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73 results on '"Service d'Urologie - Transplantation Rénale - Andrologie"'

51. Nephron-sparing surgery for renal tumors measuring more than 7 cm: morbidity, and functional and oncological outcomes

Author: Idir Ouzaid, Yann Neuzillet, Michel Soulié, Vincent Ravery, Guillaume Ploussard, Hervé Baumert, Evanguelos Xylinas, Morgan Rouprêt, Tarek Fardoun, Nicolas Grenier, Olivier Merigot de Treigny, Karim Bensalah, Laurent Bellec, Denis Chautard, Gregory Verhoest, Edouard Robine, Laurent Brureau, Pierre Bigot, Jean-Jacques Patard, Bernard Escudier, C. Maurin, Jean-François Hetet, Jean-Christophe Bernhard, Abdel-Rahmène Azzouzi, Marc Zerbib, Thomas Bessede, Souhil Lebdai, Jean-Alexandre Long, Nathalie Rioux-Leclercq, Jean Rouffilange, Philippe Paparel, François Audenet, Jérôme Rigaud, N. Hoarau, Laurence Bastien, Pierre Mongiat-Artus, Géraldine Pignot, Service d'urologie, Université d'Angers ( UA ) -CHU Angers, Service d'urologie, andrologie et transplantation rénale, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Service d'urologie [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Institut Mondor de Recherche Biomédicale ( IMRB ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), INSERM U955, équipe 7, Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ) -Institut Mondor de Recherche Biomédicale ( IMRB ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -IFR10, Service d'urologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Cochin [AP-HP], Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications [Grenoble] ( TIMC-IMAG ), Université Joseph Fourier - Grenoble 1 ( UJF ) -Institut polytechnique de Grenoble - Grenoble Institute of Technology ( Grenoble INP ) -IMAG-Centre National de la Recherche Scientifique ( CNRS ) -Université Grenoble Alpes ( UGA ), CHU Grenoble-Hôpital Michallon, CHU Angers, Service d'urologie et transplantation rénales [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Institut Mondor de recherche biomédicale ( IMRB ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), FLIRT, Fédération pour L'étude de l'Ischémie Reperfusion en Transplantation, Service d'Urologie [CHU Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Diderot - Paris 7 ( UPD7 ) -Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Institut de Génétique et Développement de Rennes ( IGDR ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Centre National de la Recherche Scientifique ( CNRS ) -Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), urology, Assistance publique - Hôpitaux de Paris (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Hôtel-Dieu, Service d'Urologie - Transplantation Rénale - Andrologie, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Hôpital Saint-Joseph, Oncologie génito-urinaire, Département de médecine oncologique [Gustave Roussy], Institut Gustave Roussy ( IGR ) -Institut Gustave Roussy ( IGR ), Service d'urologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] ( CHLS ), Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ), Imagerie moléculaire et fonctionnelle: de la physiologie à la thérapie, Université Bordeaux Segalen - Bordeaux 2-IFR8-Centre National de la Recherche Scientifique ( CNRS ), Service d'Imagerie Diagnostique et Interventionnelle de l'Adulte, CHU Bordeaux [Bordeaux], Service de Génétique Moléculaire, Jonchère, Laurent, Université d'Angers (UA)-Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire d'Angers (CHU Angers), Service d'Urologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Mondor de recherche biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Institut de Génétique et Développement de Rennes (IGDR), Université de Rennes (UR)-Centre National de la Recherche Scientifique (CNRS)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Département d'Urologie-Andrologie et Transplantation Rénale [CHU Toulouse], Pôle Urologie - Néphrologie - Dialyse - Transplantations - Brûlés - Chirurgie plastique - Explorations fonctionnelles et physiologiques [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Institut Gustave Roussy (IGR)-Institut Gustave Roussy (IGR), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Université Bordeaux Segalen - Bordeaux 2-IFR8-Centre National de la Recherche Scientifique (CNRS), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Centre National de la Recherche Scientifique (CNRS)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)
Subjects: Adult, Male, medicine.medical_specialty, Survival, Urology, medicine.medical_treatment, Population, 030232 urology & nephrology, Renal function, [SDV.GEN] Life Sciences [q-bio]/Genetics, Malignancy, Nephrectomy, Disease-Free Survival, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Renal cell carcinoma, Risk Factors, medicine, Humans, Risk factor, education, Carcinoma, Renal Cell, Aged, Retrospective Studies, Aged, 80 and over, education.field_of_study, [SDV.GEN]Life Sciences [q-bio]/Genetics, business.industry, Hazard ratio, Perioperative, Nephrons, Robotics, Middle Aged, medicine.disease, Kidney Neoplasms, 3. Good health, Survival Rate, Treatment Outcome, Oncology, 030220 oncology & carcinogenesis, Female, Laparoscopy, Neoplasm Recurrence, Local, business, [ SDV.GEN ] Life Sciences [q-bio]/Genetics
Abstract: International audience; BACKGROUND: The purpose of this study was to evaluate morbidity, functional, and oncological outcomes after NSS in renal tumors \textgreater 7 cm. MATERIALS AND METHODS: We retrospectively analyzed data from 168 patients with tumors \textgreater 7 cm who were treated using NSS between 1998 and 2012. RESULTS: Imperative and elective indications accounted for 76 (45.2%) and 92 (54.8%) patients, respectively. Major perioperative complications and renal function deterioration occurred in 33 (19.6%) and 51 patients (30.4%), respectively. In multivariate analysis, age older than 60 years (P = .001; hazard ratio [HR], 5) and tumor malignancy (P = .014; HR, 6.7) were prognostic factors for renal function deterioration whereas imperative indication was a risk factor for major postoperative complications (P = .0019; HR, 2.7). In 126 (75%) patients with malignant tumors, after a median follow-up of 30 months (range, 1-254 months), 25 patients (20.2%) died. In multivariate analysis, imperative indication (P = .023; HR, 4.2), positive surgical margin (P = .021; HR, 3.3), and Fuhrman grade \textgreater II (P = .013; HR, 3.7) were prognostic indicators for cancer-free survival (CFS). Imperative indication (P = .04; HR, 8.5) and Fuhrman grade \textgreater II (P = .04; HR, 3.9) were predictive factors of cancer-specific survival (CSS). In case of elective indication, positive surgical margin, local recurrence, and cancer-related death occurred in 4 (7.6%), 1 (1.1%), and 1 (1.1%) cases, respectively. For elective indication, 5-year estimates of CFS, CSS, and overall survival rates were: 85.7%, 98%, and 93.9%, respectively. CONCLUSION: In this selected population, imperative vs. elective indication status seems to play a critical role in oncologic outcomes. Oncologic results for elective indications are close to those reported with radical nephrectomy.
Published: 2014

52. Local recurrence after radical nephrectomy for kidney cancer: management and prediction of outcomes. a multi-institutional study

Author: Paparel, Philippe, Bigot, Pierre, Matillon, Xavier, Bensalah, Karim, Salomon, Laurent, Baumert, Hervé, Bastide, Cyril, Thuret, Rodolphe, Karsenty, Gilles, Long, Jean Alexandre, Ammi, Myriam, Bessede, Thomas, Bin, Sylvie, Roux, Adeline, Escudier, Bernard, Rioux Leclercq, Nathalie, Pignot, Géraldine, Soulie, Michel, Patard, Jean-Jacques, Service d'urologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] ( CHLS ), Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ), Service d'urologie, Université d'Angers ( UA ) -CHU Angers, Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Service d'urologie [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Institut Mondor de Recherche Biomédicale ( IMRB ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Hôpital Saint-Joseph, Service Urologie [Lapeyronie], Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Hôpital Lapeyronie, Chirurgie urologique et transplantation rénale [Hôpital de la Conception - APHM], Aix Marseille Université ( AMU ) -Assistance Publique - Hôpitaux de Marseille ( APHM ) -Hôpital de la Conception [CHU - APHM] ( LA CONCEPTION ), CHU Grenoble, Université Joseph Fourier - Grenoble 1 ( UJF ) -CHU Grenoble, Oncologie génito-urinaire, Département de médecine oncologique [Gustave Roussy], Institut Gustave Roussy ( IGR ) -Institut Gustave Roussy ( IGR ), Institut de Génétique et Développement de Rennes ( IGDR ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Centre National de la Recherche Scientifique ( CNRS ) -Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service d'urologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Cochin [AP-HP], Service d'Urologie - Transplantation Rénale - Andrologie, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Service de Génétique Moléculaire, CHU Bordeaux [Bordeaux], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Université d'Angers (UA)-Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, Institut Gustave Roussy (IGR)-Institut Gustave Roussy (IGR), Institut de Génétique et Développement de Rennes (IGDR), Université de Rennes (UR)-Centre National de la Recherche Scientifique (CNRS)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Département d'Urologie-Andrologie et Transplantation Rénale [CHU Toulouse], Pôle Urologie - Néphrologie - Dialyse - Transplantations - Brûlés - Chirurgie plastique - Explorations fonctionnelles et physiologiques [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Centre National de la Recherche Scientifique (CNRS)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), and Jonchère, Laurent
Subjects: Male, [SDV.GEN]Life Sciences [q-bio]/Genetics, Time Factors, Carcinoma, Adrenalectomy, [SDV.GEN] Life Sciences [q-bio]/Genetics, Middle Aged, Prognosis, Nephrectomy, Combined Modality Therapy, Kidney Neoplasms, Neoplasm Recurrence, Local, Multivariate Analysis, Lymph Node Excision, Humans, Female, Lymph Nodes, Neoplasm Recurrence, Local, [ SDV.GEN ] Life Sciences [q-bio]/Genetics, Retrospective Studies
Abstract: International audience; BACKGROUND: Local recurrence (LR) after radical nephrectomy (RN) for kidney cancer is uncommon. Our objectives were to analyse characteristics and therapeutic options of LR after RN and to identify survival prognostic factors. MATERIALS AND METHODS: From a multi-institutional retrospective database, we identified 72 patients who experienced LR after RN. RESULTS: Mean time to LR was 26.5 ± 3.3 months. The location of the recurrence was renal fossa, regional lymph node, homolateral adrenal and both renal fossa and regional lymph node for 43 (59.7%), 27 (37.5%), 9 (12.5%) and 7 (9.7%) patients, respectively. Patients were treated by surgery, systemic therapies, combination of therapies and palliative treatment in 24 (33.3%), 18 (25%), 24 (33.3%) and 6 (8.4%) cases, respectively. Within a mean follow-up of 26.4 ± 3.3 months from the date of local recurrence, 12 (16.6%) patients were alive without disease, 30 (41.7%) patients were alive with disease, 30 patients (41.6%) died including 28 (38.8%) from the disease. In multivariate analysis, time to recurrence \textless1 year (P \textless 0.001; HR: 4.81) and surgical treatment (P = 0.027; HR: 0.33) were predictive factors. CONCLUSIONS: Local recurrence after radical nephrectomy is associated with poor prognosis. The time to recurrence and the completeness of the surgical treatment are major prognostic factors.
Published: 2014

