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Article ; Online: Incidence et impact de la maladie thrombo-embolique sur la prise en charge du cancer de l’ovaire.

Achen, G / Dolivet, E / Turck, M / Fauvet, R

Gynecologie, obstetrique, fertilite & senologie

2020 Volume 48, Issue 6, Page(s) 506–513

Abstract: Objective: Ovarian cancer is a risk factor for venous thromboembolism (VTE), which worsens overall survival. The main objective of our study was to calculate the incidence of VTE in our population. We analyzed VTE impact on diagnosis and management of ... ...

Title translation	Incidence and impact of venous thrombosis in the diagnosis and therapeutic management of ovarian cancer.
Abstract	Objective: Ovarian cancer is a risk factor for venous thromboembolism (VTE), which worsens overall survival. The main objective of our study was to calculate the incidence of VTE in our population. We analyzed VTE impact on diagnosis and management of ovarian cancer. Methods: We conducted a retrospective, monocentric study in ovarian, fallopian tube and primary peritoneal cancer patients, divided into 2 groups (« Presence of VTE » and « Absence of VTE »). A univariate and multivariate analysis of factors associated with VTE was performed, and we compared delays of management in both groups. Results: Among 157 patients included in the study, 22.9% presented a VTE, and 52.8% were asymptomatic. The VTE was diagnosed prior to any treatment in 61.1% of patients and revealed the ovarian cancer in 27.8% of cases. In multivariate analysis, tumor size (OR=1.1, 95% CI: 1-2.21, P=0.012), malnutrition (OR=3.79, 95% CI: 1.16-12,4, P=0.028) and Ddimer level above 1.5μg/mL (OR=13.8, 95% CI 1.2-152.8, P=0.02) were significantly associated with VTE. No significant difference was found between the two groups in diagnostic or therapeutic strategy, as well as in delays of management. Conclusion: We report a high incidence of VTE in ovarian cancer, including a lot of asymptomatic events. An early diagnosis with clinical examination and Ddimer level could improve its management and its prognosis.
MeSH term(s)	Aged ; Female ; Fibrin Fibrinogen Degradation Products/analysis ; Humans ; Malnutrition/complications ; Middle Aged ; Odds Ratio ; Ovarian Neoplasms/complications ; Ovarian Neoplasms/diagnosis ; Ovarian Neoplasms/therapy ; Retrospective Studies ; Risk Factors ; Venous Thrombosis/complications ; Venous Thrombosis/diagnosis ; Venous Thrombosis/epidemiology
Chemical Substances	Fibrin Fibrinogen Degradation Products ; fibrin fragment D
Language	French
Publishing date	2020-03-12
Publishing country	France
Document type	Journal Article
ZDB-ID	2887456-0
ISSN	2468-7189
ISSN (online)	2468-7189
DOI	10.1016/j.gofs.2020.03.007
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Article ; Online: Modulation of Immunity by Lymphatic Dysfunction in Lymphedema.

Yuan, Yinan / Arcucci, Valeria / Levy, Sidney M / Achen, Marc G

Frontiers in immunology

2019 Volume 10, Page(s) 76

Abstract: The debilitating condition known as secondary lymphedema frequently occurs after lymphadenectomy and/or radiotherapy for the treatment of cancer. These therapies can damage lymphatic vessels leading to edema, fibrosis, inflammation and dysregulated ... ...

Abstract	The debilitating condition known as secondary lymphedema frequently occurs after lymphadenectomy and/or radiotherapy for the treatment of cancer. These therapies can damage lymphatic vessels leading to edema, fibrosis, inflammation and dysregulated adipogenesis, which result in profound swelling of an affected limb. Importantly, lymphedema patients often exhibit impaired immune function which predisposes them to a variety of infections. It is known that lymphadenectomy can compromise the acquisition of adaptive immune responses and antibody production; however the cellular mechanisms involved are poorly understood. Here we discuss recent progress in revealing the cellular and molecular mechanisms underlying poor immune function in secondary lymphedema, which has indicated a key role for regulatory T cells in immunosuppression in this disease. Furthermore, the interaction of CD4
MeSH term(s)	Animals ; Cell Communication ; Disease Models, Animal ; Humans ; Immune Tolerance ; Immunity, Humoral ; Inflammation/immunology ; Lymph Nodes/immunology ; Lymphangiogenesis/immunology ; Lymphatic Vessels/immunology ; Lymphedema/immunology ; Macrophages/immunology ; Mice ; T-Lymphocytes, Helper-Inducer/immunology ; T-Lymphocytes, Regulatory/immunology
Language	English
Publishing date	2019-01-29
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2019.00076
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Article ; Online: Robotic fertility-sparing surgery for early-stage epithelial ovarian cancer.

