0000000000021973
AUTHOR
Pierre-benoit Pagès
showing 15 related works from this author
Les réadmissions après résection pulmonaire en France : la base de données du PMSI
2021
BACKGROUND Readmission within 30 days is an indicator of the quality of care, because it often reflects post-discharge care that is not optimal. The objective of this work is to measure over time on the one hand the readmission rate and on the other hand the number of hospitals with a standardized readmission rate beyond the national average. METHOD All patients with major pulmonary resection for lung cancer in France were extracted from the PMSI national database. Readmission within 30 days was defined as any new hospitalization either in the same hospital or in another establishment. RESULTS From January 1, 2005 to December 31, 2018, 110,603 patients were included. The 30-day all-cause re…
Mesure de la qualité des soins à partir de la base de données nationale du PMSI. Étude de la mortalité hospitalière après résections pulmonaires pour…
2016
Introduction En 2009, les centres prenant en charge des cancers ont ete soumis a autorisation suite au premier plan cancer. Cinq annees plus tard, il nous paraissait interessant de connaitre l’impact de cette nouvelle organisation. L’objectif est d’estimer l’effet periode et d’evaluer l’influence du volume d’activite sur la mortalite. Methodes De la base de donnees PMSI ont ete extraits pour tous les patients ayant eu une resection pulmonaire pour cancer bronchique. Les caracteristiques des centres comprennent le volume d’activite annuel et le type d’etablissement : publiques non universitaires, prives et CHU. L’indicateur de qualite utilise est la mortalite hospitaliere definie comme tout …
Does age over 80 years have to be a contraindication for lung cancer surgery—a nationwide database study
2018
IF 1.804 (2017); International audience; Background: Nowadays surgery remains the best treatment for localized lung cancer (LC). However, patients over 80 years old are often denied surgery because of the postoperative risk of death. This study aimed to estimate in-hospital mortality (IHM) and determine whether age over 80 is the most important predictor of IHM after LC surgery.Methods: From January 2005 to December 2015, 97,440 patients, including 4,438 patients over 80 years old, were operated on for LC and recorded in the French Administrative Database. Characteristics of patients, hospitals and surgery were analysed.Results: Crude IHM was 3.73% (n=3,639) and 7.77% (n=345) for the over 8…
Évaluation de la pratique chirurgicale dans le traitement du cancer bronchique en France à partir de la base nationale du PMSI
2019
Background - In recent years, improving the quality of care has been a concern for health professionals in France, through the certification of institutions, accreditation and continuous professional development. Evaluation of these different measures has rarely been carried out. The objective of the study was to evaluate the quality of surgical management of lung cancer in different regions using hospital mortality as an indicator. Method - From the national database of the Program of Medical Information Systems (PMSI), data on all patients who had undergone surgery for lung cancer were extracted as well as the characteristics of the centers. The main outcome criterion was hospital mortali…
Le pneumocytome sclérosant : une tumeur rare et apparemment bénigne
2020
International audience; Introduction: Sclerosing pneumocytoma is a benign and rare lung tumor affecting epithelial cells. In most cases, patients are asymptomatic and the diagnosis is made on an X ray or a CT scan performed for other enquiry. Sex ratio favors women. Epidemiological studies report that middle-aged Asian women are more frequently affected. Radiological investigations find a solitary nodule or a mass with peripheric localization. When performed, histological analysis shows a tumor composed of at least two of the four following architectures: papillary, sclerosing, hemangiomatous and solid, with two types of cells that can be round or cubic cells.Cases report: We report two cas…
Quelle place reste-t-il pour la chirurgie dans les cancers bronchiques de stade IIIA-N2 ?
2015
Resume Introduction Le cancer bronchique non a petites cellules (CBNPC) demeure un probleme de sante majeur, avec une survie globale a 5 ans des stades IIIA de l’ordre de 25 %. La prise en charge chirurgicale des CBNPC de stade IIIA demeure cependant controversee. Nous avons donc evalue les differentes strategies de prise en charge des CBNPC de stade IIIA-N2. Methodes De janvier 1990 a decembre 2013, les essais controles randomises evaluant la survie des patients traites par chimiotherapie d’induction suivie d’une resection chirurgicale vs chirurgie seule, et ceux evaluant la survie des patients traites par radio- ou chimiotherapie d’induction suivie d’une resection chirurgicale vs la combi…
Hospital Readmission after Major Pulmonary Resection for Lung Cancer in France: A Nationwide Medico-Administrative Database
2019
Objectives: After major pulmonary resection for lung cancer, hospital readmission is considered an indicator of the quality of care. Our main objective was to define the readmission rate at 30 days after pulmonary resection. Secondary objectives were to determine the causes and predictive factors. Methods: Data for all patients operated for lung cancer were extracted from the national medico-administrative database of the Programme de Medicalisation des Systemes d'Information (PMSI). Thirty-days hospital readmission was defined as any new hospitalization within 30 days after discharge from the surgical department following major lung resection, regardless of the reason for readmission. Resu…
Acute and delayed toxicity of gemcitabine administered during isolated lung perfusion: a preclinical dose-escalation study in pigs.