53. Résultats des injections intra-détrusoriennes de toxine botulique A chez les patients spina-bifida

Author: Pascal Rischmann, M. Soulié, M. Damphousse, Mathieu Roumiguié, Juliette Hascoet, X. Gamé, B. Peyronnet, Evelyne Castel-Lacanal, Laurent Siproudhis, Andrea Manunta, Charlène Brochard, Philippe Marque, Service de Chirurgie Hépatobiliaire et Digestive [Rennes] = Hepatobiliary and Digestive Surgery [Rennes], CHU Pontchaillou [Rennes], Service d'Urologie - Transplantation Rénale - Andrologie, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Foie, métabolismes et cancer, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Département d'urologie, Département d'Urologie-Andrologie et Transplantation Rénale [CHU Toulouse], Pôle Urologie - Néphrologie - Dialyse - Transplantations - Brûlés - Chirurgie plastique - Explorations fonctionnelles et physiologiques [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )
Subjects: Gynecology, 03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, business.industry, [SDV]Life Sciences [q-bio], 030220 oncology & carcinogenesis, Urology, 030232 urology & nephrology, medicine, business, 3. Good health
Abstract: National audience; Objectifs Il existe très peu de données dans la littérature sur l’efficacité des injections intra-détrusoriennes de toxine botulique A (BoTx) chez les patients spina-bifida. L’objectif de cette étude était d’évaluer les résultats des injections intra-détrusoriennes de BoTx chez les patients spina-bifida. Méthodes Tous les patients spina-bifida traités par injections intra-détrusoriennes de BoTx entre 2006 et 2014 dans 2 centres ont été inclus rétrospectivement. Tous les patients blessés médullaires traités par injections intra-détrusoriennes de BoTx durant cette même période ont également été inclus en tant que groupe contrôle. Tous les patients remplissaient un calendrier mictionnel et avaient un bilan urodynamique avant et 6 semaines après l’injection. Le succès de l’injection de toxine était défini comme une disparition des urgenturies, de l’incontinence urinaire et de l’hyperactivité détrusorienne et un nombre d’autosondages inférieur à 8 par jour. Résultats Vingt-cinq patients spina-bifida et 81 blessés médullaires ont été inclus. Les patients spina étaient plus jeunes que dans le groupe des blessés médullaires (27,9 ans contre 38,9 ans ; p = 0,0002). Les taux de succès (52 % contre 63 % ; p = 0,34) et de résolution de l’incontinence urinaire (68 % vs 71 % ; p = 0,44) étaient comparables entre les 2 groupes. Dix patients spina avaient un trouble de la compliance (compliance < 20 mL/cm H2O) contre 16 patients blessés médullaires (40 % contre 19 % ; p = 0,04). Dans ce sous-groupe, le taux de succès était inférieur chez les spina-bifida (20 % contre 69 % ; p = 0,02). Conclusion En considérant l’ensemble des patients, l’efficacité de la toxine botulique chez les sujets spina-bifida est comparable à celle observée chez les blessés médullaires. En revanche, l’efficacité de la toxine botulique est nettement inférieure pour les troubles de compliance des spina-bifida par comparaison aux troubles de la compliance des blessés médullaires
Published: 2015

54. Predictive Factors of Oncologic Outcomes in Patients Who do not Achieve Undetectable Prostate Specific Antigen after Radical Prostatectomy

Author: Michel Soulié, Guillaume Ploussard, Frédéric Staerman, Sébastien Vincendeau, Morgan Rouprêt, Tarek Fardoun, Jean Pierrevelcin, Rodrigue Saad, Cyrille Bastide, M. Peyromaure, Nicolas Barry Delongchamps, François Audenet, Arnauld Villers, Laurent Salomon, Jean-Baptiste Beauval, Jérôme Rigaud, INSERM U955, équipe 7, Service d'urologie [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), AP-HP Hôpital universitaire Robert-Debré [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'Urologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Service d'urologie, Hôtel-Dieu, Hôpital Huriez-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service d'Urologie - Transplantation Rénale - Andrologie, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Département d'Urologie-Andrologie et Transplantation Rénale [CHU Toulouse], Pôle Urologie - Néphrologie - Dialyse - Transplantations - Brûlés - Chirurgie plastique - Explorations fonctionnelles et physiologiques [CHU Toulouse], and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)
Subjects: Male, PCA3, medicine.medical_specialty, Urology, medicine.medical_treatment, [SDV]Life Sciences [q-bio], 030232 urology & nephrology, Salvage therapy, Metastasis, Androgen deprivation therapy, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, Prostate, medicine, Humans, prostate-specific antigen, salvage therapy, Retrospective Studies, prostate, prostatectomy, business.industry, Prostatectomy, Prostatic Neoplasms, Prognosis, medicine.disease, 3. Good health, Prostate-specific antigen, Treatment Outcome, medicine.anatomical_structure, 030220 oncology & carcinogenesis, business
Abstract: International audience; Purpose We identified factors predicting oncologic outcomes in cases of persistently detectable prostate specific antigen. Materials and Methods We reviewed the charts of patients treated with radical prostatectomy between 1998 and 2011 at a total of 14 centers. Study inclusion criteria were radical prostatectomy for presumed localized prostate cancer, absent positive nodes and detectable prostate specific antigen, defined as prostate specific antigen 0.1 ng/ml or greater 6 weeks postoperatively. Of the 9,735 radical prostatectomy cases reviewed 496 (5.1%) were eligible for analysis. Predictive factors for oncologic outcomes were assessed in time dependent analyses using the Kaplan-Meier method and Cox regression models. Results At 6 weeks prostate specific antigen was 0.1 to 6.8 ng/ml. Biochemical progression was noted in 74.4% of patients and clinical metastasis was noted in 5%. The 2 most powerful predictors of general salvage treatment (vs radiotherapy) were postoperative prostate specific antigen greater than 1 ng/ml (OR 3.46, p = 0.032) and prostate specific antigen velocity greater than 0.2 ng/ml per year (HR 6.01, p = 0.001). Positive prostate specific antigen velocity was the single factor that independently correlated with the risk of failed salvage therapy (HR 2.6, p = 0.001). The 5-year disease-free survival rate was 81.0% in patients with stable or negative prostate specific antigen velocity compared with 58.4% in those with positive prostate specific antigen velocity (p
Published: 2013

55. Is there a volume-outcome relationship for partial nephrectomy?

Author: F. Salome, Laurent Zini, Laurent Bellec, P. Gimel, Michel Soulié, Karim Bensalah, F. Bruyère, J.P. Ansieau, Hervé Baumert, A. Mejean, Christian Pfister, J.J. Patard, Pierre Bigot, Christophe Vaessen, Jean-Christophe Bernhard, Géraldine Pignot, L. Salomon, Jacques Hubert, E. Mourey, J.L. Jung, Jean-Baptiste Rigaud, Herve Lang, Marc-Olivier Timsit, M. Rouprêt, J.-P. Couapel, J. Berger, Service d'Urology [Rennes], CHU Pontchaillou [Rennes], service d'urologie [CHU Bordeaux], CHU Bordeaux [Bordeaux], Service d'urologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'Urologie, andrologie et transplantation rénale [CHRU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service d'Urologie [Strasbourg], CHU Strasbourg, Service d'Urologie [Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Service d'urologie [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service d'Urologie - Transplantation Rénale - Andrologie, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Service d'Urologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service d'Urologie [Colmar], CH Colmar, Service d'Urologie [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service d'Urologie [Angers], Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Service d'urologie [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau, Service de Chirurgie urologique et andrologie [CHU Limoges], CHU Limoges, Service d'Urologie [Mulhouse], Centre Hospitalier Emile Muller [Mulhouse] (CH E.Muller Mulhouse), Groupe Hospitalier de Territoire Haute Alsace (GHTHA)-Groupe Hospitalier de Territoire Haute Alsace (GHTHA), Centre de Médecine Générale Avicenne [Cabestany], Polyclinique de Limoges - site François Chénieux [Limoges], Service d'Urologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'urologie [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Groupe Hospitalier Paris Saint Joseph, Service de Microbiologie [CHU GeorgesPompidou], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Service d'Urologie [CHU Georges Pompidou], Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Service d'Urologie [CHU de Bicêtre], AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)
Subjects: Nephrology, Adult, medicine.medical_specialty, Hospitals, Low-Volume, genetic structures, Urology, medicine.medical_treatment, 030232 urology & nephrology, Nephrectomy, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Hospital volume, Renal cell carcinoma, Internal medicine, medicine, Humans, Prospective Studies, Aged, Aged, 80 and over, Volume outcome, business.industry, Middle Aged, medicine.disease, Kidney Neoplasms, 3. Good health, Surgery, Treatment Outcome, 030220 oncology & carcinogenesis, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Hospitals, High-Volume
Abstract: International audience; OBJECTIVE:To investigate the impact of hospital volume on partial nephrectomy indications and outcomes.MATERIALS AND METHODS:Data were extracted from the National Observational Registry on the Practice and Hemostasis in Partial Nephrectomy registry. Four groups were created according to the number of partial nephrectomy (PN) performed: very high (VH, ≥ 19 PN), high (H, 10-18 PN), moderate (M, 4-9 PN) and low (L
Published: 2013

