1
|
Campedel L, Compérat E, Cancel-Tassin G, Varinot J, Pfister C, Delcourt C, Gobet F, Roumiguié M, Patard PM, Daniel G, Bigot P, Carrouget J, Eymerit C, Larré S, Léon P, Durlach A, Ruffion A, de Mazancourt ES, Decaussin-Petrucci M, Bessède T, Lebacle C, Ferlicot S, Robert G, Vuong NS, Philip M, Crouzet S, Matillon X, Mège-Lechevallier F, Lang H, Mouracade P, Lindner V, Gougis P, Cussenot O, Rouprêt M, Seisen T. Prognostic value of programmed death ligand-1 and programmed death-1 expression in patients with upper tract urothelial carcinoma. BJU Int 2023; 132:581-590. [PMID: 37488983 DOI: 10.1111/bju.16129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
OBJECTIVE To evaluate the prognostic value of programmed death ligand-1 (PD-L1) and programmed death-1 (PD-1) expression in patients with upper tract urothelial carcinoma (UTUC). PATIENTS AND METHODS A retrospective multicentre study was conducted in 283 patients with UTUC treated with radical nephroureterectomy (RNU) between 2000 and 2015 at 10 French hospitals. Immunohistochemistry analyses were performed using 2 mm-core tissue microarrays with NAT105® and 28.8® antibodies at a 5% cut-off for positivity on tumour cells and tumour-infiltrating lymphocytes to evaluate PD-L1 and PD-1 expression, respectively. Multivariable Cox regression models were used to determine the independent predictors of recurrence-free (RFS), cancer-specific (CSS) and overall survival (OS). RESULTS Overall, 63 (22.3%) and 220 (77.7%) patients with UTUC had PD-L1-positive and -negative disease, respectively, while 91 (32.2%) and 192 (67.8%) had PD-1-positive and -negative disease, respectively. Patients who expressed PD-L1 or PD-1 were more likely to have pathological tumour stage ≥pT2 (68.3% vs 49.5%, P = 0.009; and 69.2% vs 46.4%, P < 0.001, respectively) and high-grade (90.5% vs 70.0%, P = 0.001; and 91.2% vs 66.7%, P < 0.001, respectively) disease with lymphovascular invasion (52.4% vs 17.3%, P < 0.001; and 39.6% vs 18.2%, P < 0.001, respectively) as compared to those who did not. In multivariable Cox regression analysis adjusting for each other, PD-L1 and PD-1 expression were significantly associated with decreased RFS (hazard ratio [HR] 1.83, 95% confidence interval [CI] 1.09-3.08, P = 0.023; and HR 1.59, 95% CI 1.01-2.54, P = 0.049; respectively), CSS (HR 2.73, 95% CI 1.48-5.04, P = 0.001; and HR 1.96, 95% CI 1.12-3.45, P = 0.019; respectively) and OS (HR 2.08, 95% CI 1.23-3.53, P = 0.006; and HR 1.71, 95% CI 1.05-2.78, P = 0.031; respectively). In addition, multivariable Cox regression analyses evaluating the four-tier combination of PD-L1 and PD-1 expression showed that only PD-L1/PD-1-positive patients (n = 38 [13.4%]) had significantly decreased RFS (HR 3.07, 95% CI 1.70-5.52; P < 0.001), CSS (HR 5.23, 95% CI 2.62-10.43; P < 0.001) and OS (HR 3.82, 95% CI 2.13-6.85; P < 0.001) as compared to those with PD-L1/PD-1-negative disease (n = 167 [59.0%]). CONCLUSIONS We observed that PD-L1 and PD-1 expression were both associated with adverse pathological features that translated into an independent and cumulative adverse prognostic value in UTUC patients treated with RNU.
Collapse
Affiliation(s)
- Luca Campedel
- Department of Medical Oncology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
- GRC n°5, Predictive Onco-Urology, Sorbonne Université, Paris, France
| | - Eva Compérat
- GRC n°5, Predictive Onco-Urology, Sorbonne Université, Paris, France
- Departement of Pathology, Tenon Hospital, AP-HP, Paris, France
| | - Géraldine Cancel-Tassin
- GRC n°5, Predictive Onco-Urology, Sorbonne Université, Paris, France
- CeRePP, Tenon Hospital, Paris, France
| | - Justine Varinot
- Departement of Pathology, Tenon Hospital, AP-HP, Paris, France
| | | | | | | | | | | | | | - Pierre Bigot
- Department of Urology, Angers Hospital, Angers, France
| | | | | | | | | | - Anne Durlach
- Department of Pathology, Reims Hospital, Reims, France
| | | | | | | | - Thomas Bessède
- Department of Urology, Kremlin-Bicêtre Hospital, Le Kremlin-Bicêtre, France
| | - Cédric Lebacle
- Department of Urology, Kremlin-Bicêtre Hospital, Le Kremlin-Bicêtre, France
| | - Sophie Ferlicot
- Department of Pathology, Kremlin-Bicêtre Hospital, Le Kremlin-Bicêtre, France
| | | | - Nam-Son Vuong
- Department of Urology, Bordeaux Hospital, Bordeaux, France
| | - Magali Philip
- Department of Pathology, Bordeaux Hospital, Bordeaux, France
| | | | | | | | - Hervé Lang
- Department of Urology, Strasbourg Hospital, Strasbourg, France
| | | | | | - Paul Gougis
- Department of Medical Oncology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Olivier Cussenot
- GRC n°5, Predictive Onco-Urology, Sorbonne Université, Paris, France
- CeRePP, Tenon Hospital, Paris, France
- Department of Urology, Tenon Hospital, APHP, Paris, France
| | - Morgan Rouprêt
- GRC n°5, Predictive Onco-Urology, Sorbonne Université, Paris, France
- Department of Urology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| | - Thomas Seisen
- GRC n°5, Predictive Onco-Urology, Sorbonne Université, Paris, France
- Department of Urology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
| |
Collapse
|
2
|
Izérable B, Boudaoud N, Poli-Merol ML, Pons M, Léon P. [Outpatient surgery for penile hypospadias in pediatric urology: A monocentric experience with a mean follow-up of 3 years]. Prog Urol 2023; 33:474-480. [PMID: 37516601 DOI: 10.1016/j.purol.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 04/09/2023] [Accepted: 07/06/2023] [Indexed: 07/31/2023]
Abstract
INTRODUCTION Hypospadias is one of the most common congenital anomalies in men. Outpatient surgery has been proposed but is not widespread. The aim of this study was to evaluate our experience of outpatient surgery for penile hypospadias repair and to specify the constraints for a result similar to a conventional inpatient procedure. PATIENTS AND METHODS Observational, retrospective and single-center study, including all the patients operated on hypospadias for the first time by one of the 3 senior surgeons, between January 2011 and March 2018. Peno-scrotal and perineal hypospadias were excluded because systematically hospitalized. RESULTS One hundred sixty-six patients were included. 67 patients (40,4%) were treated on an outpatient basis. The mean age at the time of procedure was 15.6 (6-51) months. Forms with curvature were almost exclusively hospitalized (1 vs. 25, P<0.001). There was no significant difference for anterior penile forms (60 vs. 81, P=0.06). Middle and posterior hypospadias were more often hospitalized, although outpatient experience exists. There were no more complications in the outpatient group. CONCLUSION Outpatient hypospadias surgery seems to be achievable in most of the cases, provided that medical care is standardized and multidisciplinary, the staff is trained and involved and a specific organization is put in place in the department. Evaluation of the socio-family environment is therefore fundamental. LEVEL OF EVIDENCE: 4
Collapse
Affiliation(s)
| | - Nadia Boudaoud
- Service de chirurgie pédiatrique, American Memorial Hospital, CHU de Reims, Reims, France
| | | | - Maguelonne Pons
- Service de chirurgie infantile, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | | |
Collapse
|
3
|
Michel F, Cancrini F, Cancel-Tassin G, Gamé X, Huyghe E, Rock A, Léon G, Uzan A, Desfemmes FR, Peyronnet B, Fallot J, Léon P, Rolland E, Perrouin-Verbe MA, Wodey J, Capon G, Karsenty G, Rouprêt M, Cussenot O, Alshehhi H, Comperat E, Phé V. A study of the immunohistochemical profile of bladder cancer in neuro-urological patients by the French Association of Urology. World J Urol 2022; 40:1939-1947. [PMID: 35138436 DOI: 10.1007/s00345-022-03942-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 01/13/2022] [Indexed: 10/19/2022] Open
Abstract
PURPOSE To establish whether the expression of markers of cell differentiation (CK7, CK14, CK20, GATA3), apoptosis (p53), proliferation (Ki67, STAG2) and peri-tumoural lymphocytes (CD3, CD8), provides specific information about urothelial carcinogenesis in neuro-urological patients with bladder cancer (NBC). METHODS Tissue samples from NBC were retrieved from 15 centres in France and compared to control samples from non neuro-urological patients with bladder cancer (NNBC) and from neuro-urological patients without bladder cancer (NB). The expression of CK7, CK14, CK20, GATA3, p53, Ki67, STAG2, CD3 and CD8 markers was analysed using immunohistochemistry of tissue microarray sections. RESULTS Overall, tissue samples from 124 patients were included in the study (n = 72 NBC, n = 26 NNBC and n = 26 NB). Muscle invasive bladder cancer (MIBC) was found in 52 NBC patients (72.2%) and squamous cell differentiation in 9 (12.5%). In NBC samples, the expression of CK20 and GATA3 was significantly more frequent in NMIBC compared to MIBC (p = 0.015 and p = 0.004, respectively). CK20 and GATA3 were significantly more expressed in NBC compared to NNBC (p < 0.001 and p = 0.010, respectively). The expression of CK14, Ki67, CD3 and CD8 was significantly more frequent in NBC than in NNBC samples (p = 0.005, p < 0.001, p < 0.001 and p < 0.001, respectively). The expression of CD3 and CD8 was similar in NBC and NB samples. CONCLUSION In NBC, markers of basal differentiation, proliferation and peri-tumoural lymphocytes were significantly more expressed compared to NNBC controls. These results suggest the aggressiveness of NBC and the role of chronic inflammation in the carcinogenesis of bladder cancer in neuro-urological patients.