Azais, Henri / Koual, Meriem / Nguyen-Xuan, Huyên-Thu / Achen, Guillaume / Bentivegna, Enrica / Bats, Anne-Sophie

International journal of gynecological cancer : official journal of the International Gynecological Cancer Society

2021 Volume 32, Issue 2, Page(s) 207–208

MeSH term(s)	Adult ; Carcinoma, Ovarian Epithelial/pathology ; Carcinoma, Ovarian Epithelial/surgery ; Female ; Fertility Preservation/methods ; Humans ; Lymph Node Excision ; Minimally Invasive Surgical Procedures/methods ; Ovarian Neoplasms/pathology ; Ovarian Neoplasms/surgery ; Robotic Surgical Procedures/methods
Language	English
Publishing date	2021-08-20
Publishing country	England
Document type	Case Reports ; Journal Article ; Video-Audio Media
ZDB-ID	1070385-8
ISSN	1525-1438 ; 1048-891X
ISSN (online)	1525-1438
ISSN	1048-891X
DOI	10.1136/ijgc-2021-002799
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Article ; Online: Assessment of Underpayment for Inpatient Care at Children's Hospitals.

VonAchen, Paige / Gaur, Dipika / Wickremasinghe, Walter / Hall, Matt / Goodman, Denise M / Agrawal, Rishi / Berry, Jay G

JAMA pediatrics

2021 Volume 175, Issue 9, Page(s) 972–974

MeSH term(s)	Adolescent ; Child ; Child, Preschool ; Critical Care/economics ; Cross-Sectional Studies ; Female ; Health Care Costs ; Hospitalization/economics ; Hospitals, Pediatric/economics ; Humans ; Infant ; Infant, Newborn ; Insurance, Health, Reimbursement/economics ; Male ; Retrospective Studies ; United States
Language	English
Publishing date	2021-05-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	2701223-2
ISSN	2168-6211 ; 2168-6203
ISSN (online)	2168-6211
ISSN	2168-6203
DOI	10.1001/jamapediatrics.2021.1133
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Article ; Online: Cancers épithéliaux de l’ovaire et chirurgie de cytoréduction par voie mini-invasive après chimiothérapie néoadjuvante : revue systématique de la littérature.

Achen, G / Koual, M / Bentivegna, E / Fournier, L / Nguyen Xuan, H-T / Delanoy, N / Bats, A-S / Azaïs, H

Gynecologie, obstetrique, fertilite & senologie

2021 Volume 49, Issue 10, Page(s) 736–743

Abstract: Introduction: Advanced epithelial ovarian cancer (EOC) is associated with high mortality and often managed first with neoadjuvant chemotherapy (NACT) followed by debulking surgery. Laparoscopic surgery with or without robotic assistance (Minimally ... ...

Title translation	Epithelial ovarian cancers and minimally invasive cytoreductive surgery after neoadjuvant chemotherapy: A systematic review.
Abstract	Introduction: Advanced epithelial ovarian cancer (EOC) is associated with high mortality and often managed first with neoadjuvant chemotherapy (NACT) followed by debulking surgery. Laparoscopic surgery with or without robotic assistance (Minimally Invasive Surgery (MIS)) may represent a beneficial option for these patients. The objective of this literature review is to clarify the place of MIS in the management of advanced EOC for selected patients. Method: Pubmed, Cochrane and Clinicaltrials.gov online databases were used for this review, to select English or French published articles. Results: We selected 11 original articles published between 2015 and 2020, 6 of which compared MIS and laparotomy. Among these 11 studies, 8 were retrospective cohorts, 2 were phase II trials, and one was a case-control study. In total, there were 3721 patients, of which 854 (23%) were treated with MIS. The robotic assistance was used with 224 patients (26%) of those MIS patients. Looking specifically at MIS patients, the laparoconversion rate was 9.5%, the rate of complete resection (CC-0) was 83.4%. Finally, the MIS complication rate was 1% intraoperatively and 12% postoperatively. The rate of complete resection, postoperative complication, as well as overall survival (OS) were comparable between patients treated with MIS or laparotomy. One study found an improved disease-free survival (DFS) in MIS versus laparotomy (18 months versus 12 months; P=0.027). Conclusion: MIS seems feasible, effective, and reliable in comparison to laparotomy for the completion of cytoreductive surgery after NACT without compromising oncological safety. Prospective randomized controlled trials are needed to confirm the role of MIS in advanced EOC.
MeSH term(s)	Carcinoma, Ovarian Epithelial/drug therapy ; Case-Control Studies ; Cytoreduction Surgical Procedures ; Female ; Humans ; Minimally Invasive Surgical Procedures ; Neoadjuvant Therapy ; Ovarian Neoplasms/drug therapy ; Ovarian Neoplasms/surgery ; Prospective Studies ; Retrospective Studies
Language	French
Publishing date	2021-02-23
Publishing country	France
Document type	Journal Article ; Systematic Review
ZDB-ID	2887456-0
ISSN	2468-7189
ISSN (online)	2468-7189
DOI	10.1016/j.gofs.2021.02.006
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Article ; Online: The Pain in Dystonia Scale (PIDS)-Development and Validation in Cervical Dystonia.