56. National prospective study on the use of local haemostatic agents during partial nephrectomy

Author: Lang, Herve, Mouracade, Pascal, Gimel, Pierre, Bernhard, Jean, Pignot, Géraldine, Zini, Laurent, Crépel, Maxime, Rigaud, Jérôme, Salomon, Laurent, Bellec, Laurent, Vaessen, Christophe, Roupret, Morgan, Jung, Jean, Mourey, Eric, MARTIN, Xavier, Bigot, Pierre, Bruyere, Franck, Berger, Julien, Ansieau, Jean, Salome, Franck, Hubert, Jacques, Pfister, Christian, Trifard, François, Gigante, Marc, Baumert, Hervé, Méjean, Arnaud, Patard, Jean, Les Hôpitaux Universitaires de Strasbourg (HUS), Centre de Médecine Générale Avicenne [Cabestany], CHU de Bordeaux Pellegrin [Bordeaux], Service d'urologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Pontchaillou [Rennes], Centre hospitalier universitaire de Nantes (CHU Nantes), Service d'urologie [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service d'Urologie - Transplantation Rénale - Andrologie, Service d'Urologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital du Bocage, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Service d'urologie [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau, CHU Limoges, Centre Hospitalier Emile Muller [Mulhouse] (CH E.Muller Mulhouse), Groupe Hospitalier de Territoire Haute Alsace (GHTHA), Polyclinique de Limoges - site François Chénieux [Limoges], Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service d'urologie [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Centre hospitalier Saint-Brieuc, Service d'urologie-andrologie, CHU Saint-Etienne-Université Jean Monnet [Saint-Étienne] (UJM)-Hôpital nord, Centre hospitalier Saint-Joseph [Paris], Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), UL, IADI, Département d'Urologie-Andrologie et Transplantation Rénale [CHU Toulouse], Pôle Urologie - Néphrologie - Dialyse - Transplantations - Brûlés - Chirurgie plastique - Explorations fonctionnelles et physiologiques [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CHU Saint-Etienne-Université Jean Monnet - Saint-Étienne (UJM)-Hôpital nord, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], and Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Adult, Aged, 80 and over, Male, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Intraoperative Care, partial nephrectomy, nephron-sparing surgery, haemostatic agent, Middle Aged, Nephrectomy, Hemostatics, Young Adult, haemostasis, tissue sealants, Humans, Female, France, Prospective Studies, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Aged
Abstract: International audience; OBJECTIVE:To assess the use of local haemostatic agents (HAs) in a prospective multicentre large series of partial nephrectomies (PNs).PATIENTS AND METHODS:Prospective National Observational Registry on the Practices of Haemostasis in Partial Nephrectomy (NEPHRON): the study was conducted in 54 French urological centres from 1 June to 31 December 2010. In all, 570 consecutive patients undergoing a PN were enrolled in this study in a prospective manner. The data was collected prospectively via an electronic case-report form: five different sheets were included for preoperative, perioperative, postoperative and follow-up data respectively. Information related to haemostasis was analysed.RESULTS:The median patient age was 60 years and the mean (range) tumour size was 3.68 (0.19-15) cm. An HA was primarily used in 71.4% of patients, with a statistically significant difference among surgical approaches (P = 0.024). In 91.8% of cases, a single use of a HA was sufficient for achieving haemostasis. The HA was used either alone (13.9%) or in association with sutures (80.3%). One or more additional haemostatic action(s) was needed in 12.3% of the cases. When comparing patients who received a HA with those who did not receive a HA, there was no statistical difference between the groups for tumour size (P = 0.542), collecting system drainage (P = 0.538), hospital stay (P = 0.508), operation time (P = 0.169), blood loss (P = 0.387) or transfusion rate (P = 0.713).CONCLUSION:HAs are widely used by urologists during PN. Progress is needed for standardising HA application, especially for the timing of application. For the time being, the role of the HA in nephron-sparing surgery is still to be evaluated.
Published: 2013

57. [Nitric oxide pathway and female lower urinary tract. Physiological and pathophysiological role]

Author: Gamé, Xavier, Rischmann, Pascal, Arnal, Jean-François, Malavaud, Bernard, Service d'Urologie - Transplantation Rénale - Andrologie, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Département d'Urologie-Andrologie et Transplantation Rénale [CHU Toulouse], Pôle Urologie - Néphrologie - Dialyse - Transplantations - Brûlés - Chirurgie plastique - Explorations fonctionnelles et physiologiques [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), and Simon, Marie Francoise
Subjects: MESH: Signal Transduction, Nitric Oxide Synthase Type III, MESH: Urinary Bladder, Overactive, Bladder, Urinary Bladder, MESH: Nitric Oxide Synthase Type I, Nitric Oxide Synthase Type I, MESH: Urinary Tract Infections, Lower urinary tract, urologic and male genital diseases, Urethra, MESH: Urinary Bladder, MESH: Urinary Tract, Humans, Women, Urinary Tract, Urinary Tract Physiological Phenomena, MESH: Humans, Phosphoric Diester Hydrolases, Urinary Bladder, Overactive, MESH: Biological Markers, Nitric oxide, MESH: Urinary Tract Physiological Phenomena, female genital diseases and pregnancy complications, MESH: Urinary Bladder Neck Obstruction, Urinary Bladder Neck Obstruction, Urinary Incontinence, MESH: Urethra, MESH: Metabolic Networks and Pathways, MESH: Nitric Oxide, Urinary Tract Infections, Female, MESH: Nitric Oxide Synthase, Nitric Oxide Synthase, MESH: Female, MESH: Phosphoric Diester Hydrolases, Biomarkers, Metabolic Networks and Pathways, MESH: Nitric Oxide Synthase Type III, Signal Transduction, MESH: Urinary Incontinence
Abstract: International audience; GOAL: The aim was to review the literature on nitric oxide and female lower urinary tract. MATERIAL: A literature review through the PubMed library until December, 31 2012 was carried out using the following keywords: lower urinary tract, bladder, urethra, nervous central system, innervation, female, women, nitric oxide, phosphodiesterase, bladder outlet obstruction, urinary incontinence, overactive bladder, urinary tract infection. RESULTS: Two nitric oxide synthase isoforms, the neuronal (nNOS) and the endothelial (eNOS), are constitutively expressed in the lower urinary tract. Nevertheless, nNOS is mainly expressed in the bladder neck and the urethra. In the bladder, NO modulates the afferent neurons activity. In pathological condition, inducible NOS expression induces an increase in detrusor contractility and bladder wall thickness and eNOS facilitates Escherichia coli bladder wall invasion inducing recurrent urinary tract infections. In the urethra, NO play a major role in smooth muscle cells relaxation. CONCLUSION: The NO pathway plays a major role in the female lower urinary tract physiology and physiopathology. While it acts mainly on bladder outlet, in pathological condition, it is involved in bladder dysfunction occurrence.
Published: 2013

58. [CCAFU Recommendations 2013: Renal cancer]

Author: Patard, J.-J., Baumert, H., Bensalah, K., Bernhard, J.-C., Bigot, P., Escudier, B., Grenier, N., Hétet, J.-F., Long, J.-A., Méjean, A., Paparel, P., Richard, S., Rioux-Leclercq, N., Coloby, P., Soulié, M., CCAFU, Les, Service d'urologie, andrologie et transplantation rénale, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Imagerie moléculaire et fonctionnelle: de la physiologie à la thérapie, Université Bordeaux Segalen - Bordeaux 2-IFR8-Centre National de la Recherche Scientifique (CNRS), Laboratoire de recherche en Hydrodynamique, Énergétique et Environnement Atmosphérique (LHEEA), École Centrale de Nantes (ECN)-Centre National de la Recherche Scientifique (CNRS), Service d'urologie, CHU Grenoble-Hôpital Michallon, Applications des ultrasons à la thérapie, Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Physiopathologie cardiovasculaire, Université Montpellier 1 (UM1)-IFR3, Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'anatomie et cytologie pathologiques [Rennes] = Anatomy and Cytopathology [Rennes], CHU Pontchaillou [Rennes], Institut de Génétique et Développement de Rennes (IGDR), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Centre National de la Recherche Scientifique (CNRS)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service d'Urologie - Transplantation Rénale - Andrologie, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Université de Rennes (UR)-Centre National de la Recherche Scientifique (CNRS)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Département d'Urologie-Andrologie et Transplantation Rénale [CHU Toulouse], Pôle Urologie - Néphrologie - Dialyse - Transplantations - Brûlés - Chirurgie plastique - Explorations fonctionnelles et physiologiques [CHU Toulouse], and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)
Subjects: [SDV]Life Sciences [q-bio], Decision Trees, Humans, urologic and male genital diseases, Carcinoma, Renal Cell, Kidney Neoplasms
Abstract: International audience; INTRODUCTION: The renal sub Committee of the CCAFU established guidelines for diagnosis, treatment, evaluation and standard of care for renal cell carcinoma. METHODS: 2010 Guidelines were updated based on systematic literature search performed by the sub-Committee in Medline and PubMed databases to evaluate references, levels of evidence and grade of recommendation. RESULTS: Multiphasic CT is the standard imaging technique for renal tumors diagnosis. Percutaneous renal biopsies are increasingly important for the management of localized RCC. Partial Nephrectomy is the first option when technically feasible for cT1 tumours. Open surgery remains the standard approach for locally advanced RCCs. New drugs are available for the treatment of metastatic RCC while the role of nephrectomy needs to be established by the Carmena trial. CONCLUSIONS: Conservative and mini-invasive therapies are increasingly important for the management of localized RCC. Therapeutic armamentarium continues to increase in mRCC.
Published: 2013

59. Hypoxia, therapeutic resistance and sphingosine 1-phosphate

Author: Cuvillier, Olivier, Ader, Isabelle, Bouquerel, Pierre, Brizuela, Leyre, Gstalder, Cécile, Malavaud, Bernard, Institut de pharmacologie et de biologie structurale (IPBS), Centre National de la Recherche Scientifique (CNRS)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Service d'Urologie - Transplantation Rénale - Andrologie, CHU Toulouse [Toulouse]-Hôpital de Rangueil, and CHU Toulouse [Toulouse]
Subjects: [SDV.BBM.BC]Life Sciences [q-bio]/Biochemistry, Molecular Biology/Biochemistry [q-bio.BM]
Abstract: Hypoxia, defined as a poor oxygenation, has been long recognized as a hallmark of solid tumor and an negative prognostic factor for response to therapeutics and survival of patients. Cancer cells have evolved biochemical mechanisms that allow them to react and adapt to hypoxia. Ath the cellular level this adaptation is under the control of two related transcription factor, HIF-1 and HIF-2 (hypoxia-inducible factor), that respond rapidly to decreased levels to activate the expression of a broad range of genes promoting neoangiogenesis, glycolysis, metastasis, increased tumor growth and resistance to treatments. Recent studies have identifed the sphingosine kinase 1/sphingosis 1-phosphate (SphK1/S1P) signaling pathway - which elicits various cellular processes including cell proliferation cell survival or angiogenesis - as a new regulator of HIF-1 or HIF-2 activity. In this review, we will focus on how the inhibition-neutralization of the SphK1/S1Psignaling could be exploited for cancer therapy.
Published: 2012

60. Renal cell carcinoma (RCC) in patients with end-stage renal disease exhibits many favourable clinical, pathologic, and outcome features compared with RCC in the general population

