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Melanoma: HELP
Articles by Bruno Sassolas
Based on 21 articles published since 2008
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Between 2008 and 2019, B. Sassolas wrote the following 21 articles about Melanoma.
 
+ Citations + Abstracts
1 Guideline [Locoregional treatments of brain metastases for patients with metastatic cutaneous melanoma: French national guidelines]. 2014

Lubrano, V / Derrey, S / Truc, G / Mirabel, X / Thariat, J / Cupissol, D / Sassolas, B / Combemale, P / Modiano, P / Bedane, C / Dygai-Cochet, I / Lamant, L / Mourrégot, A / Rougé Bugat, M-È / Siegrist, S / Tiffet, O / Mazeau-Woynar, V / Verdoni, L / Planchamp, F / Leccia, M-T / Anonymous610807. ·Service de neurochirurgie, hôpital de Rangueil, CHU de Toulouse, 1, avenue du Professeur-Jean-Poulhès, TSA 50032, 31059 Toulouse, France. · Département de neurochirurgie, hôpital Charles-Nicolle, 1, rue de Germont, 76000 Rouen, France. · Département de radiothérapie, centre Georges-François-Leclerc, 1, rue du Professeur-Marion, BP 77980, 21079 Dijon, France. · Département de radiothérapie-curiethérapie, centre Oscar-Lambret, 3, rue Frédéric-Combemale, BP 307, 59020 Lille, France. · Pôle de radiothérapie, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice, France. · Service d'oncologie médicale, ICM, institut du cancer de Montpellier Val-d'Aurelle, 208, avenue des Apothicaires, parc Euromédecine, 34298 Montpellier, France. · Service de dermatologie, hôpital Cavale-Blanche, boulevard Tanguy-Prigent, 29609 Brest, France. · Unité onco-dermatologie, centre Léon Bérard, 28, rue Laennec, 69008 Lyon, France. · Service de dermatologie, hôpital Saint-Vincent-de-Paul, boulevard de Belfort, BP 387, 59020 Lille, France. · Service de dermatologie, hôpital Dupuytren, 2, avenue Martin-Luther-King, 87042 Limoges, France. · Service de médecine nucléaire, centre Georges-François-Leclerc, 1, rue du Professeur-Marion, BP 77980, 21079 Dijon, France. · Service d'anatomie pathologique, hôpital Purpan, place Baylac, 31059 Toulouse, France. · Service de chirurgie oncologique, ICM, institut du cancer de Montpellier Val-d'Aurelle, 208, avenue des Apothicaires, parc Euromédecine, 34298 Montpellier, France. · Cabinet médical, 59, rue de la Providence, 31500 Toulouse, France. · Cabinet médical, 3, rue Saint-Sigisbert, 57050 le Ban-Saint-Martin, France. · Service de chirurgie générale et thoracique, centre hospitalier universitaire, 42055 Saint-Étienne, France. · Direction des recommandations et de la qualité de l'expertise, Institut national du cancer, 52, avenue André-Morizet, 92513 Boulogne-Billancourt, France. · Direction des recommandations et de la qualité de l'expertise, Institut national du cancer, 52, avenue André-Morizet, 92513 Boulogne-Billancourt, France. Electronic address: recommandations@institutcancer.fr. · Clinique de dermatolo-vénéréologie, photobiologie et allergologie, pôle pluridisciplinaire de médecine, hôpital Michallon, 38043 Grenoble, France. ·Neurochirurgie · Pubmed #25241016.

ABSTRACT: INTRODUCTION: The management of metastatic cutaneous melanoma is changing, marked by innovative therapies. However, their respective use and place in the therapeutic strategy continue to be debated by healthcare professionals. OBJECTIVE: The French national cancer institute has led a national clinical practice guideline project since 2008. It has carried out a review of these modalities of treatment and established recommendations. METHODS: The clinical practice guidelines development process is based on systematic literature review and critical appraisal by experts. The recommendations are thus based on the best available evidence and expert agreement. Prior to publication, the guidelines are reviewed by independent practitioners in cancer care delivery. RESULTS: This article presents the results of bibliographic search, the conclusions of the literature and the recommendations concerning locoregional treatments of brain metastases for patients with metastatic cutaneous melanoma.

2 Guideline [Management of patients with metastatic cutaneous melanoma: French national guidelines. French National Cancer Institute]. 2014

Leccia, M-T / Planchamp, F / Sassolas, B / Combemale, P / Modiano, P / Bedane, C / Cupissol, D / Derrey, S / Dygai-Cochet, I / Lamant, L / Lubrano, V / Mirabel, X / Mourrégot, A / Rougé Bugat, M-E / Siegrist, S / Thariat, J / Tiffet, O / Truc, G / Verdoni, L / Mazeau-Woynar, V. ·Pôle pluridisciplinaire de médecine, clinique de dermatolo-vénéréologie, photobiologie et allergologie, hôpital Michallon, 38043 Grenoble, France. · Direction des recommandations et de la qualité de l'expertise, Institut national du cancer, 52, avenue André-Morizet, 92513 Boulogne-Billancourt, France. Electronic address: recommandations@institutcancer.fr. · Service de dermatologie, hôpital Cavale Blanche, boulevard Tanguy-Prigent, 29609 Brest, France. · Unité onco-dermatologie, centre Léon-Bérard, 28, rue Laennec, 69008 Lyon, France. · Service de dermatologie, hôpital Saint-Vincent-de-Paul, boulevard de Belfort, BP 387, 59020 Lille, France. · Service de dermatologie, hôpital Dupuytren, 2, avenue Martin-Luther-King, 87042 Limoges, France. · Service d'oncologie médicale, ICM, institut du cancer de Montpellier Val-d'Aurelle, parc Euromédecine, 208, avenue des Apothicaires, 34298 Montpellier, France. · Département de neurochirurgie, hôpital Charles-Nicolle, 1, rue de Germont, 76000 Rouen, France. · Service de médecine nucléaire, centre Georges-François-Leclerc, 1, rue du Professeur-Marion, BP 77980, 21079 Dijon, France. · Service d'anatomie pathologique, hôpital Purpan, place Baylac, 31059 Toulouse, France. · Service de neurochirurgie, hôpital de Rangueil, 1, avenue du Professeur-Jean-Poulhès, TSA 50032, 31059 Toulouse, France. · Département de radiothérapie-curiethérapie, centre Oscar-Lambret, 3, rue Frédéric-Combemale, BP 307, 59020 Lille, France. · Service de chirurgie oncologique, ICM, institut du cancer de Montpellier Val-d'Aurelle, parc Euromédecine, 208, avenue des Apothicaires, 34298 Montpellier, France. · Cabinet médical, 59, rue de la Providence, 31500 Toulouse, France. · Cabinet médical, 3, rue Saint-Sigisbert, 57050 Le Ban-Saint-Martin, France. · Pôle de radiothérapie, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice, France. · Service de chirurgie générale et thoracique, centre hospitalier universitaire de Saint-Étienne, 42055 Saint-Étienne, France. · Département de radiothérapie, centre Georges-François-Leclerc, 1, rue du Professeur-Marion, BP 77980, 21079 Dijon, France. · Direction des recommandations et de la qualité de l'expertise, Institut national du cancer, 52, avenue André-Morizet, 92513 Boulogne-Billancourt, France. ·Ann Dermatol Venereol · Pubmed #24507205.

