1
|
Long Depaquit T, Campagna J, Bastide C, Baboudjian M, Corral R, Uleri A, Toledano H. Salvage high-intensity focused ultrasound (S-HIFU) for recurrence after primary radiotherapy of prostate cancer. Fr J Urol 2024; 34:102633. [PMID: 38547931 DOI: 10.1016/j.fjurol.2024.102633] [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] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 03/04/2024] [Accepted: 03/22/2024] [Indexed: 04/13/2024]
Abstract
OBJECTIVES To evaluate functional and oncological outcomes of salvage high-intensity focal ultrasound (S-HIFU) after external beam radiotherapy (EBRT) failure in prostate cancer (PCa) patients. METHODS This single-center study included patients who underwent S-HIFU for local recurrence after EBRT between 2006 and 2023. Cancer-specific survival, metastasis-free survival and progression-free survival were illustrated using Kaplan-Meier curves. Disease progression was defined by one of the following criteria: increase of 2ng/mL or more above the PSA nadir, positive post-S-HIFU biopsy or initiation of androgen deprivation therapy (ADT). Multivariable Cox proportional hazards model was used to identify predictors of disease progression after S-HIFU. RESULTS A total of 52 S-HIFU sessions for 48 patients were performed. Median time between EBRT and S-HIFU was 6.5 years. Median PSA before S-HIFU was 3.2ng/mL and median PSA nadir after S-HIFU was 0.58ng/mL. A total of 39 (81.3%) complications was recorded, including 3 (6.3%) high grade complications according to the Clavien-Dindo classification. After a median follow-up period of 6 years, 14 (29.2%) patients developed metastatic disease. Eighteen (37.5%) patients had no recurrence, whereas 30 (62.5%) patients received ADT for disease progression. The estimated 5-yr cancer-specific survival (CSS), metastasis-free survival (MFS) and progression-free survival rates (PFSR) were 100%, 79.9% (95% CI 67-92) and 41.2% (95% CI 74-96), respectively. The estimated 10-yr CSS, MFS and PFSR were 80% (95% CI 45-100), 50.7% (95% CI 19.4-82.1) and 14% (95% CI 10.8-45), respectively. The hazard of progression increased with the intermediate (HR 3.8; 95% CI 0.99 to 15; p=0.049) and high pre-EBRT d'Amico-s risk group (HR 4.1; 95% CI 0.98 to 16.2; p=0.050). Also, the time between EBRT and S-HIFU was significantly associated with risk of progression (HR 0.61; 95% CI 0.43 to 0.86; p=0.004). No significant difference linked to the disease progression (DP) risk was found between focal vs whole-gland treatment (p=0.70). CONCLUSION Physicians should consider HIFU as a local salvage treatment after failed EBRT, thus avoiding or delaying palliative androgen deprivation therapy. Further studies are needed to improve patient selection for this therapy. LEVEL OF EVIDENCE: 4
Collapse
Affiliation(s)
- Thibaut Long Depaquit
- Department of Urology, HIA Sainte-Anne, Toulon, France; Department of Urology, North Hospital, AP-HM, Marseille, France.
| | | | - Cyrille Bastide
- Department of Urology, North Hospital, AP-HM, Marseille, France
| | | | - Renaud Corral
- Department of Urology, HIA Sainte-Anne, Toulon, France; Department of Urology, North Hospital, AP-HM, Marseille, France; Department of Urology, Martigues Hospital, Martigues, France
| | | | - Harry Toledano
- Department of Urology, North Hospital, AP-HM, Marseille, France; Department of Urology, Martigues Hospital, Martigues, France
| |
Collapse
|
2
|
Bandelier Q, Bastide C, Charvet AL, Leclercq L, Gondran-Tellier B, Campagna J, Long-Depaquit T, Daniel L, Rossi D, Lechevallier E, Baboudjian M. Active surveillance in favorable intermediate-risk prostate cancer: A single-center experience. Fr J Urol 2024; 34:102537. [PMID: 37783635 DOI: 10.1016/j.purol.2023.09.024] [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] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/12/2023] [Accepted: 09/19/2023] [Indexed: 10/04/2023]
Abstract
PURPOSE To report the long-term oncological outcomes of active surveillance (AS) in selected patients with favorable intermediate-risk (IR) prostate cancer (PCa). METHODS A retrospective database review of two academic centers was conducted to identify favorable IR PCa patients initially managed by AS between 2014 and 2022. Favorable IR PCa was defined by the presence of one single element of IR disease (i.e., PSA 10-20ng/mL, Gleason Grade Group [GG] 2, or cT2b). All patients were diagnosed and followed up according to a contemporary scheme, including MRI and image-guided biopsies. The primary endpoint was metastasis-free survival. RESULTS A total of 57 patients met our inclusion criteria and the median follow-up was 56months. During follow-up, there were no cases of metastasis or death due to PCa, but 6 deaths due to competing causes. A total of 25 (44%) and 6 patients (11%) had definitive treatment and GG 3 reclassification during follow-up, respectively. In multivariable Cox hazard regression analysis, the risk of undergoing definitive treatment was significantly associated with PSA density>0.15 (HR: 4.82, 95% CI: 1.47 to 15; P=0.01) and PI-RADS 4-5 lesions on mpMRI (HR: 2.48, 95% CI: 1.06 to 5.19; P=0.006). Interestingly, tumor burden (P=0.3) and GG (P=0.7) on biopsy were not associated with definitive treatment. CONCLUSIONS AS is a safe and valuable strategy for well-selected patients with favorable IR prostate cancer, with excellent oncological outcomes after five years' follow-up. LEVEL OF EVIDENCE: 4
Collapse
Affiliation(s)
- Q Bandelier
- Department of Urology, La Conception Hospital, Aix-Marseille University, AP-HM, Marseille, France
| | - C Bastide
- Department of Urology, North Hospital, Aix-Marseille University, AP-HM, Marseille, France
| | - A-L Charvet
- Department of Urology, North Hospital, Aix-Marseille University, AP-HM, Marseille, France
| | - L Leclercq
- Department of Urology, North Hospital, Aix-Marseille University, AP-HM, Marseille, France
| | - B Gondran-Tellier
- Department of Urology, La Conception Hospital, Aix-Marseille University, AP-HM, Marseille, France
| | - J Campagna
- Department of Urology, North Hospital, Aix-Marseille University, AP-HM, Marseille, France
| | - T Long-Depaquit
- Department of Urology, North Hospital, Aix-Marseille University, AP-HM, Marseille, France
| | - L Daniel
- Department of Pathology, Timone Hospital, Aix-Marseille University, AP-HM, Marseille, France
| | - D Rossi
- Department of Urology, North Hospital, Aix-Marseille University, AP-HM, Marseille, France
| | - E Lechevallier
- Department of Urology, La Conception Hospital, Aix-Marseille University, AP-HM, Marseille, France
| | - M Baboudjian
- Department of Urology, North Hospital, Aix-Marseille University, AP-HM, Marseille, France.
| |
Collapse
|
3
|
Berchiche W, Long Depaquit T, Baboudjian M, Barret É, Rozet F, Cathelineau X, Bastide C. Mid-term oncologic outcomes of radical prostatectomy in lymph node metastatic prostate cancer patients. Prog Urol 2023:S1166-7087(23)00090-8. [PMID: 37248105 DOI: 10.1016/j.purol.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/05/2023] [Accepted: 05/05/2023] [Indexed: 05/31/2023]
Abstract
OBJECTIVES Lymph node invasion (LNI) has been reported in 10-15% of pelvic lymph node dissection during radical prostatectomy (RP). The objective of this study was to describe the mid-term oncological outcomes in prostate cancer (PCa) patients with metastatic lymph node. METHODS We conducted a retrospective study at two French referral centers including consecutive cN0 PCa patients who underwent RP and extended pelvic lymph node dissection and had lymph node metastases on final pathological analysis (pN1) between January 2000 and May 2020. Follow-up was per institution, which generally included a PSA level measurement every 3 to 12 months for 5 years and annually thereafter. RESULTS A total of 123 patients were included: two (1.6%) low-risk, 64 (52%) intermediate-risk and 57 (46.4%) high-risk PCa according to the D'Amico risk classification. The median number of nodes removed and metastatic nodes per patient was 15 (IQR 11-22) and 1 (IQR 1-2), respectively. Adverse pathological features, i.e., ≥pT3a stage, ISUP grade ≥3, and positive surgical margins were reported in 113 (91.9%), 103 (83.7%), and 73 (59%) of cases, respectively. Postoperative treatment was administered in 104 patients, including radiotherapy alone (n=6), androgen deprivation therapy alone (n=27) or combination with androgen deprivation therapy and radiotherapy (n=71). The mean follow-up was 42.7 months. The estimated 3-year biochemical-free survival, clinical recurrence-free survival, and cancer-specific survival was 66% and 85% and 98.8%, respectively. In Cox regression analysis, the number of metastatic nodes was associated with clinical recurrence (P=0.04) and a persistently elevated PSA with biochemical recurrence (P<0.001). CONCLUSION The management of lymph node metastatic PCa patients is challenging. Risk stratification of node-positive patients, based on postoperative PSA levels and pathologic features being identified, should help physicians determine which patient would best benefit from multimodal treatment. LEVEL OF EVIDENCE: 4
Collapse
Affiliation(s)
- W Berchiche
- Department of Urology, Hôpital Nord, AP-HM, Marseille, France.
| | - T Long Depaquit
- Department of Urology, Hôpital Nord, AP-HM, Marseille, France
| | - M Baboudjian
- Department of Urology, Hôpital Nord, AP-HM, Marseille, France; Department of Urology and Kidney Transplantation, Hôpital de la Conception, AP-HM, Marseille, France
| | - É Barret
- Department of Urology, Institut Mutualiste Montsouris, Paris, France
| | - F Rozet
- Department of Urology, Institut Mutualiste Montsouris, Paris, France
| | - X Cathelineau
- Department of Urology, Institut Mutualiste Montsouris, Paris, France
| | - C Bastide
- Department of Urology, Hôpital Nord, AP-HM, Marseille, France
| |
Collapse
|
4
|
Pastene B, Bernard R, Colin M, Zunino C, Chabert-Vaudran L, Bastide C, Zieleskiewicz L, Leone M. Patient Blood Management in Transurethral Resection Surgery: Overview and Strategy Analysis from a French Tertiary Hospital. Adv Ther 2023; 40:1830-1837. [PMID: 36867328 DOI: 10.1007/s12325-023-02466-5] [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: 12/22/2022] [Accepted: 02/14/2023] [Indexed: 03/04/2023]
Abstract
INTRODUCTION Since Patient blood management (PBM) suggests a bundle of measures aiming to reduce perioperative blood transfusion because preoperative anemia and blood transfusion are associated with poor postoperative outcomes. There is a lack of data on the effect of PBM in patients undergoing transurethral resection of prostate (TURP) or bladder tumor (TURBT). We aimed to assess the bleeding risk in TURP and TURBT procedures and the effect of preoperative anemia on postoperative morbimortality. METHODS A single-center retrospective observational cohort study was conducted in a tertiary hospital in Marseille, France. All patients undergoing TURP or TURBT were included in 2020 and divided into two groups: preoperative anemia (n = 19) and no preoperative anemia (n = 59). We recorded demographic characteristics, preoperative hemoglobin concentration, iron deficiency markers, preoperative initiation of a treatment for anemia, perioperative bleeding, and postoperative outcomes up to 30 days including blood transfusion, hospital readmission, reintervention, infection, and mortality. RESULTS Baseline characteristics were comparable between groups. No patient had iron deficiency markers and no prescription of iron was initiated before surgery. No major bleeding was reported during surgery. Postoperative anemia was found in 21 patients, including 16 (76%) in the preoperative anemia group and 5 (24%) in the non-preoperative anemia group. One patient of each group received a blood transfusion after surgery. No significant differences in 30-day outcomes were reported. CONCLUSION Our study suggests that TURP and TURBT are not associated with a high-risk of postoperative bleeding. In such procedures, adherence PBM strategies do not seem beneficial. Since recent guidelines recommend restricting preoperative testing, our results may help to improve preoperative risk stratification.
Collapse
Affiliation(s)
- Bruno Pastene
- Department of Anesthesiology and Intensive Care, Hôpital Nord, Hôpitaux Universitaires de Marseille, Marseille, France.
- Centre for Cardiovascular and Nutrition Research (C2VN), INRA, Aix Marseille University, INSERM, Marseille, France.
