and gender to gain more insight into tailored risk prediction and communication of risk to general practitioners (GPs) and/or participants. Methods: In this retrospective study, data was used of 57,421 participants who underwent a colonoscopy after a positive FIT in the Flemish CRC screening programme between October 2013 until July 2016. Analyses were performed with multinomial logistic regression to predict the probability of normal or noncancerous lesions, precancerous lesions, in situ or invasive cancers. Additionally, odds ratios (OR) were established to visualize the magnitude of the differences between risk profiles within a population with positive FIT, based upon a combination of the quantitative FIT, age and gender. Results: The amount of false positive FIT results followed up by colonoscopy is $27%, where $20% are not followed up at all by colonoscopy within 6 months after a positive FIT. Based on our risk profile calculation, we found a significant difference between the risk of having a normal outcome, a precancerous lesion, an in situ or an invasive cancer. For example, the detection of invasive cancer was 58 (OR) times more likely in a male of 74 years old with a FIT result of ! 1,000 ng/ml compared to a woman of 56 years old with a FIT result of 75 ng/ml. Conclusion: The differences in precancerous lesions or CRC according to our calculated risk profiles, justifies an approach where participants with a positive FIT are not all treated in the same way, based on a binary FIT. Participants and/or their GPs should be informed about individual risks. This will promote informed decision to an extent where participants and/or professionals can make decisions on follow-up. How to communicate this personalised information to participants needs to be discussed and tested. Contrary to the participant, professionals such as GPs should be provided with extra insight in the risk differences per patient, which supports their clinical decision making. The approach above could be extended by adding simple risk factors such as BMI, diet, alcohol intake, family history etc., creating the opportunity to more accurately discriminate between participants with a normal outcome, precancerous lesion, in situ or invasive cancer. Colonoscopy follow up based upon the quantitative FIT, combined with age, gender and additional risk factors instead of upon a binary FIT result only, will probably increase accuracy.

La dermatomyosite est une maladie systémique idiopathique, associant une double symptomatologie cutanée et musculaire. La maladie fait partie de dermatose paranéoplasique. L’association de la dermatomyosite à un cancer rectal est rarement décrite dans la littérature. Nous présentons un cas d’une patiente atteinte de dermatomyosite paranéoplasique associé à un adénocarcinome rectal métastatique, et qui a présenté une symptomatologie clinique typique d’une dermatomyosite paranéoplasique, confirmée par les autres examens complémentaire (taux de créatine phosphokinase (CPK) + EMG (électromyogramme) + biopsie cutanée). La patiente était mise sous chimiothérapie, mais après sa deuxième cure, la patiente a présenté une aggravation rapide de son état général, décédée en quelque jours dans un tableau de défaillance multi-viscérale. Notre objectif est d’illustrer le caractère agressif de la dermatomyosite paranéoplasique et de faire une mise au point des connaissances actuelles concernant la place de la chimiothérapie dans la dermatomyosite néoplasique.

No abstract

No abstract

clinical oncology. They are helpful in the selection of treatment; provide insights into the disease process and the therapeutic response. This study attempts to observe the survival of rectal adenocarcinoma and to find prognostic factors and other variables potentially associated with outcome of operated rectal adenocarcinoma. Methods: It's a retrospective study based on 91 patients with operated rectal adenocarcinoma collected at the Medical Oncology Department of Hassan II University Hospital for a period of 4 years between January 2014 and June 2017. Various prognostic factors had been identified through univariate (Kaplan-Meier) then multivariate (Cox) analyze, namely: age, sex, tumor localization, degree of differentiation, stage, tumor recurrence, ACE level, neoadjuvant therapy and adjuvant chemotherapy. Results: The mean age was 59 years (6 14.14) with extremes "24-86". These were 40% men and 60% women. At endoscopic examination the tumor was located: in the middle rectum in 30.8%; 36.3% in the lower rectum and 33% in the upper rectum. Histologically, the biopsy showed that liberkunian adenocarcinoma was well differentiated in 56%, moderately differentiated in 42% and in 2% poorly differentiated. The carcinoembryonic antigen revealed a rate greater than 5 ng/ml in 25% of patients. Neo-adjuvant treatment with concomitant radiochemotherapy was performed in 61.5% and radiotherapy for 24%. Histopathological examination classified the patients according to the TNM classification with: 7% of patients in stage I, 30% in stage II, 54% in stage III and 9% in stage IV. After surgery 78 patients (86%) received adjuvant chemotherapy. Average overall survival was 25 months. In addition, 23% of patients had a recurrence, median-free survival was 29month. Adjuvant therapy was the only prognostic factor influencing survival: mean survival in the group receiving adjuvant chemotherapy was 32 months vs 14 months in the surveillance group with a very significant difference (p ¼ 0.006). Conclusion:In our series adjuvant therapy was an important prognostic factor influencing overall survival, our results correlate with those in the literature.