Longjumeau

This research aims to describe the clinical, histological, and radiological features of rare primary liver cancers. It focuses on collecting tumor and blood samples to better understand these cancers and to evaluate how well treatments used in real-world practice work, with the goal of identifying the best treatment sequences. The study serves as a foundation for future research to find new molecular and imaging biomarkers that could improve diagnosis and prognosis. The study is observational and retrospective, meaning it reviews past cases from multiple centers in France. It collects biological samples and clinical data from patients diagnosed with rare primary liver cancers after January 2018. The study evaluates treatments patients have received in clinical practice without assigning any new treatments or interventions. Participants data, including clinical characteristics, tumor biology, and imaging, will be reviewed for up to five years from diagnosis. Researchers will measure outcomes such as recurrence-free survival for patients without metastases, progression-free survival for those with metastases, and overall survival. The study includes both living patients who consent to participate and deceased patients, aiming to gather comprehensive information to support future translational studies.

Researchers are evaluating how the size of the bougie used during laparoscopic sleeve gastrectomy LSG affects the rate of postoperative stomach leaks, which is the most common and serious complication after this weight loss surgery. This prospective randomized trial compares the use of a larger 48-Fr bougie to standard smaller bougie sizes 34, 36, or 38 Fr to see if a bigger diameter lowers leak risk without reducing long-term weight loss. Participants will undergo laparoscopic sleeve gastrectomy using either the 48-Fr bougie or a standard care bougie. The bougie is inserted through the mouth by the anesthesiologist and positioned in the stomach before the gastrectomy is performed alongside it. Patients do not know which bougie size they receive. This study aims to assess differences in leak rates and weight loss outcomes between the two bougie sizes. During the study, researchers will monitor participants for stomach leaks within 30 days after surgery as the primary outcome. Secondary outcomes include complications within 90 days, weight loss at 3, 6, 12, and 24 months, and quality of life up to 2 years. Participants will have follow-up visits for these assessments to track recovery, safety, and weight changes over time.

Researchers are evaluating the effectiveness of cotrimoxazole compared to standard antibiotic therapy for treating ventilator-associated pneumonia VAP caused by Enterobacteriaceae in adult patients in intensive care units ICU. This multicenter randomized trial aims to determine if cotrimoxazole is not inferior to the best standard care in terms of survival 28 days after treatment begins. Patients with confirmed VAP and susceptibility to cotrimoxazole are included, with specific attention to those with or without septic shock and COVID-19 pneumonia. Participants are randomly assigned to receive either cotrimoxazole or standard antibiotic treatment, such as beta-lactams or fluoroquinolones, for a total of 7 days including initial empiric treatment. The antibiotic dosing and administration are adjusted based on current ICU recommendations. The treatment period can last up to 28 days or until death or ICU discharge if earlier. The study is not blinded due to variable therapies in the control group. During the study, patients are monitored daily until death, ICU discharge, or day 28 for vital signs, antibiotic use, new infections, and Clostridium difficile infection. Clinical and radiological evaluations occur at day 7, and weekly screening for multidrug-resistant bacteria is performed. Survival status is followed up to 90 days through phone or hospital interview. An independent committee reviews clinical and radiological outcomes without knowledge of treatment assignment to ensure unbiased assessment.

Researchers are studying patients who have lived for three years or more after being diagnosed with metastatic lung cancer and who are no longer receiving cytotoxic chemotherapy. The study aims to understand these patients clinical characteristics, health status, socioeconomic impacts, quality of life, and their ability to return to work. This observational research focuses on both non-small cell lung cancer NSCLC and small cell lung cancer SCLC. Participants will be observed over time without receiving experimental treatments. They will complete several questionnaires related to quality of life, anxiety, and depression at the start of the study, then at 6 and 12 months, and annually for up to five years. Their health and treatment history, including any ongoing therapies like immunotherapy or targeted therapy, will be recorded throughout the study. During the study, participants will continue their usual medical care and attend regular consultations as needed. Researchers will collect data through questionnaires and health evaluations to measure clinical characteristics, health status, socioeconomic factors, and psychological well-being. The main outcomes include baseline clinical data and repeated assessments over five years to better understand long-term survivorship after metastatic lung cancer diagnosis.

Squamous cell carcinoma of the anus is a rare but increasingly common cancer, often linked to human papillomavirus HPV. For early-stage tumors, combined radiotherapy and chemotherapy with 5FU and mitomycin-C provide good outcomes, but advanced tumors have a poor prognosis with a high relapse rate. Researchers are studying a new approach combining induction chemotherapy with docetaxel, cisplatin, and 5FU mDCF followed by standard chemoradiotherapy to improve treatment results for locally advanced anal cancer T3-4 or N1. This is a randomized phase 3 trial comparing this new strategy to the current standard treatment. The study includes two groups one receives the usual chemoradiotherapy, which involves 33 radiotherapy sessions over 6.5 weeks combined with mitomycin-C and capecitabine chemotherapy taken on radiotherapy days. The other group starts with 4 cycles of mDCF chemotherapy given every two weeks before receiving the same chemoradiotherapy as the control group. Radiotherapy uses intensity-modulated external irradiation with a targeted boost to the tumor and involved lymph nodes. Participants will be followed after treatment with check-ups at 8 weeks, then every 4 months for two years, and every 6 months in the third year. Follow-up includes clinical exams and imaging scans CT and MRI. The main measure of success is disease-related event-free survival two years after treatment. Other outcomes include overall survival, colostomy-free survival, treatment side effects, tumor response, and quality of life. The total study duration for each participant may extend over several years including this follow-up period.