- Service d'anesthésie et réanimation-Hôpital Nord-Bâtiment Etoile 1er Étage, Chemin des Bourrely, 13015, Marseille, France.
| | - Raphaël Bernard
- Department of Anesthesiology and Intensive Care, Hôpital Nord, Hôpitaux Universitaires de Marseille, Marseille, France
| | - Manon Colin
- Department of Anesthesiology and Intensive Care, Hôpital Nord, Hôpitaux Universitaires de Marseille, Marseille, France
| | - Claire Zunino
- Department of Anesthesiology and Intensive Care, Hôpital Nord, Hôpitaux Universitaires de Marseille, Marseille, France
| | - Lénaïck Chabert-Vaudran
- Department of Anesthesiology and Intensive Care, Hôpital Nord, Hôpitaux Universitaires de Marseille, Marseille, France
| | - Cyrille Bastide
- Department of Urology, Hôpital Nord, Hôpitaux Universitaires de Marseille, Marseille, France
| | - Laurent Zieleskiewicz
- Department of Anesthesiology and Intensive Care, Hôpital Nord, Hôpitaux Universitaires de Marseille, Marseille, France
- Centre for Cardiovascular and Nutrition Research (C2VN), INRA, Aix Marseille University, INSERM, Marseille, France
| | - Marc Leone
- Department of Anesthesiology and Intensive Care, Hôpital Nord, Hôpitaux Universitaires de Marseille, Marseille, France
- Centre for Cardiovascular and Nutrition Research (C2VN), INRA, Aix Marseille University, INSERM, Marseille, France
| |
Collapse
|
5
|
Baboudjian M, Breda A, Roumeguère T, Uleri A, Roche JB, Touzani A, Lacetera V, Beauval JB, Diamand R, Simone G, Windisch O, Benamran D, Fourcade A, Fiard G, Durand-Labrunie C, Roumiguié M, Sanguedolce F, Oderda M, Barret E, Fromont G, Dariane C, Charvet AL, Gondran-Tellier B, Bastide C, Lechevallier E, Palou J, Ruffion A, Van Der Bergh RCN, Peltier A, Ploussard G. Expanding inclusion criteria for active surveillance in intermediate-risk prostate cancer: a machine learning approach. World J Urol 2023; 41:1301-1308. [PMID: 36920491 DOI: 10.1007/s00345-023-04353-8] [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: 12/14/2022] [Accepted: 02/26/2023] [Indexed: 03/16/2023] Open
Abstract
PURPOSE To develop new selection criteria for active surveillance (AS) in intermediate-risk (IR) prostate cancer (PCa) patients. METHODS Retrospective study including patients from 14 referral centers who underwent pre-biopsy mpMRI, image-guided biopsies and radical prostatectomy. The cohort included biopsy-naive IR PCa patients who met the following inclusion criteria: Gleason Grade Group (GGG) 1-2, PSA < 20 ng/mL, and cT1-cT2 tumors. We relied on a recursive machine learning partitioning algorithm developed to predict adverse pathological features (i.e., ≥ pT3a and/or pN + and/or GGG ≥ 3). RESULTS A total of 594 patients with IR PCa were included, of whom 220 (37%) had adverse features. PI-RADS score (weight:0.726), PSA density (weight:0.158), and clinical T stage (weight:0.116) were selected as the most informative risk factors to classify patients according to their risk of adverse features, leading to the creation of five risk clusters. The adverse feature rates for cluster #1 (PI-RADS ≤ 3 and PSA density < 0.15), cluster #2 (PI-RADS 4 and PSA density < 0.15), cluster #3 (PI-RADS 1-4 and PSA density ≥ 0.15), cluster #4 (normal DRE and PI-RADS 5), and cluster #5 (abnormal DRE and PI-RADS 5) were 11.8, 27.9, 37.3, 42.7, and 65.1%, respectively. Compared with the current inclusion criteria, extending the AS criteria to clusters #1 + #2 or #1 + #2 + #3 would increase the number of eligible patients (+ 60 and + 253%, respectively) without increasing the risk of adverse pathological features. CONCLUSIONS The newly developed model has the potential to expand the number of patients eligible for AS without compromising oncologic outcomes. Prospective validation is warranted.
Collapse
Affiliation(s)
- Michael Baboudjian
- Department of Urology, La Croix du Sud Hôpital, Quint Fonsegrives, France. .,Department of Urology, North Hospital, Aix-Marseille University, APHM, Marseille, France. .,Department of Urology, La Conception Hospital, Aix-Marseille University, APHM, Marseille, France. .,Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain.
| | - Alberto Breda
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - Thierry Roumeguère
- Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium
| | - Alessandro Uleri
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | | | - Alae Touzani
- Department of Urology, La Croix du Sud Hôpital, Quint Fonsegrives, France
| | - Vito Lacetera
- Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy
| | | | - Romain Diamand
- Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium
| | - Guiseppe Simone
- Department of Urology, IRCCS "Regina Elena" National Cancer Institute, Rome, Italy
| | - Olivier Windisch
- Division of Urology, Geneva University Hospitals, Geneva, Switzerland
| | - Daniel Benamran
- Division of Urology, Geneva University Hospitals, Geneva, Switzerland
| | - Alexandre Fourcade
- Department of Urology, Hôpital Cavale Blanche, CHRU Brest, Brest, France
| | - Gaelle Fiard
- Department of Urology, Grenoble Alpes University Hospital, Université Grenoble Alpes, CNRS, Grenoble INP, TIMC, Grenoble, France
| | | | - Mathieu Roumiguié
- Department of Urology, Toulouse University Hospital, Toulouse, France
| | - Francesco Sanguedolce
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - Marco Oderda
- Division of Urology, Department of Surgical Sciences - Urology, Città Della Salute E Della Scienza Di Torino - Molinette Hospital, University of Turin, Turin, Italy
| | - Eric Barret
- Department of Urology, Institut Mutualiste Montsouris, Paris, France
| | | | - Charles Dariane
- Department of Urology, U1151 Inserm-INEM, Hôpital Européen Georges-Pompidou, APHP, Paris University, Necker, Paris, France
| | - Anne-Laure Charvet
- Department of Urology, La Conception Hospital, Aix-Marseille University, APHM, Marseille, France
| | - Bastien Gondran-Tellier
- Department of Urology, La Conception Hospital, Aix-Marseille University, APHM, Marseille, France
| | - Cyrille Bastide
- Department of Urology, North Hospital, Aix-Marseille University, APHM, Marseille, France
| | - Eric Lechevallier
- Department of Urology, La Conception Hospital, Aix-Marseille University, APHM, Marseille, France
| | - Joan Palou
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - Alain Ruffion
- Service d'urologie Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France.,Equipe 2, Centre d'Innovation en Cancérologie de Lyon (EA 3738 CICLY), Faculté de Médecine Lyon Sud, Université Lyon 1, Lyon, France
| | | | - Alexandre Peltier
- Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, Brussels, Belgium
| | | |
Collapse
|
6
|
Corral R, Boissier R, Depaquit TL, Gondran-Tellier B, Bastide C, Lechevallier E, Baboudjian M. Saline bladder infusion vs standard catheter removal in patients with acute urinary retention related to benign prostatic hyperplasia: The BLAPERF Study. Prog Urol 2023; 33:319-324. [PMID: 36842924 DOI: 10.1016/j.purol.2023.02.002] [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: 09/19/2022] [Revised: 10/19/2022] [Accepted: 02/10/2023] [Indexed: 02/28/2023]
Abstract
PURPOSE Bladder infusion, which involves filling the bladder with saline prior to catheter removal, has been associated with reduced time-to-discharge and increased success rates in trials without catheter (TWOCs) in perioperative setting. The objective of this study was to evaluate the applicability of this protocol in patients with acute urinary retention (AUR) related to benign prostatic hyperplasia (BPH). METHODS We conducted a retrospective single-center study comparing bladder infusion with at least 150mL of warm saline vs. standard catheter removal during TWOC in patients with BPH-related AUR between January and December 2021. The primary outcome was time to discharge. Secondary outcomes included: TWOC success, and early recurrence of urinary retention defined as recurrence within three months of successful TWOC. RESULTS A total of 75 men were included: 35 in the bladder infusion protocol and 40 in the standard protocol. Baseline characteristics were well balanced between groups. Overall, 35 patients (46.7%) had a successful TWOC without statistically significant difference between groups (P=0.10). Bladder infusion protocol was associated with a shorter median time to discharge (200 vs. 240min, P=0.003). However, patients in the bladder infusion group were associated with a higher risk of early recurrence of urinary retention (30% vs. 0%, P=0.02). CONCLUSION In patients with BPH-related AUR, the saline bladder infusion method reduced time-to-discharge with similar TWOC success rates. Larger studies are needed to properly analyze the risk of early recurrence of urinary retention before any clinical application. LEVEL OF EVIDENCE III.
Collapse
Affiliation(s)
- R Corral
- Department of Urology, La Conception Hospital, Assistance publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - R Boissier
- Department of Urology, La Conception Hospital, Assistance publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - T L Depaquit
- Department of Urology, La Conception Hospital, Assistance publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - B Gondran-Tellier
- Department of Urology, La Conception Hospital, Assistance publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - C Bastide
- Department of Urology, North Hospital, Assistance publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - E Lechevallier
- Department of Urology, La Conception Hospital, Assistance publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - M Baboudjian
- Department of Urology, La Conception Hospital, Assistance publique-Hôpitaux de Marseille (AP-HM), Marseille, France; Department of Urology, North Hospital, Assistance publique-Hôpitaux de Marseille (AP-HM), Marseille, France.
| |
Collapse
|
7
|
Affiliation(s)
- Michael Baboudjian
- Department of Urology, APHM, La Conception Hospital, Aix-Marseille University, Marseille, France.,Department of Urology, APHM, North Hospital, Aix-Marseille University, Marseille, France
| | - Cyrille Bastide
- Department of Urology, APHM, North Hospital, Aix-Marseille University, Marseille, France
| | - Eric Lechevallier
- Department of Urology, APHM, La Conception Hospital, Aix-Marseille University, Marseille, France
| |
Collapse
|
8
|
Lannes F, Baboudjian M, Ruffion A, Rouy M, Giammarile F, Rousseau T, Kraeber-Bodéré F, Rousseau C, Rusu D, Colombié M, Brenot-Rossi I, Rossi D, Mottet N, Bastide C. Radioisotope-guided Lymphadenectomy for Pelvic Lymph Node Staging in Patients With Intermediate- and High-risk Prostate Cancer (The Prospective SENTINELLE Study). J Urol 2023; 209:364-373. [PMID: 36331157 DOI: 10.1097/ju.0000000000003043] [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: 06/27/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE Our aim was to prospectively evaluate the diagnostic accuracy of sentinel lymph node biopsy-guided lymph node dissection compared to extended pelvic lymph node dissection in patients with intermediate- or high-risk prostate cancer. MATERIALS AND METHODS We conducted a prospective, single-arm, multicenter study at 3 tertiary centers in France between February 2012 and May 2019. Eligible patients had clinically localized intermediate- or high-risk prostate cancer. After intraprostatic injection of (99m)Tc-nanocolloid, the locations of the sentinel lymph nodes were defined by preoperative lymphoscintigraphy. Surgical excision of the sentinel lymph nodes was performed using intraoperative gamma probe guidance. After resection of the sentinel lymph nodes, extended pelvic lymph node dissection was performed in all patients. We assessed the diagnostic accuracy of the sentinel lymph node biopsy method using extended pelvic lymph node dissection as the reference standard. This trial was registered in ClinicalTrials.gov (NCT02732392). RESULTS A total of 162 men cN0M0 (CT scan and bone scan) were enrolled: 106 (65.4%) and 56 (34.6%) patients had intermediate- and high-risk prostate cancer, respectively. The median number of nodes retrieved was 14 (mean 16, IQR 10-21) per patient. At final pathological analysis, 22 patients (13.6%) were pN+. Sensitivity, specificity, negative predictive value, and positive predictive value of sentinel lymph node biopsy method in detecting patients with at least 1 lymph node metastasis were 95.4% (95% CI, 75.1-99.7), 100% (95% CI, 96.6-100), 99.2% (95% CI, 95.5-99.9), and 100% (95% CI, 80.7-100), respectively. CONCLUSIONS Our multicenter prospective study supports that sentinel lymph node biopsy is a very effective and sensitive method for pelvic lymph node staging in patients with intermediate- or high-risk localized prostate cancer.
Collapse
Affiliation(s)
- François Lannes
- Department of Urology, North Hospital, Aix-Marseille University, APHM, Marseille, France
- Aix-Marseille University, Marseille, France
| | - Michael Baboudjian
- Department of Urology, North Hospital, Aix-Marseille University, APHM, Marseille, France
- Aix-Marseille University, Marseille, France
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - Alain Ruffion
- Department of Urology, Hospices Civils de Lyon, Lyon, France
- Equipe 2 - Centre d'Innovation en cancérologie de Lyon (EA 3738 CICLY) - Faculté de médecine Lyon Sud - Université Lyon 1
| | | | - Francesco Giammarile
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Thierry Rousseau
- Department of Urology, Clinique Urologie Nantes Atlantis, Saint Herblain, France
| | | | | | - Daniela Rusu
- Nantes University, CHU Nantes, CNRS, Inserm, CRCINA, Nantes, France
| | | | | | - Dominique Rossi
- Department of Urology, North Hospital, Aix-Marseille University, APHM, Marseille, France
- Aix-Marseille University, Marseille, France
| | - Nicolas Mottet
- Department of Urology, University Jean Monnet, St Etienne, France
| | - Cyrille Bastide
- Department of Urology, North Hospital, Aix-Marseille University, APHM, Marseille, France
- Aix-Marseille University, Marseille, France
| |
Collapse
|
9
|
Le TK, Cherif C, Omabe K, Paris C, Lannes F, Audebert S, Baudelet E, Hamimed M, Barbolosi D, Finetti P, Bastide C, Fazli L, Gleave M, Bertucci F, Taïeb D, Rocchi P. DDX5 mRNA-targeting antisense oligonucleotide as a new promising therapeutic in combating castration-resistant prostate cancer. Mol Ther 2023; 31:471-486. [PMID: 35965411 PMCID: PMC9931527 DOI: 10.1016/j.ymthe.2022.08.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [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: 12/03/2021] [Revised: 06/26/2022] [Accepted: 08/09/2022] [Indexed: 02/07/2023] Open
Abstract
The heat shock protein 27 (Hsp27) has emerged as a principal factor of the castration-resistant prostate cancer (CRPC) progression. Also, an antisense oligonucleotide (ASO) against Hsp27 (OGX-427 or apatorsen) has been assessed in different clinical trials. Here, we illustrate that Hsp27 highly regulates the expression of the human DEAD-box protein 5 (DDX5), and we define DDX5 as a novel therapeutic target for CRPC treatment. DDX5 overexpression is strongly correlated with aggressive tumor features, notably with CRPC. DDX5 downregulation using a specific ASO-based inhibitor that acts on DDX5 mRNAs inhibits cell proliferation in preclinical models, and it particularly restores the treatment sensitivity of CRPC. Interestingly, through the identification and analysis of DDX5 protein interaction networks, we have identified some specific functions of DDX5 in CRPC that could contribute actively to tumor progression and therapeutic resistance. We first present the interactions of DDX5 and the Ku70/80 heterodimer and the transcription factor IIH, thereby uncovering DDX5 roles in different DNA repair pathways. Collectively, our study highlights critical functions of DDX5 contributing to CRPC progression and provides preclinical proof of concept that a combination of ASO-directed DDX5 inhibition with a DNA damage-inducing therapy can serve as a highly potential novel strategy to treat CRPC.
