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Article: Handling missing covariates in observational studies: an illustration with the assessment of prognostic factors of survival outcomes in soft-tissue or visceral sarcomas in irradiated fields (SIF).

Huchet, Noémie / Penel, Nicolas / Bonvalot, Sylvie / Thariat, Juliette / Ducimetière, Françoise / Giraud, Antoine / Toulmonde, Maud / Le Cesne, Axel / Blay, Jean-Yves / Bellera, Carine

Therapeutic advances in medical oncology

2024 Volume 16, Page(s) 17588359231220999

Abstract: Background: Missing covariates are common in observational research and can lead to bias and loss of statistical power. Limited data regarding prognostic factors of survival outcomes of sarcomas in irradiated fields (SIF) are available. Because of the ... ...

Abstract	Background: Missing covariates are common in observational research and can lead to bias and loss of statistical power. Limited data regarding prognostic factors of survival outcomes of sarcomas in irradiated fields (SIF) are available. Because of the long lag time between irradiation of first cancer and scarcity of SIF, missing data are a critical issue when analyzing long-term outcomes. We assessed prognostic factors of overall (OS), progression-free (PFS), and metastatic-progression-free (MPFS) survivals in SIF using three methods to account for missing covariates. Methods: We relied on the NETSARC French Sarcoma Group database, Cox (OS/PFS), and competitive hazards (MPFS) survival models. Covariates investigated were age, sex, histological subtype, tumor size, depth and grade, metastasis, surgery, surgical resection, surgeon's expertise, imaging, and neo-adjuvant treatment. We first applied multiple imputation (MI): observed data were used to estimate the missing covariate. With the missing-data modality approach, a category missing was created for qualitative variables. With the complete-case (CC) approach, analysis was restricted to patients without missing covariates. Results: CC subjects ( Conclusion: The CC population was not representative of the eligible population, introducing bias, in addition to worst precision. The 'missing-data modality method' results in biased estimates in non-randomized studies, as outcomes may be related to variables with missing values. Appropriate statistical methods for missing covariates, for example, MI, should therefore be considered.
Language	English
Publishing date	2024-01-19
Publishing country	England
Document type	Journal Article
ZDB-ID	2503443-1
ISSN	1758-8359 ; 1758-8340
ISSN (online)	1758-8359
ISSN	1758-8340
DOI	10.1177/17588359231220999
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Impact of the coronavirus disease 2019 pandemic on sarcoma management in France: a 2019 and 2020 comparison.

Penel, Nicolas / Cantarel, Coralie / Chemin-Airiau, Claire / Ducimetiere, Françoise / Gouin, François / Le Loarer, François / Toulmonde, Maud / Piperno-Neumann, Sophie / Bellera, Carine / Honore, Charles / Blay, Jean-Yves / Mathoulin-Pelissier, Simone

Therapeutic advances in medical oncology

2023 Volume 15, Page(s) 17588359231192400

Abstract: Background: The coronavirus disease 2019 (COVID-19) pandemic was an unprecedented shock to the healthcare systems, and its consequences on managing rare cancers are unknown. We investigated COVID-19's impact on the activity of sarcoma-labeled networks ... ...

Abstract	Background: The coronavirus disease 2019 (COVID-19) pandemic was an unprecedented shock to the healthcare systems, and its consequences on managing rare cancers are unknown. We investigated COVID-19's impact on the activity of sarcoma-labeled networks by comparing key indicators in 2019-2020 (before and during the pandemic, respectively). Methods: We compared the incidence of limb and trunk soft tissue sarcomas, surgery rate, surgery center, surgery quality, and surgery delays nationally and in various regions, focusing on the three most severely affected regions. Findings: In this study, sarcoma incidence did not decrease, and the tumor and patient characteristics were similar in both years. The number of patients who underwent surgery in the labeled centers increased significantly (63% Interpretation: The model of the labeled center network for managing rare tumors was resilient. Paradoxically, the quality indicators improved during the pandemic due to the direct referral of patients with sarcomas to the labeled centers. Summary: This study shows that a nationwide network organization has made it possible to maintain care for these rare tumors during the pandemic.
Language	English
Publishing date	2023-08-31
Publishing country	England
Document type	Journal Article
ZDB-ID	2503443-1
ISSN	1758-8359 ; 1758-8340
ISSN (online)	1758-8359
ISSN	1758-8340
DOI	10.1177/17588359231192400
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Article ; Online: Correction to: Beyond the map: evidencing the spatial dimension of health inequalities.