Collapse
Affiliation(s)
- Floriane Michel
- Department of Urology and Kidney Transplantation, Aix-Marseille University, La Conception Hospital, Assistance Publique-Hôpitaux de Marseille, 147 Boulevard Baille, 13005, Marseille, France. .,Sorbonne University, GRC5 Predictive Onco-urology, Assistance Publique-Hôpitaux de Paris, Paris, France.
| | - Fabiana Cancrini
- Sorbonne University, GRC5 Predictive Onco-urology, Assistance Publique-Hôpitaux de Paris, Paris, France.,Department of Medical and Surgical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy
| | - Géraldine Cancel-Tassin
- Sorbonne University, GRC5 Predictive Onco-urology, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Xavier Gamé
- Department of Urology, CHU Rangueil, Université Paul Sabatier Toulouse III, Toulouse, France
| | - Eric Huyghe
- Department of Urology, CHU Rangueil, Université Paul Sabatier Toulouse III, Toulouse, France
| | - Aurélien Rock
- Department of Urology, Groupe Hospitalier de L'Institut Catholique Lillois, Lille, France
| | - Grégoire Léon
- Department of Urology and Transplantation, CHU de Caen, Caen, France
| | - Audrey Uzan
- Department of Urology, Sorbonne University, Tenon Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | | | - Jérémy Fallot
- Department of Urology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - Priscilla Léon
- Department of Urology, Clinique Urologie Royan, Royan, France
| | | | | | - Jacques Wodey
- Department of Urology, Clinique Rhône Durance, Avignon, France
| | - Grégoire Capon
- Department of Urology, University of Bordeaux, Bordeaux, France
| | - Gilles Karsenty
- Department of Urology and Kidney Transplantation, Aix-Marseille University, La Conception Hospital, Assistance Publique-Hôpitaux de Marseille, 147 Boulevard Baille, 13005, Marseille, France
| | - Morgan Rouprêt
- Sorbonne University, GRC5 Predictive Onco-urology, Assistance Publique-Hôpitaux de Paris, Paris, France.,Department of Urology, Sorbonne University, Pitié-Salpêtrière Academic Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Olivier Cussenot
- Sorbonne University, GRC5 Predictive Onco-urology, Assistance Publique-Hôpitaux de Paris, Paris, France.,Department of Urology, Sorbonne University, Tenon Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Hussa Alshehhi
- Department of Pathology, Sorbonne University, Tenon Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Eva Comperat
- Sorbonne University, GRC5 Predictive Onco-urology, Assistance Publique-Hôpitaux de Paris, Paris, France.,Department of Pathology, Sorbonne University, Tenon Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Véronique Phé
- Sorbonne University, GRC5 Predictive Onco-urology, Assistance Publique-Hôpitaux de Paris, Paris, France.,Department of Urology, Sorbonne University, Tenon Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| |
Collapse
|
4
|
Robin D, Peyronnet B, Bentellis I, El-Akri M, Cornu JN, Brierre T, Cousin T, Gaillard V, Poussot B, Dupuis H, Tricard T, Hermieu N, Pitout A, Beraud F, Chevallier D, Bruyere F, Biardeau X, Monsaint H, Corbel L, Hermieu JF, Lecoanet P, Capon G, Saussine C, Gamé X, Léon P. Sphincter urinaire artificiel chez les patients présentant une incontinence urinaire après High Intensivity Focused Ultrasound Therapy. Prog Urol 2022; 32:284-290. [DOI: 10.1016/j.purol.2021.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/14/2021] [Accepted: 11/15/2021] [Indexed: 10/19/2022]
|
5
|
Michel F, Cancrini F, Cancel-Tassin G, Gamé X, Huyghe E, Rock A, Léon G, Uzan A, Desfemmes FR, Peyronnet B, Fallot J, Léon P, Rolland E, Perrouin-Verbe MA, Wodey J, Capon G, Karsenty G, Rouprêt M, Cussenot O, Alshehhi H, Comperat E, Phé V. A study of the immunohistochemical profile of bladder cancer in neuro-urological patients by the French Association of Urology. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00175-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
6
|
Guillot-Tantay C, Robert G, Ruffion A, Gamé X, Balanca A, Cousin T, Campello PV, Simon J, Baron M, Fleury R, Dequirez PL, Davidson S, Joussain C, Vangheluwe L, Anastay V, Léon P, Perrouin-Verbe MA, Peyronnet B, Biardeau X, Cornu JN, Karsenty G, Phé V. Impact of COVID-19 pandemic on functional urology procedures in France: a prospective study. World J Urol 2021; 40:277-282. [PMID: 34476595 PMCID: PMC8412852 DOI: 10.1007/s00345-021-03821-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 08/19/2021] [Indexed: 11/26/2022] Open
Abstract
Purpose To evaluate the impact of COVID-19 pandemic on functional urology procedures in France. Methods A prospective study was conducted within 11 secondary and tertiary referral centers in France. Patients aged > 18 years who were diagnosed with a functional urology disease before the national lockdown (March 17th, 2020) and who required a surgery were included. Study period went from March 17th to September 30th 2020. The included interventions were listed according to the guidelines for functional urology enacted by the French Association of Urology and delay of reoperation was compared to the guidelines’ delay. The primary outcome was the number of procedures left unscheduled at the end of the study period. Descriptive statistics were performed. Results From March 17th 2020 to September 3 rd 2020, 1246 patients with a previous diagnosis of a functional urological disease requiring a surgery were included. The mean follow-up was 140.4 days (± 53.4). Overall, 316 interventions (25.4%) were maintained whereas 74 (5.9%) were canceled, 848 (68.1%) postponed and 8 patients (0.6%) died. At the end of the follow-up, 184 patients (21.7%) were still not rescheduled. If the intervention was postponed, the mean delay between the initial and final date was 85.7 days (± 64.4). Conclusion Overall, more than two thirds of interventions had to be postponed and the mean delay between the initial and final date was about three months.
Collapse
Affiliation(s)
- Cyrille Guillot-Tantay
- Department of Urology, Sorbonne Université, Assistance Publique - Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Academic Hospital, 47-83 boulevard de l'hôpital, 75013, Paris, France
| | - Grégoire Robert
- Department of Urology, Centre Hospitalier Universitaire de Bordeaux, Université de Bordeaux, Bordeaux, France
| | - Alain Ruffion
- Department of Urology, Hospices Civils de Lyon, Hôpital Lyon Sud, Lyon, France
| | - Xavier Gamé
- Department of Urology, Centre Hospitalier Universitaire de Rangueil, Toulouse, France
| | - Astrid Balanca
- Department of Neuro-Urology, Assistance-Publique-Hôpitaux de Paris (AP-HP), Raymond Poincaré Academic Hospital, Garches, France
| | - Tiffany Cousin
- Department of Urology, Centre Hospitalier Universitaire de Bordeaux, Université de Bordeaux, Bordeaux, France
| | | | - Jeanne Simon
- Department of Urology, Centre Hospitalier Universitaire de Rangueil, Toulouse, France
| | - Maximilien Baron
- Department of Urology, Nantes Academic Hospital, Hôtel Dieu, Nantes, France
| | - Raphael Fleury
- Centre Hospitalier Universitaire de Rennes, Service d'urologie, Rennes, France
| | - Pierre-Luc Dequirez
- Department of Urology, Lille Academic Hospital, Claude Huriez Hospital, Lille, France
| | - Sypre Davidson
- Department of Urology, Lille Academic Hospital, Claude Huriez Hospital, Lille, France
| | - Charles Joussain
- Department of Neuro-Urology, Assistance-Publique-Hôpitaux de Paris (AP-HP), Raymond Poincaré Academic Hospital, Garches, France
| | - Lucie Vangheluwe
- Department of Urology, Centre Hospitalier Universitaire Rouen, Rouen, France
| | - Vassily Anastay
- Department of Urology, Assistance-Publique-Hôpitaux de Marseille (AP-HM), La Conception Hospital, Marseille, France
| | | | | | - Benoit Peyronnet
- Centre Hospitalier Universitaire de Rennes, Service d'urologie, Rennes, France
| | - Xavier Biardeau
- Department of Urology, Lille Academic Hospital, Claude Huriez Hospital, Lille, France
| | - Jean-Nicolas Cornu
- Department of Urology, Centre Hospitalier Universitaire Rouen, Rouen, France
| | - Gilles Karsenty
- Department of Urology, Assistance-Publique-Hôpitaux de Marseille (AP-HM), La Conception Hospital, Marseille, France
| | - Véronique Phé
- Department of urology, Sorbonne Université, Assistance Publique - Hôpitaux de Paris, Tenon Academic Hospital, Paris, France.
| |
Collapse
|
7
|
Seret R, Launois C, Barbe C, Larre S, Léon P. [Evolution of the USP and IPSS score after continuous positive airway pressure sleep apnea therapy at night]. Prog Urol 2021; 32:130-138. [PMID: 34158219 DOI: 10.1016/j.purol.2020.12.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/29/2020] [Accepted: 12/20/2020] [Indexed: 11/18/2022]
Abstract
INTRODUCTION To assess the impact of nocturnal continuous positive airway pressure (CPAP) treatment of obstructive sleep apnea (OSA) on lower urinary tract (LUTS) symptoms. MATERIALS AND METHODS A prospective, monocentric study was conducted between June 2018 and August 2019. Patients with moderate to severe OSA with an indication for treatment with nocturnal CPAP in combination with SBAU were included. SBAUs and their impact were evaluated by completing two self-administered questionnaires (Urinary Symptom Profile (USP) and International Prostate Score Symptom (IPSS)) filled out during the night-time ventilatory polygraph or diagnostic polysomnography for OSA and after 4 months of CPAP treatment. RESULTS In 79 patients, after four months of CPAP treatment, USP scores for stress urinary incontinence and overactive bladder were significantly improved, respectively 0.65±1.38 vs 1.13±2.10 ; p<0.0001 and 3.24±2.58 vs 5.43±3.66 ; p<0.0001, IPSS and IPSS-Qdv were significantly improved, respectively 5.20±3.78 vs. 7.44±5.05 ; p<0.0001 and 1.93±1.26 vs. 2.27±1.56 ; p=0.002 as well as IPSS score items on pollakiuria, urgency and nocturia. CONCLUSION Treatment with CPAP significantly improved SBAU in four months. Testing urology patients for symptoms of OSA in urology patients seeking SBAU would allow referral of patients suspected of OSA to a specialist for diagnosis and management if necessary.