Collapse
Affiliation(s)
- Thi Khanh Le
- Predictive Oncology Laboratory, Centre de Recherche en Cancérologie de Marseille, Inserm UMR 1068, CNRS UMR 7258, Institut Paoli-Calmettes, Aix-Marseille University, 27 Bd. Leï Roure, 13273 Marseille, France; Department of Life Science, University of Science and Technology of Hanoi, Hanoi 000084, Vietnam
| | - Chaïma Cherif
- Predictive Oncology Laboratory, Centre de Recherche en Cancérologie de Marseille, Inserm UMR 1068, CNRS UMR 7258, Institut Paoli-Calmettes, Aix-Marseille University, 27 Bd. Leï Roure, 13273 Marseille, France
| | - Kenneth Omabe
- Predictive Oncology Laboratory, Centre de Recherche en Cancérologie de Marseille, Inserm UMR 1068, CNRS UMR 7258, Institut Paoli-Calmettes, Aix-Marseille University, 27 Bd. Leï Roure, 13273 Marseille, France
| | - Clément Paris
- Predictive Oncology Laboratory, Centre de Recherche en Cancérologie de Marseille, Inserm UMR 1068, CNRS UMR 7258, Institut Paoli-Calmettes, Aix-Marseille University, 27 Bd. Leï Roure, 13273 Marseille, France
| | - François Lannes
- Predictive Oncology Laboratory, Centre de Recherche en Cancérologie de Marseille, Inserm UMR 1068, CNRS UMR 7258, Institut Paoli-Calmettes, Aix-Marseille University, 27 Bd. Leï Roure, 13273 Marseille, France; Urology Deparment, AP-HM Hospital Nord, Aix-Marseille University, 13915 Marseille Cedex 20, France
| | - Stéphane Audebert
- Marseille Protéomique, Centre de Recherche en Cancérologie de Marseille, INSERM, CNRS, Institut Paoli-Calmettes, Aix-Marseille University, 13009 Marseille, France
| | - Emilie Baudelet
- Marseille Protéomique, Centre de Recherche en Cancérologie de Marseille, INSERM, CNRS, Institut Paoli-Calmettes, Aix-Marseille University, 13009 Marseille, France
| | - Mourad Hamimed
- Inria - Inserm team COMPO, COMPutational pharmacology and clinical Oncology, Centre Inria Sophia Antipolis - Méditerranée, Centre de Recherches en Cancérologie de Marseille, Inserm U1068, CNRS UMR7258, Institut Paoli-Calmettes, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - Dominique Barbolosi
- Inria - Inserm team COMPO, COMPutational pharmacology and clinical Oncology, Centre Inria Sophia Antipolis - Méditerranée, Centre de Recherches en Cancérologie de Marseille, Inserm U1068, CNRS UMR7258, Institut Paoli-Calmettes, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - Pascal Finetti
- Predictive Oncology Laboratory, Centre de Recherche en Cancérologie de Marseille, Inserm UMR 1068, CNRS UMR 7258, Institut Paoli-Calmettes, Aix-Marseille University, 27 Bd. Leï Roure, 13273 Marseille, France
| | - Cyrille Bastide
- Urology Deparment, AP-HM Hospital Nord, Aix-Marseille University, 13915 Marseille Cedex 20, France
| | - Ladan Fazli
- The Vancouver Prostate Centre, University of British Columbia, Vancouver, BC V6H 3Z6, Canada
| | - Martin Gleave
- The Vancouver Prostate Centre, University of British Columbia, Vancouver, BC V6H 3Z6, Canada
| | - François Bertucci
- Predictive Oncology Laboratory, Centre de Recherche en Cancérologie de Marseille, Inserm UMR 1068, CNRS UMR 7258, Institut Paoli-Calmettes, Aix-Marseille University, 27 Bd. Leï Roure, 13273 Marseille, France
| | - David Taïeb
- Predictive Oncology Laboratory, Centre de Recherche en Cancérologie de Marseille, Inserm UMR 1068, CNRS UMR 7258, Institut Paoli-Calmettes, Aix-Marseille University, 27 Bd. Leï Roure, 13273 Marseille, France; La Timone University Hospital, Aix-Marseille University, 13005 Marseille, France; European Center for Research in Medical Imaging, Aix-Marseille University, 13005 Marseille, France
| | - Palma Rocchi
- Predictive Oncology Laboratory, Centre de Recherche en Cancérologie de Marseille, Inserm UMR 1068, CNRS UMR 7258, Institut Paoli-Calmettes, Aix-Marseille University, 27 Bd. Leï Roure, 13273 Marseille, France; European Center for Research in Medical Imaging, Aix-Marseille University, 13005 Marseille, France.
| |
Collapse
|
10
|
Baboudjian M, Breda A, Rajwa P, Gallioli A, Gondran-Tellier B, Sanguedolce F, Verri P, Diana P, Territo A, Bastide C, Spratt DE, Loeb S, Tosoian JJ, Leapman MS, Palou J, Ploussard G. Active Surveillance for Intermediate-risk Prostate Cancer: A Systematic Review, Meta-analysis, and Metaregression. Eur Urol Oncol 2022; 5:617-627. [PMID: 35934625 DOI: 10.1016/j.euo.2022.07.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [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: 06/13/2022] [Revised: 07/11/2022] [Accepted: 07/20/2022] [Indexed: 01/26/2023]
Abstract
CONTEXT Active surveillance (AS) is increasingly selected among patients with localized, intermediate-risk (IR) prostate cancer (PCa). However, the safety and optimal candidate selection for those with IR PCa remain uncertain. OBJECTIVE To evaluate treatment-free survival and oncologic outcomes in patients with IR PCa managed with AS and to compare with AS outcomes in low-risk (LR) PCa patients. EVIDENCE ACQUISITION A literature search was conducted through February 2022 using PubMed/Medline, Embase, and Web of Science databases. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed to identify eligible studies. The coprimary outcomes were treatment-free, metastasis-free, cancer-specific, and overall survival. A subgroup analysis was planned a priori to explore AS outcomes when limiting inclusion to IR patients with a Gleason grade (GG) of ≤2. EVIDENCE SYNTHESIS A total of 25 studies including 29 673 unselected IR patients met our inclusion criteria. The 10-yr treatment-free, metastasis-free, cancer-specific, and overall survival ranged from 19.4% to 69%, 80.8% to 99%, 88.2% to 99%, and 59.4% to 83.9%, respectively. IR patients had similar treatment-free survival to LR patients (risk ratio [RR] 1.16, 95% confidence interval (CI), 0.99-1.36, p = 0.07), but significantly higher risks of metastasis (RR 5.79, 95% CI, 4.61-7.29, p < 0.001), death from PCa (RR 3.93, 95% CI, 2.93-5.27, p < 0.001), and all-cause death (RR 1.44, 95% CI, 1.11-1.86, p = 0.005). In a subgroup analysis of studies including patients with GG ≤2 only (n = 4), treatment-free survival (RR 1.03, 95% CI, 0.62-1.71, p = 0.91) and metastasis-free survival (RR 2.09, 95% CI, 0.75-5.82, p = 0.16) were similar between LR and IR patients. Treatment-free survival was significantly reduced in subgroups of patients with unfavorable IR disease and increased cancer length on biopsy. CONCLUSIONS The present systematic review and meta-analysis highlight the need to optimize patient selection for those with IR features. Our findings support limiting the inclusion of IR patients in AS to those with low-volume GG 2 tumor. PATIENT SUMMARY Active surveillance is increasingly used in patients with localized, intermediate-risk (IR) prostate cancer. In this population, we have reported higher risks of metastasis and cancer mortality in unselected patients than in patients with low-risk features, underscoring the need to optimize the selection of patients with IR features.
Collapse
Affiliation(s)
- Michael Baboudjian
- Department of Urology, APHM, North Academic Hospital, Marseille, France; Department of Urology, APHM, La Conception Hospital, Marseille, France; Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain; Department of Urology, La Croix du Sud Hôpital, Quint Fonsegrives, France.
| | - Alberto Breda
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - Pawel Rajwa
- Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, Medical University of Silesia, Zabrze, Poland
| | - Andrea Gallioli
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | | | - Francesco Sanguedolce
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain; Department of Medical, Surgical and Experimental Sciences, Université degli Studi di Sassari, Italy
| | - Paolo Verri
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - Pietro Diana
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - Angelo Territo
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - Cyrille Bastide
- Department of Urology, APHM, North Academic Hospital, Marseille, France
| | - Daniel E Spratt
- Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Stacy Loeb
- Department of Urology and Population Health, New York University and Manhattan Veterans Affairs, New York, NY, USA
| | - Jeffrey J Tosoian
- Department of Urology, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Joan Palou
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - Guillaume Ploussard
- Department of Urology, La Croix du Sud Hôpital, Quint Fonsegrives, France; Department of Urology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
| |
Collapse
|
11
|
Baboudjian M, Pradere B, Martin N, Gondran-Tellier B, Angerri O, Boucheron T, Bastide C, Emiliani E, Misrai V, Breda A, Lechevallier E. Life Cycle Assessment of Reusable and Disposable Cystoscopes: A Path to Greener Urological Procedures. Eur Urol Focus 2022:S2405-4569(22)00291-7. [PMID: 36543725 DOI: 10.1016/j.euf.2022.12.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 11/28/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND The environmental impact of reusable and disposable devices is unclear; reuse is expected to reduce the carbon footprint, but the environmental impact of reprocessing of reusable devices is increasingly being questioned. OBJECTIVE The aim was to provide the first rigorous life cycle assessment of reusable and disposable flexible cystoscopes. DESIGN, SETTING, AND PARTICIPANTS We performed a life cycle assessment of reusable flexible cystoscopes and the aS4C single-use cystoscope (aScope; Ambu, Ballerup, Denmark). For the aScope, the complete lifespan of the scope was evaluated, including raw material extraction, material formulation, component production, product assembly, distribution, transportation after use, and final disposal. For reusable cystoscopes, we limited our analysis to their reprocessing, using a model consisting of standard high-level disinfection with peracetic acid. The environmental impact was evaluated by an independent third-party consulting company APESA (Technopole Hélioparc, Pau, France) dedicated to such risk assessments. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS The environmental footprint of both cystoscopes was assessed using five environmental impact categories, namely, climate change, mineral resource depletion, ecotoxicity, acidification, and eutrophication. To perform the life cycle assessment, Simapro v9.3.3 software was used and the Ecoinvent v3.5 database was employed as the primary life cycle inventory database. A Monte Carlo analysis was used to account for the inherent uncertainty in life cycle inventory data and the variability in material and energy consumption for each type of flexible cystoscope. RESULTS AND LIMITATIONS By only comparing the disinfection reprocessing of reusable cystoscopes with the complete lifespan of the single-use cystoscope, the use of the aScope would allow a reduction of at least 33% in the climate change category, 50% in the mineral resources' depletion category, 51% in the ecotoxicity category, 71% in the acidification category, and 49% in the eutrophication category. Our results cannot be generalized to all health care facilities as we studied only one type of reprocessing method and one disposable flexible cystoscope. CONCLUSIONS Disinfection reprocessing of reusable cystoscopes was found to have a significantly larger environmental footprint and impact than the whole lifespan of the single-use cystoscope aScope. PATIENT SUMMARY Using a cradle-to-grave life cycle analysis, we showed that the environmental footprint of a flexible cystoscopy procedure can be reduced by using a disposable cystoscope instead of a reusable cystoscope.
Collapse
|
12
|
Boucheron T, Lechevallier E, Gondran-Tellier B, Michel F, Bastide C, Martin N, Baboudjian M. Cost and Environmental Impact of Disposable Flexible Cystoscopes Compared to Reusable Devices. J Endourol 2022; 36:1317-1321. [PMID: 35703325 DOI: 10.1089/end.2022.0201] [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] [Indexed: 11/13/2022] Open
Abstract
Objectives: To quantify the environmental impact and costs associated with flexible cystoscopy procedures from an institutional perspective, with particular attention for the comparison between disposable and reusable cystoscopes. Materials and Methods: This is a single-center retrospective study, including all flexible cystoscopies performed between 2020 and 2021 using reusable or single-use devices. The Ambu aS4C single-use cystoscope (Ballerup, Denmark) gradually replaced the reusable device in our center, with exclusive use from October 2021. Reprocessing costs for reusable cystoscopes were evaluated using a micro-costing approach. The environmental impact of reusable and disposable cystoscopes was assessed by the amount of waste and water consumed for each procedure. Results: A total of 1578 flexible cystoscopies using reusable cystoscopes were performed in 2020, and 550 cystoscopies were performed using the Ambu aS4C cystoscope from October 2021 to February 2022. The cost of flexible cystoscopy with a reusable and a disposable endoscope was €196 and €192, respectively. The amount of waste generated by reprocessing reusable and disposable cystoscopes was 800 and 200 g per procedure, respectively. Water consumption for sterilization of the reusable cystoscope was 60 L per procedure, whereas no water consumption was required with the Ambu aS4C cystoscope. A 100% Ambu aS4C cystoscope use would reduce waste generation and water consumption by 946.8 kg and 94.68 m3 per year. Conclusion: In this study, implementing a strategy of using 100% disposable cystoscopes was associated with similar costs and reduced waste generation and water consumption compared to reusable devices. Future studies are needed to compare the carbon footprint of these devices, through a comprehensive and rigorous life cycle assessment from manufacturing to recycling.
