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Leyne E, Anselem O, Jordan P, Vivanti AJ, Benachi A, Salomon L, Jacquier M, Jouannic J, Dhombres F, Cambier T, Rosenblatt J, Pannier E, Goffinet F, Tsatsaris V, Athiel Y. Prenatal diagnosis of isolated bilateral clubfoot: Is amniocentesis indicated? Acta Obstet Gynecol Scand 2024; 103:51-58. [PMID: 37942915 PMCID: PMC10755119 DOI: 10.1111/aogs.14716] [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: 05/22/2023] [Revised: 10/09/2023] [Accepted: 10/18/2023] [Indexed: 11/10/2023]
Abstract
INTRODUCTION The aim of this study is to evaluate the benefit of cytogenetic testing by amniocentesis after an ultrasound diagnosis of isolated bilateral talipes equinovarus. MATERIAL AND METHODS This multicenter observational retrospective study includes all prenatally diagnosed cases of isolated bilateral talipes equinovarus in five fetal medicine centers from 2012 through 2021. Ultrasound data, amniocentesis results, biochemical analyses of amniotic fluid and parental blood samples to test neuromuscular diseases, pregnancy outcomes, and postnatal outcomes were collected for each patient. RESULTS In all, 214 fetuses with isolated bilateral talipes equinovarus were analyzed. A first-degree family history of talipes equinovarus existed in 9.8% (21/214) of our cohort. Amniocentesis was proposed to 86.0% (184/214) and performed in 70.1% (129/184) of cases. Of the 184 karyotypes performed, two (1.6%) were abnormal (one trisomy 21 and one triple X syndrome). Of the 103 microarrays performed, two (1.9%) revealed a pathogenic copy number variation (one with a de novo 18p deletion and one with a de novo 22q11.2 deletion) (DiGeorge syndrome). Neuromuscular diseases (spinal muscular amyotrophy, myasthenia gravis, and Steinert disease) were tested for in 56 fetuses (27.6%); all were negative. Overall, 97.6% (165/169) of fetuses were live-born, and the diagnosis of isolated bilateral talipes equinovarus was confirmed for 98.6% (139/141). Three medical terminations of pregnancy were performed (for the fetuses diagnosed with Down syndrome, DiGeorge syndrome, and the 18p deletion). Telephone calls (at a mean follow-up age of 4.5 years) were made to all parents to collect medium-term and long-term follow-up information, and 70 (33.0%) families were successfully contacted. Two reported a rare genetic disease diagnosed postnatally (one primary microcephaly and one infantile glycine encephalopathy). Parents did not report any noticeably abnormal psychomotor development among the other children during this data collection. CONCLUSIONS Despite the low rate of pathogenic chromosomal abnormalities diagnosed prenatally after this ultrasound diagnosis, the risk of chromosomal aberration exceeds the risks of amniocentesis. These data may be helpful in prenatal counseling situations.
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Affiliation(s)
- Edouard Leyne
- Department of Obstetrics and Gynecology, Assistance Publique‐Hôpitaux de Paris, Port‐Royal MaternityUniversity Hospital Center Cochin Broca Hôtel DieuParisFrance
- Inserm UMR 1195Université Paris SaclayLe Kremlin‐BicêtreFrance
| | - Olivia Anselem
- Department of Obstetrics and Gynecology, Assistance Publique‐Hôpitaux de Paris, Port‐Royal MaternityUniversity Hospital Center Cochin Broca Hôtel DieuParisFrance
| | - Pénélope Jordan
- Department of Genomic Medicine of System and Organs Diseases, Cochin Hospital, APHP CentreUniversité Paris CitéParisFrance
| | - Alexandre J. Vivanti
- Inserm UMR 1195Université Paris SaclayLe Kremlin‐BicêtreFrance
- Department of Obstetrics and Gynecology, DMU Santé des Femmes et des Nouveau‐nés, Antoine Béclère Hospital, AP‐HPUniversité Paris SaclayClamartFrance
| | - Alexandra Benachi
- Department of Genomic Medicine of System and Organs Diseases, Cochin Hospital, APHP CentreUniversité Paris CitéParisFrance
| | - Laurent Salomon
- Maternity and Fetal Medicine Department, Necker Enfant Malades Hospital, APHP, EA 7328Université de ParisParisFrance
| | - Mathilde Jacquier
- Maternity and Fetal Medicine Department, Necker Enfant Malades Hospital, APHP, EA 7328Université de ParisParisFrance
| | - Jean‐Marie Jouannic
- Fetal Medicine Department, Armand Trousseau Hospital, AP‐HPSorbonne UniversityParisFrance
| | - Ferdinand Dhombres
- Fetal Medicine Department, Armand Trousseau Hospital, AP‐HPSorbonne UniversityParisFrance
| | - Tatiana Cambier
- Department of Obstetrics and Gynecology, “Robert Debré” HospitalAssistance Publique ‐ Hôpitaux de ParisParisFrance
| | - Jonathan Rosenblatt
- Department of Obstetrics and Gynecology, “Robert Debré” HospitalAssistance Publique ‐ Hôpitaux de ParisParisFrance
| | - Emmanuelle Pannier
- Department of Obstetrics and Gynecology, Assistance Publique‐Hôpitaux de Paris, Port‐Royal MaternityUniversity Hospital Center Cochin Broca Hôtel DieuParisFrance
| | - François Goffinet
- Department of Obstetrics and Gynecology, Assistance Publique‐Hôpitaux de Paris, Port‐Royal MaternityUniversity Hospital Center Cochin Broca Hôtel DieuParisFrance
| | - Vassilis Tsatsaris
- Department of Obstetrics and Gynecology, Assistance Publique‐Hôpitaux de Paris, Port‐Royal MaternityUniversity Hospital Center Cochin Broca Hôtel DieuParisFrance
| | - Yoann Athiel
- Department of Obstetrics and Gynecology, Assistance Publique‐Hôpitaux de Paris, Port‐Royal MaternityUniversity Hospital Center Cochin Broca Hôtel DieuParisFrance
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Latorzeff I, Guerif S, Castan F, Meyer E, Supiot S, Lagneau E, Deniaud-Alexandre E, Ronchin P, Benyoucef A, Cartier L, Hamidou H, Crehange G, Pommier P, Magne N, Zibouche M, Gross E, Ploussard G, Salomon L, Sargos P. GETUG-AFU 22 Phase II Randomized Trial Evaluating Outcomes of Post-Operative Immediate Salvage Radiation Therapy with or without ADT for Patients with Persistently Elevated PSA Level. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.09.011] [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: 11/16/2022]
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Miro-Padovani M, Batista da Costa J, Salomon L, Ingels A, De la Taille A. [High risk localized and locally advanced prostate cancer: Long-term oncological outcomes after prostatectomy]. Prog Urol 2022; 32:702-710. [PMID: 35773175 DOI: 10.1016/j.purol.2022.04.014] [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: 09/12/2021] [Revised: 03/21/2022] [Accepted: 04/28/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION High risk localized and locally advanced forms are responsible for the vast majority of specific deaths from prostate cancer among non-metastatic diseases at diagnosis. No randomized study has yet been published to establish the best local treatment in terms of survival. AIM Conduct a large-volume cohort study with long-term follow-up to analyze specific and overall survival outcomes after surgery. METHOD A single-center retrospective study of all patients operated on for localized high-risk and locally advanced prostate cancer was performed. Actuarial survival analyses and multivariate analyses were performed to discern predictive risk factors. RESULTS Five hundred patients were included. MRI stage was≥iT3a in 40.7% of cases and 50.2% of patients had a Gleason score≥8 on biopsy. The mean follow-up was 63.1 months. The overall, specific and biological recurrence-free survival were respectively 77.6%, 93.9% and 26.8% at 10 years. A PSA level≥20, a Gleason score on biopsy≥9 and a MRI stage≥iT3a were significantly associated with the 10-years biological recurrence risk. CONCLUSION This study shows very good long-term oncological results. In the absence of a randomized controlled trial, these results suggest the primary role of surgery in this indication and support the evolution of current practices. We pointed out very pejorative features that might help selection of the best candidates for surgical treatment. LEVEL OF EVIDENCE: 4
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Affiliation(s)
- M Miro-Padovani
- Service d'urologie et de transplantation rénale, faculté de médecine Paris 12, CHU d'Henri-Mondor, 51, avenue Marechal-de-Lattre-de-Tassigny, 94000 Créteil, France.
| | - J Batista da Costa
- Service d'urologie et de transplantation rénale, faculté de médecine Paris 12, CHU d'Henri-Mondor, 51, avenue Marechal-de-Lattre-de-Tassigny, 94000 Créteil, France.
| | - L Salomon
- Service d'urologie, centre hospitalier Mont-de-Marsan, 417, avenue Pierre-de-Coubertin, 40024 Mont-de-Marsan, France.
| | - A Ingels
- Service d'urologie et de transplantation rénale, faculté de médecine Paris 12, CHU d'Henri-Mondor, 51, avenue Marechal-de-Lattre-de-Tassigny, 94000 Créteil, France.
| | - A De la Taille
- Service d'urologie et de transplantation rénale, faculté de médecine Paris 12, CHU d'Henri-Mondor, 51, avenue Marechal-de-Lattre-de-Tassigny, 94000 Créteil, France.
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Saïer E, Pinar U, De La Taille A, Irani J, Salomon L. Impact des marges chirurgicales positives après prostatectomie radicale chez les patients atteints d’un cancer de la prostate localisé pT2. Prog Urol 2022; 32:354-362. [DOI: 10.1016/j.purol.2022.01.007] [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: 09/04/2021] [Revised: 01/25/2022] [Accepted: 01/28/2022] [Indexed: 10/19/2022]
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Le Bihan E, Derman J, Salomon L, De La Taille A, Irani J, Lebacle C. Recul à 10 ans des patients opérés pour un cancer de prostate Gleason 6 (ISUP1). Prog Urol 2021; 32:108-114. [DOI: 10.1016/j.purol.2021.10.008] [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: 05/19/2021] [Revised: 10/18/2021] [Accepted: 10/21/2021] [Indexed: 11/30/2022]
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Bailleul A, Athiel Y, Gueneuc A, Salomon L. Ultrasound findings in Pseudoamniotic band syndrome after fetoscopic surgery: Antenatal description of three cases and review of literature. J Gynecol Obstet Hum Reprod 2021; 50:102178. [PMID: 34107358 DOI: 10.1016/j.jogoh.2021.102178] [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: 03/24/2021] [Revised: 05/20/2021] [Accepted: 06/01/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Pseudoamniotic Bands Syndrome (PABS) was described as iatrogenic complication from in utero procedure as fetoscopy. OBJECTIVE The aim of our study was to identify the ultrasound findings in PABS diagnosed prenatally METHODS: First, we reported cases of PABS following fetoscopic surgery that were diagnosed prenatally in our institution. We collected all ultrasound data with fetal and neonatal issues. Then, a literature review was conducted by searching the Medline and Cochrane Library computer databases until 2020 to find publications that involve PABS diagnosed prenatally or postnatally. The following keywords were selected and combined: "pseudoamniotic bands syndrome", "fetoscopy", "fetal surgery". RESULTS We collected three cases of PABS diagnosed prenatally in our center following fetoscopic procedures for complicated monochorionic pregnancies. Among these cases, we reported the following ultrasound findings: floating membrane, amniotic bands, striction of limbs, perilesional edema, reduced member size and anomalies of Doppler flow. Including our cases, we reported 23 published PABS of which eight (35%) were prenatally diagnosed. When it was diagnosed, mean GA at PABS diagnosis was 23 weeks (mean interval from fetoscopic to diagnosis was 4 weeks). Three fetoscopic release of amniotic bands were described. The principal parts affected were the limbs, more particularly the extremities. CONCLUSION PABS was accessible to an antenatal diagnosis, as well as ABS. Although it is a rare complication of fetoscopic surgery, ultrasound examinations after procedure should focus on PABS signs to improve prognosis of the neonates.
