1
|
Zambon A, Nguyen TA, Fourcade A, Segalen T, Saout K, Deruelle C, Joulin V, Tissot V, Doucet L, Fournier G, Valeri A. Which protocol for prostate biopsies in patients with a positive MRI? Interest of systematic biopsies by sectors. Prostate Cancer Prostatic Dis 2023:10.1038/s41391-023-00770-3. [PMID: 38114598 DOI: 10.1038/s41391-023-00770-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 11/16/2023] [Accepted: 11/24/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Current prostate biopsy (PBx) protocol for prostate cancer (PCa) diagnosis is to perform systematic biopsies (SBx) combined with targeted biopsies (TBx) in case of positive MRI (i.e. PI-RADS ≥ 3). To assess the utility of performing SBx in combination with TBx, we determined the added value of SBx brought to the diagnosis of PCa according to their sextant location and MRI target characteristics. METHODS In our local prospectively collected database, we conducted a single-center retrospective study including all patients with a suspicion of PCa, who underwent transrectal ultrasound-guided (TRUS) prostate biopsies (PBx) with a prior MRI and a single lesion classified as PI-RADS ≥ 3. We have characterized the SBx according to their location on MRI: same sextant (S-SBx), adjacent sextant (A-SBx), ipsilateral side (I-SBx) and contralateral side (C-SBx). The added value of SBx and TBx was defined as any upgrading to significant PCa (csPCa) (ISUP ≥2). RESULTS 371 patients were included in the study. The added value of SBx was 10% overall. Regarding the lesion location and the SBx sextant, the added value of SBx was: 5.1% for S-SBx, 5.4% for A-SBx, 4.9% for I-SBx and 1.9% for C-SBx. The overall added value of SBx was 6.8% for PI-RADS 3 lesions, 14% for PI-RADS 4 lesions and 6.7% for PI-RADS 5 lesions (p = 0.063). The added value of SBx for contralateral side was 1.9% (2/103), 3.1% (5/163) and 0% (0/105) for PI-RADS 3, PI-RADS 4 and PI-RADS 5 lesions, respectively (p = 0,4). The added value of SBx was lower when the number of TBx was higher (OR 0.57; CI 95% 0.37-0.85; p = 0.007). CONCLUSIONS Our results suggest that the utility of performing SBx in the contralateral lobe toward the MRI lesion was very low, supporting that they might be avoided.
Collapse
Affiliation(s)
- A Zambon
- Urology Department, Brest University Hospital, Brest, France.
| | - T-A Nguyen
- Urology Department, Brest University Hospital, Brest, France
- LaTIM-UMR 1101, INSERM, EFS, Université de Bretagne Occidentale, Brest, France
| | - A Fourcade
- Urology Department, Brest University Hospital, Brest, France
| | - T Segalen
- Urology Department, Brest University Hospital, Brest, France
| | - K Saout
- Urology Department, Brest University Hospital, Brest, France
| | - C Deruelle
- Urology Department, Brest University Hospital, Brest, France
| | - V Joulin
- Urology Department, Brest University Hospital, Brest, France
| | - V Tissot
- Radiology Department, Brest University Hospital, Brest, France
| | - L Doucet
- Pathology Department, Brest University Hospital, Brest, France
| | - G Fournier
- Urology Department, Brest University Hospital, Brest, France
- LaTIM-UMR 1101, INSERM, EFS, Université de Bretagne Occidentale, Brest, France
- CeRePP, Paris, France
| | - A Valeri
- Urology Department, Brest University Hospital, Brest, France
- LaTIM-UMR 1101, INSERM, EFS, Université de Bretagne Occidentale, Brest, France
- CeRePP, Paris, France
| |
Collapse
|
2
|
Payrard-Starck C, Fourcade A, An Nguyen T, Tissot V, Doucet L, Marolleau J, Lucas C, Fournier G, Valeri A. Direct comparison between Grade Group assessed on systematic and MRI/ultrasound fusion targeted biopsies correlated to the radical prostatectomy specimens in patients with prostate cancer. Prog Urol 2023; 33:265-271. [PMID: 36740508 DOI: 10.1016/j.purol.2023.01.004] [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: 05/01/2022] [Revised: 10/02/2022] [Accepted: 01/16/2023] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To compare the correlation of Gleason score (GS) and ISUP grade determined by prostate biopsies (PBx) and radical prostatectomy (RP) specimens according to the biopsy technique: ultrasound randomised (RBx) vs. MRI/ultrasound fusion targeted (TBx). MATERIALS AND METHODS Between March 2013 and June 2018, we retrospectively included patients who underwent RP for prostate cancer (PCa) histopathologically proven by RBx and/or TBx. All patients had a prebiopsy MRI by a single radiologist (using PI-RADS score), then transrectal RBx (12cores, blinded to MRI lesions) and TBx (2-4 cores/target) with elastic MRI/ultrasound fusion (UroStation™, Koelis, Grenoble, France). Histological findings were compared: PBx vs. RP. RESULTS One hundred and four patients underwent RP after RBx and/or TBx. ISUP concordance rate was better with the association RBx+TBx 49% (51/104) vs. 43.3% with TBx (P=0.07) and 43.3% with RBx (P=0.13). With RBx, 50% of the patients were downgraded (52/104) against 42.3% (44/104) with TBx (P=0.088). The association RBx+TBx significantly decreased the rate of downgrading of the ISUP score compared to the ISUP score of RP 35.6% (37/104) vs. RBx (50%, P=0.0001) and vs. TBx (42.3%, P=0.016). CONCLUSION In half of cases, the ISUP score was underestimated in RBx compared to RP specimens. Adding TBx to RBx significantly reduced downgrading. The combination of both biopsy techniques appeared to be the best protocol to get closer to ISUP score and GS of the RP specimens. LEVEL OF EVIDENCE C.
Collapse
Affiliation(s)
- C Payrard-Starck
- Urology Department, CHU Brest, Brest, France; Faculté de Médecine et des Sciences de la Santé, Université de Brest, Brest, France.
| | - A Fourcade
- Urology Department, CHU Brest, Brest, France
| | - T An Nguyen
- Urology Department, CHU Brest, Brest, France; Faculté de Médecine et des Sciences de la Santé, Université de Brest, Brest, France; LaTIM, Inserm, UMR 1101, CHU Brest, Brest, France
| | - V Tissot
- Radiology Department, CHU Brest, Brest, France
| | - L Doucet
- Pathology Department, CHU Brest, Brest, France
| | - J Marolleau
- Urology Department, CHU Brest, Brest, France
| | - C Lucas
- Urology Department, CHU Brest, Brest, France; Faculté de Médecine et des Sciences de la Santé, Université de Brest, Brest, France
| | - G Fournier
- Urology Department, CHU Brest, Brest, France; Faculté de Médecine et des Sciences de la Santé, Université de Brest, Brest, France; LaTIM, Inserm, UMR 1101, CHU Brest, Brest, France
| | - A Valeri
- Urology Department, CHU Brest, Brest, France; Faculté de Médecine et des Sciences de la Santé, Université de Brest, Brest, France; LaTIM, Inserm, UMR 1101, CHU Brest, Brest, France
| |
Collapse
|
3
|
Zambon A, Nguyen T, Fourcade A, Saout K, Deruelle C, Joulin V, Tissot V, Doucet L, Fournier G, Valeri A. Interest of systematic prostatic biopsies in patients with a suspicious lesion on MRI: Analysis by sectors according to the target location. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00222-1] [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: 02/12/2023]
|
4
|
Marolleau J, Nguyen TA, Doucet L, Coste A, Schoentgen N, Rousseau B, Valeri A, Fournier G. [Morbidity of extended pelvic lymphadenectomy during robot-assisted laparoscopic prostatectomy for localized cancer prostate]. Prog Urol 2022; 32:1455-1461. [PMID: 36088200 DOI: 10.1016/j.purol.2022.07.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 07/02/2022] [Accepted: 07/18/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To assess the morbidity specific of extended pelvic lymphadenectomy during robot-assisted laparoscopic radical prostatectomy in a 8 year retrospective study. MATERIAL We carried out a single-center, single-surgeon retrospective study on 342 consecutive patients who underwent a robot-assisted laparoscopic radical prostatectomy and extended pelvic lymphadenectomy, from July 2010 to March 2018. Postoperative complications were recorded up to 3 months after the operation. RESULTS Thirty (8.8%) patients had at least one complication related to lymphadenectomy including 1 vascular injury (0.3%), 7 injuries of the obturator nerve (2%), 5 venous thromboembolic complications (1.5%) including 4 pulmonary embolisms, 10 symptomatic lymphoceles (2.9%) and 8 lymphoedemas (2.3%). Of these complications, 13 were classified Clavien 1 (43.3%), 8 Clavien 2 (26.7%), 7 Clavien 3a (23.3%) and 2 Clavien 3b (6.7%). In univariate analysis a high age (P=0.04), high BMI (P<0.01) and pT stage (P=0.02) were significantly associated with complication whereas in multivariate analysis, only age (P=0.02) and BMI (P<0.01) lived were. In univariate analysis high BMI (P=0.04) and lymph node involvement (P=0.04) were associated with lymphatic complication. We did not find any other specific risk factor for the other complications. CONCLUSION With 8.8% of overall complications related to lymphadenectomy and 5% of complication classified Clavien grade 2 or higher, extended pelvic lymphadenectomy was not very morbid. Age and BMI were risk factors for a overall complication. BMI and lymph node involvement were risk factors for lymphatic complications. LEVEL OF PROOF 4.
