Cancer-related fatigue among long-term survivors of breast, cervical, and colorectal cancer: a French registry-based controlled study.
Identifieur interne : 000279 ( Main/Exploration ); précédent : 000278; suivant : 000280Cancer-related fatigue among long-term survivors of breast, cervical, and colorectal cancer: a French registry-based controlled study.
Auteurs : François Gernier [France] ; Florence Joly [France] ; Delphine Klein [France] ; Mariette Mercier [France] ; Michel Velten [France] ; Idlir Licaj [France, Norvège]Source :
- Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer [ 1433-7339 ] ; 2020.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen (MeSH), Anxiété (psychologie), Enquêtes et questionnaires (MeSH), Enregistrements (MeSH), Fatigue (psychologie), Femelle (MeSH), France (MeSH), Humains (MeSH), Maladie chronique (psychologie), Mâle (MeSH), Plan de recherche (MeSH), Qualité de vie (psychologie), Récidive tumorale locale (psychologie), Sujet âgé (MeSH), Survivants du cancer (psychologie), Tumeurs du col de l'utérus (psychologie), Tumeurs du col de l'utérus (thérapie), Tumeurs du côlon (psychologie), Tumeurs du côlon (thérapie), Tumeurs du sein (psychologie), Tumeurs du sein (thérapie).
- MESH :
- psychologie : Anxiété, Fatigue, Maladie chronique, Qualité de vie, Récidive tumorale locale, Survivants du cancer, Tumeurs du col de l'utérus, Tumeurs du côlon, Tumeurs du sein.
- thérapie : Tumeurs du col de l'utérus, Tumeurs du côlon, Tumeurs du sein.
- Adulte d'âge moyen, Enquêtes et questionnaires, Enregistrements, Femelle, France, Humains, Mâle, Plan de recherche, Sujet âgé.
- Wicri :
- geographic : France.
English descriptors
- KwdEn :
- Aged (MeSH), Anxiety (psychology), Breast Neoplasms (psychology), Breast Neoplasms (therapy), Cancer Survivors (psychology), Chronic Disease (psychology), Colonic Neoplasms (psychology), Colonic Neoplasms (therapy), Fatigue (psychology), Female (MeSH), France (MeSH), Humans (MeSH), Male (MeSH), Middle Aged (MeSH), Neoplasm Recurrence, Local (psychology), Quality of Life (psychology), Registries (MeSH), Research Design (MeSH), Surveys and Questionnaires (MeSH), Uterine Cervical Neoplasms (psychology), Uterine Cervical Neoplasms (therapy).
- MESH :
- geographic : France.
- psychology : Anxiety, Breast Neoplasms, Cancer Survivors, Chronic Disease, Colonic Neoplasms, Fatigue, Neoplasm Recurrence, Local, Quality of Life, Uterine Cervical Neoplasms.
- therapy : Breast Neoplasms, Colonic Neoplasms, Uterine Cervical Neoplasms.
- Aged, Female, Humans, Male, Middle Aged, Registries, Research Design, Surveys and Questionnaires.
Abstract
BACKGROUND
While several studies have documented fatigue during and after cancer treatment, long-term cancer survivor fatigue is underreported. In this study, we compare fatigue, quality of life (QoL), and anxiety between relapse-free cancer survivors 15 years after diagnosis and healthy controls.
METHODS
Cancer survivors (CS) were randomly selected from three large population-based cancer registries (Bas-Rhin, Calvados, and Doubs, France). Cancer-free controls were randomly selected from electoral lists with stratification on age group, residence area, and gender. All participants completed self-reported fatigue (MFI), QoL (EORTC QLQ-C30), and anxiety (STAI) questionnaires. Univariable and multivariable logistic regression were used to study the association between fatigue and cancer status, in three cancer subgroups: breast cancer (BC), cervical cancer (CC), and colorectal cancer (CRC).
RESULTS
Two hundred sixty-three CS and 688 controls (125/275, 45/153, 93/260 CS/controls for BC, CC, and CRC respectively) were included. The mean age was 66 years. In multivariable analyses, CS had higher general and mental fatigue than controls p = 0.04 and p = 0.02, respectively. No difference in QoL was observed between CS and controls. CS were more anxious than controls (p < 0.01). Anxiety was associated with general fatigue (p < 0.0001) and mental fatigue (p < 0.0001).
