiopathologie des maladies, ainsi qu en cancérologie, du diagnostic précoce au traitement des cancers. Notre travail de thèse a consisté à démontrer la pertinence du microscanner dans le suivi longitudinal et la prise en charge de modèles orthotopiques de cancers hépatiques et pancréatiques chez le rat. Il s'agit de deux types de cancers très peu ou pas curables pour lesquelles la recherche concernant les bases de l'oncogenèse de même que l'exploration des nouvelles voies thérapeutiques qui en résultent devient une urgence. Au vu des résultats de notre thèse l'imagerie par microscanner pourrait avoir un rôle dans l'évaluation préclinique de thérapeutiques émergeantes pour ces types de cancers. Sur le plan de l'expérimentation animale, l'imagerie in vivo par microscanner permet d'une part de réduire le nombre d'animaux utilisés pour chaque expérience et d'autre part de définir de nouveaux points limites (issus de l'imagerie) autorisant l'arrêt des expériences en amont de toute souffrance de l'animal. Ceci répond ainsi aux principales exigences de l'expérimentation animale.Animal experimentation is an unavoidable step in preclinical studies and relies on small animals. In vivo imaging constitutes a precious tool giving information on anatomy, biochemistry, physiology, genetic, pharmacology, while saving cell and tissue integrities of investigated animals. It opens wide the scientific perspective in the field of biological development, physiopathology of diseases, as well as in oncology, from early diagnosis to cancer treatment. This thesis had demonstrated the relevance of microscanner in the longitudinal follow up and the management of orthotopopic models of hepatic and pancreatic carcinoma in the rat. For both of these cancers, known to be very poorly or even non curable, there is an urgent need of research on the bases of their oncogenesis as of investigation of the resulting new therapeutic routes. The results of our thesis suggest a role for micro-CT in the preclinical evaluation of their emerging therapies. As far as animal experiment is concerned, in vivo microscanner imaging permits, beside a reduction in the number of experimental animals, to establish new (imaging) end-points allowing experiment ending before any sign of animal suffering. It fulfils the main requirements of animal experiment

Le curage lombo-aortique (faisabilité, indications et controverses dans la prise en charge des cancers gynécologiques)

STRASBOURG-Medecine (674822101) / SudocSudocFranceF

Evaluation de nos pratiques cliniques dans la prise en charge chirurgicale des adénocarcinomes de l'endomètre de stades précoces

STRASBOURG-Medecine (674822101) / SudocSudocFranceF

Place de la chimiothérapie néoadjuvante dans le traitement des cancers de l'ovaire de stades avancés.

STRASBOURG-Medecine (674822101) / SudocSudocFranceF

Place actuelle de la promontofixation coelioscopique dans la prise en charge du prolapsus génital féminin (à propos d'une série rétrospective de 178 patientes)

STRASBOURG-Medecine (674822101) / SudocSudocFranceF