Bruno, Veronica / Achen, Beatrice / Morgante, Francesca / Erro, Roberto / Fox, Susan H / Edwards, Mark J / Schrag, Anette / Stamelou, Maria / Appel-Cresswell, Silke / Defazio, Giovanni / Chaudhuri, K Ray / Pirio Richardson, Sarah / Jinnah, Hyder A / Martino, Davide

Movement disorders : official journal of the Movement Disorder Society

2023 Volume 38, Issue 7, Page(s) 1175–1186

Abstract: Background: A better understanding of pain in adult-onset idiopathic dystonia (AOID) is needed to implement effective therapeutic strategies.: Objective: To develop a new rating instrument for pain in AOID and validate it in cervical dystonia (CD).!## ...

Abstract	Background: A better understanding of pain in adult-onset idiopathic dystonia (AOID) is needed to implement effective therapeutic strategies. Objective: To develop a new rating instrument for pain in AOID and validate it in cervical dystonia (CD). Methods: Development and validation of the Pain in Dystonia Scale (PIDS) comprised three phases. In phase 1, international experts and participants with AOID generated and evaluated the preliminary items for content validity. In phase 2, the PIDS was drafted and revised by the experts, followed by cognitive interviews to ensure self-administration suitability. In phase 3, the PIDS psychometric properties were assessed in 85 participants with CD and retested in 40 participants. Results: The final version of PIDS evaluates pain severity (by body-part), functional impact, and external modulating factors. Test-retest reliability showed a high-correlation coefficient for the total score (0.9, P < 0.001), and intraclass correlation coefficients were 0.7 or higher for all items in all body-parts subscores. The overall PIDS severity score showed high internal consistency (Cronbach's α, 0.9). Convergent validity analysis revealed a strong correlation between the PIDS severity score and the Toronto Western Spasmodic Torticollis Rating Scale pain subscale (0.8, P < 0.001) and the Brief Pain Inventory-short form items related to pain at time of the assessment (0.7, P < 0.001) and impact of pain on daily functioning (0.7, P < 0.001). Conclusion: The PIDS is the first specific questionnaire developed to evaluate pain in all patients with AOID, here, demonstrating high-level psychometric properties in people with CD. Future work will validate PIDS in other forms of AOID. © 2023 International Parkinson and Movement Disorder Society.
MeSH term(s)	Adult ; Humans ; Torticollis/complications ; Pain Measurement ; Reproducibility of Results ; Dystonic Disorders ; Pain ; Psychometrics ; Surveys and Questionnaires
Language	English
Publishing date	2023-05-25
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	607633-6
ISSN	1531-8257 ; 0885-3185
ISSN (online)	1531-8257
ISSN	0885-3185
DOI	10.1002/mds.29452
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Article ; Online: Clinical use of Indocyanine green fluorescence method for sentinel lymph node biopsy in breast cancer in France in 2021.

Benoit, Louise / de Thorey, Axelle Gillet / David, Manuel Gomes / Azais, Henri / Bentivegna, Enrica / Nguyen-Xuan, Huyen-Thu / Simon, Vanille / Achen, Guillaume / Bats, Anne-Sophie / Koual, Meriem

Journal of gynecology obstetrics and human reproduction

2023 Volume 53, Issue 1, Page(s) 102703

Abstract: Introduction: Indocyanine green (ICG) for axillary sentinel lymph node (SLN) detection in early breast cancer is at least equivalent to radioisotopic and/or colorimetric techniques. This procedure has not yet been recommended by learned societies in ... ...