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Affiliation(s)
- Alexandre Bailleul
- Fetal Medicine Unit, Department of Obstetrics and Fetal Medicine, Necker-Enfants Malades Hospital, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
| | - Yoann Athiel
- Fetal Medicine Unit, Department of Obstetrics and Fetal Medicine, Necker-Enfants Malades Hospital, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Alexandra Gueneuc
- Fetal Medicine Unit, Department of Obstetrics and Fetal Medicine, Necker-Enfants Malades Hospital, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; National Referral Centre for the Management of Complicated Monochorionic Pregnancies, Department of Obstetrics and Fetal Medicine, Necker-Enfants Malades Hospital, Université Paris Descartes, APHP, Paris, France
| | - Laurent Salomon
- Fetal Medicine Unit, Department of Obstetrics and Fetal Medicine, Necker-Enfants Malades Hospital, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; National Referral Centre for the Management of Complicated Monochorionic Pregnancies, Department of Obstetrics and Fetal Medicine, Necker-Enfants Malades Hospital, Université Paris Descartes, APHP, Paris, France
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Ohuma EO, Villar J, Feng Y, Xiao L, Salomon L, Barros FC, Cheikh Ismail L, Stones W, Jaffer Y, Oberto M, Noble JA, Gravett MG, Wu Q, Victora CG, Lambert A, Di Nicola P, Purwar M, Bhutta ZA, Kennedy SH, Papageorghiou AT. Fetal growth velocity standards from the Fetal Growth Longitudinal Study of the INTERGROWTH-21 st Project. Am J Obstet Gynecol 2021; 224:208.e1-208.e18. [PMID: 32768431 PMCID: PMC7858163 DOI: 10.1016/j.ajog.2020.07.054] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/23/2020] [Accepted: 07/29/2020] [Indexed: 01/12/2023]
Abstract
BACKGROUND Human growth is susceptible to damage from insults, particularly during periods of rapid growth. Identifying those periods and the normative limits that are compatible with adequate growth and development are the first key steps toward preventing impaired growth. OBJECTIVE This study aimed to construct international fetal growth velocity increment and conditional velocity standards from 14 to 40 weeks' gestation based on the same cohort that contributed to the INTERGROWTH-21st Fetal Growth Standards. STUDY DESIGN This study was a prospective, longitudinal study of 4321 low-risk pregnancies from 8 geographically diverse populations in the INTERGROWTH-21st Project with rigorous standardization of all study procedures, equipment, and measurements that were performed by trained ultrasonographers. Gestational age was accurately determined clinically and confirmed by ultrasound measurement of crown-rump length at <14 weeks' gestation. Thereafter, the ultrasonographers, who were masked to the values, measured the fetal head circumference, biparietal diameter, occipitofrontal diameter, abdominal circumference, and femur length in triplicate every 5 weeks (within 1 week either side) using identical ultrasound equipment at each site (4-7 scans per pregnancy). Velocity increments across a range of intervals between measures were modeled using fractional polynomial regression. RESULTS Peak velocity was observed at a similar gestational age: 16 and 17 weeks' gestation for head circumference (12.2 mm/wk), and 16 weeks' gestation for abdominal circumference (11.8 mm/wk) and femur length (3.2 mm/wk). However, velocity growth slowed down rapidly for head circumference, biparietal diameter, occipitofrontal diameter, and femur length, with an almost linear reduction toward term that was more marked for femur length. Conversely, abdominal circumference velocity remained relatively steady throughout pregnancy. The change in velocity with gestational age was more evident for head circumference, biparietal diameter, occipitofrontal diameter, and femur length than for abdominal circumference when the change was expressed as a percentage of fetal size at 40 weeks' gestation. We have also shown how to obtain accurate conditional fetal velocity based on our previous methodological work. CONCLUSION The fetal skeleton and abdomen have different velocity growth patterns during intrauterine life. Accordingly, we have produced international Fetal Growth Velocity Increment Standards to complement the INTERGROWTH-21st Fetal Growth Standards so as to monitor fetal well-being comprehensively worldwide. Fetal growth velocity curves may be valuable if one wants to study the pathophysiology of fetal growth. We provide an application that can be used easily in clinical practice to evaluate changes in fetal size as conditional velocity for a more refined assessment of fetal growth than is possible at present (https://lxiao5.shinyapps.io/fetal_growth/). The application is freely available with the other INTERGROWTH-21st tools at https://intergrowth21.tghn.org/standards-tools/.
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Affiliation(s)
- Eric O Ohuma
- Centre for Tropical Medicine and Global Health, Headington, Oxford, United Kingdom; Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine (LSHTM), London, United Kingdom.
| | - José Villar
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, United Kingdom; Oxford Maternal & Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, United Kingdom
| | - Yuan Feng
- Department of Statistics, North Carolina State University, Raleigh, NC
| | - Luo Xiao
- Department of Statistics, North Carolina State University, Raleigh, NC
| | - Laurent Salomon
- Department of Obstetrics and Fetal Medicine, Hôpital Necker Enfants Malades, Université Paris Descartes, Paris, France
| | - Fernando C Barros
- Programa de Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Pelotas, Brazil
| | - Leila Cheikh Ismail
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, United Kingdom; Clinical Nutrition and Dietetics Department, University of Sharjah, Sharjah, United Arab Emirates
| | - William Stones
- Faculty of Health Sciences, Aga Khan University, Nairobi, Kenya
| | - Yasmin Jaffer
- Department of Family & Community Health, Ministry of Health, Muscat, Sultanate of Oman
| | - Manuela Oberto
- S.C. Ostetricia 2U, Città della Salute e della Scienza di Torino, Italy
| | - J Alison Noble
- Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom
| | - Michael G Gravett
- Departments of Obstetrics & Gynecology and Public Health, University of Washington, Seattle, WA
| | - Qingqing Wu
- Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Cesar G Victora
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Ann Lambert
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Paola Di Nicola
- Dipartimento di Scienze Pediatriche e dell' Adolescenza, Terapia Intensiva Neonatale Ospedale (TINO), Torino, Italy
| | - Manorama Purwar
- Nagpur INTERGROWTH-21st Research Centre, Ketkar Hospital, Nagpur, India
| | - Zulfiqar A Bhutta
- Center for Global Child Health, Hospital for Sick Children, Toronto, Canada
| | - Stephen H Kennedy
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, United Kingdom; Oxford Maternal & Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, United Kingdom
| | - Aris T Papageorghiou
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, United Kingdom; Oxford Maternal & Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, United Kingdom
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Steffann J, Monnot S, Magen M, Assouline Z, Gigarel N, Ville Y, Salomon L, Bessiere B, Martinovic J, Rötig A, Bengoa J, Borghèse R, Munnich A, Barcia G, Bonnefont JP. A retrospective study on the efficacy of prenatal diagnosis for pregnancies at risk of mitochondrial DNA disorders. Genet Med 2020; 23:720-731. [PMID: 33303968 DOI: 10.1038/s41436-020-01043-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 11/11/2020] [Accepted: 11/11/2020] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Prenatal diagnosis of mitochondrial DNA (mtDNA) disorders is challenging due to potential instability of fetal mutant loads and paucity of data connecting prenatal mutant loads to postnatal observations. Retrospective study of our prenatal cohort aims to examine the efficacy of prenatal diagnosis to improve counseling and reproductive options for those with pregnancies at risk of mtDNA disorders. METHODS We report on a retrospective review of 20 years of prenatal diagnosis of pathogenic mtDNA variants in 80 pregnant women and 120 fetuses. RESULTS Patients with undetectable pathogenic variants (n = 29) consistently had fetuses free of variants, while heteroplasmic women (n = 51) were very likely to transmit their variant (57/78 fetuses, 73%). In the latter case, 26 pregnancies were terminated because fetal mutant loads were >40%. Of the 84 children born, 27 were heteroplasmic (mutant load <65%). To date, no medical problems related to mitochondrial dysfunction have been reported. CONCLUSION Placental heterogeneity of mutant loads questioned the reliability of chorionic villous testing. Fetal mutant load stability, however, suggests the reliability of a single analysis of amniotic fluid at any stage of pregnancy for prenatal diagnosis of mtDNA disorders. Mutant loads under 40% reliably predict lack of symptoms in the progeny of heteroplasmic women.
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Affiliation(s)
- Julie Steffann
- Université de Paris-Sorbonne Paris Cité, Imagine Institute, INSERM UMR1163, Paris, France. .,Service de Génétique Moléculaire, Groupe hospitalier Necker-Enfants Malades, AP-HP, Paris, France.
| | - Sophie Monnot
- Service de Génétique Moléculaire, Groupe hospitalier Necker-Enfants Malades, AP-HP, Paris, France
| | - Maryse Magen
- Service de Génétique Moléculaire, Groupe hospitalier Necker-Enfants Malades, AP-HP, Paris, France
| | - Zahra Assouline
- Service de Génétique Moléculaire, Groupe hospitalier Necker-Enfants Malades, AP-HP, Paris, France
| | - Nadine Gigarel
- Service de Génétique Moléculaire, Groupe hospitalier Necker-Enfants Malades, AP-HP, Paris, France
| | - Yves Ville
- Université de Paris-Sorbonne Paris Cité, Imagine Institute, INSERM UMR1163, Paris, France.,Service d'Obstétrique - Maternité, chirurgie médecine et imagerie fœtale, Groupe hospitalier Necker-Enfants Malades, AP-HP, Paris, France
| | - Laurent Salomon
- Université de Paris-Sorbonne Paris Cité, Imagine Institute, INSERM UMR1163, Paris, France.,Service d'Obstétrique - Maternité, chirurgie médecine et imagerie fœtale, Groupe hospitalier Necker-Enfants Malades, AP-HP, Paris, France
| | - Bettina Bessiere
- Service d'histo-embryologie et fœtopathologie, Groupe hospitalier Necker-Enfants Malades, AP-HP, Paris, France
| | - Jelena Martinovic
- Unité de Foetopathologie, Hôpital Antoine Béclère, GHU Paris Saclay, AP-HP, Clamart, France
| | - Agnès Rötig
- Université de Paris-Sorbonne Paris Cité, Imagine Institute, INSERM UMR1163, Paris, France
| | - Joana Bengoa
- Service de Génétique Moléculaire, Groupe hospitalier Necker-Enfants Malades, AP-HP, Paris, France
| | - Roxana Borghèse
- Service de Génétique Moléculaire, Groupe hospitalier Necker-Enfants Malades, AP-HP, Paris, France
| | - Arnold Munnich
- Université de Paris-Sorbonne Paris Cité, Imagine Institute, INSERM UMR1163, Paris, France.,Service de Génétique Moléculaire, Groupe hospitalier Necker-Enfants Malades, AP-HP, Paris, France
| | - Giulia Barcia
- Service de Génétique Moléculaire, Groupe hospitalier Necker-Enfants Malades, AP-HP, Paris, France
| | - Jean-Paul Bonnefont
- Université de Paris-Sorbonne Paris Cité, Imagine Institute, INSERM UMR1163, Paris, France.,Service de Génétique Moléculaire, Groupe hospitalier Necker-Enfants Malades, AP-HP, Paris, France
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Hautier S, Kermorvant E, Khen-Dunlop N, de Wailly D, Beauquier B, Corroenne R, Milani G, Bonnet D, James S, Vinit N, Blanc T, Aigrain Y, Colmant C, Salomon L, Ville Y, Stirnemann J. [Prenatal path of care following the diagnosis of a malformation for which a novel prenatal therapy is available]. ACTA ACUST UNITED AC 2020; 49:172-179. [PMID: 33166705 DOI: 10.1016/j.gofs.2020.11.003] [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: 08/25/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Fetal therapy is part of the available care offer for several severe malformations. The place of these emergent prenatal interventions in the prenatal path of care is poorly known. The objective of this study is to describe the decision-making process of patients facing the option of an emergent in utero intervention. METHODS We have conducted a retrospective monocentric descriptive study in the department of maternal-fetal medicine of Necker Hospital. We collected data regarding eligibility or not for fetal surgery and the pregnancy outcomes of patients referred for myelomeningocele, diaphragmatic hernia, aortic stenosis and low obstructive uropathies. RESULTS All indications combined, 70% of patients opted for fetal surgery. This rate was lower in the case of myelomeningocele with 21% consent, than in the other pathologies: 69% for diaphragmatic hernias, 90% for aortic stenoses and 76% for uropathy. When fetal intervention was declined, the vast majority of patients opted for termination of pregnancy: 86%. In 14% of the considering fetal surgery, the patient was referred too far. CONCLUSION The acceptance rate for fetal surgeries depends on condition. It offers an additional option and is an alternative for couples for which termination of pregnancy (TOP) is not an option. Timely referral to an expert center allows to discuss the place of a fetal intervention and not to deprive couples of this possibility.
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Affiliation(s)
- S Hautier
- Maternité et médecine fœtale, hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France
| | - E Kermorvant
- Maternité et médecine fœtale, hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France
| | - N Khen-Dunlop
- Maternité et médecine fœtale, hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France
| | - D de Wailly
- Maternité et médecine fœtale, hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France
| | - B Beauquier
- Maternité et médecine fœtale, hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France
| | - R Corroenne
- Maternité et médecine fœtale, hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France
| | - G Milani
- Maternité et médecine fœtale, hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France
| | - D Bonnet
- Maternité et médecine fœtale, hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France
| | - S James
- Maternité et médecine fœtale, hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France
| | - N Vinit
- Maternité et médecine fœtale, hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France
| | - T Blanc
- Maternité et médecine fœtale, hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France
| | - Y Aigrain
- Maternité et médecine fœtale, hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France
| | - C Colmant
- Maternité et médecine fœtale, hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France
| | - L Salomon
- Maternité et médecine fœtale, hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France
| | - Y Ville
- Maternité et médecine fœtale, hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France
| | - J Stirnemann
- Maternité et médecine fœtale, hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75015 Paris, France.