Author: Laurent Salomon, Lionel Badet, Georges Karam, Jacques Tostain, Pierre Bigot, Nathalie Rioux-Leclercq, Sébastien Barbet, Jean-Etienne Terrier, Bernard Escudier, Michel Soulié, Hicham Elkentaoui, Abdel-Rahmène Azzouzi, Fabrice Dugardin, Yann Neuzillet, Jean-Christophe Bernhard, Jacques Hubert, Aurélien Descazeaux, Karim Fehri, Nicolas Brichart, Philippe Paparel, J.M. Boutin, Laurent Guy, Baptiste Tisserand, Arnaud Mejean, Ismaël Galliot, Marc-Olivier Timsit, Laurence Bastien, Jérôme Rigaud, Antoine Valeri, Jacques Petit, Laurent Zini, Benoit Barrou, Christian Pfister, Xavier Tillou, Franck Bruyère, Fabien Saint, Herve Lang, Jean-Jacques Patard, Marie-Dominique Azemar, Denis Chautard, Julien Branchereau, Hervé Wallerand, Pascal Rischmann, Laura Poissonnier, Charles Deruelle, Lucille Martin, Laurence Albiges, Jacques Irani, Arnauld Villers, Thierry Lebret, Hervé Baumert, François Kleinclauss, Nicolas Terrier, Jean-Alexandre Long, Pierre-Etienne Theveniaud, M. Gigante, Frédéric Staerman, Jean-Marie Ferriere, Romain Mathieu, Morgan Rouprêt, F. Sallusto, Benoit Feuillu, Service d'urologie, Hôpital Foch [Suresnes], CHU Amiens-Picardie, Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-CHU Pontchaillou [Rennes], CHU Grenoble-Hôpital Michallon, Service d'urologie-andrologie, CHU Saint-Etienne-Université Jean Monnet [Saint-Étienne] ( UJM ) -Hôpital nord, Service d'urologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] ( CHLS ), Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ), Hôpital Saint-Joseph, Département de médecine oncologique [Gustave Roussy], Institut Gustave Roussy ( IGR ), CHU Strasbourg, Service d'anatomie et cytologie pathologiques [Rennes], Université d'Angers ( UA ) -CHU Angers, Service d'urologie, andrologie et transplantation rénale, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Institut Mondor de recherche biomédicale ( IMRB ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Service d'urologie [Tours], Hôpital Bretonneau-CHRU Tours, Hôtel-Dieu, Service d'Urologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Hôpital Huriez-Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Service de Chirurgie urologique et andrologie [CHU Limoges], CHU Limoges, Service d'urologie et transplantation rénales [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Service de Néphrologie et Urologie, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques, Service d'urologie [Rouen], CHU Rouen-Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Normandie Université ( NU ), Université de Reims Champagne-Ardenne ( URCA ), Centre hospitalier universitaire de Poitiers ( CHU Poitiers ) -Hôpital La Milétrie, Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Descartes - Paris 5 ( UPD5 ) -CHU Necker - Enfants Malades [AP-HP], Service d'Urologie - Transplantation Rénale - Andrologie, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], CHU Clermont-Ferrand-Hôpital Gabriel Montpied, Université de Brest ( UBO ) -Centre Hospitalier Régional Universitaire de Brest ( CHRU Brest ), Service d'urologie [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Université Paris-Sud - Paris 11 ( UP11 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Bicêtre, members of the Comité de Transplantation de l'Association Française d'Urologie, the Comité de Cancérologie de l'Association Française d'Urologie, Service d'urologie [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], CHU Saint-Etienne-Université Jean Monnet [Saint-Étienne] (UJM)-Hôpital nord, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Institut Gustave Roussy (IGR), Université d'Angers (UA)-Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Institut Mondor de recherche biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Bretonneau-Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Hôpital Huriez-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service d'urologie et transplantation rénales [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Hôpital Saint-Jacques, CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Université de Reims Champagne-Ardenne (URCA), Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Hôpital La Milétrie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Bicêtre-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11), Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Service d'anatomie et cytologie pathologiques [Rennes] = Anatomy and Cytopathology [Rennes], CHU Pontchaillou [Rennes], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau, Service d'Urologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, De Villemeur, Hervé, CHU Saint-Etienne-Université Jean Monnet - Saint-Étienne (UJM)-Hôpital nord, Département d'Urologie-Andrologie et Transplantation Rénale [CHU Toulouse], Pôle Urologie - Néphrologie - Dialyse - Transplantations - Brûlés - Chirurgie plastique - Explorations fonctionnelles et physiologiques [CHU Toulouse], and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)
Subjects: Male, [ SDV.MHEP.UN ] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, MESH: Chi-Square Distribution, Time Factors, MESH : Retrospective Studies, 030232 urology & nephrology, MESH : Aged, Kaplan-Meier Estimate, MESH: Risk Assessment, urologic and male genital diseases, Gastroenterology, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, MESH: Proportional Hazards Models, MESH : Carcinoma, Renal Cell, 0302 clinical medicine, Renal cell carcinoma, MESH: Risk Factors, Risk Factors, MESH : Female, MESH : Neoplasm Staging, MESH : Risk Assessment, MESH: Treatment Outcome, MESH: Aged, education.field_of_study, Univariate analysis, MESH: Middle Aged, MESH: Carcinoma, Renal Cell, MESH: Neoplasm Staging, Middle Aged, MESH : Adult, MESH : Survival Rate, MESH : Risk Factors, Kidney Neoplasms, 3. Good health, Survival Rate, Treatment Outcome, MESH: Kidney Failure, Chronic, 030220 oncology & carcinogenesis, Female, France, MESH : Time Factors, Adult, medicine.medical_specialty, MESH: Survival Rate, Urology, MESH : Male, Population, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH : Treatment Outcome, Risk Assessment, MESH : Kidney Failure, Chronic, End stage renal disease, MESH : Kaplan-Meier Estimate, 03 medical and health sciences, [SDV.CAN] Life Sciences [q-bio]/Cancer, Internal medicine, medicine, Humans, MESH : Middle Aged, education, MESH : France, Survival rate, Carcinoma, Renal Cell, MESH: Kaplan-Meier Estimate, Aged, Neoplasm Staging, Proportional Hazards Models, Retrospective Studies, MESH: Humans, Chi-Square Distribution, MESH : Chi-Square Distribution, business.industry, MESH: Time Factors, MESH : Humans, MESH: Adult, MESH: Retrospective Studies, medicine.disease, MESH : Proportional Hazards Models, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, MESH: Male, MESH : Kidney Neoplasms, Surgery, Transplantation, MESH: France, Kidney Failure, Chronic, MESH: Kidney Neoplasms, business, Kidney cancer, MESH: Female, Kidney disease
Abstract: International audience; BACKGROUND: Patients with end-stage renal disease (ESRD) are at risk of developing renal tumours. OBJECTIVE: Compare clinical, pathologic, and outcome features of renal cell carcinomas (RCCs) in ESRD patients and in patients from the general population. DESIGN, SETTING, AND PARTICIPANTS: Twenty-four French university departments of urology participated in this retrospective study. INTERVENTION: All patients were treated according to current European Association of Urology guidelines. MEASUREMENTS: Age, sex, symptoms, tumour staging and grading, histologic subtype, and outcome were recorded in a unique database. Categoric and continuous variables were compared by using chi-square and student statistical analyses. Cancer-specific survival (CSS) was assessed by Kaplan-Meier and Cox methods. RESULTS AND LIMITATIONS: The study included 1250 RCC patients: 303 with ESRD and 947 from the general population. In the ESRD patients, age at diagnosis was younger (55 ± 12 yr vs 62 ± 12 yr); mean tumour size was smaller (3.7 ± 2.6 cm vs 7.3 ± 3.8 cm); asymptomatic (87% vs 44%), low-grade (68% vs 42%), and papillary tumours were more frequent (37% vs 7%); and poor performance status (PS; 24% vs 37%) and advanced T categories (≥ 3) were more rare (10% vs 42%). Consistently, nodal invasion (3% vs 12%) and distant metastases (2% vs 15%) occurred less frequently in ESRD patients. After a median follow-up of 33 mo (range: 1-299 mo), 13 ESRD patients (4.3%), and 261 general population patients (27.6%) had died from cancer. In univariate analysis, histologic subtype, symptoms at diagnosis, poor PS, advanced TNM stage, high Fuhrman grade, large tumour size, and non-ESRD diagnosis context were adverse predictors for survival. However, only PS, TNM stage, and Fuhrman grade remained independent CSS predictors in multivariate analysis. The limitation of this study is related to the retrospective design. CONCLUSIONS: RCC arising in native kidneys of ESRD patients seems to exhibit many favourable clinical, pathologic, and outcome features compared with those diagnosed in patients from the general population.
Published: 2011

61. Oncologic outcomes and survival in pT0 tumors after radical cystectomy in patients without neoadjuvant chemotherapy: results from a large multicentre collaborative study

Author: Jean-Jacques Patard, Henry Botto, Evanguelos Xylinas, Jeremy Crew, Christian Pfister, Karim Bensalah, Vincent Flamand, Pascal Rischmann, Michel Soulié, François-Xavier Nouhaud, Benoit Peyronnet, Julien Casenave, François Iborra, François Rozet, Laurent Salomon, Stéphane Larré, Morgan Rouprêt, Stéphane Droupy, Hervé Wallerand, Sophie Ferlicot, Aurélie Paule Floch, Maryam Hitier, Yann Neuzillet, Laura Poissonnier, Pascale Grès, Luc Cormier, Jacques Irani, Jean-Nicolas Cornu, Xavier Durand, Sarah J. Drouin, Cyrille Bastide, Pierre Lunardi, Jérôme Rigaud, Denis Champetier, Service d'Urologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Department of Urology, Hôpital Foch [Suresnes], Service d'urologie, Hôtel-Dieu, Service d'urologie [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service Urologie [Lapeyronie], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, Service d'Urologie [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service d'Urologie - Transplantation Rénale - Andrologie, Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Hôpital La Milétrie, Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Service d'urologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Service d'urologie, andrologie et transplantation rénale, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Service d'urologie [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Bladder Cancer Committee of the French National Association of Urology ('CC-AFU Vessie'), Service d'urologie et transplantation rénales [CHU Pitié-Salpêtrière], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Service d'urologie [Rennes], Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes]
Subjects: Oncology, Male, medicine.medical_treatment, 030218 nuclear medicine & medical imaging, 0302 clinical medicine, MESH: Aged, 80 and over, Medicine, Neoadjuvant therapy, MESH: Aged, Aged, 80 and over, education.field_of_study, 030219 obstetrics & reproductive medicine, MESH: Middle Aged, MESH: Neoplasm Staging, MESH: Follow-Up Studies, Middle Aged, Prognosis, Neoadjuvant Therapy, 3. Good health, MESH: Urinary Bladder Neoplasms, Survival Rate, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Female, MESH: Neoplasm Recurrence, Local, Adult, medicine.medical_specialty, MESH: Survival Rate, Urology, Population, MESH: Neoadjuvant Therapy, [SDV.CAN]Life Sciences [q-bio]/Cancer, Cystectomy, MESH: Prognosis, 03 medical and health sciences, Text mining, Internal medicine, Humans, In patient, education, Survival rate, Survival analysis, Aged, Neoplasm Staging, Retrospective Studies, MESH: Carcinoma, Transitional Cell, Chemotherapy, Carcinoma, Transitional Cell, MESH: Humans, Proportional hazards model, business.industry, MESH: Cystectomy, Retrospective cohort study, MESH: Adult, MESH: Retrospective Studies, MESH: Male, Urinary Bladder Neoplasms, Surgery, Lymphadenectomy, Neoplasm Recurrence, Local, business, MESH: Female, Follow-Up Studies
Abstract: International audience; PURPOSE: To assess the postsurgical survival of patients with urothelial carcinoma of the bladder with pT0 tumor at pathologic examination of cystectomy specimens. METHODS: A multi-institutional, retrospective database was analyzed with data from 4758 radical cystectomy (RC) patients who underwent RC without neoadjuvant chemotherapy and who were diagnosed with pT0 on the basis of the pathologic specimen. Survival curves were estimated. A multivariate Cox model was used to evaluate the association between prognosis factors and disease recurrence or survival. RESULTS: Overall, 258 patients (5.4%) were included in the study. The median age was 64 years. At last resection, 171 tumors were invasive (at least pT2), and 87 were not. Median follow-up was 51 months. At multivariate analysis, initial location of the tumor and absence of lymphadenectomy were associated with tumor recurrence (P = 0.03 and P = 0.005, respectively) and specific mortality (P = 0.005 and 0.001, respectively). The main limitation of the study is its retrospective design, which is due to the rarity of this situation. Cancer-specific and recurrence-free survival rates were 89 and 85%, respectively, at 5 years and 82 and 80%, respectively, at 10 years. CONCLUSIONS: Despite acceptable oncological outcomes, patients with a pT0 tumor at the time of RC are still at risk of recurrence and progression and should not be considered to be entirely cured. In this population, stringent follow-up according to current recommendations should be effective.
Published: 2011