Collapse
Affiliation(s)
- Tiphaine Boucheron
- Pharmacy Department, La Conception Hospital, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Eric Lechevallier
- Department of Urology, La Conception Hospital, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Bastien Gondran-Tellier
- Department of Urology, La Conception Hospital, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Floriane Michel
- Department of Urology, La Conception Hospital, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Cyrille Bastide
- Department of Urology, North Hospital, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Nathalie Martin
- Pharmacy Department, La Conception Hospital, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Michael Baboudjian
- Department of Urology, La Conception Hospital, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France.,Department of Urology, North Hospital, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France.,Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| |
Collapse
|
13
|
Lo Verde K, Toledano H, Campagna J, Rossi D, Bastide C, Baboudjian M. Long-term outcomes of whole gland high-intensity focused ultrasound for localized prostate cancer. Int Urol Nephrol 2022; 54:1233-1238. [PMID: 35397077 DOI: 10.1007/s11255-022-03156-x] [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: 02/01/2022] [Accepted: 02/19/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To report the 10-year oncologic and functional outcomes of whole-gland HIFU as first-line treatment for localized prostate cancer (PCa). PATIENTS AND METHODS Patients were retrospectively included between January 2005 and July 2018 from a prospectively maintained database at a single academic institution. No patient underwent androgen deprivation therapy prior to HIFU. Primary endpoint was biochemical recurrence-free survival (BRFS). Secondary oncological endpoints included salvage treatment-free survival (STFS), cancer-specific survival (CSS) and overall survival (OS). RESULTS A total of 97 patients met our inclusion criteria and were included in the final analysis. According to D'Amico classification, the numbers of patients with low-, intermediate-, and high-risk disease were 38 (39.2%), 52 (53.6%), and 7 (7.2%). A total of 21 (21.6%) patients received salvage treatment at a mean of 4.1 years (± 2.8) after HIFU. The 10-year OS, CSS and BRFS rates were 91.8%, 100% and 40.3% in the overall cohort, respectively. In multivariate analysis, predictive factors for biochemical recurrence were intermediate-risk group (RR = 2.065; 95% CI 1.008-4.230; p = 0.047) and PSA nadir > 0.5 ng/mL (RR = 4.963; 95% CI 2.251-10.947; p < 0.001). Symptoms related to bladder outlet obstruction were the most frequently recorded adverse events. In multivariate analysis, positive biopsy on the prostatic apex was predictor of obstructive complications (RR = 3.2, 95% CI 1.092-9.476, p = 0.034). Only four patients developed severe urinary incontinence (> 1 pad/day). CONCLUSIONS HIFU showed low PCa-specific mortality, but biochemical recurrence rates were highly variable among patients. Future studies are needed to improve patient selection.
Collapse
Affiliation(s)
- Kevin Lo Verde
- Department of Urology, North Hospital, Aix-Marseille University, APHM, Marseille, France
| | - Harry Toledano
- Department of Urology, North Hospital, Aix-Marseille University, APHM, Marseille, France.,Department of Urology, Martigues Hospital, Martigues, France
| | - Jennifer Campagna
- Department of Urology, North Hospital, Aix-Marseille University, APHM, Marseille, France
| | - Dominique Rossi
- Department of Urology, North Hospital, Aix-Marseille University, APHM, Marseille, France
| | - Cyrille Bastide
- Department of Urology, North Hospital, Aix-Marseille University, APHM, Marseille, France
| | - Michael Baboudjian
- Department of Urology, North Hospital, Aix-Marseille University, APHM, Marseille, France. .,Department of Urology, La Conception Hospital, Aix-Marseille University, APHM, Marseille, France. .,Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain.
| |
Collapse
|
14
|
Couderc AL, Villani P, Berbis J, Nouguerède E, Rey D, Rossi D, Lechevallier É, Badinand D, Bastide C, Karsenty G, Boissier R, Amichi K, Muracciole X. HoSAGE: sarcopenia in older patient with intermediate / high-risk prostate cancer, prevalence and incidence after androgen deprivation therapy: study protocol for a cohort trial. BMC Cancer 2022; 22:78. [PMID: 35042460 PMCID: PMC8764762 DOI: 10.1186/s12885-021-09105-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 12/12/2021] [Indexed: 11/17/2022] Open
Abstract
Background Sarcopenia is defined by a loss of muscle strength associated to a decrease in skeletal muscle mass. Ageing greatly contributes to sarcopenia as may many other factors such as cancer or androgen deprivation therapies (ADT). This cohort study aims to evaluate (1) the prevalence of muscle disorders and sarcopenia in older patients before initiation of intermediate to high risk prostate cancer treatment with ADT and radiotherapy, and (2) the occurrence and/or aggravation of muscle disorders and sarcopenia at the end of cancer treatment. Methods This cohort study is monocentric and prospective. The primary objectives are to determine the risk factor of sarcopenia prevalence and to study the relationship between ADT and sarcopenia incidence, in patients 70 years and older with histologically proven localized or locally advanced prostate cancer, addressed to a geriatrician (G8 score ≤14) for comprehensive geriatric assessment (CGA) in Marseille University Hospital. Secondary objectives encompass, measurement of sarcopenia clinical criteria along prostate oncological treatment; evaluation of the quality of life of patients with sarcopenia; evaluation of the impact of socio-behavioral and anthropological factors on sarcopenia evolution and incidence; finally the evaluation of the impact of ADT exposure on sarcopenia. Sarcopenia prevalence was estimated to be between 20 and 30%, therefore the study will enroll 200 patients. Discussion The current guidelines for older patients with prostate cancer recommend a pelvic radiotherapy treatment associated to variable duration (6 to 36 months) of ADT. However ADT impacts muscle mass and could exacerbate the risks of sarcopenia. Our study intends to assess the specific effect of ADT on sarcopenia incidence and/or worsening as well as to estimate sarcopenia prevalence in this population. The results of this cohort trial will lead to a better understanding of sarcopenia prevalence and incidence necessary to further elaborate a prevention plan. Trial registration The protocol was registered to the French drug and device regulation agency under the number 2019-A02319-48, before beginning the study (11/12/2019). The ClinicalTrials.gov identifier is NCT04484246, registration on the ClinicalTrials.gov (https://clinicaltrials.gov/ct2/show/NCT04484246).
Collapse
|
15
|
Tadrist A, Morelli M, Gondran-Tellier B, Akiki A, McManus R, Delaporte V, Bastide C, Karsenty G, Lechevallier E, Boissier R, Baboudjian M. Long-term results of endoscopic treatment in vesicoureteral reflux after kidney transplantation. World J Urol 2022; 40:815-821. [PMID: 35028772 DOI: 10.1007/s00345-021-03902-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 09/29/2021] [Accepted: 11/25/2021] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES To assess the long-term clinical outcomes and identify factors predicting success of endoscopic treatment for symptomatic vesicoureteral reflux (VUR) after kidney transplantation. PATIENTS AND METHODS A retrospective chart review of all patients who had a symptomatic VUR after renal transplantation at our centre between January 2000 and December 2020 was performed. VUR was documented by retrograde cystography and was determined by at least one episode of acute graft pyelonephritis (AGPN). Endoscopic injections of polydimethylsiloxane (MacroPlastique™) or dextranomer/hyaluronic acid copolymer (Deflux™) were performed by expert urologists via rigid cystoscopy with a bevelled needle system. The results of endoscopic treatment were evaluated by cystography at three months. The primary endpoint was clinical efficacy as defined by the absence of AGPN during follow-up. Radiological success was defined by the absence of VUR at the three months follow-up cystography. RESULTS Out of 2135 kidney transplantations, a total of 117 (5.5%) patients had symptomatic VUR: 100 (85.5%) underwent Deflux™ and 17 (14.5%) MacroPlastique™. Preoperative high-grade VUR was recorded in 71% of patients. One postoperative complication was observed, Clavien > II. After a median follow-up of 11.2 years (IQR 6.5-14.4), clinical success was achieved in 73 patients (62.4%). Radiological success was obtained in 42 patients (36%). Multivariable analysis failed to identify predictors of endoscopic treatment success, which was independent of the preoperative grade of VUR and the type of bulking agent used. CONCLUSION Endoscopic treatment of VUR is a simple and well-tolerated procedure with long-term clinical efficacy.
Collapse
Affiliation(s)
- Abel Tadrist
- Department of Urology and Kidney Transplantation, Aix-Marseille University, Conception Academic Hospital, AP-HM, 147 Bd Baille, 13005, Marseilles, France.,Aix-Marseille University, 58 Bd Charles Livon, 13007, Marseilles, France
| | - Michele Morelli
- Department of Urology and Kidney Transplantation, Aix-Marseille University, Conception Academic Hospital, AP-HM, 147 Bd Baille, 13005, Marseilles, France.,University of Milan, Via Festa del Perdono, 7, 20122, Milan, Italy.,Aix-Marseille University, 58 Bd Charles Livon, 13007, Marseilles, France.,Department of Urology, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Bastien Gondran-Tellier
- Department of Urology and Kidney Transplantation, Aix-Marseille University, Conception Academic Hospital, AP-HM, 147 Bd Baille, 13005, Marseilles, France.,Aix-Marseille University, 58 Bd Charles Livon, 13007, Marseilles, France
| | - Akram Akiki
- Department of Urology and Kidney Transplantation, Aix-Marseille University, Conception Academic Hospital, AP-HM, 147 Bd Baille, 13005, Marseilles, France.,Aix-Marseille University, 58 Bd Charles Livon, 13007, Marseilles, France
| | - Robin McManus
- Department of Urology and Kidney Transplantation, Aix-Marseille University, Conception Academic Hospital, AP-HM, 147 Bd Baille, 13005, Marseilles, France.,Aix-Marseille University, 58 Bd Charles Livon, 13007, Marseilles, France
| | - Veronique Delaporte
- Department of Urology and Kidney Transplantation, Aix-Marseille University, Conception Academic Hospital, AP-HM, 147 Bd Baille, 13005, Marseilles, France.,Aix-Marseille University, 58 Bd Charles Livon, 13007, Marseilles, France
| | - Cyrille Bastide
- Aix-Marseille University, 58 Bd Charles Livon, 13007, Marseilles, France.,Department of Urology, North Hospital, AP-HM, Marseilles, France
| | - Gilles Karsenty
- Department of Urology and Kidney Transplantation, Aix-Marseille University, Conception Academic Hospital, AP-HM, 147 Bd Baille, 13005, Marseilles, France.,Aix-Marseille University, 58 Bd Charles Livon, 13007, Marseilles, France
| | - Eric Lechevallier
- Department of Urology and Kidney Transplantation, Aix-Marseille University, Conception Academic Hospital, AP-HM, 147 Bd Baille, 13005, Marseilles, France.,Aix-Marseille University, 58 Bd Charles Livon, 13007, Marseilles, France
| | - Romain Boissier
- Department of Urology and Kidney Transplantation, Aix-Marseille University, Conception Academic Hospital, AP-HM, 147 Bd Baille, 13005, Marseilles, France.,Aix-Marseille University, 58 Bd Charles Livon, 13007, Marseilles, France
| | - Michael Baboudjian
- Department of Urology and Kidney Transplantation, Aix-Marseille University, Conception Academic Hospital, AP-HM, 147 Bd Baille, 13005, Marseilles, France. .,Aix-Marseille University, 58 Bd Charles Livon, 13007, Marseilles, France. .,Department of Urology, North Hospital, AP-HM, Marseilles, France.
| |
Collapse
|
16
|
Deledalle FX, Ambrosetti D, Durand M, Michel F, Baboudjian M, Gondran-Tellier B, Lannes F, Daniel L, André M, Fais PO, Savoie PH, Durand X, Rossi D, Karsenty G, Bastide C, Lechevallier E, Boissier R. Active Surveillance for Biopsy Proven Renal Oncocytomas: Outcomes and Feasibility. Urology 2021; 156:185-190. [PMID: 34087310 DOI: 10.1016/j.urology.2021.05.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/13/2021] [Accepted: 05/19/2021] [Indexed: 01/05/2023]
Abstract
OBJECTIVES To report the outcomes and feasibility of active surveillance (AS) of biopsy-proven renal oncocytomas. METHODS Multicentric retrospective study (2010-2016) in 6 academic centers that included patients with biopsy-proven renal oncocytomas who were allocated to AS (imperative or elective indication) with a follow-up ≥1 year. Imaging was performed at least once a year, by CT-scan or ultrasound or MRI. Conversion to active treatment (surgical excision or ablative treatment) was at the discretion of the urologist. The primary endpoint was renal tumor growth (cm/year). Secondary outcomes included accuracy of biopsy, incidence, and reason to change AS to active treatment. RESULTS Eighty-nine patients were included: Median age 67 years (26-89) and median tumor size 26 mm [15-90] on diagnosis. During a mean follow-up of 43 months'' (median 36 [12-180]), mean tumor growth was 0.24 cm/year. No predictive factors (demographical, radiological or histologic) of tumor growth could be identified. Conversion from AS to active treatment occurred in 24 patients (27%) (13 surgical excisions, 11 ablative procedures), in a median time of 45 (12-76) months'' after diagnosis. Tumor growth was the main indication to convert AS to active treatment (58%) with 8% of the patients opting to discontinue AS. No patient had metastatic progression nor disease-specific death. The correlation between biopsy and surgical specimen was 92%. CONCLUSION Active surveillance for biopsy-proven renal oncocytomas was oncologically safe and patient adherence was high. No predictive factor for tumor growth could be identified but the tumor growth rate was low, and biopsy efficacy was high.
