Publications of Marc POLUS
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See detailOLFM4, KNG1 and Sec24C identified by proteomics and immunohistochemistry as potential markers of early colorectal cancer stages
QUESADA-CALVO, Florence ULiege; MASSOT, Charlotte ULiege; Bertrand, Virginie ULiege et al

in Clinical Proteomics (2017), 24(9),

Abstract Background: Despite recent advances in colorectal cancer (CRC) diagnosis and population screening programs, the identification of patients with preneoplastic lesions or with early CRC stages ... [more ▼]

Abstract Background: Despite recent advances in colorectal cancer (CRC) diagnosis and population screening programs, the identification of patients with preneoplastic lesions or with early CRC stages remains challenging and is important for reducing CRC incidence and increasing patient’s survival. Methods: We analysed 76 colorectal tissue samples originated from early CRC stages, normal or inflamed mucosa by label-free proteomics. The characterisation of three selected biomarker candidates was performed by immunohisto‑ chemistry on an independent set of precancerous and cancerous lesions harbouring increasing CRC stages. Results: Out of 5258 proteins identified, we obtained 561 proteins with a significant differential distribution among groups of patients and controls. KNG1, OLFM4 and Sec24C distributions were validated in tissues and showed differ‑ ent expression levels especially in the two early CRC stages compared to normal and preneoplastic tissues. Conclusion: We highlighted three proteins that require further investigations to better characterise their role in early CRC carcinogenesis and their potential as early CRC markers. [less ▲]

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See detailComment je traite... les cancers localises de l'oesophage. Etat actuel des donnees et strategie therapeutique. 2eme partie : l'interet des approches multimodales avec ou sans chirurgie.
VAN DAELE, Daniel ULiege; Honoré, Pierre ULiege; COLLIGNON, Joëlle ULiege et al

in Revue Médicale de Liège (2017), 72(4), 168-174

In recent years, the treatment of esophagus cancer has been completely changed, thus competing the dogma of surgery as the cornerstone treatment. Multimodality treatments as radio-chemotherapy directly ... [more ▼]

In recent years, the treatment of esophagus cancer has been completely changed, thus competing the dogma of surgery as the cornerstone treatment. Multimodality treatments as radio-chemotherapy directly followed by surgery, or delayed surgery, significantly improve patient survival compared to surgery alone. Neoadjuvant radiochemotherapy is associated with a higher complete pathologic response rate and improved survival compared to chemotherapy alone. Immediate surgery after radio-chemotherapy is challenged for patients who present a complete clinical response, especially in case of squamous cell carcinoma. Indeed, systematic resection is associated with a significant postoperative mortality rate and has not proven any survival advantage in complete clinical responders as opposed to delayed resection in case of locally persistent or recurrent disease. In squamous cell carcinoma, this could lead to organ preservation, thus avoiding the mortality and durable functional impairment of esophagectomy. This review will discuss the positioning of the multimodality treatment strategy with neoadjuvant radiochemotherapy and chemotherapy and also the strategy of organ preservation. [less ▲]

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See detailComment je traite... les cancers localises de l'oesophage. Etat actuel des donnees et strategie therapeutique. 1ere partie : le point sur les approches chirurgicales et non chirurgicales.
VAN DAELE, Daniel ULiege; Honoré, Pierre ULiege; COLLIGNON, Joëlle ULiege et al

in Revue Médicale de Liège (2017), 72(2), 58-63

Esophageal cancers represent a highly heterogeneous entity mixing two different tumour types : AdenoCarcinoma (ADC) and Squamous Cell Carcinoma (SSC). Developing in the same organ, they are very often ... [more ▼]

