Sentinel lymph node biopsy validation for large tumors.

Background: Sentinel lymph node biopsy (SLNB) remains under discussion for large size tumors. The aim of this work has been to study the false negative rate (FNR) of SLNB for large tumors and predictive factors of false negative (FN).

Materials And Methods: A study of a multicentric cohort, involved patients presenting N0 breast cancer with a SLNB eventually completed by complementary axillary lymph node dissection (cALND).

Tolerance of latissimus dorsi in immediate breast reconstruction without implant to radiotherapy.

Introduction: Immediate breast reconstruction (IBR) improves the quality of life of patients who undergo mastectomy. The latissimus dorsi flap (LDF) method provides particularly good aesthetic results, but its tolerance to subsequent radiotherapy remains unclear. We thus sought to assess tolerance and esthetic results and satisfaction, as reported by patients who underwent IBR by LDF with or without subsequent radiotherapy.

Surgical Management of Benign and Borderline Phyllodes Tumors of the Breast.

Phyllodes tumors (PT) are uncommon fibroepithelial breast neoplasms and there is currently no clear consensual treatment for these tumors. The aim of our study was to evaluate the surgical management and outcome of benign and borderline PT. We retrospectively assessed 76 cases of benign or borderline PT managed at the Leon Berard comprehensive cancer center in Lyon, France between July 2003 and December 2013.

[Lipofilling and breast cancer: Literature review in 2015?].

Introduction: The clinical surveillance of a patient treated for breast cancer involves many specialists: a surgeon, an oncologist, a radiotherapist, a gynecologist, and a general practitioner. The patients diagnosed with breast cancer will require regular clinical examination in order to identify possible recurrences. In our team, fat grafting has been used since 1998 for breast reconstruction because its results are natural breasts.

[Axillary lymph node dissection after breast reconstruction by pedicled Latissimus dorsi: Operative steps and outcomes].

Objectives: We retrospectively reviewed all the cases of axillary lymph node dissection (ALND) performed within a year after an immediate breast reconstruction procedure by a pedicled Latissimus dorsi, which is transferred to the anterior thoracic wall through an axillary funnel. Operative technical steps are described taking account of the new anatomical relationship of the axilla.

Methods: We assessed postoperative immediate complications and late sequelaes.

[Axillary lymph node metastases with an occult breast: About 16 cases from a cohort of 7770 patients].

Objectives: Isolated axillary lymph node metastases is an unusual clinical presentation of breast carcinoma. We studied its different issues.

Methods: This study is a follow-up study of 16patients, treated between 1996 and 2012, presenting with axillary metastases with an occult breast carcinoma, which could not be identified by physical examination nor by a conventional imaging or a breast MRI.

Breast reconstruction with fat grafting and BRAVA(®) pre-expansion: Efficacy evaluation in 45 cases.

Introduction: Fat grafting for breast surgery, in reconstruction or aesthetics, gained a lot of popularity over the last years. As an addition to breast reconstruction with flaps or prosthesis, lipofilling improved the aesthetic result, increasing the patients' satisfaction rate. The demand for breast reconstruction using only fat grafting increased, because patients want a natural result in breast reconstruction and also the body contouring associated with liposuction of specified fat areas.

[Tolerance of latissimus dorsi without implant to radiotherapy in immediate breast reconstruction].

Objectives: Rates of immediate breast reconstruction (IBR) after mastectomy are currently increasing, leading us to evaluate outcomes of breast reconstruction with latissimus dorsi without implant followed by adjuvant radiotherapy.

Materials And Methods: From January 1999 to August 2013, 31 breast reconstructions with latissimus dorsi have been irradiated. Patients have been selected from a prospective database and contacted to evaluate outcomes of breast reconstruction, and 2 patients have been lost.

TIF1γ interferes with TGFβ1/SMAD4 signaling to promote poor outcome in operable breast cancer patients.

Background: The Transforming growth factor β (TGFβ) signaling has a paradoxical role in cancer development and outcome. Besides, the prognostic significance of the TGFβ1, SMAD4 in breast cancer patients is an area of many contradictions. The transcriptional intermediary factor 1γ (TIF1γ) is thought to interact with the TGFβ/SMAD signaling through different mechanisms.

[Metastatic screening before adjuvant chemotherapy in breast cancer].

Introduction: Systematic metastasis staging in early breast cancer is no longer recommended. However, it is still performed before adjuvant chemotherapy.

Materials And Methods: We assessed metastasis screening of asymptomatic women with a local breast cancer without lymph node involvement when adjuvant chemotherapy was indicated.

[Postoperative morbidities after modified posterior pelvic exenteration for ovarian cancer].

Objective: Complication and survival analysis of cytoreduction surgery with modified posterior pelvic exenteration in the surgical treatment of the ovarian malignant tumor.

Methods: A retrospective monocentric study between 2000 and 2013 in Rhone-Alpes cancer treatment center. One hundred and fifty-two patients with ovarian cancer and treated by surgery with modified posterior pelvic exenteration were included.

[Satisfaction in ambulatory patients with breast-conserving surgery and sentinel node biopsy for breast cancer].

Objective: The objective of this study was to evaluate outpatient satisfaction for breast cancer surgery and compare with inpatient satisfaction.

Patients And Methods: Our observational prospective study included all patients who underwent breast cancer surgical procedure (breast-conserving surgery and sentinel node biopsy) between July and December 2013 in a cancer center. Patients were asked to answer a questionnaire at discharge and 30 days after surgery.