Collapse
Affiliation(s)
| | - Damien Ambrosetti
- Department of Pathology, Nice University, Pasteur University Hospital, Nice, France
| | - Mathieu Durand
- Department of Urology, Nice University, Pasteur University Hospital, Nice, France
| | - Floriane Michel
- Department of Urology and Kidney Transplantation, Aix-Marseille University, APHM, Conception University Hospital, Marseille, France
| | - Michael Baboudjian
- Department of Urology and Kidney Transplantation, Aix-Marseille University, APHM, Conception University Hospital, Marseille, France
| | - Bastien Gondran-Tellier
- Department of Urology and Kidney Transplantation, Aix-Marseille University, APHM, Conception University Hospital, Marseille, France
| | - François Lannes
- Department of Urology, Aix-Marseille University, APHM, Nord University Hospital, Marseille, France
| | - Laurent Daniel
- Department of Pathology, Aix-Marseille University, APHM, La Timone University Hospital, Marseille, France
| | - Marc André
- Department of Radiology, Aix-Marseille University, APHM, La Conception University Hospital, Marseille, France
| | | | | | - Xavier Durand
- Department of Urology, Military Hospital Bégin, Saint Mandé, France
| | - Dominique Rossi
- Department of Urology, Aix-Marseille University, APHM, Nord University Hospital, Marseille, France
| | - Gilles Karsenty
- Department of Urology and Kidney Transplantation, Aix-Marseille University, APHM, Conception University Hospital, Marseille, France
| | - Cyrille Bastide
- Department of Urology, Aix-Marseille University, APHM, Nord University Hospital, Marseille, France
| | - Eric Lechevallier
- Department of Urology and Kidney Transplantation, Aix-Marseille University, APHM, Conception University Hospital, Marseille, France
| | - Romain Boissier
- Department of Urology and Kidney Transplantation, Aix-Marseille University, APHM, Conception University Hospital, Marseille, France.
| |
Collapse
|
17
|
Gondran-Tellier B, Abdallah R, Sichez PC, Akiki A, Toledano H, Gaillet S, Delaporte V, Karsenty G, Bastide C, Daniel L, Garcia S, Rossi D, Lechevallier E, Boissier R, Baboudjian M. Continuous saline bladder irrigation after blue light transurethral resection of bladder tumor increases recurrence-free survival in low- to intermediate-risk non-muscle invasive bladder cancer. Prog Urol 2021; 31:316-323. [PMID: 33663939 DOI: 10.1016/j.purol.2021.01.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 09/21/2020] [Revised: 12/30/2020] [Accepted: 01/29/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To evaluate the efficacy of Continuous Saline Bladder Irrigation (CSBI) after blue light transurethral resection of bladder tumor (TURBT) to prevent recurrence of low- to intermediate-risk Non-Muscle Invasive Bladder Cancer (NMIBC). PATIENTS AND METHODS We conducted a retrospective study including patients with low- to intermediate-risk NMIBC who underwent TURBT in two urological centers between January 2017 and December 2018. Each TURBT was performed using blue light after intravesical instillation of hexaminolaevulinic acid. The experimental group included patients who received CSBI while the control group included patients without CSBI. When practice, CSBI was started immediately after the surgery and was interrupted 24 hours thereafter. Low-risk NMIBC had a surveillance while intermediate NMIBC had 8 adjuvant endovesical instillations of Mitomycin. The primary endpoint was bladder tumor recurrence free-survival which was defined as the time between the initial TURBT and the date of TURBT for bladder recurrence. RESULTS A total of 167 patients (median age: 71 years) were included: 20% female, 15% low-risk, 85% intermediate-risk NMIBC. CSBI was performed in 95 cases (57%). No complication related to irrigation was reported. Bladder recurrence was observed in 55 cases (32.9%): 22 (23.1%) in the CSBI group vs. 33 (45.8%) in the control group (P=0.002). Multivariate stepwise logistic regression analysis with backward selection revealed that CSBI (HR 0.47 [0.27-0.81]; P=0.006) and MMC (HR 0.55 [0.31-0.95]; P=0.034) were significantly associated with reduced risk of bladder recurrence. CONCLUSIONS Continuous saline bladder irrigation reduced the risk of bladder recurrence after blue light TURBT in patients with low- to intermediate-risk NMIBC while being safe. Prospective randomized study is needed to confirm these results. LEVEL OF EVIDENCE 3.
Collapse
Affiliation(s)
- B Gondran-Tellier
- Department of Urology and Kidney Transplantation, APHM, Conception Academic Hospital, Aix-Marseille University, Marseille, France
| | - R Abdallah
- Department of Urology and Kidney Transplantation, APHM, Conception Academic Hospital, Aix-Marseille University, Marseille, France
| | - P C Sichez
- Department of Urology and Kidney Transplantation, APHM, Conception Academic Hospital, Aix-Marseille University, Marseille, France
| | - A Akiki
- Department of Urology and Kidney Transplantation, APHM, Conception Academic Hospital, Aix-Marseille University, Marseille, France
| | - H Toledano
- Department of Urology, APHM, Nord University Hospital, Aix-Marseille University, Marseille, France
| | - S Gaillet
- Department of Urology and Kidney Transplantation, APHM, Conception Academic Hospital, Aix-Marseille University, Marseille, France
| | - V Delaporte
- Department of Urology and Kidney Transplantation, APHM, Conception Academic Hospital, Aix-Marseille University, Marseille, France
| | - G Karsenty
- Department of Urology and Kidney Transplantation, APHM, Conception Academic Hospital, Aix-Marseille University, Marseille, France
| | - C Bastide
- Department of Urology, APHM, Nord University Hospital, Aix-Marseille University, Marseille, France
| | - L Daniel
- Department of Pathological Anatomy and Cytology, APHM, Conception Academic Hospital, Aix-Marseille University, Marseille, France
| | - S Garcia
- Department of Pathological Anatomy and Cytology, APHM, Nord University Hospital, Aix-Marseille University, Marseille, France
| | - D Rossi
- Department of Urology, APHM, Nord University Hospital, Aix-Marseille University, Marseille, France
| | - E Lechevallier
- Department of Urology and Kidney Transplantation, APHM, Conception Academic Hospital, Aix-Marseille University, Marseille, France
| | - R Boissier
- Department of Urology and Kidney Transplantation, APHM, Conception Academic Hospital, Aix-Marseille University, Marseille, France
| | - M Baboudjian
- Department of Urology and Kidney Transplantation, APHM, Conception Academic Hospital, Aix-Marseille University, Marseille, France.
| |
Collapse
|
18
|
Couderc AL, Nicolas E, Boissier R, Boucekine M, Bastide C, Badinand D, Rossi D, Mugnier B, Villani P, Karsenty G, Cowen D, Lechevallier E, Muracciole X. Impact of Androgen Deprivation Therapy Associated to Conformal Radiotherapy in the Treatment of D'Amico Intermediate-/High-Risk Prostate Cancer in Older Patients. Cancers (Basel) 2020; 13:E75. [PMID: 33383957 PMCID: PMC7795189 DOI: 10.3390/cancers13010075] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/18/2020] [Accepted: 12/24/2020] [Indexed: 11/16/2022] Open
Abstract
PURPOSE/OBJECTIVE The association of 3D Conformal External Beam Radiotherapy (3D-CEBRT) with adjuvant Androgen Deprivation Therapy (ADT) proved to treat patients with intermediate- and high-risk localized prostate cancer (IR and HR). However, older patients were underrepresented in literature. We aimed to report the oncological results and morbidity 3D-CEBRT +ADT in ≥80 years patients. MATERIAL AND METHODS From June 1998 to July 2017, 101 patients ≥80 years were included in a tertiary center. The median age was 82 years. ADT was initiated 3 months prior 3D-CEBRT in all patients, with a total duration of 6 months for IR prostate cancer (group A; n = 41) and 15 months for HR prostate cancer (group B; n = 60). Endpoints included overall survival (OS), metastasis-free survival (DMFS), biochemical recurrence-free survival (BRFS) and toxicity. RESULTS Five years-OS was 95% and 86.7% in groups A and B, respectively. Cardiovascular events occurred in 22.8% of ≥80 years patients with no impact on OS. In the multivariate analysis, age <82 years, Karnofsky index and normalization of testosterone levels were significantly associated with better OS. CONCLUSION Age ≥80 years should not be a limitation for the treatment of IR and HR prostate cancer patients with 3D-CEBRT and ADT, but cardiovascular monitoring and prevention are mandatory.
Collapse
Affiliation(s)
- Anne-Laure Couderc
- Internal Medicine, Geriatric and Therapeutic Unit, Assistance Publique-Hôpitaux de Marseille (AP-HM), and Coordination Unit for Geriatric Oncology (UCOG), PACA West, 13009 Marseille, France; (B.M.); (P.V.)
- Medical School, Aix-Marseille University, 13005 Marseille, France; (R.B.); (C.B.); (D.R.); (G.K.); (D.C.); (E.L.)
| | - Emanuel Nicolas
- Department of Medical Oncology, University Hospital of Nimes, 30000 Nimes, France;
- IDESP Institute Desbrest of Epidemiology and Public Health, Research Unit INSERM, University of Montpellier, 34000 Montpellier, France
| | - Romain Boissier
- Medical School, Aix-Marseille University, 13005 Marseille, France; (R.B.); (C.B.); (D.R.); (G.K.); (D.C.); (E.L.)
- Urology Department, Conception Hospital, AP-HM, 13005 Marseille, France
| | - Mohammed Boucekine
- Department of Public Health, EA 3279 Self-Perceveid Health Assessment Research Unit, Medical School, Aix-Marseille University, 13005 Marseille, France;
| | - Cyrille Bastide
- Medical School, Aix-Marseille University, 13005 Marseille, France; (R.B.); (C.B.); (D.R.); (G.K.); (D.C.); (E.L.)
- Urology Department, Nord Hospital, AP-HM, 13015 Marseille, France
| | - Delphine Badinand
- Radiotherapy Department, La Timone Hospital, AP-HM, 13005 Marseille, France; (D.B.); (X.M.)
| | - Dominique Rossi
- Medical School, Aix-Marseille University, 13005 Marseille, France; (R.B.); (C.B.); (D.R.); (G.K.); (D.C.); (E.L.)
- Urology Department, Nord Hospital, AP-HM, 13015 Marseille, France
| | - Benedicte Mugnier
- Internal Medicine, Geriatric and Therapeutic Unit, Assistance Publique-Hôpitaux de Marseille (AP-HM), and Coordination Unit for Geriatric Oncology (UCOG), PACA West, 13009 Marseille, France; (B.M.); (P.V.)
| | - Patrick Villani
- Internal Medicine, Geriatric and Therapeutic Unit, Assistance Publique-Hôpitaux de Marseille (AP-HM), and Coordination Unit for Geriatric Oncology (UCOG), PACA West, 13009 Marseille, France; (B.M.); (P.V.)
- Medical School, Aix-Marseille University, 13005 Marseille, France; (R.B.); (C.B.); (D.R.); (G.K.); (D.C.); (E.L.)
| | - Gilles Karsenty
- Medical School, Aix-Marseille University, 13005 Marseille, France; (R.B.); (C.B.); (D.R.); (G.K.); (D.C.); (E.L.)
- Urology Department, Conception Hospital, AP-HM, 13005 Marseille, France
| | - Didier Cowen
- Medical School, Aix-Marseille University, 13005 Marseille, France; (R.B.); (C.B.); (D.R.); (G.K.); (D.C.); (E.L.)
- Radiotherapy Department, La Timone Hospital, AP-HM, 13005 Marseille, France; (D.B.); (X.M.)
| | - Eric Lechevallier
- Medical School, Aix-Marseille University, 13005 Marseille, France; (R.B.); (C.B.); (D.R.); (G.K.); (D.C.); (E.L.)
- Urology Department, Conception Hospital, AP-HM, 13005 Marseille, France
| | - Xavier Muracciole
- Radiotherapy Department, La Timone Hospital, AP-HM, 13005 Marseille, France; (D.B.); (X.M.)
| |
Collapse
|
19
|
Michel F, Gaillet S, Boissier R, Delaporte V, Ragni-ghazarossian E, Bastide C, Rossi D, Lechevallier E, Karsenty G. Fistules uro-génitales féminines dans un CHU français durant la dernière décennie : description et résultats de la prise en charge. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.116] [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]
|
20
|
Vanacore D, Deledalle F, Ambrosetti D, Durand M, Michel F, Baboudjian M, Gondran-Tellier B, Daniel L, André M, Fais P, Savoie P, Durand X, Rossi D, Karsenty G, Bastide C, Lechevallier E, Boissier R. Active surveillance of biopsy-proven renal oncocytomas, whatever the size at diagnosis. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35497-5] [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] Open
|
21
|
Gondran-Tellier B, McManus R, Sichez PC, Akiki A, Gaillet S, Toledano H, Andre M, Delaporte V, Vidal V, Karsenty G, Bastide C, Rossi D, Lechevallier E, Boissier R, Baboudjian M. Efficacy and Safety of Surgery for Benign Prostatic Obstruction in Patients with Preoperative Urinary Catheter. J Endourol 2020; 35:102-108. [PMID: 32814442 DOI: 10.1089/end.2020.0704] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Purpose: To evaluate the efficacy and safety of benign prostatic obstruction (BPO) surgery in patients with preoperative urinary catheterization. Patients and Methods: We conducted a multi-institutional retrospective study including all patients who failed a trial without catheter (TWOC) after acute urinary retention (AUR) between January 2017 and January 2019. Patients with neurogenic bladder, prostate cancer, or urethral stricture were excluded from the analysis. Patients underwent either monopolar/bipolar transurethral resection of the prostate (TURP), photoselective vaporization of the prostate (PVP), prostate artery embolization (PAE), open prostatectomy (OP), or endoscopic enucleation. The primary endpoint was 12-month urinary catheter-free survival without using benign prostatic hyperplasia medications. Results: One hundred seventy-one consecutive men (median age: 71 years; median prostate volume: 75 cm3) underwent BPO surgery, including 48 (28%) TURP, 62 (36.3%) PVP, 21 (12.3%) endoscopic enucleation, 15 (8.8%) PAE, and 25 (14.6%) OP. The median duration of preoperative urinary catheterization was 69 days (interquartile range 46-125). The 12-month urinary catheter-free survival rate was 84.8% (145/171). Satisfactory voiding returned to 121 patients (70.8%). On backward stepwise multivariable analysis, PVP (odds ratio [OR] 0.27 [0.10-0.69]; p = 0.008), PAE (OR 5.27 [1.28-27.75]; p = 0.03), endoscopic enucleation (OR 0.08 [0-0.49]; p = 0.023), OP (OR 0.10 [0.01-0.57]; p = 0.034), Charlson score (OR 1.36 [1.14-1.66]; p = 0.001), and number of preoperative TWOC failure (OR 2.53 [1.23-5.51]; p = 0.014) were significantly associated with catheter-free survival. Conclusions: In this multi-institutional retrospective study, including patients with preoperative catheterization, the overall success rate of BPO surgery was 70.8% after 1-year follow-up. Compared with TURP, enucleation methods and PVP were associated with better catheter-free survival, whereas PAE was associated with higher risk of AUR recurrence.