Esophageal cancers represent a highly heterogeneous entity mixing two different tumour types : AdenoCarcinoma (ADC) and Squamous Cell Carcinoma (SSC). Developing in the same organ, they are very often considered as a unique pathology and, consequently, the same therapeutic strategy is indiscriminately applied. Esophageal cancer treatments are particularly complex and require a multidisciplinary approach. Despite impressive advances in the tumour statidifaction, surgery, radiotherapy and chemotherapy, the overall prognosis remains grim even at an early stage of the disease. In order to improve the treatment of esophageal cancers and the patientaeuros survival, we need to consider that ADC and SCC represent two different pathologies requiring specific therapeutic strategies. This review in two parts will present recent data from clinical trials under the scope of tumour histology to set up dedicated therapeutic strategies. In this first part, we explain the restricted role of surgical resection, the prognostic factors and the results of exclusive combined chemotherapy and radiation in localized esophageal cancer. [less ▲]

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See detailUse of cinacalcet and sunitinib to treat hypercalcaemia due to a pancreatic neuroendocrine tumor.
VALDES SOCIN, Hernan Gonzalo ULiege; Almanza, Matilde Rubio; Fernandez-Ladreda, Mariana Tome et al

in Archives of Endocrinology and Metabolism (2017)

Neuroendocrine tumors (NETs) can secrete hormones, including ectopic secretions, but they have been rarely associated with malignant hypercalcemia. A 52-year-old man with a history of diabetes mellitus ... [more ▼]

Neuroendocrine tumors (NETs) can secrete hormones, including ectopic secretions, but they have been rarely associated with malignant hypercalcemia. A 52-year-old man with a history of diabetes mellitus was diagnosed with a pancreatic tumor. A pancreatic biopsy confirmed a well-differentiated pancreatic NET (pNET). The patient subsequently developed liver metastasis and hypercalcemia with high 1,25 OH vitamin D and suppressed parathyroid hormone (PTH) levels. Hypercalcemia was refractory to chemotherapy, intravenous saline fluids, diuretics, calcitonin and zoledronate. Cinacalcet administration (120 mg/day) resulted in a significant calcium reduction. Hypocalcemia was observed when sunitinib was added three months later and cinacalcet was stopped. Subsequently, the calcium and PTH levels normalized. After six months, we observed 20% shrinkage of the pancreatic tumor and necrosis of a liver metastasis. Cinacalcet is an allosteric activator of the calcium receptor agonist, and it is used for severe hypercalcemia in patients with primary (benign and malignant) hyperparathyroidism. In this patient, cinacalcet demonstrated a calcium lowering effect, normalized hypophosphatemia, and improved the clinical condition of the patient. The mechanism through which cinacalcet improved PTH-rp mediated hypercalcemia is still unclear, but studies have suggested that a potential mechanism is the activation of calcitonin secretion. Sunitinib is an oral multi-targeted tyrosine kinase inhibitor used to treat advanced pNETs. The hypocalcemic effects of sunitinib have not been previously described in a patient with pNET. Here, we report for the first time the successful combination of cinacalcet and sunitinib in the treatment of a pNET patient presenting with malignant hypercalcemia. [less ▲]

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See detailHypercalcémie paranéoplasique et hypercalcémie associée à la Néoplasie Multiple de type I (NEM1): traitement par Cinacalcet
VALDES SOCIN, Hernan Gonzalo ULiege; POLUS, Marc ULiege

Conference (2015, October 17)

Paraneoplastic hypercalcemia and hypercalcemia associated with neoplastic syndromes are particularly resistant to conventional hypocalcemic treatments. We present and discuss two case reports in which ... [more ▼]

Paraneoplastic hypercalcemia and hypercalcemia associated with neoplastic syndromes are particularly resistant to conventional hypocalcemic treatments. We present and discuss two case reports in which Cinacalcet was used to control hypercalcemia. Paraneoplastic hypercalcemia is present in the first case report, in association with a metastasic neuroendocrine pancreas. In the second case report ,cinacalcet is used to control hypecalcemia in a patient with multiple endocrine neoplasia and hyperparathyroidism not controlled by neck surgery. Cinacalcet is an oral agonist of the Calcium Sensing Receptor. The hypocalcemic effects of Cinacalcet have not been documented so far in hypercalcemia-paraneo plastic linked to cancer of the pancreas (Valdés-Socin & al. Rev Med Switzerland 2009). On the other hand, its use seems promising in the MEN1-associated hyperparathyroidism. (Giusti & al. Endocrine 2015). [less ▲]

