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Systemic chemotherapy for hepatocellular carcinoma in non-cirrhotic liver:A retrospective study

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World Journal of Gastroenterology 2009年第6期15卷 713-716页

作者： Julien Edeline jean-luc raoul Elodie Vauleon Anne Guillygomac'h Karim Boud jema Eveline Boucher Department of Medical Oncology Centre Eugène Marquis CS 4422935042 Rennes cedexFrance European University in Brittany 35042 Rennes cedexFrance Department of Liver Disease Pontchaillou University Hospital35033 Rennes cedexFrance Department of Liver Surgery and Transplantation Pontchaillou University Hospital35033 Rennes cedexFrance

AIM:To investigate the efficacy and toxicity of systemic chemotherapy in a retrospective study of patients with hepatocellular carcinoma(HCC)occurring in normal or fibrotic liver without cirrhosis. METHODS:Twenty-four patients with metastatic or locally advanced HCC in a normal or a fibrotic liver were given systemic chemotherapy(epirubicin,cis- platin and 5-fluorouracil or epirubicin,cisplatin and capecitabine regimens).Tumor response,time to pro- gression,survival,and toxicity were evaluated. RESULTS:There were 7 women and 17 men,mean age 54±10 years;18 patients had a normal liver and 6 had a fibrotic liver(F1/F2 on biopsy).Mean tumor size was 14 cm,5 patients had portal vein thrombosis and 7 had *** received a median of 4 chemotherapy *** tolerance was good. There were 5 partial responses(objective response rate =22%),and tumor control rate was 52%.Second line surgical resection was possible in two *** survival was 11 mo,and 1-and 2-year overall survival rates were 50%±10%and 32%±11%,respectively. CONCLUSION:In patients with HCC in a non-cirrhotic liver,chemotherapy was well tolerated and associated with an objective response rate of 22%,including two patients who underwent secondary surgical resection.

关键词： Antineoplastic protocols Chemotherapy Hepatocellular carcinoma

One case of intrahepatic cholangiocarcinoma amenable to resection after radioembolization

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World Journal of Gastroenterology 2014年第17期20卷 5131-5134页

作者： Cecilia Servajean Marine Gilabert Gilles Piana Geneviève Monges jean-Robert Delpero Isabelle Brenot jean-luc raoul Department of Medical Oncology Paoli-Calmettes Institute13273 MarseilleFrance Department of Radiology Paoli-Calmettes Institute13273 MarseilleFrance Department of Pathology Paoli-Calmettes Institute13273 MarseilleFrance Department of Digestive Surgery PaoliCalmettes Institute13273 MarseilleFrance Department of Nuclear Medicine PaoliCalmettes Institute13273 MarseilleFrance

We report the case of a 57-year-old man who was diagnosed with a large unresectable cholangiocarcinoma associated with 2 satellite nodules and without clear margins with the right hepatic vein. Despite 4 cycles of GEMOX (stopped due to a hypertransaminasemia believed to be due to gemcitabine) and 4 cycles of FOLFIRINOX, the tumor remained stable and continued to be considered unresectable. Radioembolization (resin microspheres, SIRS-spheres®) targeting the left liver (474 MBq) and segment IV (440 MBq) was performed. This injection was very well tolerated, and 4 more cycles of FOLFIRINOX were given while waiting for radioembolization efficacy. On computed tomography scan, a partial response was observed; the tumor was far less hypervascularized, and a margin was observed between the tumor and the right hepatic vein. A left hepatectomy enlarged to segment VIII was performed. On pathological exam, most of the tumor was acellular, with dense fibrosis around visible microspheres. Viable cells were observed only at a distance from beads. Radioembolization can be useful in the treatment of cholangiocarcinoma, allowing in some cases a secondary resection.