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10
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Belkacemi Y, Jouhaud A, Ingels A, Brunel A, Coraggio G, Joly C, Hadhri A, Hassani W, Nourieh M, Vega Salazar B, de la Taille A, Salomon L. Impact Of Cytoterm On Vasomotor Symptoms (VMS) And Quality Of Life (Qol) Impairments In Patients Receiving Hormone Therapy (HT) And Radiotherapy (RT) For Prostate Cancer (Pca). Results Of The ESCULAPE Phase II Study. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.437] [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]
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11
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Flateau C, Aït-Ammar N, Angebault C, Salomon L, Matignon M, Lepeule R, Melica G, Grimbert P, Lelièvre JD, Gallien S, Botterel F. Risk factors for intra-abdominal fungal infection after simultaneous pancreas-kidney transplantation: A single-center retrospective experience. Transpl Infect Dis 2020; 23:e13486. [PMID: 33047447 DOI: 10.1111/tid.13486] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 03/24/2020] [Revised: 08/17/2020] [Accepted: 09/20/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Data on the risk factors and outcome of intra-abdominal fungal infections (IAFI) following simultaneous pancreas-kidney transplantation (PKT) are scarce. MATERIALS/METHODS A retrospective monocentric study was conducted on all patients who underwent simultaneous PKT from January 2007 to December 2016. Deep sites positive cultures for fungi during the first post-transplantation year were collected. Clinical, radiological, and microbiological data of proven and probable invasive fungal infections were analysed. RESULTS Among sixteen PKT patients, 15 were included. Seven patients (47%) developed an invasive fungal infection, exclusively IAFI (six proven, one probable). The proven IAFI included four peritonitis, one pancreatic necrosis with infected hematoma, and one patient with positive preservation fluid only (PF). Candida albicans (n = 4) was the most prevalent species (associated with Galactomyces candidus in one case), C glabrata, C dubliniensis, and C krusei were found in one case each. Three patients had either a positive direct examination and/or culture for renal or pancreatic PF and the culture of PF was positive for the same species that caused IAFI. IAFIs were significantly associated with pancreatic graft arterial thrombosis (5/7 vs 0/8, P = .007) and fungal contamination of PF (3/7 vs 0/8, P = .008). Among patients with IAFI, all required an early surgical revision post-transplantation [1-18 days] and six had early or delayed pancreatic graft removal. One patient died in the first post-transplant year. CONCLUSION IAFI is a common complication in PKT, associated with pancreatic graft thrombosis or fungal contamination of the graft PF, and can sometimes lead to pancreatic detransplantation.
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Affiliation(s)
- Clara Flateau
- Service de maladies infectieuses, Groupe Hospitalier Sud Ile de France, Melun, France.,Groupe de Recherche et d'Etude des Maladies Infectieuses - Paris Sud-Est (GREMLIN Paris Sud-Est), Paris, France
| | - Nawel Aït-Ammar
- Unité de Parasitologie-Mycologie, Département Prévention, Diagnostic, DMU Biologie-Pathologie, CHU Henri Mondor, Assistance Publique des Hôpitaux de Paris (APHP), Créteil, France.,Faculté de Santé, Université Paris-Est Créteil, Créteil, France
| | - Cécile Angebault
- Unité de Parasitologie-Mycologie, Département Prévention, Diagnostic, DMU Biologie-Pathologie, CHU Henri Mondor, Assistance Publique des Hôpitaux de Paris (APHP), Créteil, France.,Faculté de Santé, Université Paris-Est Créteil, Créteil, France
| | - Laurent Salomon
- Faculté de Santé, Université Paris-Est Créteil, Créteil, France.,Service d'urologie, APHP, CHU Henri Mondor, Créteil, France
| | - Marie Matignon
- Service de néphrologie, APHP, CHU Henri Mondor, Créteil, France
| | - Raphaël Lepeule
- Groupe de Recherche et d'Etude des Maladies Infectieuses - Paris Sud-Est (GREMLIN Paris Sud-Est), Paris, France.,Unité Transversale du traitement des infections, Département Prévention, Diagnostic, DMU Biologie-Pathologie, APHP, CHU Henri Mondor, Créteil, France
| | - Giovanna Melica
- Service d'immunologie clinique et maladies infectieuses, APHP, CHU Henri Mondor, Créteil, France
| | | | - Jean-Daniel Lelièvre
- Faculté de Santé, Université Paris-Est Créteil, Créteil, France.,Service d'immunologie clinique et maladies infectieuses, APHP, CHU Henri Mondor, Créteil, France
| | - Sébastien Gallien
- Groupe de Recherche et d'Etude des Maladies Infectieuses - Paris Sud-Est (GREMLIN Paris Sud-Est), Paris, France.,Faculté de Santé, Université Paris-Est Créteil, Créteil, France.,Service d'immunologie clinique et maladies infectieuses, APHP, CHU Henri Mondor, Créteil, France
| | - Françoise Botterel
- Groupe de Recherche et d'Etude des Maladies Infectieuses - Paris Sud-Est (GREMLIN Paris Sud-Est), Paris, France.,Unité de Parasitologie-Mycologie, Département Prévention, Diagnostic, DMU Biologie-Pathologie, CHU Henri Mondor, Assistance Publique des Hôpitaux de Paris (APHP), Créteil, France.,Faculté de Santé, Université Paris-Est Créteil, Créteil, France
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12
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Abdessater M, Champy CM, da Costa JB, Courcier J, Yiou R, Hoznek A, Vordos D, Grimbert P, Matignon M, Londero T, le Corvoisier P, Salomon L, De la Taille A, Ingels A. Comparison of the iliac, vaginal and umbilical graft extraction in robot-assisted laparoscopic living donor nephrectomy. World J Urol 2020; 39:2783-2788. [PMID: 33015741 DOI: 10.1007/s00345-020-03462-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 06/30/2020] [Accepted: 09/16/2020] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To compare different extractions routes for robot-assisted living donor nephrectomy in terms of post-operative pain and renal function recovery. METHODS Live donor kidney transplantation data from our institution were reviewed from November 2011 to March 2017. Postoperative pain was estimated using cumulative painkillers consumption. Variables were compared between the 3 groups with ANOVA for continuous data, χ2 test for categorial data. A survival analysis with Kaplan-Meier curve assessing time to transplant recipient nadir was performed to compare the renal function recovery. RESULTS Sixty-three RLDN were performed (23 iliac, 23 vaginal and 17 umbilical extractions). There was no significant difference between the three groups in terms of operative time, blood lost, warm ischemia time, cumulative painkiller consumption and renal function recovery time. Postoperative complications for Umbilical, Vaginal and Iliac were, respectively, of 0, 3 and 1. No major difference was found between the 3 groups beside a slightly longer hospital stay in the iliac group. CONCLUSION Iliac incision might impact post-operative pain with a moderate but significant longer hospital stay. Vaginal extraction is an option when cosmetic outcomes present a real demand. The three options appeared to be safe and should be discussed with the patient in regard of the surgeon experience.
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Affiliation(s)
- Maher Abdessater
- Department of Urology, APHP, Henri Mondor University Hospital, UPEC, 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
| | - Cécile M Champy
- Department of Urology, APHP, Henri Mondor University Hospital, UPEC, 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
| | - José Batista da Costa
- Department of Urology, APHP, Henri Mondor University Hospital, UPEC, 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
| | - Jean Courcier
- Department of Urology, APHP, Henri Mondor University Hospital, UPEC, 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
| | - René Yiou
- Department of Urology, APHP, Henri Mondor University Hospital, UPEC, 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
| | - Andras Hoznek
- Department of Urology, APHP, Henri Mondor University Hospital, UPEC, 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
| | - Dimitri Vordos
- Department of Urology, APHP, Henri Mondor University Hospital, UPEC, 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
| | - Philippe Grimbert
- Department of Nephrology, APHP, Henri Mondor University Hospital, UPEC, Créteil, France
| | - Marie Matignon
- Department of Nephrology, APHP, Henri Mondor University Hospital, UPEC, Créteil, France
| | - Tiphanie Londero
- Department of Nephrology, APHP, Henri Mondor University Hospital, UPEC, Créteil, France
| | - Philippe le Corvoisier
- Department of Clinical Investigations, APHP, Henri Mondor University Hospital, UPEC, Créteil, France.,INSERM, CIC 1430, Créteil, France
| | - Laurent Salomon
- Department of Urology, Hôpital Mont-de-Marsan, Mont-de-Marsan, France
| | - Alexandre De la Taille
- Department of Urology, APHP, Henri Mondor University Hospital, UPEC, 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
| | - Alexandre Ingels
- Department of Urology, APHP, Henri Mondor University Hospital, UPEC, 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France.
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13
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Sargos P, Guerif S, Fraisse J, Meyer E, Supiot S, Lagneau E, Deniaud-Alexandre E, Rochin P, Benyoucef A, Cartier L, Hamidou H, Hasbini A, Crehange G, Pommier P, De Laroche G, Pelissier S, Gross E, Fourneret P, Salomon L, Latorzeff I. Late toxicity and quality of life from GETUG-AFU 22 study: A randomized phase II trial comparing 6 months of degarelix in combination with radiotherapy to radiotherapy alone for patients with detectable PSA after radical prostatectomy. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33522-9] [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: 10/23/2022] Open
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14
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Latorzeff I, Guerif S, Pelissier S, Meyer E, Fraisse J, Supiot S, Crehange G, Lagneau E, Ronchin P, Benyoucef A, Hasbini A, Pommier P, De Laroche G, Salomon L, Sargos P. Late toxicity and quality of life from GETUG-AFU 22 study. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.6_suppl.331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
331 Background: Radical prostatectomy (RP) is recommended as a standard treatment for localized prostate cancer. However no recommendations exist for pts with immediate detectable PSA after RP. Methods: Pts with localized prostate cancer, treated by RP (R0 or R1), with a PSA level post-RP ≥0.2 ng/mL and ≤2 ng/mL at randomization and N0 M0 on imaging were included. Pts were randomized (1:1) to radiotherapy (RT) alone (RT arm) or 6 months degarelix hormone therapy (HT) with RT (RT+HT arm). RT consisted of pelvic irradiation (46 Gy in 23 Fr) with a boost on the prostate bed (66 Gy in 33 Fr). The primary endpoint was event-free survival (EFS). Acute and late toxicities were evaluated as secondary endpoints and scored using CTCAE V4.0 scale. Quality of life (QOL) was assessed with QLQ-C30 and QLQ-PR25 questionnaires at 12 and 24 months. Late toxicity was reported at 24 months. Results: From Jan-2013 to Sept-2015, 125 pts were included (RT arm: 64 pts; RT+HT arm: 61). Median follow up is 38 months (31.4; 44). The baseline characteristics are well-balanced between two arms: median age was 66 yrs (50-77), all men having an ECOG ≤1 (ECOG 0 in 92%), a median Gleason score of 7 (3-9), a median PSA of 0.3 ng/mL (0.09-1.82) post-RP and 0.6 ng/mL (0.12-3.65) at randomization. All pts received 33 Fr of RT. In the RT+HT arm 98.4% of pts received the 6 months of HT planned. All pts were eligible for safety analysis. At 24 months, no difference in late genitourinary (GU) or gastrointestinal (GI)toxicity was observed between the two arms (p=0.145) Grade 3 late toxicities were reported for 15/125 pts (12%): 8/64 pts (6.5%) in the RT arm and 7/61 pts (5.5%) in RT+HT arm (NS) and no toxicity grade >3 was observed. Evaluation of QOL was assessable at 12 and 24 months of FU for 80%/89% pts and 59%/77% pts in RT/RT-HT arms respectively. At 12 months QLQ-PR25 HT related symptoms was significantly more important in the RT-HT arm (p=0.04). At 24 months no significant difference in QLQC-30 or QLQ-PR25 analysis was reported. Conclusions:, At 24 months in this phase II trial no significant difference in GI/GU toxicity and.QOL was observed between the two arms. GETUG-AFU 22 efficacy analysis is still pending. Clinical trial information: NCT01994239.
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Affiliation(s)
| | | | | | | | - Julien Fraisse
- Institut du Cancer de Montpellier (ICM), Univ Montpellier, Montpellier, France
| | - Stephane Supiot
- Institut de Cancerologie de l'Ouest - Rene Gauducheau, Nantes, France
| | | | - Edouard Lagneau
- Centre d'Oncologie et de Radiotherapie du Parc, Dijon, France
| | | | | | | | | | - Guy De Laroche
- Institut de Cancerologie de La Loire, St Priest En Jarez, France
| | - Laurent Salomon
- Urology Department, APHP, Henri-Mondor Hospital, Creteil, France
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15
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Mussat E, Jouinot A, Saldana C, Joly C, Allory Y, Nourieh M, Vordos D, Salomon L, de la TAILLE A, Tournigand C, Rousseau B. Clinical criteria predicting an overall survival benefit to platinum rechallenge (PR) in metastatic urothelial cancer (mUC). J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.6_suppl.490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
490 Background: In mUC, 2nd line treatments after platinum-based regimen have limited efficacy, such as vinca-alkaloid, taxan or immune checkpoint inhibitors. PR is proposed by ESMO guidelines if progression occurs >12 months after initial exposure with low level of evidence. Our objectives were to assess if PR was associated with better outcomes compared to other regimens and to identify parameters predicting its benefit in mUC. Methods: From a large monocentric cohort of mUC pts pretreated by 1st line platinum-based regimen, we retrospectively included pts who received a second line (PR, other cytotoxic drugs, immunotherapy). The primary end point was overall survival (OS). Survival analyses were performed using Cox models, weighted on a propension score to ensure groups comparability. Results: Among 155 consecutive pts firstly treated between 2006 and 2017, 55 pts were then treated by PR and 45 pts treated by other chemotherapy (n=37), immunotherapy (n=6) or targeted therapy (n=2). As PR is used in pts who benefited from platinum therapy, we restricted the analyses to pts who did not progressed during 1st line, resulting in 43 PR pts and 25 pts treated by other regimens. Univariate analyses identified main factors impairing OS at 2nd line initiation: time from prior chemotherapy <6 months, non-complete response to 1st line treatment and 2nd line treatment without platinum. These factors were subsequently used in a propension score to weigh survival analyses. PR was significantly associated with better OS than other regimens (HR=0.57, CI95% [0.37-0 .88], p=0.011). Median OS, median PFS and ORR were 16.5 vs 9.0 months (P=0.012), 5.8 vs 2.4 months (P=0.012) and 45 vs 15% (P=0.048) for PR and other regimens respectively. The most common grade 3 to 4 adverse events were hematologic toxicities: 54% for PR vs 22% for other treatments. ROC curve analysis of the best delay for PR since the end of 1st line was 5.7 months (sensitivity 60%, specificity 84%). Conclusions: PR is feasible and associated with significant OS improvement in second line treatment of mUC in pts that benefited initially from 1st line platinum and with Platinum-free interval >6 months. These results should be confirmed prospectively.