CONCLUSION
Fifteen years after diagnosis, cancer survivors reported more general and mental fatigue compared with controls. Our results reinforce guidelines, identifying fatigue as a persistent symptom.
DOI: 10.1007/s00520-020-05427-8
PubMed: 32253602
Affiliations:
- France, Norvège
- Alsace (région administrative), Basse-Normandie, Bourgogne-Franche-Comté, Franche-Comté, Grand Est, Région Normandie
- Besançon, Caen, Strasbourg
- Université de Caen Basse-Normandie, Université de Strasbourg
Links toward previous steps (curation, corpus...)
Le document en format XML
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<author><name sortKey="Mercier, Mariette" sort="Mercier, Mariette" uniqKey="Mercier M" first="Mariette" last="Mercier">Mariette Mercier</name>
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<author><name sortKey="Velten, Michel" sort="Velten, Michel" uniqKey="Velten M" first="Michel" last="Velten">Michel Velten</name>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged (MeSH)</term>
<term>Anxiety (psychology)</term>
<term>Breast Neoplasms (psychology)</term>
<term>Breast Neoplasms (therapy)</term>
<term>Cancer Survivors (psychology)</term>
<term>Chronic Disease (psychology)</term>
<term>Colonic Neoplasms (psychology)</term>
<term>Colonic Neoplasms (therapy)</term>
<term>Fatigue (psychology)</term>
<term>Female (MeSH)</term>
<term>France (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Male (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>Neoplasm Recurrence, Local (psychology)</term>
<term>Quality of Life (psychology)</term>
<term>Registries (MeSH)</term>
<term>Research Design (MeSH)</term>
<term>Surveys and Questionnaires (MeSH)</term>
<term>Uterine Cervical Neoplasms (psychology)</term>
<term>Uterine Cervical Neoplasms (therapy)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen (MeSH)</term>
<term>Anxiété (psychologie)</term>
<term>Enquêtes et questionnaires (MeSH)</term>
<term>Enregistrements (MeSH)</term>
<term>Fatigue (psychologie)</term>
<term>Femelle (MeSH)</term>
<term>France (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Maladie chronique (psychologie)</term>
<term>Mâle (MeSH)</term>
<term>Plan de recherche (MeSH)</term>
<term>Qualité de vie (psychologie)</term>
<term>Récidive tumorale locale (psychologie)</term>
<term>Sujet âgé (MeSH)</term>
<term>Survivants du cancer (psychologie)</term>
<term>Tumeurs du col de l'utérus (psychologie)</term>
<term>Tumeurs du col de l'utérus (thérapie)</term>
<term>Tumeurs du côlon (psychologie)</term>
<term>Tumeurs du côlon (thérapie)</term>
<term>Tumeurs du sein (psychologie)</term>
<term>Tumeurs du sein (thérapie)</term>
</keywords>
<keywords scheme="MESH" type="geographic" xml:lang="en"><term>France</term>
</keywords>
<keywords scheme="MESH" qualifier="psychologie" xml:lang="fr"><term>Anxiété</term>
<term>Fatigue</term>
<term>Maladie chronique</term>
<term>Qualité de vie</term>
<term>Récidive tumorale locale</term>
<term>Survivants du cancer</term>
<term>Tumeurs du col de l'utérus</term>
<term>Tumeurs du côlon</term>
<term>Tumeurs du sein</term>
</keywords>
<keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Anxiety</term>
<term>Breast Neoplasms</term>
<term>Cancer Survivors</term>
<term>Chronic Disease</term>
<term>Colonic Neoplasms</term>
<term>Fatigue</term>
<term>Neoplasm Recurrence, Local</term>
<term>Quality of Life</term>
<term>Uterine Cervical Neoplasms</term>
</keywords>
<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Breast Neoplasms</term>
<term>Colonic Neoplasms</term>
<term>Uterine Cervical Neoplasms</term>
</keywords>
<keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Tumeurs du col de l'utérus</term>
<term>Tumeurs du côlon</term>
<term>Tumeurs du sein</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Aged</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Registries</term>
<term>Research Design</term>
<term>Surveys and Questionnaires</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term>
<term>Enquêtes et questionnaires</term>
<term>Enregistrements</term>
<term>Femelle</term>
<term>France</term>
<term>Humains</term>
<term>Mâle</term>
<term>Plan de recherche</term>
<term>Sujet âgé</term>
</keywords>
<keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>France</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b>
</p>