Collapse
Affiliation(s)
| | - T A Nguyen
- Service d'urologie, CHU, Brest, France; Faculté de Médecine et des Sciences de la Santé, Université de Bretagne Occidentale, Brest, France; LaTIM, Inserm, UMR 1101, Université de Bretagne Occidentale, Brest, France
| | - L Doucet
- Laboratoire d'anatomo-pathologie, CHU, Brest, France
| | - A Coste
- LaTIM, Inserm, UMR 1101, Université de Bretagne Occidentale, Brest, France; Service de médecine infectieuse et tropicale, CHU, Brest, France
| | | | | | - A Valeri
- Service d'urologie, CHU, Brest, France; Faculté de Médecine et des Sciences de la Santé, Université de Bretagne Occidentale, Brest, France; LaTIM, Inserm, UMR 1101, Université de Bretagne Occidentale, Brest, France; CeRePP, Paris, France
| | - G Fournier
- Service d'urologie, CHU, Brest, France; Faculté de Médecine et des Sciences de la Santé, Université de Bretagne Occidentale, Brest, France; LaTIM, Inserm, UMR 1101, Université de Bretagne Occidentale, Brest, France; CeRePP, Paris, France
| |
Collapse
|
5
|
Ramel S, Beauvillard D, Le Bihan J, Valeri A, Touilin F, Kerbrat M. WS09.02 Setting up an e-learning program for male patients presenting cystic fibrosis (CF) infertility. J Cyst Fibros 2022. [DOI: 10.1016/s1569-1993(22)00202-8] [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: 11/27/2022]
|
6
|
Nguyen T, Tixier F, Tissot V, Fourcade A, Saout K, Zambon A, Payrard C, Deruelle C, Joulin V, Doucet L, Visvikis D, Fournier G, Valeri A. Radiomic-based model for prediction of clinically significant prostate cancer in patients with a PI-RADS 3 MRI lesion. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00360-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
7
|
Saout K, Zambon A, Nguyen T, Lucas C, Payrard-Starck C, Segalen T, Tissot V, Doucet L, Marolleau J, Deruelle C, Joulin V, Fourcade A, Fournier G, Valeri A. Impact of multiparametric MRI and PSA density on the initial indication or the maintaining in active surveillance during follow-up in low-risk prostate cancer. Clin Genitourin Cancer 2022; 20:e244-e252. [DOI: 10.1016/j.clgc.2022.01.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 01/12/2022] [Accepted: 01/17/2022] [Indexed: 11/25/2022]
|
8
|
Nguyen T, Cussenot O, Fiard G, Fourcade A, Tissot V, Doucet L, Fournier G, Valeri A. Impact de l’âge et de la densité du PSA sur la détection du cancer de prostate chez les patients avec IRM prostatique négative. Prog Urol 2021. [DOI: 10.1016/j.purol.2021.08.074] [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]
|
9
|
Lang SS, Valeri A, Storm PB, Heuer GG, Tucker AM, Kennedy BC, Kozyak BW, Sinha A, Kilbaugh TJ, Huh JW. Acute neurological injury in pediatric patients with single-ventricle congenital heart disease. J Neurosurg Pediatr 2021; 28:335-343. [PMID: 34243155 DOI: 10.3171/2021.2.peds2142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 02/22/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Single-ventricle congenital heart disease (CHD) in pediatric patients with Glenn and Fontan physiology represents a unique physiology requiring the surgical diversion of the systemic venous return from the superior vena cava (Glenn) and then the inferior vena cava (Fontan) directly to the pulmonary arteries. Because many of these patients are on chronic anticoagulation therapy and may have right-to-left shunts, arrhythmias, or lymphatic disorders that predispose them to bleeding and/or clotting, they are at risk of experiencing neurological injury requiring intubation and positive pressure ventilation, which can significantly hamper pulmonary blood flow and cardiac output. The aim of this study was to describe the complex neurological and cardiopulmonary interactions of these pediatric patients after acute central nervous system (CNS) injury. METHODS The authors retrospectively analyzed the records of pediatric patients who had been admitted to a quaternary children's hospital with CHD palliated to bidirectional Glenn (BDG) or Fontan circulation and acute CNS injury and who had undergone intubation and mechanical ventilation. Patients who had been admitted from 2005 to 2019 were included in the study. Clinical characteristics, surgical outcomes, cardiovascular and pulmonary data, and intracranial pressure data were collected and analyzed. RESULTS Nine pediatric single-ventricle patients met the study inclusion criteria. All had undergone the BDG procedure, and the majority (78%) were status post Fontan palliation. The mean age was 7.4 years (range 1.3-17.3 years). At the time of acute CNS injury, which included traumatic brain injury, intracranial hemorrhage, and cerebral infarct, the median time interval from the most recent cardiac surgical procedure was 3 years (range 2 weeks-11 years). Maintaining normocarbia to mild hypercarbia for most patients during intubation periods did not cause neurological deterioration, and hemodynamic profiles were more favorable as compared to periods of hypocarbia. Hypocarbia was associated with unfavorable hemodynamics but was necessary to decrease intracranial hypertension. Most patients were managed using low mean airway pressure (MAWP) in order to minimize the impact on preload and cardiac output. CONCLUSIONS The authors highlight the complex neurological and cardiopulmonary interactions with respect to partial pressure of arterial CO2 (PaCO2) and MAWP when pediatric CHD patients with single-ventricle physiology require mechanical ventilation. The study data demonstrated that tight control of PaCO2 and minimizing MAWP with the goal of early extubation may be beneficial in this population. A multidisciplinary team of pediatric critical care intensivists, cardiac intensivists and anesthesiologists, and pediatric neurosurgeons and neurologists are recommended to ensure the best possible outcomes.
