Publications by authors named "C Mariette"

306 Publications

Associations between the severity of medical and surgical complications and perception of surgeon empathy in esophageal and gastric cancer patients.

Support Care Cancer 2021 Jun 10. Epub 2021 Jun 10.

SCALab UMR CNRS 9193, University of Lille, Villeneuve D'AscqCedex, Rue du Barreau BP 60149, Lille, France.

Objective: To assess the impact of global physician empathy and its three subdimensions (establishing rapport, emotional and cognitive processes) on the severity of postoperative complications in a sample of cancer patients.

Methods: We retrospectively analyzed data on 256 patients with esogastric cancer from the French national FREGAT database. Empathy and its subdimensions were assessed using the patient-reported CARE scale and the severity of medical and surgical complications was reported with the Clavien-Dindo classification system. The usual covariates were included in multinomial logistic regression analyses.

Results: Physician empathy predicted the odds of reporting major complications. When patients perceived high empathy, they were less likely to report major complications compared to no complications (OR = .95, 95% CI = [.91-.99], p = .029). Among the three dimensions, only "establishing rapport" (OR = .84, 95% CI = [.73-.98], p = .019) and the "emotional process" (OR = .85, 95% CI = [.74-.98], p = .022) predicted major complications.

Conclusions: Physician empathy is essential before surgery. Further research is needed to understand the mechanisms associating empathy with health outcomes in cancer. Physicians should be trained to establish good rapport with patients, especially in the preoperative period.
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June 2021

Patient-reported outcomes after oesophagectomy in the multicentre LASER study.

Br J Surg 2021 May 11. Epub 2021 May 11.

Oesophago-gastric Centre, Churchill Hospital, University of Oxford, Oxford, UK.

Background: Data on the long-term symptom burden in patients surviving oesophageal cancer surgery are scarce. The aim of this study was to identify the most prevalent symptoms and their interactions with health-related quality of life.

Methods: This was a cross-sectional cohort study of patients who underwent oesophageal cancer surgery in 20 European centres between 2010 and 2016. Patients had to be disease-free for at least 1 year. They were asked to complete a 28-symptom questionnaire at a single time point, at least 1 year after surgery. Principal component analysis was used to assess for clustering and association of symptoms. Risk factors associated with the development of severe symptoms were identified by multivariable logistic regression models.

Results: Of 1081 invited patients, 876 (81.0 per cent) responded. Symptoms in the preceding 6 months associated with previous surgery were experienced by 586 patients (66.9 per cent). The most common severe symptoms included reduced energy or activity tolerance (30.7 per cent), feeling of early fullness after eating (30.0 per cent), tiredness (28.7 per cent), and heartburn/acid or bile regurgitation (19.6 per cent). Clustering analysis showed that symptoms clustered into six domains: lethargy, musculoskeletal pain, dumping, lower gastrointestinal symptoms, regurgitation/reflux, and swallowing/conduit problems; the latter two were the most closely associated. Surgical approach, neoadjuvant therapy, patient age, and sex were factors associated with severe symptoms.

Conclusion: A long-term symptom burden is common after oesophageal cancer surgery.
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May 2021

Upfront Carfilzomib, Lenalidomide, Dexamethasone with Transplant in Multiple Myeloma Patients, the IFM KRd final results.

Blood 2021 04 7. Epub 2021 Apr 7.

IUC Oncopole, Toulouse, France.

Bortezomib, lenalidomide, dexamethasone plus transplant is a standard of care for eligible Multiple Myeloma patients. As responses can deepen with time, regimens with longer and more potent induction/consolidation phases are needed. In this phase II study, patients received eight 28-day cycles of carfilzomib (K) 20/36mg/m2 (D1-2,8-9,15-16), lenalidomide (R) 25 mg (D1-21), and dexamethasone (d) 20 mg (D1-2,8-9,15-16,22-23). All patients proceeded to transplant after 4 cycles and received 1-year lenalidomide maintenance (10 mg, D1-21). The primary objective was stringent complete response (sCR) at the completion of consolidation. Overall, 48 patients were screened and 46 enrolled; 21% had adverse cytogenetics. Among 42 evaluable patients after consolidation, 26 were in sCR (61.9%), 27 in ≥CR (64.3%): 92.6% had undetectable Minimal Residual Disease by flow cytometry (≥2.5 x10-5) and 63.0% by next generation sequencing (10-6). Median time to CR was 10.6 months. By MFC and NGS, 69.0% and 66.7% patients, respectively had undetectable MRD at some point. With a median follow-up of 60.5 months, 21 patients progressed and 10 died (7 from MM). Median PFS was 56.4 months. There was no KRd related death. Four patients discontinued the program due to toxicities; 56 serious AEs were reported in 31 patients including 8 cardiovascular events (2 heart failures, 5 pulmonary embolisms or deep vein thrombosis). Common grade 3/4 AEs were hematological (74%) and infectious (22%). In conclusion, 8 cycles of KRd produce fast and deep responses in transplant eligible NDMM patients. Safety profile is acceptable but cardiovascular AEs should be closely monitored.
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April 2021

Strain wave pathway to semiconductor-to-metal transition revealed by time-resolved X-ray powder diffraction.

Nat Commun 2021 Feb 23;12(1):1239. Epub 2021 Feb 23.

SwissFEL, Paul Scherrer Institut, Villigen PSI, Switzerland.

One of the main challenges in ultrafast material science is to trigger phase transitions with short pulses of light. Here we show how strain waves, launched by electronic and structural precursor phenomena, determine a coherent macroscopic transformation pathway for the semiconducting-to-metal transition in bistable TiO nanocrystals. Employing femtosecond powder X-ray diffraction, we measure the lattice deformation in the phase transition as a function of time. We monitor the early intra-cell distortion around the light absorbing metal dimer and the long range deformations governed by acoustic waves propagating from the laser-exposed TiO surface. We developed a simplified elastic model demonstrating that picosecond switching in nanocrystals happens concomitantly with the propagating acoustic wavefront, several decades faster than thermal processes governed by heat diffusion.
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February 2021