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See detailSyndrome thyrogastrique autoimmun (STGA) : la gastrite auto-immune isolée (GAI) et celle associée à Helicobacter (Hp) ont des caractéristiques anatomocliniques différentes
VALDES SOCIN, Hernan Gonzalo ULiege; MESUREUR, Thierry ULiege; POLUS, Marc ULiege et al

in Abstract book - Annales d'Endocrinologie - 32ème Congrès de la Société Française d'Endocrinologie (2015, October)

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See detailLA RADIOTHÉRAPIE DANS LE CANCER DU RECTUM : quand, comment et pourquoi ?
MARTINIVE, Philippe ULiege; VAN DAELE, Daniel ULiege; LENNERTS, Evelyne ULiege et al

in Revue Médicale de Liège (2014), 69(Supp 1), 37-46

Depuis plusieurs décades, la radiothérapie préopéra - toire ou postopératoire joue un rôle important dans le contrôle local de l’adénocarcinome du rectum. Cette dernière décennie, avec la systématisation ... [more ▼]

Depuis plusieurs décades, la radiothérapie préopéra - toire ou postopératoire joue un rôle important dans le contrôle local de l’adénocarcinome du rectum. Cette dernière décennie, avec la systématisation de la chirurgie d’exérèse en totalité du mésorectum (TME), le profil de récidive locale du cancer du rectum a été fortement modifié. Dans un tel contexte, la place de la radiothérapie doit être réévaluée en tenant compte de ces modifications. Dans cet article, nous proposons de faire la revue des différentes grandes études concernant les techniques et les indications d’un traitement de radiothérapie pré- ou post opératoire dans le contexte d’une chirurgie rectale TME. [less ▲]

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See detailLA RADIOTHÉRAPIE DANS LE CANCER DU RECTUM CHEZ LA PERSONNE ÂGÉE: Quel bénéfice pour le traitement ?
MARTINIVE, Philippe ULiege; ALLEPAERTS, Sophie ULiege; VAN DAELE, Daniel ULiege et al

in Revue Médicale de Liège (2014), 69(Supp 1), 47-52

Dans les années à venir, nous serons de plus en plus amenés à prendre en charge des patients âgés en oncologie. Dans ce contexte, quelles sont les évidences scientifiques à notre disposition qui nous ... [more ▼]

Dans les années à venir, nous serons de plus en plus amenés à prendre en charge des patients âgés en oncologie. Dans ce contexte, quelles sont les évidences scientifiques à notre disposition qui nous permettent de prendre en charge de façon correcte cette population oncologique âgée ? Les patients âgés présentent souvent de multiples co-morbidités pouvant interférer avec le traitement oncologique rendant d’autant plus complexe leur prise en charge. Le pic d’inci - dence du cancer du rectum se situe autour des 80 ans, loin au-dessus de l’âge moyen des patients inclus dans les études cliniques. La survie globale des patients traités pour un cancer du rectum s’est améliorée au cours de la dernière décennie, essentiellement pour des patients de moins de 75 ans. Le trai - tement du cancer du rectum nécessite une approche multidis - ciplinaire. L’évaluation gériatrique en fait partie intégrante. Elle permet de définir au mieux la stratégie thérapeutique en fonction de l’état général du patient, de son contexte neuro- psychologique, fonctionnel et social. La radiothérapie joue un rôle majeur dans le traitement du rectum. Quelle est sa place chez les personnes âgées ? Bénéficient-elles également de la radiothérapie, comme la population jeune sélectionnée dans les études contrôlées ? Quel est l’impact de ce traitement sur la qualité de vie ? Voilà des questions essentielles auxquelles nous allons tenter d’apporter une réponse [less ▲]