62. Predictive factors for ipsilateral recurrence after nephron-sparing surgery in renal cell carcinoma

Author: Karim Bensalah, Laurent Salomon, Clement Claude Abbou, Allan J. Pantuck, Maxime Crepel, Grégoire Robert, Laurent Bellec, Jacques Tostain, Jean-Marie Ferriere, B. Albouy, Michel Soulié, Arie S. Belldegrun, Jean-Christophe Bernhard, Bertrand Lacroix, D. Lopes, Sylvie Maurice-Tison, Christian Pfister, Jean-Jacques Patard, Alexandre de la Taille, Marc Colombel, Hervé Wallerand, Rodolphe Thuret, Gilles Pasticier, Service d'urologie, andrologie et transplantation rénale, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Department of Urology, University of California [Los Angeles] (UCLA), University of California-University of California, Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Service d'Urologie - Transplantation Rénale - Andrologie, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Service d'information médicale, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Service d'urologie [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service d'urologie [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service d'urologie-andrologie, CHU Saint-Etienne-Université Jean Monnet [Saint-Étienne] (UJM)-Hôpital nord, Service Urologie [Lapeyronie], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, Service d'urologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), University of California (UC)-University of California (UC), Département d'Urologie-Andrologie et Transplantation Rénale [CHU Toulouse], Pôle Urologie - Néphrologie - Dialyse - Transplantations - Brûlés - Chirurgie plastique - Explorations fonctionnelles et physiologiques [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CHU Saint-Etienne-Université Jean Monnet - Saint-Étienne (UJM)-Hôpital nord, De Villemeur, Hervé, Service d'urologie [Rennes], Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes]
Subjects: Male, MESH: Tumor Burden, [SDV.MHEP.CHI] Life Sciences [q-bio]/Human health and pathology/Surgery, medicine.medical_treatment, 030232 urology & nephrology, Nephrectomy, Surgery, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, MESH: Proportional Hazards Models, 0302 clinical medicine, Renal cell carcinoma, Risk Factors, MESH: Risk Factors, Local recurrence, Multicenter Studies as Topic, MESH: Aged, MESH: Middle Aged, MESH: Carcinoma, Renal Cell, MESH: Neoplasm Staging, Middle Aged, Prognosis, Kidney Neoplasms, Tumor Burden, 030220 oncology & carcinogenesis, Female, Nephron sparing surgery, MESH: Neoplasm Recurrence, Local, medicine.medical_specialty, Urology, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, MESH: Prognosis, 03 medical and health sciences, Text mining, [SDV.CAN] Life Sciences [q-bio]/Cancer, Carcinoma, medicine, Humans, In patient, Carcinoma, Renal Cell, Aged, Neoplasm Staging, Proportional Hazards Models, Retrospective Studies, MESH: Humans, business.industry, Proportional hazards model, fungi, Retrospective cohort study, MESH: Retrospective Studies, medicine.disease, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, MESH: Male, MESH: Nephrectomy, MESH: Multicenter Studies as Topic, Neoplasm Recurrence, Local, MESH: Kidney Neoplasms, business, MESH: Female
Abstract: Ipsilateral recurrence after nephron-sparing surgery (NSS) is rare, and little is known about its specific determinants.To determine clinical or pathologic features associated with ipsilateral recurrence after NSS performed for renal cell carcinoma (RCC).We analysed 809 NSS procedures performed at eight academic institutions for sporadic RCCs retrospectively.Age, gender, indication, tumour bilaterality, tumour size, tumour location, TNM stage, Fuhrman grade, histologic subtype, and presence of positive surgical margins (PSMs) were assessed as predictors for recurrence in univariate and multivariate analysis by using a Cox proportional hazards regression model.Among 809 NSS procedures with a median follow-up of 27 (1-252) mo, 26 ipsilateral recurrences (3.2%) occurred at a median time of 27 (14.5-38.2) mo. In univariate analysis, the following variables were significantly associated with recurrence: pT3a stage (p=0.0489), imperative indication (p0.01), tumour bilaterality (p0.01), tumour size4cm (p0.01), Fuhrman grade III or IV (p=0.0185), and PSM (p0.01). In multivariate analysis, tumour bilaterality, tumour size4cm, and presence of PSM remained independent predictive factors for RCC ipsilateral recurrence. Hazard ratios (HR) were 6.31, 4.57, and 11.5 for tumour bilaterality, tumour size4cm, and PSM status, respectively. The main limitations of this study included its retrospective nature and a short follow-up.RCC ipsilateral recurrence risk after NSS is significantly associated with tumour size4cm, tumour bilaterality (synchronous or asynchronous), and PSM. Careful follow-up should be advised in patients presenting with such characteristics.
Published: 2010

63. Avancées et synthèse des derniers congrès : ASCO-GU, EAU, AUA, ASCO concernant la prise en charge médicale du cancer du rein localement avancé ou métastatique. [Progress and summary of recent congress: ASCO-GU, EAU, AUA, ASCO about the medical management of locally advanced or metastatic kidney cancer]

Author: Patard, Jean-Jacques, Escudier, Bernard, Paparel, Philippe, Neuzillet, Yann, Long, Jean-Alexandre, Baumert, Hervé, Corréas, Jean-Michel, Lang, Hervé, Poissonnier, Laura, Rioux-Leclercq, Nathalie, Soulié, Michel, Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Institut de Génétique et Développement de Rennes (IGDR), Université de Rennes (UR)-Centre National de la Recherche Scientifique (CNRS), Département d'Urologie-Andrologie et Transplantation Rénale [CHU Toulouse], Pôle Urologie - Néphrologie - Dialyse - Transplantations - Brûlés - Chirurgie plastique - Explorations fonctionnelles et physiologiques [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Service d'urologie, Hôpital Foch [Suresnes], CHU Strasbourg, Service d'anatomie et cytologie pathologiques [Rennes] = Anatomy and Cytopathology [Rennes], CHU Pontchaillou [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Centre National de la Recherche Scientifique (CNRS), PRES Université de Toulouse, Service d'Urologie - Transplantation Rénale - Andrologie, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], and De Villemeur, Hervé
Subjects: MESH: Nephrectomy, MESH: Humans, [SDV.CAN] Life Sciences [q-bio]/Cancer, MESH: Disease Progression, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH: Kidney Neoplasms, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, MESH: Neoplasm Metastasis, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, MESH: Congresses as Topic, MESH: Prognosis
Abstract: International audience; During the recent congress of urology and oncology key topics discussed were the evolution of survival data in metastatic kidney cancer which median is now around 40 months, persistent questions about the role of nephrectomy, including access to the systemic treatment of nephrectomized patients and tumor resectability induced by systemic therapies, the emergence of new prognostic models which are adapted to new therapeutic standards, and the emergence of promising new drugs including pazopanib. This article describes these advances.
Published: 2010

64. Positive surgical margin appears to have negligible impact on survival of renal cell carcinomas treated by nephron-sparing surgery