Researchers are collecting real-life data on patients aged 70 years and older who are receiving first-line treatment for thoracic tumors, specifically Non-Small-Cell Lung Carcinoma, following standards defined by the European Society for Medical Oncology. The study aims to characterize participants geriatric health, biology, and cancer features, as well as to describe treatment methods and assess outcomes such as efficacy, safety, and quality of life. Exploratory subgroups treated with the same drug or innovative strategies will also be identified. Participants will undergo systemic treatment for their lung cancer according to current standard care or innovative therapies. Blood samples will be collected before the first treatment for biobanking, and tumor samples will be sent for central analysis. Patients will attend clinic visits as per usual care and will complete three quality of life questionnaires during the study. Throughout the study, participants will have regular visits and tests to monitor their general condition and treatment effects. This includes lab tests, imaging, re-biopsies, and assessments tailored for older adults. Quality of life is measured at several time points using validated questionnaires. The main outcome being tracked is progression-free survival up to two years, along with other outcomes like response rates, overall survival, safety events, and geriatric interventions. Participants may be followed for up to two years in total.

This research aims to evaluate the use of DDAVP desmopressin to prevent rapid overcorrection of serum sodium levels in ICU patients with severe hyponatremia. The trial is a multicenter, prospective, open-label randomized controlled study that includes patients with severe hyponatremia defined by specific sodium levels and neurological symptoms, with stratification based on risk factors for central pontine myelinolysis. The study focuses on patients with normal or low extracellular fluid volume and investigates whether adding DDAVP to standard treatment reduces the risk of sodium overcorrection. Participants are randomized to receive either standard hyponatremia treatment alone or standard treatment plus DDAVP 4 gml intravenously, with additional doses every 6 hours for up to 48 hours. Standard treatment varies based on neurological symptoms, involving either sodium chloride 3% infusion or hypertonicisotonic fluids excluding hypotonic fluids. Due to the clear clinical effects of DDAVP on urine output and osmolarity, the trial is open-label, but MRI scans will be evaluated blinded to treatment allocation. During the study, participants will be monitored closely with assessments including neurological symptom evaluation, urine output and osmolality measurements at multiple time points, and brain MRI scans to detect demyelination. The primary outcome is the reduction of serum sodium overcorrection within 48 hours after randomization. Secondary outcomes include neurological symptom reversal, length of ICU and hospital stay, survival, and occurrence of osmotic demyelination. The study duration for each participant covers the initial 48 hours, with follow-up assessments up to 28 days after randomization.

Colorectal cancer is a leading cause of cancer-related death, with many patients developing liver metastases that are often difficult to remove surgically. This trial focuses on first-line treatment for patients with metastatic colorectal cancer limited to the liver, aiming to evaluate the effectiveness of combining systemic chemotherapy, targeted therapies, and intra-arterial oxaliplatin chemotherapy. The study seeks to improve tumor response rates, progression-free survival, and overall survival in this patient group. Participants will receive one of four treatment regimens involving combinations of oxaliplatin administered either intra-arterially or intravenously, along with folinic acid, 5-fluorouracil 5-FU, irinotecan, and targeted therapies such as panitumumab or bevacizumab depending on RAS mutation status. Treatment cycles occur every 15 days, with dosing tailored to each arm including variations in drug delivery methods and combinations. The trial includes both experimental and reference treatment arms to compare outcomes. Throughout the study, participants will be monitored for progression-free survival up to 24 months after randomization. Assessments include measuring tumor response by RECIST criteria and evaluating liver metastases. Safety and tolerability will be tracked through laboratory tests and clinical evaluations, while participants eligibility and health status will be closely followed. The study duration extends up to 2028, with ongoing data collection to assess long-term outcomes and treatment effects.

Researchers are investigating kidney cancer through the UroCCR network, a national registry and research platform in France that collects detailed real-world data on patient care and disease progression. Established in 2011, this extensive database includes over 21,000 cases from 58 centers and links clinical information with annotated biological samples and national health data. The platform supports multiple types of research, including translational studies, clinical evaluations, and social science investigations, aiming to improve understanding and management of renal cell carcinoma. The study involves adult patients diagnosed with kidney cancer and documents their treatments, including procedures such as radical or partial nephrectomy as determined by the surgeon. Data collected encompasses clinical parameters, imaging, patient-reported outcomes, and socioeconomic factors. The registry supports prospective research projects and ancillary studies, with a focus on real-world practice following national guidelines. It also integrates digital tools for monitoring and prediction, enhancing personalized treatment strategies. Participants contribute data continuously from enrollment through long-term follow-up, which may last until death or withdrawal. The study collects comprehensive clinical, biological, imaging, and patient-reported information, along with biological samples like plasma, urine, and tumor tissue. Researchers measure outcomes related to research project promotion, biological sample collection, epidemiology, treatment monitoring, quality of life, biomarker research, and clinical practice evaluation. This ongoing data collection supports knowledge advancement and improved kidney cancer care over many years.