关键词： Intrahepatic cholangiocarcinomal Radioembolization Surgery Combined treatments

Expected outcomes and patients’selection before chemoembolization—“Six-and-Twelve or Pre-TACE-Predict”scores may help clinicians:Real-life French cohorts results

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World Journal of Clinical Cases 2021年第18期9卷 4559-4572页

作者： Xavier Adhoute Edouard Larrey Rodolphe Anty Patrick Chevallier Guillaume Penaranda Albert Tran jean-Pierre Bronowicki jean-luc raoul Paul Castellani HervéPerrier Olivier Bayle Olivier Monnet Bernard Pol Marc Bourliere Department of Gastroenterology and Hepatology Hôpital Saint-JosephMarseille 13008France Department of Gastroenterology and Hepatology Hôpital Universitaire de l’ArchetNice 06000France Department of Radiology Hôpital Universitaire de l’ArchetNice 06000France Statistics Department AlphaBio LaboratoryMarseille 13003France Department of Gastroenterology and Hepatology Centre Hospitalo-Universitaire de NancyVandoeuvre les Nancy 54511France Department of Medical Oncology Institut de Cancérologie de l’OuestSite de NantesNantes 44805France Department of Radiology Hôpital Saint-JosephMarseille 13008France Department of Hepatobiliary Surgery Hôpital Saint-JosephMarseille 13008France

BACKGROUND Careful selection of hepatocellular carcinoma(HCC)patients prior to chemoembolization treatment is a daily reality,and is even more necessary with new available therapeutic options in *** propose two new models to better stratify patients and maximize clinical benefit:“6 and 12”and“pre/post-TACE-predict”(TACE,transarterial chemoembolization).METHODS We evaluated and compared their performance in predicting overall survival with other systems{Barcelona Clinic Liver Cancer(BCLC),Albumin-Bilirubin(ALBI)and NIACE[Number of tumor(s),Infiltrative HCC,alpha-fetoprotein,Child-Pugh(CP),and performance status]}in two HCC French cohorts of different stages enrolled between 2010 and *** The cohorts included 324 patients classified as BCLC stages A/B(cohort 1)and 137 patients classified as BCLC stages B/C(cohort 2).The majority of the patients had cirrhosis with preserved liver function.“Pre-TACE-predict”and“6 and 12”models identified three distinct categories of patients exhibiting different prognosis in cohort ***,their prognostic value was no better than the BCLC system or NIACE *** function based on CP and ALBI grades significantly impacted patient ***,the“post-TACE-predict”model had a higher predictive value than other *** stratification ability as well as predictive performance of these new models in an intermediate/advanced stage population was less efficient(cohort 2).CONCLUSION The newly proposed“Pre-TACE-predict”and“6 and 12”models offer an interesting stratification into three categories in a recommended TACE population,as they identify poor candidates,those with partial control and durable *** models'contribution was reduced in a population with advanced stage HCCs.

关键词： Hepatocellular carcinoma Transarterial chemoembolization Pre-TACEpredict Six-and-twelve Barcelona Clinic Liver Cancer Prognosis

How to assess the efficacy or failure of targeted therapy:deciding when to stop sorafenib in hepatocellular carcinoma

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World Journal of Hepatology 2016年第35期8卷 1541-1546页

作者： jean-luc raoul Xavier Adhoute Marine Gilabert Julien Edeline Department of Medical Oncology Paoli-Calmettes Institute Department of Hepatology Hopital Saint-Joseph Department of Medical Oncology Centre E MarquisBd de la Bataille Frandres-Dunkerque

Sorafenib is thus far the only systemic treatment for hepatocellular carcinoma(HCC) based on the results of two randomized controlled trials performed in Western and in Eastern countries, despite a poor response rate(from 2% to 3.3%) following conventional evaluation criteria. It is now recognized that the criteria(European Association of the Study of the Liver criteria, modified response evaluation criteria in solid tumors) based on contrast enhanced techniques(computed tomography scan, magnetic resonance imaging) aimed to assess the evolution of the viable part of the tumor(hypervascularized on arterial phase) are of major interest to determine the efficacy of sorafenib and of most antiangiogenic drugs in patients with HCC. The role of alphafetoprotein serum levels remains unclear. In 2016, in accordance with the SHARP and the Asia-Pacific trials, sorafenib must be stopped when tolerance is poor despite dose adaptation or in cases of radiological and symptomatic progression. This approach will be different in cases of available second-line therapy trials. Some recent data(in renal cell carcinoma) revealed that despite progression in patients who received sorafenib, this drug can still decrease tumor progression compared to drug cessation. Then, before deciding to continue sorafenib post-progression or shift to another drug, knowing other parameters of post-progression survival(Child-Pugh class, Barcelona Clinic Liver Cancer, alphafetoprotein, post-progression patterns in particular, the development of extrahepatic metastases and of portal vein thrombosis) will be of major importance.

