Le but de cette étude est d’évaluer l’impact sur la survie du réseau national français « ENDOCAN-COMETE » qui prend en charge les patients atteints de corticosurrénalome (CS) depuis 2009. Entre 2010 et 2017 ont été identifiés 134 CS (incidence moyenne estimée à 0,14/100 000 pers-an) à partir de 13 registres des cancers du réseau français FRANCIM couvrant 18 % de la population française. Les CS ont été catégorisés en 1/référés dans l’un des centres du réseau ENDOCAN-COMETE au moment du diagnostic (CS-R) ou, 2/les patients CS référés tardivement ou non-référés au réseau (CS-nR). Les taux de survie à 2, 3 et 5 ans ont été comparés, selon le stade ENSAT classé comme localisé (stade I–II) ou avancé (stade III–IV). Parmi les 134 CCS diagnostiqués, 12 (9 %) étaient stade I, 44 (33 %) stade II, 17 (13 %) stade III et 48 (36 %) stade IV (13 patients stade ENSAT inconnu). Les taux de survie globale (SG) des CS localisés étaient significativement plus élevés dans l’CS-R que dans l’CS-nR : la SG à 2 ans de 94 % contre 65 %, à 3 ans de 90 % contre 65 %, à 5 ans de 79 % contre 51 % (p = 0,025). Les taux de SG étaient similaires dans les CS avancés entre CS-R et CS-nR. Dans les CS localisés : 39 % étaient CS-R. L’ajustement aux variables pronostiques sera discuté. Notre étude montre une meilleure survie des patients CS de stade I-II traités dans un centre du réseau français ENDOCAN COMETE.

Le registre des tumeurs de l’Hérault (RTH) est un registre général qualifié par le comité national des registres depuis 1987. L’objectif de cette étude est de présenter l’évolution de l’épidémiologie des tumeurs de la vessie de stade ≥ T1 dans le département de l’Hérault à partir des données collectées par le RTH sur la période de 1987 à 2019. Nous avons analysé les tendances de l’incidence des cancers de la vessie dans l’Hérault entre 1987 et 2019 par sexe, par âge et par stade, ainsi que les tendances de la mortalité entre 1987 et 2017. Pour les années 2018–2019 qui sont les deux dernières années validées par le registre, nous avons décrit les fréquences relatives, le sex-ratio, l’âge moyen et médian au diagnostic, le risque cumulé, les stades au diagnostic, les données anatomopathologiques et les primo-traitements. Les données de survie observée et nette sont analysées pour les personnes diagnostiquées entre le 01/01/2000 et le 31/12/2015 avec une date de point au 30/06/2018. En 2018–2019, le cancer de la vessie était le 7e cancer dans l’Hérault (5e chez l’homme et 12e chez la femme) avec un sex-ratio d’incidence de 3,9 hommes pour une femme. L’âge moyen au diagnostic était de 75,3 ans chez l’homme et de 77,8 ans chez la femme. La probabilité d’avoir un cancer de la vessie avant l’âge de 75 ans était de 1,68 % pour un homme (1/59) et de 0,34 % pour une femme (1/295). Les carcinomes urothéliaux représentaient 90,7 % des cancers. Entre 1987 et 2019, les TSM (taux standardisés mondiaux) d’incidence du cancer de la vessie ont diminué de 0,8 %par an chez l’homme et sont restés stables chez la femme. Les TSM de mortalité entre 1987 et 2017 suivent les mêmes tendances avec une diminution de 2,2 % par an chez l’homme et une stabilité chez la femme. Pour les 3304 cancers de vessie diagnostiqués entre le 01/01/2000 et le 31/12/2015, la survie observée à 5 ans était de 38 % (34 % chez la femme et 38 % chez l’homme). Les taux d’incidence et de mortalité des cancers de la vessie ont faiblement diminué chez l’homme mais restent stables chez la femme dans l’Hérault. Les registres ne recueillent qu’un nombre de variables limités pour chaque patient. En 2018 le Registre de l’Hérault spécialisé en onco-urologie (RHESOU) a été créé, pour avoir des données exhaustives. 