Collapse
Affiliation(s)
- Shih-Shan Lang
- 1Division of Neurosurgery, Children's Hospital of Philadelphia, Department of Neurosurgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia
- 2Center for Data Driven Discovery in Biomedicine, Children's Hospital of Philadelphia, Philadelphia
| | - Amber Valeri
- 3Department of Neurosurgery, Philadelphia College of Osteopathic Medicine, Philadelphia
| | - Phillip B Storm
- 1Division of Neurosurgery, Children's Hospital of Philadelphia, Department of Neurosurgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia
- 2Center for Data Driven Discovery in Biomedicine, Children's Hospital of Philadelphia, Philadelphia
| | - Gregory G Heuer
- 1Division of Neurosurgery, Children's Hospital of Philadelphia, Department of Neurosurgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia
- 2Center for Data Driven Discovery in Biomedicine, Children's Hospital of Philadelphia, Philadelphia
| | - Alexander M Tucker
- 1Division of Neurosurgery, Children's Hospital of Philadelphia, Department of Neurosurgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia
- 2Center for Data Driven Discovery in Biomedicine, Children's Hospital of Philadelphia, Philadelphia
| | - Benjamin C Kennedy
- 1Division of Neurosurgery, Children's Hospital of Philadelphia, Department of Neurosurgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia
- 2Center for Data Driven Discovery in Biomedicine, Children's Hospital of Philadelphia, Philadelphia
| | - Benjamin W Kozyak
- 4Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania, Perelman School of Medicine, Philadelphia
- 5Division of Cardiac Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and
| | - Anjuli Sinha
- 4Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania, Perelman School of Medicine, Philadelphia
- 6Division of Pediatric Cardiology, Lucile Packard Stanford Children's Hospital, Palo Alto, California
| | - Todd J Kilbaugh
- 4Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania, Perelman School of Medicine, Philadelphia
| | - Jimmy W Huh
- 4Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania, Perelman School of Medicine, Philadelphia
| |
Collapse
|
10
|
Saout K, Zambon A, N’Guyen T, Lucas C, Payrard-Starck C, Marolleau J, Segalen T, Tissot V, Doucet L, Deruelle C, Joulin V, Fourcade A, Fournier G, Valeri A. Impact de la densité du PSA et de l’IRM multiparamétrique dans l’indication à une surveillance active d’un adénocarcinome prostatique à faible risque. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
11
|
Ollivier L, Lucia F, Lucas C, Bourbonne V, Marolleau J, Boussion N, Goasduff G, Fournier G, Dissaux G, Pradier O, Valeri A, Schick U. PO-1198: Comparison between built custom linked seeds and loose seeds in prostate brachytherapy. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01216-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
12
|
Georges J, Qi X, Liu X, Zhou Y, Woolf EC, Valeri A, Al-Atrache Z, Belykh E, Feuerstein BG, Preul M, Scheck AC, Reiser M, Anderson T, Gopez J, Appelt D, Yocom S, Eschbacher J, Yan H, Nakaji P. Provision of rapid and specific ex vivo diagnosis of central nervous system lymphoma from rodent xenograft biopsies by a fluorescent aptamer. J Neurosurg 2020; 134:1783-1790. [PMID: 32707545 DOI: 10.3171/2020.4.jns192476] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 04/23/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Differentiating central nervous system (CNS) lymphoma from other intracranial malignancies remains a clinical challenge in surgical neuro-oncology. Advances in clinical fluorescence imaging contrast agents and devices may mitigate this challenge. Aptamers are a class of nanomolecules engineered to bind cellular targets with antibody-like specificity in a fraction of the staining time. Here, the authors determine if immediate ex vivo fluorescence imaging with a lymphoma-specific aptamer can rapidly and specifically diagnose xenografted orthotopic human CNS lymphoma at the time of biopsy. METHODS The authors synthesized a fluorescent CNS lymphoma-specific aptamer by conjugating a lymphoma-specific aptamer with Alexa Fluor 488 (TD05-488). They modified human U251 glioma cells and Ramos lymphoma cells with a lentivirus for constitutive expression of red fluorescent protein and implanted them intracranially into athymic nude mice. Three to 4 weeks postimplantation, acute slices (biopsies, n = 28) from the xenografts were collected, placed in aptamer solution, and imaged with a Zeiss fluorescence microscope. Three aptamer staining concentrations (0.3, 1.0, and 3.0 μM) and three staining times (5, 10, and 20 minutes) followed by a 1-minute wash were tested. A file of randomly selected images was distributed to neurosurgeons and neuropathologists, and their ability to distinguish CNS lymphoma from negative controls was assessed. RESULTS The three staining times and concentrations of TD05-488 were tested to determine the diagnostic accuracy of CNS lymphoma within a frozen section time frame. An 11-minute staining protocol with 1.0-μM TD05-488 was most efficient, labeling 77% of positive control lymphoma cells and less than 1% of negative control glioma cells (p < 0.001). This protocol permitted clinicians to positively identify all positive control lymphoma images without misdiagnosing negative control images from astrocytoma and normal brain. CONCLUSIONS Ex vivo fluorescence imaging is an emerging technique for generating rapid histopathological diagnoses. Ex vivo imaging with a novel aptamer-based fluorescent nanomolecule could provide an intraoperative tumor-specific diagnosis of CNS lymphoma within 11 minutes of biopsy. Neurosurgeons and neuropathologists interpreted images generated with this molecular probe with high sensitivity and specificity. Clinical application of TD05-488 may permit specific intraoperative diagnosis of CNS lymphoma in a fraction of the time required for antibody staining.
Collapse
Affiliation(s)
- Joseph Georges
- 7Department of Neurosurgery, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania.,8Department of Neurosurgery, Cooper University Health Care, Camden, New Jersey.,9Department of Neurosurgery
| | - Xiaodong Qi
- 4The Biodesign Institute.,5School of Molecular Sciences
| | | | - Yu Zhou
- 4The Biodesign Institute.,5School of Molecular Sciences
| | | | - Amber Valeri
- 7Department of Neurosurgery, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania.,8Department of Neurosurgery, Cooper University Health Care, Camden, New Jersey
| | - Zein Al-Atrache
- 7Department of Neurosurgery, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania
| | | | - Burt G Feuerstein
- 2Neurology, and.,3Child Health, University of Arizona, College of Medicine, Phoenix, Arizona
| | - Mark Preul
- 9Department of Neurosurgery.,10Neuro-Oncology Research
| | - Adrienne C Scheck
- 3Child Health, University of Arizona, College of Medicine, Phoenix, Arizona
| | - Mark Reiser
- 6School of Mathematics and Statistical Sciences, Arizona State University, Tempe, Arizona
| | | | - Jonas Gopez
- 12Department of Neurosurgery, Abington Hospital-Jefferson Health, Abington, Pennsylvania
| | - Denah Appelt
- 7Department of Neurosurgery, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania
| | - Steven Yocom
- 7Department of Neurosurgery, Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania.,8Department of Neurosurgery, Cooper University Health Care, Camden, New Jersey
| | - Jennifer Eschbacher
- 11Division of Neuropathology, Barrow Neurological Institute, Phoenix, Arizona; and
| | | | | |
Collapse
|
13
|
Lang SS, Valeri A, Zhang B, Storm PB, Heuer GG, Leavesley L, Bellah R, Kim CT, Griffis H, Kilbaugh TJ, Huh JW. Head of bed elevation in pediatric patients with severe traumatic brain injury. J Neurosurg Pediatr 2020; 26:465-475. [PMID: 32679558 DOI: 10.3171/2020.4.peds20102] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 04/27/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Head of bed (HOB) elevation to 30° after severe traumatic brain injury (TBI) has become standard positioning across all age groups. This maneuver is thought to minimize the risk of elevated ICP in the hopes of decreasing cerebral blood and fluid volume and increasing cerebral venous outflow with improvement in jugular venous drainage. However, HOB elevation is based on adult population data due to a current paucity of pediatric TBI studies regarding HOB management. In this prospective study of pediatric patients with severe TBI, the authors investigated the role of different head positions on intracranial pressure (ICP), cerebral perfusion pressure (CPP), and cerebral venous outflow through the internal jugular veins (IJVs) on postinjury days 2 and 3 because these time periods are considered the peak risk for intracranial hypertension. METHODS Patients younger than 18 years with a Glasgow Coma Scale score ≤ 8 after severe TBI were prospectively recruited at a single quaternary pediatric intensive care unit. All patients had an ICP monitor placed, and no other neurosurgical procedure was performed. On the 2nd and 3rd days postinjury, the degree of HOB elevation was varied between 0° (head-flat or horizontal), 10°, 20°, 30°, 40°, and 50° while ICP, CPP, and bilateral IJV blood flows were recorded. RESULTS Eighteen pediatric patients with severe TBI were analyzed. On each postinjury day, 13 of the 18 patients had at least 1 optimal HOB position (the position that simultaneously demonstrated the lowest ICP and the highest CPP). Six patients on each postinjury day had 30° as the optimal HOB position, with only 2 being the same patient on both postinjury days. On postinjury day 2, 3 patients had more than 1 optimal HOB position, while 5 patients did not have an optimal position. On postinjury day 3, 2 patients had more than 1 optimal HOB position while 5 patients did not have an optimal position. Interestingly, 0° (head-flat or horizontal) was the optimal HOB position in 2 patients on postinjury day 2 and 3 patients on postinjury day 3. The optimal HOB position demonstrated lower right IJV blood flow than a nonoptimal position on both postinjury days 2 (p = 0.0023) and 3 (p = 0.0033). There was no significant difference between optimal and nonoptimal HOB positions in the left IJV blood flow. CONCLUSIONS In pediatric patients with severe TBI, the authors demonstrated that the optimal HOB position (which decreases ICP and improves CPP) is not always at 30°. Instead, the optimal HOB should be individualized for each pediatric TBI patient on a daily basis.