Author: Romain Spie, Jérôme Rigaud, Jacques Tostain, Michel Soulié, Bastien Rambeaud, Hendrik Van Poppel, Alfredo Aguilera, Maxime Crepel, Laurent Zini, Ofer Nativ, Jean Marie Ferriere, Luis Martinez Pineiro, Steven Joniau, Patrick J. Bastian, Rodolphe Thuret, Jean Jacques Patard, Stefan C. Müller, Frédéric Pouliot, Jean-Christophe Bernhard, Amnon Zisman, Andreas H. Wille, Christian Pfister, Pascal Rischmann, Nicolas Mottet, Laurent Bellec, Alexandre de la Taille, Allan J. Pantuck, Laurent Guy, Thierry Dujardin, R. Avakian, Jan Roigas, François Richard, Nathalie Rioux-Leclercq, Christian Doehn, Pierre I. Karakiewicz, Arie S. Belldegrun, Roberto Bertini, Orit E. Raz, Karim Bensalah, Laurent Salomon, B. Albouy, T. Culty, Thierry Lebret, Morgan Rouprêt, A. Villers, Francesco Montorsi, Fabien Saint, Herve Lang, Roy Farfara, Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Department of Urology, University of California [Los Angeles] (UCLA), University of California-University of California, Service Urologie [Lapeyronie], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, Department of urology, Università Vita-Salute San Raffaele, Cancer Prognostics and Health Outcomes Unit, Université de Montréal (UdeM), Cancer Prognostics and Health Outcome Unit, Service d'urologie-andrologie, CHU Saint-Etienne-Université Jean Monnet [Saint-Étienne] (UJM)-Hôpital nord, Université Jean Monnet [Saint-Étienne] (UJM), Service d'urologie, Hôpital Huriez-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service d'urologie [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service d'Urologie - Transplantation Rénale - Andrologie, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), National and Kapodistrian University of Athens (NKUA), Service d'urologie, andrologie et transplantation rénale, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Université Fédérale Toulouse Midi-Pyrénées, Université de Nantes (UN), Service d'urologie [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Image Science for Interventional Techniques (ISIT), Université d'Auvergne - Clermont-Ferrand I (UdA)-Centre National de la Recherche Scientifique (CNRS)-Clermont Université, Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), Hôpital Foch [Suresnes], Université de Picardie Jules Verne (UPJV), Assaf Harofeh Medical Centre, Tel Aviv University [Tel Aviv]-Assaf Harofeh Medical Centre, CHU Strasbourg, Berlin Charity Hospital, La Paz University Hospital, Bnai Zion Hospital, Service d'Urologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Lubeck University Hospital, Bonn University Hospital, Institut de Génétique et Développement de Rennes (IGDR), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Centre National de la Recherche Scientifique (CNRS), University of California (UC)-University of California (UC), CHU Saint-Etienne-Université Jean Monnet - Saint-Étienne (UJM)-Hôpital nord, Université Jean Monnet - Saint-Étienne (UJM), Département d'Urologie-Andrologie et Transplantation Rénale [CHU Toulouse], Pôle Urologie - Néphrologie - Dialyse - Transplantations - Brûlés - Chirurgie plastique - Explorations fonctionnelles et physiologiques [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université d'Auvergne - Clermont-Ferrand I (UdA)-Clermont Université-Centre National de la Recherche Scientifique (CNRS), Tel Aviv University (TAU)-Assaf Harofeh Medical Centre, Université de Rennes (UR)-Centre National de la Recherche Scientifique (CNRS), De Villemeur, Hervé, Bensalah, Karim, Pantuck Allan, J., Rioux Leclercq, Nathalie, Thuret, Rodolphe, Montorsi, Francesco, Karakiewicz Pierre, I., Mottet, Nicola, Zini, Laurent, Bertini, Roberto, Salomon, Laurent, Villers, Arnaud, Soulie, Michel, Bellec, Laurent, Rischmann, Pascal, De La Taille, Alexandre, Avakian, Raffi, Crepel, Maxime, Ferriere Jean, Marie, Bernhard Jean, Christophe, Dujardin, Thierry, Pouliot, Frederic, Rigaud, Jerome, Pfister, Christian, Albouy, Baptiste, Guy, Laurent, Joniau, Steven, van Poppel, Hendrik, Lebret, Thierry, Culty, Thibault, Saint, Fabien, Zisman, Amnon, Raz, Orit, Lang, Herve, Spie, Romain, Wille, Andrea, Roigas, Jan, Aguilera, Alfredo, Rambeaud, Bastien, Martinez Pineiro, Lui, Nativ, Ofer, Farfara, Roy, Richard, Francoi, Roupret, Morgan, Doehn, Christian, Bastian Patrick, J., Muller Stefan, C., Tostain, Jacque, Belldegrun Arie, S., Patard Jean, Jacques, Service d'Urologie - Andrologie [CHU Saint-Etienne], Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E)-Université Jean Monnet - Saint-Étienne (UJM), Université de Toulouse (UT), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and University Hospital Bonn
Subjects: Surgical margin, medicine.medical_specialty, [SDV.MHEP.CHI] Life Sciences [q-bio]/Human health and pathology/Surgery, MESH: Survival Rate, Urology, medicine.medical_treatment, 030232 urology & nephrology, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, Nephrectomy, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, 03 medical and health sciences, 0302 clinical medicine, [SDV.CAN] Life Sciences [q-bio]/Cancer, Renal cell carcinoma, Predictive Value of Tests, medicine, Humans, Survival rate, Carcinoma, Renal Cell, MESH: Nephrons, Retrospective Studies, MESH: Humans, MESH: Middle Aged, Proportional hazards model, business.industry, Retrospective cohort study, MESH: Retrospective Studies, Nephrons, MESH: Carcinoma, Renal Cell, Middle Aged, medicine.disease, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, Kidney Neoplasms, MESH: Predictive Value of Tests, 3. Good health, Surgery, Survival Rate, MESH: Nephrectomy, 030220 oncology & carcinogenesis, Predictive value of tests, MESH: Kidney Neoplasms, business, Kidney cancer
Abstract: International audience; BACKGROUND: The occurrence of positive surgical margins (PSMs) after partial nephrectomy (PN) is rare, and little is known about their natural history. OBJECTIVE: To identify predictive factors of cancer recurrence and related death in patients having a PSM following PN. DESIGN, SETTING, AND PARTICIPANTS: Some 111 patients with a PSM were identified from a multicentre retrospective survey and were compared with 664 negative surgical margin (NSM) patients. A second cohort of NSM patients was created by matching NSM to PSM for indication, tumour size, and tumour grade. MEASUREMENTS: PSM and NSM patients were compared using student t tests and chi-square tests on independent samples. A Cox proportional hazards regression model was used to test the independent effects of clinical and pathologic variables on survival. RESULTS AND LIMITATIONS: Mean age at diagnosis was 61+/-12.5 yr. Mean tumour size was 3.5+/-2 cm. Imperative indications accounted for 39% (43 of 111) of the cases. Some 18 patients (16%) underwent a second surgery (partial or total nephrectomy). With a mean follow-up of 37 mo, 11 patients (10%) had recurrences and 12 patients (11%) died, including 6 patients (5.4%) who died of cancer progression. Some 91% (10 of 11) of the patients who had recurrences and 83% of the patients (10 of 12) who died belonged to the group with imperative surgical indications. Rates of recurrence-free survival, of cancer-specific survival, and of overall survival were the same among NSM patients and PSM patients. The multivariable Cox model showed that the two variables that could predict recurrence were the indication (p=0.017) and tumour location (p=0.02). No other variable, including PSM status, had any effect on recurrence. None of the studied parameters had any effect on the rate of cancer-specific survival. CONCLUSIONS: PSM status occurs more frequently in cases in which surgery is imperative and is associated with an increased risk of recurrence, but PSM status does not appear to influence cancer-specific survival. Additional follow-up is needed.
Published: 2010

65. Acute page kidney after a kidney allograft biopsy: successful outcome from observation and medical treatment

Author: Federico Sallusto, Lionel Rostaing, Nassim Kamar, Institut de médecine moléculaire de Rangueil (I2MR), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-IFR150-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Néphrologie - Hypertension Artérielle Dialyse - Transplantation, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Service d'Urologie - Transplantation Rénale - Andrologie, Centre de Physiopathologie Toulouse Purpan (CPTP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées- Institut Fédératif de Recherche Bio-médicale Institution (IFR150)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département d'Urologie-Andrologie et Transplantation Rénale [CHU Toulouse], Pôle Urologie - Néphrologie - Dialyse - Transplantations - Brûlés - Chirurgie plastique - Explorations fonctionnelles et physiologiques [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), and Simon, Marie Francoise
Subjects: MESH: Signal Transduction, 030232 urology & nephrology, MESH: Genes, p53, 030230 surgery, MESH: Protein Isoforms, MESH: Base Sequence, Bioinformatics, MESH: Hypertension, law.invention, MESH: Kidney Transplantation, MESH: Biopsy, 0302 clinical medicine, law, MESH: Animals, MESH: Tumor Suppressor Protein p53, Zebrafish, MESH: Treatment Outcome, [SDV.MHEP.EM] Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism, Kidney, Gene knockdown, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, MESH: Radiation Tolerance, MESH: Middle Aged, biology, Page kidney, MESH: Diuresis, MESH: DNA, MESH: Sequence Deletion, [SDV.MHEP.EM]Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism, Cell biology, medicine.anatomical_structure, MESH: Acute Disease, Gene isoform, MESH: Zebrafish Proteins, MESH: Creatinine, MESH: Digestive System, MESH: bcl-X Protein, MESH: Animals, Genetically Modified, 03 medical and health sciences, MESH: Promoter Regions, Genetic, medicine, MESH: Diuretics, MESH: Zebrafish, Gene, MESH: RNA, Messenger, MESH: DNA Damage, Transplantation, MESH: Kidney Diseases, MESH: Humans, MESH: Apoptosis, MESH: Feedback, Biochemical, MESH: Genes, Reporter, MESH: Models, Biological, biology.organism_classification, MESH: Male, MESH: Hematoma, Apoptosis, Suppressor, MESH: Transcriptional Activation, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; p53 is a well-known tumor suppressor and is also involved in processes of organismal aging and developmental control. A recent exciting development in the p53 field is the discovery of various p53 isoforms. One p53 isoform is human Delta133p53 and its zebrafish counterpart Delta113p53. These N-terminal-truncated p53 isoforms are initiated from an alternative p53 promoter, but their expression regulation and physiological significance at the organismal level are not well understood. We show here that zebrafish Delta113p53 is directly transactivated by full-length p53 in response to developmental and DNA-damaging signals. More importantly, we show that Delta113p53 functions to antagonize p53-induced apoptosis via activating bcl2L (closest to human Bcl-x(L)), and knockdown of Delta113p53 enhances p53-mediated apoptosis under stress conditions. Thus, we demonstrate that the p53 genetic locus contains a new p53 response gene and that Delta113p53 does not act in a dominant-negative manner toward p53 but differentially modulates p53 target gene expression to antagonize p53 apoptotic activity at the physiological level in zebrafish. Our results establish a novel feedback pathway that modulates the p53 response and suggest that modulation of the p53 pathway by p53 isoforms might have an impact on p53 tumor suppressor activity.
Published: 2009

66. Erectile dysfunction in end-stage liver disease men

Author: Eric Huyghe, Nassim Kamar, Lionel Rostaing, Fabien Wagner, Pierre Plante, Fabrice Muscari, Labib El-Kahwaji, Aude-Hélène Capietto, Simon, Marie Francoise, Département d'Urologie-Andrologie et Transplantation Rénale [CHU Toulouse], Pôle Urologie - Néphrologie - Dialyse - Transplantations - Brûlés - Chirurgie plastique - Explorations fonctionnelles et physiologiques [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Groupe de recherche en fertilité humaine ( GRFH), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Service de Néphrologie - Hypertension Artérielle Dialyse - Transplantation, Institut de médecine moléculaire de Rangueil (I2MR), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées- Institut Fédératif de Recherche Bio-médicale Institution (IFR150)-Institut National de la Santé et de la Recherche Médicale (INSERM), Chirurgie Générale et Digestive [Rangueil], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre de Physiopathologie Toulouse Purpan (CPTP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service d'Urologie - Transplantation Rénale - Andrologie, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], and Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-IFR150-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Adult, Male, medicine.medical_specialty, Cirrhosis, Time Factors, Urology, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Population, Comorbidity, Liver transplantation, 03 medical and health sciences, Liver disease, Young Adult, 0302 clinical medicine, Endocrinology, Erectile Dysfunction, Risk Factors, Internal medicine, medicine, Prevalence, Humans, 030212 general & internal medicine, education, Aged, Hepatitis, education.field_of_study, business.industry, Hepatitis B, Middle Aged, medicine.disease, Health Surveys, 3. Good health, Liver Transplantation, Psychiatry and Mental health, Erectile dysfunction, Reproductive Medicine, 030211 gastroenterology & hepatology, business, Sexual function, Liver Failure
Abstract: Introduction In men, erectile dysfunction (ED) is an important issue. Data concerning ED in men with end-stage liver disease (ESLD) is limited, and the risk factors for ED in this population are still unknown. Aims To determine the prevalence, timescale, and risk factors for ED in ESLD patients candidates to liver transplantation. Methods Patients candidates for a liver transplantation were asked to participate in a mailed survey about sexual function. Among the 123 eligible men, 98 (84%) agreed to complete the questionnaire. Main Outcome Measures The quality of erection was evaluated using the five-item International Index of Erectile Function (IIEF-5) score, and satisfaction for sexuality, using the patient-baseline Treatment-Satisfaction Scale (TSS) score. Other questions also focused on patient perception of changes over time. Results On the overall population, 28 patients (29%) were nonsexually active. Among the 70 patients who were sexually active, 52 patients (74%) had ED. Regarding the development of ED, 50% of the patients perceived that a deterioration of erectile function occurred within the six previous months. The absence of sexual activity was more frequent in hepatitis B or C patients ( P = 0.02). The risk factors for ED were alcohol intake ( P = 0.03), tobacco use ( P = 0.03), and cardiovascular disease ( P = 0.004). The significant risk factors for having a low TSS score were having viral hepatitis ( P = 0.01), and cardiovascular disease ( P = 0.01). Conclusion Population of men with ESLD who are candidates for a liver transplantation is characterized by a high frequency of lack of sexual activity, and by a high prevalence of ED and should be targeted by interventions to improve sexual functioning. These preliminary data need further validation in prospective trial using more comprehensive questionnaires. Huyghe E, Kamar N, Wagner F, Capietto A-H, El-Kahwaji L, Muscari F, Plante P, and Rostaing L. Erectile dysfunction in end-stage liver disease men. J Sex Med 2009;6:1395–1401.
Published: 2009