4. The Hérault Tumor Registry (RTH) is a general registry qualified by the national committee of registries since 1987. The objective of this study is to present the evolution of the epidemiology of bladder cancer (stage ≥ T1) in the Hérault department based on data collected by the RTH over a period from 1987 to 2019. We analyzed trends in bladder cancer incidence in Hérault between 1987 and 2019 by sex, age, and stage, as well as mortality trends between 1987 and 2017. For the years 2018–2019, which are the last two years validated by the registry, we described relative frequencies, sex ratio, mean and median age at diagnosis, cumulative risk, stages at diagnosis, pathology data, and primary treatments. Observed and net survival data are analyzed for those diagnosed between 01/01/2000 and 12/31/2015 with a point date of 06/30/2018. In 2018–2019, bladder cancer was the 7th most common cancer in Hérault (5th in men and 12th in women) with an incidence sex ratio of 3.9 men to one woman. The mean age at diagnosis was 75.3 years for men and 77.8 years for women. The probability of having bladder cancer before the age of 75 years was 1.68% for a man (1/59) and 0.34% for a woman (1/295). Urothelial carcinomas accounted for 90.7% of cancers. Between 1987 and 2019, bladder cancer incidence TSMs (worldwide standardized rates) decreased by 0.8% per year in men and remained stable in women. Mortality TSMs between 1987 and 2017 followed the same trends with a decrease of 2.2% per year in men and stability in women. For the 3304 bladder cancers diagnosed between 01/01/2000 and 12/31/2015, the observed 5-year survival was 38% (34% in women and 38% in men). Bladder cancer incidence and mortality rates have decreased slightly in men but remain stable in women in the Hérault. Registries collect only a limited number of variables for each patient. In 2018 the Hérault Registry Specialized in Onco-Urology (RHESOU) was created, to have comprehensive data. 4.

Objectives. - The Herault Tumor Registry (RTH) is a general registry qualified by the national committee of registries since 1987. The objective of this study is to present the evolution of the epidemiology of bladder cancer (stage >= T1) in the Herault department based on data collected by the RTH over a period from 1987 to 2019.Material and methods. - We analyzed trends in bladder cancer incidence in Herault between 1987 and 2019 by sex, age, and stage, as well as mortality trends between 1987 and 2017. For the years 2018-2019, which are the last two years validated by the registry, we described relative frequencies, sex ratio, mean and median age at diagnosis, cumulative risk, stages at diagnosis, pathology data, and primary treatments. Observed and net survival data are analyzed for those diagnosed between 01/01/2000 and 12/31/2015 with a point date of 06/30/2018.Results. - In 2018-2019, bladder cancer was the 7th most common cancer in Herault (5th in men and 12th in women) with an incidence sex ratio of 3.9 men to one woman. The mean age at diagnosis was 75.3 years for men and 77.8 years for women. The probability of having bladder cancer before the age of 75 years was 1.68% for a man (1/59) and 0.34% for a woman (1/295). Urothelial carcinomas accounted for 90.7% of cancers. Between 1987 and 2019, bladder cancer incidence TSMs (worldwide standardized rates) decreased by 0.8% per year in men and remained stable in women. Mortality TSMs between 1987 and 2017 followed the same trends with a decrease of 2.2% per year in men and stability in women. For the 3304 bladder cancers diagnosed between 01/01/2000 and 12/31/2015, the observed 5-year survival was 38% (34% in women and 38% in men). Conclusions. - Bladder cancer incidence and mortality rates have decreased slightly in men but remain stable in women in the Herault. Registries collect only a limited number of variables for each patient. In 2018 the Herault Registry Specialized in Onco-Urology (RHESOU) was created, to have comprehensive data. Level of evidence.- 4.(c) 2023 Published by Elsevier Masson SAS.