Collapse
Affiliation(s)
- R Seret
- Service d'urologie, centre hospitalier universitaire Reims, rue du Général-Koenig, 51100 Reims, France.
| | - C Launois
- Service des maladies respiratoires, unité de sommeil et ventilation, centre hospitalier universitaire Reims, 51100 Reims, France
| | - C Barbe
- Service de santé publique et d'aide méthologique, centre hospitalier universitaire Reims, 51100 Reims, France
| | - S Larre
- Service d'urologie, centre hospitalier universitaire Reims, rue du Général-Koenig, 51100 Reims, France
| | - P Léon
- Service d'urologie, clinique Pasteur, 17200 Royan, France
| |
Collapse
|
8
|
Tambwe Kayombo R, Léon P, Lasserre T, Fournier R, Branchu B, Hulin M, Durlach A, Larré S. [Impact of positive surgical margins on prostate cancer prognosis]. Prog Urol 2021; 31:709-715. [PMID: 33941458 DOI: 10.1016/j.purol.2020.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 11/15/2020] [Accepted: 11/16/2020] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To examine the impact of positive surgical margins (PSM) after radical prostatectomy (RP) for prostate cancer on oncological results. PATIENTS AND METHODS We performed a study where all patients who underwent radical prostatectomy between January 2004 and December 2018 for prostate cancer were included. The preoperative, postoperative data and the carcinological results collected were analyzed. Data were analysed using Kaplan-Meier survival analysis and proportional hazards models. RESULTS A total of 319 patients with a median age of 65 years (IQR : 62-69) were included. The median follow-up was 43.6 months (IQR: 19.4-79.3). The overall rate of PSM was 33.5%. PSM was associated with biochemical recurrence (P<0.001). Overall mortality was not associated with positive margins. A clinical stage> T1c was an independent predictor of PSM on multivariate analysis (P=0.01). CONCLUSION PSM would increase the risk of biochemical recurrence with no impact on survival. Clinical stage>T1c was an adverse predictor for PSM. LEVEL OF EVIDENCE 3.
Collapse
Affiliation(s)
| | - P Léon
- Service d'urologie, Clinique Pasteur, 17200 Royan, France
| | - T Lasserre
- Service d'Urologie, CMC Les Cèdres, 19100 Brive, France
| | - R Fournier
- Service d'Urologie, Centre d'Urologie Trénel, 69560 Sainte-Colombe, France
| | - B Branchu
- Service d'urologie, CHU de Reims, 51100 Reims, France
| | - M Hulin
- Service d'urologie, CHU de Reims, 51100 Reims, France
| | - A Durlach
- Laboratoire d'anatomopathologie, CHU de Reims, 51100 Reims, France
| | - S Larré
- Service d'urologie, CHU de Reims, 51100 Reims, France
| |
Collapse
|
9
|
Branchu B, Léon P, Fournier R, Lasserre T, Tambwe R, Hoquetis L, Joncour C, Larré S. [Impact of antiplatelet and anticoagulant treatments on bleeding complications in patients treated with HoLEP]. Prog Urol 2020; 30:639-645. [PMID: 32409241 DOI: 10.1016/j.purol.2020.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 04/10/2020] [Accepted: 04/15/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION We aimed to assess the impact of antiplatelet and anticoagulation therapy for patients undergoing HoLEP. METHODS We performed a study during the learning curve on a consecutive series of patients who underwent HoLEP surgery from 2015 to 2018. The patients were divided into 3 groups: a control group, patients with antiplatelet therapy and patients with anticoagulation therapy. RESULTS A total of 223 patients underwent HoLEP surgery during this period: 124 in the control group, 63 in the antiplatelet group and 36 in the anticoagulant group. In the anticoagulant group, we observe significant differences with the control group for the catheterization time (2.05 days vs 5.17 days; P<0.001), the hospital length of stay (1.5 nights vs 4.49 nights; P<0.001) and complications (8.9% vs 58%; P<0.001). No difference between the control and antiplatelet groups in terms of catheterization time, hospital length of stay and complications (2.05 days vs 2.68 days; 1.5 nights vs 1.6 nights) but variation in terms of complications and bleeding complications (8.9% vs 21%; P<0,001; 8.1% vs 19%; P<0,001) CONCLUSION: Our study shows that HoLEP is therefore associated with a higher risk of bleeding for patients treated with anticoagulation therapy. Complications increase morbidity with longer catheterization time, hospitalization times and higher transfusion's rates, revision surgery and readmission. LEVEL OF EVIDENCE 3.
Collapse
Affiliation(s)
- B Branchu
- Service d'urologie, CHU de Reims, rue Cognacq-Jay, 51100 Reims, France.
| | - P Léon
- Service d'urologie, clinique Pasteur, 17200 Royan, France
| | - R Fournier
- Service d'urologie, CHU de Reims, rue Cognacq-Jay, 51100 Reims, France
| | - T Lasserre
- Service d'urologie, CHU de Reims, rue Cognacq-Jay, 51100 Reims, France
| | - R Tambwe
- Service d'urologie, CHU de Reims, rue Cognacq-Jay, 51100 Reims, France
| | - L Hoquetis
- Service d'urologie, CHU de Reims, rue Cognacq-Jay, 51100 Reims, France
| | - C Joncour
- Service d'urologie, CHU de Reims, rue Cognacq-Jay, 51100 Reims, France
| | - S Larré
- Service d'urologie, CHU de Reims, rue Cognacq-Jay, 51100 Reims, France
| |
Collapse
|
10
|
Branchu B, Léon P, Jeglinschi SC, Durlach A, Trigui S, Birembaut P, Larré S. [Interest of reTURB for pTa high grade bladder urothelial carcinoma]. Prog Urol 2019; 30:19-25. [PMID: 31866142 DOI: 10.1016/j.purol.2019.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 11/01/2019] [Accepted: 11/28/2019] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Second look TURB (Transurethral Resection of Bladder Tumor) is recommended for high-risk pT1 tumors. It is well acquired for tumors classified pT1 high grade but its interest is still discussed for high-grade pTa tumors in the absence of high level of evidence. We evaluated the impact of second-look resection for the high-grade pTa bladder tumor. METHODS We performed a retrospective study in 2 centers from 2007 to 2016. We included all urothelial tumors classified pTa high grade. We studied the anatomopathological findings of reTURB and its consequences on survival without recurrence and progression. RESULTS Eighty-four patients were included. Thirty-five patients (41.7%) had reTURB and residual tumor was found in 42.9% of cases. The anatomopathology of reTURB was in 20% of cases high grade pTa, in 14.3% of cases pTis, and in 8.6% of cases pT1. Forty-three patients had recurrence, 13 reTURB patients (30.2%). In the patients who had a reTURB, 12 had recurrence (34.3%) against 31 without reTURB, (63.3%). After the first TURB, 45 patients (53.6%) had bladder instillation: 38 received BCG (45.2%) and 7 ametycin (8.3%). The main factor decreasing recurrence was BCG adjuvant therapy (HR=0.4 [0.2-0.9], P=0.02). The absence of reRTUV appeared to be a recurrence factor, but the result was not statistically significant (HR=1.4 [0.7-3], P=0.3). CONCLUSION reTURB confirms that residual tumor is often found. His interest in survival without recurrence remains to be proved by a prospective study with a larger number of patients. LEVEL OF EVIDENCE 3.
Collapse
Affiliation(s)
- B Branchu
- Service d'urologie, CHU de Reims, 51000 Reims, France.
| | - P Léon
- Service d'urologie, clinique Pasteur, 17200 Royan, France
| | | | - A Durlach
- Laboratoire d'anatomopathologie, CHU de Reims, 51000 Reims, France
| | - S Trigui
- Service d'urologie, Polyclinique Montier-la-celle, 10120 Saint-André-les-Vergers, France
| | - P Birembaut
- Laboratoire d'anatomopathologie, CHU de Reims, 51000 Reims, France
| | - S Larré
- Service d'urologie, CHU de Reims, 51000 Reims, France
| |
Collapse
|
11
|
Jeglinschi S, Schirmann A, Durand M, Sanchez S, Larré S, Léon P. Factors affecting guideline adherence in the initial treatment of non-muscle invasive bladder cancer: Retrospective study in a French peripheral hospital. Prog Urol 2019; 30:26-34. [PMID: 31813714 DOI: 10.1016/j.purol.2019.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 09/10/2019] [Accepted: 11/07/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To assess whether the initial treatment of non-muscle invasive bladder cancer (NMIBC) was performed according to the guidelines, and to determine the reasons why initial treatment was not provided in nonadherence cases. MATERIALS AND METHODS We retrospectively reviewed all patients with NMIBC who underwent their first transurethral resection of bladder tumor (TURBT) at a peripheral hospital, between 2007 and 2016. The treatment offered to the patient was compared to the European Association of Urology guidelines according to risk stratification. For each patient who did not receive the treatment according to the guidelines, one of the following reasons was identified: poor patient compliance, poor patient general health status, urologist's decision, lack of resources. RESULTS One hundred fifty-nine patients were included with a mean age of 72.2 years at the time of NMIBC diagnosis. The low-risk patients were strictly treated according to the guidelines. Among the intermediate-risk patients, 14% received mitomycin C. Among the high-risk patients, 39% received intravesical Bacillus Calmette-Guerin. In the nonadherence cases (61%), the reasons were related to the patient in 44% of cases (poor compliance, 21%; poor patient general health status, 23%), urologist's decision in 54% of cases, and lack of resources in 2% of cases. Thirty-seven percent of the high-risk patients underwent re-resection. CONCLUSIONS Overall, adherence to NMIBC guidelines was low in all treatment types (intravesical therapy, re-resection, or cystectomy for very high-risk patients), but this finding was similar to that in previous studies. Reasons were mainly related to the urologist's decision or to the patient condition (poor compliance or poor general health status). LEVEL OF EVIDENCE 3.
