9 research outputs found
Ătude descriptive du carcinome de Merkel en population gĂ©nĂ©rale Ă partir des donnĂ©es du registre des cancers du Bas-Rhin entre 1985 et 2013
MĂ©decine. Dermatologie et vĂ©nĂ©rĂ©ologieRĂ©sumĂ© : Le carcinome de Merkel (CM) est une tumeur cutanĂ©e rare et trĂšs agressive dont lâĂ©pidĂ©miologie est peu connue en France. Dans une prĂ©cĂ©dente Ă©tude, nous avons montrĂ© une multiplication par plus de 3 de son incidence dans le Bas-Rhin entre 1985 et 2013. Lâobjectif de ce travail est de prĂ©ciser les donnĂ©es dĂ©mographiques, cliniques, diagnostiques, de prise en charge et de suivi du CM dans le Bas-Rhin Ă partir des donnĂ©es du registre du cancer entre 1985 et 2013. Cent onze patients ont Ă©tĂ© enregistrĂ©s et 76 dossiers ont pu ĂȘtre analysĂ©s. La majoritĂ© Ă©tait issue du Service de Dermatologie ou du Centre Paul Strauss (80%). Il y avait une prĂ©dominance de femmes (55%). La tumeur Ă©tait principalement localisĂ©e sur la tĂȘte (43%) ou les membres (50%) sans prĂ©dominance droite/gauche, en zone photo-exposĂ©e dans 70% des cas avec un diamĂštre clinique moyen de 2,2 cm. La durĂ©e mĂ©diane dâĂ©volution Ă©tait de 3 mois et la vitesse de croissance du diamĂštre de 0,9 cm/mois. Le diagnostic Ă©tait principalement fait au stade prĂ©coce. Le traitement Ă©tait chirurgical dans 90% des cas associĂ© Ă une radiothĂ©rapie adjuvante dans 67% des cas. La mĂ©diane de survie Ă©tait de 4,7 ans et le taux de survie Ă 5 ans de 44%. Cette Ă©tude longue de 28 ans basĂ©e sur des donnĂ©es trĂšs complĂštes, issues du registre des cancers du Bas-Rhin, nous a permis dâobtenir des informations prĂ©cises et reprĂ©sentatives sur le CM dans la population du Bas-Rhin. Ces donnĂ©es sont rares dans la littĂ©rature et permettent dâavoir une vision populationnelle et pas uniquement hospitaliĂšre de cette tumeur.Merkel Cell Carcinoma (MCC) is a very rare and highly aggressive skin cancer and epidemiologic data are very rare in France. As shown in a previous study, incidence of MCC increased and roughly tripled from 1985 to 2013 in bas-Rhin. We aimed to precise demographic, clinical, diagnosis, managment and follow-up data based on the Bas-Rhin Cancer Registry between 1985 and 2013. One hundred and eleven cases of MCC were registred and 76 cases were analysed. Eighty percent came from the Dermatological Service of the University Hospital and from Paul Strauss Center. Women were 55% of cases . MCC was mainly localized on the head (43%) or limbs, on UV-site in 70% of cases without asymetrical distribution. The mean clinical diameter was 2.2 cm and the median time to progression was 3 months. The rate of growth for diameter was 0,9 cm/ month. The majority of MCC was localized at diagnosis. Ninety percent of patients received surgery and 67% adjuvante radiotherapy. Five-year crude survival rate was 44%. Data obtained in this very long standing study (28 years) based on very exhaustive and population-based data are very representative of MCC in the general population in Bas-Rhin. Data from general population are rare. This study bring a global, and not just an hospital, vision of MCC
Dynamic Evolution of Clonal Composition and Neoantigen Landscape in Recurrent Metastatic Melanoma with a Rare Combination of Driver Mutations
International audienc
Psychotherapieforschung
These guidelines address the diagnosis and management of atherosclerotic, aneurysmal, and thromboembolic peripheral arterial diseases (PADs). The clinical manifestations of PAD are a major cause of acute and chronic illness, are associated with decrements in functional capacity and quality of life, cause limb amputation, and increase the risk of death. Whereas the term âperipheral arterial diseaseâ encompasses a large series of disorders that affect arterial beds exclusive of the coronary arteries, this writing committee chose to limit the scope of the work of this document to include the disorders of the abdominal aorta, renal and mesenteric arteries, and lower extremity arteries. The purposes of the full guidelines are to (a) aid in the recognition, diagnosis, and treatment of PAD of the aorta and lower extremities, addressing its prevalence, impact on quality of life, cardiovascular ischemic risk, and risk of critical limb ischemia (CLI); (b) aid in the recognition, diagnosis, and treatment of renal and visceral arterial diseases; and (c) improve the detection and treatment of abdominal and branch artery aneurysms. Clinical management guidelines for other arterial beds (e.g., the thoracic aorta, carotid and vertebral arteries, and upper-extremity arteries) have been excluded from the current guidelines to focus on the infradiaphragmatic arterial system and in recognition of the robust evidence base that exists for the aortic, visceral, and lower extremity arteries