ABSTRACT: BACKGROUND: Recent years have seen the emergence of new molecules for the treatment of patients with metastatic cutaneous melanoma, with significant benefits in terms of survival and the opening of new therapeutic perspectives. In addition, many techniques are currently being developed for locoregional treatment of metastatic sites. Management of metastatic melanoma is thus fast-changing and is marked by innovative therapeutic approaches. However, the availability of these new treatments has prompted debate among healthcare professionals concerning their use and their place in therapeutic strategy. AIMS: Since 2008, the French National Cancer Institute (INCa) has been leading a project to define and diffuse national clinical practice guidelines. It has performed a review of these treatment methods, which it aims to circulate, and it is seeking to develop recommendations in order to allow nationwide implementation of innovative approaches while promoting good use thereof. METHODS: The clinical practice guidelines development process is based on systematic literature review and critical appraisal by experts within a multidisciplinary working group, with feedback from specialists in cancer care delivery. The recommendations are thus based on the best available evidence and expert agreement. Prior to publication, the guidelines are reviewed by independent practitioners in cancer care delivery. RESULTS: This article presents the national recommendations for first- and second-line systemic treatment and for locoregional treatment of metastatic sites in patients presenting metastatic cutaneous melanoma.

3 Guideline [Loco-regional treatments of the metastatic sites for patients with pauci-metastatic cutaneous melanoma (without brain metastasis): French national guidelines]. 2014

Sassolas, Bruno / Mourrégot, Anne / Thariat, Juliette / Tiffet, Olivier / Dygai-Cochet, Inna / Mirabel, Xavier / Truc, Gilles / Cupissol, Didier / Modiano, Philippe / Combemale, Patrick / Bedane, Christophe / Derrey, Stéphane / Lamant, Laurence / Lubrano, Vincent / Siegrist, Sophie / Rougé-Bugat, Marie-Ève / Mazeau-Woynar, Valérie / Verdoni, Laëtitia / Planchamp, François / Leccia, Marie-Thérèse. ·Hôpital Cavale Blanche, boulevard Tanguy-Prigent, 29609 Brest, France. · Institut du Cancer de Montpellier Val-d'Aurelle, parc Euromédecine, 208, avenue des Apothicaires, 34298 Montpellier, France. · Centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice, France. · Centre hospitalier universitaire de Saint-Étienne, 42055 Saint-Étienne, France. · Centre Georges-François-Leclerc, 1, rue du Professeur-Marion, BP 77980, 21079 Dijon, France. · Centre Oscar-Lambret, 3, rue Frédéric-Combemale, BP 307, 59020 Lille, France. · Hôpital Saint-Vincent-de-Paul, boulevard de Belfort, BP 387, 59020 Lille, France. · Centre Léon-Bérard, 28, rue Laënnec, 69008 Lyon, France. · Hôpital Dupuytren, 2, avenue Martin-Luther-King, 87042 Limoge, France. · Hôpital Charles-Nicolle, 1, rue de Germont, 76000 Rouen, France. · Hôpital Purpan, place Baylac, 31059 Toulouse, France. · Hôpital de Rangueil, 1, avenue du Professeur-Jean-Poulhès, TSA 50032, 31059 Toulouse, France. · Cabinet médical, 3, rue Saint-Sigisbert, 57050Le Ban-Saint-Martin, France. · Cabinet médical, 59, rue de la Providence, 31500 Toulouse, France. · Institut national du cancer, 52, avenue André-Morizet, 92513 Boulogne-Billancourt, France. · Hôpital Michallon, 38043 Grenoble, France. ·Bull Cancer · Pubmed #24369290.

ABSTRACT: INTRODUCTION: The last years are marked by the emergence of new molecules for the treatment of metastatic cutaneous melanoma with a significant benefit on the survival. Besides, some techniques are in development for the loco-regional treatment of the metastatic sites, bringing new therapeutic perspectives. However, their respective use and place in the therapeutic strategy are debated by healthcare professionals. OBJECTIVE: The French National Cancer Institute leads a national clinical practice guidelines project since 2008. It realized a review of these modalities of treatment and developed recommendations. METHODS: The clinical practice guidelines development process is based on systematic literature review and critical appraisal by a multidisciplinary expert workgroup. The recommendations are thus based on the best available evidence and expert agreement. Prior to publication, the guidelines are reviewed by independent practitioners in cancer care delivery. RESULTS: This article presents recommendations for loco-regional treatments of the pulmonary, bone, cutaneous, hepatic and digestive metastatic sites for patients with pauci-metastatic cutaneous melanoma.

4 Clinical Trial Treatment patterns and outcomes in patients with advanced melanoma in France. 2013

Bedane, Christophe / Leccia, Marie-Thérèse / Sassolas, Bruno / Bregman, Bruno / Lebbé, Céleste / Anonymous4020762. ·Hôpital Dupuytren, CHU de Limoges , Limoges , France. ·Curr Med Res Opin · Pubmed #23808961.