Adrenocortical carcinoma (ACC) belongs to the family of rare cancers (annual rate of 0.72-1.3 cases/million people). The French national network « ENDOCAN-COMETE », was set up in 2009 to structure care and research on ACC patients across the country. The aim of this study was to look for the survival impact of this national network organization. ACC diagnosed between 2010 and 2017 were, first, identified from 13 cancer registries of the French network FRANCIM covering 18% of the French population. This population was described in term of characteristics, systemic managements and treatment delays. Secondly, ACC patients identified by FRANCIM were categorized as 1/ referred to one of the 11 centres of the French ENDOCAN-COMETE network at diagnosis (ACC-R) or, 2/ ACC patients lately or not referred (ACC-nR). The survival rate at 2, 3 and 5 years (2-yrs OS, 3yrs OS and 5yrs-OS) were compared, according to ENSAT stage classified as localized (stage I-II) or advanced (stage III-IV). Between 2010 and 2017, 134 ACC were diagnosed in this population (mean estimated incidence of 0.14/100000 pers-yrs): 12 (9%) were stage I, 44 (33%) stage II, 17 (13%) stage III and 48 (36%) stage IV (13 patients ENSAT stage was unknown). Among them, 124 patients were analyzed (10 patients were excluded). Eighty-seven out 124 patients (70%) were referred to an ENDOCAN-COMETE network at diagnosis (ACC-R). Mean age at diagnosis was 51.5 yrs (ACC-R) vs. 58.6 (ACC-nR). Overall Survival (OS) rates of localized ACC (ENSAT stage I-II) was significantly higher in ACC-R compared to ACC-nR : 2-yrs OS was 94% vs 65%, 3-yrs OS was 90% vs 65% and 5-yrs OS was 79% vs 51%, p=0.025 (mean OS : 6.6 vs 3.15 yrs). OS rates were similar in advanced ACC (ENSAT stage III-IV) between ACC-R vs ACC-nR. In localized ACC: 39% were ACC-R vs. 54% ACC-nR. By comparing localized ACC-R vs localized ACC-nR, we found that complete resection was found in 76% vs 68%, Weiss score median was 5 vs 5, median Ki67 was 6% vs 15%, presence of endocrine syndrome was 47% vs 35% and age was 47 vs 58 yrs, respectively. Moreover 81% of ACC-R patients received mitotane treatment vs 65% of ACC-nR. Our study shows a better survival of stage I-II ACC patients treated in the French ENDOCAN COMETE network.

Objectives. - The literature review shows a low adhesion of urologists to the recommendations of learned societies in the imaging work-up of localized prostate cancer (CaP), especially for low and intermediate risks of the D'Amico classification. We analyzed the adhesion of urologists in the Herault region (France) to the CCAFU 2016/2018, 2018/2020 recommendations.Material and methods. - From the Herault Onco Urology Registry (RHESOU) database, we iden-tified localized CaP diagnosed between 01/01/2017 and 31/12/2019, and then classified them into 3 distinct risk groups according to the D'Amico classification. We compared the imaging workup performed by each patient to the CCAFU 2016/2018, 2018/2020 recommendations, according to the risk group.Results. - Of the 2,049 localized CaPs included in our study, 591 belonged to the low-risk group, 1059 to the intermediate-risk group, and 399 to the high-risk group. In the low-risk group 45.2% of the cases did not follow the CCAFU 2016/2018, 2018/2020 recommendations in the imaging workup, 77.3% in the intermediate-risk group and 80.9% in the high-risk group. For our entire study, 1,408 patients (68.7%) had an imaging workup that did not follow the CCAFU recommendations.Conclusion. - Our results show a low adhesion of urologists to the CCAFU recommendations in the imaging assessment of localized CaP. The causes of this non-adhesion are multifactorial and difficult to analyze.(c) 2022 Elsevier Masson SAS. All rights reserved.