Collapse
Affiliation(s)
- Shih-Shan Lang
- 1Division of Neurosurgery, Children's Hospital of Philadelphia, Department of Neurosurgery, University of Pennsylvania, Perelman School of Medicine.,2Center for Data Driven Discovery in Biomedicine, Children's Hospital of Philadelphia
| | - Amber Valeri
- 3Department of Neurosurgery, Philadelphia College of Osteopathic Medicine
| | - Bingqing Zhang
- 4Healthcare Analytics Unit, Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia
| | - Phillip B Storm
- 1Division of Neurosurgery, Children's Hospital of Philadelphia, Department of Neurosurgery, University of Pennsylvania, Perelman School of Medicine.,2Center for Data Driven Discovery in Biomedicine, Children's Hospital of Philadelphia
| | - Gregory G Heuer
- 1Division of Neurosurgery, Children's Hospital of Philadelphia, Department of Neurosurgery, University of Pennsylvania, Perelman School of Medicine.,2Center for Data Driven Discovery in Biomedicine, Children's Hospital of Philadelphia
| | - Lauren Leavesley
- 5Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania, Perelman School of Medicine
| | - Richard Bellah
- 6Department of Radiology and Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania, Perelman School of Medicine; and
| | - Chong Tae Kim
- 7Department of Physical Medicine and Rehabilitation and Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Heather Griffis
- 4Healthcare Analytics Unit, Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia
| | - Todd J Kilbaugh
- 5Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania, Perelman School of Medicine
| | - Jimmy W Huh
- 5Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, University of Pennsylvania, Perelman School of Medicine
| |
Collapse
|
14
|
Giordano A, Prosperi P, Alemanno G, Bergamini C, Bruscino A, Valeri A. Diagnostic and therapeutic role of laparoscopy in perforated peptic ulcer in the elderly patients. G Chir 2020; 41:40-45. [PMID: 32038011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
AIM The purpose of this study is to analyze the outcome of elderly patients with perforated peptic ulcer comparing laparoscopic treatment versus open approach. METHODS In our General and Emergency Surgery Unit in the last 3 years, 20 elderly patients with perforated peptic ulcer were performed. We considered elderly all patients over the age of 65 years (10 females and 10 males; the mean age was 75 years). 16 patients (80%) were submitted to laparoscopic repair with omentoplasty and 4 (20%) to open repair. The patients were classified using the Boye's score which influenced the choice of surgical treatment and the outcoEmergency Romame. The two groups were compared in terms of operative surgery times, complication rate, mortality and postoperative outcomes. DISCUSSION Perforated peptic ulcer is a common abdominal disease that is treated by surgery. The potential advantages of laparoscopy, both in terms of diagnosis and therapy, are clear and the major advantages may be observed in cases with peritonitis secondary as a perforated peptic ulcer where laparoscopy allows the confirmation of the diagnosis, the identification of the position of the ulcer and the repair. With the age the risks of comorbidities increases multidisease syndrome. Elderly patients suffer from frailty syndrome. All these factors make the elderly patient a major challenge for a laparoscopy treatment. CONCLUSION The laparoscopic approach is an effective method for treatment of perforated peptic ulcer in the elderly with a great diagnostic and therapeutic role. Nowadays more prospective randomized studies are needed to evaluate the effectiveness of laparoscopic versus open repair.
Collapse
|
15
|
Perrouin-Verbe MA, Schoentgen N, Talagas M, Garlantezec R, Uguen A, Doucet L, Rosec S, Marcorelles P, Potier-Cartereau M, Vandier C, Ferec C, Fromont G, Fournier G, Valeri A, Mignen O. Overexpression of certain transient receptor potential and Orai channels in prostate cancer is associated with decreased risk of systemic recurrence after radical prostatectomy. Prostate 2019; 79:1793-1804. [PMID: 31475744 DOI: 10.1002/pros.23904] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Accepted: 08/16/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND Several studies had suggested the potential role of calcium signaling in prostate cancer (PCa) prognosis and agressiveness. We aimed to investigate selected proteins contributing to calcium (Ca2+ ) signaling, (Orai, stromal interaction molecule (STIM), and transient receptor potential (TRP) channels) and involved in cancer hallmarks, as independent predictors of systemic recurrence after radical prostatectomy (RP). METHODS A case-control study including 112 patients with clinically localized PCa treated by RP between 2002 and 2009 and with at least 6-years' follow-up. Patients were divided into two groups according to the absence or presence of systemic recurrence. Expression levels of 10 proteins involved in Ca2+ signaling (TRPC1, TRPC4, TRPV5, TRPV6, TRPM8, STIM1, STIM2, Orai1, Orai2, and Orai3), were assessed by immunohistochemistry using tissue microarrays (TMAs) constructed from paraffin-embedded PCa specimens. The level of expression of the various transcripts in PCa was assessed using quantitative polymerase chain reaction (qPCR) analysis. RNA samples for qPCR were obtained from fresh frozen tissue samples of PCa after laser capture microdissection on RP specimens. Relative gene expression was analyzed using the 2-▵▵Ct method. RESULTS Multivariate analysis showed that increased expression of TRPC1, TRPC4, TRPV5, TRPV6, TRPM8, and Orai2 was significantly associated with a lower risk of systemic recurrence after RP, independently of the prostate-specific antigen (PSA) level, percentage of positive biopsies, and surgical margin (SM) status (P = .007, P = .01, P < .001, P = .0065, P = .007, and P = .01, respectively). For TRPC4, TRPV5, and TRPV6, this association was also independent of Gleason score and pT stage. Moreover, overexpression of TRPV6 and Orai2 was significantly associated with longer time to recurrence after RP (P = .048 and .023, respectively). Overexpression of TRPC4, TRPV5, TRPV6, and Orai2 transcripts was observed in group R- (3.71-, 5.7-, 1.14-, and 2.65-fold increase, respectively). CONCLUSIONS This is the first study to suggest the independent prognostic value of certain proteins involved in Ca2+ influx in systemic recurrence after RP: overexpression of TRPC1, TRPC4, TRPV5, TRPV6, TRPM8, and Orai2 is associated with a lower risk of systemic recurrence. TRPC4, TRPV5, and TRPV6 appear to be particularly interesting, as they are independent of the five commonly used predictive factors, that is, PSA, percentage of positive biopsies, SM status, Gleason score, and pT stage.
Collapse
Affiliation(s)
- M A Perrouin-Verbe
- Department of Urology, CHRU-Université de Brest, Brest, France
- INSERM UMR1078, Université de Bretagne Occidentale, Brest, France
- Department of Urology, CHU-Université de Nantes, Nantes, France
| | - N Schoentgen
- Department of Urology, CHRU-Université de Brest, Brest, France
- INSERM UMR1078, Université de Bretagne Occidentale, Brest, France
| | - M Talagas
- Department of Pathology, CHRU-Université de Brest, Brest, France
- EA 4685 - LIEN, Université de Bretagne Occidentale, Brest, France
| | - R Garlantezec
- INSERM UMR1085-IRSET, Université Rennes 1, Rennes, France
| | - A Uguen
- Department of Pathology, CHRU-Université de Brest, Brest, France
| | - L Doucet
- Department of Pathology, CHRU-Université de Brest, Brest, France
| | - S Rosec
- INSERM UMR1412, Centre d'Investigation Clinique, CHRU-Université de Brest, Brest, France
| | - P Marcorelles
- Department of Pathology, CHRU-Université de Brest, Brest, France
| | | | - C Vandier
- INSERM UMR1069, Université François Rabelais, Tours, France
| | - C Ferec
- INSERM UMR1078, Université de Bretagne Occidentale, Brest, France
| | - G Fromont
- INSERM UMR1069, Université François Rabelais, Tours, France
- Department of Pathology, CHRU-Université de Tours, Tours, France
| | - G Fournier
- Department of Urology, CHRU-Université de Brest, Brest, France
| | - A Valeri
- Department of Urology, CHRU-Université de Brest, Brest, France
| | - O Mignen
- INSERM UMR1078, Université de Bretagne Occidentale, Brest, France
- INSERM UMR1227, Université de Bretagne Occidentale, Brest, France
| |
Collapse
|
16
|
Nguyen T, Fourcade A, Payrard-Starck C, Tissot V, Marolleau J, Doucet L, Lucas C, Deruelle C, Joulin V, Fournier G, Valeri A. Faut-il encore biopsier les patients avec IRM prostatique normale ? Sur la piste de facteurs prédictifs de cancer prostatique. Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.092] [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: 11/27/2022]
|
17
|
Georges JF, Valeri A, Wang H, Brooking A, Kakareka M, Cho SS, Al-Atrache Z, Bamimore M, Osman H, Ifrach J, Yu S, Li C, Appelt D, Lee JYK, Nakaji P, Brill K, Yocom S. Delta-Aminolevulinic Acid-Mediated Photodiagnoses in Surgical Oncology: A Historical Review of Clinical Trials. Front Surg 2019; 6:45. [PMID: 31555659 PMCID: PMC6737001 DOI: 10.3389/fsurg.2019.00045] [Citation(s) in RCA: 15] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 07/17/2019] [Indexed: 12/11/2022] Open
Abstract
Fluorescence imaging is an emerging clinical technique for real-time intraoperative visualization of tumors and their boundaries. Though multiple fluorescent contrast agents are available in the basic sciences, few fluorescence agents are available for clinical use. Of the clinical fluorophores, delta aminolevulinic acid (5ALA) is unique for generating visible wavelength tumor-specific fluorescence. In 2017, 5ALA was FDA-approved for glioma surgery in the United States. Additionally, clinical studies suggest this agent may have utility in surgical subspecialties outside of neurosurgery. Data from dermatology, OB/GYN, urology, cardiothoracic surgery, and gastrointestinal surgery show 5ALA is helpful for intraoperative visualization of malignant tissues in multiple organ systems. This review summarizes data from English-language 5ALA clinical trials across surgical subspecialties. Imaging systems, routes of administration, dosing, efficacy, and related side effects are reviewed. We found that modified surgical microscopes and endoscopes are the preferred imaging devices. Systemic dosing across surgical specialties range between 5 and 30 mg/kg bodyweight. Multiple studies discussed potential for skin irritation with sun exposure, however this side effect is infrequently reported. Overall, 5ALA has shown high sensitivity for labeling malignant tissues and providing a means to visualize malignant tissue not apparent with standard operative light sources.