ABSTRACT: BACKGROUND: Melanoma is associated with high mortality and poor response to standard chemotherapy. In order to benchmark benefits of recently introduced treatments, outcome with standard chemotherapy in everyday practice should be documented. OBJECTIVES: To document treatment pathways in patients with advanced melanoma, to compare clinical outcomes between treatment lines, and to measure associated healthcare resource utilisation in terms of hospital visits and adverse event management. METHODS: An observational, longitudinal survey of patients with unresectable stage III/IV melanoma in France evaluated 278 patients with ≥ 2 months follow-up. Data were collected retrospectively for 2-3 years following the index consultation. Treatment history was documented and outcomes determined for each treatment line. Complete and partial response rates were compared between treatment lines. Overall and progression-free survival were determined by Kaplan-Meier analysis. Health resource utilisation was documented hospitalisations, hospice stays, emergency room visits, outpatient visits and adverse event management. RESULTS: In total, 271 patients (97.5%) received first-line therapy, 161 (57.9%) second-line therapy and 85 (30.6%) third-line therapy. The most frequent first-line therapy strategies were systemic treatment alone (46.5%) or in combination with surgery (22.9%). The most frequently used chemotherapy was dacarbazine monotherapy (62.3% of chemotherapy). Median duration of first-line systemic therapy was 11.9 (IQR: 6.6-24.0) weeks. First-line therapy was discontinued in 190 patients (68.3%), principally due to disease progression (150 patients). Median overall survival was 17.1 (95% CI: 14.6-20.1) months since diagnosis, 9.5 (95% CI: 6.7-12.8) months since initiation of first-line therapy and 5.3 (95% CI: 3.7-7.2) months since initiation of second-line therapy. Median progression-free survival time was 2.8 (95% CI: 2.5-3.3) months. Ninety-six patients (40.2%) received medication to manage adverse events and 131 patients (47.1%) required hospitalisation (mean: 3.1 hospitalisations; mean duration: 27 days). STUDY LIMITATIONS: The retrospective data collection precludes ascertainment of medical information and completion of missing data. CONCLUSIONS: Existing therapies provide limited survival benefit to patients with unresectable stage III/IV melanoma. New more effective treatment options are needed.

5 Clinical Trial Adjuvant therapy with pegylated interferon alfa-2b (36 months) versus low-dose interferon alfa-2b (18 months) in melanoma patients without macrometastatic nodes: an open-label, randomised, phase 3 European Association for Dermato-Oncology (EADO) study. 2013

Grob, Jean Jacques / Jouary, Thomas / Dréno, Brigitte / Asselineau, Julien / Gutzmer, Ralf / Hauschild, Axel / Leccia, Marie Thérèse / Landthaler, Michael / Garbe, Claus / Sassolas, Bruno / Herbst, Rudolf A / Guillot, Bernard / Chene, Genevieve / Pehamberger, Hubert. ·Aix-Marseille University, CRO2, Service de Dermatologie, Hopital de Timone, 264 Rue St Pierre, 13885 Marseille CEDEX 05, Marseille, France. jean-jacques.grob@ap-hm.fr ·Eur J Cancer · Pubmed #22975216.

ABSTRACT: AIM: Both low-dose interferon (IFN) alfa-2b and pegylated interferon (Peg-IFN) alfa-2b have been shown to be superior to observation in the adjuvant treatment of melanoma without macrometastatic nodes, but have never been directly compared. Peg-IFN facilitates prolongation of treatment, which could provide additional benefit. This multicentre, open-label, randomised, phase 3 trial compared standard low-dose interferon IFN and prolonged treatment with Peg-IFN. PATIENTS AND METHODS: Patients with resected melanoma ≥1.5mm thick and without clinically detectable node metastases were randomised 1:1 to treatment with IFN 3 MU subcutaneously (SC) three times weekly for 18 months or Peg-IFN 100 μg SC once weekly for 36 months. Sentinel lymph node dissection (SLND) was optional. The primary endpoint was disease-free survival (DFS). Secondary endpoints included distant metastasis-free survival (DMFS), overall survival (OS) and adverse events (AEs) grade 3-4. RESULTS: Of 898 patients enrolled, 896 (443 Peg-IFN, 453 IFN) were eligible for evaluation (median follow-up 4.7 years). SLND was performed in 68.2% of patients. There were no statistical differences between the two arms for the primary outcome of DFS (hazard ratio [HR] 0.91, 95% confidence interval [CI] 0.73-1.15) or the secondary outcomes of DMFS (HR 1.02, 95% CI 0.80-1.32) and OS (HR 1.09, 95% CI 0.82-1.45). Peg-IFN was associated with higher rates of grade 3-4 AEs (47.3% versus 25.2%; p<0.0001) and discontinuations (54.3% versus 30.4%) compared with IFN. CONCLUSION: This trial did not show superiority for adjuvant Peg-IFN over conventional low-dose IFN in melanoma patients without clinically detectable nodes. ClinicalTrials.gov identifier: NCT00221702.

6 Clinical Trial Temozolomide and cisplatin combination in naive patients with metastatic cutaneous melanoma: results of a phase II multicenter trial. 2010

Wierzbicka-Hainaut, Ewa / Sassolas, Bruno / Mourey, Laurent / Guillot, Bernard / Bedane, Christophe / Guillet, Gerard / Tourani, Jean Marc. ·Departments of Dermatology, CHU de Poitiers, Institut Claudius Rigaud, Toulouse, France. e.wierzbicka@chu-poitiers.fr ·Melanoma Res · Pubmed #20075758.

ABSTRACT: Temozolomide (TMZ) is a second-generation alkylating agent that has recently shown some efficacy in stage IV melanoma. The purpose of this study was to test the efficacy and safety of combination therapy with TMZ and cisplatin (CDDP) in patients with metastatic melanoma. Chemo-naive patients with metastatic cutaneous melanoma were included in a phase II study of combined therapy with TMZ (200 mg/m/day), days 1-5, and CDDP (75 mg/m/day) on day 1. The treatment was given every 28 days, for up to six cycles. The primary endpoint was the overall response rate and the secondary endpoints were progression-free survival, probability of survival, and tolerance. Thirty patients were enrolled into this study. Median age was 59 years. A total of 126 cycles were administered. Grade 3 and 4 hematological toxicity was observed in 14 patients (46.6%) and clinical toxicity in seven patients (23.3%). No complete response was observed among the 30 included patients. Five patients (16.7%) achieved a partial response. An additional six patients (20%) showed disease stabilization and 17 patients (56.6%) revealed progressive disease. Median survival and median response duration were 8 and 7.2 months, respectively. One- and 2-year survivals were 36.7 and 13.3%. One- and 2-year progression-free survivals were 13.3 and 3.3%. Our results suggest that concurrent adjunction of CDDP to TMZ regimen increases toxicity according to this schedule and does not improve the outcome of stage IV melanoma. The objective response rate is close to response rates observed with single-agent chemotherapy.

