Is Palliative Laparoscopic Hyperthermic Intraperitoneal Chemotherapy Effective in Patients with Malignant Hemorrhagic Ascites?

Malignant hemorrhagic ascites may complicate the terminal evolution of digestive cancers with peritoneal carcinomatosis. It has a bad influence on prognosis and may severely impair patients’ quality of life. Palliative laparoscopic hyperthermic intraperitoneal chemotherapy (HIPEC) has been proposed to treat debilitating malignant ascites. Two cases of peritoneal carcinomatosis causing hemorrhagic ascites and severe anemia that needed iterative blood transfusions are reported. These patients were treated by laparoscopic HIPEC (mitomycin C and cisplatin with an inflow temperature of 43°C), resulting in cessation of peritoneal bleeding. No postoperative complication or relapse of ascites occurred during the following months. No more blood transfusion was needed. Laparoscopic HIPEC might be an effective and safe therapeutic option to consider in patients with malignant hemorrhagic ascites

Progression-Free Survival as a Surrogate for Overall Survival in Advanced/Recurrent Gastric Cancer Trials: A Meta-Analysis

The traditional endpoint for assessing efficacy of chemotherapies for advanced/recurrent gastric cancer is overall survival (OS), but OS requires prolonged follow-up. We investigated whether progression-free survival (PFS) is a valid surrogate for OS. Using individual patient data from the GASTRIC meta-analysis, surrogacy of PFS was assessed through the correlation between the endpoints and through the correlation between the treatment effects on the endpoints. External validation of the prediction based on PFS was also evaluated. Individual data from 4069 patients in 20 randomized trials were analyzed. The rank correlation coefficient between PFS and OS was 0.853 (95% confidence interval [CI] = 0.852 to 0.854). The R 2 between treatment effects on PFS and on OS was 0.61 (95% CI = 0.04 to 1.00). Treatment effects on PFS and on OS were only moderately correlated, and we could not confirm the validity of PFS as a surrogate endpoint for OS in advanced/recurrent gastric cance

Kinemetry of SINS High-Redshift Star-Forming Galaxies: Distinguishing Rotating Disks from Major Mergers

We present a simple set of kinematic criteria that can distinguish between galaxies dominated by ordered rotational motion and those involved in major merger events. Our criteria are based on the dynamics of the warm ionized gas (as traced by H-alpha) within galaxies, making this analysis accessible to high-redshift systems, whose kinematics are primarily traceable through emission features. Using the method of kinemetry (developed by Krajnovic and co-workers), we quantify asymmetries in both the velocity and velocity dispersion maps of the warm gas, and the resulting criteria enable us to empirically differentiate between non-merging and merging systems at high redshift. We apply these criteria to 11 of our best-studied rest-frame UV/optical-selected z~2 galaxies for which we have near infrared integral field spectroscopic data from SINFONI on the VLT. Of these 11 systems, we find that >50% have kinematics consistent with a single rotating disk interpretation, while the remaining systems are more likely undergoing major mergers. This result, combined with the short formation timescales of these systems, provides evidence that rapid, smooth accretion of gas plays a significant role in galaxy formation at high redshift.Comment: Accepted for publication in the Astrophysical Journal. 24 pages, 14 figure

The Science Case for Multi-Object Spectroscopy on the European ELT

This White Paper presents the scientific motivations for a multi-object spectrograph (MOS) on the European Extremely Large Telescope (E-ELT). The MOS case draws on all fields of contemporary astronomy, from extra-solar planets, to the study of the halo of the Milky Way and its satellites, and from resolved stellar populations in nearby galaxies out to observations of the earliest 'first-light' structures in the partially-reionised Universe. The material presented here results from thorough discussions within the community over the past four years, building on the past competitive studies to agree a common strategy toward realising a MOS capability on the E-ELT. The cases have been distilled to a set of common requirements which will be used to define the MOSAIC instrument, entailing two observational modes ('high multiplex' and 'high definition'). When combined with the unprecedented sensitivity of the E-ELT, MOSAIC will be the world's leading MOS facility. In analysing the requirements we also identify a high-multiplex MOS for the longer-term plans for the E-ELT, with an even greater multiplex (>1000 targets) to enable studies of large-scale structures in the high-redshift Universe. Following the green light for the construction of the E-ELT the MOS community, structured through the MOSAIC consortium, is eager to realise a MOS on the E-ELT as soon as possible. We argue that several of the most compelling cases for ELT science, in highly competitive areas of modern astronomy, demand such a capability. For example, MOS observations in the early stages of E-ELT operations will be essential for follow-up of sources identified by the James Webb Space Telescope (JWST). In particular, multi-object adaptive optics and accurate sky subtraction with fibres have both recently been demonstrated on sky, making fast-track development of MOSAIC feasible.Comment: Significantly expanded and updated version of previous ELT-MOS White Paper, so there is some textual overlap with arXiv:1303.002