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See detailRefractory hypercalcemia and ectopic calcitonin secretion in a malignant pancreatic neuroendocrine tumor: hypocalcemic effects on cinacalcet
VALDES SOCIN, Hernan Gonzalo ULiege; rubio almanza, Matilde; LOLY, Jean-Philippe ULiege et al

in Acta Clinica Belgica (2013), 68(6), 42

Introduction: Paraneoplastic hypercalcemia is a sign of poor prognosis, as it is particularly resistant to the usual hypocalcemic treatments. Observation: In 2009, a well differentiated pancreatic ... [more ▼]

Introduction: Paraneoplastic hypercalcemia is a sign of poor prognosis, as it is particularly resistant to the usual hypocalcemic treatments. Observation: In 2009, a well differentiated pancreatic neuroendocrine tumor (Ki-67= 2%) is diagnosed in a 52-year-old diabetic man. The tumor is revealed with a splenic and hepatic carcinomatosis. Plasmatic calcium was: 3.54 mmol/L (2.15 - 2.6). Biology showed hypophosphatemia, PTH < 4 ng/ml, high 1-25 OH VitD, calcitonin: 1016 ng/ml (< 12 ng/ml). He had hypercalciuria and hypophosphaturia. He received for two years several cycles of Streptozotocin-ADRIAMYCIN and FOLFOX, with partial control of the tumor mass and calcium levels. In 2012, calcitonin levels are 29 ng/ml whereas calcemia is 3.17 mmol/L. Hypercalcemia is refractory to hyperhydration, diuretics, corticosteroids, and bisphosphonates therapy. Cinacalcet (Mimpara) is prescribed up to 120 mg/day (PO). Calcemia decreases gradually from 3 to 2.87 and then 2.76 mmol/L. PTH and calcitonin-the tumor mass remain unchanged. After two months of Cinacalcet treatment, Sunitinib (Sutent) 37.5 mg per day was added. During the third month, calcium levels dropped to 2.09 mmol/L and PTH raised to 78 pg/ml, requiring discontinuation of Mimpara. Calcitonin normalized, with a further improvement over pancreatic and metastatic lesions. Conclusion: Cinacalcet is a Calcium Sensing Receptor oral agonist. Cinacalcet hypocalcemic effects have not been previously documented in pancreatic paraneoplastic hypercalcemia. In our patient, Cinacalcet has significantly improved cancer prognosis: this drug could be a new alternative in paraneoplastic hypercalcemia. [less ▲]

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See detailHypercalcémie réfractaire et sécrétion ectopique de calcitonine dans un cancer neuroendocrine du pancréas : Effets hypocalcémiants du Cinacalcet
VALDES SOCIN, Hernan Gonzalo ULiege; LOLY, Jean-Philippe ULiege; BETEA, Daniela ULiege et al

in Annales d'Endocrinologie (2013, September), 74(4), 235-462

Introduction: Paraneoplastic hypercalcemia is a sign of poor prognosis, as it is particularly resistant to the usual hypocalcemic treatments. Observation: In 2009, a well differentiated pancreatic ... [more ▼]

