Multidisciplinary meetings specific to hepatocellular carcinoma: How to proceed?

The French "cancer plan" has created a framework for good practice in the course of care for cancer patients. Decisions must be made in a multidisciplinary team meeting (MDM) and an individualized care plan (ICP) is to be established for each patient. Hepatocellular carcinoma (HCC) is a common cancer with complex treatments that warrant a dedicated meeting. Cancer coordination centers (3C) ensure the organization and the functioning of MDMs. Multidisciplinary, standardized and systematic assessment of HCC patients allows for personalized management and orients them toward treatment that is either curative (transplantation, surgical resection, ablathermy) or palliative (chemoembolization, radiotherapy, systemic treatment, supportive care). MDMs bring together all the professionals treating the disease, and who are tasked with producing an enforceable document effective that justifies decisions and is often an essential step towardinclusion of patients in a clinical trial. It must be carried out according to a systematic schema in an approach applied from initial diagnosis to treatment outset and throughout the treatment. Numerous advances in HCC treatments have rendered their management complex, with the possibility of liver transplantation, twhose access is regulated by the Biomedicine Agency requiring the submission of MDM reports. MDMs must meet specific quality criteria to ensure effective management based on general guidelines and yet specifically tailored to each patient.

Specific immunity to human papilloma virus (HPV) in patients with genital warts.

A study of human papilloma virus (HPV) specific cellular and humoral immunity in 30 patients with genital warts is reported. By in vivo testing with purified, inactivated plantar wart virus, a cell-mediated immunity to HPV was determined in 60% of patients. Circulating antibodies, evaluated by immunofluorescence testing, were rare, but these increased after an intradermal test had been carried out, especially in patients with a positive skin test, suggesting a booster effect. No significant difference was found between this group of patients and those having skin warts. Our results showed a specific immune response to HPV in most patients, confirming the role of the viral agent in the induction of genital warts.