La revue de la littérature montre une faible adhésion des urologues aux recommandations des sociétés savantes dans le bilan d’imagerie du cancer localisé de la prostate (CaP) surtout pour les faibles risques et les risques intermédiaires de la classification de D’Amico. Nous avons analysé l’adhésion des urologues de l’Hérault (France) aux recommandations du CCAFU. À partir de la base de données du Registre de l’Hérault spécialisé en Onco Urologie (RHESOU), nous avons identifié les CaP localisés diagnostiqués entre le 01/01/2017 et le 31/12/2019, et nous les avons classés en 3 groupes à risque en fonction de la classification de D’Amico. Nous avons comparé le bilan d’imagerie réalisé pour chaque patient aux recommandations du CCAFU, en fonction du groupe à risque auquel il appartenait. Sur les 2 049 CaP localisés inclus dans notre étude, 591 appartenaient au groupe faible risque, 1 059 au groupe risque intermédiaire et 399 au groupe haut risque. Dans le groupe faible risque 45,2 % des cas ne suivaient pas les recommandations du CCAFU 2016/2018,2018/2020 dans le bilan d’imagerie, 77,3 % dans le groupe de risque intermédiaire et 80,9 % dans le groupe haut risque. Pour l’ensemble de notre étude, 1 408 patients (68,7 %) ont eu un bilan d’imagerie non conforme aux recommandations. Nos résultats montrent une faible adhésion des urologues aux recommandations du CCAFU dans le bilan d’imagerie du CaP localisé. Les causes de cette non adhésion sont multifactorielles et difficiles à analyser. The literature review shows a low adhesion of urologists to the recommendations of learned societies in the imaging work-up of localized prostate cancer (CaP), especially for low and intermediate risks of the D’Amico classification. We analyzed the adhesion of urologists in the Hérault region (France) to the CCAFU 2016/2018, 2018/2020 recommendations. From the Hérault Onco Urology Registry (RHESOU) database, we identified localized CaP diagnosed between 01/01/2017 and 31/12/2019, and then classified them into 3 distinct risk groups according to the D’Amico classification. We compared the imaging workup performed by each patient to the CCAFU 2016/2018, 2018/2020 recommendations, according to the risk group. Of the 2,049 localized CaPs included in our study, 591 belonged to the low-risk group, 1059 to the intermediate-risk group, and 399 to the high-risk group. In the low-risk group 45.2% of the cases did not follow the CCAFU 2016/2018, 2018/2020 recommendations in the imaging workup, 77.3% in the intermediate-risk group and 80.9% in the high-risk group. For our entire study, 1,408 patients (68.7%) had an imaging workup that did not follow the CCAFU recommendations. Our results show a low adhesion of urologists to the CCAFU recommendations in the imaging assessment of localized CaP. The causes of this non-adhesion are multifactorial and difficult to analyze.

Les cancers représentaient la première cause de mortalité chez les personnes vivant avec le VIH (PVVIH), soit 34 % en France en 2010. Depuis la mise en place des traitements antirétroviraux (ARV), les cancers classant SIDA ont vu leur incidence diminuer alors que l’incidence des cancers non liés au VIH était stable ou augmentait durant la même période. Il a aussi été montré que les cancers non classant SIDA étaient plus fréquents chez les PVVIH que dans la population générale. L’objectif de notre étude était de comparer l’incidence des cancers du poumon et HPV-induits chez les PVVIH avec la population générale de Gironde entre 2010 et 2017. Les données concernant les PVVIH proviennent de la cohorte prospective ANRS CO3 Aquitaine, incluant les PVVIH suivis en Aquitaine. L’incidence des cancers des PVVIH en Gironde était comparée à l’incidence des cancers issue du registre des cancers de Gironde. Entre 2010 et 2017, 68 patients parmi les 3572 suivis dans la cohorte avaient un cancer : 35 un cancer du poumon et 33 un cancer HPV-induit (18 oropharynx, 10 anus, 5 col de l’utérus). À l’inclusion dans la cohorte, il n’y avait pas de différence concernant le statut SIDA des patients mais 27,1 % des patients ayant un cancer avaient moins de 200/mm3 CD4 vs 15,1 % en l’absence de cancer, p = 0,08. La médiane d’âge de survenue de ces cancers était 53 ans pour les hommes et 51 ans pour les femmes. Les taux d’incidence standardisés de cancer dans la cohorte/le registre des cancers (VIH+/VIH-) étaient 281,2/71,2 pour les 40-49 ans, 387,5/242,0 pour les 50-59 ans et 593,4/501,4 pour les plus de 60 ans. Le risque relatif (RR) de cancer chez les PVVIH était de 1,5 [Intervalle de confiance 95 % (IC95 %) : 1,3 ; 1,8] pour l’ensemble des cancers : 1,8 [IC95 % : 1,4 ; 2,2] pour les cancers du poumon et 1,3 [IC95 % : 1,0 ; 1,6] pour les cancers HPV-induits. Il était particulièrement élevé pour les patients entre 40 et 49 ans : 4,4 [IC95 % : 2,3 ; 8,4] pour les cancers du poumon et 3,7 [IC95 % : 2,1 ; 6,5] pour les cancers HPV-induits. Le RR était aussi particulièrement élevé pour les cancers du poumon chez femmes tous âges confondus : 1,8 [1,0 ; 3,2] vs 1,4 [1,1 ; 1,8] pour les hommes. Notre étude confirme l’augmentation significative de risque de cancers du poumon et HPV-induits chez les PVVIH, touchant particulièrement les femmes et les sujets jeunes dans la strate d’âge [40-49 ans]. Cette augmentation peut en partie être expliquée par la prévalence élevée de tabagisme et d’exposition au virus HPV chez les PVVIH mais elle n’est pas suffisante car des études montrent la persistance de cet excès de risque après ajustement sur le tabac. L’immunodépression et l’activation immunitaire résiduelle ont été avancées pour expliquer ce surrisque, même si l’augmentation d’incidence de cancers non classant SIDA à l’ère du traitement ARV universel va à l’encontre de cette hypothèse. Ces résultats soulignent l’importance des mesures de prévention et de dépistage renforcé des cancers chez les PVVIH, en particulier chez les femmes.