Abstract	Introduction: Indocyanine green (ICG) for axillary sentinel lymph node (SLN) detection in early breast cancer is at least equivalent to radioisotopic and/or colorimetric techniques. This procedure has not yet been recommended by learned societies in France. Following the recent drug approval of Infracyanin ® in this indication, we wished to study the use of ICG in France. Methods: We conducted a web-based survey among members of multiple French breast cancer societies throughout November 2021. The survey assessed the profile of the respondent, the use or not of ICG for the detection of SLN in breast cancer, the technique used and the opinion of non-users and their expectations on the subject. Results: Seventy-five surgeons participated. More than a third (37 %) have been using ICG for the detection of SLN in breast cancer for 2 to 3 years. Technique was highly variable. According to 82.1 % of the respondents, less than 20 procedures are necessary to master the use of ICG. The main advantage reported for this method is the reduction of organizational constraints. The obstacles to the use of the ICG are the near infra-red camera equipment, but also the lack of validation by the French guidelines. Among non-users, 83 % would like to develop this technique in their center and 72.3 % are interested in training on this subject. Conclusion: This work highlights the need for French learned societies to take a stand on this issue but also the need to carry out studies on the technical aspects in order to standardise practices.
MeSH term(s)	Humans ; Female ; Sentinel Lymph Node Biopsy ; Indocyanine Green ; Breast Neoplasms/pathology ; Coloring Agents ; France
Chemical Substances	Indocyanine Green (IX6J1063HV) ; Coloring Agents
Language	English
Publishing date	2023-11-29
Publishing country	France
Document type	Journal Article
ISSN	2468-7847
ISSN (online)	2468-7847
DOI	10.1016/j.jogoh.2023.102703
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Article: Clinical Impact of Lymphadenectomy after Neoadjuvant Chemotherapy in Advanced Epithelial Ovarian Cancer: A Review of Available Data.

Seidler, Stephanie / Koual, Meriem / Achen, Guillaume / Bentivegna, Enrica / Fournier, Laure / Delanoy, Nicolas / Nguyen-Xuan, Huyên-Thu / Bats, Anne-Sophie / Azaïs, Henri

Journal of clinical medicine

2021 Volume 10, Issue 2

Abstract: Recent robust data allow for omitting lymph node dissection for patients with advanced epithelial ovarian cancer (EOC) and without any suspicion of lymph node metastases, without compromising recurrence-free survival (RFS), nor overall survival (OS), in ... ...

Abstract	Recent robust data allow for omitting lymph node dissection for patients with advanced epithelial ovarian cancer (EOC) and without any suspicion of lymph node metastases, without compromising recurrence-free survival (RFS), nor overall survival (OS), in the setting of primary surgical treatment. Evidence supporting the same postulate for patients undergoing complete cytoreductive surgery after neoadjuvant chemotherapy (NACT) is lacking. Throughout a systematic literature review, the aim of our study was to evaluate the impact of lymph node dissection in patients undergoing surgery for advanced-stage EOC after NACT. A total of 1094 patients, included in six retrospective series, underwent either systematic, selective or no lymph node dissection. Only one study reveals a positive effect of lymphadenectomy on OS, and two on RFS. The four remaining series fail to demonstrate any beneficial effect on survival, neither for RFS nor OS. All of them highlight the higher peri- and post-operative complication rate associated with systematic lymph node dissection. Despite heterogeneity in the design of the studies included, there seems to be a trend showing no improvement on OS for systematic lymph node dissection in node negative patients. A well-conducted prospective trial is mandatory to evaluate this matter.
Language	English
Publishing date	2021-01-18
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm10020334
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Article ; Online: Docking for robotic extraperitoneal para-aortic lymphadenectomy with Da Vinci Xi surgical system.

Bentivegna, Enrica / Koual, Meriem / Nguyen-Xuan, Huyên-Thu / Plait, Laurent / Seidler, Stéphanie / Achen, Guillaume / Bats, Anne-Sophie / Azaïs, Henri

Journal of gynecology obstetrics and human reproduction

2021 Volume 50, Issue 8, Page(s) 102131

Abstract: Regarding extraperitoneal para-aortic lymphadenectomy, installation is key when performed with the assistance of the Da Vinci Xi robotic system. We developed a step-by-step guide, from patient installation to placement of the trocars to patient cart ... ...