7 Article Real-world treatment patterns and clinical outcomes in advanced cutaneous melanoma patients in France. 2018

Sassolas, B / Leccia, M T / Godard, C / Benmahamed, L / Flinois, A / Levy-Bachelot, L / Bédane, C. ·Hôpital Morvan, CHU de Brest, Brest, France. · Hôpital Michallon, CHU de Grenoble, Grenoble, France. · MSD France, Courbevoie, France. · Kantar Health, Paris, France. · Hôpital Dupuytren, CHU de Limoges, Limoges, France. ·J Eur Acad Dermatol Venereol · Pubmed #28960564.

ABSTRACT: BACKGROUND: Since 2011, the management of advanced melanoma has radically changed with the availability of new therapies (immunotherapy and BRAF-targeted therapy) and with BRAF testing. OBJECTIVES: Following the introduction of these new therapies, the objectives of this AMEL study were to describe treatment patterns and evaluate overall survival (OS) among unresectable stage III/IV melanoma patients, in a real-life setting in France. METHODS: The AMEL study is a multicentre retrospective record review study. Thirty-three physicians working in 33 unique treatment centres participated in the study. Two hundred and sixty-four patients diagnosed between 1 January 2012 and 31 October 2012 with unresectable stage III/IV melanoma were included in the study. RESULTS: 94.7% of the patients received a first-line antitumour drug treatment, 62.5% a second-line treatment while 26.9% received a third-line treatment with no significant differences between patients with a BRAF mutation (50.4%) and BRAF wild type (47.0%). First-line treatment differs according to the BRAF status: 74.8% of patients with a BRAF mutation received a BRAF inhibitor while 79.3% of the BRAF wild-type patients were treated with conventional chemotherapy. In second line and over, the treatment patterns were more heterogeneous, depending on the BRAF mutation, the treatment received previously, the speed of progression of the disease and the availability of immunotherapy at the time the treatment was initiated. CONCLUSION: Regardless of the BRAF mutation status, the median OS of patients was 16 months (95% CI = 14-18). Compared to a similar study conducted in 2007 (MELODY), a gain of 4 months is observed. The gain seems to be higher for patients with a BRAF mutation (18 months) than for those without a BRAF mutation (14 months). The OS of patients who sequentially received both a BRAF inhibitor and ipilimumab (28 months) highlights the benefit of this treatment sequence.

8 Article Dual NRASQ61R and BRAFV600E mutation-specific immunohistochemistry completes molecular screening in melanoma samples in a routine practice. 2015

Uguen, Arnaud / Guéguen, Paul / Legoupil, Delphine / Bouvier, Stéphanie / Costa, Sebastian / Duigou, Sandrine / Lemasson, Gilles / Ledé, Françoise / Sassolas, Bruno / Talagas, Matthieu / Férec, Claude / Le Maréchal, Cédric / De Braekeleer, Marc / Marcorelles, Pascale. ·INSERM, U1078, Brest, F-29200 France; Service d'Anatomie et Cytologie Pathologiques, CHRU Brest, Brest, F-29220 France; Université Européenne de Bretagne, Brest, F-29200 France. Electronic address: arnaud.uguen@chu-brest.fr. · INSERM, U1078, Brest, F-29200 France; Université Européenne de Bretagne, Brest, F-29200 France; CHRU Brest, Laboratoire de Génétique Moléculaire et d'Histocompatibilité, Brest, F-29220 France. Electronic address: paul.gueguen@chu-brest.fr. · Service de Dermatologie, CHRU Brest, Brest, F-29220 France. · Service d'Anatomie et Cytologie Pathologiques, CHRU Brest, Brest, F-29220 France. Electronic address: stephanie.bouvier4@gmail.com. · Service d'Anatomie et Cytologie Pathologiques, CHRU Brest, Brest, F-29220 France. Electronic address: sebastian.costa@chu-brest.fr. · Service d'Anatomie et Cytologie Pathologiques, CHRU Brest, Brest, F-29220 France. Electronic address: sandrine.duigou@chu-brest.fr. · Service d'Anatomie et Cytologie Pathologiques, CHRU Brest, Brest, F-29220 France. Electronic address: gilles.lemasson@chu-brest.fr. · Service d'Anatomie et Cytologie Pathologiques, CHRU Brest, Brest, F-29220 France. Electronic address: francoise.lede@chu-brest.fr. · Institut de Cancérologie et Hématologie, CHRU Brest, Brest, F-29220 France. Electronic address: bruno.sassolas@chu-brest.fr. · Service d'Anatomie et Cytologie Pathologiques, CHRU Brest, Brest, F-29220 France; Université Européenne de Bretagne, Brest, F-29200 France; Faculté de Médecine et des Sciences de la Santé, Université de Brest, Brest, F-29200 France. Electronic address: matthieu.talagas@chu-brest.fr. · INSERM, U1078, Brest, F-29200 France; Université Européenne de Bretagne, Brest, F-29200 France; CHRU Brest, Laboratoire de Génétique Moléculaire et d'Histocompatibilité, Brest, F-29220 France. Electronic address: claude.ferec@chu-brest.fr. · INSERM, U1078, Brest, F-29200 France; Université Européenne de Bretagne, Brest, F-29200 France; CHRU Brest, Laboratoire de Génétique Moléculaire et d'Histocompatibilité, Brest, F-29220 France. Electronic address: cedric.lemarechal@chu-brest.fr. · INSERM, U1078, Brest, F-29200 France; Université Européenne de Bretagne, Brest, F-29200 France; Service de Cytogénétique et Biologie de la Reproduction, CHRU Brest, Brest, F-29220 France. Electronic address: marc.debraekeleer@chu-brest.fr. · Service d'Anatomie et Cytologie Pathologiques, CHRU Brest, Brest, F-29220 France; Université Européenne de Bretagne, Brest, F-29200 France; Faculté de Médecine et des Sciences de la Santé, Université de Brest, Brest, F-29200 France. Electronic address: pascale.marcorelles@chu-brest.fr. ·Hum Pathol · Pubmed #26297254.