关键词： Tumor evaluation Response evaluation criteria in solid tumors Sorafenib Hepatocellular carcinoma Modified response evaluation criteria in solid tumors

Barcelona clinic liver cancer nomogram and others staging/scoring systems in a French hepatocellular carcinoma cohort

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World Journal of Gastroenterology 2017年第14期23卷 2545-2555页

作者： Xavier Adhoute Guillaume Pénaranda jean luc raoul Julien Edeline jean-Frédéric Blanc Bernard Pol Manuela Campanile HervéPerrierO livier Bayle Olivier Monnet Patrick Beaurain Cyril Muller Paul Castellani Yves Patrice Le Treut jean Pierre Bronowicki Marc Bourlière Department of Hepato-Gastroenterology Hopital Saint-Joseph Marseille Alpha Bio Laboratory Marseille Department of Hepato-Gastroenterology and Digestive Oncology Institut Paoli-Calmette Marseille Department of Hepato-Gastroenterology and Digestive Oncology Centre Eugène Marquis Rennes Department of Hepato-Gastroenterology Centre Hospitalo-Universitaire Saint-AndréBordeaux Department of Hepatobiliary Surgery Hopital Saint-Joseph Marseille Department of Radiology Hopital Saint-Joseph Marseille Department of Hepatobiliary Surgery Centre Hospitalo-Universitaire Timone Marseille Department of Hepato-Gastroenterology Centre Hospitalo-Universitaire de Nancy INSERM U954 Universitéde LorraineCHU de NancyVandoeuvre les Nancy

AIM To compare the performances of the Barcelona clinic liver cancer(BCLC) nomogram and others systems(BCLC, HKLC, CLIP, NIACE) for survival prediction in a large hepatocellular carcinoma(HCC) French *** Data were collected retrospectively from 01/2007 to 12/2013 in five French centers. Newly diagnosed HCC patients were analyzed. The discriminatory ability, homogeneity ability, prognostic stratification ability Akaike information criterion(AIC) and C-index were compared among scoring systems. RESULTS The cohort included 1102 patients, mostly men, median age 68 [60-74] years with cirrhosis(81%), child-Pugh A(73%), alcohol-related(41%), HCV-related(27%). HCC were multinodular(59%) and vascular invasion was present in 41% of cases. At time of HCC diagnosis BCLC stages were A(17%), B(16%), C(60%) and D(7%). First line HCC treatment was curative in 23.5%, palliative in 59.5%, BSC in 17% of our population. Median OS was 10.8 mo [4.9-28.0]. Each system distinguished different survival prognosis groups(P < 0.0001). The nomogram had the highest discriminatory ability, the highest C-index value. NIACE score had the lowest AIC value. The nomogram distinguished sixteen different prognosis groups. By classifying unifocal large HCC into tumor burden 1, the nomogram was less powerful. CONCLUSION In this French cohort, the BCLC nomogram and the NIACE score provided the best prognostic information, but the NIACE could even help treatment strategies.

关键词： Barcelona clinical liver cancer Hong kong liver cancer NIACE CLIP Hepatocellular carcinoma

Usefulness of the MESH score in a European hepatocellular carcinoma cohort

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World Journal of Hepatology 2017年第15期9卷 711-714页

作者： Xavier Adhoute Guillaume Pénaranda jean-luc raoul Marc Bourlière Department of Hepato-Gastroenterology Hopital Saint-Joseph Marseille AlphaBio Laboratory Marseille Department of Hepato-Gastroenterology and Digestive Oncology Institut Paoli-Calmette Marseille

The Barcelona Clinic Liver Cancer classification is the most widely-used hepatocellular carcinoma(HCC) staging system because it is simple,precise and linked to a treatment algorithm based on randomized *** each group includes a broad spectrum of tumors,with limited therapeutic options,particularly for intermediate and advanced ***,different additional scoring systems have been proposed to refine the prognosis and/or to improve the *** until now,there is no *** et al proposes a new scoring system,based on a large HCC cohort,with patients at different stages,treated using diverse *** score includes six parameters used in current *** is simple to calculate,reliable,with an ability to predict survival superior to other systems,which also works with our European HCC *** MESH score may be especially useful to differentiate subgroups with different prognosis for each treatment modality.