Fayet, Yohan / Praud, Delphine / Fervers, Béatrice / Ray-Coquard, Isabelle / Blay, Jean-Yves / Ducimetiere, Françoise / Fagherazzi, Guy / Faure, Elodie

International journal of health geographics

2021 Volume 20, Issue 1, Page(s) 1

Language	English
Publishing date	2021-01-04
Publishing country	England
Document type	Published Erratum
ISSN	1476-072X
ISSN (online)	1476-072X
DOI	10.1186/s12942-020-00255-9
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Article ; Online: Beyond the map

Fayet Yohan / Praud Delphine / Fervers Béatrice / Ray-Coquard Isabelle / Blay Jean-Yves / Ducimetiere Françoise / Fagherazzi Guy / Faure Elodie

International Journal of Health Geographics, Vol 19, Iss 1, Pp 1-

evidencing the spatial dimension of health inequalities

2020 Volume 11

Abstract: Abstract Background Spatial inequalities in health result from different exposures to health risk factors according to the features of geographical contexts, in terms of physical environment, social deprivation, and health care accessibility. Using a ... ...

Abstract	Abstract Background Spatial inequalities in health result from different exposures to health risk factors according to the features of geographical contexts, in terms of physical environment, social deprivation, and health care accessibility. Using a common geographical referential, which combines indices measuring these contextual features, could improve the comparability of studies and the understanding of the spatial dimension of health inequalities. Methods We developed the Geographical Classification for Health studies (GeoClasH) to distinguish French municipalities according to their ability to influence health outcomes. Ten contextual scores measuring physical and social environment as well as spatial accessibility of health care have been computed and combined to classify French municipalities through a K-means clustering. Age-standardized mortality rates according to the clusters of this classification have been calculated to assess its effectiveness. Results Significant lower mortality rates compared to the mainland France population were found in the Wealthy Metropolitan Areas (SMR = 0.868, 95% CI 0.863–0.873) and in the Residential Outskirts (SMR = 0.971, 95% CI 0.964–0.978), while significant excess mortality were found for Precarious Population Districts (SMR = 1.037, 95% CI 1.035–1.039), Agricultural and Industrial Plains (SMR = 1.066, 95% CI 1.063–1.070) and Rural Margins (SMR = 1.042, 95% CI 1.037–1.047). Conclusions Our results evidence the comprehensive contribution of the geographical context in the constitution of health inequalities. To our knowledge, GeoClasH is the first nationwide classification that combines social, environmental and health care access scores at the municipality scale. It can therefore be used as a proxy to assess the geographical context of the individuals in public health studies.
Keywords	Health inequalities ; Environment ; Social deprivation ; Health care access ; Geography ; Public health ; Computer applications to medicine. Medical informatics ; R858-859.7
Subject code	910
Language	English
Publishing date	2020-11-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Comprehensive Immune Profiling Unveils a Subset of Leiomyosarcoma with "Hot" Tumor Immune Microenvironment.

Feng, Xiaolan / Tonon, Laurie / Li, Haocheng / Darbo, Elodie / Pleasance, Erin / Macagno, Nicolas / Dufresne, Armelle / Brahmi, Mehdi / Bollard, Julien / Ducimetière, Francoise / Karanian, Marie / Meurgey, Alexandra / Pérot, Gaëlle / Valentin, Thibaud / Chibon, Frédéric / Blay, Jean-Yves

Cancers

2023 Volume 15, Issue 14

Abstract: Purpose: ...

Abstract	Purpose:
Language	English
Publishing date	2023-07-21
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers15143705
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Article ; Online: Reasons for acceptance and refusal of early palliative care in patients included in early-phase clinical trials in a regional comprehensive cancer centre in France: protocol for a qualitative study.