Collapse
Affiliation(s)
- S Jeglinschi
- Service d'urologie, CHU Nice, 06000 Nice, France; Service d'urologie, CHU Reims, 51100 Reims, France.
| | - A Schirmann
- Service d'urologie, CHU Reims, 51100 Reims, France
| | - M Durand
- Service d'urologie, CHU Nice, 06000 Nice, France
| | - S Sanchez
- Départment d'information médicale, centre hospitalier, 10000 Troyes, France
| | - S Larré
- Service d'urologie, CHU Reims, 51100 Reims, France
| | - P Léon
- Service d'urologie, CHU Reims, 51100 Reims, France; Service d'urologie, clinique Pasteur, 17200 Royan, France
| |
Collapse
|
12
|
Perrouin-Verbe MA, Léon P, Denys P, Mongiat-Artus P, Chartier-Kastler E, Phé V. Long-term functional outcomes of augmentation cystoplasty in adult spina bifida patients: A single-center experience in a multidisciplinary team. Neurourol Urodyn 2018; 38:330-337. [PMID: 30350892 DOI: 10.1002/nau.23857] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 09/23/2018] [Indexed: 12/19/2022]
Abstract
AIM To report the very long-term functional outcomes of augmentation cystoplasty (AC) in adult spina bifida patients. METHODS All consecutive adult spina bifida patients who underwent AC between 1991 and 2008 were enrolled. Early postoperative complications (Clavien-Dindo classification) and long-term outcomes (voiding modalities, urodynamic parameters, renal function, continence, and quality of life) were assessed. RESULTS Twenty-eight patients with a median age of 20 years (IQR 17-25) were included. They all underwent AC with a supratrigonal cystectomy (SC). The median follow-up was 13.6 years (IQR 6-16.5). Thirteen early postoperative complications (12 grade I-II, 1 grade III) were observed in 11 patients (39%). Eight patients (29%) had upper urinary tract infections managed with antibiotics, with 2 patients requiring ureteral stents. Bladder stones occurred in 2 patients (7%) and were managed with endoscopy and cystostomy. One bladder perforation was reported. One bladder cancer was observed 26 years after surgery. Creatinine clearance and all urodynamic parameters were significantly improved post-operatively. The overall complication and reoperation rates were 57% and 14%, respectively. At last follow up, the continence rate was 71% (n = 20), with 93% (n = 26) performing intermittent self-catheterization. Quality of life was improved for 71% of patients. CONCLUSION In adult spina bifida population, AC is a high-risk procedure with an overall complication rate of 57% and a reoperation rate of 14%. However, AC is beneficial to the overall health of the patients since it provides a satisfying continence rate, an improvement of quality of life, and long-term protection of the upper urinary tract.
Collapse
Affiliation(s)
- Marie-Aimée Perrouin-Verbe
- Pitié-Salpétrière Academic Hospital, Department of Urology, Sorbonne University, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Priscilla Léon
- Pitié-Salpétrière Academic Hospital, Department of Urology, Sorbonne University, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Pierre Denys
- Department of Physical Medicine and Rehabilitation, Raymond Poincaré Hospital, Garches, France
| | | | - Emmanuel Chartier-Kastler
- Pitié-Salpétrière Academic Hospital, Department of Urology, Sorbonne University, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Véronique Phé
- Pitié-Salpétrière Academic Hospital, Department of Urology, Sorbonne University, Assistance Publique-Hôpitaux de Paris, Paris, France
| |
Collapse
|
13
|
Guillot-Tantay C, Chartier-Kastler E, Perrouin-Verbe MA, Denys P, Léon P, Phé V. MP49-14 COMPLICATIONS OF NON-CONTINENT CUTANEOUS URINARY DIVERSION IN ADULT SPINAL CORD. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.1605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
14
|
Guillot-Tantay C, Chartier-Kastler E, Perrouin-Verbe MA, Denys P, Léon P, Phé V. Complications of non-continent cutaneous urinary diversion in adults with spinal cord injury: a retrospective study. Spinal Cord 2018. [DOI: 10.1038/s41393-018-0083-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
15
|
Guillot-Tantay C, Chartier-Kastler E, Mozer P, Bitker MO, Richard F, Ambrogi V, Denys P, Léon P, Phé V. [Male neurogenic stress urinary incontinence treated by artificial urinary sphincter AMS 800™ (Boston Scientific, Boston, USA): Very long-term results (>25 years)]. Prog Urol 2017; 28:39-47. [PMID: 29102375 DOI: 10.1016/j.purol.2017.09.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 08/03/2017] [Accepted: 09/26/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The aim of the study was to report the very long-term functional outcomes of artificial urinary sphincter (AUS) in male neurological patients. MATERIAL AND METHODS Male neurological patients diagnosed with stress urinary incontinence due to sphincter deficiency and undergoing AUS (AMS 800®) implantation between 1985 and 1992 were enrolled. Continence, defined by no pad/condom usage, explantation and revision rates were reported. RESULTS Fourteen patients with a median age of 27.3 years (IQR: 27.3-40.8) were included: four had a spinal cord injury and ten a spina bifida. Prior continence surgery was reported by 6 patients (42.9 %). Artificial urinary sphincter was implanted in a peribulbar (n=4) or periprostatic position (n=10). Median follow-up was 18.3 years (IQR: 10.1-20.3). At last follow-up, all patients were alive. Three native devices were still in place, eight were revised (four of them were secondarily explanted) and three were explanted due to erosion or infection. The 5-, 10-, 15-, 20-year explantation-free survival rates were respectively 85.7, 62.3, 52.0, 39.0 %. The 5-, 10-, 15-, 20-year revision-free survival rates were respectively 78.6, 42.9, 28.6, 7.1 %. At last follow-up, 50 % patients were continent. CONCLUSION In the very long run, AUS provided a 50 % continence rate in male neurological patients but the revision rates were important. LEVEL OF EVIDENCE 4.
Collapse
Affiliation(s)
- C Guillot-Tantay
- Service d'urologie et de transplantation rénale, hôpital universitaire La Pitié Salpêtrière, Assistance publique-Hôpitaux de Paris, faculté de médecine Pierre et Marie Curie, Sorbonne universités, université Paris 6, 47-83, boulevard de L'hôpital, 75013 Paris, France.
| | - E Chartier-Kastler
- Service d'urologie et de transplantation rénale, hôpital universitaire La Pitié Salpêtrière, Assistance publique-Hôpitaux de Paris, faculté de médecine Pierre et Marie Curie, Sorbonne universités, université Paris 6, 47-83, boulevard de L'hôpital, 75013 Paris, France
| | - P Mozer
- Service d'urologie et de transplantation rénale, hôpital universitaire La Pitié Salpêtrière, Assistance publique-Hôpitaux de Paris, faculté de médecine Pierre et Marie Curie, Sorbonne universités, université Paris 6, 47-83, boulevard de L'hôpital, 75013 Paris, France
| | - M-O Bitker
- Service d'urologie et de transplantation rénale, hôpital universitaire La Pitié Salpêtrière, Assistance publique-Hôpitaux de Paris, faculté de médecine Pierre et Marie Curie, Sorbonne universités, université Paris 6, 47-83, boulevard de L'hôpital, 75013 Paris, France
| | - F Richard
- Service d'urologie et de transplantation rénale, hôpital universitaire La Pitié Salpêtrière, Assistance publique-Hôpitaux de Paris, faculté de médecine Pierre et Marie Curie, Sorbonne universités, université Paris 6, 47-83, boulevard de L'hôpital, 75013 Paris, France
| | - V Ambrogi
- Service d'urologie et de transplantation rénale, hôpital universitaire La Pitié Salpêtrière, Assistance publique-Hôpitaux de Paris, faculté de médecine Pierre et Marie Curie, Sorbonne universités, université Paris 6, 47-83, boulevard de L'hôpital, 75013 Paris, France
| | - P Denys
- Service de médecine physique et réadaptation, hôpital Raymond-Poincaré, Assistance publique-Hôpitaux de Paris, UFR des sciences de la santé Simone Veil, université Versailles-Saint-Quentin-en-Yvelines, 104, boulevard Raymond-Poincaré, 92380 Garches, France
| | - P Léon
- Service d'urologie et de transplantation rénale, hôpital universitaire La Pitié Salpêtrière, Assistance publique-Hôpitaux de Paris, faculté de médecine Pierre et Marie Curie, Sorbonne universités, université Paris 6, 47-83, boulevard de L'hôpital, 75013 Paris, France
| | - V Phé
- Service d'urologie et de transplantation rénale, hôpital universitaire La Pitié Salpêtrière, Assistance publique-Hôpitaux de Paris, faculté de médecine Pierre et Marie Curie, Sorbonne universités, université Paris 6, 47-83, boulevard de L'hôpital, 75013 Paris, France
| |
Collapse
|
16
|
Léon P, López J, Elola C, Domingo C, Echevarría J. Detection of Antibody to Hepatitis C Virus E2 Recombinant Antigen among Samples Indeterminate for Anti-HCV after Wide Serological Testing and Correlation with Viremia. Vox Sang 2017. [DOI: 10.1159/000462118] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
17
|
Léon P, Cancel Tassin G, Sighar K, Compérat E, Gaffory C, Ondet V, Hugonin S, Audouin M, Doizi S, Traxer O, Ciofu C, Rouprêt M, Lacave R, Cussenot O. [Correlation of genetic and cytogenetic alterations in pathological aggressiveness urothelial carcinoma of the bladder: Performance of BCA-1, a mini-array comparative genomic hybridisation-based test]. Prog Urol 2017; 27:451-457. [PMID: 28576425 DOI: 10.1016/j.purol.2017.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 05/05/2017] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Urothelial carcinomas are the fourth leading cause of cancer in humans. Their incidence is increasing by more than 50% in 25 years. The superficial forms (70% cases) require a close active surveillance to identify frequent recurrences and progression to invasive stage. Our main goal was to identify prognostic molecular markers for bladder cancer that could be used alone or in combination in routine clinical practice. In this aim, we evaluated the capability of the BCA-oligo test based on a CGH array to correctly classify tumoral grade/stage. METHOD Urinary DNA was extracted from 81 patients with superficial bladder cancer and has been hybridized on the BCA-oligo array. The results from the molecular analysis were correlated with the tumoral grade and stage. RESULTS Several chromosomal alterations were significantly more frequent in tumors of higher grade and more advanced stage. A significant association was observed between a high grade and the presence of one of these alterations: loss on 6p, gain on 8q or 13q, loss or gain on 9q or 11q, with an odds ratio of 6.91 (95% CI=2.20-21.64; P=0.0009). Moreover, a significant association was found between a more advanced stage (pT1) and the presence of one of these alterations: loss on 6p, gain on 8q, loss or gain on 5p, with an odds ratio of 15.2 (95% CI=3.71-62.58; P=0.0002). CONCLUSION Our results showed that molecular analyses of superficial bladder cancers based on urinary DNA and the BCA-oligo test could be used as prognostic factor for the tumor evolution, allowing then a more adapted clinical management.