Collapse
Affiliation(s)
- Joseph F Georges
- Department of Neurosurgery, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, United States.,Department of Neurosurgery, Cooper University Healthcare, Philadelphia, PA, United States
| | - Amber Valeri
- Department of Neurosurgery, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, United States.,Department of Neurosurgery, Cooper University Healthcare, Philadelphia, PA, United States
| | - Huan Wang
- School of Medicine, Cooper Medical School of Rowan University, Camden, NJ, United States
| | - Aaron Brooking
- Department of Neurosurgery, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, United States.,Department of Neurosurgery, Cooper University Healthcare, Philadelphia, PA, United States
| | - Michael Kakareka
- Department of Neurosurgery, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, United States.,Department of Neurosurgery, Cooper University Healthcare, Philadelphia, PA, United States
| | - Steve S Cho
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.,Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, PA, United States
| | - Zein Al-Atrache
- School of Medicine, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, United States
| | - Michael Bamimore
- School of Medicine, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, United States
| | - Hany Osman
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, United States
| | - Joseph Ifrach
- School of Medicine, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, United States
| | - Si Yu
- School of Medicine, Cooper Medical School of Rowan University, Camden, NJ, United States
| | - Carrie Li
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Denah Appelt
- Department of Neurosurgery, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, United States
| | - John Y K Lee
- Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, PA, United States
| | - Peter Nakaji
- Department of Neurosurgery, St. Joseph's Hospital and Medical Center, Barrow Neurological Institute, Phoenix, AZ, United States
| | - Kristin Brill
- Department of Surgery, MD Anderson Cancer Center at Cooper Health Systems, Camden, NJ, United States
| | - Steven Yocom
- Department of Neurosurgery, Cooper University Healthcare, Philadelphia, PA, United States
| |
Collapse
|
18
|
Giordano A, Alemanno G, Bici K, Prosperi P, Viligiardi R, Bisogni D, Iacopini V, Dibella A, Valeri A. A dramatic and rare complication: bowel perforation following abdominal liposuction. G Chir 2019; 40:429-432. [PMID: 32003724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
AIM The purpose of this study is to analyze a rare and under-reported complication of abdominal liposuction and the role of laparoscopy. CLINICAL CASE We report a case of bowel perforation after 7 days of abdominal liposuction and bilateral mastopexy. The patient presented clinical and radiological findings of bowel obstructive syndrome and bilateral peripheral pulmonary embolism. An emergency diagnostic laparoscopy was performed and confirmed the diagnosis of bowel perforation. DISCUSSION Bowel perforation is a known but under-reported comSOD Romaplication of abdominal liposuction, and it is characterized by a difficult diagnosis. The clinical presentation is characterized by a difficult diagnosis and severe complications. Bowel obstructive syndrome was constant, as our case and also peritonitis was never frank. This is an important point because it is one of the reasons for diagnostic delay. The development of laparoscopic surgery has changed the way to manage such conditions, where the diagnosis was doubt. In particular, when an acute abdomen occurs, laparoscopy may have three different roles: to confirm or not the diagnosis, to facilitate and guide a subsequent laparotomy or, finally, to entirely treat the disease. CONCLUSION The bowel perforation is a dramatic and underestimated complication of abdominal liposuction. Diagnosis is complex. A clinical and radiological investigation should be quickly performed. In doubtful cases, an emergency laparoscopy can confirm the diagnosis and guide a possible subsequent laparotomy.
Collapse
|
19
|
Bisogni D, Valeri A, Talamucci L, Manetti R, Giordano ABF, Ardu M, Naspetti R, Prosperi P. Life-threatening bleeding for a large cameron ulcer. A novel description of a tailored-surgical strategy: report of a case and literature overview. G Chir 2019; 40:398-404. [PMID: 32003718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Hiatal hernias (HHs) are usually divided into two main groups: sliding and para-esophageal (torsional) ones. Sometimes patients presenting HHs experience progressive anemia, whereas rarely an acute anemia with melena or hematemesis can occur. In such cases a Cameron ulcer should be suspected and a careful esophago-gastro-duodenoscopy (EGDS) with a meticulous inspection of the mucosal folds along the neck of the hernia is the best examination in order to find out the ulcer itself. In front of massive hemorrhage due to a Cameron erosion, the first aim should be the control of the bleeding itself, in order to ree1Romastablish hemodynamic stability. The Authors report the case of a 72-year-old man presenting a severe bleeding secondary to a large Cameron ulcer in a para-esophageal hiatal hernia. Firstly, a combined medical-endoscopic therapy was tried; the patient underwent transfusions of pooled red blood cells and endovenous anti-acid therapy combined with an operative endoscopic treatment; unfortunately this initial approach failed, therefore the patient was referred to surgery. The surgeons realized a minimally invasive atypical gastric resection associated with the HH repair; the post-operative course was uneventful and no other rebleeding episodes occurred. The urgency treatment of a life-threatening bleeding for Cameron ulcers remains a very challenging problem as no univocal and standardized recommendation has been described in literature since now. In this case-report the Authors make an overview of the current literature on the treatment of Cameron ulcers, describing a novel surgical technique for massive upper gastro-intestinal bleeding secondary to these lesions.
Collapse
|
20
|
Szabla N, Benbouzid S, Larre S, Gaudez F, Matillon X, Thuret R, Valeri A, Blanchereau J, Timsit M, Boutin J, Culty T, Bensadoun H, Salomon L, Neuzillet Y, Bouillet S, Terrier N, Lechevallier E, Verhoest G, Sallusto F, Tillou X. Une étude nationale des traitements conservateurs des tumeurs du greffon rénal : vers les thérapies ablatives. Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
21
|
Schoentgen N, Marolleau J, Valeri A, Rousseau B, Fournier G. Suivi à long terme après prostatectomie et curage ganglionnaire étendu d’une cohorte de patient atteint d’un cancer de prostate localisé avec envahissement ganglionnaire : intérêt du curage ? Prog Urol 2018. [DOI: 10.1016/j.purol.2018.07.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
22
|
Dissaux G, Bert J, Visvikis D, Pradier O, Valeri A, Schick U. Modélisation dosimétrique de la curiethérapie focale prostatique à bas débit de dose : bénéfice d’un traitement de la lésion index associé à une irradiation prophylactique. Cancer Radiother 2018. [DOI: 10.1016/j.canrad.2018.07.079] [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: 10/28/2022]
|
23
|
Martellucci J, Sturiale A, Bergamini C, Boni L, Cianchi F, Coratti A, Valeri A. Role of transanal irrigation in the treatment of anterior resection syndrome. Tech Coloproctol 2018; 22:519-527. [PMID: 30083782 DOI: 10.1007/s10151-018-1829-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 07/23/2018] [Indexed: 01/17/2023]
Abstract
BACKGROUND Transanal irrigation(TAI) has been reported to be an inexpensive and effective treatment for low anterior resection syndrome(LARS). The aim of the present prospective study was to evaluate the use of TAI in patients with significant LARS symptoms at a single medical center. METHODS Patients who had low anterior resection for rectal cancer between April 2015 and May 2016 at the Careggi University Hospital were assessed for LARS using the LARS and the Memorial Sloan-Kettering Cancer Center Bowel Function Instrument (MSKCC BFI) questionnaires 30-40 days after surgery or ileostomy closure (if this was done). Quality of life was evaluated using a visual analog scale and the Short Form-36 Health Survey. All patients with LARS score of 30 or higher were included (early LARS) as were all patients with a LARS score of 30 or higher referred 6 months or longer after surgery performed elsewhere (chronic LARS) in the same study period. Study participants were trained to perform TAI using the Peristeen™ System for 6 months, followed by 3 months of enema therapy following a similar protocol. RESULTS Thirty-three patients were enrolled in the study. Six patients stopped the treatment. The 27 patients (19 early LARS and 8 chronic LARS) who completed the study had a significant decrease in the number of median daily bowel movements [baseline 7 (range 0-14); 6 months 1 (range 0-4); 9 months 4 (range 0-13)]. The median LARS Score fell from 35.1 (range 30-42) (baseline) to 12.2 (range 0-21) after 6 months (p < 0.0001) and then rose to 27 (range 5-39) after 3 months of enema therapy. There was no difference in LARS score decrease at 6 months between the patients with early and chronic LARS (22.5 and 23.9 respectively; p=0.7) and there were no predictors of score decrease. Four components of the SF-36 significantly improved during the TAI period. The MSKCC BFI score significantly improved in several domains. Twenty-three patients (85%) asked to continue the treatment with TAI after the study ended. CONCLUSIONS TAI appears to be an effective treatment for LARS and results in a marked improvement of continence and quality of life. Patients may be assessed and treated for LARS early after surgery since the treatment benefit is similar to that observed in patients with LARS diagnosed 6 months or longer after surgery. The potential rehabilitative role of TAI for LARS is promising and should be further investigated.
