Méningiomes atypiques et malins, à propos de 36 cas

REIMS-BU Santé (514542104) / SudocSudocFranceF

Comportement de deux poissons prédateurs Esox lucius Linnaeus, 1758 et Silurus glanis Linnaeus, 1758 lors de deux crues successives dans l’Aisne (France).

International audienceFrench rivers are subject to winter floods. The northern pike (Esox lucius) needs these, as it performs lateral migrations for breeding. On the contrary, the allochthonous European catfish (Silurus glanis) is known to be less active in winter. however, very few studies have focused on the behaviour of these two predatory fishes during winter floods. Thus, we propose to characterize their respective responses to high waters, using a radio telemetry approach: thirty northern pikes and seven European catfish were tagged with radio transmitters in the aisne river (northern France) and monitored between october 2020 and May 2021. as a result, some northern pikes and at least one catfish were recorded in the major bed, in various habitats, during two major floods. A "preferential zone" was identified for the northern pike and defined from the pre-flood positions; three types of behaviour were identified: "sedentary" pikes never left these zones, "returned" pikes left during floods but returned when the water level dropped, and "departed" pikes did not come back at all. Individuals from the departed group were significantly larger than those from the other two groups (5% threshold), and those in the sedentary group significantly smaller (10% threshold), suggesting a greater exploration capacity in experienced northern pikes. Meanwhile, the supposed winter quiescence of the European catfish can be questioned, as our observations highlight an adaptability to various conditions. These results also underline the importance of taking the major bed into account in riverine management policies. Résumé.-Comportement de deux poissons prédateurs Esox lucius linnaeus, 1758 et Silurus glanis linnaeus, 1758 lors de deux crues successives dans l'Aisne (France).Les rivières françaises sont sujettes aux crues hivernales, et ces périodes d’inondation sont des événements importants pour le comportement du brochet commun (Esox lucius), qui effectue des migrations latérales pour se reproduire. Le silure glane (Silurus glanis), allochtone, est quant à lui connu pour être plutôt moins actif pendant l’hiver. Cependant, peu d’études ont été réalisées sur le comportement de ces deux poissons prédateurs lors des crues hivernales. Nous avons donc cherché à caractériser leurs réponses respectives à la montée des eaux à l’aide d’une approche de radio télémétrie. Trente brochets communs et sept silures glanes ont été marqués à l’aide d’émetteurs radio dans la rivière Aisne (Nord de la France), et suivis entre octobre 2020 et mai 2021. Un nombre important de brochets ainsi qu’au moins un silure ont été enregistrés dans le lit majeur, dans divers habitats inondés, lors des deux crues les plus importantes. Concernant les brochets, une “zone préférentielle” a été identifiée, et définie à partir des positions des individus avant les inondations. Trois types de comportements principaux ont été identifiés : les brochets “sédentaires” ne quittaient jamais ces zones, les brochets “explorateurs” les quittaient mais revenaient à la décrue, et les brochets “délaisseurs” n’y revenaient pas du tout. Les individus du groupe des délaisseurs étaient significativement plus gros que ceux des deux autres groupes au seuil de 5 %, et ceux du groupe des sédentaires significativement plus petits au seuil de 10 %. Ceci suggère une plus grande capacité d’exploration chez les brochets plus expérimentés. Concernant le silure glane, nos observations remettent en cause sa supposée quiescence et mettent en évidence l’adaptabilité de l’espèce à diverses conditions. Ces résultats soulignent l’importance de la prise en compte du lit majeur dans les politiques de gestion fluviale

Implanted Carmustine Wafers Followed by Concomitant Radiochemotherapy to Treat Newly Diagnosed Malignant Gliomas: Prospective, Observational, Multicenter Study on 92 Cases

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Delaying standard combined chemoradiotherapy after surgical resection does not impact survival in newly diagnosed glioblastoma patients

International audienceBACKGROUND:To assess the influence of the time interval between surgical resection and standard combined chemoradiotherapy on survival in newly diagnosed and homogeneously treated (surgical resection plus standard combined chemoradiotherapy) glioblastoma patients; while controlling confounding factors (extent of resection, carmustine wafer implantation, functional status, neurological deficit, and postoperative complications).METHODS:From 2005 to 2011, 692 adult patients (434 men; mean of 57.5 ± 10.8 years) with a newly diagnosed glioblastoma were enrolled in this retrospective multicentric study. All patients were treated by surgical resection (65.5% total/subtotal resection, 34.5% partial resection; 36.7% carmustine wafer implantation) followed by standard combined chemoradiotherapy (radiotherapy at a median dose of 60 Gy, with daily concomitant and adjuvant temozolomide). Time interval to standard combined chemoradiotherapy was analyzed as a continuous variable and as a dichotomized variable using median and quartiles thresholds. Multivariate analyses using Cox modeling were conducted.RESULTS:The median progression-free survival was 10.3 months (95% CI, 10.0-11.0). The median overall survival was 19.7 months (95% CI, 18.5-21.0). The median time to initiation of combined chemoradiotherapy was 1.5 months (25% quartile, 1.0; 75% quartile, 2.2; range, 0.1-9.0). On univariate and multivariate analyses, OS and PFS were not significantly influenced by time intervals to adjuvant treatments. On multivariate analysis, female gender, total/subtotal resection and RTOG-RPA classes 3 and 4 were significant independent predictors of improved OS.CONCLUSIONS:Delaying standard combined chemoradiotherapy following surgical resection of newly diagnosed glioblastoma in adult patients does not impact survival