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Affiliation(s)
| | - Anne Jouinot
- Department of Medical Oncology, Cochin Hospital, Paris Descartes University, AP-HP, CARPEM, Immunomodulatory Therapies Multidisciplinary Study Group (CERTIM), Paris, France
| | - Carolina Saldana
- Oncology Department, Hôpital Henri Mondor, APHP, Créteil, France
| | - Charlotte Joly
- Oncology Department, Hôpital Henri Mondor, APHP, Créteil, France
| | | | | | - Dimitri Vordos
- Department of Urology, Hôpital Henri Mondor, Creteil, France
| | - Laurent Salomon
- Urology Department, APHP, Henri-Mondor Hospital, Creteil, France
| | | | | | - Benoit Rousseau
- Oncology Department, Hopital Henri Mondor, APHP, Creteil, France
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16
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Faure-Bardon V, Millischer AE, Deloison B, Sonigo P, Grévent D, Salomon L, Stirnemann J, Nicloux M, Magny JF, Leruez-Ville M, Ville Y. Authors' reply re: Refining the prognosis of fetuses infected with cytomegalovirus in the first trimester of pregnancy by serial prenatal assessment: a single-centre retrospective study. BJOG 2019; 127:647-648. [PMID: 31885146 DOI: 10.1111/1471-0528.16062] [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] [Accepted: 12/13/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Valentine Faure-Bardon
- EA 73-28, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Maternity, AP-HP, Hospital Necker-E.M., Paris, France
| | - Anne-Elodie Millischer
- EA 73-28, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Radiology, AP-HP, Hospital Necker-E.M., Paris, France
| | - Benjamin Deloison
- EA 73-28, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Maternity, AP-HP, Hospital Necker-E.M., Paris, France
| | - Pascale Sonigo
- EA 73-28, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Radiology, AP-HP, Hospital Necker-E.M., Paris, France
| | - David Grévent
- EA 73-28, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Radiology, AP-HP, Hospital Necker-E.M., Paris, France
| | - Laurent Salomon
- EA 73-28, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Maternity, AP-HP, Hospital Necker-E.M., Paris, France
| | - Julien Stirnemann
- EA 73-28, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Maternity, AP-HP, Hospital Necker-E.M., Paris, France
| | - Muriel Nicloux
- EA 73-28, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Neonatal Intensive Care Unit, AP-HP, Hospital Necker-E.M., Paris, France
| | - Jean-François Magny
- EA 73-28, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Neonatal Intensive Care Unit, AP-HP, Hospital Necker-E.M., Paris, France
| | - Marianne Leruez-Ville
- EA 73-28, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Virology Laboratory, Reference Laboratory for Cytomegalovirus Infections, AP-HP, Hospital Necker-E.M., Paris, France
| | - Yves Ville
- EA 73-28, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Maternity, AP-HP, Hospital Necker-E.M., Paris, France
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17
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Duquesne I, Champy C, Klap J, Chahwan C, Vordos D, de la Taille A, Salomon L. [When to introduce hormone therapy after total prostatectomy with positive lymph nodes? Study of the factors influencing the time of introduction of hormone therapy]. Prog Urol 2019; 29:981-988. [PMID: 31735682 DOI: 10.1016/j.purol.2019.09.009] [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: 04/11/2019] [Revised: 09/26/2019] [Accepted: 09/28/2019] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Adjuvant hormone therapy is the standard treatment after total prostatectomy with positive lymph node. However, this treatment has side effects and at the time of the PSA era and extensive lymph node dissection, this principle is questioned. The aim of this study is to describe the oncological characteristics of patients that may explain the delay in introducing hormone therapy in patients with positive lymph node. METHODS Monocentric, retrospective study of 161 patients from November 1988 to February 2018 in a single French University Hospital, having undergone radical prostatectomy with positive lymph nodes on pathology. For each patient, preoperative data (age, clinical stage, biopsy results, d'Amico classification) and postoperative data (pathological results, number of lymph nodes removed, number of positive lympnodes, recurrence free survival, specific survival and overall survival) were collected. The date of introduction of hormone therapy was noted and survival without hormonal therapy was established according to the Kaplan Meier curve. The pre- and post-operative oncological factors that could influence hormone therapy introduction were investigated with Chi2 and Student tests (statistically significant when P<0.05). RESULTS The mean number of lymph nodes removed was 12 [1-40]. The mean number of positive lymph nodes was 2.5 [1-24], the mean percentage of positive lymph nodes was 25% (2.5-100). After a mean follow-up of 95 months (3-354), 88 patients (54.6%) had no hormonal treatment. The average time to hormonal treatment was 40 months [0-310]. At 3 years, survival without hormone therapy was 52% and 51% at 5 years. Only the percentage of positive lymphnodes appeared to be a significant predictor of the introduction of hormone therapy. (29.32% vs. 21.99%, P=0.047). Hormone-free survival was significantly higher in patients with lymph node involvement less than 25% (P<0.0001) or with less than 2 positive lymph nodes (P=0.0294). CONCLUSION Lymph node invasion is a factor of poor prognosis after total prostatectomy and leads to introduce hormone therapy. Our study identified the percentage and number of positive lymph nodes as factors that identify patients who may be delayed in introducing this hormone therapy. LEVEL OF PROOF 3.
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Affiliation(s)
- I Duquesne
- Service d'urologie, CHU Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
| | - C Champy
- Service d'urologie, CHU Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - J Klap
- Service d'urologie, CHU Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - C Chahwan
- Service d'urologie, CHU Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - D Vordos
- Service d'urologie, CHU Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - A de la Taille
- Service d'urologie, CHU Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - L Salomon
- Service d'urologie, CHU Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
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18
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Latorzeff I, Guerif S, Fraisse J, Meyer E, Pelissier S, Salomon L, Sargos P. Toxicité tardive et qualité de vie de l’étude GETUG-AFU 22. Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.242] [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]
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19
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Pelegrin T, Champy C, Ingels A, Matignon M, Grimbert P, Salomon L, De la Taille A. Retour d’expérience sur 100 prélèvements de rein de donneur vivant par cœlioscopie robot-assistée : mise à jour d’une série monocentrique. Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.199] [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]
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20
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Hutin M, Thezenas S, Timsit M, Pettenati C, Gallon J, Karam G, Branchereau J, Heldhli O, Badet L, Matillon X, Salomon L, Cholley I, Bessede T, Neuzillet Y, Robert G, Bensadoun H, Allenet C, Cormier L, Schneider A, Leclercq V, Sallusto F, Descazeaud A, Peyronnet B, Hascoet J, Bouye S, Lechevallier E, Delaporte V, Lannes F, Boutin J, Berthelot L, Iborra F, Thuret R. Incidence et morbi-mortalité des tumeurs de la voie excrétrice du transplant après transplantation rénale : étude multicentrique française. Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.094] [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]
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21
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Faure-Bardon V, Millischer AE, Deloison B, Sonigo P, Grévent D, Salomon L, Stirnemann J, Nicloux M, Magny JF, Leruez-Ville M, Ville Y. Refining the prognosis of fetuses infected with Cytomegalovirus in the first trimester of pregnancy by serial prenatal assessment: a single-centre retrospective study. BJOG 2019; 127:355-362. [PMID: 31505103 DOI: 10.1111/1471-0528.15935] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [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: 08/27/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To define the predictive value (PV) of known prognostic factors of fetal infection with Cytomegalovirus following maternal primary infection <14 weeks of gestation, at different time points of pregnancy: the end of the second trimester; following prenatal magnetic resonance imaging (MRI) at 32 weeks of gestation; and using all ultrasound scans performed in the third trimester (US3rdT). DESIGN A retrospective study. SETTING Reference fetal medicine unit. POPULATION Sixty-two fetuses infected <14 weeks of gestation. METHODS We defined second-trimester assessment (STA) as the combination of ultrasound findings <28 weeks of gestation and fetal platelet count at cordocentesis. Three groups were defined: normal, extracerebral, and cerebral STA. MAIN OUTCOME MEASURES For each group, the PV of STA alone, STA + MRI, and STA + US3rdT were assessed retrospectively. Outcome at birth and at follow-up were reported. RESULTS The STA was normal, and with extracerebral and cerebral features, in 43.5, 42.0, and 14.5%, respectively. The negative PV of normal STA and MRI for moderate to severe sequelae was 100%. The residual risk was unilateral hearing loss in 16.7% of cases. Of pregnancies with cerebral STA, 44% were terminated. Following extracerebral STA, 48% of neonates were symptomatic and 30% had moderate to severe sequelae. In those cases, the positive and negative PV of MRI for sequelae were 33 and 73%, respectively. STA + US3rdT had a lower negative PV than MRI for symptoms at birth and for moderate to severe sequelae. Any false-positive findings at MRI were mostly the result of hypersignals of white matter. CONCLUSIONS Serial assessment in the second and third trimesters by ultrasound and MRI is necessary to predict the risk of sequelae occurring in 35% of pregnancies following fetal infection in the first trimester of pregnancy. TWEETABLE ABSTRACT Serial ultrasound prognostic assessment following fetal CMV infection in the 1st trimester is improved by MRI at 32 weeks.
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Affiliation(s)
- V Faure-Bardon
- EA 73-28, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Maternity, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - A-E Millischer
- EA 73-28, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Radiology, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - B Deloison
- EA 73-28, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Maternity, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - P Sonigo
- EA 73-28, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Radiology, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - D Grévent
- EA 73-28, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Radiology, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - L Salomon
- EA 73-28, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Maternity, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - J Stirnemann
- EA 73-28, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Maternity, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - M Nicloux
- EA 73-28, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Neonatal Intensive Care Unit, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - J-F Magny
- EA 73-28, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Neonatal Intensive Care Unit, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - M Leruez-Ville
- EA 73-28, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Virology Laboratory, Reference Laboratory for Cytomegalovirus Infections, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Y Ville
- EA 73-28, Paris Descartes University, Sorbonne Paris Cité, Paris, France.,Maternity, Hôpital Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris, Paris, France
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22
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Benyounes Iglesias N, Van Der Vynckt C, Sabben C, Salomon L, Tibi T, Medaouri S, Gout O, Obadia M. P2469The yield of transoesophageal echocardiography in embolic stroke of unknown source. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Purpose
Transthoracic echocardiography (TTE) and transoesophageal (TOE) are the main diagnostic tools for the detection of potential cardiac and aortic sources of embolism (PCSE).
TOE is superior to TTE. However, its therapeutic impact is questioned. TOE is no longer recommended in ESUS (embolic stroke of unknown source), which is thought to be caused by undiagnosed atrial fibrillation (AF). Recent studies however report an about 10% change in therapeutic management due to TOE.
We aimed to assess prospectively, in patients admitted to our stoke unit and diagnosed ESUS, the rate of treatment change induced by TOE.
Methods
Patients diagnosed with acute (≤7 days) ESUS were included to undergo TOE. ON TTE, PCSE, left ventricular ejection fraction (LVEF, %), left atrial area (LA-A, cm2), indexed left atrial volume (LAV, ml/m2) were recorded. On TOE, PCSE, left atrial appendage area (LAA-A, cm2), left atrial appendage emptying velocity (LAA-EV, cm/s) were recorded. PCSE on TTE and TOE were classified according to EAE guidelines.
Results
Between October 2016 and May 2018, 1322 TTEs were performed in patients admitted to our newly labelled stroke unit. ESUS was diagnosed in 152 patients, who underwent TOE.
Mean delay (95% CI) between stroke onset and TTE was 2.2 days (1.9–2.5).
Mean (95% CI) age was 61 years (58–63). 56/152 were female (37%). On TTE, mean (95% CI) LVEF was 62% (61–64), mean LA-A was 19 cm2 (19–20) and mean LA-V was 32 ml/m2 (31–34) ml/m2.
In 38 patients, a major PCSE was identified by TTE. In 4 cases, there were 2 potential major PCSE and in one case 3.
In 79 patients, at least one minor PCSE was identified by TTE, among which 35 PFO.
On TEE, mean (95% CI) LAA-A and LAA-EV were: 5.2 cm2 (4.9–5.5) % and 76 cm/s (72–80) cm/s.
In 50 patients, a major PCSE was identified by TOE. Eleven patients had 2 major PCSE.
In 115 patients, at least one minor PCSE was identified by TOE, among which 34 PFO.
According to EAE guidelines, a treatment change induced by TOE occurred in 12 patients. Anticoagulation in 5 patients (aortic arch thrombus in 2, thrombus of the proximal descending aorta in 1, LAA thrombus in 1, and thrombotic non-infectious vegetations in 2). Surgery in one patient (LAA fibroelastoma), antibiotics in two patients with infectious endocarditis,
One patient had aortic fibroelastoma not seen on TTE. Finally, two patients with mobile aortic arch debris had dual antiplatelet therapy (DAT).