Introduction: Paraneoplastic hypercalcemia is a sign of poor prognosis, as it is particularly resistant to the usual hypocalcemic treatments. Observation: In 2009, a well differentiated pancreatic neuroendocrine tumor (Ki-67= 2%) is diagnosed in a 52-year-old diabetic man. The tumor is revealed with a splenic and hepatic carcinomatosis. Plasmatic calcium was: 3.54 mmol/L (2.15 - 2.6). Biology showed hypophosphatemia, PTH < 4 ng/ml, high 1-25 OH VitD, calcitonin: 1016 ng/ml (< 12 ng/ml). He had hypercalciuria and hypophosphaturia. He received for two years several cycles of Streptozotocin-ADRIAMYCIN and FOLFOX, with partial control of the tumor mass and calcium levels. In 2012, calcitonin levels are 29 ng/ml whereas calcemia is 3.17 mmol/L. Hypercalcemia is refractory to hyperhydration, diuretics, corticosteroids, and bisphosphonates therapy. Cinacalcet (Mimpara) is prescribed up to 120 mg/day (PO). Calcemia decreases gradually from 3 to 2.87 and then 2.76 mmol/L. PTH and calcitonin-the tumor mass remain unchanged. After two months of Cinacalcet treatment, Sunitinib (Sutent) 37.5 mg per day was added. During the third month, calcium levels dropped to 2.09 mmol/L and PTH raised to 78 pg/ml, requiring discontinuation of Mimpara. Calcitonin normalized, with a further improvement over pancreatic and metastatic lesions. Conclusion: Cinacalcet is a Calcium Sensing Receptor oral agonist. Cinacalcet hypocalcemic effects have not been previously documented in pancreatic paraneoplastic hypercalcemia. In our patient, Cinacalcet has significantly improved cancer prognosis: this drug could be a new alternative in paraneoplastic hypercalcemia. [less ▲]

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See detaille syndrome auto-immun thyrogastrique: ses effets sur les micronutriments et la tumorigénèse gastrique.
VALDES SOCIN, Hernan Gonzalo ULiege; LUTTERI, Laurence ULiege; CAVALIER, Etienne ULiege et al

in Revue Médicale de Liège (2013)

Summary : The thyrogastric autoimmune syndrome (TAS) was described in patients in whom the serum cross-reacted both with gastric parietal cells antigens and thyroid antigens. We report two cases ... [more ▼]

Summary : The thyrogastric autoimmune syndrome (TAS) was described in patients in whom the serum cross-reacted both with gastric parietal cells antigens and thyroid antigens. We report two cases illustrating the spectrum of pathogical features of TAS. The first case associates Hashimoto’s thyroiditis and anemia perniciosa,and develops a gastric neuroendocrine tumor during follow up. The second case presents with a Graves’ disease and an autoimmune reversible gastritis, secondary to Helicobacter Pylori. Whereas type III autoimmune polyendocrinopathy is rare, TAS is frequent in our experience. Some 13% (32/240) of patients that we have prospectively followed affected with thyroiditis have also autoimmune gastritis. Helicobacter pylori is clearly implicated in 16% of autoimmune gastritis cases. Infection, malabsorption and gastritis are potentially reversible after bacterial eradication treatment. In the other 84% of gastritis patients, no histological or serological proof of Helicobacter pylori is found. Gastric autoimmunity is then irreversible, leading to gastric severe atrophy, hypochlorhydria and hypergastrinemia. Hypergastrinemia stimulates enterochromaffin cell hyperplasia, possibly progressing c to neuroendocrine tumors. We propose a diagnostic approach to improve the characterization of TAS. We review the literature on the subject and discuss some interesting animal models of infectious gastric autoimmunity [less ▲]

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See detailLaparoscopic liver resection: a single center experience
SZECEL, Delphine ULiege; DE ROOVER, Arnaud ULiege; DELWAIDE, Jean ULiege et al

in Surgical Endoscopy (2013), 27

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See detailShort course chemotherapy followed by concomitant chemoradiotherapy and surgery in locally advanced rectal cancer: a randomized multicentric phase II study.
Marechal, R.; Vos, B.; POLUS, Marc ULiege et al

in Annals of Oncology (2012), 23(6), 1525-30

BACKGROUND: Induction chemotherapy has been suggested to impact on preoperative chemoradiation efficacy in locally advanced rectal cancer (LARC). To evaluate in LARC patients, the feasibility and efficacy ... [more ▼]