Collapse
Affiliation(s)
- Bastien Gondran-Tellier
- Department of Urology and Kidney Transplantation, Conception Academic Hospital, Aix-Marseille University, APHM, Marseille, France
| | - Robin McManus
- Department of Urology and Kidney Transplantation, Conception Academic Hospital, Aix-Marseille University, APHM, Marseille, France
| | - Pierre Clement Sichez
- Department of Urology and Kidney Transplantation, Conception Academic Hospital, Aix-Marseille University, APHM, Marseille, France
| | - Akram Akiki
- Department of Urology and Kidney Transplantation, Conception Academic Hospital, Aix-Marseille University, APHM, Marseille, France
| | - Sarah Gaillet
- Department of Urology and Kidney Transplantation, Conception Academic Hospital, Aix-Marseille University, APHM, Marseille, France
| | - Harry Toledano
- Department of Urology, Martigues Hospital, Martigues, France
| | - Marc Andre
- Deparment of Radiology and Medical imaging, La Timone Academic Hospital, Aix-Marseille University, APHM, Marseille, France.,European Center for Medical Imaging Research CERIMED/LIIE, Aix-Marseille University, Marseille, France
| | - Veronique Delaporte
- Department of Urology and Kidney Transplantation, Conception Academic Hospital, Aix-Marseille University, APHM, Marseille, France
| | - Vincent Vidal
- Deparment of Radiology and Medical imaging, La Timone Academic Hospital, Aix-Marseille University, APHM, Marseille, France.,European Center for Medical Imaging Research CERIMED/LIIE, Aix-Marseille University, Marseille, France
| | - Gilles Karsenty
- Department of Urology and Kidney Transplantation, Conception Academic Hospital, Aix-Marseille University, APHM, Marseille, France
| | - Cyrille Bastide
- Department of Urology, North Academic Hospital, Aix-Marseille University, APHM, Marseille, France
| | - Dominique Rossi
- Department of Urology, North Academic Hospital, Aix-Marseille University, APHM, Marseille, France
| | - Eric Lechevallier
- Department of Urology and Kidney Transplantation, Conception Academic Hospital, Aix-Marseille University, APHM, Marseille, France
| | - Romain Boissier
- Department of Urology and Kidney Transplantation, Conception Academic Hospital, Aix-Marseille University, APHM, Marseille, France
| | - Michael Baboudjian
- Department of Urology and Kidney Transplantation, Conception Academic Hospital, Aix-Marseille University, APHM, Marseille, France
| |
Collapse
|
22
|
Deledalle FX, Doisy L, Daniel L, Garcia S, Lechevallier E, Bastide C, Boissier R. [Evolution of followed renal oncocytomas]. Prog Urol 2020; 30:514-521. [PMID: 32376210 DOI: 10.1016/j.purol.2020.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 06/20/2019] [Accepted: 04/05/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Oncocytomas are primitive kidney tumours, considered benign but their evolution is not fully established. The local progression is generally admitted but few data explain what makes a oncocytoma to grow more or less quickly. The objective of our study is to analyse the evolution of followed renal oncocytomas after histologic confirmation and to identify factors that can influence their growth. MATERIAL AND METHODS This is a retrospective study in two centers (North Hospital and Hospital of the Conception of Marseille). All patients with renal oncocytoma diagnosed with percutaneous biopsy from September 2010 to April 2016 and followed for more than one year were included. Epidemiological, histological, and morphological data were collected at diagnosis, during follow-up and in case of strategy change (intervention). Statistical analysis of factors influencing oncocytomes growth was based on the Pearson correlation test. RESULTS Fifty-three patients were included. The median age for diagnosis was 65 years [39-85]. The sex ratio H/F was 6/5. The median follow-up was 34 months [12-180]. The average diagnosis size was 29 mm [12-90]. Thirteen patients (25%) were treated secondarily, including 70% by conservative treatment. The average growth was 0.25 (±0.23) cm/yr. The patients treated were younger and had a higher growth rate than the untreated (0.48±0.23cm/yr versus 0.18±0.18cm/yr, P<0,001). According to Pearson's analysis, there was a positive linear relationship (R=0.27, P=0.047) between velocity and initial size and a negative linear relationship (ρ=-0.44, P<0.001) between velocity and age at diagnosis. So tumor growth was faster if the patients were young and the tumor voluminous at diagnosis. DISCUSSION Rapid growth often leads to a cessation of surveillance in favour of an intervention strategy. For young patients, conservative treatment (partiel nephrectomy or ablative treatment) in the medium term is likely to be preferred, but for elderly patients or with important comorbidities follow-up is an alternative to an invasive attitude. LEVEL OF EVIDENCE 3.
Collapse
Affiliation(s)
- F-X Deledalle
- Service de chirurgie urologique, hôpital de la Conception, AP-HM, 147, boulevard Baille, 13005 Marseille, France; Laboratoire d'anatomopathologie, hôpital de-la-Timone, AP-HM, 264, rue Saint-Pierre, 13005 Marseille, France.
| | - L Doisy
- Service de chirurgie urologique, hôpital de la Conception, AP-HM, 147, boulevard Baille, 13005 Marseille, France; Laboratoire d'anatomopathologie, hôpital de-la-Timone, AP-HM, 264, rue Saint-Pierre, 13005 Marseille, France
| | - L Daniel
- Laboratoire d'anatomopathologie, hôpital de-la-Timone, AP-HM, 264, rue Saint-Pierre, 13005 Marseille, France
| | - S Garcia
- Service de chirurgie urologique, hôpital de la Conception, AP-HM, 147, boulevard Baille, 13005 Marseille, France; Laboratoire d'anatomopathologie, hôpital Nord, AP-HM, chemin des Bourrely, 13015 Marseille, France
| | - E Lechevallier
- Service de chirurgie urologique, hôpital de la Conception, AP-HM, 147, boulevard Baille, 13005 Marseille, France; Laboratoire d'anatomopathologie, hôpital de-la-Timone, AP-HM, 264, rue Saint-Pierre, 13005 Marseille, France
| | - C Bastide
- Service de chirurgie urologique, hôpital de la Conception, AP-HM, 147, boulevard Baille, 13005 Marseille, France; Service de chirurgie urologique, hôpital Nord, AP-HM, chemin des-Bourrely, 13015 Marseille, France
| | - R Boissier
- Laboratoire d'anatomopathologie, hôpital de-la-Timone, AP-HM, 264, rue Saint-Pierre, 13005 Marseille, France
| |
Collapse
|
23
|
Baboudjian M, Gondran-Tellier B, Abdallah R, Lannes F, Sichez PC, Akiki A, Gaillet S, Toledano H, Delaporte V, Andre M, Karsenty G, Lechevallier E, Rossi D, Vidal V, Boissier R, Bastide C. Selective Trans-arterial Embolization of Iatrogenic Vascular Lesions Did Not Influence the Global Renal Function After Partial Nephrectomy. Urology 2020; 141:108-113. [PMID: 32283170 DOI: 10.1016/j.urology.2020.03.036] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 03/19/2020] [Accepted: 03/26/2020] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To evaluate the renal function outcomes after selective trans-arterial embolization (SAE) of iatrogenic vascular lesions (IVL), including pseudoaneurysm and arteriovenous fistula, following partial nephrectomy (PN). MATERIALS AND METHODS A multi-institutional study was conducted including consecutive patients who underwent PN between January 2009 and March 2019. Two surgical approaches were used: open and robot-assisted PN. Patients with SAE were identified and matched (1:2) with patients without IVL. The matching criteria were age, gender, Charlson score, creatinine clearance, RENAL score, and tumor size. The primary outcome was the evolution of global renal function at 6-months postoperatively. RESULTS A total of 493 consecutive PN (360 open PN and 133 robot-assisted PN) were included. IVL occurred in 17 cases (3.4%) without statistical difference according to the surgical approach (P = .78). Patients from embolization group were matched to 34 cases without postoperative IVL. Groups were comparable concerning clinical, tumor and surgical characteristics. The clinical success of SAE, defined as the absence of recourse to a second embolization or a total nephrectomy, was obtained in 16 (94.1%) cases. No minor or major complications were reported after SAE. The preoperative estimated glomerular filtration rate (eGFR) was similar between control group (93 [85-102] ml/min) and embolization group (95 [83-102] ml/min) (P = .99). Median (IQR) eGFR between control group (87 [72-95] ml/min) and embolization group (83 [76-93] ml/min) at a follow-up of 6 months showed no significant difference (P = .73). CONCLUSION IVL are rare complications of PN. SAE is an effective and minimally invasive management tool, with no deleterious effect on global renal function.
Collapse
Affiliation(s)
- Michael Baboudjian
- Aix-Marseille University, APHM, Conception Academic Hospital, Dept. of Urology and Kidney Transplantation, Marseille, France.
| | - Bastien Gondran-Tellier
- Aix-Marseille University, APHM, Conception Academic Hospital, Dept. of Urology and Kidney Transplantation, Marseille, France
| | - Rony Abdallah
- Aix-Marseille University, APHM, Conception Academic Hospital, Dept. of Urology and Kidney Transplantation, Marseille, France
| | - Francois Lannes
- Aix-Marseille University, APHM, Nord Academic Hospital, Dept. of Urology, Marseille, France
| | - Pierre Clement Sichez
- Aix-Marseille University, APHM, Conception Academic Hospital, Dept. of Urology and Kidney Transplantation, Marseille, France
| | - Akram Akiki
- Aix-Marseille University, APHM, Conception Academic Hospital, Dept. of Urology and Kidney Transplantation, Marseille, France
| | - Sarah Gaillet
- Aix-Marseille University, APHM, Conception Academic Hospital, Dept. of Urology and Kidney Transplantation, Marseille, France
| | - Harry Toledano
- Aix-Marseille University, APHM, Nord Academic Hospital, Dept. of Urology, Marseille, France
| | - Veronique Delaporte
- Aix-Marseille University, APHM, Conception Academic Hospital, Dept. of Urology and Kidney Transplantation, Marseille, France
| | - Marc Andre
- Aix-Marseille University, APHM, Conception Academic Hospital, Dept. of Radiology and Medical imaging, Marseille, France
| | - Gilles Karsenty
- Aix-Marseille University, APHM, Conception Academic Hospital, Dept. of Urology and Kidney Transplantation, Marseille, France
| | - Eric Lechevallier
- Aix-Marseille University, APHM, Conception Academic Hospital, Dept. of Urology and Kidney Transplantation, Marseille, France
| | - Dominique Rossi
- Aix-Marseille University, APHM, Nord Academic Hospital, Dept. of Urology, Marseille, France
| | - Vincent Vidal
- Aix-Marseille University, APHM, La Timone Academic Hospital, Dept. of Radiology and Medical imaging, Marseille, France; European Center for Medical Imaging Research CERIMED/LIIE, Marseille, France
| | - Romain Boissier
- Aix-Marseille University, APHM, Conception Academic Hospital, Dept. of Urology and Kidney Transplantation, Marseille, France
| | - Cyrille Bastide
- Aix-Marseille University, APHM, Nord Academic Hospital, Dept. of Urology, Marseille, France
| |
Collapse
|
24
|
Branger N, Pignot G, Lannes F, Koskas Y, Toledano H, Thomassin-Piana J, Giusiano S, Alessandrini M, Rossi D, Walz J, Bastide C. Comparison between Zumsteg classification and Briganti nomogram for the risk of lymph-node invasion before radical prostatectomy. World J Urol 2019; 38:1719-1727. [PMID: 31560121 DOI: 10.1007/s00345-019-02965-7] [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: 05/01/2019] [Accepted: 09/17/2019] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To evaluate the performance of the Zumsteg classification to estimate the risk of lymph-node invasion (LNI) compared with the Briganti nomogram (BN) in prostatectomy patients with intermediate-risk prostate cancer (IRPC). METHODS We included consecutive patients who had extended pelvic lymph-node dissection associated with radical prostatectomy for IRPC. To be classified favorable intermediate risk (FIR), patients could only have one intermediate-risk factor, fewer than 50% positive biopsies and no primary Gleason score of 4. RESULTS On the 387 patients included, 149 (38.5%) and 238 (54.3%) were classified FIR and unfavorable intermediate risk (UIR), respectively, and 212 (54.8%) had a BN inferior to 5%. Thirty-eight patients (9.8%) had LNI: 6 FIR patients (4.0%) versus 32 UIR patients (13.4%) and 14 patients (6.6%) with a BN inferior to 5% versus 24 patients (13.7%) with a BN superior to 5%. Eight patients with a BN inferior to 5%, but classified UIR, had LNI. Sensitivity to detect LNI was higher with the Zumsteg classification than with the BN: 84.2% (CI 95% [68-93]) versus 63.2% (CI 95% [46-78]). Both screening tests were concordant to predict LNI (kappa coefficient of 0.076, p < 0.05 for Zumsteg and Briganti) CONCLUSIONS: Zumsteg classification appeared to be more sensitive and as effective (despite the impossibility to make decision curve analysis) than the BN to estimate the risk of LNI. Regarding the modest number of pN+ patients, further studies are needed to see the interest of proposing ePLND for UIR patients only.
Collapse
Affiliation(s)
- Nicolas Branger
- Urology Department, Hôpital Nord, Chemin des Bourrely, 13015, Marseille, France. .,Urology Department, Institut Paoli Calmettes, Marseille, France.
| | | | - François Lannes
- Urology Department, Hôpital Nord, Chemin des Bourrely, 13015, Marseille, France
| | - Yoann Koskas
- Urology Department, Hôpital Nord, Chemin des Bourrely, 13015, Marseille, France.,Urology Department, Institut Paoli Calmettes, Marseille, France
| | - Harry Toledano
- Urology Department, Hôpital Nord, Chemin des Bourrely, 13015, Marseille, France
| | | | | | - Marine Alessandrini
- EA 3279-Public Health, Chronic Diseases and Quality of Life, Research Unit, Aix-Marseille University, Marseille, 13005, France
| | - Dominique Rossi
- Urology Department, Hôpital Nord, Chemin des Bourrely, 13015, Marseille, France
| | - Jochen Walz
- Urology Department, Hôpital Nord, Chemin des Bourrely, 13015, Marseille, France
| | - Cyrille Bastide
- Urology Department, Hôpital Nord, Chemin des Bourrely, 13015, Marseille, France
| |
Collapse
|
25
|
Ghaoui-Mansour H, Mortier P, Koskas Y, Gaillet S, Toledano H, Ragny-Ghazarossian E, Rossi D, Bastide C. An exceptional migration of ureteral stent after antegrade placement: A case report. Urol Case Rep 2019; 26:100932. [PMID: 31388491 PMCID: PMC6676010 DOI: 10.1016/j.eucr.2019.100932] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Accepted: 05/30/2019] [Indexed: 11/29/2022] Open
Abstract
We report an exceptional migration of ureteral stent in patient who underwent a robot-assisted laparoscopic right pyelotomy. After stone removal, an antegrade ureteral stenting (7-french; Double J) was performed without fluoroscopic control. A radiographic control was performed the next day and highlighted a migration into the cardiovascular system. The Double J was removed percutaneously through the right femoral vein under fluoroscopic guidance.