In two other patients, TOE showed a mitral fibroelastoma and a mobile aortic arch thrombus, but these abnormalities were already seen on TTE, hence not taken into account.
When considering the eight patients who had, at neurologist's discretion, the instauration of DAT for complex aortic arch atheroma, 12+8 patients had therapeutic modifications induced by TOE (13%).
Conclusion
Major PCSE on TOE lead to a treatment change in 12/152 patients (8%) according to EAE guidelines, and 13% when complex aortic arch atheroma was considered.
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Affiliation(s)
| | - C Van Der Vynckt
- Fondation Ophtalmologique A. de Rothschild, Cardiology Unit, Paris, France
| | - C Sabben
- Fondation Ophtalmologique A. de Rothschild, Neurology, Paris, France
| | | | - T Tibi
- Fondation Ophtalmologique A. de Rothschild, Neurology, Paris, France
| | | | - O Gout
- Fondation Ophtalmologique A. de Rothschild, Neurology, Paris, France
| | - M Obadia
- Fondation Ophtalmologique A. de Rothschild, Neurology, Paris, France
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23
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Latorzeff I, Guerif S, Fraisse J, Meyer E, Supiot S, Lagneau E, Deniaud-Alexandre E, Ronchin P, Benyoucef A, Cartier L, Hamidou H, Hasbini A, Crehange G, Pommier P, Magne N, Pelissier S, Gross E, Fourneret P, Salomon L, Sargos P. Late Toxicity and Quality of Life from GETUG-AFU 22 Study: A Multicenter Randomized Phase II Trial Comparing Radiotherapy +/- 6 Months of Degarelix as a Salvage Treatment for Patients with Detectable PSA after Radical Prostatectomy. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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24
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Toinet T, Dominique I, Cholley I, Vanalderwerelt V, Goujon A, Paret F, Bessede T, Delaporte V, Salomon L, Badet L, Boutin JM, Verhoest G, Branchereau J, Timsit MO. Renal outcome after simultaneous heart and kidney transplantation. Clin Transplant 2019; 33:e13615. [PMID: 31215696 DOI: 10.1111/ctr.13615] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 03/10/2019] [Revised: 05/10/2019] [Accepted: 05/20/2019] [Indexed: 01/06/2023]
Abstract
Simultaneous heart-kidney transplant (HKTx) is a valid treatment for patients with coexisting heart and renal failure. The aim of this study was to assess renal outcome in HKTx and to identify predictive factors for renal loss. A retrospective study was conducted among 73 HKTx recipients: Donors' and recipients' records were reviewed to evaluate patients' and renal transplants' survival and their prognostic factors. The mean follow-up was 5.36 years. Renal primary non-function occurred in 2.7%, and complications Clavien IIIb or higher were observed in 67.1% including 16 (22%) postoperative deaths. Five-year overall survival and renal survival were 74.5% and 69.4%. Among survivors, seven returned to dialysis during follow-up. The postoperative use of ECMO (HR = 6.04, P = 0.006), dialysis (HR = 1.04/day, P = 0.022), and occurrence of complications (HR = 31.79, P = 0.022) were independent predictors of postoperative mortality but not the history of previous HTx or KTx nor renal function prior to transplantation. History of KTx (HR = 2.52, P = 0.026) and increased delay between the two transplantations (HR = 1.25/hour, P = 0.018) were associated with renal transplant failure. HKTx provides good renal transplant survival and function, among survivors. Early mortality rate of 22% underlines the need to identify perioperative risk factors that would lead to more judicious and responsible allocation of a scarce resource.
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Affiliation(s)
- Théodore Toinet
- Department of Urology and Transplant Surgery, Hôpital Européen Georges-Pompidou, AP-HP, Université de Paris, Paris, France
| | - Inès Dominique
- Department of Urology and Transplant Surgery, Hôpital Edouard-Herriot, Hospices Civils de Lyon, Lyon, France
| | - Irène Cholley
- Department of Urology, AP-HP, Hôpital Henri Mondor, Créteil, France
| | | | - Anna Goujon
- Department of Urology, CHU de Rennes, Rennes, France
| | - Fanny Paret
- Department of Urology, CHU de Nantes, Nantes, France
| | - Thomas Bessede
- Department of Urology, AP-HP, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Véronique Delaporte
- Department of Urology and Kidney Transplantation, AP-HM, CHU la Conception, Marseille, France
| | - Laurent Salomon
- Department of Urology, AP-HP, Hôpital Henri Mondor, Créteil, France
| | - Lionel Badet
- Department of Urology and Transplant Surgery, Hôpital Edouard-Herriot, Hospices Civils de Lyon, Lyon, France
| | | | | | | | - Marc-Olivier Timsit
- Department of Urology and Transplant Surgery, Hôpital Européen Georges-Pompidou, AP-HP, Université de Paris, Paris, France
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25
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Merzeau N, Champy C, Such M, Klapp J, Chahwan C, Vordos D, Hoznek A, Matignon M, Grimbert P, de la Taille A, Salomon L. [Evaluation of single kidney graft outcome in patients initially programmed for a dual kidney graft transplantation]. Prog Urol 2019; 29:340-346. [PMID: 31151914 DOI: 10.1016/j.purol.2019.04.003] [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: 06/25/2018] [Revised: 02/16/2019] [Accepted: 04/18/2019] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Kidney transplantation is championed as the gold standard treatment for patients with end-stage kidney disease. According to the biomedical agency, there is an increasing number of patients waiting for kidney transplantation. Faced with organ shortage, the use of marginal grafts may well increase the number of available kidney grafts. Occasionally, during dual kidney graft transplantation, the poor quality of one of the two grafts, or other specific circumstances, may lead to transplantation of only one of the two grafts. We have compared patient outcome concerning single kidney transplantation from an initial dual kidney graft with respect to dual kidney graft transplantation. MATERIAL Among 67 patients enrolled for a dual kidney graft, 39 dual kidney grafts (group 1) were compared with 12 grafts performed with only one of the two kidneys of a dual kidney graft (group 2) as well as 15 grafts performed following a classic kidney graft protocol (group 3). RESULTS The survival of grafts was respectively for groups 1, 2 and 3 of 100%, 72,5% and 75,4% (P=0.17). The survival of patients was respectively for groups 1, 2 and 3 of 78.3%, 89.9% and 87.8% (P=0.47). CONCLUSION Our study suggests that transplantation of a single kidney, initially proposed as dual kidney graft candidate, has satisfying results in terms of graft survival and patient mortality at the expense of poorer renal function in comparison to dual kidney graft. Indeed, there was no significant difference in the survival of patients and grafts. This seems promising taking into consideration that the aim of transplantation in elderly recipients is primarily to avoid dialysis, rather than having optimal post-transplantation kidney function. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- N Merzeau
- Service d'urologie, hôpital Robert-Debré, rue du Général-Koenig, 51092 Reims cedex, France.
| | - C Champy
- Service d'urologie, hôpital Henri-Mondor, 51, avenue du Ml de Lattre-de-Tassigny, 94010 Créteil cedex, France
| | - M Such
- Service d'urologie, hôpital Henri-Mondor, 51, avenue du Ml de Lattre-de-Tassigny, 94010 Créteil cedex, France
| | - J Klapp
- Service d'urologie, hôpital Henri-Mondor, 51, avenue du Ml de Lattre-de-Tassigny, 94010 Créteil cedex, France
| | - C Chahwan
- Service d'urologie, hôpital Henri-Mondor, 51, avenue du Ml de Lattre-de-Tassigny, 94010 Créteil cedex, France
| | - D Vordos
- Service d'urologie, hôpital Henri-Mondor, 51, avenue du Ml de Lattre-de-Tassigny, 94010 Créteil cedex, France
| | - A Hoznek
- Service d'urologie, hôpital Henri-Mondor, 51, avenue du Ml de Lattre-de-Tassigny, 94010 Créteil cedex, France
| | - M Matignon
- Service de néphrologie, hôpital Henri-Mondor, 51, avenue du Ml de Lattre-de-Tassigny, 94010 Créteil cedex, France
| | - P Grimbert
- Service de néphrologie, hôpital Henri-Mondor, 51, avenue du Ml de Lattre-de-Tassigny, 94010 Créteil cedex, France
| | - A de la Taille
- Service d'urologie, hôpital Henri-Mondor, 51, avenue du Ml de Lattre-de-Tassigny, 94010 Créteil cedex, France
| | - L Salomon
- Service d'urologie, hôpital Henri-Mondor, 51, avenue du Ml de Lattre-de-Tassigny, 94010 Créteil cedex, France
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26
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Hureaux M, Guterman S, Hervé B, Till M, Jaillard S, Redon S, Valduga M, Coutton C, Missirian C, Prieur F, Simon-Bouy B, Beneteau C, Kuentz P, Rooryck C, Gruchy N, Marle N, Plutino M, Tosca L, Dupont C, Puechberty J, Schluth-Bolard C, Salomon L, Sanlaville D, Malan V, Vialard F. Chromosomal microarray analysis in fetuses with an isolated congenital heart defect: A retrospective, nationwide, multicenter study in France. Prenat Diagn 2019; 39:464-470. [PMID: 30896039 DOI: 10.1002/pd.5449] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 03/05/2019] [Accepted: 03/15/2019] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Congenital heart defects (CHDs) may be isolated or associated with other malformations. The use of chromosome microarray (CMA) can increase the genetic diagnostic yield for CHDs by between 4% and 10%. The objective of this study was to evaluate the value of CMA after the prenatal diagnosis of an isolated CHD. METHODS In a retrospective, nationwide study performed in France, we collected data on all cases of isolated CHD that had been explored using CMAs in 2015. RESULTS A total of 239 fetuses were included and 33 copy number variations (CNVs) were reported; 19 were considered to be pathogenic, six were variants of unknown significance, and eight were benign variants. The anomaly detection rate was 10.4% overall but ranged from 0% to 16.7% as a function of the isolated CHD in question. The known CNVs were 22q11.21 deletions (n = 10), 22q11.21 duplications (n = 2), 8p23 deletions (n = 2), an Alagille syndrome (n = 1), and a Kleefstra syndrome (n = 1). CONCLUSION The additional diagnostic yield was clinically significant (3.1%), even when anomalies in the 22q11.21 region were not taken into account. Hence, patients with a suspected isolated CHD and a normal karyotype must be screened for chromosome anomalies other than 22q11.21 duplications and deletions.
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Affiliation(s)
- Marguerite Hureaux
- Service d'Histologie-Embryologie-Cytogénétique, Hôpital Necker-Enfants Malades, APHP, Paris, France
| | - Sarah Guterman
- EA7404-GIG, UFR des sciences de la Santé Simone Veil, UVSQ, Montigny le Bretonneux, France.,Service de Gynécologie Obstétrique, CHI de Poissy, St Germain, Poissy, France
| | - Bérénice Hervé
- EA7404-GIG, UFR des sciences de la Santé Simone Veil, UVSQ, Montigny le Bretonneux, France.,Unité de Cytogénétique, CHI de Poissy St Germain, Poissy, France
| | - Marianne Till
- Service de Génétique, Hospices civils de Lyon, Lyon, France
| | | | - Sylvie Redon
- Laboratoire de Cytogénétique, Cytologie et Biologie de la Reproduction, CHRU, Brest, France
| | | | - Charles Coutton
- Service de Génétique Chromosomique, Hôpital Couple-Enfant, CHU Grenoble Alpes, La Tronche, France.,Equipe GETI - IAB, INSERM U1209, Université Grenoble-Alpes, La Tronche, France
| | - Chantal Missirian
- Département de Génétique Médicale, CHU Timone Enfants, APHM, Marseille, France
| | - Fabienne Prieur
- Service de Génétique Clinique Chromosomique Moléculaire, CHU Saint-Etienne, Saint-Etienne, France
| | - Brigitte Simon-Bouy
- Génétique Constitutionnelle, Laboratoire de Biologie, Centre Hospitalier de Versailles, Le Chesnay, France
| | | | - Paul Kuentz
- Service de Génétique Biologique, CHRU Besançon, Besançon, France
| | - Caroline Rooryck
- CHU de Bordeaux, Service de Génétique Médicale, Bordeaux, France
| | | | - Nathalie Marle
- Laboratoire de Génétique Chromosomique et Moléculaire, CHU Dijon, Dijon, France
| | | | - Lucie Tosca
- Service d'Histologie Embryologie Cytogénétique, Hôpital Antoine Béclère, Clamart, France
| | - Celine Dupont
- Service de Cytogénétique, APHP Hôpital Robert Debré, Paris, France
| | | | | | - Laurent Salomon
- Service d'Obstétrique, Hôpital Necker-Enfants Malades, APHP, Paris, France
| | | | - Valérie Malan
- Service d'Histologie-Embryologie-Cytogénétique, Hôpital Necker-Enfants Malades, APHP, Paris, France.,Sorbonne Paris Cité, Université Paris Descartes, Paris, France
| | - François Vialard
- EA7404-GIG, UFR des sciences de la Santé Simone Veil, UVSQ, Montigny le Bretonneux, France.,Unité de Cytogénétique, CHI de Poissy St Germain, Poissy, France
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27
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Klap J, Butow Z, Champy CM, Masson-Lecomte A, Defontaines J, De la Taille A, Salomon L. 1,000 Retroperitoneoscopic Procedures of the Upper Urinary Tract: Analysis of Complications. Urol Int 2019; 102:406-412. [PMID: 30840956 DOI: 10.1159/000497038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 11/20/2018] [Accepted: 01/16/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND OBJECTIVE To evaluate risk factors and complications of retroperitoneoscopic procedures of upper urinary tract and adrenal gland. METHODS From 1994 to 2016, 1,000 retroperitoneal laparoscopies were performed - 476 nephrectomies, 201 adrenalectomies, 103 partial nephrectomies, 91 pyeloplasties, 70 nephro-ureterectomies, and 59 miscellaneous surgeries (diverticulectomy). Data collection was prospective. We analyzed age, body mass index (BMI), American Society of Anesthesiologists (ASA) score, operative time, blood loss, hospitalization stay and complications. Risks factors were explored with univariate and multivariate analysis. RESULTS The mean BMI was 25 and median ASA 2. The mean operative time was 136 mn, mean blood loss 149 mL. There were 49 conversions. Of the patients, 41 required re-interventions, predominantly due to urinary fistula or post-operative bleeding. Post-operatively, 145 complications were recorded. In multivariate analysis, partial nephrectomies (OR 2.12, p = 0.031, 95% CI [1.07-4.22]) and pyeloplasties (OR 1.97, p = 0.02, 95% CI [1.11-3.48]) were significantly more at risk of complication than nephrectomies. An ASA score of 3 was also a significant risk factor of complications (OR 2.3, p = 0.014, 95% CI [1.17-4.47]) and an increased BMI carried a higher risk of conversion. There was no significant difference of conversion or complication rates between the first and last 500 patients. CONCLUSIONS Upper urinary tract and adrenal surgeries can be performed by retroperitoneal laparoscopy. This surgical technic is safe and reproducible. The choice of the technic must be oriented by ASA, BMI and the type of surgery.
