The incidence of kidney cancer is rising. It is the 7th most common cancer in men and the 10th most common in women. Diagnosis is based on imaging (thoraco-abdominopelvic computed tomography scan +/- abdominal magnetic resonance) and histopathology. Clear cell carcinoma is the most frequently observed histological subtype. Management of localized kidney cancer involves surgery or ablative treatments. Active surveillance is indicated in the indolent oligometastatic setting with local treatment in case of localized progression. Apart from this specific situation, two first-line therapeutic strategies are recommended in the metastatic setting : a dual immunotherapy regimen or the combination of immunotherapy with an antiangiogenic tyrosine kinase inhibitor. Both combinations have demonstrated superior survival outcomes compared to sunitinib, the previous standard of care until 2019. Treatment selection should be individualized, considering the characteristics of the disease (histology, tumour burden, location of metastases and if they are threatening, speed of progression), potential side effects of the treatments, the patient's general health, comorbidities and preferences.

Giant cell tumours (GCTs) are benign primary bone tumours that frequently present with local recurrence and occasionally malignant transformation to high-grade sarcoma. Surgery is the mainstay of treatment and generally consists of intralesional curettage. Denosumab was approved by the European Medicines Agency (EMA) in 2014 for the treatment of skeletally mature adults and adolescents with unresectable GCTs or where resection is likely to result in severe morbidity.

Osteosarcoma (OS) and Ewing Sarcoma (ES) are the two most frequent malignant bone tumors in children, adolescents and young adults. In case of disease recurrence, both are characterized by an aggressive behaviour and a relatively poor overall survival rate, with approximately a third of patients having a long-term disease-free survival. In case of recurrent or refractory (R/R) disease, the therapeutic strategy should be discussed in multidisciplinary staff meetings with expertise in bone sarcoma management. The standard management of R/R OS depends on the disease-free interval and the number and sites of metastases and is primarily surgical in patients with isolated lung metastases or local relapse. On the other hand, conventional chemotherapy remains the standard for R/R ES and include high-dose ifosfamide, cyclophosphamide with topotecan and irinotecan with temozolomide.

Ewing sarcomas are the 2nd cause of malignant bone tumors in children and young adults. After induction chemotherapy, local treatment is essential and most often includes surgery of the primary tumor. Radiotherapy may be necessary as an exclusive local procedure when surgery is not possible, or in an adjuvant situation when the surgical procedure must be completed (incomplete resection or poor histological response in particular). Radiotherapy can also concern metastatic sites, particularly in cases of pulmonary metastases and/or in an oligo-metastatic situation. This article provides a review of current indications for radiotherapy, technical modalities of irradiation (delineation of volumes, recommended doses), and the results of recent studies.

Patients who develop Ewing sarcoma with extra-pulmonary metastasis have a poor prognosis. A recent French protocol, CombinaiR3, was set up to evaluate the efficacy of induction chemotherapy followed by high-dose chemotherapy and metronomic maintenance treatment. It is now closed for inclusions and while waiting for the results, we propose a French consensus guideline for the management of patients diagnosed with Ewing sarcoma with extra-pulmonary dissemination. Main recommendations include induction chemotherapy with nine cycles of vincristine/doxorubicin/cyclophosphamide alternating with ifosfamide/etoposide. In case of insufficient response, other chemotherapy combination or inclusion in a clinical trial should be considered. Induction chemotherapy should be followed by local treatment, consisting of surgery and/or radiotherapy. Optimal local treatment is a milestone in the management of patients with Ewing sarcoma and should be discussed with experts and surgeons/radiotherapists working in the sarcoma network. High-dose chemotherapy (HDC) containing busulfan and melphalan followed by autologous stem-cell transplantation is still unclear, with contradictory results. HDC will then be discussed in national tumor board and administered to patients when compatible with local treatment. Given the high relapse rate observed among these metastatic patients, maintenance chemotherapy (so called metronomic regimen) will then be given for two years.