Collapse
|
26
|
Koskas Y, Lannes F, Branger N, Giusiano S, Guibert N, Pignot G, Walz J, Rossi D, Bastide C. Extent of positive surgical margins following radical prostatectomy: impact on biochemical recurrence with long-term follow-up. BMC Urol 2019; 19:37. [PMID: 31092240 PMCID: PMC6518701 DOI: 10.1186/s12894-019-0470-8] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 05/01/2019] [Indexed: 11/16/2022] Open
Abstract
Background To assess the prognostic value of the extent of positive surgical margins (PSM) following radical prostatectomy (RP) on biochemical recurrence (BR) with long-term follow-up. Methods This retrospective study analyzed 1275 RPs performed between January 1992 and December 2013 in two university centers in Marseille (France). The inclusion criteria were: follow-up > 24 months, undetectable postoperative prostate-specific antigen (PSA), no seminal vesicle (SV) invasion, no lymph node invasion confirmed by surgery (pN0) or imaging (pNx), and no neoadjuvant or adjuvant treatment. BR was defined by PSA level ≥ 0.2 ng/mL on two successive samples. We included 189 patients, divided into two groups: - Focal PSM (fPSM): single PSM (sPSM) ≤3 mm; - Extensive PSM (ePSM): sPSM with linear length > 3 mm or several margins regardless of the length. Results The median follow-up was 101 months (18–283) and the median age was 63 years (46–76). BR occurred in only 12.1% (14/115) of cases involving fPSM and in 54.1% (40/74) of cases involving ePSM. In the multivariate model, ePSM patients were significantly associated with increased BR compared to fPSM (hazard ratio [HR] = 6.11; 95% confidence interval [CI] = 3.25–11.49). The ePSM significantly decreased BR-free survival (p < 0.001) for every patient and every subgroup (pT2, pT3a, pG ≤6, and pG ≥7). The median BR time following RP was significantly shorter for ePSM patients than fPSM (57.2 vs. 89.2 months p < 0.001). Conclusion With a median 8-year follow-up, ePSM was strongly associated with BR compared to fPSM. Therefore, it seems legitimate to monitor patients with fPSM. In cases of ePSM, adjuvant treatment appears effective.
Collapse
Affiliation(s)
- Yoann Koskas
- Department of Urology, Hopital Nord, Chemin des Bourrely, 13015, Marseille, France.
| | - François Lannes
- Department of Urology, Hopital Nord, Chemin des Bourrely, 13015, Marseille, France
| | - Nicolas Branger
- Department of Urology, Hopital Nord, Chemin des Bourrely, 13015, Marseille, France
| | - Sophie Giusiano
- Department of Anatomic Pathology, Hôpital nord, Chemin des Bourrely, 13015, Marseille, France
| | - Nicolas Guibert
- Centre hospitalier universitaire de Lyon, Lyon, France.,Hopital Edouard Herriot, 69003, Lyon, France
| | - Géraldine Pignot
- Departement of urology, Institut Paoli-Calmettes, 13008, Marseille, France
| | - Jochen Walz
- Departement of urology, Institut Paoli-Calmettes, 13008, Marseille, France
| | - Dominique Rossi
- Department of Urology, Hopital Nord, Chemin des Bourrely, 13015, Marseille, France
| | - Cyrille Bastide
- Department of Urology, Hopital Nord, Chemin des Bourrely, 13015, Marseille, France
| |
Collapse
|
27
|
Boissier* R, Regis F, Loverde K, Territo A, Toledano H, Gallioli A, Bastide C, Bastide C, Rossi D, Breda A, Palou J. MP78-18 LONG TERM ONCOLOGICAL OUTCOMES OF CRYOABLATION AND HIFU IN WHOLE GLAND AND FIRST LINE TREATMENT FOR LOCALIZED PROSTATE CANCER. J Urol 2019. [DOI: 10.1097/01.ju.0000557350.47574.a6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
28
|
Campagna J, Toledano H, Rossi D, Bastide C. HIFU de rattrapage pour récidive après radiothérapie prostatique : morbidité et résultats carcinologiques à propos d’une série monocentrique de 45 patients. Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.163] [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]
|
29
|
Branger N, Pignot G, Koskas Y, Toledano H, Thomassin-Piana J, Giusiano S, Rossi D, Walz J, Bastide C. Risques intermédiaires favorables ou défavorable : une classification simple et efficace pour estimer le risque d’envahissement ganglionnaire avant prostatectomie. Prog Urol 2017. [DOI: 10.1016/j.purol.2017.07.096] [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: 11/30/2022]
|
30
|
Mortier P, Bastide C, Lechevallier E, Walz J, Fournier R, Savoie PH, Ben Othman K, Giorgi R, André M, Giusiano S, Rossi D. [Oncological results of active surveillance in prostate cancer: A retrospective multicentric cohort]. Prog Urol 2016; 27:38-45. [PMID: 27986459 DOI: 10.1016/j.purol.2016.11.004] [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] [Received: 11/19/2015] [Revised: 09/02/2016] [Accepted: 11/14/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE To report oncological outcomes of patients with prostate cancer undergoing active surveillance according to SURACAP criteria. METHODS This multicentric study included patients who were initially treated with active surveillance for localized prostate cancer according to the SURACAP criteria. The duration of active surveillance as well as the causes of discontinuing the protocol and the definitive pathological results of patients who further underwent radical prostatectomy were retrospectively evaluated. The predictors of discontinuing active surveillance were assessed using a univariable Cox Model. In addition, the predictive value of initial MRI was assessed for patients who performed such imagery. RESULTS Between 2007 and 2013, 80 patients were included, with a median age of 64 years [47-74]. Median follow-up was 52.9 months [24-108]. At 5 years follow-up, 43.4% patients were still under surveillance. Among patients that underwent surgery, 17.8% had an extra-capsular extension. The risk of discontinuing was not significantly greater for patients with tumor size of 2 or 3mm versus 1mm (HR=0.9 [0.46-1.75], P=0.763), 2 positives cores versus 1 (HR=0.98 [0.48-2.02], P=0.967), T2a vs. T1c stage (HR=2.18 [0.77-6.18], P=0.133), increased PSA level (HR=1 [0.96-1.15], P=0.975) or the patient's age (HR=1 [0.93-1.16], P=0.966). Among the 50 patients who performed initial MRI, the results of such imagery was not significantly associated to the risk of discontinuing active surveillance MRI (HR=1.49 [0.63-3.52], P=0.36). CONCLUSION Although this study reveals a high rate of release from active surveillance at 5 years, the rate of extra-capsular tumors reported in the group of patients that underwent surgery is among the lowest in literature. LEVEL OF EVIDENCE 4.
Collapse
Affiliation(s)
- P Mortier
- Service d'urologie, hôpital nord, chemin des Bourrely, 13015 Marseille, France.
| | - C Bastide
- Service d'urologie, hôpital nord, chemin des Bourrely, 13015 Marseille, France.
| | - E Lechevallier
- Service d'urologie et de transplantation rénale, hôpital de La Conception, 147, boulevard Baille, 13005 Marseille, France.
| | - J Walz
- Service de chirurgie oncologique urologique, institut Paoli-Calmettes, 232, boulevard de Sainte-Marguerite, 13009 Marseille, France.
| | - R Fournier
- Service d'urologie, hôpital d'instruction des armées Sainte-Anne, 2, boulevard Sainte-Anne, 83800 Toulon, France
| | - P-H Savoie
- Service d'urologie, hôpital d'instruction des armées Sainte-Anne, 2, boulevard Sainte-Anne, 83800 Toulon, France
| | - K Ben Othman
- Service d'urologie et de transplantation rénale, hôpital de La Conception, 147, boulevard Baille, 13005 Marseille, France.
| | - R Giorgi
- Sciences économiques et sociales de la santé et traitement de l'information médicale (SESSTIM), UMR 912, Inserm, IRD, faculté de médecine, Aix-Marseille université, 27, boulevard Jean-Moulin, 13385 Marseille cedex 05, France.
| | - M André
- Service de radiologie et imagerie médicale, hôpital de La Conception, 147, boulevard Baille, 13005 Marseille, France.
| | - S Giusiano
- Service d'anatomie pathologique, hôpital nord, chemin des Bourrely, 13015 Marseille, France.
| | - D Rossi
- Service d'urologie, hôpital nord, chemin des Bourrely, 13015 Marseille, France.
| |
Collapse
|
31
|
Branger N, Brenot-rossi I, Koskas Y, Toledano H, Loundou A, Chemouni D, Rossi D, Bastide C. Performance diagnostique pour la localisation de foyers tumoraux intra-prostatiques du TEP-choline chez des patients faibles risques de la classification de d’Amico. Prog Urol 2016. [DOI: 10.1016/j.purol.2016.07.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
32
|
Branger N, Koskas Y, Toledano H, Loundou A, Rossi D, Bastide C. Évolution de la testostéronémie totale après prostatectomie totale : étude prospective sur 101 patients. Prog Urol 2016. [DOI: 10.1016/j.purol.2016.07.204] [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: 11/30/2022]
|
33
|
Maubon T, Branger N, Bastide C, Lonjon G, Harvey-Bryan KA, Validire P, Giusiano S, Rossi D, Cathelineau X, Rozet F. Impact of the extent of extraprostatic extension defined by Epstein's method in patients with negative surgical margins and negative lymph node invasion. Prostate Cancer Prostatic Dis 2016; 19:317-21. [PMID: 27401033 DOI: 10.1038/pcan.2016.24] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 05/04/2016] [Accepted: 06/01/2016] [Indexed: 11/09/2022]
Abstract
BACKGROUND To assess the impact of the degree of extraprostatic extension (EPE) on biochemical recurrence (BCR) and utility of the original Epstein's criteria to define EPE in a cohort of pT3aN0 without positive surgical margin (PSM). METHODS A two-center retrospective analysis was performed on data from 490 pT3aN0 patients who underwent radical prostatectomy between 2000 and 2012. Patients with neoadjuvant and/or adjuvant therapy, detectable PSA and PSM were excluded. Our pathologists used Epstein's criteria to report the degree of EPE. When pathology reports did not reflect the terms 'focal' or 'established' (non-focal), slides were analyzed by a single genitourinary pathologist for final evaluation. The end point was defined by BCR. RESULTS Selection criteria yielded 247 patients. Mean follow-up was 56.3±4.6 months; mean age at surgery was 62.5 years. Sixty-one (24.7%) patients experienced BCR during follow-up. Patients with focal extension had a 5-year recurrence-free survival of 89% versus 80% for those with non-focal extension (P=0.0018). In multivariate analysis, both pathologic Gleason score (hazard ratio 2.5; 95% confidence interval 1.4-4.5; P=0.002) and the extent of EPE (hazard ratio 1.8; 95% confidence interval 1.1-3.5; P=0.029) were significant predictors of BCR. CONCLUSIONS The extent of EPE is an independent predictor of BCR in pT3aN0 prostate cancer without PSM. This study reinforces the utility of the subjective Epstein approach already adopted by most pathologists for quantification of the extent of EPE.