Collapse
Affiliation(s)
- J Martellucci
- General Emergency and Minimally Invasive Surgery, Careggi University Hospital, largo Brambilla 3, 50134, Florence, Italy.
| | - A Sturiale
- General Emergency and Minimally Invasive Surgery, Careggi University Hospital, largo Brambilla 3, 50134, Florence, Italy
| | - C Bergamini
- General Emergency and Minimally Invasive Surgery, Careggi University Hospital, largo Brambilla 3, 50134, Florence, Italy
| | - L Boni
- Clinical Trial Center, Careggi University Hospital, Florence, Italy
| | - F Cianchi
- General and Endocrine Surgery, Careggi University Hospital, Florence, Italy
| | - A Coratti
- Oncologic and Robotic Surgery, Careggi University Hospital, Florence, Italy
| | - A Valeri
- General Emergency and Minimally Invasive Surgery, Careggi University Hospital, largo Brambilla 3, 50134, Florence, Italy
| |
Collapse
|
24
|
Boussion N, Valeri A, Malhaire J, Visvikis D. PO-0897: Predicting the number of seeds in LDR prostate brachytherapy using machine learning and 320 patients. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31207-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
25
|
Carreño-Tarragona G, Cedena T, Montejano L, Alonso R, Miras F, Valeri A, Rivero A, Lahuerta JJ, Martinez-Lopez J. Papain-treated panels are a simple method for the identification of alloantibodies in multiple myeloma patients treated with anti-CD38-based therapies. Transfus Med 2018; 29:193-196. [DOI: 10.1111/tme.12508] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 12/18/2017] [Accepted: 12/31/2017] [Indexed: 12/31/2022]
Affiliation(s)
- G. Carreño-Tarragona
- Department of Hematology; Hospital Universitario 12 de Octubre, Universidad Complutense, CNIO; Madrid Spain
| | - T. Cedena
- Department of Hematology; Hospital Universitario 12 de Octubre, Universidad Complutense, CNIO; Madrid Spain
| | - L. Montejano
- Department of Hematology; Hospital Universitario 12 de Octubre, Universidad Complutense, CNIO; Madrid Spain
| | - R. Alonso
- Department of Hematology; Hospital Universitario 12 de Octubre, Universidad Complutense, CNIO; Madrid Spain
| | - F. Miras
- Department of Hematology; Hospital Universitario 12 de Octubre, Universidad Complutense, CNIO; Madrid Spain
| | - A. Valeri
- Department of Hematology; Hospital Universitario 12 de Octubre, Universidad Complutense, CNIO; Madrid Spain
| | - A. Rivero
- Department of Hematology; Hospital Universitario 12 de Octubre, Universidad Complutense, CNIO; Madrid Spain
| | - J. J. Lahuerta
- Department of Hematology; Hospital Universitario 12 de Octubre, Universidad Complutense, CNIO; Madrid Spain
| | - J. Martinez-Lopez
- Department of Hematology; Hospital Universitario 12 de Octubre, Universidad Complutense, CNIO; Madrid Spain
| |
Collapse
|
26
|
Callerot P, Valeri A, Fournier G, Moineau M, Cussenot O, Doucet L, Cancel-tassin G, Cormier L. Dépistage du cancer de la prostate dans les familles à risque. Le nombre d’apparentés atteints et l’âge précoce de diagnostic dans la famille augmentent le risque de CaP. Prog Urol 2017. [DOI: 10.1016/j.purol.2017.07.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
27
|
Kabbaj O, Robin P, Fournier G, Valeri A, Bourhis D, Dissaux G, Salaun P, Pradier O, Malhaire J, Abgral R, Schick U. Target Definition in Salvage Postoperative Radiation Therapy for Prostate Cancer: 18F-Fluorocholine PET/CT Assessment of Local Relapse. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
28
|
Thoulouzan M, Perrouin-Verbe MA, Calves J, Deruelle C, Joulin V, Valeri A, Fournier G. [Outcomes of GreenLight XPS-180W laser photovaporization for BPH larger than 80mL]. Prog Urol 2017; 27:489-496. [PMID: 28483481 DOI: 10.1016/j.purol.2017.04.001] [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: 09/05/2016] [Revised: 03/13/2017] [Accepted: 04/02/2017] [Indexed: 10/19/2022]
Abstract
AIM To evaluate the results of GreenLight XPS photovaporization (PVP/XPS) with intraoperative transrectal ultrasonographic monitoring for the treatment of large Benign Prostatic Hyperplasia (BPH) (>80mL). PATIENTS AND METHODS Operative and perioperative data of 82 patients were collected prospectively. Complications and functional outcomes (IPSS, quality of life (QoL) score, maximal flow rate and post-void residual (PVR)) were evaluated at 1, 3, 12 months post-operatively prostate volume and PSA were assessed at 3 and 12 months post-operatively. RESULTS Median patient age was 68.5years (50-85). Twenty percent had an indwelling catheter and 5%/22% were on anticoagulant/antiplatelet therapy. Median prostate volume and PSA were 103mL (80-220) and 6.4ng/mL (0.66-44.0). Median operative time and energy delivered were 107min (46-219) and 581kJ (212-1193). Energy delivered/prostate volume was 5.4kJ/mL (1.6-10.5). Transurethral catheter was removed at day 1 or 2 in 96% of cases. Patients were discharged as outpatient, p.o. day 1 or day 2 in 4%, 55% and 21% of cases, respectively. Transfusion and Clavien≥3 complication rates were 1.2% and 3.7%. Significant improvement of IPSS (4 vs 19.5), QoL (1 vs 5), maximum flow rate (19.1 vs 8.2mL/s) and PVR (26 vs 100mL) was observed (P<0.001) at 12-months evaluation. PSA and prostate volume were decreased by 61 and 62%. Late complications were urethral strictures (6%), stress incontinence (1.2%). Eighty-five percent of patients had no antegrade ejaculation. CONCLUSION The treatment of large BPH with PVP/XPS is safe and effective, with a long operative time. The functional outcomes are good and stable at mid-term evaluation. LEVEL OF EVIDENCE 4.
Collapse
Affiliation(s)
- M Thoulouzan
- Service de chirurgie urologique et de transplantation rénale, hôpital de la Cavale-Blanche, centre hospitalier régional universitaire de Brest, 29200 Brest, France.