Collapse
Affiliation(s)
- P Léon
- GRC n(o) 5, ONCOTYPE-URO, institut universitaire de cancérologie, UPMC université Paris 06, 75020 Paris, France; Département de chirurgie urologique, CHU de Reims, rue Cognacq-Jay, 51000 Reims, France.
| | - G Cancel Tassin
- GRC n(o) 5, ONCOTYPE-URO, institut universitaire de cancérologie, UPMC université Paris 06, 75020 Paris, France; CeRePP, 75020 Paris, France
| | - K Sighar
- Arraygenomics, 78960 Voisins-le-Bretonneux, France
| | - E Compérat
- GRC n(o) 5, ONCOTYPE-URO, institut universitaire de cancérologie, UPMC université Paris 06, 75020 Paris, France; CeRePP, 75020 Paris, France; Département d'anatomopathologie, hôpital de la Pitié-Salpétrière, UPMC université Paris 06, AP-HP, 75013 Paris, France
| | - C Gaffory
- GRC n(o) 5, ONCOTYPE-URO, institut universitaire de cancérologie, UPMC université Paris 06, 75020 Paris, France; CeRePP, 75020 Paris, France
| | - V Ondet
- GRC n(o) 5, ONCOTYPE-URO, institut universitaire de cancérologie, UPMC université Paris 06, 75020 Paris, France; CeRePP, 75020 Paris, France; Département de chirurgie urologique, hôpital Tenon, UPMC université Paris 06, AP-HP, 75020 Paris, France
| | - S Hugonin
- Département de biologie tumorale, hôpital Tenon, UPMC université Paris 06, AP-HP, 75020 Paris, France
| | - M Audouin
- GRC n(o) 5, ONCOTYPE-URO, institut universitaire de cancérologie, UPMC université Paris 06, 75020 Paris, France; Département de chirurgie urologique, hôpital Tenon, UPMC université Paris 06, AP-HP, 75020 Paris, France
| | - S Doizi
- Département de chirurgie urologique, hôpital Tenon, UPMC université Paris 06, AP-HP, 75020 Paris, France
| | - O Traxer
- Département de chirurgie urologique, hôpital Tenon, UPMC université Paris 06, AP-HP, 75020 Paris, France
| | - C Ciofu
- Département de chirurgie urologique, hôpital Tenon, UPMC université Paris 06, AP-HP, 75020 Paris, France
| | - M Rouprêt
- GRC n(o) 5, ONCOTYPE-URO, institut universitaire de cancérologie, UPMC université Paris 06, 75020 Paris, France; CeRePP, 75020 Paris, France; Département de chirurgie urologique, hôpital de la Pitié-Salpétrière, UPMC université Paris 06, AP-HP, 75013 Paris, France
| | - R Lacave
- Département de biologie tumorale, hôpital Tenon, UPMC université Paris 06, AP-HP, 75020 Paris, France
| | - O Cussenot
- GRC n(o) 5, ONCOTYPE-URO, institut universitaire de cancérologie, UPMC université Paris 06, 75020 Paris, France; CeRePP, 75020 Paris, France; Département de chirurgie urologique, hôpital Tenon, UPMC université Paris 06, AP-HP, 75020 Paris, France
| |
Collapse
|
18
|
Guillot-Tantay C, Chartier-Kastler E, Perrouin-Verbe M, Denys P, Léon P, Phé V. Complications à long terme des dérivations urinaires non continentes de type Bricker chez les patients blessés médullaires. Prog Urol 2016. [DOI: 10.1016/j.purol.2016.07.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
19
|
Phé V, Léon P, Granger B, Denys P, Bitker MO, Mozer P, Chartier-Kastler E. Stress urinary incontinence in female neurological patients: long-term functional outcomes after artificial urinary sphincter (AMS 800TM
) implantation. Neurourol Urodyn 2016; 36:764-769. [DOI: 10.1002/nau.23019] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Accepted: 03/30/2016] [Indexed: 11/10/2022]
Affiliation(s)
- Véronique Phé
- Department of Urology; Pitié-Salpêtrière Academic Hospital; Assistance Publique-Hôpitaux de Paris; Pierre and Marie Curie Medical School; Paris 6 University; Paris France
| | - Priscilla Léon
- Department of Urology; Pitié-Salpêtrière Academic Hospital; Assistance Publique-Hôpitaux de Paris; Pierre and Marie Curie Medical School; Paris 6 University; Paris France
| | - Benjamin Granger
- Department of Statistics; Pitié-Salpêtrière Academic Hospital; Assistance Publique-Hôpitaux de Paris; Pierre and Marie Curie Medical School; Paris 6 University; Paris France
| | - Pierre Denys
- Department of Physical Medicine and Rehabilitation; Raymond Poincaré Hospital; Assistance Publique-Hôpitaux de Paris; Paris France
| | - Marc-Olivier Bitker
- Department of Urology; Pitié-Salpêtrière Academic Hospital; Assistance Publique-Hôpitaux de Paris; Pierre and Marie Curie Medical School; Paris 6 University; Paris France
| | - Pierre Mozer
- Department of Urology; Pitié-Salpêtrière Academic Hospital; Assistance Publique-Hôpitaux de Paris; Pierre and Marie Curie Medical School; Paris 6 University; Paris France
| | - Emmanuel Chartier-Kastler
- Department of Urology; Pitié-Salpêtrière Academic Hospital; Assistance Publique-Hôpitaux de Paris; Pierre and Marie Curie Medical School; Paris 6 University; Paris France
| |
Collapse
|
20
|
Affiliation(s)
| | | | | | | | - Morgan Rouprêt
- Academic Department of Urology of La Pitié-Salpétrière, Assistance-Publique Hôpitaux de Paris, Faculté de Médecine Pierre et Marie Curie, University Paris 6; UPMC University Paris 06, GRC n°5, ONCOTYPE-URO, Paris, France
| |
Collapse
|
21
|
Phe V, Compérat E, Chartier-Kastler E, Léon P, Cussenot O, Gamé X, Karsenty G, Ruffion A, Drouin S, Rouprêt M. Étude de l’influence de l’expression de Foxp3 (Forkhead box protein) sur la survie des patients neuro-urologiques ayant une tumeur de vessie. Prog Urol 2015; 25:849. [DOI: 10.1016/j.purol.2015.08.267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
22
|
Seisen T, Granger B, Colin P, Léon P, Utard G, Renard Penna R, Compérat E, Mozer P, Cussenot O, Shariat S, Rouprêt M. Revue systématique de la littérature et méta-analyse des facteurs de risque de récidive vésicale après néphro-uréterectomie totale pour le traitement d’une tumeur de la voie excrétrice urinaire supérieure. Prog Urol 2015; 25:805. [DOI: 10.1016/j.purol.2015.08.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
23
|
Seisen T, Rouprêt M, Cancel Tassin G, Léon P, Compérat E, Drouin S, Phé V, Renard Penna R, Mozer P, Cussenot O. Évaluation du risque de récidive vésicale par la recherche de la mutation FGFR3 sur l’ADN urinaire prélevé avant néphro-uréterectomie pour le traitement d’une tumeur de la voie excrétrice supérieure. Prog Urol 2015; 25:806. [DOI: 10.1016/j.purol.2015.08.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
24
|
Bigot P, Bernhard J, Gill I, Vuong N, Verhoest G, Flammand V, Reix B, Suer E, Gökce I, Beauval J, Nouhaud F, Eto M, Baco E, Matsugasumi T, Chowaniec Y, Rigaud J, Lenormand C, Pfister C, Hetet J, Ploussard G, Roupret M, Léon P, El bakri A, Larré S, Tillou X, Doerfler A, Descazeaud A. Les résultats de la néphrectomie partielle pour les carcinomes chromophobes du rein sont excellents. Étude rétrospective multicentrique à partir de 234 cas. Prog Urol 2015; 25:800. [DOI: 10.1016/j.purol.2015.08.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
25
|
Affiliation(s)
- P Léon
- Service d'urologie et andrologie, hôpital de la Pitié-Salpêtrière, Paris, France
| | - S Drouin
- Hôpital de la Pitié-Salpêtrière, Paris, France
| | - T Seisen
- Hôpital de la Pitié-Salpêtrière, Paris, France
| | | | - P Mozer
- Hôpital de la Pitié-Salpêtrière, Paris, France
| | - O Cussenot
- Hôpital de la Pitié-Salpêtrière, Paris, France
| | - M Bitker