Collapse
Affiliation(s)
- T Maubon
- Assistance Publique des Hopitaux de Marseille, Hopital Nord, Urology Department, Marseille, France
| | - N Branger
- Assistance Publique des Hopitaux de Marseille, Hopital Nord, Urology Department, Marseille, France
| | - C Bastide
- Assistance Publique des Hopitaux de Marseille, Hopital Nord, Urology Department, Marseille, France
| | - G Lonjon
- Laboratoire INSERM U1153 Centre de recherche Epidémiologique et Statistique de la Sorbonne, Paris Cité, France
| | - K-A Harvey-Bryan
- Institut Mutualiste Montsouris, Urology Department, Paris, France
| | - P Validire
- Institut Mutualiste Montsouris, Pathology Department, Paris, France
| | - S Giusiano
- Assistance Publique des Hopitaux de Marseille, Hopital Nord, Pathology Department, Marseille, France
| | - D Rossi
- Assistance Publique des Hopitaux de Marseille, Hopital Nord, Urology Department, Marseille, France
| | - X Cathelineau
- Institut Mutualiste Montsouris, Urology Department, Paris, France
| | - F Rozet
- Institut Mutualiste Montsouris, Urology Department, Paris, France
| |
Collapse
|
34
|
Mortier P, Bastide C. Résultats oncologiques de la surveillance active dans le cancer de la prostate selon les critères SURACAP : série rétrospective multicentrique. Prog Urol 2015; 25:833. [DOI: 10.1016/j.purol.2015.08.233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
35
|
Affiliation(s)
| | | | | | | | | | | | - D Rossi
- Hôpital Nord, Marseille, France
| | | |
Collapse
|
36
|
Rozet F, Bastide C, Beuzeboc P, Cormier L, Fromont G, Hennequin C, Mongiat-Artus P, Peyromaure M, Renard-Penna R, Richaud P, Salomon L, Soulié M. Prise en charge des tumeurs de la prostate à faible risque évolutif. Prog Urol 2015; 25:1-10. [DOI: 10.1016/j.purol.2014.10.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 10/10/2014] [Accepted: 10/18/2014] [Indexed: 11/15/2022]
|
37
|
Toledano H, Rossi D, Brenot-Rosssi I, Bastide C. Intérêt du TEP Scanner à la choline en situation de récidive biologique d’un cancer de prostate avant HIFU de rattrapage. Prog Urol 2014; 24:819. [DOI: 10.1016/j.purol.2014.08.079] [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]
|
38
|
Branger N, Rossi D, Bastide C. Évolution de la testostéronémie totale avant et après prostatectomie radicale : étude prospective monocentrique sur 43 patients. Prog Urol 2014; 24:868-9. [DOI: 10.1016/j.purol.2014.08.187] [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: 10/24/2022]
|
39
|
Pignot G, Salomon L, Neuzillet Y, Masson-Lecomte A, Lebacle C, Patard JJ, Lunardi P, Rischmann P, Pasticier G, Bernhard JC, Cohen J, Timsit MO, Verkarre V, Peyronnet B, Verhoest G, Le Goux C, Zerbib M, Brecheteau F, Bigot P, Larre S, Murez T, Thuret R, Lacarriere E, Champy C, Roupret M, Comperat E, Berger J, Descazeaud A, Toledano H, Bastide C, Lavilledieu S, Avances C, Delage F, Valeri A, Molimard B, Houlgatte A, Gres P, Donnaint A, Kleinclauss F, Legal S, Doerfler A, Koutlidis N, Cormier L, Hetet JF, Colls P, Arvin-Berod A, Rambeaud JJ, Quintens H, Soulie M, Pfister C. Clinicopathological Characteristics of Incidental Prostate Cancer Discovered from Radical Cystoprostatectomy Specimen: A Multicenter French Study. Ann Surg Oncol 2014; 21:684-690. [DOI: 10.1245/s10434-013-3340-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
|
40
|
Cormier L, Bastide C, Beuzeboc P, Fromont G, Hennequin C, Mongiat-Artus P, Peyromaure M, Ploussard G, Renard-Penna R, Richaud P, Rozet F, Soulié M, Salomon L. [Prostate cancer surgical margin: review by the CCAFU (Oncology Committee of the French Association of Urology)]. Prog Urol 2013; 24:334-45. [PMID: 24821555 DOI: 10.1016/j.purol.2013.11.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2013] [Revised: 10/27/2013] [Accepted: 11/11/2013] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Literature showed the impact of surgical margin status on prognosis after radical prostatectomy (mostly on biochemical survival). Margin status is an easy self-evaluation of surgical practice to assess. The aim of this paper was to define what a positive surgical margin (PSM) is and how to prevent the occurrence, to precise the impact on survival and how to treat. METHOD A literature analysis with Pubmed has been performed to 2012, furthermore conclusions of the main congresses with selection committee and review publication have also been studied. RESULTS PSM is defined as "tumor cells touching the ink on the specimen edge". The most frequent reported incidence is between 15 to 20%. Margin status remains one of the major criteria to determine the need of adjuvant radiotherapy after surgery. Quality of life is not or only lightly modified by radiotherapy with the current techniques. Adjuvant radiotherapy improves biological survival but is synonymous with overtreatment in many times. Salvage radiotherapy has to be quickly performed after Prostate Specific Antigen (PSA) relapse (PSA<1 ng/mL even<0.5 ng/mL). CONCLUSION This literature review did not allow to suggest superiority of one surgical technique over another. In the same way, the kind of dissection i.e. bladder neck or neurovascular bundle preservation does no clearly modify PSM rate. However, it seems logical to "customize" dissection according to prostate cancer characteristics (D'Amico criteria for instance) guided with multiparametric MRI. Intrafascial dissection has to be applied only to low risk. Lastly, the debate between adjuvant or salvage radiotherapy is always ongoing.
Collapse
Affiliation(s)
- L Cormier
- Sous-comité « prostate » du CCAFU, hôpital du Bocage, CHU de Dijon, 14, rue Gaffarel, BP 77908, 21079 Dijon cedex, France.
| | - C Bastide
- Sous-comité « prostate » du CCAFU, CHU de Marseille, 13015 Marseille, France.
| | - P Beuzeboc
- Sous-comité « prostate » du CCAFU, institut Curie, 75248 Paris, France.
| | - G Fromont
- Sous-comité « prostate » du CCAFU, CHU de Tours, 37044 Tours, France.
| | - C Hennequin
- Sous-comité « prostate » du CCAFU, CHU Saint-Louis, 75475 Paris, France.
| | - P Mongiat-Artus
- Sous-comité « prostate » du CCAFU, CHU Saint-Louis, 75475 Paris, France.
| | - M Peyromaure
- Sous-comité « prostate » du CCAFU, CHU de Cochin, 75014 Cochin, France.
| | - G Ploussard
- Sous-comité « prostate » du CCAFU, CHU Saint-Louis, 75475 Paris, France.
| | - R Renard-Penna
- Sous-comité « prostate » du CCAFU, CHU La Pitié, 75013 Paris, France.
| | - P Richaud
- Sous-comité « prostate » du CCAFU, institut Bergonié, 33076 Bordeaux, France.
| | - F Rozet
- Sous-comité « prostate » du CCAFU, institut Monstsouris, 75014 Paris, France.
| | - M Soulié
- Sous-comité « prostate » du CCAFU, CHU de Toulouse, 31403 Toulouse, France.
| | - L Salomon
- Sous-comité « prostate » du CCAFU, CHU Mondor, 94010 Paris, France.
| | | |
Collapse
|
41
|
Karsenty G, Marcelli F, Geoffroy R, Huygues E, Rigot JM, Droupy S, Bastide C, Guy L, Bruyère F. Erratum à l’article « Les médicaments de la médecine sexuelle » [Prog. Urol. 2013;23(15):1299–311]. Prog Urol 2013. [DOI: 10.1016/j.purol.2013.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
42
|
Ploussard G, Staerman F, Pierrevelcin J, Larue S, Villers A, Ouzzane A, Bastide C, Gaschignard N, Buge F, Pfister C, Bonniol R, Rebillard X, Fadli S, Mottet N, Saint F, Saad R, Beauval JB, Roupret M, Audenet F, Peyromaure M, Delongchamps NB, Vincendeau S, Fardoun T, Rigaud J, Soulie M, Salomon L. Clinical outcomes after salvage radiotherapy without androgen deprivation therapy in patients with persistently detectable PSA after radical prostatectomy: results from a national multicentre study. World J Urol 2013; 32:1331-8. [DOI: 10.1007/s00345-013-1214-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Accepted: 11/13/2013] [Indexed: 10/26/2022] Open
|
43
|
Bruyère F, Desoubeaux G, Malavaud S, Fourcade C, Chandenier J, Lachaud L, Guy L, Karsenty G, Bastide C, Lavigne JP, Sotto A. [Non-antibiotic anti-infectious treatments in urology]. Prog Urol 2013; 23:1342-56. [PMID: 24183092 DOI: 10.1016/j.purol.2013.09.003] [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: 09/03/2013] [Revised: 09/05/2013] [Accepted: 09/06/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To define the terms of use of pesticides, antifungal, antiviral and antiseptic treatments in urology. MATERIALS AND METHODS A literature search was conducted on MEDLINE for all these treatments used in urology. The molecules were classified by family. Modes of action, indications in urology and adverse effects have been detailed. Authorisation files were consulted and then complemented by a literature analysis. RESULTS Although parasitic or viral diseases are uncommon in urology, their specific treatment deserves a thorough knowledge of pesticide and antiviral molecules. Antifungal treatments are regularly used in urology with special features to know to improve the efficacy/safety ratio. Antiseptics are used daily in urology and a better understanding of these molecules allows better use. CONCLUSION Beyond antibiotics, antiviral, antiparasitic and antifungal deserve a thorough knowledge. Antiseptic although used daily have features little known.
Collapse
Affiliation(s)
- F Bruyère
- Service d'urologie, CHRU Bretonneau, 2, boulevard Tonnellé, 37044 Tours cedex, France; Université François-Rabelais de Tours, PRES Centre Val-de-Loire université, 37000 Tours, France.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Bruyère F, Karsenty G, Guy L, Bastide C, Bernard L. [Anti-infectious treatments in urology: general remarks]. Prog Urol 2013; 23:1318-26. [PMID: 24183090 DOI: 10.1016/j.purol.2013.08.324] [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: 08/28/2013] [Accepted: 08/29/2013] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To define the general use of anti-infectious treatments in urology. MATERIALS AND METHODS A review of national guidelines and articles published on the subject in the Medline database, selected by keywords, depending on the scientific relevance was performed. RESULTS While the epidemiology clearly shows the non-reduction of the anti-infectious treatments use in France, the resistance increases to highlight foo-resistant germs. Urology is not an exception to this observation, and different means are set to improve the prescription made by urologists. CONCLUSION The epidemiological observation confirms the urgent need to improve the prescription of anti-infectious treatments particularly in urology.
Collapse
Affiliation(s)
- F Bruyère
- Service d'urologie, CHRU Bretonneau, 2, boulevard Tonnellé, 37044 Tours cedex, France; PRES centre Val-de-Loire université, université François-Rabelais de Tours, 37000 Tours, France.
| | | | | | | | | |
Collapse
|
45
|
Deville JL, Flechon A, Bruyère F, Karsenty G, Guy L, Bastide C. [Chemotherapy in male external genital organs (testicular and penile cancer)]. Prog Urol 2013; 23:1265-70. [PMID: 24183085 DOI: 10.1016/j.purol.2013.08.321] [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: 08/27/2013] [Accepted: 08/28/2013] [Indexed: 10/26/2022]
Abstract
AIM To describe drugs used in the chemotherapy of testis and penis neoplasms. MATERIAL Bibliographical search was performed from the database Medline (National Library of Medicine, PubMed) and websites of the HAS and the ANSM. The search was focused on the characteristics, the mode of action, the efficiency and the side effects of the various drugs concerned. RESULTS Nowadays, the chemotherapy is perfectly codified in adjuvant treatment or in first-line treatment of metastatic testis cancer. A single dose of carboplatin for seminoma testicular (stage I) in adjuvant treatment situation is one of the latest advances. Concerning penis cancer, the optimal protocols validated by a high level of evidence are missing. CONCLUSION The chemotherapy in testis and penis neoplasms knew few advances in recent years. So, it is necessary to include patients in clinical research protocols.
Collapse
Affiliation(s)
- J-L Deville
- Service d'oncologie, hôpital de la Timone, Aix-Marseille université, AP-HM, 13385 Marseille cedex 5, France
| | | | | | | | | | | |
Collapse
|
46
|
Bastide C. [The good assessment criteria in oncology is not still the one we think]. Prog Urol 2013; 23:1224. [PMID: 24183080 DOI: 10.1016/j.purol.2013.08.326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 08/28/2013] [Accepted: 08/29/2013] [Indexed: 10/26/2022]
Affiliation(s)
- C Bastide
- Service d'urologie, hôpital Nord, Aix-Marseille université, AP-HM, chemin des Bourrely, 13015 Marseille, France.
| |
Collapse
|
47
|
Game X, Cornu JN, Robert G, Descazeaud A, Droupy S, Benard-Laribiere A, Bastide C, Guy L, Bruyére F, Karsenty G. [Drug therapy of urethral diseases]. Prog Urol 2013; 23:1287-98. [PMID: 24183087 DOI: 10.1016/j.purol.2013.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 09/16/2013] [Indexed: 02/02/2023]
Abstract
AIM To describe drugs targeting urethra and prostate to treat dysfunctions such LUTS related to BPH, primary bladder neck obstruction (PBNO), detrusor sphincter dyssynergia (DSD) or sphincter deficiency (SD). METHOD Pubmed search for efficacy, mode of action and side effects for each molecule. Additional data were searched from the French regulatory agencies web sites (HAS and ANSM). RESULTS To treat LUTS related to BPH alpha-blockers (AB) and 5-alpha reductase inhibitors (5ARIs) have a clearer efficacy than plant extract. Daily Phosphodiesterase 5 inhibitors (PDE5Is) alone or in association with AB also demonstrate efficacy in this indication. AB are an option in PBNO and DSD related to multiple sclerosis. Although Botulinum toxin A derived molecules decrease urethral pressure in patient with DSD related to spinal cord injury or multiple sclerosis, efficiency remains to be demonstrated. Duloxetine a serotonin reuptake inhibitor increases urethral sphincter pressure and reduce stress urinary incontinence in women and men. Nevertheless, moderate efficacy combine with frequent side effects lead French regulation agency to reject its agreement. CONCLUSION Armamenterium to treat urethral dysfunctions has recently increases. Two new therapeutic classes emerge: PDE5Is to treat LUTS related to BPH and an SRIs (Duloxetine) to treat stress urinary incontinence. Efficacy and safety evaluation of all the possible associations between drugs targeting urethra and/or bladder is needed to a subtler and more efficient pharmacologic modulation of lower urinary tract dysfunction.
Collapse
Affiliation(s)
- X Game
- Département d'urologie, transplantation rénale et andrologie, CHU Rangueil, TSA 50032, 31059 Toulouse, France
| | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Chaussade H, Sunder S, Bernard L, Coloby P, Guy L, Karsenty G, Bastide C, Bruyère F. Les médicaments antibiotiques en urologie. Prog Urol 2013; 23:1327-41. [DOI: 10.1016/j.purol.2013.09.001] [Citation(s) in RCA: 4] [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: 09/03/2013] [Revised: 09/04/2013] [Accepted: 09/05/2013] [Indexed: 11/16/2022]
|
49
|
Karsenty G, Marcelli F, Geoffroy R, Huygues E, Rigot JM, Droupy S, Bastide C, Guy L, Bruyère F. Les médicaments de la médecine sexuelle. Prog Urol 2013; 23:1299-311. [DOI: 10.1016/j.purol.2013.09.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 09/18/2013] [Indexed: 11/16/2022]
|
50
|
Salomon L, Bastide C, Beuzeboc P, Cormier L, Fromont G, Hennequin C, Mongiat-Artus P, Peyromaure M, Ploussard G, Renard-Penna R, Rozet F, Azria D, Coloby P, Molinié V, Ravery V, Rebillard X, Richaud P, Villers A, Soulié M. Recommandations en onco-urologie 2013 du CCAFU : Cancer de la prostate. Prog Urol 2013; 23 Suppl 2:S69-101. [DOI: 10.1016/s1166-7087(13)70048-4] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
|