Chvetzoff, Gisele / Girodet, Magali / Despax, Johanna / Baudry, Valentine / Duranti, Julie / Mastroianni, Bénédicte / Vanacker, Hélène / Vinceneux, Armelle / Brahmi, Mehdi / Renard, Olivier / Gautier, Julien / Britel, Manon / Ducimetière, Françoise / Anota, Amélie / Cassier, Philippe / Christophe, Véronique

BMJ open

2022 Volume 12, Issue 4, Page(s) e060317

Abstract: Introduction: A few studies have highlighted the potential synergy between early palliative care and inclusion in an early-phase clinical trial that may improve quality of life, reduce symptoms of exhaustion related to the side effects of treatment and ... ...

Abstract	Introduction: A few studies have highlighted the potential synergy between early palliative care and inclusion in an early-phase clinical trial that may improve quality of life, reduce symptoms of exhaustion related to the side effects of treatment and allow patients to complete their treatment protocol. The primary objective of this qualitative study is to evaluate the reasons for acceptance or refusal of early palliative care in patients included in early-phase clinical trials. Method and analysis: All patients from the Centre Léon Bérard (Comprehensive Cancer Centre in Lyon, France) who consent to one of the early-phase clinical trials proposed at the centre will be invited to participate in this study. The cohort will consist of a subgroup (n=20) of patients who accept palliative care together with their clinical trial, and a second subgroup (n=20) of patients who decline it. Patients will be interviewed in exploratory interviews conducted by a psychology researcher before the start of their clinical trial. The interviews will be audio-recorded. Patients will also be asked to complete quality of life and anxiety/depression questionnaires both before the beginning of the treatment and at the end of their clinical trial. The content of the interviews will be analysed thematically. Descriptive and comparative statistical analysis of both cohorts will also be conducted. Ethics and dissemination: Personal data will be collected and processed in accordance with the laws and regulations in force. All patients will give informed consent to participate. This study complies with reference methodology MR004 of the Commission Nationale de l'Informatique et des Libertés. The protocol has received the validation of an ethics committee (Groupe de Réflexion Ethique du CLB, number: 2020-006). The results will be disseminated through conference presentations and peer-reviewed publications. Trial registration number: NCT04717440.
MeSH term(s)	France ; Hospice and Palliative Care Nursing ; Humans ; Neoplasms/therapy ; Palliative Care ; Qualitative Research ; Quality of Life
Language	English
Publishing date	2022-04-22
Publishing country	England
Document type	Clinical Study ; Journal Article
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2021-060317
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Article ; Online: Refining Prognosis in Localized Gastrointestinal Stromal Tumor: Clinical Significance of Phosphatase and Tensin Homolog Low Expression and Gene Loss.

Feng, Xiaolan / Li, Haocheng / Fourquet, Joanna / Brahmi, Mehdi / Dufresne, Armelle / Meurgey, Alexandra / Ray-Coquard, Isabelle / Wang, Qing / Bollard, Julien / Ducimetiere, Francoise / Chibon, Frederic / Blay, Jean-Yves

JCO precision oncology

2022 Volume 6, Page(s) e2200129

Abstract: Purpose: To investigate the use of PTEN biomarker to improve prognostic stratification in patients with localized gastrointestinal stromal tumor (GIST).: Methods: PTEN expression and genomic analysis were performed on two independent GIST-60 (n = 60) ...

Abstract	Purpose: To investigate the use of PTEN biomarker to improve prognostic stratification in patients with localized gastrointestinal stromal tumor (GIST). Methods: PTEN expression and genomic analysis were performed on two independent GIST-60 (n = 60) and GIST-100 (n = 100) cohorts, respectively. Results: PTEN expression was significantly lower in patients with local and metastatic recurrent tumor compared with those with no recurrence ( Conclusion: PTEN low expression/gene loss is an independent significant prognostic factor and a promising component to strengthen the clinical prognostic tools in patients with localized GIST.
MeSH term(s)	Disease-Free Survival ; Gastrointestinal Neoplasms/genetics ; Gastrointestinal Stromal Tumors/genetics ; Humans ; Prognosis ; Tensins
Chemical Substances	Tensins
Language	English
Publishing date	2022-08-24
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2473-4284
ISSN (online)	2473-4284
DOI	10.1200/PO.22.00129
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Article ; Online: Beyond the map: evidencing the spatial dimension of health inequalities.