Clinical, Pathological, and Molecular Characteristics in Colorectal Cancer

Colorectal cancer (CRC) is the third most diagnosed cancer worldwide, and the second leading cause of death in patients with cancer [...

Implications of RAS Mutations on Oncological Outcomes of Surgical Resection and Thermal Ablation Techniques in the Treatment of Colorectal Liver Metastases

Colorectal cancer (CRC) is the third most common cancer worldwide and the second leading cause of cancer-related death. More than 50% of patients with CRC will develop liver metastases (CRLM) during their disease. In the era of precision surgery for CRLM, several advances have been made in the multimodal management of this disease. Surgical treatment, combined with a modern chemotherapy regimen and targeted therapies, is the only potential curative treatment. Unfortunately, 70% of patients treated for CRLM experience recurrence. RAS mutations are associated with worse overall and recurrence-free survival. Other mutations such as BRAF, associated RAS /TP53 and APC/PIK3CA mutations are important genetic markers to evaluate tumor biology. Somatic mutations are of paramount interest for tailoring preoperative treatment, defining a surgical resection strategy and the indication for ablation techniques. Herein, the most relevant studies dealing with RAS mutations and the management of CRLM were reviewed. Controversies about the implication of this mutation in surgical and ablative treatments were also discussed

Reply to E.C. Smyth et al and E. Elimova et al.

International audienceComment on Prospective, randomized, multicenter, phase III study of fluorouracil, leucovorin, and irinotecan versus epirubicin, cisplatin, and capecitabine in advanced gastric adenocarcinoma: a French intergroup (Fédération Francophone de Cancérologie Digestive, Fédération Nationale des Centres de Lutte Contre le Cancer, and Groupe Coopérateur Multidisciplinaire en Oncologie) study. [J Clin Oncol. 2014] Time-to-Treatment Failure As the Primary End Point of a First-Line Advanced Gastric Cancer Randomized Trial: How Confused Would You Want Us to Be? [J Clin Oncol. 2015] Epirubicin, Cisplatin, and Capecitabine Versus Fluorouracil, Leucovorin, and Irinotecan for Esophagogastric Cancer: The Original and the Rest. [J Clin Oncol. 2015

Automatic Identification of Paraffin Pixels on FTIR Images Acquired on FFPE Human Samples

International audienceThe transfer of mid-infrared spectral histopathology to the clinic will be possible provided that its application in clinical practice is simple. Rapid analysis of formalin-fixed paraffin-embedded (FFPE) tissue section is thus a prerequisite. The chemical dewaxing of these samples before image acquisition used by the majority of studies is in contradiction with this principle. Fortunately, the in silico analysis of the images acquired on FFPE samples is possible using extended multiplicative signal correction (EMSC). However, the removal of pure paraffin pixels is essential to perform a relevant classification of tissue spectra. So far, this task was possible only if using manual and subjective histogram analysis. In this article, we thus propose a new automatic and multivariate methodology based on the analysis of optimized combinations of EMSC regression coefficients by validity indices and KMeans clustering to separate paraffin and tissue pixels. The validation of our method is performed using simulated infrared spectral images by measuring the Jaccard index between our partitions and the image model, with values always over 0.90 for diverse baseline complexity and signal-to-noise ratio. These encouraging results were also validated on real images by comparing our method with classical ones and by computing the Jaccard index between our partitions and the KMeans partitions obtained on the infrared image acquired on the same samples but after chemical dewaxing, with values always over 0.84