<p>While several studies have documented fatigue during and after cancer treatment, long-term cancer survivor fatigue is underreported. In this study, we compare fatigue, quality of life (QoL), and anxiety between relapse-free cancer survivors 15 years after diagnosis and healthy controls.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>METHODS</b>
</p>
<p>Cancer survivors (CS) were randomly selected from three large population-based cancer registries (Bas-Rhin, Calvados, and Doubs, France). Cancer-free controls were randomly selected from electoral lists with stratification on age group, residence area, and gender. All participants completed self-reported fatigue (MFI), QoL (EORTC QLQ-C30), and anxiety (STAI) questionnaires. Univariable and multivariable logistic regression were used to study the association between fatigue and cancer status, in three cancer subgroups: breast cancer (BC), cervical cancer (CC), and colorectal cancer (CRC).</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS</b>
</p>
<p>Two hundred sixty-three CS and 688 controls (125/275, 45/153, 93/260 CS/controls for BC, CC, and CRC respectively) were included. The mean age was 66 years. In multivariable analyses, CS had higher general and mental fatigue than controls p = 0.04 and p = 0.02, respectively. No difference in QoL was observed between CS and controls. CS were more anxious than controls (p < 0.01). Anxiety was associated with general fatigue (p < 0.0001) and mental fatigue (p < 0.0001).</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSION</b>
</p>
<p>Fifteen years after diagnosis, cancer survivors reported more general and mental fatigue compared with controls. Our results reinforce guidelines, identifying fatigue as a persistent symptom.</p>
</div>
</front>
</TEI>
<pubmed><MedlineCitation Status="MEDLINE" IndexingMethod="Curated" Owner="NLM"><PMID Version="1">32253602</PMID>
<DateCompleted><Year>2021</Year>
<Month>01</Month>
<Day>14</Day>
</DateCompleted>
<DateRevised><Year>2021</Year>
<Month>01</Month>
<Day>14</Day>
</DateRevised>
<Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1433-7339</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>28</Volume>
<Issue>12</Issue>
<PubDate><Year>2020</Year>
<Month>Dec</Month>
</PubDate>
</JournalIssue>
<Title>Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer</Title>
<ISOAbbreviation>Support Care Cancer</ISOAbbreviation>
</Journal>
<ArticleTitle>Cancer-related fatigue among long-term survivors of breast, cervical, and colorectal cancer: a French registry-based controlled study.</ArticleTitle>
<Pagination><MedlinePgn>5839-5849</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1007/s00520-020-05427-8</ELocationID>
<Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">While several studies have documented fatigue during and after cancer treatment, long-term cancer survivor fatigue is underreported. In this study, we compare fatigue, quality of life (QoL), and anxiety between relapse-free cancer survivors 15 years after diagnosis and healthy controls.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">Cancer survivors (CS) were randomly selected from three large population-based cancer registries (Bas-Rhin, Calvados, and Doubs, France). Cancer-free controls were randomly selected from electoral lists with stratification on age group, residence area, and gender. All participants completed self-reported fatigue (MFI), QoL (EORTC QLQ-C30), and anxiety (STAI) questionnaires. Univariable and multivariable logistic regression were used to study the association between fatigue and cancer status, in three cancer subgroups: breast cancer (BC), cervical cancer (CC), and colorectal cancer (CRC).</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">Two hundred sixty-three CS and 688 controls (125/275, 45/153, 93/260 CS/controls for BC, CC, and CRC respectively) were included. The mean age was 66 years. In multivariable analyses, CS had higher general and mental fatigue than controls p = 0.04 and p = 0.02, respectively. No difference in QoL was observed between CS and controls. CS were more anxious than controls (p < 0.01). Anxiety was associated with general fatigue (p < 0.0001) and mental fatigue (p < 0.0001).</AbstractText>
<AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">Fifteen years after diagnosis, cancer survivors reported more general and mental fatigue compared with controls. Our results reinforce guidelines, identifying fatigue as a persistent symptom.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Gernier</LastName>