- Hôpital de la Pitié-Salpêtrière, Paris, France
| | - M Rouprêt
- Hôpital de la Pitié-Salpêtrière, Paris, France
| |
Collapse
|
26
|
Léon P, Kloutidis N, Calves J, Compérat E, Funes de la Vega M, Cancel Tassin G, Ciofu C, Haab F, Fournier G, Korman P, Valeri A, Rouprêt M, Cormier L, Larré S, Cussenot O. [Not Available]. Prog Urol 2015; 24:784. [PMID: 26461534 DOI: 10.1016/j.purol.2014.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- P Léon
- Service d'urologie et andrologie, hôpital de la Pitié-Salpêtrière, Paris, France
| | - N Kloutidis
- Service d'urologie, CHU de Dijon, Dijon, France
| | - J Calves
- Service d'urologie, CHU de Brest, Brest, France
| | - E Compérat
- Service d'anatomopathologie, hôpital de la Pitié-Salpêtrière, CeRePP, Paris, France
| | | | - G Cancel Tassin
- GRC-N(o)5 Institut universitaire de cancérologie Paris 6 (urologie-anatomo-pathologie Pitié/Tenon), CeReSPP, Paris, France
| | - C Ciofu
- GRC-N(o)5 Institut universitaire de cancérologie Paris 6 (urologie-anatomo-pathologie Pitié/Tenon), CeReSPP, Paris, France
| | - F Haab
- GRC-N(o)5 Institut universitaire de cancérologie Paris 6 (urologie-anatomo-pathologie Pitié/Tenon), CeReSPP, Paris, France
| | - G Fournier
- Service d'urologie du CHU de Brest et CeRePP, Brest, France
| | - P Korman
- Myriad Genetics SAS, Issy les Moulineaux, France
| | - A Valeri
- Service d'urologie du CHU de Brest et CeRePP, Brest, France
| | - M Rouprêt
- GRC-N(o)5 Institut universitaire de cancérologie Paris 6 (urologie-anatomo-pathologie Pitié/Tenon), CeReSPP, Paris, France
| | - L Cormier
- Service d'urologie, CHU de Dijon, CeRePP, Dijon, France
| | - S Larré
- Service d'urologie, CHU de Reims, CeRePP, Reims, France
| | - O Cussenot
- GRC-N(o)5 Institut universitaire de cancérologie Paris 6 (urologie-anatomo-pathologie Pitié/Tenon), CeReSPP, Paris, France
| |
Collapse
|
27
|
Renard-Penna R, Cancel-Tassin G, Comperat E, Varinot J, Léon P, Roupret M, Mozer P, Vaessen C, Lucidarme O, Bitker MO, Cussenot O. Multiparametric Magnetic Resonance Imaging Predicts Postoperative Pathology but Misses Aggressive Prostate Cancers as Assessed by Cell Cycle Progression Score. J Urol 2015; 194:1617-23. [PMID: 26272031 DOI: 10.1016/j.juro.2015.06.107] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE We identified prognostic biomarkers in prostate cancer by a radiogenomics strategy that integrates gene expression using the cell cycle progression score and medical images. MATERIALS AND METHODS We obtained institutional review board approval and written informed consent from 106 men with prostate cancer, including 60% at low risk, who underwent multiparametric magnetic resonance imaging before radical prostatectomy was done and a cell cycle progression score was determined. The correlation between the results of multiparametric magnetic resonance imaging and Gleason grade or cell cycle progression score was assessed by logistic regression. RESULTS Patients with primary Gleason grade greater than 3 had a longer median maximal tumor diameter (13 vs 10 mm) and a lower median apparent diffusion coefficient (0.745 vs 0.88×10(-3) mm2 per second, each p=0.0001) than those with primary Gleason grade 3 or less. Maximal diameter 10 mm or greater (OR 4.9, 95% CI 1.7 to 14.0, p=0.0012) and apparent diffusion coefficient 0.80×10(-3) mm2 per second or less (OR 7.5, 95% CI 3.0 to 18.7, p<0.0001) were significantly associated with primary Gleason grade greater than 3. The combined measure of maximal diameter less than 10 mm and apparent diffusion coefficient greater than 0.80×10(-3) mm2 per second identified only index lesions harboring primary Gleason grade 3. However, 7 of those lesions showed a molecular pattern of high risk lethal prostate cancer (cell cycle progression score greater than 0). CONCLUSIONS Multiparametric magnetic resonance imaging is able to predict low and high risk Gleason scores in the tumor. However, the cell cycle progression score did not completely match the imaging result. These findings suggest that management of early stages prostate cancer could strongly benefit by performing magnetic resonance imaging targeted biopsy coupled with molecular analysis.
Collapse
Affiliation(s)
- Raphaële Renard-Penna
- Institut Universitaire de Cancérologie, ONCOTYPE-URO, GRC No. 5, Université Pierre et Marie Curie, Université Paris 06, Pitié-Salpêtrière Hospital, Paris, France; Department of Radiology, Pitié-Salpêtrière Hospital, Paris, France
| | - Géraldine Cancel-Tassin
- Institut Universitaire de Cancérologie, ONCOTYPE-URO, GRC No. 5, Université Pierre et Marie Curie, Université Paris 06, Pitié-Salpêtrière Hospital, Paris, France; Assistance Publique-Hôpitaux de Paris and Centre Recherche Pathologies Prostatique, Paris, France
| | - Eva Comperat
- Institut Universitaire de Cancérologie, ONCOTYPE-URO, GRC No. 5, Université Pierre et Marie Curie, Université Paris 06, Pitié-Salpêtrière Hospital, Paris, France; Department of Pathology, Pitié-Salpêtrière Hospital, Paris, France; Assistance Publique-Hôpitaux de Paris and Centre Recherche Pathologies Prostatique, Paris, France
| | - Justine Varinot
- Institut Universitaire de Cancérologie, ONCOTYPE-URO, GRC No. 5, Université Pierre et Marie Curie, Université Paris 06, Pitié-Salpêtrière Hospital, Paris, France; Department of Pathology, Pitié-Salpêtrière Hospital, Paris, France
| | - Priscilla Léon
- Institut Universitaire de Cancérologie, ONCOTYPE-URO, GRC No. 5, Université Pierre et Marie Curie, Université Paris 06, Pitié-Salpêtrière Hospital, Paris, France; Department of Urology, Pitié-Salpêtrière Hospital, Paris, France
| | - Morgan Roupret
- Institut Universitaire de Cancérologie, ONCOTYPE-URO, GRC No. 5, Université Pierre et Marie Curie, Université Paris 06, Pitié-Salpêtrière Hospital, Paris, France; Department of Urology, Pitié-Salpêtrière Hospital, Paris, France; Assistance Publique-Hôpitaux de Paris and Centre Recherche Pathologies Prostatique, Paris, France
| | - Pierre Mozer
- Institut Universitaire de Cancérologie, ONCOTYPE-URO, GRC No. 5, Université Pierre et Marie Curie, Université Paris 06, Pitié-Salpêtrière Hospital, Paris, France; Department of Urology, Pitié-Salpêtrière Hospital, Paris, France
| | - Christophe Vaessen
- Institut Universitaire de Cancérologie, ONCOTYPE-URO, GRC No. 5, Université Pierre et Marie Curie, Université Paris 06, Pitié-Salpêtrière Hospital, Paris, France; Department of Urology, Pitié-Salpêtrière Hospital, Paris, France
| | | | - Marc-Olivier Bitker
- Institut Universitaire de Cancérologie, ONCOTYPE-URO, GRC No. 5, Université Pierre et Marie Curie, Université Paris 06, Pitié-Salpêtrière Hospital, Paris, France; Department of Urology, Pitié-Salpêtrière Hospital, Paris, France
| | - Olivier Cussenot
- Institut Universitaire de Cancérologie, ONCOTYPE-URO, GRC No. 5, Université Pierre et Marie Curie, Université Paris 06, Pitié-Salpêtrière Hospital, Paris, France; Department of Urology, Pitié-Salpêtrière Hospital, Paris, France; Assistance Publique-Hôpitaux de Paris and Centre Recherche Pathologies Prostatique, Paris, France.