BACKGROUND: Induction chemotherapy has been suggested to impact on preoperative chemoradiation efficacy in locally advanced rectal cancer (LARC). To evaluate in LARC patients, the feasibility and efficacy of a short intense course of induction oxaliplatin before preoperative chemoradiotherapy (CRT). PATIENTS AND METHODS: Patients with T2-T4/N+ rectal adenocarcinoma were randomly assigned to arm A-preoperative CRT with 5-fluorouracil (5-FU) continuous infusion followed by surgery-or arm B-induction oxaliplatin, folinic acid and 5-FU followed by CRT and surgery. The primary end point was the rate of ypT0-1N0 stage achievement. RESULTS: Fifty seven patients were randomly assigned (arm A/B: 29/28) and evaluated for planned interim analysis. On an intention-to-treat basis, the ypT0-1N0 rate for arms A and B were 34.5% (95% CI: 17.2% to 51.8%) and 32.1% (95% CI: 14.8% to 49.4%), respectively, and the study therefore was closed prematurely for futility. There were no statistically significant differences in other end points including pathological complete response, tumor regression and sphincter preservation. Completion of the preoperative CRT sequence was similar in both groups. Grade 3/4 toxicity was significantly higher in arm B. CONCLUSIONS: Short intense induction oxaliplatin is feasible in LARC patients without compromising the preoperative CRT completion, although the current analysis does not indicate increased locoregional impact on standard therapy. [less ▲]

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See detailLaparoscopic liver resection: a single center experience
SZECEL, Delphine ULiege; DE ROOVER, Arnaud ULiege; DELWAIDE, Jean ULiege et al

in Acta Chirurgica Belgica (2012, May), 112(3), 631

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See detailLe syndrome de Lynch et l'instabilité des microsatellites : revue de littérature.
Desselle, Françoise; VERSET, Gontran ULiege; POLUS, Marc ULiege et al

in Revue Médicale de Liège (2012), 67(12), 638-642

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See detailLaparoscopic liver resection: monocentric university experience
Szecel, D.; ARENAS SANCHEZ, Maria Mara ULiege; DE ROOVER, Arnaud ULiege et al

in Acta Gastro-Enterologica Belgica (2011, March), 74(1), 30

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See detailDeoxycitidine kinase is associated with prolonged survival after adjuvant gemcitabine for resected pancreatic adenocarcinoma.
Marechal, Raphael; Mackey, John R; Lai, Raymond et al

in Cancer (2010), 116(22), 5200-6

BACKGROUND: Gemcitabine (2',2'-difluorodeoxycytidine) administration after resection of pancreatic cancer improves both disease-free survival (DFS) and overall survival (OS). Deoxycytidine kinase (dCK ... [more ▼]

BACKGROUND: Gemcitabine (2',2'-difluorodeoxycytidine) administration after resection of pancreatic cancer improves both disease-free survival (DFS) and overall survival (OS). Deoxycytidine kinase (dCK) mediates the rate-limiting catabolic step in the activation of gemcitabine. The authors of this report studied patient outcomes according to the expression of dCK after a postoperative gemcitabine-based chemoradiation regimen. METHODS: Forty-five patients with resected pancreatic adenocarcinoma received adjuvant gemcitabine based-therapy in the context of multicenter phase 2 studies. Their tumors were evaluated retrospectively for dCK protein expression by immunohistochemistry. A composite score based on the percentage of dCK-positive cancer cells and the intensity of staining was generated, and the results were dichotomized at the median values. RESULTS: The median follow-up was 19.95 months (95% confident interval [CI], 3.3-107.4 months). The lymph node (LN) ratio and dCK protein expression were significant predictors of DFS and OS in univariate analysis. On multivariate analysis, dCK protein expression was the only independent prognostic variable (DFS: hazard ratio [HR], 3.48; 95% CI, 1.66-7.31; P = .001; OS: HR, 3.2; 95% CI,1.44-7.13; P = .004). CONCLUSIONS: dCK protein expression was identified as an independent and strong prognostic factor in patients with resected pancreatic adenocarcinoma who received adjuvant gemcitabine therapy. The authors concluded that it deserves prospective evaluation as a predictive biomarker for patient selection. [less ▲]