ABSTRACT: NRAS and BRAF mutational status has become mandatory to treat patients with metastatic melanomas. Mutation-specific immunohistochemistry (IHC) can help analyze challenging tumor samples. We report our experience integrating NRASQ61R (SP174) and BRAFV600E (VE1) IHC in routine practice in a cancer molecular genetic platform. All samples screened for BRAF and NRAS mutations during the year 2014 were analyzed by IHC and pyrosequencing, with an independent analysis of the 2 methods. Cases with first-line discordant results benefited from a complementary second-round IHC and next-generation sequencing (NGS) with a final interpretation taking into account the results of pyrosequencing, IHC, NGS, and quantification of the tumor cells. We analyzed 111 consecutive formalin-fixed and paraffin-embedded melanoma samples from 101 patients. Twenty-two and 11 samples were concordant for BRAFV600E and NRASQ61R mutations, respectively. Second-round analyses of 9 discordant and 1 molecularly inconclusive samples allowed conclusion in 4 further mutated samples (2 BRAFV600E and 2 NRASQ61R). A sample remained NRASQ61R IHC negative but NRASQ61R mutated with molecular methods. Overall, BRAFV600 and NRASQ61 mutation frequencies were 31.7% and 30.7%, respectively. When compared to molecular results, the sensitivity and specificity of IHC were 100% for BRAFV600E IHC and 92.3% and 98.9% for NRASQ61R IHC, respectively. IHC interpretation required a more stringent cutoff for BRAFV600E IHC than NRASQ61R to minimize false results. We conclude that NRASQ61R and BRAFV600E IHC coupled with NGS allow detection of mutations in melanoma challenging samples.

9 Article Melanoma risk-takers: fathers and sons. 2015

Eisinger, F / Morère, J-F / Pivot, X / Grange, F / Lhomel, C / Mortier, L / Robert, C / Saiag, P / Sassolas, B / Viguier, J. ·Paoli-Calmettes Institute, Inserm umr 599, Marseille, France. ·J Eur Acad Dermatol Venereol · Pubmed #25639932.

ABSTRACT: OBJECTIVES: The incidence of skin cancers, melanoma in particular, is increasing rapidly. Consequently, specific recommendations for sun-protection measures now exist. This survey set out to assess the compliance of the general population with these guidelines. METHODS: The French nationwide observational survey, EDIFICE Melanoma, was conducted (28 September to 20 October 2011) through phone interviews of a representative sample of 1502 subjects aged ≥ 18 years, using the quota method. Sun-protection was defined as frequent or systematic use of clothes or sunscreen. The group of individuals who declared exposure to the sun (N = 1172) was subdivided: risk-takers (N = 442), and those who used sun protection (N = 730). RESULTS: Risk-takers were significantly more often male (62% vs. 44%, P < 0.01), had a lower level of education (40% vs. 26%, P < 0.01), lower incomes (2587 euros vs. 2948 euros/month) and were more often smokers (42% vs. 31%, P < 0.01). In contrast, age, marital status and use of sunbeds were not significantly different between the two groups. Interestingly, risk-takers had less risk factors for melanoma. However, they were less well-informed about high-risk exposure and optimal use of sunscreen. Sun-protection measures for their children were less stringent than those of the group who used sun protection: systematic/frequent use of sunglasses (42% vs. 59%, P < 0.01), systematic use of sunscreen (77% vs. 86%, P < 0.01), and frequent renewal (69% vs. 82%, P < 0.01), high sun protection factors (SPF) (46% vs. 56%, P < 0.01), use of clothing (84% vs. 92%, P < 0.01) and hats (88% vs. 94%, P < 0.01). CONCLUSIONS: Risk-takers are characterized by a lesser understanding of sun-protection measures and behaviours. Their children benefit less from protective measures than those of people who use sun protection themselves. Improved understanding may well improve behaviours; one can therefore legitimately predict a considerable impact on parents' attitude to their own protection and that of their children.

10 Article Personal vs. intrinsic melanoma risk awareness: results of the EDIFICE Melanoma survey. 2015

Robert, C / Lebbe, C / Ricard, S / Saiag, P / Grange, F / Mortier, L / Lhomel, C / Sassolas, B. ·Department of Dermatology, Institut Gustave Roussy, Villejuif, France. ·J Eur Acad Dermatol Venereol · Pubmed #25639931.

ABSTRACT: BACKGROUND: The efficiency of skin cancer prevention programmes is strongly correlated with the information dispensed, and with the level of risk awareness, of the overall population on one hand, and on the other, of specific sub-populations, according to their risk profiles. OBJECTIVES: The primary objective of this analysis was to establish a correlation between individual perceptions of the risk of developing a melanoma, and the recognized intrinsic risk factors for a given individual. Secondary objectives were to assess factors that are potentially associated with acceptable, high or low perception of melanoma risk. METHODS: The EDIFICE Melanoma survey was conducted in 2011 via telephone interviews of a representative sample of 1502 individuals aged 18 and older in the French population. RESULTS: Although most respondents (73%) had a true estimation of their intrinsic risk for melanoma, those who did not (underestimation, 17%; overestimation, 10%) had an attitude towards environmental risk factors (sun exposure, sun protection, sunbed use) that did not compensate for this misplaced perception. CONCLUSIONS: Skin cancer prevention messages need to be reinforced, new methods of evaluating understanding of the messages need to be implemented, and both need to be included into personal risk assessment.

11 Article Prevalence of sunbed use, and characteristics and knowledge of sunbed users: results from the French population-based Edifice Melanoma survey. 2015

Grange, F / Mortier, L / Crine, A / Robert, C / Sassolas, B / Lebbe, C / Lhomel, C / Saiag, P. ·Department of Dermatology, Robert Debré University Hospital, Reims, France. ·J Eur Acad Dermatol Venereol · Pubmed #25639930.