2014
BACKGROUND: Colorectal cancer is the third most commonly diagnosed cancer worldwide, with up to 25% of patients presenting with metastases at the time of diagnosis. Despite pulmonary metastasectomy many patients go on to develop pulmonary recurrence, which might be linked to the presence of lung micrometastases. In this setting, the adjuvant administration of high-dose chemotherapy by isolated lung perfusion (ILP) has shown encouraging results. However, the tolerance to and efficacy of modern gemcitabine (GEM)-based chemotherapy regimens during adjuvant ILP remain unknown. We conducted a dose-escalating preclinical study to evaluate the immediate and delayed toxicity of GEM in a pig model t…
Is an activity volume threshold really realistic for lung cancer resection?
2018
IF 1.804 (2017); International audience; Background:We analyzed volume as a continuous variable to estimate threshold, which is a methodology rarely seen in the literature. The objective of this work was to assess hospital volume for lung cancer (LC) surgery and to establish the associated threshold for acceptable in-hospital mortality (IHM). Data was obtained from the French national medico-administrative database.Methods:From January 2005 to December 2016, data from 108,571 patients operated for LC in France were collected from the national administrative database. To estimate the volume threshold, hierarchical logistic regression models were developed.Results:The crude IHM rate was 5.2% …
Guidelines on enhanced recovery after pulmonary lobectomy
2021
International audience; Objective : To establish recommendations for optimisation of the management of patients undergoing pulmonary lobectomy, particularly Enhanced Recovery After Surgery (ERAS).Design : A consensus committee of 13 experts from the French Society of Anaesthesia and Intensive Care Medicine (Soci,t, franOaise d'anesth,sie et de r,animation, SFAR) and the French Society of Thoracic and Cardiovascular Surgery (Soci,t, franOaise de chirurgie thoracique et cardiovasculaire, SFCTCV) was convened. A formal conflict-of-interest policy was developed at the onset of the process and enforced throughout. The entire guidelines process was conducted independently of any industry funding.…
Validation and update of the thoracic surgery scoring system (Thoracoscore) risk model.
2020
Abstract OBJECTIVES The performance of prediction models tends to deteriorate over time. The purpose of this study was to update the Thoracoscore risk prediction model with recent data from the Epithor nationwide thoracic surgery database. METHODS From January 2016 to December 2017, a total of 56 279 patients were operated on for mediastinal, pleural, chest wall or lung disease. We used 3 recommended methods to update the Thoracoscore prediction model and then proceeded to develop a new risk model. Thirty-day hospital mortality included patients who died within the first 30 days of the operation and those who died later during the same hospital stay. RESULTS We compared the baseline patient…
Impact of video-assisted thoracic surgery approach on postoperative mortality after lobectomy in octogenarians.
2019
The number of octogenarians who present with localized lung cancer eligible for surgical resection is increasing. Video-assisted thoracic surgery lobectomy has been widely accepted, but the potential benefit in octogenarians is not well established, especially for postoperative mortality. This study aimed to assess the impact of a video-assisted thoracic surgery approach on postoperative mortality after lobectomy for lung cancer in octogenarians.From January 2005 to December 2016, all patients aged more than 80 years who received lobectomy treatment for lung cancer were retrieved from the French Administrative Database. The end point was 30-day postoperative death. A propensity score was ge…
Chirurgie des métastases pulmonaires des cancers colorectaux : facteurs prédictifs de survie
2016
Resume Introduction Le cancer colorectal represente la 3e cause de mortalite par cancer : 5 % des patients vont developper des metastases pulmonaires. Le concept de chirurgie des cancers oligometastatiques est base sur l’objectif d’un controle local optimal de la maladie. Etat des connaissances A ce jour, aucun essai controle randomise ne valide la chirurgie de resection des metastases pulmonaires des patients oligometastatiques porteurs d’un cancer colorectal controle localement. Cependant, de nombreuses series, le plus souvent retrospectives, rapportent des survies prolongees chez des patients tres selectionnes, allant de 45 a 65 % a 5 ans dans les series les plus recentes. Les facteurs c…
Isolated Lung Perfusion as an Adjuvant Treatment of Colorectal Cancer Lung Metastases: A Preclinical Study in a Pig Model
2012
BackgroundThe lung is a frequent site of colorectal cancer (CRC) metastases. After surgical resection, lung metastases recurrences have been related to the presence of micrometastases, potentially accessible to a high dose chemotherapy administered via adjuvant isolated lung perfusion (ILP). We sought to determine in vitro the most efficient drug when administered to CRC cell lines during a short exposure and in vivo its immediate and delayed tolerance when administered via ILP.MethodsFirst, efficacy of various cytotoxic molecules against a panel of human CRC cell lines was tested in vitro using cytotoxic assay after a 30-minute exposure. Then, early (operative) and delayed (1 month) tolera…
In-hospital mortality following lung cancer resection: nationwide administrative database.
2016
Our aim was to determine the effect of a national strategy for quality improvement in cancer management (the “Plan Cancer”) according to time period and to assess the influence of type and volume of hospital activity on in-hospital mortality (IHM) within a large national cohort of patients operated on for lung cancer.From January 2005 to December 2013, 76 235 patients were included in the French Administrative Database. Patient characteristics, hospital volume of activity and hospital type were analysed over three periods: 2005–2007, 2008–2010 and 2011–2013.Global crude IHM was 3.9%: 4.3% during 2005–2007, 4% during 2008–2010 and 3.5% during 2011–2013 (p<0.01). 296, 259 and 209 centres p…