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Affiliation(s)
- Julia Klap
- Department of Urology, Hôpital Henri Mondor, Créteil, France,
| | - Zentia Butow
- Department of Urology, Hôpital Henri Mondor, Créteil, France
| | - Cecile M Champy
- Department of Urology, Hôpital Henri Mondor, Créteil, France
| | | | | | | | - Laurent Salomon
- Department of Urology, Hôpital Henri Mondor, Créteil, France
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28
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Le Bihan E, Lebacle CM, Bessede T, de la TAILLE A, Salomon L, Irani J. Outcomes in a cohort of patients with a Gleason score 6 on radical prostatectomy specimen. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.7_suppl.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
112 Background: This retrospective study evaluates the outcome of a cohort of patients who had a radical prostatectomy with GS 6 on the prostatic specimen. Methods: Consecutive cases were extracted from prostatectomy database of 2 teaching hospitals between 2000 and 2006 for a prostate cancer and were scored GS 6 on the specimen. Overall, specific, metastasis and PSA progression-free survivals were analyzed. Cox model was used to evaluate predictive factors. PSA progression was defined by a level of 0.2 ng/mL or above. Results: Mean age of the 616 analyzed patients was 62.8 yrs (SD 6.4). Mean initial PSA was 8.2 ng/mL (SD 8.0). In 46 cases (7.5%) grade 4 was described on pre-operative prostatic biopsies. Median total tumor length (TTL) was 3 mm (IQ 7.7). Pelvic lymphadenectomy was performed in 213 cases and no positive lymph node was diagnosed. Positive margin (R1) was diagnosed in 79 patients (12.8%). pT3a and pT3b stages were described in 65 and 11 cases (10.5% and 1.8%) respectively. Mean follow-up (FU) was 57.2 months (SD 48). None of the 4 deaths were attributed to prostate cancer. PSA progression was observed in 73 patients (11.8%) of whom 48 had a secondary treatment. One patient developed metastasis. Independent predictive factors of PSA progression were TTL on prostatic biopsy (p = 0.007), R1 status (p = 0.005) and seminal vesicles invasion (p = 0.005). Center, initial PSA, number of positive cores and GS on prostatic biopsy were not associated with outcome. Conclusions: No specific mortality was observed in this cohort of prostatectomy GS 6 prostate cancer patients with the limitation of an insufficient FU. The number of positive cores on pre-operative prostatic biopsies was not predictive of outcome which calls into question its use as criterion for active surveillance.
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Affiliation(s)
| | | | - Thomas Bessede
- Service d’urologie CHU Bicêtre, APHP, Université Paris-Sud Paris Saclay, Le Kremlin-Bicetre, France
| | | | | | - Jacques Irani
- Bicetre University Hospital, Service d’urologie CHU Bicêtre, APHP, Université Paris-Sud Paris Saclay, Le Kremlin-Bicetre, France
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29
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Leibler C, Matignon M, Moktefi A, Samson C, Zarour A, Malard S, Boutin E, Pilon C, Salomon L, Natella PA, Durrbach A, Robert T, Canoui-Poitrine F, Grimbert P. Belatacept in renal transplant recipient with mild immunologic risk factor: A pilot prospective study (BELACOR). Am J Transplant 2019; 19:894-906. [PMID: 30582270 DOI: 10.1111/ajt.15229] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [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: 03/28/2018] [Revised: 11/21/2018] [Accepted: 12/06/2018] [Indexed: 01/25/2023]
Abstract
The benefit of belatacept on antibody-mediated rejection (ABMR) incidence after kidney transplant with preformed donor-specific antibodies (DSAs) has never been assessed. Between 2014 and 2016, we conducted a multicenter prospective clinical trial with 49 patients to determine kidney allograft outcome in recipients with preformed DSAs (maximal mean fluorescence intensity 500 to 3000) treated with belatacept (BELACOR trial). Immunosuppressive strategy included antithymocyte globulin, belatacept, mycophenolate mofetil, and steroids. An ancillary control group was designed retrospectively, including patients fulfilling the same inclusion criteria treated with calcineurin inhibitors. In BELACOR group, no patient exhibited acute ABMR, patient and allograft survival at 1 year was 100% and 95.4%, respectively, and the estimated glomerular filtration rate was 53.2 mL/min/1.73 m2 . However, the 12-month incidence of acute T cell-mediated rejection was 25.4% (14.5% to 42.4%). Comparison with the control group showed significantly higher T cell-mediated rejection incidence only in the BELACOR group (P = .003). Considering the DSAs, the outcome was similar in the 2 groups except a significantly higher number of patients displayed a complete disappearance of class II DSAs in the BELACOR group (P = .001). Belatacept was not associated with an acute ABMR increased risk and may be considered as immunosuppressive strategy in transplant recipients with preformed DSAs (maximal mean fluorescence intensity 500 to 3000). Prospective randomized trials are needed to confirm these results.
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Affiliation(s)
- Claire Leibler
- Assistance Publique-Hôpitaux de Paris, Nephrology and Renal Transplantation Department, Institut Francilien de Recherche en Néphrologie et Transplantation, Groupe Hospitalier Henri-Mondor/Albert-Chenevier, Créteil, France.,Université Paris-Est-Créteil, Département Hospitalo-Universitaire Virus-Immunité-Cancer, Institut Mondor de Recherche Biomédicale, Créteil, France
| | - Marie Matignon
- Assistance Publique-Hôpitaux de Paris, Nephrology and Renal Transplantation Department, Institut Francilien de Recherche en Néphrologie et Transplantation, Groupe Hospitalier Henri-Mondor/Albert-Chenevier, Créteil, France.,Université Paris-Est-Créteil, Département Hospitalo-Universitaire Virus-Immunité-Cancer, Institut Mondor de Recherche Biomédicale, Créteil, France
| | - Anissa Moktefi
- Université Paris-Est-Créteil, Département Hospitalo-Universitaire Virus-Immunité-Cancer, Institut Mondor de Recherche Biomédicale, Créteil, France.,Assistance Publique-Hôpitaux de Paris, Pathology Department, Groupe Hospitalier Henri-Mondor/Albert-Chenevier, Créteil, France
| | - Chloé Samson
- Université Paris-Est-Créteil, Département Hospitalo-Universitaire Virus-Immunité-Cancer, Institut Mondor de Recherche Biomédicale, Créteil, France
| | - Anissa Zarour
- Assistance Publique-Hôpitaux de Paris, Public Health Department/Clinical Research Unit (URC-Mondor), Groupe Hospitalier Henri-Mondor/Albert Chenevier, Créteil, France
| | - Stéphanie Malard
- Assistance Publique-Hôpitaux de Paris, Laboratoire Régional d' Histocompatibilité, Hôpital Saint Louis, Paris, France
| | - Emmanuelle Boutin
- Assistance Publique-Hôpitaux de Paris, Public Health Department/Clinical Research Unit (URC-Mondor), Groupe Hospitalier Henri-Mondor/Albert Chenevier, Créteil, France.,Assistance Publique-Hôpitaux de Paris, Nephrology and Renal Transplantation Department, Institut Francilien de Recherche en Néphrologie et Transplantation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Caroline Pilon
- Université Paris-Est-Créteil, Département Hospitalo-Universitaire Virus-Immunité-Cancer, Institut Mondor de Recherche Biomédicale, Créteil, France
| | - Laurent Salomon
- Assistance Publique-Hôpitaux de Paris, Urology Department, Groupe Hospitalier Henri-Mondor/Albert Chenevier, Créteil, France
| | - Pierre-André Natella
- Assistance Publique-Hôpitaux de Paris, Public Health Department/Clinical Research Unit (URC-Mondor), Groupe Hospitalier Henri-Mondor/Albert Chenevier, Créteil, France
| | - Antoine Durrbach
- Assistance Publique-Hôpitaux de Paris, Nephrology and Renal Transplantation Department, Institut Francilien de Recherche en Néphrologie et Transplantation, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Thomas Robert
- Department of Nephrology, Transplantation and Emergency, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France
| | - Florence Canoui-Poitrine
- Assistance Publique-Hôpitaux de Paris, Public Health Department/Clinical Research Unit (URC-Mondor), Groupe Hospitalier Henri-Mondor/Albert Chenevier, Créteil, France.,Département Hospitalo-Universitaire A-TVB, Institut Mondor de Recherche Biomédicale - EA 7376 Clinical Epidemiology and Ageing Unit, Université Paris-Est-Créteil, Créteil, France
| | - Philippe Grimbert
- Assistance Publique-Hôpitaux de Paris, Nephrology and Renal Transplantation Department, Institut Francilien de Recherche en Néphrologie et Transplantation, Groupe Hospitalier Henri-Mondor/Albert-Chenevier, Créteil, France.,Université Paris-Est-Créteil, Département Hospitalo-Universitaire Virus-Immunité-Cancer, Institut Mondor de Recherche Biomédicale, Créteil, France.,Assistance Publique-Hôpitaux de Paris, CIC-BT 504, Créteil, France
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Guendouz S, Bodez D, Galat A, Kharoubi M, Lebras F, Belhadj K, Funalot B, Couetil J, Dubois Randé J, Mongardon N, Azoulay D, Duvoux C, Salomon L, Audart V, Plante-Bordeneuve V, Damy T. Single or combined cardiac transplantation for Cardiac Amyloidosis. A report from the French National Referral Center for Cardiac Amyloidosis. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.090] [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: 12/01/2022]
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Rousseau B, Guillemin A, Duvoux C, Neuzillet C, Tlemsani C, Compagnon P, Azoulay D, Salloum C, Laurent A, de la Taille A, Salomon L, Cholley I, Haioun C, Dupuis J, Wolkenstein P, Matignon MB, Grimbert P, Tournigand C. Optimal oncologic management and mTOR inhibitor introduction are safe and improve survival in kidney and liver allograft recipients withde novocarcinoma. Int J Cancer 2018; 144:886-896. [DOI: 10.1002/ijc.31769] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 06/30/2018] [Accepted: 07/17/2018] [Indexed: 12/15/2022]
Affiliation(s)
- Benoit Rousseau
- Medical Oncology, Henri Mondor Hospital; Assistance Publique-Hôpitaux de Paris; 94100 Créteil France
- Faculty of Medicine; University of Paris-Est; 94000 Créteil France
- IMRB, INSERM U955; University Paris Est Créteil, Team 18; 94100 Créteil France
| | - Aude Guillemin
- Medical Oncology, Henri Mondor Hospital; Assistance Publique-Hôpitaux de Paris; 94100 Créteil France
- Faculty of Medicine; University of Paris-Est; 94000 Créteil France
| | - Christophe Duvoux
- Faculty of Medicine; University of Paris-Est; 94000 Créteil France
- Hepatology, Henri Mondor Hospital; Assistance Publique-Hôpitaux de Paris; 94100 Créteil France
| | - Cindy Neuzillet
- Medical Oncology, Henri Mondor Hospital; Assistance Publique-Hôpitaux de Paris; 94100 Créteil France
- Faculty of Medicine; University of Paris-Est; 94000 Créteil France
| | - Camille Tlemsani
- Medical Oncology, Cochin Hospital; Assistance Publique-Hôpitaux de Paris; 75014 Paris France
| | - Philippe Compagnon
- Faculty of Medicine; University of Paris-Est; 94000 Créteil France
- Visceral and hepatobiliary surgery, Henri Mondor Hospital; Assistance Publique-Hôpitaux de Paris; 94100 Créteil France
| | - Daniel Azoulay
- Faculty of Medicine; University of Paris-Est; 94000 Créteil France
- Visceral and hepatobiliary surgery, Henri Mondor Hospital; Assistance Publique-Hôpitaux de Paris; 94100 Créteil France
| | - Chaddy Salloum
- Faculty of Medicine; University of Paris-Est; 94000 Créteil France
- Visceral and hepatobiliary surgery, Henri Mondor Hospital; Assistance Publique-Hôpitaux de Paris; 94100 Créteil France
| | - Alexis Laurent
- Faculty of Medicine; University of Paris-Est; 94000 Créteil France