Long-term results of carmustine wafer implantation for newly diagnosed glioblastomas: a controlled propensity-matched analysis of a French multicenter cohort

CERVOXY COLLInternational audienceBACKGROUND: The standard of care for newly diagnosed glioblastoma is maximal safe surgical resection, followed by chemoradiation therapy. We assessed carmustine wafer implantation efficacy and safety when used in combination with standard care. METHODS: Included were adult patients with (n = 354, implantation group) and without (n = 433, standard group) carmustine wafer implantation during first surgical resection followed by chemoradiation standard protocol. Multivariate and case-matched analyses (controlled propensity-matched cohort, 262 pairs of patients) were conducted. RESULTS: The median progression-free survival was 12.0 months (95% CI: 10.7-12.6) in the implantation group and 10.0 months (9.0-10.0) in the standard group and the median overall survival was 20.4 months (19.0-22.7) and 18.0 months (17.0-19.0), respectively. Carmustine wafer implantation was independently associated with longer progression-free survival in patients with subtotal/total surgical resection in the whole series (adjusted hazard ratio [HR], 0.76 [95% CI: 0.63-0.92], P = .005) and after propensity matching (HR, 0.74 [95% CI: 0.60-0.92], P = .008), whereas no significant difference was found for overall survival (HR, 0.95 [0.80-1.13], P = .574; HR, 1.06 [0.87-1.29], P = .561, respectively). Surgical resection at progression whether alone or combined with carmustine wafer implantation was independently associated with longer overall survival in the whole series (HR, 0.58 [0.44-0.76], P \textless .0001; HR, 0.54 [0.41-0.70], P \textless .0001, respectively) and after propensity matching (HR, 0.56 [95% CI: 0.40-0.78], P \textless .0001; HR, 0.46 [95% CI: 0.33-0.64], P \textless .0001, respectively). The higher postoperative infection rate in the implantation group did not affect survival. CONCLUSIONS: Carmustine wafer implantation during surgical resection followed by the standard chemoradiation protocol for newly diagnosed glioblastoma in adults resulted in a significant progression-free survival benefi

Prognostic factors for survival in adult patients with recurrent glioblastoma: a decision-tree-based model

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Descriptive epidemiology of 399 histologically confirmed newly diagnosed meningeal solitary fibrous tumours and haemangiopericytomas in France: 2006–2015

International audiencePurpose: Meningeal solitary fibrous tumour (SFT) and haemangiopericytoma (HPC) are uncommon tumours that have been merged into a single entity in the last 2021 WHO Classification of Tumors of the Central Nervous System. To describe the epidemiology of SFT/HPC operated in France and, to assess their incidence.Methods: We processed the French Brain Tumour Database (FBTDB) to conduct a nationwide population-based study of all histopathologically confirmed SFT/HPC between 2006 and 2015.Results: Our study included 399 SFT/HPC patients, operated in France between 2006 and 2015, in one of the 46 participating neurosurgical centres. The incidence reached 0.062, 95%CI[0.056-0.068] for 100,000 person-years. SFT accounted for 35.8% and, HPC for 64.2%. The ratio of SFT/HPC over meningioma operated during the same period was 0.013. SFT/HPC are about equally distributed in women and men (55.9% vs. 44.1%). For the whole population, mean age at surgery was 53.9 (SD ± 15.8) years. The incidence of SFT/HPC surgery increases with the age and, is maximal for the 50-55 years category. Benign SFT/HPC accounted for 65.16%, SFT/HPC of uncertain behaviour for 11.53% and malignant ones for 23.31%. The number of resection progresses as the histopathological behaviour became more aggressive. 6.7% of the patients with a benign SFT/HPC had a second surgery vs.16.6% in case of uncertain behaviour and, 28.4% for malignant SFT/HPC patients.Conclusion: Meningeal SFT and HPC are rare CNS mesenchymal tumours which both share common epidemiological characteristics, asserting their merging under a common entity. SFT/HPC incidence is less that one case for 1 billion per year and, for around 100 meningiomas-like tumours removed, one SFT/HPC may be diagnosed. SFT/HPC are equally distributed in women and men and, are mainly diagnosed around 50-55 years. The more aggressive the tumour, the higher the probability of recurrence