Publications by authors named "Richard Villet"

Background: Results of IBCSG-23-01-trial which included breast cancer patients with involved sentinel nodes (SN) by isolated-tumor-cells or micro-metastases supported the non-inferiority of completion axillary-lymph-node-dissection (cALND) omission. However, current data are considered insufficient to avoid cALND for all patients with SN-micro-metastases.

Methods: To investigate the impact of cALND omission on disease-free-survival (DFS) and overall survival (OS), we analyzed a cohort of 1421 patients <75 years old with SN-micro-metastases who underwent breast conservative surgery (BCS).

View Article and Find Full Text PDF

Based on results of clinical trials, completion ALND (cALND) is frequently not performed for patients with breast conservation therapy and one or two involved sentinel nodes (SN) by micro- or macro-metastases. However, there were limitations despite a conclusion of non-inferiority for cALND omission. No trial had included patients with SN macro-metastases and total mastectomy or with >2 SN macro-metastases.

View Article and Find Full Text PDF

Objective: Pelvic organ prolapse is a common condition among post-menopausal women, and surgery is often the standard treatment proposed. Native tissue vaginal surgery is burdened by a high rate of recurrence, and mesh vaginal surgery has become current practice. The purpose of this study was to evaluate the safety and the effectiveness of the vaginal kit Anterior/Apical single incision mesh Elevate™ for the correction of anterior and apical compartment prolapse.

View Article and Find Full Text PDF

Purpose: The prevalence of pelvic organ prolapse (POP) is increasing. The number of women aged 70-80 years requiring surgical management for POP is also increasing. The purpose of this study was to compare the complications associated with three pelvic organ prolapse repair methods, sacrocolpopexy (SCP), native tissue repair (NTR), and vaginal mesh repair (VMR), in women aged 70-80 years.

View Article and Find Full Text PDF
Article Synopsis
  • There is a strong link between breast cancer molecular subtypes and axillary status, highlighting the importance of predicting lymph node positivity.
  • Researchers created multivariable models using logistic regression to predict lymph node metastases, incorporating data from surgical results and biopsies.
  • Analysis of data from over 12,000 early breast cancer patients showed significant factors like age and tumor size impact the risk of lymph node metastases, leading to predictive nomograms that can help in deciding treatment strategies.
View Article and Find Full Text PDF

Background: Three randomized trials have concluded at non inferiority of omission of complementary axillary lymph node dissection (cALND) for patients with involved sentinel node (SN). However, we can outline strong limitations of these trials to validate this attitude with a high scientific level. We designed the SERC randomized trial ( ClinicalTrials.

View Article and Find Full Text PDF

Descending Perineum Syndrome (DPS) is a coloproctologic disease and the best treatment for it is yet to be defined. DPS is frequently associated with pelvic organ prolapse (POP) and it is reasonable to postulate, that treatment of POP will also have an impact on DPS. We aimed to evaluate the subjective satisfaction and improvement of DPS for patients who have undergone a sacral colpoperineopexy associated with retrorectal mesh for concomitant POP.

View Article and Find Full Text PDF

Background: Vaginal mesh safety information is limited, especially concerning single incision techniques using ultra lightweight meshes for the treatment of anterior pelvic organ prolapse (POP).

Objective: To determine the intraoperative and postoperative complication rates after anterior POP repair involving an ultralight mesh (19g/m): Restorelle Direct Fix™.

Methods: A case series of 218 consecutive patients, operated on between January 2013 and December 2016 in ten tertiary and secondary care centres, was retrospectively analyzed.

View Article and Find Full Text PDF

Background: Laparoscopic mesh sacropexy (LS) or transvaginal mesh repair (TVM) are surgical techniques used to treat cystoceles. Health authorities have highlighted the need for comparative studies to evaluate the safety of surgeries with meshes.

Objective: To compare the rate of complications, and functional and anatomical outcomes between LS and TVM.

View Article and Find Full Text PDF

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).

View Article and Find Full Text PDF

Introduction: The aim of this study was to examine changes in therapeutic practices for early breast cancer T0-2 N0 managed by upfront surgery and SLNB.

Population: Between 1999 and 2012, 15.508 patients were treated.