<ForeName>François</ForeName>
<Initials>F</Initials>
<AffiliationInfo><Affiliation>Clinical Research Departement, François Baclesse Comprehensive Cancer Center, UNICANCER, 3 av General Harris, Caen, 14076, France. f.gernier@baclesse.unicancer.fr.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>INSERM, U1086, Caen, France. f.gernier@baclesse.unicancer.fr.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Joly</LastName>
<ForeName>Florence</ForeName>
<Initials>F</Initials>
<AffiliationInfo><Affiliation>Clinical Research Departement, François Baclesse Comprehensive Cancer Center, UNICANCER, 3 av General Harris, Caen, 14076, France.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>INSERM, U1086, Caen, France.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>UMR-S1077, Université de Caen Basse-Normandie, Caen, France.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Department of Oncology, CHU de Caen, Caen, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Klein</LastName>
<ForeName>Delphine</ForeName>
<Initials>D</Initials>
<AffiliationInfo><Affiliation>Registre des cancers du Bas-Rhin, Inserm IRFAC UMR-S 1113, Université de Strasbourg, Strasbourg, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Mercier</LastName>
<ForeName>Mariette</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>EA3181, University of Franche-Comté, Besançon, France.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>INSERM UMR 1098, University of Franche-Comte, Besançon, France.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>French National Quality of Life in Oncology Platform, Besançon, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Velten</LastName>
<ForeName>Michel</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Registre des cancers du Bas-Rhin, Inserm IRFAC UMR-S 1113, Université de Strasbourg, Strasbourg, France.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Service de Santé Publique, Centre Paul Strauss, Strasbourg, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Licaj</LastName>
<ForeName>Idlir</ForeName>
<Initials>I</Initials>
<AffiliationInfo><Affiliation>Clinical Research Departement, François Baclesse Comprehensive Cancer Center, UNICANCER, 3 av General Harris, Caen, 14076, France.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>INSERM, U1086, Caen, France.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>Department of Community Medicine, Faculty of Health Sciences, The UiT Arctic University of Norway, Tromsø, Norway.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<GrantList CompleteYN="Y"><Grant><GrantID>None</GrantID>
<Agency>Institut National Du Cancer</Agency>
<Country></Country>
</Grant>
<Grant><GrantID>none</GrantID>
<Agency>French hospital research program (Programme Hospitalier de Recherche Clinique)</Agency>
<Country></Country>
</Grant>
</GrantList>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic"><Year>2020</Year>
<Month>04</Month>
<Day>06</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo><Country>Germany</Country>
<MedlineTA>Support Care Cancer</MedlineTA>
<NlmUniqueID>9302957</NlmUniqueID>
<ISSNLinking>0941-4355</ISSNLinking>
</MedlineJournalInfo>
<CitationSubset>IM</CitationSubset>
<MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D001007" MajorTopicYN="N">Anxiety</DescriptorName>
<QualifierName UI="Q000523" MajorTopicYN="N">psychology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D001943" MajorTopicYN="N">Breast Neoplasms</DescriptorName>
<QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName>
<QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000073116" MajorTopicYN="N">Cancer Survivors</DescriptorName>
<QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D002908" MajorTopicYN="N">Chronic Disease</DescriptorName>
<QualifierName UI="Q000523" MajorTopicYN="N">psychology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D003110" MajorTopicYN="N">Colonic Neoplasms</DescriptorName>
<QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName>
<QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005221" MajorTopicYN="N">Fatigue</DescriptorName>
<QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005602" MajorTopicYN="N" Type="Geographic">France</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D009364" MajorTopicYN="N">Neoplasm Recurrence, Local</DescriptorName>
<QualifierName UI="Q000523" MajorTopicYN="N">psychology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D011788" MajorTopicYN="N">Quality of Life</DescriptorName>