- Visceral and hepatobiliary surgery, Henri Mondor Hospital; Assistance Publique-Hôpitaux de Paris; 94100 Créteil France
| | - Alexandre de la Taille
- Faculty of Medicine; University of Paris-Est; 94000 Créteil France
- Urology, Henri Mondor Hospital; Assistance Publique-Hôpitaux de Paris; 94100 Créteil France
| | - Laurent Salomon
- Faculty of Medicine; University of Paris-Est; 94000 Créteil France
- Urology, Henri Mondor Hospital; Assistance Publique-Hôpitaux de Paris; 94100 Créteil France
| | - Irène Cholley
- Faculty of Medicine; University of Paris-Est; 94000 Créteil France
- Urology, Henri Mondor Hospital; Assistance Publique-Hôpitaux de Paris; 94100 Créteil France
| | - Corinne Haioun
- Faculty of Medicine; University of Paris-Est; 94000 Créteil France
- Lymphoid Malignancies Unit, Henri Mondor Hospital; Assistance Publique-Hôpitaux de Paris; 94100 Créteil France
| | - Jehan Dupuis
- Faculty of Medicine; University of Paris-Est; 94000 Créteil France
- Lymphoid Malignancies Unit, Henri Mondor Hospital; Assistance Publique-Hôpitaux de Paris; 94100 Créteil France
| | - Pierre Wolkenstein
- Faculty of Medicine; University of Paris-Est; 94000 Créteil France
- Dermatology, Henri Mondor Hospital; Assistance Publique-Hôpitaux de Paris; 94100 Créteil France
| | - Marie-Bénédicte Matignon
- Faculty of Medicine; University of Paris-Est; 94000 Créteil France
- Nephrology, Henri Mondor Hospital; Assistance Publique-Hôpitaux de Paris; 94100 Créteil France
| | - Philippe Grimbert
- Faculty of Medicine; University of Paris-Est; 94000 Créteil France
- Nephrology, Henri Mondor Hospital; Assistance Publique-Hôpitaux de Paris; 94100 Créteil France
| | - Christophe Tournigand
- Medical Oncology, Henri Mondor Hospital; Assistance Publique-Hôpitaux de Paris; 94100 Créteil France
- Faculty of Medicine; University of Paris-Est; 94000 Créteil France
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Michiels C, Bernhard J, Beauval J, Doumerc N, Roupret M, Vaessen C, Dariane C, Flamand V, Long JA, Paparel P, Baumert H, Bruyere F, Lang H, Salomon L, Guilloneau B, Descazeaud A, Lebret T, Arnaud M, Patard J, Bensalah K. Ropan : observatoire national sur la néphrectomie partielle robotisée. Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.208] [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: 11/28/2022]
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Szabla N, Benbouzid S, Larre S, Gaudez F, Matillon X, Thuret R, Valeri A, Blanchereau J, Timsit M, Boutin J, Culty T, Bensadoun H, Salomon L, Neuzillet Y, Bouillet S, Terrier N, Lechevallier E, Verhoest G, Sallusto F, Tillou X. Une étude nationale des traitements conservateurs des tumeurs du greffon rénal : vers les thérapies ablatives. Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.020] [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: 10/27/2022]
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Toinet T, Dominique I, Cholley I, Vanalderwerelt V, Goujon A, Paret F, Bessede T, Delaporte V, Salomon L, Badet L, Boutin J, Verhoest G, Branchereau J, Loupy A, Timsit M. Évolution rénale dans la transplantation combinée rein – cœur. Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.024] [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]
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35
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Lebâcle C, Pooli A, Faiena I, Johnson D, Bernhard J, Paparel P, Bensalah K, Beauval J, Méjean A, Dariane C, Bigot P, Lang H, Bessede T, De La Taille A, Salomon L, Rouprêt M, Leon P, Larré S, Cussenot O, Bruyère F, Long JA, Ouzaid I, Irani J, Patard JJ, Chamie K, Drakaki A, Pantuck A. Facteurs prédictifs et pronostics du cancer du rein à composante sarcomatoïde. Résultats d’une étude UCLA et UroCCR 45. Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.180] [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: 11/16/2022]
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Roux N, Jakubowicz D, Salomon L, Grangé G, Giuseppi A, Rousseau V, Khen-Dunlop N, Beaudoin S. Early surgical management for giant omphalocele: Results and prognostic factors. J Pediatr Surg 2018; 53:1908-1913. [PMID: 29803304 DOI: 10.1016/j.jpedsurg.2018.04.036] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [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: 09/18/2017] [Revised: 04/25/2018] [Accepted: 04/26/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Giant omphalocele often represents a major surgical challenge and is reported with high mortality and morbidity rates. The aim of this study was to assess the outcome of neonates with giant omphalocele managed with early operative surgical treatment, and subsequently to identify possible factors that could alter the prognosis. METHODS We reviewed the medical records of 29 consecutive newborns with prenatally diagnosed giant omphalocele. In these cases one of two procedures had been performed: either staged closure after silo, or immediate closure with a synthetic patch. The cases were separated into 2 groups: Isolated giant omphalocele (IO group) and giant omphalocele associated with malformation (NIO group). RESULTS Infants in the IO group had a lower size of the omphalocele (p<0,001), a shorter hospital stay (95 days [45-915] vs. 41.5 days [10-110] p= 0, 02), and a shorter median ventilation length (10 days [1-33] vs. 27, 5 [6-65] p = 0, 05). In the NIO group, 5 cases displayed a significantly more difficult course than the others. They were compared to the remaining cases for prenatal and anatomic features. Four factors associated with greater morbidity were identified: CONCLUSIONS: Isolated omphalocele, even containing the whole liver, has a very good prognosis with early surgical treatment. Without associated anomalies, 95% of giant omphaloceles can be discharged with a median of 41.5 days in hospital. However, associated anomalies (especially cardiopathies) may burden the prognosis and should be both carefully assessed during pregnancy and taken into account in parental information. TYPE OF STUDY Retrospective Study LEVEL OF EVIDENCE: Level I.
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Affiliation(s)
- Nathalie Roux
- Department of Obstetrics, Hôpital Necker-Enfants Malades, APHP, Paris, France
| | - Déborah Jakubowicz
- Department of Paediatric Surgery, Hôpital Necker-Enfants Malades, APHP, Paris, France
| | - Laurent Salomon
- Department of Obstetrics, Hôpital Necker-Enfants Malades, APHP, Paris, France
| | - Gilles Grangé
- Department of Obstetrics, Maternité Port Royal, APHP, Paris, France
| | - Agnès Giuseppi
- Department of Neonatal Medecine, Hôpital Necker-Enfants Malades, APHP, Paris, France
| | - Véronique Rousseau
- Department of Paediatric Surgery, Hôpital Necker-Enfants Malades, APHP, Paris, France
| | - Naziha Khen-Dunlop
- Department of Paediatric Surgery, Hôpital Necker-Enfants Malades, APHP, Paris, France
| | - Sylvie Beaudoin
- Department of Paediatric Surgery, Hôpital Necker-Enfants Malades, APHP, Paris, France.
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Denormandie AC, de la Taille A, Salomon L, Abbou C, Yiou R. [Is transition from pure laparoscopic to robotic-assisted radical prostatectomy associated with increase of surgical procedures for urinary incontinence and erectile dysfunction?]. Prog Urol 2018; 28:921-926. [PMID: 30219647 DOI: 10.1016/j.purol.2018.08.008] [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: 03/18/2018] [Revised: 08/01/2018] [Accepted: 08/09/2018] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To study the impact of changing the technique of radical prostatectomy [pure laparoscopic radical (PR-Lap) to robot-assisted radical prostatectomy (RP-Rob)] on the rate of secondary procedures for urinary incontinence (UI) and erectile dysfunction (ED). MATERIAL Retrospective study evaluating the number and type of surgical procedures for post-RP UI and DE between 2008 and 2015, according to the technique of (RP-Lap or RP-Rob). RESULTS Between 2008 et 2015, 2046 RP were performed in our department including 372 RP-Lap and 1674 RP-Rob. Among these patients, 84 (4%) had a surgical procedure for post-RP UI (18 AMS800, 9 balloons Pro-Act, and 57 male slings) and 15 (0.7%) had implantation of penile prosthesis for post-RP ED; 16 (0.7%) patients had both procedures. The mean delay between RP and UI surgery decrease from 3.2 years in 2008 to 1 year in 2015 and remain stable for penile prosthesis implantation (mean delay: 3.4 years). The overall rates of secondary procedures for UI and DE remained stable and below 5% and 1.7%, respectively, even during the transition period. For each year of PR studied, the rates of secondary procedure were higher in the RP-Lap group. CONCLUSION Changing the technique of RP from RP-Lap to PR-Rob has a favorable impact on the rate of secondary procedures for UI and ED from the outset.
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Affiliation(s)
- A C Denormandie
- Service d'urologie, CHU Henri-Mondor, AP-HP, 51, avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France
| | - A de la Taille
- Service d'urologie, CHU Henri-Mondor, AP-HP, 51, avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France
| | - L Salomon
- Service d'urologie, CHU Henri-Mondor, AP-HP, 51, avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France
| | - C Abbou
- Service d'urologie, CHU Henri-Mondor, AP-HP, 51, avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France
| | - R Yiou
- Service d'urologie, CHU Henri-Mondor, AP-HP, 51, avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France.
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Varca V, Benelli A, Perri D, Gozen AS, Fiedler M, de la Taille A, Casazza G, Salomon L, Rassweiler J, Gregori A, Gaboardi F. Laparoscopic Radical Prostatectomy in Patients with High-Risk Prostate Cancer: Feasibility and Safety. Results of a Multicentric Study. J Endourol 2018; 32:843-851. [PMID: 30027748 DOI: 10.1089/end.2018.0086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 11/13/2022] Open
Abstract
INTRODUCTION In Western countries about 25% of prostate cancer (PCa) are high-risk tumors at presentation and its treatment is still a matter of debate among urologists. When a surgical approach is preferred the use of a mininvasive tecnique is still difficult due to the lack of data supporting it in literature. The aim of this study is to evaluate feasibility and safety of laparoscopic radical prostatectomy (LRP) for high-risk PCa. MATERIALS AND METHODS The study included 1114 patients with high-risk PCa submitted to LRP between 1998 and 2014. High-risk patients were defined according to D'Amico classification. We collected functional and oncological long-term outcomes and evaluated with univariate and multivariate analyses the role of predictive factors for survival and biochemical recurrence (BR). RESULTS Mean age at treatment was 62 ± 8 years; mean follow-up was 74 ± 50 months. We obtained an overall survival (OS) of 96.6% at a mean follow-up of 74 months (1076 patients) and a disease-free survival of 66.2% (737 patients). Age (p = 0.0006), pT (p < 0.0001), pN (p = 0.0018), and surgical margins (p = 0.0076) resulted as independent predictors for BR in multivariate analysis. pN (p = 0.0025) and Gs (p = 0.0003) are independent predictors for OS and cancer-specific survival in a univariate analysis; just the Gs results significant in the multivariate model. CONCLUSIONS According to our encouraging data about oncological and functional outcomes we believe that radical prostatectomy represents an effective treatment for patients with high-risk PCa and that laparoscopy is a safe approach offering a mini-invasive alternative to open surgery.