Fayet, Yohan / Praud, Delphine / Fervers, Béatrice / Ray-Coquard, Isabelle / Blay, Jean-Yves / Ducimetiere, Françoise / Fagherazzi, Guy / Faure, Elodie

International journal of health geographics

2020 Volume 19, Issue 1, Page(s) 46

Abstract: Background: Spatial inequalities in health result from different exposures to health risk factors according to the features of geographical contexts, in terms of physical environment, social deprivation, and health care accessibility. Using a common ... ...

Abstract	Background: Spatial inequalities in health result from different exposures to health risk factors according to the features of geographical contexts, in terms of physical environment, social deprivation, and health care accessibility. Using a common geographical referential, which combines indices measuring these contextual features, could improve the comparability of studies and the understanding of the spatial dimension of health inequalities. Methods: We developed the Geographical Classification for Health studies (GeoClasH) to distinguish French municipalities according to their ability to influence health outcomes. Ten contextual scores measuring physical and social environment as well as spatial accessibility of health care have been computed and combined to classify French municipalities through a K-means clustering. Age-standardized mortality rates according to the clusters of this classification have been calculated to assess its effectiveness. Results: Significant lower mortality rates compared to the mainland France population were found in the Wealthy Metropolitan Areas (SMR = 0.868, 95% CI 0.863-0.873) and in the Residential Outskirts (SMR = 0.971, 95% CI 0.964-0.978), while significant excess mortality were found for Precarious Population Districts (SMR = 1.037, 95% CI 1.035-1.039), Agricultural and Industrial Plains (SMR = 1.066, 95% CI 1.063-1.070) and Rural Margins (SMR = 1.042, 95% CI 1.037-1.047). Conclusions: Our results evidence the comprehensive contribution of the geographical context in the constitution of health inequalities. To our knowledge, GeoClasH is the first nationwide classification that combines social, environmental and health care access scores at the municipality scale. It can therefore be used as a proxy to assess the geographical context of the individuals in public health studies.
MeSH term(s)	Cities ; France/epidemiology ; Health Status Disparities ; Humans ; Risk Factors ; Rural Population ; Socioeconomic Factors
Language	English
Publishing date	2020-11-09
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1476-072X
ISSN (online)	1476-072X
DOI	10.1186/s12942-020-00242-0
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Article ; Online: The value of research collaborations and consortia in rare cancers.

Blay, Jean-Yves / Coindre, Jean-Michel / Ducimetière, Françoise / Ray-Coquard, Isabelle

The Lancet. Oncology

2016 Volume 17, Issue 2, Page(s) e62–e69

Abstract: Rare cancers are defined by an incidence of less than six per 100,000 people per year. They represent roughly 20% of all human cancers and are associated with worse survival than are so-called frequent tumours, because of delays to accurate diagnosis, ... ...

Abstract	Rare cancers are defined by an incidence of less than six per 100,000 people per year. They represent roughly 20% of all human cancers and are associated with worse survival than are so-called frequent tumours, because of delays to accurate diagnosis, inadequate treatments, and fewer opportunities to participate in clinical trials (because of a paucity of dedicated trials from both academic and industrial sponsors). In this Series paper, we discuss how these challenges can be addressed by research consortia and suggest the integration of these consortia with reference networks, which gather multidisciplinary expert centres, for management of rare tumours.
MeSH term(s)	Biomedical Research/organization & administration ; Clinical Trials as Topic/legislation & jurisprudence ; Clinical Trials as Topic/methods ; Communication ; Cooperative Behavior ; Drug Industry ; Humans ; Neoplasms/diagnosis ; Neoplasms/therapy ; Patient Advocacy ; Rare Diseases/diagnosis ; Rare Diseases/therapy ; Translational Medical Research
Language	English
Publishing date	2016-02
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	2049730-1
ISSN	1474-5488 ; 1470-2045
ISSN (online)	1474-5488
ISSN	1470-2045
DOI	10.1016/S1470-2045(15)00388-5
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Article: Evolution of Patterns of Care and Outcomes in the Real-Life Setting for Patients with Metastatic GIST Treated in Three French Expert Centers over Three Decades.

Cancers

2023 Volume 15, Issue 17

Abstract: Gastrointestinal stromal tumors (GIST) are rare mesenchymal tumors characterized ... ...

Abstract	Gastrointestinal stromal tumors (GIST) are rare mesenchymal tumors characterized by
Language	English
Publishing date	2023-08-28
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers15174306
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