<QualifierName UI="Q000523" MajorTopicYN="N">psychology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D012042" MajorTopicYN="N">Registries</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D012107" MajorTopicYN="N">Research Design</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D011795" MajorTopicYN="N">Surveys and Questionnaires</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D002583" MajorTopicYN="N">Uterine Cervical Neoplasms</DescriptorName>
<QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName>
<QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName>
</MeshHeading>
</MeshHeadingList>
<KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Breast cancer</Keyword>
<Keyword MajorTopicYN="N">Cervical cancer</Keyword>
<Keyword MajorTopicYN="N">Colorectal cancer</Keyword>
<Keyword MajorTopicYN="N">Fatigue</Keyword>
<Keyword MajorTopicYN="N">Long-term survivors</Keyword>
<Keyword MajorTopicYN="N">Population-based study</Keyword>
</KeywordList>
</MedlineCitation>
<PubmedData><History><PubMedPubDate PubStatus="received"><Year>2019</Year>
<Month>11</Month>
<Day>21</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="accepted"><Year>2020</Year>
<Month>03</Month>
<Day>19</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="pubmed"><Year>2020</Year>
<Month>4</Month>
<Day>8</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="medline"><Year>2021</Year>
<Month>1</Month>
<Day>15</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="entrez"><Year>2020</Year>
<Month>4</Month>
<Day>8</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
</History>
<PublicationStatus>ppublish</PublicationStatus>
<ArticleIdList><ArticleId IdType="pubmed">32253602</ArticleId>
<ArticleId IdType="doi">10.1007/s00520-020-05427-8</ArticleId>
<ArticleId IdType="pii">10.1007/s00520-020-05427-8</ArticleId>
</ArticleIdList>
</PubmedData>
</pubmed>
<affiliations><list><country><li>France</li>
<li>Norvège</li>
</country>
<region><li>Alsace (région administrative)</li>
<li>Basse-Normandie</li>
<li>Bourgogne-Franche-Comté</li>
<li>Franche-Comté</li>
<li>Grand Est</li>
<li>Région Normandie</li>
</region>
<settlement><li>Besançon</li>
<li>Caen</li>
<li>Strasbourg</li>
</settlement>
<orgName><li>Université de Caen Basse-Normandie</li>
<li>Université de Strasbourg</li>
</orgName>
</list>
<tree><country name="France"><region name="Région Normandie"><name sortKey="Gernier, Francois" sort="Gernier, Francois" uniqKey="Gernier F" first="François" last="Gernier">François Gernier</name>
</region>
<name sortKey="Gernier, Francois" sort="Gernier, Francois" uniqKey="Gernier F" first="François" last="Gernier">François Gernier</name>
<name sortKey="Joly, Florence" sort="Joly, Florence" uniqKey="Joly F" first="Florence" last="Joly">Florence Joly</name>
<name sortKey="Joly, Florence" sort="Joly, Florence" uniqKey="Joly F" first="Florence" last="Joly">Florence Joly</name>
<name sortKey="Joly, Florence" sort="Joly, Florence" uniqKey="Joly F" first="Florence" last="Joly">Florence Joly</name>
<name sortKey="Joly, Florence" sort="Joly, Florence" uniqKey="Joly F" first="Florence" last="Joly">Florence Joly</name>
<name sortKey="Klein, Delphine" sort="Klein, Delphine" uniqKey="Klein D" first="Delphine" last="Klein">Delphine Klein</name>
<name sortKey="Licaj, Idlir" sort="Licaj, Idlir" uniqKey="Licaj I" first="Idlir" last="Licaj">Idlir Licaj</name>
<name sortKey="Licaj, Idlir" sort="Licaj, Idlir" uniqKey="Licaj I" first="Idlir" last="Licaj">Idlir Licaj</name>
<name sortKey="Mercier, Mariette" sort="Mercier, Mariette" uniqKey="Mercier M" first="Mariette" last="Mercier">Mariette Mercier</name>
<name sortKey="Mercier, Mariette" sort="Mercier, Mariette" uniqKey="Mercier M" first="Mariette" last="Mercier">Mariette Mercier</name>
<name sortKey="Mercier, Mariette" sort="Mercier, Mariette" uniqKey="Mercier M" first="Mariette" last="Mercier">Mariette Mercier</name>
<name sortKey="Velten, Michel" sort="Velten, Michel" uniqKey="Velten M" first="Michel" last="Velten">Michel Velten</name>
<name sortKey="Velten, Michel" sort="Velten, Michel" uniqKey="Velten M" first="Michel" last="Velten">Michel Velten</name>
</country>
<country name="Norvège"><noRegion><name sortKey="Licaj, Idlir" sort="Licaj, Idlir" uniqKey="Licaj I" first="Idlir" last="Licaj">Idlir Licaj</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>
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