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Affiliation(s)
- Virginia Varca
- 1 Department of Urology, ASST-Rhodense, Garbagnate, Milan, Italy
| | - Andrea Benelli
- 1 Department of Urology, ASST-Rhodense, Garbagnate, Milan, Italy
| | - Davide Perri
- 2 Department of Urology, University of Novara , Novara, Italy
| | - Ali Sedar Gozen
- 3 Department of Urology, SLK-Kliniken Heilbronn, University of Heidelberg , Heilbronn, Germany
| | - Marcel Fiedler
- 3 Department of Urology, SLK-Kliniken Heilbronn, University of Heidelberg , Heilbronn, Germany
| | | | - Giovanni Casazza
- 5 Department of biochemical and Clinical Science, University of Milan, Milan, Italy
| | - Laurent Salomon
- 4 Urology Creteil, Hopital Henri Mondor , Île-de-France, France
| | - Jens Rassweiler
- 3 Department of Urology, SLK-Kliniken Heilbronn, University of Heidelberg , Heilbronn, Germany
| | - Andrea Gregori
- 1 Department of Urology, ASST-Rhodense, Garbagnate, Milan, Italy
| | - Franco Gaboardi
- 6 Division of Experimental Oncology, Department of Urology, Vita-Salute San Raffaele University of Milan , Milan, Italy
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Gandaglia G, van den Bergh RC, Tilki D, Fossati N, Ost P, Surcel CI, Sooriakumaran P, Tsaur I, Valerio M, Kretschmer A, Zaffuto E, Salomon L, Montorsi F, Graefen M, van der Poel H, de la Taille A, Briganti A, Ploussard G. How can we expand active surveillance criteria in patients with low- and intermediate-risk prostate cancer without increasing the risk of misclassification? Development of a novel risk calculator. BJU Int 2018; 122:823-830. [DOI: 10.1111/bju.14391] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Giorgio Gandaglia
- Unit of Urology/Division of Oncology; URI; IRCCS Ospedale San Raffaele; Milan Italy
| | | | - Derya Tilki
- Martini-Klinik Prostate Cancer Center; University-Hospital Hamburg-Eppendorf; Hamburg Germany
- Department of Urology; University-Hospital Hamburg-Eppendorf; Hamburg Germany
| | - Nicola Fossati
- Unit of Urology/Division of Oncology; URI; IRCCS Ospedale San Raffaele; Milan Italy
| | - Piet Ost
- Department of Radiotherapy; Ghent University Hospital; Ghent Belgium
| | - Christian I. Surcel
- Centre of Urological Surgery; Dialysis and Renal Transplantation; Fundeni Clinical Institute; Bucharest Romania
| | | | - Igor Tsaur
- Department of Urology; University Medicine Mainz; Mainz Germany
| | - Massimo Valerio
- Department of Urology; Centre Hospitalier Universitaire Vaudois; Lausanne Switzerland
| | - Alexander Kretschmer
- Urologische Klinik und Poliklinik; Campus Großhadern; Ludwig-Maximilians-Universität; Munich Germany
| | - Emanuele Zaffuto
- Unit of Urology/Division of Oncology; URI; IRCCS Ospedale San Raffaele; Milan Italy
| | - Laurent Salomon
- Department of Urology; Henri Mondor Hospital; Assistance-Publique Hopitaux de Paris; Creteil France
| | - Francesco Montorsi
- Unit of Urology/Division of Oncology; URI; IRCCS Ospedale San Raffaele; Milan Italy
- Vita-Salute San Raffaele University; Milan Italy
| | - Markus Graefen
- Martini-Klinik Prostate Cancer Center; University-Hospital Hamburg-Eppendorf; Hamburg Germany
| | - Henk van der Poel
- Department of Urology; Netherlands Cancer Institute; Amsterdam The Netherlands
| | - Alexandre de la Taille
- Department of Urology; Henri Mondor Hospital; Assistance-Publique Hopitaux de Paris; Creteil France
| | - Alberto Briganti
- Unit of Urology/Division of Oncology; URI; IRCCS Ospedale San Raffaele; Milan Italy
- Vita-Salute San Raffaele University; Milan Italy
| | - Guillaume Ploussard
- Department of Urology; Henri Mondor Hospital; Assistance-Publique Hopitaux de Paris; Creteil France
- Department of Urology; Saint Jean Languedoc Hospital; Toulouse France
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Dell'Oglio P, Stabile A, Grande P, Soligo M, Cristel G, Damascelli A, Renard-Penna R, Salomon L, Fossati N, Esposito A, Gandaglia G, Karnes JR, De Cobelli F, Roupret M, De La Taille A, Montorsi F, Briganti A. MP53-20 MULTI-INSTITUTIONAL EXTERNAL VALIDATION OF THE EAU GUIDELINES RECOMMENDATIONS FOR THE USE OF STAGING MPMRI PRIOR TO RADICAL PROSTATECTOMY IN MEN WITH INTERMEDIATE AND HIGH-RISK PROSTATE CANCER. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.1691] [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: 10/17/2022]
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Sophie D, Latxague C, Bensalah K, Bigot P, Paparel P, Beauval JB, Salomon L, De La Taille A, Bessede T, Lang H, Nouhaud FX, Dariane C, Baumert H, Roupret M, Long JA, VILLERS A, PATARD JJ, Soulié M, Mejean A, Videau MN, Bernhard JC. MP42-07 POSTOPERATIVE OUTCOMES OF ELDERLY PATIENTS UNDERGOING PARTIAL NEPHRECTOMY: A MULTICENTRIC-STUDY OF THE FRENCH RESEARCH NETWORK ON KIDNEY CANCER UROCCR. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.1314] [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: 11/27/2022]
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42
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Stabile A, Dell'Oglio P, Soligo M, Grande P, Brembilla G, Cristel G, Fossati N, Gandaglia G, Esposito A, De Cobelli F, Grubmüller B, Renard-Penna R, Salomon L, Shariat SF, Karnes JR, Montorsi F, De La Taille A, Roupret M, Briganti A. PD47-03 DEVELOPMENT AND SPLIT-SAMPLE VALIDATION OF THE FIRST NOMOGRAM TO IDENTIFY THE CANDIDATES FOR EXTENDED PELVIC LYMPH NODE DISSECTION AMONG MEN STAGED WITH MULTI-PARAMETRIC MRI FOR CLINICALLY LOCALIZED PROSTATE CANCER. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.2163] [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: 11/30/2022]
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43
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Defontaines J, Salomon L, Champy C, Cholley I, Chiaradia M, de la Taille A. [Prostate cancer diagnostic by saturation randomized biopsy versus rigid targeted biopsy]. Prog Urol 2017; 27:1023-1030. [PMID: 29122487 DOI: 10.1016/j.purol.2017.09.002] [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: 04/28/2017] [Revised: 08/07/2017] [Accepted: 09/07/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Optimal diagram teaming up randomized biopsy (BR) to targeted biopsy (BC) is still missing for the diagnostic of prostate cancer (CP). This study compares diagram of 6, 12 or 18 BR with or without BC rigid. METHODS Between January 2014 and May 2016, 120 patients had prostate biopsy BR and BC. Each patient had 18 BR and BC. Results compared sextant (6 BR), standard (12 BR) and saturation (18 BR) protocol with or without the adding of BC for the detection of CP. RESULTS Rectal examination was normal, mean PSA at 8.99ng/mL and mean volume at 54cm3. It was first round for 48% of patients. Forty-four cancers were found by the group 18 BR+BC (control). The detection rate was respectively, for 6, 12 and 18 BR of 61%, 82% and 91%. The add of BC increased this detection of +27% for 6 BR+BC, +13% for 12 BR+BC and +9% for 18 BR+BC. BC found 70% of all CP. Nine percent of CP were missed by BR only. Significant CP (Gleason≥7) diagnostic was the same for 12 BR+BC and 18 BR+BC. CONCLUSION The add of BC to BR increase the detection of CP by 10%. Twelve BR+BC is the optimal diagram for the diagnostic of CP finding 95% of CP and 97% of significant CP. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- J Defontaines
- Service d'urologie, CHU Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France.
| | - L Salomon
- Service d'urologie, CHU Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - C Champy
- Service d'urologie, CHU Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - I Cholley
- Service d'urologie, CHU Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - M Chiaradia
- Service de radiologie, CHU Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
| | - A de la Taille
- Service d'urologie, CHU Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France
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Fontenil A, Bigot P, Bernhard JC, Beauval J, Larré S, Charles T, Salomon L, Papare P, Nouhaud FX, Patard J, Baumert H, Lang H, Long J, Villiers A, Henon F, Mejean A, Bensalah K, Soulié M. Mortalité postopératoire dans les trente premiers jours après néphrectomie pour cancer : étude des caractéristiques des patients décédés et des causes de décès. Prog Urol 2017. [DOI: 10.1016/j.purol.2017.07.223] [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: 11/15/2022]
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Ploussard G, Prudhomme T, Soulié M, Salomon L, De la Taille A, Beauval JB. Caractéristiques des candidats idéaux à la thérapie focale : comment les identifier avant décision thérapeutique ? Prog Urol 2017. [DOI: 10.1016/j.purol.2017.07.021] [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: 10/18/2022]
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46
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Branchereau J, Timsit MO, Neuzillet Y, Bessède T, Thuret R, Gigante M, Tillou X, Codas R, Boutin J, Doerfler A, Sallusto F, Culty T, Delaporte V, Brichart N, Barrou B, Salomon L, Karam G, Rigaud J, Badet L, Kleinklauss F. Management of renal transplant urolithiasis: a multicentre study by the French Urology Association Transplantation Committee. World J Urol 2017; 36:105-109. [DOI: 10.1007/s00345-017-2103-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 10/11/2017] [Indexed: 10/18/2022] Open
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47
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Oudard S, Mejean A, Topart D, Thuret R, Tournigand C, Salomon L, Thiery-Vuillemin A, Guichard G, Le Moulec S, Houlgatte A, Guillot A, Mottet N, Cessot A, Barry-Delongchamps N, Elaidi R, Turajlic S, Swanton C, Escudier B, Patard J, Albiges L. Biomarkers before and after nephrectomy of locally advanced or metastatic renal cell carcinoma (RCC) treated with everolimus: Neorad phase 2 trial (PREDICT consortium). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx371.034] [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: 11/14/2022] Open
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48
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Rousseau B, Jobard A, Duvoux C, Neuzillet C, Compagnon P, Azoulay D, de la Taille A, Salomon L, Cholley I, Matignon M, Grimbert P, Tournigand C. Feasibility and barriers to optimal oncological treatment in solid organ transplant patients with de novo cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx385.021] [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: 11/13/2022] Open
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49
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Vinceneux A, Bruyère F, Haillot O, Charles T, de la Taille A, Salomon L, Allory Y, Ouzaid I, Choudat L, Rouprêt M, Comperat E, Houede N, Beauval JB, Vourc'h P, Fromont G. Ductal adenocarcinoma of the prostate: Clinical and biological profiles. Prostate 2017; 77:1242-1250. [PMID: 28699202 DOI: 10.1002/pros.23383] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [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: 03/15/2017] [Accepted: 06/14/2017] [Indexed: 12/24/2022]
Abstract
BACKGROUND Ductal adenocarcinoma (DAC) is a rare and aggressive subtype of prostate cancer (PCa). In the present study, we analyzed the clinical and biological characteristics of DAC, in comparison with high grade conventional acinar PCa. METHODS Samples and data were retrospectively collected from seven institutions and centrally reviewed. Immunohistochemistry was performed on tissue microarrays to assess the expression of candidate proteins, based on the molecular classification of PCa, including ERG, PTEN, and SPINK1. SPOP mutations were investigated from tumor DNA by Sanger sequencing. Relationships with outcome were analyzed using log-rank analysis and multivariable Cox regression. RESULTS Among 56 reviewed prostatectomy specimens, 45 cases of DAC were finally confirmed. The pathological stage was pT3 in more than 66% of cases. ERG was expressed in 42% of DAC, SPINK1 in 9% (all ERG-negative), and two cases (ERG-negative) harbored a SPOP mutation. Compared to high grade conventional PCa matched for the pathological stage, cell proliferation was higher (P = 0.04) in DAC, and complete PTEN loss more frequent (P = 0.023). In multivariate analysis, SPINK1 overexpression (P = 0.017) and loss of PSA immunostaining (P = 0.02) were significantly associated with biochemical recurrence. CONCLUSION these results suggest that, despite biological differences that highlighted DAC aggressiveness, the molecular classification recently proposed in conventional PCa could also be applied in DAC.
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Affiliation(s)
- Armelle Vinceneux
- Department of Pathology, CHU de tours, Université François Rabelais, Tours, France
- INSERM UMR 1069, Tours, France
| | - Franck Bruyère
- Department of Urology, CHU de Tours, Pres Centre Val de Loire, Université François Rabelais de Tours, Tours, France
| | - Olivier Haillot
- Department of Urology, CHU de Tours, Pres Centre Val de Loire, Université François Rabelais de Tours, Tours, France
| | - Thomas Charles
- Service d'Urologie, CHU de Poitiers, Université de Poitiers, Poitiers, France
| | | | - Laurent Salomon
- Department of Urology, Henri Mondor Hospital, AP-HP, Créteil, France
| | - Yves Allory
- Department of Pathology and Tissue Biobank Unit, Henri Mondor Hospital, AP-HP, Créteil, France
| | - Idir Ouzaid
- Department of Urology, Bichat-Claude Bernard Hospital, AP-HP, Paris, France
| | - Laurence Choudat
- Department of Pathology, Bichat-Claude Bernard Hospital, AP-HP, Paris, France
| | - Morgan Rouprêt
- Department of Urology, Pitié- Salpétrière Hospital, Assistance Publique Hôpitaux de Paris, University Pierre et Marie Curie, Paris 6, Paris, France
| | - Eva Comperat
- Department of Pathology, Pitié-Salpétrière Hospital, Assistance Publique Hôpitaux de Paris, University Pierre et Marie Curie, Paris 6, Paris, France
| | - Nadine Houede
- Department of Medical Oncology, Groupe Hospitalier Universitaire Caremeau, Nîmes, France
| | - Jean-Baptiste Beauval
- Department of Urology, Andrology and Renal Transplantation, CHU Rangueil, Toulouse, France
| | - Patrick Vourc'h
- Laboratoire de Biochimie et Biologie moléculaire, CHRU de Tours, INSERM U930, Université François-Rabelais, Tours, France
| | - Gaëlle Fromont
- Department of Pathology, CHU de tours, Université François Rabelais, Tours, France
- INSERM UMR 1069, Tours, France
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Chahwan C, Doerfler A, Brichart N, Bouyé S, Culty T, Iselin C, Pfister C, Sallusto F, Salomon L, Verhoest G, Viart L, Tillou X. Prostate cancer before renal transplantation: A multicentre study. Prog Urol 2017; 27:166-175. [DOI: 10.1016/j.purol.2017.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 01/08/2017] [Accepted: 01/24/2017] [Indexed: 12/26/2022]
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