67. Prognostic variables to predict cancer-related death in incidental renal tumours

Author: Bernard Lobel, Jacques Tostain, Karim Bensalah, Laurent Salomon, Antoine Valeri, Eric Lechevallier, Alexandre de la Taille, Arnaud Méjean, Luca Cindolo, Vincenzo Ficarra, Richard Zigeuner, Francois Guille, Michel Soulié, Allan J. Pantuck, Gregory Verhoest, Jean-Marie Ferriere, Christian Pfister, Jean-Jacques Patard, Luigi Schips, Marc Colombel, Denis Chautard, Arie S. Belldegrun, Claude C. Abbou, Maxime Crepel, Jean-Luc Descotes, Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Institut de Génétique et Développement de Rennes (IGDR), Centre National de la Recherche Scientifique (CNRS)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Service d'urologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Service d'urologie [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service d'urologie, andrologie et transplantation rénale, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Service d'Urologie - Transplantation Rénale - Andrologie, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Oncogénèse des tumeurs respiratoires et urogénitales, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service d'urologie [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service d'urologie-andrologie, CHU Saint-Etienne-Université Jean Monnet [Saint-Étienne] (UJM)-Hôpital nord, Université d'Angers (UA)-Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Service d'urologie et de transplantation rénale, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM), Service de chirurgie, CHU Grenoble-Hôpital Michallon, Service d'urologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Centre National de la Recherche Scientifique (CNRS), Université de Rennes (UR)-Centre National de la Recherche Scientifique (CNRS), Département d'Urologie-Andrologie et Transplantation Rénale [CHU Toulouse], Pôle Urologie - Néphrologie - Dialyse - Transplantations - Brûlés - Chirurgie plastique - Explorations fonctionnelles et physiologiques [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Service d'Urologie - Andrologie [CHU Saint-Etienne], Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E)-Université Jean Monnet - Saint-Étienne (UJM), Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Institut de Génétique et Développement de Rennes ( IGDR ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -IFR140-Centre National de la Recherche Scientifique ( CNRS ), Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Descartes - Paris 5 ( UPD5 ) -CHU Necker - Enfants Malades [AP-HP], Université de Brest ( UBO ) -Centre Hospitalier Régional Universitaire de Brest ( CHRU Brest ), CHU Rouen-Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Normandie Université ( NU ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), CHU Saint-Etienne-Université Jean Monnet [Saint-Étienne] ( UJM ) -Hôpital nord, Université d'Angers ( UA ) -CHU Angers, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille ( APHM ), Centre Hospitalier Lyon Sud [CHU - HCL] ( CHLS ), and Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL )
Subjects: [ SDV.MHEP.UN ] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, Male, MESH : Retrospective Studies, MESH : Aged, 030232 urology & nephrology, Nephrectomy, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, MESH : Carcinoma, Renal Cell, 0302 clinical medicine, MESH: Aged, 80 and over, Renal cell carcinoma, MESH : Neoplasm Staging, MESH : Female, Stage (cooking), MESH: Incidental Findings, Aged, 80 and over, MESH: Aged, Incidental Findings, MESH : Prognosis, MESH: Middle Aged, MESH : Incidental Findings, MESH: Neoplasm Staging, MESH: Carcinoma, Renal Cell, MESH : Adult, Middle Aged, Prognosis, Kidney Neoplasms, 3. Good health, renal cell carcinoma, prognostic factors, MESH: Young Adult, 030220 oncology & carcinogenesis, MESH: Survival Analysis, Female, Radiology, Adult, Prognostic variable, medicine.medical_specialty, Adolescent, MESH : Male, Urology, MESH : Young Adult, [SDV.CAN]Life Sciences [q-bio]/Cancer, MESH: Multivariate Analysis, MESH: Prognosis, Young Adult, 03 medical and health sciences, MESH : Adolescent, medicine, Carcinoma, Humans, MESH : Middle Aged, MESH : Aged, 80 and over, Carcinoma, Renal Cell, Survival analysis, Aged, Neoplasm Staging, Retrospective Studies, MESH: Adolescent, MESH: Humans, Performance status, business.industry, MESH : Humans, MESH : Nephrectomy, MESH : Multivariate Analysis, MESH: Adult, MESH: Retrospective Studies, medicine.disease, Survival Analysis, MESH : Kidney Neoplasms, MESH: Male, Surgery, MESH: Nephrectomy, Multivariate Analysis, T-stage, MESH : Survival Analysis, MESH: Kidney Neoplasms, business, Kidney cancer, MESH: Female
Abstract: International audience; OBJECTIVE: To identify, in a large multicentre series of incidental renal tumours, the key factors that could predict cancer-related deaths, as such tumours have a better outcome than symptomatic tumours and selected patients are increasingly being included in watchful-waiting protocols. PATIENTS AND METHODS: Data from 3912 patients were extracted from three international kidney-cancer databases. Age, gender, Eastern Cooperative Oncology Group (ECOG) performance status (PS), Tumour-Node-Metastasis (TNM) stage, tumour size, Fuhrman grade, and final pathology were recorded. Benign tumours and malignant lesions with incomplete information were excluded from final analysis. RESULTS: The mean (SD) age of the patients was 60.6 (12.2) years and the mean tumour size 5.5 (3.5) cm. Most tumours were malignant (90.2%) and of low stage (T1-T2, 71.7%) and low grade (G1-G2, 72.4%). There were nodal and distant metastases in 5.7% and 13% of the patients. In all, 525 (14.4%) patients died from cancer; in this group, tumours were >4 cm in 88.2% and had nodal or distant metastases in 20.2% and 49.3%, respectively. Multivariable analysis showed that tumour size >4 cm, ECOG PS >or=1, TNM stage and Fuhrman grade were independent predictors of cancer-related death. CONCLUSION: A significant proportion of incidental renal tumours can lead to the death of the patient. Standard prognostic variables for renal cell carcinoma appear to remain valid for this subset of patients. A watchful-waiting strategy should not be recommended if the tumour diameter is >4 cm, if biopsy confirms high-grade tumours, or if there is an impaired ECOG PS, or computed tomography findings suggest the presence of advanced T stage.
Published: 2008

68. Successful retransplantation of a kidney allograft affected by thrombotic microangiopathy into a second transplant recipient

Author: Céline Guilbeau-Frugier, Didier Noury, Marylise Fort, Lionel Rostaing, Marie-Bernadette Delisle, Nassim Kamar, Federico Sallusto, Pascal Rischmann, Mehdi Khedis, Service de Néphrologie - Hypertension Artérielle Dialyse - Transplantation, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Institut de médecine moléculaire de Rangueil (I2MR), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-IFR150-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Urologie - Transplantation Rénale - Andrologie, Service d'anatomie pathologique et histologie-cytologie [Rangueil], Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital de Rangueil, Laboratoire d'Immunologie et d'Histocompatibilité, Centre de Physiopathologie Toulouse Purpan (CPTP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées- Institut Fédératif de Recherche Bio-médicale Institution (IFR150)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département d'Urologie-Andrologie et Transplantation Rénale [CHU Toulouse], Pôle Urologie - Néphrologie - Dialyse - Transplantations - Brûlés - Chirurgie plastique - Explorations fonctionnelles et physiologiques [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Département Immunologie [CHU Toulouse], Institut Fédératif de Biologie (IFB), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Pôle Biologie [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), and Simon, Marie Francoise
Subjects: Adult, Nephrology, medicine.medical_specialty, MESH: Tissue Donors, Tissue and Organ Procurement, Thrombotic microangiopathy, Biopsy, medicine.medical_treatment, 030232 urology & nephrology, Renal function, 030230 surgery, Kidney, MESH: Tissue and Organ Procurement, Nephrectomy, MESH: Kidney Transplantation, 03 medical and health sciences, MESH: Biopsy, 0302 clinical medicine, Recurrence, Internal medicine, medicine, Polycystic kidney disease, MESH: Transplantation, Homologous, Humans, Transplantation, Homologous, MESH: Thrombosis, Kidney transplantation, MESH: Humans, MESH: Middle Aged, business.industry, Thrombosis, MESH: Adult, MESH: Kidney, Middle Aged, medicine.disease, Kidney Transplantation, Tissue Donors, 3. Good health, Surgery, MESH: Recurrence, Transplantation, MESH: Nephrectomy, surgical procedures, operative, Female, business, MESH: Female, Kidney disease
Abstract: International audience; The donor organ shortage has compelled transplant centers to use organs from nontraditional sources. One example is the reuse of a previously transplanted organ, such as a kidney or liver retrieved from a brain-dead allograft recipient. For the first time, we reused a previously transplanted kidney that experienced intractable recurrent thrombotic microangiopathy (TMA) from a living allograft recipient. Within a few weeks posttransplantation, a deceased kidney allograft recipient developed intractable severe recurrent idiopathic TMA in the allograft despite intensive plasma exchanges and steroid and rituximab therapy. This required nephrectomy to cure TMA. The index recipient was believed to have a well-functioning allograft despite TMA (serum creatinine, 1.36 mg/dL [120 micromol/L]) and microalbuminuria with albumin of 1.2 g/dL [12 g/L]), and it appeared mildly damaged on biopsy examination. After donor and recipient informed consents were obtained and after approval of the French Agency of Biomedicine, the TMA allograft was reused and transplanted into a recipient whose original kidney disease was polycystic kidney disease. The retransplantation was uneventful, and at 6 months posttransplantation, the ultimate recipient's serum creatinine level was 1.06 mg/L (97 micromol/L) and albuminuria was 0.5 g/dL (5 g/L). A routine kidney biopsy showed mild glomerular lesions. After allograft nephrectomy, the donor's hematologic TMA symptoms dissipated within 10 days. We conclude that a kidney allograft with TMA recurrence can be successfully retransplanted into another recipient with excellent kidney function while still curing the first recipient of recurrent TMA. This might increase the number of kidney allografts from extended criteria donors.
Published: 2008

69. Quelle pratique de la néphrectomie partielle en France ? [What is the clinical practice of partial nephrectomy in France?]