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See detailL’étude du mois. Traitement de l’hépatocarcinome au stade palliatif par Sorafenib (Nexavar) :Résultats de l’étude SHARP (Sorafenib Hepatocarcinoma Assessment Randomized Protocol)
Detry, Olivier ULiege; Delwaide, Jean ULiege; Deroover, Arnaud ULiege et al

in Revue Médicale de Liège (2009), 64(3), 168-170

Curative management of early-stage hepatocarcinoma may include partial hepatic resection, liver transplantation or tumoral necrosis using radiofrequency ablation or alcoholisation. Until recently, no ... [more ▼]

Curative management of early-stage hepatocarcinoma may include partial hepatic resection, liver transplantation or tumoral necrosis using radiofrequency ablation or alcoholisation. Until recently, no efficient therapeutic mean was available for advanced hepatocarcinoma. Sorafenib is a multikinase inhibitor that decreases tumoral proliferation and angiogenesis, and increases apoptosis in many cancer models. The results of a phase 3 randomized, multicentric, study, entitled SHARP, have now demonstrated that Sorafenib increases survival in patients with advanced hepatocarcinoma developed in Child A cirrhosis. Mean survival gain was a little less than 3 months, without any radiologic response or improvement in the delay before symptomatic progression of the disease. The monthly cost of Sorafenib is a little more than 5,000 euros. It is now crucial to evaluate the potential role of Sorafenib in adjuvant therapy after liver resection or radiofrequency ablation of hepatocarcinoma. The CHU of Liège is taking part to a randomized, multicentric study evaluating the use of Sorafenib after liver resection or radiofrequency ablation for hepatocarcinoma. Another future evaluation could be the association of Sorafenib with other antitumoral agents. [less ▲]

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See detailTraitement des carcinomes hépatocellulaires à un stade avancé
Van Daele, Daniel ULiege; Belaiche, Jacques ULiege; Delwaide, Jean ULiege et al

in Revue Médicale de Liège (2009), 64(3), 140-147

Hepatocellular carcinoma is the main primitive tumor of the liver. It occurs in the setting of liver cirrhosis in more than 90% of the cases in developping countries. The prognosis depends on the size ... [more ▼]

Hepatocellular carcinoma is the main primitive tumor of the liver. It occurs in the setting of liver cirrhosis in more than 90% of the cases in developping countries. The prognosis depends on the size, number and extension of the tumor as well as on the severity of the underlying liver disease. The Barcelona Clinic Classification takes into account these different parameters and helps the clinician in the therapeutic decision. Some patients (around 25%) are amenable to therapy with a curative intent (liver transplantation, resection, destruction by radiofrequency). In patients with hepatocellular carcinoma at an intermediate stage, lipiodolized chemoembolization gives a survival advantage in comparison with placebo. No conventional regimen of chemotherapy has a proven survival benefit. In patients with a hepatocellular carcinoma at an advanced stage, sorafenib, an oral multi-targeted kinase inhibitor, is the first coumpound to demonstrate a significant effect on survival free of disease progression in a selected group of patients. Its toxicity profile is particularly favourable. Combination of surgical and medical therapies should be properly evaluated in clinical trials in the near future. [less ▲]

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See detailLe depistage generalise du cancer colorectal: une absolue necessite et une realite imminente en Communaute francaise.
Polus, Marc ULiege; Montrieux, Christian ULiege; Giet, Didier ULiege et al

in Revue Médicale de Liège (2009), 64(2), 96-102

Colorectal cancer is a real problem of public health. Screening is an absolute necessity. An ambitious program of screening is launched in the French Community. Faecal occult blood test will be proposed ... [more ▼]

Colorectal cancer is a real problem of public health. Screening is an absolute necessity. An ambitious program of screening is launched in the French Community. Faecal occult blood test will be proposed to average risk patients in the general population. A total colonoscopy will be performed if FOBT is positive. First step colonoscopy will be proposed to high or very high risk patients. General practitioners are in the core of the multi-disciplinary program. [less ▲]

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