In France, in 2015, colorectal cancer is the third most common cancer and the second leading cause of cancer deaths. The management of these cancers has evolved, particularly since the setting up of multidisciplinary team meetings (MDTm) to present the medical records of cancer patients to a multidisciplinary team. The presentation in MDTm has progressively increased and in 2010, in the Gironde, 80% of patients with colorectal cancer were presented in MDTm. Given this finding, we conducted a study aimed, in a first objective, at highlighting the factors associated with non-presentation in MDTm, as well as, in a second objective, to estimate the link between non-presentation in MDTm and the diagnostic and therapeutic management of these patients, in two departments: Gironde and Tarn, in 2010. All cases of invasive colon cancer diagnosed in the Gironde and Tarn during 2010 in patients over 18 years of age and not presented in MDTm were included from the cancer registries of these two departments. A comparison group was selected on the same criteria corresponding to a random draw of 50% of patients presented in MDTm. After a description step, we compared these two groups according to a case-control design (without MDTm/MDTm) to assess the factors associated with the absence of MDTm presentation in patients with colon cancer. A second analysis compared these groups, without the early deaths following the diagnosis of colon cancer, according to an exposed/unexposed type design (without MDTm/MDTm) to study the link between non-presentation in CPR and management. Five indicators were defined and validated: performing a thoracic CT scan during the extension assessment, performing chemotherapy (stages II and III), delay surgery-chemotherapy, death during chemotherapy. In order to take into account the socio-demographic level of the patients, we used the aggregate index of deprivation "European Deprivation Index" (EDI). This EDI was divided into quintiles: Q5 corresponding to patients living in most disadvantaged geographic areas. The analyzes were performed using logistic regression models. The first factor explaining patients' non-presentation in MDTm was death in the month following diagnosis (OR = 2.94, 95% CI = [1.52–5.66]), these patients were therefore excluded from the analyzes of the second objective. Moreover, regardless of the early death, advanced age and living in more deprived areas were associated with non-presentation in MDTm (OR85–103 years = 2.10, 95% CI = [1.06–4.18] and ORQ4–Q5 = 1.96, 95% CI = [1.23–3.14]). For the second objective of this study, after adjusting for patient-related variables (age, comorbidities, EDI) and tumor (stage to diagnosis), thoracic CT scan was less often performed in non-MDTm patients (OR = 0.40, 95% CI = [0.24–0.65]). There was no association between the absence of MDTm and the others management indicators, these remain influenced by patient and tumor characteristics such as age at diagnosis, comorbidities and stage of tumor. However, regardless of stage of diagnosis and MDTm status, patients living in a more disadvantaged area died more often during postoperative chemotherapy (ORQ4 Q5 = 2.08, 95% CI = [1.02–4.25]). In 2010, in Gironde and in the Tarn departments, the factors associated with the non-presentation of a patient file in MDTm were having died in the month following the diagnosis, as well as two independent factors of death: the advanced age of patients (over 85 years) and residing in more disadvantaged areas. In the end, therapeutic management was not associated with the presentation in MDTm but with patient and tumor characteristics, including age, comorbidities but also level of deprivation. For the continuation, survival analyzes of patients with colon cancer based on their MDTm status are underway.