View Article and Find Full Text PDF

Purpose: Benefit of adjuvant trastuzumab-based chemotherapy for node-positive and/or >1 cm human epidermal growth factor receptor 2-positive (HER2+) breast carcinomas has been clearly demonstrated in randomized clinical trials. Yet, evidence that adjuvant chemotherapy with or without trastuzumab is effective in pT1abN0 HER2+ tumors is still limited. The primary objective of this study was to investigate the impact of adjuvant chemotherapy ± trastuzumab on outcome in this subpopulation.

View Article and Find Full Text PDF

Background: To estimate the proportion of elderly patients (>70 years) with breast cancer eligible for an Exclusive IntraOperative RadioTherapy (E-IORT) and to evaluate their local recurrence-free survival rate.

Methods: This retrospective study examining two cohorts focuses on patients over 70 years old: a multi-centric cohort of 1411 elderly patients and a mono-centric cohort of 592 elderly patients. All patients underwent conservative surgery followed by external radiotherapy for T0-T3 N0-N1 invasive breast cancer, between 1980 and 2008.

View Article and Find Full Text PDF

Purpose: Controversy exists about the prognosis of breast cancer in young women. Our objective was to describe clinicopathological and prognostic features to improve adjuvant treatment indications.

Methods: We conducted a retrospective multi centre study including fifteen French hospitals.

View Article and Find Full Text PDF
Article Synopsis
  • - The study analyzed 14,095 breast cancer patients to determine the rate and factors affecting axillary recurrence (AR) after sentinel lymph node biopsy, finding an overall AR rate of just 0.51% during a median follow-up of 55.2 months.
  • - Key predictors for AR included higher tumor grades, lack of radiotherapy, and specific tumor subtypes, particularly noting higher AR rates in triple-negative and HER2-positive tumors.
  • - AR was significantly associated with lower overall survival rates, particularly in patients with early-onset AR, highlighting the need for systemic treatment in cases of isolated AR, though the actual benefits of such treatments are still unclear.
View Article and Find Full Text PDF

Purpose: Persistent urinary retention (UR) is a complication of 3.5-14.3% of patients having undergone deep pelvic endometriosis (DPE) surgery of posterior compartment, and it is prone to persist.

View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to determine the percentage of breast cancer patients eligible for targeted intraoperative radiotherapy (TARGIT) and their survival rates without local recurrence.
  • Two cohorts were analyzed: a larger multicentric cohort with 7,580 patients and a smaller monocentric cohort with 4,445 patients, both undergoing conservative surgery and external radiotherapy between 1980 and 2005.
  • Results showed that eligibility for TARGIT varied significantly between the cohorts, with higher rates in the multicentric group and better five-year survival rates observed in eligible patients compared to non-eligible patients.
View Article and Find Full Text PDF

To define the prognostic value of isolated tumor cells (ITC), micrometastases (pN1mi) and macrometastases in early stage breast cancer (ESBC). We conducted a retrospective multicenter cohort study at 13 French sites. All the eligible patients who underwent SLNB from January 1999 to December 2008 were identified, and appropriate data were extracted from medical records and analyzed.

View Article and Find Full Text PDF

The delegation of low-risk breast cancer patients' follow-up to non-hospital practitionners (NHP), including gynaecologists and general practitioners, has been assessed prospectively within a care network in the Paris region. Patients with early stage breast cancer were eligible. The follow-up protocol was built according to international guidelines.

View Article and Find Full Text PDF

Genital prolapse is a frequent functional pathology in women. Its surgical treatment depends specially upon the suspension and fixation of the vaginal vault. Thus, sacrocolpopexy has become a gold standard technique to correct genital prolapse.

View Article and Find Full Text PDF

Although benign, pelvic organ prolapse is a real public health problem, affecting mostly women above sixty-five. Eighty-year-old women have an 11.1% lifetime risk of undergoing surgery for prolapse or stress urinary incontinence and 29% will need a second procedure.

View Article and Find Full Text PDF

We report a case of a pregnancy and follow the delivery of a young woman who previously underwent a laparoscopic sacral colpopexy (LSC) for pelvic organ prolapse (POP). A 38-year-old woman with POP desires pregnancy who after unsuccessful medical treatment with pessary underwent a laparoscopic uterine ventrosuspension (LUV). However, this procedure also failed and there was an immediate relapse.

View Article and Find Full Text PDF