Author: Bernhard, J.-C., Ferriere, J.-M., Crepel, M., Wallerand, H., Bellec, L., Lacroix, B., Lopes, D., Albouy, B., Robert, G., Ravaud, A., Colombel, M., Tostain, J., Pfister, C., Soulie, M., Salomon, Laurent, De La Taille, Alexandre, Pasticier, G., Abbou, Claude Clément, Manunta, Andréa, Guille, François, Patard, Jean-Jacques, Service d'urologie, andrologie et transplantation rénale, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Service d'Urologie - Transplantation Rénale - Andrologie, Service d'urologie-andrologie, CHU Saint-Etienne-Université Jean Monnet [Saint-Étienne] (UJM)-Hôpital nord, Service d'urologie [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service d'urologie [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Service d'oncologie médicale, CHU Bordeaux [Bordeaux], Service d'urologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Institut de Génétique et Développement de Rennes (IGDR), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Centre National de la Recherche Scientifique (CNRS), Département d'Urologie-Andrologie et Transplantation Rénale [CHU Toulouse], Pôle Urologie - Néphrologie - Dialyse - Transplantations - Brûlés - Chirurgie plastique - Explorations fonctionnelles et physiologiques [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Service d'Urologie - Andrologie [CHU Saint-Etienne], Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E)-Université Jean Monnet - Saint-Étienne (UJM), Université de Rennes (UR)-Centre National de la Recherche Scientifique (CNRS), CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Centre National de la Recherche Scientifique (CNRS)-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)
Subjects: [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology
Abstract: International audience; OBJECTIVE: To describe the practice of partial nephrectomy (PN) in France and assess its results in terms of morbidity and cancer control. MATERIAL AND METHOD: Seven French University Hospitals in which nephron sparing surgery represents at least 30% of the total number of nephrectomies for renal tumour, participated in this study. All centres included, as exhaustively as possible, all their PN cases. For each patient, 70 variables were harvested in order to characterize the patient population, the indications, the operative technique, the per- and postoperative course and complications, the tumor specificities, the carcinologic control and renal function follow-up. RESULTS: Seven hundred and forty-one PN, of which 579 for malignant tumours were analysed. The mean tumour size was 3.4+/-2.1cm (0.1-18) and 20.8% of the tumours were larger than 4cm. In 30.1% of cases, the indication was imperative. Among the PN, 12.2% were performed laparoscopically. The mean operating time was 151+/-54.2min (55-420). The medical and surgical complications rates were respectively 15.2 and 14.7%. At a mean 38 months follow-up, the local recurrence rate was 3.5% and the specific death rate was 4.5%. CONCLUSION: PN is nowadays getting a more and more widely used technique in France. This expansion is completely justified by its results and urologists must consider nephron sparing surgery as the gold standard treatment for renal tumours measuring less than 4cm.
Published: 2008

70. Prostate cancer in renal transplant recipients

Author: François, Kleinclauss, Marc, Gigante, Yann, Neuzillet, Marc, Mouzin, Nicolas, Terrier, Laurent, Salomon, François, Iborra, Jacques, Petit, Luc, Cormier, Eric, Lechevallier, P, Wolf, Service d'urologie, andrologie et transplantation rénale, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, Comité de transplantation rénale, Association Française d'Urologie, Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (RIGHT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté]), Service d'urologie, Centre Hospitalier Universitaire de Nice (CHU Nice), Service d'urologie et de transplantation rénale, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM), Service d'Urologie - Transplantation Rénale - Andrologie, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Département Urologie, CHU Grenoble, Service d'urologie [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service Urologie [Lapeyronie], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, Service d'Urologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Renal Transplantation Committee of the French Urological Association, Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Saas, Philippe, Département d'Urologie-Andrologie et Transplantation Rénale [CHU Toulouse], Pôle Urologie - Néphrologie - Dialyse - Transplantations - Brûlés - Chirurgie plastique - Explorations fonctionnelles et physiologiques [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS BFC)-Université de Franche-Comté (UFC)
Subjects: Male, medicine.medical_treatment, 030232 urology & nephrology, Azathioprine, MESH: Kidney Transplantation, Prostate cancer, 0302 clinical medicine, Risk Factors, MESH: Risk Factors, Mass Screening, Medicine, Kidney transplantation, MESH: Aged, MESH: Middle Aged, Immunosuppression, Middle Aged, 3. Good health, Nephrology, 030220 oncology & carcinogenesis, [SDV.IMM]Life Sciences [q-bio]/Immunology, France, MESH: Calcineurin, MESH: Immunosuppressive Agents, Immunosuppressive Agents, medicine.drug, medicine.medical_specialty, [SDV.IMM] Life Sciences [q-bio]/Immunology, Calcineurin Inhibitors, Urology, MESH: Multivariate Analysis, 03 medical and health sciences, Humans, MESH: Mass Screening, Mass screening, MESH: Azathioprine, Aged, Retrospective Studies, MESH: Mycophenolic Acid, Transplantation, MESH: Humans, business.industry, Prostatic Neoplasms, Cancer, MESH: Retrospective Studies, Mycophenolic Acid, medicine.disease, Kidney Transplantation, MESH: Male, Surgery, MESH: France, MESH: Prostatic Neoplasms, Multivariate Analysis, business, Kidney disease
Abstract: International audience; BACKGROUND: We conducted a retrospective multi-centre study to determine the characteristics of prostate cancer in renal transplant recipients (RTR) and to analyse the relation with immunosuppressive maintenance therapies. METHODS: Patients from 19 French transplant centres diagnosed with prostate cancer at least 1 year after kidney transplantation were included in this study. Data regarding demographics, kidney transplantation, prostate cancer and immunosuppressive treatment were analysed. RESULTS: Sixty-two patients met the eligibility criteria for this study. Thirty-eight patients (61.3%) received calcineurin inhibitors (CNI) and azathioprine (AZA) with or without steroids, twenty received CNI with or without steroids (32.2%) and four received CNI and mycophenolate mofetil (6.5%). Patients with CNI and AZA immunosuppressive therapy presented more high-stage cancer (T3 and T4) when compared to patients receiving CNI alone (47.5% versus 15%, respectively, P = 0.03). A non-significant increase in lymph node invasion was found in patients receiving CNI and AZA compared to patients receiving CNI alone (21% versus 5%, P = 0.16). In the multivariate analysis, the immunosuppressive regimen with CNI and AZA was the only independent risk factor for locally advanced disease (P = 0.007). CONCLUSION: Our results showed that RTR are at risk for early occurrence and for locally advanced prostate cancer, especially when they received a CNI and AZA maintenance immunosuppressive therapy.
Published: 2008

71. [Modalities of gynecological follow-up of transgender patients - Literature review].

Author: Briet M, Barkatz J, Frontczak S, Ramanah R, Chabbert Buffet N, and Cristofari S
Subjects: Male, Humans, Female, Follow-Up Studies, Global Health, Transgender Persons, Sexually Transmitted Diseases epidemiology, Gynecology
Abstract: Transgender patients are at increased risk of cancer, sexually transmitted diseases, short- and long-term postoperative complications in patients with vaginoplasty, but also unwanted pregnancy in non-hysterectomized trans men. However, access to care is often difficult for these patients, who often do not benefit from appropriate gynecological monitoring, especially for fear of judgment or discrimination. In view of the health risks of these patients, it is essential to be able to offer them specific and adapted gynecological follow-up. To date, there are no clear recommendations regarding the gynecological follow-up of transgender patients. We relied on the recommendations of the World Professional Association of Transgender Health (W-PATH) and the Endocrine Society Guideline and performed a literature review. We carried out several searches via pubmed in order to explore one by one the different aspects of gynecological follow-up, in particular of non-hysterectomized transgender men and transgender women with a vaginoplasty. It emerges from this a lack of follow-up of transgender people, with a reluctance to consult a gynecologist, associated with the lack of knowledge and experience of health professionals. Due to the risks identical to those of the general population, added to those specific to transgender people, it is important to be able to offer these patients specialized and personalized gynecological follow-up, and to raise awareness and train health professionals on the importance of and the specificities of the gynecological follow-up of these patients., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)
Published: 2022
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72. [Domino transplantation of a living-donor kidney graft affected by thrombotic microangiopathy: surgical aspects].

Author: Sallusto F, Kamar N, Khedis M, Gamé X, Taj K, Delisle MB, Fort M, Noury D, Durand D, Rostaing L, and Rischmann P
Subjects: Adult, Biopsy, Cadaver, Female, Graft Survival, Humans, Kidney pathology, Kidney Transplantation adverse effects, Middle Aged, Reoperation, Thrombocythemia, Essential, Thrombosis etiology, Transplantation, Homologous, Treatment Outcome, Graft Rejection prevention & control, Kidney Transplantation methods, Living Donors, Nephrectomy, Thrombosis surgery, Tissue and Organ Procurement methods
Abstract: We report surgical aspects of the first case of retransplantation of a kidney initially retrieved from a cadaveric donor, then on a first recipient which developed a recurrent severe and intractable thrombotic microangiopathy on the allograft.
Published: 2009
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73. [Current treatment of bladder cancer: from epidemiology to surgical treatment].

Author: Rischmann P
Subjects: France epidemiology, Humans, Urinary Bladder Neoplasms epidemiology, Urinary Bladder Neoplasms surgery
Abstract: Urothelial carcinoma of the bladder accounts for over 95% of bladder tumours in France. The incidence of this disease is increasing in industrialised countries. Several types of bladder cancer can be distinguished: (1) superficial tumours which have a risk of recurrence and progression, although conservative treatment based on endoscopic resection possibly followed by adjuvant therapy is a feasible option; (2) muscle-invasive tumours which require radical treatment; and (3) a group of so-called superficial tumours which require particularly close monitoring since they present a high risk of progression. Management of bladder tumours requires assessment of their potential to progress to a more invasive stage, and also consideration of a number of prognostic factors including endoscopic, histological and biological findings.
Published: 2000

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73 results on '"Service d'Urologie - Transplantation Rénale - Andrologie"'

51. Nephron-sparing surgery for renal tumors measuring more than 7 cm: morbidity, and functional and oncological outcomes

52. Local recurrence after radical nephrectomy for kidney cancer: management and prediction of outcomes. a multi-institutional study

53. Résultats des injections intra-détrusoriennes de toxine botulique A chez les patients spina-bifida

54. Predictive Factors of Oncologic Outcomes in Patients Who do not Achieve Undetectable Prostate Specific Antigen after Radical Prostatectomy

55. Is there a volume-outcome relationship for partial nephrectomy?

56. National prospective study on the use of local haemostatic agents during partial nephrectomy

57. [Nitric oxide pathway and female lower urinary tract. Physiological and pathophysiological role]

58. [CCAFU Recommendations 2013: Renal cancer]

59. Hypoxia, therapeutic resistance and sphingosine 1-phosphate

60. Renal cell carcinoma (RCC) in patients with end-stage renal disease exhibits many favourable clinical, pathologic, and outcome features compared with RCC in the general population

61. Oncologic outcomes and survival in pT0 tumors after radical cystectomy in patients without neoadjuvant chemotherapy: results from a large multicentre collaborative study

62. Predictive factors for ipsilateral recurrence after nephron-sparing surgery in renal cell carcinoma

64. Positive surgical margin appears to have negligible impact on survival of renal cell carcinomas treated by nephron-sparing surgery

65. Acute page kidney after a kidney allograft biopsy: successful outcome from observation and medical treatment

66. Erectile dysfunction in end-stage liver disease men

67. Prognostic variables to predict cancer-related death in incidental renal tumours

68. Successful retransplantation of a kidney allograft affected by thrombotic microangiopathy into a second transplant recipient

69. Quelle pratique de la néphrectomie partielle en France ? [What is the clinical practice of partial nephrectomy in France?]

70. Prostate cancer in renal transplant recipients

71. [Modalities of gynecological follow-up of transgender patients - Literature review].

72. [Domino transplantation of a living-donor kidney graft affected by thrombotic microangiopathy: surgical aspects].

73. [Current treatment of bladder cancer: from epidemiology to surgical treatment].

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