Osteosarcomas of the mandible represent 3-8% of osteosarcomas. The rarity of this anatomic site and its specific treatment explain that only retrospective and a few prospective studies are available in literature. However, there is a consistent evidence on the natural history and treatment of these tumors, which clearly differentiates them from osteosarcomas of the long bones. The aim of this study was to draw up recommendations based on these data and on a retrospective study by the French Sarcoma Group (GSF-GETO). Osteosarcomas of the mandible should be centrally reviewed by an expert pathologist. MDM2, GNAS and RASAL1 status should be checked, and a fragment should be frozen. Complete surgical resection with wide margins is the cornerstone of treatment. Mandibular reconstruction techniques can reduce the sequelae. Contrary to the validated treatment for osteosarcomas of limbs, the role of chemotherapy to prevent metastasis or local recurrence has yet to be clarified for mandibular osteosarcomas. The role of postoperative radiotherapy, in adults, should be discussed for these tumors, whose wide soft-tissue resection may be difficult to confirm. In children, adjuvant chemotherapy is preferable in cases of uncertain/possibly incomplete resection. Relapse of mandibular osteosarcomas is primarily local. Pulmonary metastases are delayed and less frequent than in long-bone osteosarcomas. The overall survival rate at five years is about 70%.

To update the recommendations issued by the National Cancer Institute (INCa) on the management of women with abnormal cervical cytology.

The incidence of follicular-derived thyroid cancers has increased worldwide in recent decades, mainly papillary thyroid cancers at low recurrence risk. A process of de-escalation in the initial management and follow-up of these patients has therefore been implemented in parallel. This article provides the best practice recommendations made by the French learned societies (Société française d'endocrinologie, Société française de médecine nucléaire, Association française de chirurgie endocrine, Société française d'oto-rhino-laryngologie et de chirurgie de la face et du cou), european and international learned societies (European Society for Medical Oncology and the American Thyroid Association), in the management of follicular-derived thyroid cancer without distant metastases. The extent of thyroid surgery and lymph node dissection, strategies of radioiodine ablation, follow-up protocols and the management of excellent prognosis papillary cancers ≤ 10 mm will be addressed.

In this article, we propose a consensus delineation of postoperative clinical target volumes for the primary tumour in maxillary sinus and nasal cavity cancers. These guidelines are developed based on radioanatomy and the natural history of those cancers. They require the fusion of the planning CT with preoperative imaging for accurate positioning of the initial GTV and the combined use of the geometric and anatomical concepts for the delineation of clinical target volume for the primary tumour. This article does not discuss the indications of external radiotherapy (nor concurrent systemic treatment) but focuses on target volumes when there is an indication for radiotherapy.

High-grade endometrial stromal sarcoma (HGESS) and uterine undifferentiated sarcoma (UUS) are rare uterine malignancies arising from mesenchymal endometrial cells. They are characterized by aggressive behavior and poor prognosis. Median age of diagnostic is 55years. The most common symptoms are vaginal bleeding, abdominal pain, and pelvic mass. Approximately 65 % are diagnosed witch advance disease stage III or IV according to the International Federation of Gynecology and Obstetrics classification. Median overall survival is around 20months. The management of the disease must be discussed in multidisciplinary staff meetings. The standard management of HGESS and UUS is total hysterectomy with bilateral oophorectomy. Systematic lymphadenectomy is not recommended. Adjuvant therapies, such as chemotherapy and radiotherapy must be discussed. In case of oligo-metastasic disease, surgery of the primary tumor and metastasis must be discussed and if not operable the standard management is doxorubine-based chemotherapy.

Low-grade endometrial stromal sarcoma (LG-ESS) accounts for approximately 15% of all uterine sarcomas. Median age of patients is around 50 years and half of the patients are premenopausal. In all, 60% of cases present with FIGO stage I disease. Preoperatively radiologic findings of ESS are not specific. Pathological diagnosis remains essential. This review aimed to present the French guidelines for low grade ESS treatment within the Groupe sarcome français - Groupe d'étude des tumeurs osseuse (GSF-GETO)/NETSARC+ and tumeur maligne rare gynécologique (TMRG) networks. Treatments should be validated in multidisciplinary team involved in sarcomas or rare gynecologic tumors. Hysterectomy is the cornerstone of treatment for localized ESS, and morcellation should be avoided. Systematic lymphadenectomy in ESS does not improve the outcome and is not recommended. Leaving the ovaries in situ in stage I tumors could be discussed for young women. Adjuvant hormonal treatment could be considered, for two years for stage I with morcellation or stage II and livelong for stages III or IV. Nevertheless, several questions remain, such as optimal doses, regimens (progestins or aromatase inhibitors) and duration of therapy. Tamoxifen is contraindicated. Secondary cytoreductive surgery if feasible for recurrent disease, appears to be an acceptable approach. Systemic treatment for recurrent or metastatic disease is mainly hormonal, with or without surgery.