Abstract	Regarding extraperitoneal para-aortic lymphadenectomy, installation is key when performed with the assistance of the Da Vinci Xi robotic system. We developed a step-by-step guide, from patient installation to placement of the trocars to patient cart docking, to perform in the efficient and safest installation possible this procedure. The operation does not differ from standard laparoscopic extraperitoneal lymphadenectomy. The benefits of robotic surgery in this indication are comparable to those of the standard laparoscopic approach. Those benefits imply a precise knowledge of the management and installation of the da Vinci Xi robotic system.
MeSH term(s)	Aorta, Thoracic/abnormalities ; Aorta, Thoracic/surgery ; Humans ; Laparoscopy/methods ; Laparoscopy/statistics & numerical data ; Lymph Node Excision/instrumentation ; Lymph Node Excision/methods ; Lymph Node Excision/statistics & numerical data ; Lymph Nodes/surgery ; Robotic Surgical Procedures/instrumentation ; Robotic Surgical Procedures/methods ; Robotic Surgical Procedures/statistics & numerical data
Language	English
Publishing date	2021-03-26
Publishing country	France
Document type	Journal Article
ISSN	2468-7847
ISSN (online)	2468-7847
DOI	10.1016/j.jogoh.2021.102131
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Article ; Online: Key signaling networks are dysregulated in patients with the adipose tissue disorder, lipedema.

Ishaq, Musarat / Bandara, Nadeeka / Morgan, Steven / Nowell, Cameron / Mehdi, Ahmad M / Lyu, Ruqian / McCarthy, Davis / Anderson, Dovile / Creek, Darren J / Achen, Marc G / Shayan, Ramin / Karnezis, Tara

International journal of obesity (2005)

2021 Volume 46, Issue 3, Page(s) 502–514

Abstract: ... involved in critical signaling and cell function-regulating pathways (e.g., lipid metabolism and cell-cycle ...

Abstract	Objectives: Lipedema, a poorly understood chronic disease of adipose hyper-deposition, is often mistaken for obesity and causes significant impairment to mobility and quality-of-life. To identify molecular mechanisms underpinning lipedema, we employed comprehensive omics-based comparative analyses of whole tissue, adipocyte precursors (adipose-derived stem cells (ADSCs)), and adipocytes from patients with or without lipedema. Methods: We compared whole-tissues, ADSCs, and adipocytes from body mass index-matched lipedema (n = 14) and unaffected (n = 10) patients using comprehensive global lipidomic and metabolomic analyses, transcriptional profiling, and functional assays. Results: Transcriptional profiling revealed >4400 significant differences in lipedema tissue, with altered levels of mRNAs involved in critical signaling and cell function-regulating pathways (e.g., lipid metabolism and cell-cycle/proliferation). Functional assays showed accelerated ADSC proliferation and differentiation in lipedema. Profiling lipedema adipocytes revealed >900 changes in lipid composition and >600 differentially altered metabolites. Transcriptional profiling of lipedema ADSCs and non-lipedema ADSCs revealed significant differential expression of >3400 genes including some involved in extracellular matrix and cell-cycle/proliferation signaling pathways. One upregulated gene in lipedema ADSCs, Bub1, encodes a cell-cycle regulator, central to the kinetochore complex, which regulates several histone proteins involved in cell proliferation. Downstream signaling analysis of lipedema ADSCs demonstrated enhanced activation of histone H2A, a key cell proliferation driver and Bub1 target. Critically, hyperproliferation exhibited by lipedema ADSCs was inhibited by the small molecule Bub1 inhibitor 2OH-BNPP1 and by CRISPR/Cas9-mediated Bub1 gene depletion. Conclusion: We found significant differences in gene expression, and lipid and metabolite profiles, in tissue, ADSCs, and adipocytes from lipedema patients compared to non-affected controls. Functional assays demonstrated that dysregulated Bub1 signaling drives increased proliferation of lipedema ADSCs, suggesting a potential mechanism for enhanced adipogenesis in lipedema. Importantly, our characterization of signaling networks driving lipedema identifies potential molecular targets, including Bub1, for novel lipedema therapeutics.
MeSH term(s)	Adipocytes/metabolism ; Adipogenesis/genetics ; Adipose Tissue/metabolism ; Cell Differentiation/physiology ; Humans ; Lipedema/genetics ; Lipids
Chemical Substances	Lipids
Language	English
Publishing date	2021-11-11
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	752409-2
ISSN	1476-5497 ; 0307-0565
ISSN (online)	1476-5497
ISSN	0307-0565
DOI	10.1038/s41366-021-01002-1
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