| | - M-A Perrouin-Verbe
- Service de chirurgie urologique et de transplantation rénale, hôpital de la Cavale-Blanche, centre hospitalier régional universitaire de Brest, 29200 Brest, France
| | - J Calves
- Service de chirurgie urologique et de transplantation rénale, hôpital de la Cavale-Blanche, centre hospitalier régional universitaire de Brest, 29200 Brest, France
| | - C Deruelle
- Service de chirurgie urologique et de transplantation rénale, hôpital de la Cavale-Blanche, centre hospitalier régional universitaire de Brest, 29200 Brest, France
| | - V Joulin
- Service de chirurgie urologique et de transplantation rénale, hôpital de la Cavale-Blanche, centre hospitalier régional universitaire de Brest, 29200 Brest, France
| | - A Valeri
- Service de chirurgie urologique et de transplantation rénale, hôpital de la Cavale-Blanche, centre hospitalier régional universitaire de Brest, 29200 Brest, France
| | - G Fournier
- Service de chirurgie urologique et de transplantation rénale, hôpital de la Cavale-Blanche, centre hospitalier régional universitaire de Brest, 29200 Brest, France
| |
Collapse
|
29
|
Mountris KA, Bert J, Noailly J, Aguilera AR, Valeri A, Pradier O, Schick U, Promayon E, Ballester MAG, Troccaz J, Visvikis D. Modeling the impact of prostate edema on LDR brachytherapy: a Monte Carlo dosimetry study based on a 3D biphasic finite element biomechanical model. Phys Med Biol 2017; 62:2087-2102. [PMID: 28140369 DOI: 10.1088/1361-6560/aa5d3a] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
30
|
Peyronnet B, Belas O, Capon G, Manunta A, Callerot P, Allenet C, Tondut L, Belas M, Perrouin-verbe M, Vincendeau S, Gobeaux N, Pasticier G, Desportes L, Valeri A, Colla S, Descazeaud A, Robert G, Fournier G. Résultats de la voie d’abord robot-assistée pour l’implantation du sphincter artificiel urinaire AMS 800 chez la femme : une étude multicentrique. Prog Urol 2016. [DOI: 10.1016/j.purol.2016.07.270] [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]
|
31
|
Perrouin-verbe M, Mignen O, Doucet L, Talagas M, Rosec S, Fournier G, Valeri A. Remodelage de la signalisation calcique dans la tumeur prostatique : signature moléculaire de la récidive du cancer de prostate après chirurgie ? Prog Urol 2015; 25:839. [DOI: 10.1016/j.purol.2015.08.245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
32
|
Coquet J, Delage F, Perrouin-Verbe M, Malhaire J, Schoentgen N, Fourcade A, Rousseau B, Thoulouzan M, Callerot P, Fournier G, Valeri A. Évaluation du « Quadrella » a 2ans : nouvel indice de performance oncologique et fonctionnelle spécifique de la curiethérapie prostatique. Prog Urol 2015; 25:836-7. [DOI: 10.1016/j.purol.2015.08.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
33
|
Thoulouzan M, Huet R, Mathieu R, Berquet G, Bensalah K, Calves J, Coeurdacier P, Corbel L, Della negra E, Gires B, Graffeille V, Perrouin-verbe M, Peyronnet B, Serey-eiffel S, Valeri A, Verhoest G, Vincendeau S, Fournier G. Résultats fonctionnels après traitement de l’HBP par laser Greenlight XPS : étude prospective multicentrique (575 patients). Prog Urol 2015; 25:781. [DOI: 10.1016/j.purol.2015.08.134] [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: 11/27/2022]
|
34
|
Thoulouzan M, Huet R, Mathieu R, Berquet G, Bensalah K, Calves J, Coeurdacier P, Corbel L, Della Negra E, Gires B, Graffeille V, Perrouin-Verbe M, Peyronnet B, Serey-Eiffel S, Valeri A, Verhoest G, Vincendeau S, Fournier G. Photovaporisation laser Greenlight XPS pour les adénomes prostatiques de gros volume : une étude prospective multicentrique. Prog Urol 2015; 25:729-30. [DOI: 10.1016/j.purol.2015.08.029] [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: 11/17/2022]
|
35
|
Léon P, Kloutidis N, Calves J, Compérat E, Funes de la Vega M, Cancel Tassin G, Ciofu C, Haab F, Fournier G, Korman P, Valeri A, Rouprêt M, Cormier L, Larré S, Cussenot O. [Not Available]. Prog Urol 2015; 24:784. [PMID: 26461534 DOI: 10.1016/j.purol.2014.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- P Léon
- Service d'urologie et andrologie, hôpital de la Pitié-Salpêtrière, Paris, France
| | - N Kloutidis
- Service d'urologie, CHU de Dijon, Dijon, France
| | - J Calves
- Service d'urologie, CHU de Brest, Brest, France
| | - E Compérat
- Service d'anatomopathologie, hôpital de la Pitié-Salpêtrière, CeRePP, Paris, France
| | | | - G Cancel Tassin
- GRC-N(o)5 Institut universitaire de cancérologie Paris 6 (urologie-anatomo-pathologie Pitié/Tenon), CeReSPP, Paris, France
| | - C Ciofu
- GRC-N(o)5 Institut universitaire de cancérologie Paris 6 (urologie-anatomo-pathologie Pitié/Tenon), CeReSPP, Paris, France
| | - F Haab
- GRC-N(o)5 Institut universitaire de cancérologie Paris 6 (urologie-anatomo-pathologie Pitié/Tenon), CeReSPP, Paris, France
| | - G Fournier
- Service d'urologie du CHU de Brest et CeRePP, Brest, France
| | - P Korman
- Myriad Genetics SAS, Issy les Moulineaux, France
| | - A Valeri
- Service d'urologie du CHU de Brest et CeRePP, Brest, France
| | - M Rouprêt
- GRC-N(o)5 Institut universitaire de cancérologie Paris 6 (urologie-anatomo-pathologie Pitié/Tenon), CeReSPP, Paris, France
| | - L Cormier
- Service d'urologie, CHU de Dijon, CeRePP, Dijon, France
| | - S Larré
- Service d'urologie, CHU de Reims, CeRePP, Reims, France
| | - O Cussenot
- GRC-N(o)5 Institut universitaire de cancérologie Paris 6 (urologie-anatomo-pathologie Pitié/Tenon), CeReSPP, Paris, France
| |
Collapse
|
36
|
Serey-Eiffel S, Coquet JB, Fournier G, Valeri A, Perrouin-Verbe MA. [Outpatient suburethral sling in women: Review of the literature]. Prog Urol 2015; 25:1204-12. [PMID: 26149176 DOI: 10.1016/j.purol.2015.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 05/31/2015] [Accepted: 06/01/2015] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The aim of this study was to assess efficacy, complication and feasibility of outpatient suburethral slings for stress urinary incontinence in women. MATERIAL AND METHODS A systematic review of the literature was done from the Pubmed data-base by searching following keywords: suburethral sling, midurethral sling, TVT, TOT, outpatient surgery, day surgery. RESULTS Seventy-eight percent to 88% of patients were continent postoperatively, and 6.8 to 12% of patients were significantly improved. No major complication occurred and minor complications were observed in 7.2 to 19.8% of patients. Eighty to 86.6% of patients experienced no complication. Seventy percent to 100% of patients were discharged on post operative day 0. The satisfaction rate was 89.4 to 95%. CONCLUSION Outpatient suburethral sling for stress urinary incontinence is suitable, effective, with a low complication rate, and with a high rate of satisfaction.
Collapse
Affiliation(s)
- S Serey-Eiffel
- Service d'urologie, CHU de Brest, 20, boulevard Tanguy-Prigent, 29200 Brest, France.
| | - J-B Coquet
- Service d'urologie, CHU de Brest, 20, boulevard Tanguy-Prigent, 29200 Brest, France
| | - G Fournier
- Service d'urologie, CHU de Brest, 20, boulevard Tanguy-Prigent, 29200 Brest, France
| | - A Valeri
- Service d'urologie, CHU de Brest, 20, boulevard Tanguy-Prigent, 29200 Brest, France
| | - M-A Perrouin-Verbe
- Service d'urologie, CHU de Brest, 20, boulevard Tanguy-Prigent, 29200 Brest, France
| |
Collapse
|
37
|
Affiliation(s)
- J Radhakrishnan
- Columbia University College of Physicians and Surgeons, New York, USA
| | | | | | | |
Collapse
|
38
|
|
39
|
Schoentgen N, Delage F, Perrouin Verbe M, Le Fur E, Coquet J, Malhaire J, Pradier O, Fournier G, Valeri A. Étude prospective, sur 4 ans, de l’évolution de la fonction érectile après curiethérapie prostatique à l’iode 125 chez des patients ayant un score IIEF5 initial>16. Prog Urol 2014; 24:874. [DOI: 10.1016/j.purol.2014.08.198] [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: 11/29/2022]
|
40
|
Moulin M, Fourcade A, Phan Q, Mege J, Valeri A, Mourey E, Fournier G, Cormier L. Comparaison des résultats de prédiction du risque d’envahissement ganglionnaire du score de Roach et des tables de Partin : étude multicentrique. Prog Urol 2014; 24:785. [DOI: 10.1016/j.purol.2014.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
41
|
Rousseau B, Doucet L, Perrouin Verbe MA, Papin G, Erauso A, Joulin V, Deruelle C, Valeri A, Fournier G. Comparaison de la morbidité entre curage étendu et curage limité au cours de la prostatectomie radicale laparoscopique. Prog Urol 2014; 24:114-20. [DOI: 10.1016/j.purol.2013.07.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2013] [Revised: 07/25/2013] [Accepted: 07/29/2013] [Indexed: 11/29/2022]
|
42
|
Delage F, Le Fur E, Perrouin-Verbe M, Papin G, Rousseau B, Loiselle A, Thoulouzan M, Coquet J, Malhaire J, Pradier O, Fournier G, Valeri A. Évolution de la fonction érectile après curiethérapie prostatique à l’iode 125 pour tumeur localisée de faible risque : étude prospective chez des patients ayant un score IIEF5 initial>16. Prog Urol 2013. [DOI: 10.1016/j.purol.2013.08.103] [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: 11/17/2022]
|
43
|
Fournier G, Perrouin-Verbe M, Papin G, Thoulouzan M, Valeri A. Bandelette rétrourétrale transobturatrice Advance XP : technique chirurgicale étape par étape. Prog Urol 2013. [DOI: 10.1016/j.purol.2013.08.281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
44
|
Greto D, Paiar F, Saieva C, Galardi A, Mangoni M, Livi L, Agresti B, Franceschini D, Bonomo P, Scotti V, Detti B, Tonelli F, Valeri A, Messerini L, Biti G. Neoadjuvant oxaliplatin and 5-fluorouracil with concurrent radiotherapy in patients with locally advanced rectal cancer: a singleinstitution experience. Radiol Med 2013; 118:570-82. [DOI: 10.1007/s11547-012-0909-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Accepted: 02/14/2012] [Indexed: 12/12/2022]
|
45
|
Le Fur E, Malhaire J, Baverez D, Delage F, Perrouin-Verbe M, Schlurmann F, Guerif S, Fournier G, Pradier O, Valeri A. Impact of learning curve and technical changes on dosimetry in low-dose brachytherapy for prostate cancer. Strahlenther Onkol 2012; 188:1091-5. [DOI: 10.1007/s00066-012-0242-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Accepted: 09/17/2012] [Indexed: 11/30/2022]
|
46
|
Thoulouzan M, Perrouin-Verbe MA, Deruelle C, Joulin V, Valeri A, Loiselle A, Fournier G. Traitement de l’hyperplasie bénigne de prostate (HBP) par laser Greenlight™ XPS (180W) avec contrôle échographique endorectal en temps réel : résultats à moyen terme. Prog Urol 2012. [DOI: 10.1016/j.purol.2012.08.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
47
|
Erauso A, Perrouin-Verbe MA, Papin G, Volant A, Doucet L, Joulin V, Deruelle C, Rousseau B, Valeri A, Fournier G. [Urinary continence following laparoscopic radical prostatectomy: qualitative analysis]. Prog Urol 2012; 22:945-53. [PMID: 23102017 DOI: 10.1016/j.purol.2012.07.005] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Revised: 07/06/2012] [Accepted: 07/11/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE The main purpose of this study was to report urinary continence after laparoscopic radical prostatectomy (LRP) for localised prostate cancer and the return to baseline rate for urinary continence. The minor purpose was to determine the risk factors, which influence return to baseline urinary continence after radical prostatectomy. METHODS Prospective evaluation of urinary continence with self-administered questionnaire in 300 consecutive LRP for localized prostate cancer. RESULTS After LRP, at 3, 6 and 12 months, respectively 12.5%, 23% and 33.7% of patients recover baseline urinary continence. Fifty-four percent, 72.3% and 78.4% of patients did not wear pads 3, 6 and 12 months after LRP. In patients without pad, 43 % recovered baseline continence one year after radical prostatectomy. In univariate analysis, age older than 60 years (P=0.003, P=0.003, P=0.02, 3, 6 and 12 months after LRP) and no sparing of neurovascular bundles (P=0.01, P=0.08 at 3 and 6 months after LRP) were risks factors of urinary incontinence. In multivariate analysis, only age older than 60 years (P=0.018, P=0.01 and P=0.01 at 3, 6 and 12 months after LRP) was a risk factor of urinary incontinence. CONCLUSION One year after LRP, 66.3% of patients had urinary incontinence according to our evaluation using stringent criteria, i.e. return to baseline continence status. However, only 21.6% of patients wore pads and less than 2% wore more than two pads per day.