To revise the 1983 colposcopic terminology form the French Society of Colposcopy and cervicovaginal pathology (SFCPCV).

Nipple-areolar complex anomalies may be secondary to many etiologies from simple anatomic variations to malignant processes as Paget disease or invasive breast cancer, passing through benign locally aggressive processes as erosive adenomatosis of the nipple. Differential diagnosis is not always simple. If clinical exam and standard radiological checkup can't confirm the benignity of the lesion, a biopsy specimen will be obtained to allow an anatomopathological examination. A precise diagnosis can then be made leading to optimal management. This paper describes how to explore nipple-areolar complex anomalies through an uncommon clinical case associating independently an invasive retro-areolar cancer and a dermatological disease of the areola mimicking a Paget disease.

Since the previous 2013 and 2016 recommendations for clinical practice (RPC) Nice/Saint-Paul-de-Vence for gynecological cancers, the management of ovarian cancer has become more complex with the evolution of the quality criteria recommended for surgery and the integration of molecular biology for the decision of medical treatments, especially for high grade epithelial ovarian cancers. Surgical indications have become more precise both in the first line and in the context of relapse. Treatments with PARP inhibitors is a major advance in medical management with significant efficacy in maintenance after response to platinum-based chemotherapy. The benefit already known in the case of late relapse has also been demonstrated in first-line treatment with progression-free survival never observed in this pathology with patients with very long responses, especially in the case of BRCA gene abnormalities (somatic or constitutional). In 2021, medical and surgical strategies in front line including PARP inhibitors associated or not with bevacizumab as a maintenance complement after platinum chemotherapy are guided by both response to platinum agents and molecular profiling including BRCA (somatic or constitutional) genetic status and homologous recombination pathway (HRD) abnormalities, that should be early tested. On behalf of the GINECO national oncologist group, we have updated the guidelines for high grade ovarian epithelial cancer (excepted rare tumors) in order to allow rapid dissemination of the latest advances to the medical community and improve daily practice.

- To update French guidelines for the management of bladder cancer specifically non-muscle invasive (NMIBC) and muscle-invasive bladder cancers (MIBC).

Prostate biopsy is sometimes complicated by infection which can lead to death. The risk factors remain controversial, notably the urine bacterial culture carried out before a prostate biopsy. The increase in resistance induces an increase in the number of complications and the need to define new antibiotic prophylaxis strategies. The urine bacterial culture remains widely discussed in cases with post-prostate biopsy infections and urologists or experts await clear recommendations on this subject. The Infectiology Committee of the French Association of Urology has therefore set up a literature analysis work in order to reach a consensus within the committee.

Brachytherapy is part of the treatment of locally advanced cervical cancers, accounting for about half of the total delivered dose. The benefit of dose escalation is the most important in advanced cases or if the tumor has responded poorly. The use of interstitial implantations makes it possible to reach doses of the order of 85 to 90Gy (including external beam radiotherapy contribution) in most patients, through image-guided approaches. Brachytherapy delivery is one of the quality criteria for patient care. To date, no data allow us to consider as an alternative the use of external boost through intensity-modulated or stereotactic body radiotherapy. Indeed, the doses delivered to the tumor and the capacity to spare normal tissues remains lower, as compared to what is permitted by brachytherapy. It is therefore appropriate for centers that do not have access to the technique to establish networks with centers where brachytherapy is performed, to allow each patient to have access to the technique. It is also necessary to promote brachytherapy teaching. The issue of reimbursement will be crucial in the coming years to maintain expertise that is today insufficiently valued in its financial aspects, but has a very high added value for patients.

The aim of the Cancerology Committee of the French Association of urology (CCAFU) is to propose an update of the guidelines in the management of hormone-sensitive metastatic prostate cancer.

To propose updated French guidelines for non-muscle invasive (NMIBC) and muscle-invasive (MIBC) bladder cancers.

To evaluate the diagnostic value of serum biomarkers in the management strategy of borderline ovarian tumours (BOT) to make management recommendations.