[Glandular posterior flap of the breast for oncoplastic surgery].

Introduction: Breast conservative surgeries, associated with radiotherapy within the framework of conservatives treatments for breast malignant tumors, can occur deformation of the breast in 10 to 15% of cases. The deformity can be more or less important according to the size of the initial lesion and the glandular reshaping reconstruction. Our experience in oncologic and reconstructive surgery of the breast reflects us about difficult cases of breast conservative surgeries in a glandular reshaping to obtain the best aesthetic result.

[Perinatal mortality and quality of clinical management in the Aurore network from 2005 to 2011. Implementation of morbidity and mortality conferences].

Objectives: Evaluate the incidence of perinatal mortality and evaluate the percentage of non optimal care management of fatal pregnancies between 2005 and 2011 in the Rhone-Alpes region in France, by the use of the Aurore network. Evaluate the development of morbi-mortality revues (MMR) in this region.

Methods: Retrospective study of perinatal mortality in the Aurore network, from 2005 to 2011.

Quality of life of surgical oncology residents and fellows across Europe.

Background: Data are currently lacking regarding the quality of life of surgical oncology (SO) trainees. We sought to assess the training conditions and quality of life of SO residents and fellows across Europe.

Material And Methods: Members of the European Society for Surgical Oncology were invited to complete a Web-based survey that included a questionnaire specifically designed for SO trainees.

Primary ovarian borderline tumor in the inguinal lymph node.

We report the case of a primary serous ovarian borderline tumour developed in an inguinal lymph node. No primary ovarian borderline tumour was observed within the ovaries after bilateral ovariectomy and complete pathological examination. We considered the diagnosis of ectopic ovarian tissue because the tumour was completely surrounded by normal ovarian tissue with positive FOXL2 staining.

[Adjuvant treatments in breast cancer: interest of completion of axillary dissection in case of micrometastases or isolated tumor cells in sentinel lymph node].

Prognostic signification of micrometastases ou isolated tumor cells (ITC) has not yet been clearly precised. Management of the axilla in case of micrometastases or ITC depends on the local pratices: no surgical completion or axillary lymph node dissection (ALND). Axillary lymph node status is the most important prognostic factor in patients with breast cancer; morbidity of ALND is now well known whereas its therapeutic benefit has not been demonstrated.

[Insights of young French surgical oncologists: motives and training].

Introduction: In France, surgical oncology is not recognized as a unique specialty, but as a sub-specialization offered to surgeons in training. To date, their motives and training have not been studied.

Materials And Methods: We set a dedicated online survey suggested to 102 surgeons applying for the specific national degree in surgical oncology.

New developments in treatment of ovarian carcinoma: focus on trabectedin.

Trabectedin is a new marine-derived compound that binds the DNA minor groove and interacts with proteins of the DNA repair machinery. Trabectedin has shown promising single-agent activity in pretreated patients with soft tissue sarcoma, and ovarian and breast cancer, and combination with various other chemotherapeutic drugs seems feasible. Toxicities are mainly hematologic and hepatic, with Grade 3-4 neutropenia and thrombocytopenia observed in approximately 50% and 20% of patients, respectively, and Grade 3-4 elevation of liver enzymes observed in 35%-50% of patients treated with trabectedin.

Hyperthermic intraperitoneal chemotherapy with oxaliplatin and without adjuvant chemotherapy in stage IIIC ovarian cancer.

Objective: To assess the feasibility and efficacy of cytoreductive surgery (CRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC) without adjuvant chemotherapy for relapsed or persistent advanced ovarian cancer.

Methods: This observational study included stage IIIC ovarian cancer patients due to undergo CRS (interval debulking or recurrent surgery) followed by HIPEC with oxaliplatin (460 mg/m2) for 30 min.

Results: Twenty-two patients (12 interval debulking procedures and 10 recurrence procedures) were enrolled between September 2003 and September 2007.

Bedside assessment of fibrinogen level in postpartum haemorrhage by thrombelastometry.

Objectives: To establish whether reagent-supported thrombelastometry with the rotation thrombelastometry system (ROTEM) point-of-care device correlated with fibrinogen level in postpartum haemorrhages.

Design: Prospective observational study.

Population And Setting: Ninety-one women at the third trimester of pregnancy: 37 with postpartum haemorrhage (study group) and 54 without abnormal bleeding (control group).

[Effects of morbidity mortality conferences. Experience of the Aurore perinatal network from 2005 to 2007].

Objectives: To assess the impact of morbidity mortality conferences on medical care in case of perinatal death and to point out situations with high risk of inappropriate care.

Patients And Methods: We have prospectively listed in the Aurore perinatal network all the perinatal deaths and their related causes using a controlled declarative system between January 2005 and December 2007. A multidisciplinary committee retrospectively analysed during morbidity mortality conferences the quality of care and subsequently classified the management as appropriate, inappropriate or doubtful.

Coagulation assessment by rotation thrombelastometry in normal pregnancy.

We analysed changes in coagulation during normal pregnancy with a novel point-of-care device based on thrombelastometry (ROTEM). We compared the results obtained with those of standard coagulation tests in 104 patients: 20 non-pregnant women (controls) and 84 women in the first (T1, n = 17), second (T2, n = 9) and third (T3, n = 58) trimesters of pregnancy. We measured the clotting time (CT), the maximum clot firmness (MCF), the early clot amplitude at 5 and 15 minutes (CA(5), CA(15)) and the clot lysis index (CLI(30)) with four tests containing specific reagents.