| |
Collapse
|
28
|
Seisen T, Granger B, Colin P, Léon P, Utard G, Renard-Penna R, Compérat E, Mozer P, Cussenot O, Shariat SF, Rouprêt M. A Systematic Review and Meta-analysis of Clinicopathologic Factors Linked to Intravesical Recurrence After Radical Nephroureterectomy to Treat Upper Tract Urothelial Carcinoma. Eur Urol 2015; 67:1122-1133. [DOI: 10.1016/j.eururo.2014.11.035] [Citation(s) in RCA: 162] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2014] [Accepted: 11/18/2014] [Indexed: 12/26/2022]
|
29
|
Phé V, Léon P, Granger B, Rouprêt M, Denys P, Bitker MO, Charttier-Kastler E. PD10-11 LONG-TERM FUNCTIONAL OUTCOMES AFTER ARTIFICIAL URINARY SPHINCTER (AMS 800®) IMPLANTATION IN FEMALE NEUROGENIC PATIENTS WITH STRESS URINARY INCONTINENCE. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
30
|
Léon P, Chartier-Kastler E, Rouprêt M, Denys P, Robain G, Montgiat-Artus P, Phé V. PD11-09 LONG-TERM FUNCTIONAL OUTCOMES OF AUGMENTATION CYSTOPLASTY IN ADULT SPINA BIFIDA PATIENTS: A SINGLE-CENTER EXPERIENCE IN A MULTIDISCIPLINARY TEAM. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.1098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
31
|
Bigot P, Bernhard JC, Gill I, Verhoest G, Reix B, Suer E, Eto M, Nouhaud FX, Flammand V, Gökce I, Matsugasumi T, Beauval JB, Chowaniec Y, Rigaud J, Lenormand C, Pfister C, Hetet JF, Ploussard G, Son VUONG N, Baco E, Rouprêt M, Léon P, El Bakhri A, Larré S, Tillou X, Doerfler A, Descazeau A, Sebe P, Koutlidis N, Schneider A, Azzouzi AR, Soulié M, Bensalah K, Patard JJ. MP63-12 NON CLEAR CELL RENAL CELL CARCINOMAS: ONCOLOGICAL OUTCOME AFTER NEPHRON SPARING SURGERY BASED ON AN INTERNATIONAL MULTICENTER STUDY. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.2344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
32
|
Bigot P, Bernhard JC, Gill I, Verhoest G, Reix B, Suer E, Eto M, Nouhaud FX, Flammand V, GÖKCE I, Matsugasumi T, Beauval JB, Lenormand C, Chowaniec Y, Rigaud J, Pfister C, Hetet JF, Ploussard G, Son VUONG N, Baco E, Rouprêt M, Léon P, El Bakhri A, Larré S, Tillou X, Doerfler A, Descazeau A, Sebe P, Koutlidis N, Schneider A, Azzouzi AR, Soulié M, Bensalah K, Patard JJ. MP63-15 THE SUBCLASSIFICATION OF PAPILLARY RENAL CELL CARCINOMA DOES NOT AFFECT ONCOLOGICAL OUTCOMES AFTER NEPHRON SPARING SURGERY. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.2347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
33
|
Seisen T, Rouprêt M, Brault D, Léon P, Cancel-Tassin G, Compérat E, Renard-Penna R, Mozer P, Guechot J, Cussenot O. Accuracy of the prostate health index versus the urinary prostate cancer antigen 3 score to predict overall and significant prostate cancer at initial biopsy. Prostate 2015; 75:103-11. [PMID: 25327361 DOI: 10.1002/pros.22898] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Accepted: 08/21/2014] [Indexed: 11/07/2022]
Abstract
BACKGROUND It remains unclear whether the Prostate Health Index (PHI) or the urinary Prostate-Cancer Antigen 3 (PCA-3) score is more accurate at screening for prostate cancer (PCa). The aim of this study was to prospectively compare the accuracy of PHI and PCA-3 scores to predict overall and significant PCa in men undergoing an initial prostate biopsy. METHODS Double-blind assessments of PHI and PCA-3 were conducted by referent physicians in 138 patients who subsequently underwent trans-rectal ultrasound-guided prostate biopsy according to a 12-core scheme. Predictive accuracies of PHI and PCA-3 were assessed using AUC and compared according to the DeLong method. Diagnostic performances with usual cut-off values for positivity (i.e., PHI >40 and PCA-3 >35) were calculated, and odds ratios associated with predicting PCa overall and significant PCa as defined by pathological updated Epstein criteria (i.e., Gleason score ≥7, more than three positive cores, or >50% cancer involvement in any core) were estimated using logistic regression. RESULTS Prevalences of overall and significant PCa were 44.9% and 28.3%, respectively. PCA-3 (AUC = 0.71) was the most accurate predictor of PCa overall, and significantly outperformed PHI (AUC = 0.65; P = 0.03). However, PHI (AUC = 0.80) remained the most accurate predictor when screening exclusively for significant PCa and significantly outperformed PCA-3 (AUC = 0.55; P = 0.03). Furthermore, PCA-3 >35 had the best accuracy, and positive or negative predictive values when screening for PCa overall whereas these diagnostic performances were greater for PHI >40 when exclusively screening for significant PCa. PHI > 40 combined with PCA-3 > 35 was more specific in both cases. In multivariate analyses, PCA-3 >35 (OR = 5.68; 95%CI = [2.21-14.59]; P < 0.001) was significantly correlated with the presence of PCa overall, but PHI >40 (OR = 9.60; 95%CI = [1.72-91.32]; P = 0.001) was the only independent predictor for detecting significant PCa. CONCLUSIONS Although PCA-3 score is the best predictor for PCa overall at initial biopsy, our findings strongly indicate that PHI should be used for population-based screening to avoid over-diagnosis of indolent tumors that are unlikely to cause death.
Collapse
Affiliation(s)
- Thomas Seisen
- Academic Department of Urology, Pitié-Salpétrière Hospital, AP-HP, Paris, France; UPMC Univ Paris 06, GRC5, ONCOTYPE-URO, Institut Universitaire de Cancérologie, Paris, France
| | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Seisen T, Colin P, Hupertan V, Léon P, Bozzini G, Nison L, Phé V, Rozet F, Shariat S, Cussenot O, Rouprêt M. Validation externe du nomogramme prédictif de la récidive vésicale après néphro-urétérectomie totale pour le traitement des tumeurs de la voie excrétrice urinaire supérieure. Prog Urol 2014; 24:845-6. [DOI: 10.1016/j.purol.2014.08.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
35
|
Léon P, Staerman F, Pogu B, Lupsasca N. Résultats des biopsies prostatiques à 1 an chez des patients placés en surveillance active (protocole PRIAS). Prog Urol 2014; 24:870-1. [DOI: 10.1016/j.purol.2014.08.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
36
|
Léon P, Staerman F, Pogu B, Lupsasca N. Résultats anatomo-pathologiques après prostatectomie radicale (PR) chez des patients initialement placés en surveillance active (protocole PRIAS). Prog Urol 2014; 24:871. [DOI: 10.1016/j.purol.2014.08.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
37
|
Léon P, Chartier-Kastler E, Rouprêt M, Ambrogi V, Mozer P, Phé V. Long-term functional outcomes after artificial urinary sphincter implantation in men with stress urinary incontinence. BJU Int 2014; 115:951-7. [PMID: 24958004 DOI: 10.1111/bju.12848] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate long-term functional outcomes of artificial urinary sphincters (AUSs) and to determine how many men required explantation because of stress urinary incontinence (SUI) caused by sphincter deficiency after prostate surgery. PATIENTS AND METHODS Men who had undergone placement of an AUS (American Medical Systems AMS 800®) between 1984 and 1992 to relieve SUI caused by sphincter deficiency after prostate surgery were included. Continence, defined as no need for pads, was assessed at the end of the follow-up. Kaplan-Meier survival curves estimated the survival rate of the device without needing explantation or revision. RESULTS In all, 57 consecutive patients were included with a median (interquartile range, IQR) age of 69 (64-72) years. The median (IQR) duration of follow-up was 15 (8.25-19.75) years. At the end of follow-up, 25 patients (43.8%) still had their primary AUS. The AUS was explanted in nine men because of erosion (seven) and infection (two). Survival rates, without AUS explantation, were 87%, 87%, 80%, and 80% at 5, 10, 15, and 20 years, respectively. Survival rates, without AUS revision, were 59%, 28%, 15%, and 5% at 5, 10, 15, and 20 years, respectively. At the end of the follow-up, in intention-to-treat analysis, 77.2% of patients were continent. CONCLUSION In the long term (>10 years) the AMS 800 can offer a high rate of continence to men with SUI caused by sphincter deficiency, with a tolerable rate of explantation and revision.
Collapse
Affiliation(s)
- Priscilla Léon
- Department of Urology, Pitié-Salpétrière Academic Hospital, Paris, France
| | | | - Morgan Rouprêt
- Department of Urology, Pitié-Salpétrière Academic Hospital, Paris, France
| | - Vanina Ambrogi
- Department of Statistics, Assistance Publique-Hôpitaux de Paris, Pierre and Marie Curie Medical School, Paris 6 University, Paris, France
| | - Pierre Mozer
- Department of Urology, Pitié-Salpétrière Academic Hospital, Paris, France
| | - Véronique Phé
- Department of Urology, Pitié-Salpétrière Academic Hospital, Paris, France
| |
Collapse
|
38
|
Léon P, Jolly C, Binet A, Fiquet C, Vilette C, Lefebvre F, Bouché-Pillon-Persyn MA, Poli-Mérol ML. Botulinum toxin injections in the management of non-neurogenic overactive bladders in children. J Pediatr Surg 2014; 49:1424-8. [PMID: 25148752 DOI: 10.1016/j.jpedsurg.2014.04.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2013] [Revised: 03/20/2014] [Accepted: 04/09/2014] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Non-neurogenic detrusor overactivity in children leads to varying degrees of functional impairments (urinary urgency, pollakiuria, urge incontinence, nocturia). Botulinum toxin has shown its effectiveness in the management of detrusor overactivity in neurological patients. OBJECTIVES To evaluate the relevance of intravesical Botulinum toxin injections for the treatment of non-neurogenic overactive bladders in children. These pediatric patients were resistant to all the usual therapeutics (e.g. bladder/bowel rehabilitation, anticholinergic drugs, management of diet/hygiene habits and constipation, percutaneous posterior tibial nerve stimulation). MATERIALS AND METHODS 8 children (mean age: 12.5years), 5 girls, 3 boys with daytime and/or nighttime incontinence and non-neurogenic detrusor overactivity validated by urodynamic testing. Urodynamic testing was conducted before the injections as well as 6weeks and 1year post injections. We used Dysport® 8 Speywood Units/kg injected via cystoscopy into 25 different sites. RESULTS We noted improvements without any complaints during bladder voiding for all patients, in 6 patients the overactivity disappeared after 1 injection. Compliance was improved early-on in half the cases and at 1year for all cases (from 12% to 61%, p=0.01). Noninhibited contractions decreased constantly in both frequency and intensity. Clinical symptoms improved: mean of 7.75 daytime urinary incontinence episodes (IE) per week before the injection vs. 3 after the procedure (p=0.04). For nighttime IE the improvement was even more noticeable with 7.38 nighttime IE episodes per week before the injection vs. 2.06 after the procedure (p=0,02). CONCLUSION Intradetrusor Botulinum toxin injections are a potential therapeutic option for the management of non-neurogenic detrusor overactivity in children resistant to the usual treatments.