Collapse
Affiliation(s)
- A Erauso
- Service d'urologie, hôpital de la Cavale Blanche, CHRU de Brest, Brest, France.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Valeri A, Fiorenzani P, Rossi R, Aloisi AM, Valoti M, Pessina F. The soy phytoestrogens genistein and daidzein as neuroprotective agents against anoxia-glucopenia and reperfusion damage in rat urinary bladder. Pharmacol Res 2012; 66:309-16. [PMID: 22743170 DOI: 10.1016/j.phrs.2012.06.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Revised: 06/13/2012] [Accepted: 06/18/2012] [Indexed: 11/25/2022]
Abstract
Some bladder disorders, such as obstructive bladder and hyperactivity, may be caused partly by ischemia/reperfusion injury (I/R). The neuroprotective effects of estrogens were demonstrated in in vitro studies and a great interest in soy isoflavones (genistein and daidzein) as alternative to the synthetic estrogen receptor modulators for therapeutic use has been pointed out. The aim of this study was to investigate the effect of genistein and daidzein, on rat detrusor smooth muscle contractility and their possible neuroprotective role against I/R-like condition. Whole rat urinary bladders were subjected to in vitro anoxia-glucopenia (A-G) and reperfusion (R) in the absence or presence of drugs and response to electrical field stimulation (EFS) of intrinsic nerves evaluated. Furthermore rats were treated in vivo for 1 week with the phytoestrogens and the same in vitro protocol was applied to the ex vivo bladders. Antioxidant activity of genistein and daidzein on the A-G/R model was determined by measuring malonyldialdehyde (MDA). Moreover, hormones plasma levels were determined by radioimmunoassay. Genistein and daidzein administered either in vitro or in vivo showed significant neuroprotective effect and antioxidant activity. Testosterone and 17β-estradiol plasma levels were not modified by daidzein, while a significant decrease of testosterone in genistein treated rats was evident. Moreover both phytoestrogens significantly decreased detrusor contractions induced by EFS in a concentration-dependent manner. For being either neuroprotective and myorelaxant, genistein and daidzein could be considered a good lead for new therapeutic agents to protect the urinary bladder from hyperactivity and nerve damage.
Collapse
Affiliation(s)
- A Valeri
- Clinica San Carlo, Paderno Dugnano, Milano, Italy
| | | | | | | | | | | |
Collapse
|
49
|
Rapizzi E, Ercolino T, Canu L, Giaché V, Francalanci M, Pratesi C, Valeri A, Mannelli M. Mitochondrial function and content in pheochromocytoma/paraganglioma of succinate dehydrogenase mutation carriers. Endocr Relat Cancer 2012; 19:261-9. [PMID: 22323561 DOI: 10.1530/erc-11-0263] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
To date, the consequences of succinate dehydrogenase (SDH) impairment on overall mitochondrial functions are still obscure. In this study, we evaluated SDH activity and expression and mitochondrial homeostasis in 57 tissue samples of pheochromocytoma (PHEO)/paraganglioma (PGL) obtained from patients genotyped for PHEO/PGL susceptibility genes. The resulted SDH activity and content always decreased in SDH-mutated tumors, in one out of two MAX-mutated patients and in four patients resulted wild type (wt) at genetic screening. All these four wt patients were further screened for large deletions in SDH genes, TMEM127 and MAX and resulted wt but two had somatic SDHD mutations. The RT-PCR in the MAX-mutated sample suggests that the decrease in SDH depends on complex instability and not on a reduced SDHB expression. SDH mutations neither alter citrate synthase (CS) activity nor the content of voltage-dependent anion channel (VDAC) while the expression of the mitochondrial complex IV (cytochrome c oxidase (COX)) was found extremely variable in all (mutated and wt) samples suggesting an impairment of mitochondrial cristae in these tumors. In conclusion, tumors from patients with germ line SDH mutations invariably show decreased enzymatic activity and content, but an SDH impairment may also depend on SDH somatic mutations or, seemingly, on MAX mutations. The impaired SDH activity in the two wt tissues suggests mutations in other still unknown susceptibility genes. Finally, the extreme variability in COX expression levels is yet to be explained and this strongly suggests to evaluate other mitochondrial features to better understand the mitochondrial role in the pathogenesis of these tumors.
Collapse
Affiliation(s)
- E Rapizzi
- Endocrinology Unit, Department of Clinical Pathophysiology, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy
| | | | | | | | | | | | | | | |
Collapse
|
50
|
Yates DR, Hupertan V, Colin P, Ouzzane A, Descazeaud A, Long JA, Pignot G, Crouzet S, Rozet F, Neuzillet Y, Soulie M, Bodin T, Valeri A, Cussenot O, Rouprêt M. Cancer-specific survival after radical nephroureterectomy for upper urinary tract urothelial carcinoma: proposal and multi-institutional validation of a post-operative nomogram. Br J Cancer 2012; 106:1083-8. [PMID: 22374463 PMCID: PMC3304431 DOI: 10.1038/bjc.2012.64] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Background: Owing to the scarcity of upper urinary tract urothelial carcinoma (UUT-UC) it is often necessary for investigators to pool data. A patient-specific survival nomogram based on such data is needed to predict cancer-specific survival (CSS) post nephroureterectomy (NU). Herein, we propose and validate a nomogram to predict CSS post NU. Patients and methods: Twenty-one French institutions contributed data on 1120 patients treated with NU for UUT-UC. A total of 667 had full data for nomogram development. Study population was divided into the nomogram development cohort (397) and external validation cohort (270). Cox proportional hazards regression models were used for univariate and multivariate analyses and to build a nomogram. A reduced model selection was performed using a backward step-down selection process, and Harrell's concordance index (c-index) was used for quantifying the nomogram accuracy. Internal validation was performed by bootstrapping and the reduced nomogram model was calibrated. Results: Of the 397 patients in the nomogram development cohort, 91 (22.9%) died during follow-up, of which 66 (72.5%) died as a consequence of UUT-UC. The actuarial CSS probability at 5 years was 0.76 (95% CI, 71.62-80.94). On multivariate analysis, T stage (P<0.0001), N status (P=0.014), grade (P=0.026), age (P=0.005) and location (P=0.022) were associated with CSS. The reduced nomogram model had an accuracy of 0.78. We propose a nomogram to predict 3 and 5-year CSS post NU for UUT-UC. Conclusion: We have devised and validated an accurate nomogram (78%), superior to any single clinical variable or current model, for predicting 5-year CSS post NU for UUT-UC.
Collapse
Affiliation(s)
- D R Yates
- Academic Department of Urology of la Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine Pierre et Marie Curie, University Paris VI, 47-83 Boulevard de l'Hopital, Paris 75013, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|