ABSTRACT: BACKGROUND: In addition to natural sunlight, indoor tanning has emerged as a common source of ultraviolet (UV) radiation associated with an increased risk of melanoma. It is classified as a class I human carcinogen by the World Health Organization. OBJECTIVES: This analysis presents data on the prevalence of sunbed use in France, on factors associated with sunbed use, and on risk factors, attitude and awareness of risk among sunbed users and non-users. METHODS: Edifice Melanoma, a nationwide observational survey, was conducted in France via telephone interviews among a representative sample of 1502 subjects aged ≥18 years, using the quota method. Sunbed users were defined as individuals who reported having used a sunbed at least once in their lifetime. Logistical regressions were conducted in order to identify which factors differentiate the population of sunbed users from that of non-users. RESULTS: One in ten respondents was a sunbed user and three out of four declared having used tanning facilities for over one year. In multivariate analysis, factors significantly associated with the sunbed-user group were female gender (OR = 3.897 [2.573-5.903], P < 0.001), a higher socio-professional category (OR = 2.227 [1.542-3.217]; P < 0.001), fair hair (OR = 1.583 [1.025-2.447], P = 0.039), fair skin (OR = 1.879 [1.086-3.253]; P = 0.024), freckles (OR = 1.570 [1.071-2.302]; P = 0.021) and a history of smoking (OR = 2.383 [1.633-3.476]; P < 0.001). In a second multivariate model, the fact of having a large number of melanoma risk factors was strongly associated with sunbed use (P = 0.001). Sunbed users were more likely to be informed of the role of sun exposure in reducing the skin's regenerative capacity (OR = 2.181 [1.319-3.607]; P = 0.002) but were nevertheless more likely to consider that a tan makes a person look more attractive (OR = 2.309 [1.312-4.064]; P = 0.004) and protects the skin (OR = 2.490 [1.532-4.046]; P < 0.001); they were also more frequently exposed to natural sunlight (OR = 2.214 [1.196-4.102]; P = 0.011). CONCLUSIONS: Compared to non-users, sunbed users cumulate risk factors for melanoma. Knowledge, attitudes and intentions of individuals are critical targets for public education programmes. However, awareness campaigns focusing on sunbed use, and more generally on skin cancer, should also take social and cultural norms into account.

12 Article Comparison of sun protection modalities in parents and children. 2015

Mortier, L / Lepesant, P / Saiag, P / Robert, C / Sassolas, B / Grange, F / Lhomel, C / Lebbe, C. ·Department of Dermatology, Hôpital Claude Huriez, Lille, France. ·J Eur Acad Dermatol Venereol · Pubmed #25639928.

ABSTRACT: BACKGROUND: Routine sun protection is recommended to prevent skin cancer. The aims of the present analysis were to assess and compare modalities of sun protection in parents and their children. METHODS: EDIFICE Melanoma is a French nationwide observational survey. It was conducted through phone interviews among a representative sample of 1502 individuals aged ≥18 years, using the method of quotas. The survey took place shortly after the summer, from 28 September to 20 October 2011. RESULTS: Of the 1502 subjects interviewed, 1067 reported sun exposure (SE) at least 10 days per year, 748 were parents and 319 had no children. Sun protection measures seemed adequate in both the 'parents' and 'non-parents' groups: 74% used clothing and 43% used sunscreen, which was reapplied regularly in 57% of cases. Sun protection measures used by SE parents for SE children were superior, both qualitatively and quantitatively, to those used for themselves, i.e., 50% of parents reported using clothing, sunglasses and hats for their children vs. 23% for themselves. In 87% of cases, parents reported regular re-application of sunscreen for their children vs. 44% for themselves. The sunscreen SPF (Sun Protection Factor) was significantly lower for parents than for their children. CONCLUSIONS: Sun protection awareness appears to be globally satisfactory in the French population, with no difference between adults who are parents and those who are not. From both qualitative and quantitative standpoints, French parents use sun protective measures more efficiently for their children than for themselves.

13 Article EDIFICE Melanoma survey: knowledge and attitudes on melanoma prevention and diagnosis. 2015

Saiag, P / Sassolas, B / Mortier, L / Grange, F / Robert, C / Lhomel, C / Lebbé, C. ·Department of Dermatology, Hôpital Ambroise Paré, Boulogne-Billancourt, France. ·J Eur Acad Dermatol Venereol · Pubmed #25639927.

ABSTRACT: BACKGROUND: Melanoma incidence is increasing worldwide thus justifying information campaigns aimed at reducing ultraviolet exposure levels and promoting early diagnosis. OBJECTIVES: We set out to assess awareness, knowledge and attitudes of the French population with regard to melanoma prevention and early diagnosis, following more than 15 years of nationwide information campaigns. METHODS: The French nationwide observational survey, EDIFICE Melanoma, was conducted after the summer (September to October 2011) through structured telephone interviews of a representative sample of 1502 individuals aged ≥18 years, using the quota method. All French regions were represented. RESULTS: Respondents had heard of sun-induced skin damage: 92% knew that sun increases melanoma risk. Knowledge of sun-protection measures was also good: 97% correctly cited at least one method of photoprotection (clothing 80%, sunscreens 69%) and 97% declared that sun exposure should be reduced between 12 pm and 4 pm in France. Knowledge of melanoma was encouraging: 70% of respondents could define the disease accurately and 60% knew the ABCDE rule for early diagnosis. However, self-tanning and sunbed use were considered by 25% and 13% of respondents, respectively, to provide protection from skin cancer. Although 43% of respondents (58% of high-risk respondents) declared they had consulted a doctor at least once for a suspect skin lesion, their actual behaviour was less encouraging: 30% declared never or almost never protecting their skin; 25% declared regularly checking their skin for atypical nevi; 12% declared checking the entire skin surface. Declared behaviour was better in fair-skin responders and those with a history of sunburn or skin cancer. CONCLUSIONS: Awareness of melanoma, early-diagnosis procedures and preventive behaviour has improved in the general French population since 1990. However, despite the good level of information, numerous misconceptions persist. Improved information campaigns in the future may help reduce the ever-increasing incidence of melanoma in France.

14 Article Sun exposure profile in the French population. Results of the EDIFICE Melanoma survey. 2015

Sassolas, B / Grange, F / Touboul, C / Lebbe, C / Saiag, P / Mortier, L / Lhomel, C / Robert, C. ·Department of Internal medicine and Respiratory Diseases, Hôpital Cavale Blanche, Brest, France. ·J Eur Acad Dermatol Venereol · Pubmed #25639926.

ABSTRACT: BACKGROUND: The incidence of melanoma is increasing worldwide, causing significant economic burden at community and individual levels. Ultraviolet radiation, from natural sunlight or artificial sources, is the main environmental, modifiable risk factor for melanoma. OBJECTIVES: The present analysis assesses the profile of sun exposure in the French population as well as the level of awareness about ultraviolet risk and protection. METHODS: The survey was conducted via telephone interviews in September and October 2011. In total, 1502 respondents were questioned about their own sun exposure with the question "do you ever, even occasionally, spend time in the sun, during leisure-time, vacation or your professional occupation?" They were also asked about sun protection measures used: protective clothing, a hat or sunscreen. RESULTS: More than three respondents out of four (78%) declared exposing themselves to the sun, with an average of 113 days per year. Of these, 38% did not use appropriate sun protection measures. We identified the following characteristics of individuals declaring high sun exposure: chiefly men under the age of 40, higher socio-professional levels, and adults with no children. Individuals who make a poor use of protective measures are mostly men and of low educational levels. Individuals declaring low sun exposure were chiefly: women, individuals over the age of 60, and those with no professional activity. The high sun protection population comprises mostly: women, higher socio-professional levels, with no specific age-group profile. CONCLUSIONS: Analysis of the EDIFICE Melanoma survey provides information about the attitudes of the French population towards sun exposure. The most frequent contexts of sun exposure and the associated socio-demographic characteristics of the population with at-risk attitudes regarding sun exposure are identified. This deeper insight into the profile of at-risk populations will allow interventions to be more accurately targeted, thus potentially improving public health benefits.