Collapse
Affiliation(s)
- Priscilla Léon
- Pediatric Surgery Department, American Hospital, CHU de Reims, France.
| | - Catherine Jolly
- Pediatric Surgery Department, American Hospital, CHU de Reims, France
| | - Aurélien Binet
- Pediatric Surgery Department, American Hospital, CHU de Reims, France
| | - Caroline Fiquet
- Pediatric Surgery Department, American Hospital, CHU de Reims, France
| | - Christine Vilette
- Pediatric Surgery Department, American Hospital, CHU de Reims, France
| | - Francis Lefebvre
- Pediatric Surgery Department, American Hospital, CHU de Reims, France
| | | | | |
Collapse
|
39
|
Léon P, Seisen T, Rouprêt M. Surgical landscape of radical cystectomy for bladder cancer in France over the last 10 years. World J Urol 2014; 33:889-90. [PMID: 24973047 DOI: 10.1007/s00345-014-1352-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 06/18/2014] [Indexed: 11/28/2022] Open
Affiliation(s)
- Priscilla Léon
- Academic Department of Urology of La Pitié-Salpétrière, Assistance-Publique Hôpitaux de Paris, 47-83 bvd de l'Hôpital, 75013, Paris, France
| | | | | |
Collapse
|
40
|
Phé V, Léon P, Ambrogi V, Rouprêt M, Mozer P, Denys P, Chartier-Kastler E. Résultats fonctionnels à très long terme du sphincter urinaire artificiel AMS 800 chez les patients neurologiques. Ann Phys Rehabil Med 2014. [DOI: 10.1016/j.rehab.2014.03.320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
41
|
Léon P, Binet A, Bouche Pillon M, Lefebvre F, Belouadah M, Guyot E, Poret S, Poli-Merol M. Ressenti à long terme des enfants traités pour exstrophie vésicale. Prog Urol 2013. [DOI: 10.1016/j.purol.2013.08.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
42
|
Léon P, Drouin S, Larré S, Champy C, Casenave J, Lasselin J, Bitker M, Cussenot O, Vaessen C, Chartier-Kastler E, Rouprêt M. Étude de la corrélation entre le taux préopératoire de testostérone et les caractéristiques anatomopathologiques des pièces de prostatectomie radicale. Prog Urol 2013. [DOI: 10.1016/j.purol.2013.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
43
|
Lasselin J, Drouin SJ, Champy CM, Léon P, Casenave J, Cussenot O, Bitker MO, Rouprêt M. [Influence of plasmatic testosterone during natural history of prostate cancer: a review]. Prog Urol 2013; 23:438-43. [PMID: 23721702 DOI: 10.1016/j.purol.2013.01.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2012] [Revised: 12/10/2012] [Accepted: 01/13/2013] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Prostate cancer (PCa) is the most common disease in male patients and it has the particularity to be androgen dependent. The aim of the current study was to provide an overview about the interest of testosterone dosage during the management of PCa regardless of the stage of the disease. PATIENTS ET METHODS: A systematic review of the literature was done from the PubMed database by searching the following key words alone or in combination: prostate cancer; testosterone; risk; aggressiveness; hormonotherapy; active surveillance; prognosis; androgen; cardiovascular risk; biochemical recurrence. RESULTS The level of plasmatic testosterone depends on the moment of the day with a peak between the end of the night and in the morning. We can test either the whole testosterone level, the free testosterone level or the bioavailable testosterone. The bioavailable testosterone is more representative of the presence of androgen in tissues but a specialized laboratory is mandatory. The testosterone plasmatic rate is potentially useful during several steps of the PCa management: in localized prostate cancer cases, men with low testosterone levels are more likely to have an aggressive disease and are therefore not good candidates for active surveillance. An extensive radical prostatectomy should be considered in case of young men since these patients are more likely to recur subsequently; in advanced prostate cancer cases, a testosterone level has to be less or equal to 0.2 ng/mL to guarantee an appropriate castration when a patient is undergoing an androgen deprivation treatment. A dissociation between the trend of PSA and testosterone levels can be the starting point of the castration-resistant period of the disease. CONCLUSION The testosterone level can bring useful information regarding the profile of PCa and its ability to evolve during the whole natural history of the disease.
Collapse
Affiliation(s)
- J Lasselin
- Service d'urologie, l'hôpital Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris, groupe de recherche GRC 5 oncotype, institut universitaire de cancérologie de l'UPMC, faculté de médecine Pierre-et-Marie-Curie, université Paris VI, bâtiment Gaston-Cordier, 83, boulevard de l'Hôpital, 75013 Paris, France
| | | | | | | | | | | | | | | |
Collapse
|
44
|
Staerman F, Léon P. Andropause (androgen deficiency of the aging male): diagnosis and management. Minerva Med 2012; 103:333-342. [PMID: 23042368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Androgen deficiency of the aging male is a pathological syndrome and should not be viewed simply as a stage in physiological aging. It is often overlooked despite evidence for a deleterious impact on many physiological processes and on quality of life. Its identification should be part of the routine practice of physicians in charge of this population, in particular general practitioners and specialists treating associated comorbidities (e.g. metabolic syndrome, diabetes, cardiovascular disorders) or sexual dysfunction. The consultant urologist has a key role to play in prostate surveillance before and during treatment. Treatment is often simple with few side-effects. However, long-term benefits and side effects need to be investigated in prospective studies.
Collapse
Affiliation(s)
- F Staerman
- Department of Urology, Institute of Sexual Medicine, Les Bleuets Clinic, Reims, France.
| | | |
Collapse
|
45
|
Léon P, Garbay-Jaureguiberry C, Le Greneur S, Besselièvre R, Roques BP. Tritium labelling of antitumor DNA bis-intercalators: Synthesis of [3H] ditercalinium. J Labelled Comp Radiopharm 2006. [DOI: 10.1002/jlcr.2580251012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
46
|
Léon P, López J, Elola C, Domingo C, Echevarría J. Are Synthetic Peptides Sensitive Enough for Screening Anti-Hepatitis C Virus at Blood Banks? Vox Sang 1994. [DOI: 10.1159/000462564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
47
|
Tuset C, Tuset T, Tuset L, Léon P, Elorza JF, Tacons J. Utility of beta-2-microglobulin concentrations as a marker of infection with human immunodeficiency virus. Pediatr Infect Dis J 1991; 10:551. [PMID: 1876476 DOI: 10.1097/00006454-199107000-00020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
|
48
|
Léon P, Garbay-Jaureguiberry C, Roques BP. Convenient synthesis of 3-methyl-1-(4-pyridinyl)-2-butanone using phenyllithium as a metalating agent. J Heterocycl Chem 1988. [DOI: 10.1002/jhet.5570250554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
49
|
Léon P, Garbay-Jaureguiberry C, Le Pecq JB, Roques BP. Relationship between the size and position of substituents on 7H-pyrido[4,3-c]carbazole monomers and dimers and their DNA binding and anti-tumor properties. Anticancer Drug Des 1988; 3:1-13. [PMID: 3382504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Among the various DNA intercalating molecules prepared in our laboratory, ditercalinium, made up of two 7H-pyrido[4,3-c]carbazole rings linked by a rigid bis-ethylbipiperidine chain (NSC 366241) displays high anti-tumor properties. This dimeric molecule elicits its cytotoxicity through an original mechanism of action. At the molecular level, interaction of ditercalinium with the self-complementary d(CpGpCpG)2 nucleotide has been studied by 1H n.m.r. and the geometry of the bis-intercalating complex has been elucidated. Ditercalinium bis-intercalates through the major groove with the convex face of the 7H-pyrido[4,3-c]carbazole ring oriented toward the sugar moiety. Previous studies have shown the strong modulating effect brought about by substitution of the intercalating ring by methyl groups on both the DNA binding and anti-tumor potency of 7H-pyridocarbazole monomers and dimers. In order to further investigate structure activity relationships in the ditercalinium and related monomers series, a new family of monomeric and dimeric 7H-pyrido[4,3-c]carbazoles was prepared with ethyl, isopropyl or hydroxyethyl substitution on position 6 or 7 of the aromatic ring. DNA binding and anti-tumor potency of these compounds are reported. In contrast to their methylated analogs, none of the 6- or 7-substituted monomers studied here are active although most of them remain able to intercalate into DNA. Substitution of dimeric molecules by substituents of increasing size induces a progressive decrease in the anti-tumor potency, concomitantly with a disappearance of bis-intercalative properties. The modulating effect of the size of substituents on the DNA binding and anti-tumor properties of dimers is more pronounced in the 7-substituted series. These results are discussed in relation to the geometry of intercalation of ditercalinium and its related monomer into d(CpGpCpG)2.
Collapse
Affiliation(s)
- P Léon
- Département de Chimie Organique, U 266 INSERM, UA 498 CNRS, UER des Sciences Pharmaceutiques et Biologiques, Paris, France
| | | | | | | |
Collapse
|
50
|
Abstract
Ditercalinium and its analogues are dimeric molecules made up of two identical 7H-pyrido[4,3-c]carbazole rings linked by symmetrical linking chains. These dimers elicit antitumor properties through a new mechanism of action. Recently, a relationship was found between their antitumor properties and their cytotoxic effect on the polA Escherichia coli mutant strain, suggesting that 7H-pyrido[4,3-c]carbazole dimers might induce a DNA deformation that could be recognized by the E. coli SOS repair system. Thus, the role of symmetry in ditercalinium analogues for their DNA binding, antitumor properties, and bacterial toxicity is investigated in the present study, by introducing asymmetric parameters in their structures. Dimers were either synthesized with an asymmetrical rigid linking chain or made up of two chemically different chromophores, i.e., acridine and 7H-pyrido[4,3-c]carbazole. The asymmetrical dimers remain able to bisintercalate into DNA with high affinities, but a dramatic loss in their antitumor potency is observed. On the other hand, these asymmetrical dimers are cytotoxic for polA E. coli mutants, like their symmetrical analogues. These results show that the symmetry plays a crucial role for the antitumor potency in the 7H-pyrido[4,3-c]carbazole dimers series.
Collapse
Affiliation(s)
- P Léon
- Département de Chimie Organique, U 266 INSERM, UA 498 CNRS, UER des Sciences Pharmaceutiques et Biologiques, Paris, France
| | | | | | | | | |
Collapse
|