关键词： Hepatocellular carcinoma Barcelona Clinic Liver Cancer Scoring system MESH NIACE

“Six-and-twelve” score for outcome prediction of hepatocellular carcinoma following transarterial chemoembolization. In-depth analysis from a multicenter French cohort

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World Journal of Hepatology 2020年第8期12卷 525-532页

作者： Xavier Adhoute Guillaume Pénaranda jean-luc raoul jean-Pierre Bronowicki Rodolphe Anty MarcBourlière Department of Gastroenterology and Hepatology Hôpital Saint-JosephMarseille 13008France AlphaBio Laboratory Marseille 13003France Department of Medical Oncology Institut de Cancérologie de l'OuestNantes 44805France Department of Gastroenterology and Hepatology Centre Hospitalo-Universitaire deNancy 54511France Department of Gastroenterology and Hepatology Hôpital Universitaire de l’ArchetNice 06200France

The“six-and-twelve”(6&12)score is a new hepatocellular carcinoma(HCC)prognostic index designed for recommended transarterial chemoembolization(TACE)*** and easy to use by the sum of tumor size(cm)and number,this model identifies three groups with different survival time(the sum is≤6;or>6 but≤12;or>12);a survival benefit with TACE can be expected for HCC patients with a score not exceeding ***,Wang ZW et al showed that the“6&12”model was the best system correlated with radiological response after the first ***,we wanted to assess its survival prediction ability as well as its prognostic value and compared it to other systems(Barcelona Clinic Liver Cancer,Hong Kong Liver Cancer(HKLC)staging,Albumin-Bilirubin grade,tumor nodularity,infiltrative nature of the tumor,alpha-fetoprotein,Child-Pugh class,and Performance Status score,Cancer of the Liver Italian Program,Model to Estimate Survival for HCC scores,up-to-seven criteria)different from Wang ZW et al study in a multicenter French cohort of HCC including only recommended TACE candidates retrospectively *** previously demonstrated,we show that the"6&12”score can classify survival within this French cohort,with a prognostic value comparable to that of other systems,except HKLC *** importantly,the“6&12”score simplicity and ability in patients’stratification outperform other systems for a routine clinical practice.

关键词： Hepatocellular carcinoma Transarterial chemoembolization “Six-and-twelve”score Prognosis Albumin-Bilirubin grade Tumor nodularity,infiltrative nature of the tumor,alpha-fetoprotein,Child-Pugh class,and performance status score

Recurrent Oxaliplatin-Induced Immune Hemolytic Anemia by Chemotherapy for Metastatic Colon Cancer: A Case Report

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Journal of Cancer Therapy 2013年第1期4卷 159-160页

作者： Sandrine Oziel-Taieb Renaud Sabatier Marine Gilabert Sylvain Garciaz Pauline Ries Slimane Dermeche jean-luc raoul Department of Medical Oncology Paoli-Calmettes Institute Marseille France.

We report herein the case of a 55-year-old man who presented an acute hemolysis following a 6th cycle of FOLFOX regimen for a metastatic colorectal cancer;this patient had previously received 12 cycles in an adjuvant setting. He had presented attenuated signs during the previous cycle. This corresponded to an oxaliplatin-induced immune hemolytic anemia. This unfrequent side effect of oxaliplatin needs to be known in order to avoid severe complications.

关键词： Oxaliplatine Hemolysis Auto-Immune Colorectal Cancer

It’s not all in your feet: Improving penalty kick performance with humanavatar interaction and machine learning

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The Innovation 2024年第2期5卷 115-121页

作者： jean-luc Bloechle Julien Audiffren Thibaut Le Naour Andrea Alli Dylan Simoni Gabriel Wüthrich jean-Pierre Bresciani Control and Perception Laboratory University of FribourgBd Perolles 901700 FribourgSwitzerland Motion-up Le PrismePlace Albert Einstein56000 VannesFrance FC Basel 1893 Birsstrasse 320A4002 BaselSwitzerland

Penalty kicks are increasingly decisive in major international football ***,over 30%of shootout kicks are *** outcome of the kick often relies on the ability of the penalty taker to exploit anticipatory movements of the goalkeeper to redirect the kick toward the open side of the ***,this ability is difficult to train using classical *** used an augmented reality simulator displaying an holographic goalkeeper to test and train penalty kick performance with 13 young elite *** learning algorithms were used to optimize the learning rate by maintaining an optimal level of training *** training sessions of 20 kicks reduced the redirection threshold by 120 ms,which constituted a 28%reduction with respect to the baseline ***,redirection threshold reduction was observed for all trained players,and all things being equal,it corresponded to an estimated 35%improvement of the success rate.

关键词： kick penalty learning