15 Article Cutaneous melanoma in patients treated with tumour necrosis factor inhibitors: a retrospective series of 15 patients. 2014

Chabbert, C / Adamski, H / Guillet, G / Sassolas, B / Misery, L / Perrinaud, A / Machet, L / Quereux, G / Esteve, E / Solau-Gervais, E / Saraux, A / Polard, E / Lesimple, T / Le Gall, F / Dreno, B / Dupuy, A. ·Department of Dermatology, University Hospital of Rennes, Rennes, France. ·J Eur Acad Dermatol Venereol · Pubmed #24329560.

ABSTRACT: BACKGROUND: Several case reports suggested that tumour necrosis factor-α (TNF) inhibitors might increase the incidence and/or alter the natural course of melanoma towards a more aggressive behaviour. OBJECTIVE: Our objective was to point if history of melanoma in patients exposed to TNF inhibitors could present with a particular pattern at diagnosis or during follow-up. METHODS: We performed a retrospective multicentre study settled in the West part of France to collect and analyse all cases of patients with melanoma who received anti-TNF therapy. RESULTS: Fifteen cases were included. First, 10 patients (mean age: 55.6 years; sex ratio: 1) had a melanoma diagnosed after TNF inhibitors initiation. The mean duration between initiation of treatment and melanoma was 48.7 months. Two patients died of metastatic disease. Second, four patients had a past history of melanoma before anti-TNF therapy (mean duration of treatment: 10.8 months). None experienced a progression of melanoma disease. Last, one woman had a past history of melanoma before and then developed a second melanoma when exposed to biotherapy. CONCLUSION: Our case series does not reveal a distinct profile of melanoma in the patients exposed to TNF inhibitors. Additional prospective trials including larger number of patient are needed to demonstrate the possible link between biological therapy with TNF inhibitors and development of melanoma.

16 Article [Malignant skin tumours]. 2010

Gelot, Pauline / Sassolas, Bruno / Quereux, Gaëlle. ·Centre hospitalier universitaire, Nantes. ·Soins · Pubmed #20963982.

ABSTRACT: The constant increase in the incidence of malignant skin tumours is a public health problem. The main known causal agent of these tumours is sun exposure. Preventive action therefore consists in raising people's awareness of the dangers of the sun and promoting sun protection.

17 Article Clinical and therapeutic impact of 18F-FDG PET/CT whole-body acquisition including lower limbs in patients with malignant melanoma. 2010

Querellou, Solene / Keromnes, Nathalie / Abgral, Ronan / Sassolas, Bruno / Le Roux, Pierre-Yves / Cavarec, Marie-Béatrice / Le Duc-Pennec, Alexandra / Couturier, Olivier / Salaun, Pierre-Yves. ·Department of Nuclear Medicine, University Hospital, Brest, France. solenequerellou@hotmail.com ·Nucl Med Commun · Pubmed #20585271.

ABSTRACT: OBJECTIVES: To assess the added benefit of scanning lower limbs in addition to the usual whole-body positron emission tomography/computed tomography (PET/CT) scan in patients with no known or suspected primary or metastatic melanoma involving the lower limbs. MATERIALS AND METHODS: This is a retrospective study of 122 consecutive patients [174 2-[¹⁸F]-fluoro-2-deoxy-D-glucose (FDG) PET/CT] who underwent FDG PET/CT for staging of melanoma at different time points in the course of the disease from October 2005 to February 2009 at the Brest University Hospital. Reports of whole-body PET/CT scans including lower limbs were reviewed. PET/CT abnormalities on the lower extremities were tabulated by location and correlated with pathology, other imaging studies and at least a 6-month clinical follow-up. The usefulness of lower limbs acquisition in clinical management was evaluated according to imagery findings. RESULTS: Among the 174 consecutive PET/CT scans performed in 122 patients, 33 scans in 28 patients highlighted abnormal FDG uptakes considered as equivocal or suggestive of malignancy in the lower limbs. In 28 cases, uptakes were located at once in the lower limbs and in the rest of the body (lung, liver, mediastinal and sub-diaphragmatic lymph nodes, adrenal glands, bone) corresponding to disseminated disease. In five cases, PET/CT uptakes were located only in lower limbs; each pathological uptake corresponded to benign lesions. Lower limbs findings never impacted clinical and therapeutic decision. CONCLUSION: Lower limbs additional PET/CT acquisition seems to offer poor additional benefit with none unexpected lesion detected and routine skull base to upper thigh images might be sufficient for this subset of patients.

18 Article Management and outcome of metastatic melanoma during pregnancy. 2010

Pagès, C / Robert, C / Thomas, L / Maubec, E / Sassolas, B / Granel-Brocard, F / Chevreau, C / De Raucourt, S / Leccia, M-T / Fichet, D / Khammari, A / Boitier, F / Stoebner, P-E / Dalac, S / Celerier, P / Aubin, F / Viguier, M. ·Service de Dermatologie, Université Paris VII, Hôpital Saint-Louis, INSERM U697, 1 Avenue Claude-Vellefaux, 75475 Paris Cedex 10, France. ·Br J Dermatol · Pubmed #19804595.

