[Reliability of the response rate in oncology: analysis of the causes for variation]. / Fiabilité des taux de réponses en oncologie: analyse des causes de variation.

We evaluated the impact of an evaluation committee (EC) on patients' overall response status in a large multicenter trial in oncology. We identified reasons for disagreements between investigators and the EC. The Cancer Renal Cytokine (CRECY) study was a French multicenter trial that tested cytokine therapy in 489 patients with metastatic renal cell carcinoma. Objective response (OR) evaluation included medical imaging and was studied according to international guidelines. A blinded peer review of all responders and litigious cases was performed by an EC. Major disagreements occurred in 43% and minor disagreements in 10.5% of the reviewed files. The number of significant tumor responses was reduced by 23.2% after review by the EC. Reasons for disagreements included errors in tumor measurements, errors in selection of measurable targets, intercurrent diseases, and radiologic technical problems. These reasons for disagreements are analyzed and discussed. We conclude that all therapeutic trial results should be reviewed by peer analysis of all presumed responders by an EC. International guidelines for response evaluation should be updated by including more reliable methods of measurements and definition of minimal imaging procedures.

Response rate accuracy in oncology trials: reasons for interobserver variability. Groupe Français d'Immunothérapie of the Fédération Nationale des Centres de Lutte Contre le Cancer.

PURPOSE: We evaluated the impact of an evaluation committee (EC) on patients' overall response status in a large multicenter trial in oncology. We identified reasons for disagreements between investigators and the EC. MATERIALS AND METHODS: The Cancer Renal Cytokine (CRECY) study was a French multicenter trial that tested cytokine therapy in 489 patients with metastatic renal cell carcinoma. Objective response (OR) evaluation included medical imaging and was studied according to international guidelines. A blinded peer review of all responders and litigious cases was performed by an EC. RESULTS: Major disagreements occurred in 40% and minor disagreements in 10.5% of the reviewed files. The number of significant tumor responses was reduced by 23.2% after review by the EC. Reasons for disagreements included errors in tumor measurements, errors in selection of measurable targets, intercurrent diseases, and radiologic technical problems. These reasons for disagreements are analyzed and discussed. CONCLUSION: We conclude that all therapeutic trial results should be reviewed by peer analysis of all presumed responders by an EC. International guidelines for response evaluation should be updated by including more reliable methods of measurements and definition of minimal imaging procedures.

[Periprosthetic false aneurysm after Bentall's operation: diagnosis with magnetic resonance imaging]. / Faux anévrysme péri-prothétique après intervention de Bentall: diagnostic par imagerie par résonance magnétique.

Periprosthetic false aneurysm due to dehiscence of a suture line represents a serious postoperative complications after Bentall's procedure, because of its asymptomatic presentation and spontaneous course towards progressive increase in size with high risk of sudden rupture. This type of complication justifies systematic radiologic follow-up. Magnetic Resonance Imaging, as proved by our two cases, is a reliable technique in the diagnosis of this complication requiring reoperation.

[Uterine cervix cancers: staging by magnetic resonance imaging]. / Cancers du col utérin: stadification par imagerie par résonance magnétique.

The accuracy of Magnetic Resonance Imaging in cervical carcinoma staging for clinical stages superior to IB was studied retrospectively in 27 patients. The MRI results were then correlated with operative findings in 12 cases and with examination carried out under general anesthesia in 15 cases for myometrial, bladder, rectal, parametrial, parietal and vaginal extension. The accuracy of MRI was 81.5% for bladder, 92.5% for rectal, 87% for parametrial and 73% for vaginal extension. The accuracy of staging by MRI was 59%. The contribution of MRI in pre-operative studies for cervical carcinomas has not been properly defined until now. Nevertheless it is a particularly valuable technique due to its non invasive nature.

[Digitalized angiography in the study of critical ischemia of the lower limbs]. / Apport de l'angiographie numérisée dans l'exploration des ischémies critiques des membres inférieurs.

Twenty three patients suffering from severe chronic ischemia of the lower limbs were explored by conventional and digital angiography. A comparative study of these 2 angiographic techniques was carried out to appreciate the pre-operative distal vascular tree and the surgical indications. In all cases, digital angiography was never found to be less informative than conventional angiography. In 14 cases, the surgical approach was changed as a result of digital angiography in 4 cases the method of revascularization and in 10 cases the surgical indication itself (distal bypass instead of amputation). The authors consider digital angiography to be essential in this surgical indication.

Pseudocoarctation of the aorta associated with retro-aortic left brachiocephalic vein: a case report.

The authors report a case of pseudocoarctation of the aorta associated with a retro-aortic left brachiocephalic vein. This exceptional congenital malformation, never described before, was studied by aortography, computed tomography and magnetic resonance imaging.