Institute Paoli-Calmettes

Background and study aimsEsophagogastric junction (EGJ) lesions are uncommon and histologically diverse. Among these, EGJ hyperplastic lesions are rare and generally considered benign. However, their nonspecific appearance makes accurate endoscopic identification challenging. Endoscopic resection is both a diagnostic and therapeutic approach, yet risk factors for neoplastic transformation in EGJ lesions remain unclear. This study aimed to identify predictive factors for neoplastic transformation in hyperplastic EGJ lesions.Patients and methodsThis multicenter, retrospective study included patients with hyperplastic EGJ lesions endoscopically resected across 13 European hospitals. Data were collected from endoscopy and pathology reports. Neoplastic transformation was defined by presence of dysplasia or adenocarcinoma. A multivariable logistic regression model was conducted to assess predictive factors for neoplastic transformation in resected hyperplastic lesions.ResultsFrom January 2015 to October 2024, 91 EGJ hyperplastic lesions were included. Polypectomy/endoscopic mucosal resection (EMR) was performed in 86% of cases, endoscopic submucosal dissection (ESD) in 19%. En bloc resection was successfully achieved in 93% of cases, whereas R0 resection rates were confirmed in 84% of cases. Twenty-one lesions (23%) showed neoplastic transformation on histology. Independent predictive factors for neoplastic transformation in hyperplastic lesions included non-polypoid morphology (odds ratio [OR] 5.48;P= 0.025), presence of surface ulceration (OR 11.5;P= 0.0005) and lesion size (OR 5.48;P= 0.021). Lesion size > 12 mm was identified as a significant predictor of neoplastic transformation in hyperplastic lesions.ConclusionsEGJ hyperplastic lesions showed a non-negligible risk of neoplastic transformation. These findings highlight the need for careful endoscopic assessment to predict malignancy while promoting appropriate management strategies to ensure adequate R0 resection in case of undetected local malignancy.

BackgroundPatients treated for rare ovarian germ cell tumors (GCT) and sex cord stromal tumors (SCST) often experience long-term survival. Treatments include surgery with or without chemotherapy (CT), which can cause late side effects that negatively impact quality of life (QoL). This study assessed long-term QoL among GCT and SCST survivors compared to age-matched healthy women (HW), focusing on patients treated with CT.MethodsCancer-free GCT and SCST survivors (≥ 2 years post-treatment) were recruited from the INCa French Network TMRG. HW were recruited via the “Seintinelles” platform. Participants completed validated questionnaires assessing QoL (FACT-G/FACT-O), fatigue (MFI), anxiety/depression (HADS), insomnia (ISI), neurotoxicity (FACT/GOG-NTX), cognition (FACT-COG), and sexuality (FACT-O OCS). Clinically relevant differences were defined as ≥ 5% between groups.ResultsA total of 144 survivors (99 GCT and 45 SCST) were included and compared with 284 matched HW (median age: 35.2 years). The median time from the end of treatment was 6 years [Q1 3.5–Q3 9.3]. At inclusion, 42% of patients were menopausal compared to 17% of HW (p < 0.001), with reduced sexual QoL. Survivors reported more cognitive impairment (32% vs. 21%, p = 0.025) and severe neurotoxicity (23% vs. 8%, p < 0.001). QoL, fatigue, anxiety/depression, and insomnia scores were similar for patients and HW.ConclusionsWith a median of 6 years after CT, most GCT and SCST survivors reported similar overall QoL compared to HW but faced premature menopause, reduced sexual QoL, and persistent cognitive and neurotoxic effects.Trial registration numberNCT03418844.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12916-025-04540-x.

Frontline high-dose therapy (HDT) is, in 2025, the standard of care for patients with multiple myeloma (MM) who are eligible for autologous stem cell transplantation (ASCT). Prior to high-dose melphalan, induction therapy with quadruplet combinations is also proposed systematically when possible. Lenalidomide maintenance until progression is also recommended per international guidelines. This strategy has been developed over recent decades, based on results of phase 3 trials designed and conducted by different academic groups. With these therapeutic advances, the median overall survival (OS) for patients with MM has increased from 5 years in the 1990s, to over 15 years at present. Here, we present the contribution of the French myeloma cooperative group Intergroupe Francophone du Myélome (IFM) to these advances in the newly diagnosed transplant-eligible (NDTE) setting.

Background and study aimsEndoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) has been proposed as a minimally invasive alternative to surgery for treatment of both functional (F-) and non-functional (NF-) pancreatic neuroendocrine tumors (PanNETs). We performed a large prospective multicenter study to evaluate safety and effectiveness of EUS-RFA in patients with F- and NF-PanNETs.Patients and methodsPatients with F- (≤ 2 cm) and NF-PanNETs (15 mm-25 mm) were prospectively enrolled over a 43-month period. The primary aim was safety, defined as rate of adverse events (AEs). The secondary aim was effectiveness defined as complete disappearance of the hormonal secretion syndrome in F- PanNETs, whereas for NF-PanNETs, complete response was defined as absence of enhancing tissue and of detectable lesion at magnetic resonance imaging/computed tomography scan and Gallium-positron emission tomography, respectively. The EUSRA 19G needle was used in all patients. After treatment completion, follow-up was performed for 1 year.ResultsDuring the study period, a total of 60 patients were enrolled, 30 with insulinomas and 30 with NF-PanNETs (mean lesion size 14.5 ± 4.5 mm). In 78.3% of patients, a single RFA session was performed. Overall, AEs occurred in nine of 60 patients (15%), in four patients (13.3%) with insulinomas and in five (16.7%) with NF-PanNETs, with only one severe AE. Complete insulin hypersecretion symptom resolution was obtained in 29 of 30 patients (96.7%) with insulinomas, whereas for NF-PanNETs, complete radiological response was obtained in 22 of 25 patients (88%) with long-term follow up.ConclusionsOur prospective international multicenter study demonstrated that EUS-RFA is highly safe and effective for the treatment for both F- and NF-PanNETs.