ABSTRACT: BACKGROUND: Although metastatic melanoma occurrence during pregnancy challenges the physician in several ways, only a few studies have been published. OBJECTIVES: Our aim was to investigate therapeutic management together with maternal and fetal outcomes in pregnant women with advanced melanoma. METHODS: A French national retrospective study was conducted in 34 departments of Dermatology or Oncology. All patients with American Joint Committee on Cancer (AJCC) stage III/IV melanoma diagnosed during pregnancy were included. Data regarding melanoma history, pregnancy, treatment, delivery, maternal and infant outcomes were collected. RESULTS: Twenty-two women were included: 10 AJCC stage III and 12 stage IV. Abortion was performed in three patients. Therapeutic abstention during pregnancy was observed in three cases, 14 patients underwent surgery, four patients received chemotherapy and one patient was treated with brain radiotherapy alone. The median gestational age was 36 weeks amenorrhoea. Neither neonatal metastases nor deformities were observed. Placenta metastases were found in one case. Among 18 newborns, 17 are currently alive (median follow up, 17 months); one died of sudden infant death. The 2-year maternal survival rates were 56% (stage III) and 17% (stage IV). CONCLUSIONS: Faced with metastatic melanoma, a majority of women chose to continue with pregnancy, giving birth, based on our samples, to healthy, frequently premature infants. Except during the first trimester of pregnancy, conventional melanoma treatment was applied. No serious side effect was reported, except one case of miscarriage after surgery. Mortality rates do not suggest a worsened prognosis due to pregnancy but larger prospective controlled studies are necessary to assess this specific point.

19 Article Impact of a campaign to train general practitioners in screening for melanoma. 2009

Peuvrel, Lucie / Quereux, Gaëlle / Jumbou, Olivier / Sassolas, Bruno / Lequeux, Yves / Dreno, Brigitte. ·Réseau Mélanome Ouest, Dermatological Clinic, Nantes University Hospital Center, Nantes, France. ·Eur J Cancer Prev · Pubmed #19491609.

ABSTRACT: Melanoma is a serious cancer whose incidence is growing. At this time, its prognosis is dependent on the Breslow index and therefore on early screening. The objective of the study was to evaluate the impact of a campaign to train general practitioners based, in particular, on learning the ABCDE rule. The training, performed by Réseau Mélanome Ouest, involved 210 general practitioners from the Pays de la Loire (Loire region) in France. Eight identical 2-h sessions were held between 2004 and 2006, conducted by a hospital dermatologist, a dermatologist in private practice, and a general practitioner as a moderator. The training was evaluated in two stages, with a self-administered questionnaire followed by a telephone survey. Thirty-six percent of the doctors stated that they had detected melanomas since the training over a median period of 27 months (2-39 months); 15% sent in the corresponding pathological anatomy reports on 37 confirmed melanomas from 30 doctors. The Breslow index scores of the melanomas detected ranged from 0.16 to 4 mm. Therefore, our training promoted the screening of a large number of melanomas, most of them with a low Breslow index. As a result, after a short prior training, the ABCDE rule clearly seems to be a valuable tool. Dermatologists retain an important role both in the diagnostic confirmation of melanomas and in the training of general practitioners.

20 Article The contribution of large genomic deletions at the CDKN2A locus to the burden of familial melanoma. 2008

Lesueur, F / de Lichy, M / Barrois, M / Durand, G / Bombled, J / Avril, M-F / Chompret, A / Boitier, F / Lenoir, G M / Anonymous2230603 / Bressac-de Paillerets, B / Baccard, Monique / Bachollet, Bertrand / Berthet, Pascaline / Bonadona, Valérie / Bonnetblanc, Jean-Marie / Caron, Olivier / Chevrant-Breton, Jacqueline / Cuny, Jean-François / Dalle, Stéphane / Delaunay, Michèle / Demange, Liliane / De Quatrebarbes, Julie / Doré, Jean-François / Frénay, Marc / Fricker, Jean-Pierre / Gauthier-Villars, Marion / Gesta, Paul / Giraud, Sophie / Gorry, Philippe / Grange, Florent / Green, Andrew / Huiart, Laetitia / Janin, Nicolas / Joly, Pascal / Kérob, Delphine / Lasset, Christine / Leroux, Dominique / Limacher, Jean-Marc / Longy, Michel / Mansard, Sandrine / Marrou, Karine / Martin-Denavit, Tanguy / Mateus, Christine / Maubec, Eve / Olivier-Faivre, Laurence / Orlandini, Vincent / Pujol, Pascal / Sassolas, Bruno / Stoppa-Lyonnet, Dominique / Thomas, Luc / Vabres, Pierre / Venat, Laurence / Wierzbicka, Ewa / Zattara, Hélène. ·Groupe Mélanome, Institut Gustave Roussy, FRE2939 CNRS-Université Paris-Sud, Villejuif, France. ·Br J Cancer · Pubmed #18612309.

ABSTRACT: Mutations in two genes encoding cell cycle regulatory proteins have been shown to cause familial cutaneous malignant melanoma (CMM). About 20% of melanoma-prone families bear a point mutation in the CDKN2A locus at 9p21, which encodes two unrelated proteins, p16(INK4a) and p14(ARF). Rare mutations in CDK4 have also been linked to the disease. Although the CDKN2A gene has been shown to be the major melanoma predisposing gene, there remains a significant proportion of melanoma kindreds linked to 9p21 in which germline mutations of CDKN2A have not been identified through direct exon sequencing. The purpose of this study was to assess the contribution of large rearrangements in CDKN2A to the disease in melanoma-prone families using multiplex ligation-dependent probe amplification. We examined 214 patients from independent pedigrees with at least two CMM cases. All had been tested for CDKN2A and CDK4 point mutation, and 47 were found positive. Among the remaining 167 negative patients, one carried a novel genomic deletion of CDKN2A exon 2. Overall, genomic deletions represented 2.1% of total mutations in this series (1 of 48), confirming that they explain a very small proportion of CMM susceptibility. In addition, we excluded a new gene on 9p21, KLHL9, as being a major CMM gene.

21 Minor NRASQ61R and BRAFV600E Mutation-specific Immunohistochemistry Is a Helpful Tool to Diagnose Metastatic Undifferentiated/Dedifferentiated Melanomas. 2016

Uguen, Arnaud / Sassolas, Bruno / Mondine, Philippe / Doucet, Laurent / Ginestet, Florent / Benigni, Paolo / Costa, Sebastian / De Braekeleer, Marc / Marcorelles, Pascale. ·*Inserm, U1078 †Service d'anatomie et cytologie pathologiques §Institut de Cancérologie et Hématologie ∥Service de Chirurgie Cardio-Thoracique et Vasculaire ¶Service de cytogénétique et biologie de la reproduction, CHRU Brest #Faculté de Médecine et des Sciences de la Santé, Université de Brest, Brest ‡Université Européenne de Bretagne Bretagne, France. ·Am J Surg Pathol · Pubmed #26999502.

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