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Prise en charge du cancer de prostate métastasé androgéno-indépendant
2008
- Réf : Prog Urol, 2008, 12, 18, S343, suppl. S7

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After first line hormonal therapy (agonist LHRH), metastasic prostate cancer becomes androgen independent in a period of 18 months on average. After this period and after having verified the castration by blood testosterone level, a few options are possible: either inhibit adrenal androgens by maximum androgen blockage (+anti androgens) or by specific adrenal androgen inhibitors. It is also possible to use estrogen or, in a few cases, to propose chemotherapy.

Mots clés:
cancer de prostate / Hormonothérapie / Deuxième ligne / Blocage androgénique / Échappement hormonal
Mots-clés:
Prostate cancer / Hormonotherapy / 2 / line / Androgen blockage
Prise en charge du cancer rénal métastatique
2008
- Réf : Prog Urol, 2008, 12, 18, S298, suppl. S7

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Metastatic renal carcinoma concerns 30 to 50% of patients. The principal localisations are lung, liver, bone and brain. In case of unique localisation the treatment is almost surgical whatever the organ may be with sometimes long remissions. In case of many localisations, targeted therapy is the gold standard of treatment in first or second line. In France, today, 4 drugs are currently approved (sunitinib, sorafenib, temsirolimus, bevacizumab). Because of a poor prognosis trials testing combinaison of therapies are required to benefit patients. At least nephrectomy is necessary looking forward prospective studies to estimate its real impact.

Mots clés:
Carcinome rénal / cancer du rein / Tumeur rénale / Traitement antiangiogénique / Néphrectomie
Mots-clés:
Renal cell carcinoma / Antiangiogenic treatment / nephrectomy / Metastasis / Targeted therapy
Sites métastatiques atypiques des tumeurs germinales du testicule
2008
- Réf : Prog Urol, 2008, 12, 18, S388, suppl. S7


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Testicular carcinoma metastatic are most frequently localized in lungs, liver, brain or bone. Nevertheless many other areas have also been described. Using Pubmed and Cochrane the most exhaustive research possible has been carried out to list these secondary prostate carcinoma lesions.

Mots clés:
Cancer du testicule / Métastase / Épidémiologie
Mots-clés:
Testis carcinoma / metastasis / epidemiology
Sites métastatiques atypiques des tumeurs urothéliales
2008
- Réf : Prog Urol, 2008, 12, 18, S289, suppl. S7


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The liver, the lungs lung and bone are the most frequent sites for urothelial carcinoma metastasis. Nevertheless many other areas have also been described. Using Pubmed and Cochrane the most exhaustive research possible has been carried out to list these secondary urothelial carcinoma lesions.

Mots clés:
carcinome urothélial / Cancer de vessie / Métastase / Chirurgie / Cystectomie
Mots-clés:
Urothelial carcinoma / Bladder carcinoma / metastasis / Surgery / Cystectomy
Sites métastatiques atypiques du cancer du pénis
2008
- Réf : Prog Urol, 2008, 12, 18, S396, suppl. S7

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The liver, the lungs lung and bone are the most frequent sites for urothelial carcinoma metastasis. Nevertheless many other areas have also been described. Using Pubmed and Cochrane the most exhaustive research possible has been carried out to list these secondary urothelial carcinoma lesions.

Mots clés:
cancer du pénis / Métastase / Épidémiologie
Mots-clés:
Penile cancer / Metastasis / epidemiology
Sites métastatiques atypiques du cancer du rein
2008
- Réf : Prog Urol, 2008, 12, 18, S320, suppl. S7

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The lung, the liver, the bone tissue and the brain are the most frequent site for renal cell carcinoma metastasis. Nevertheless many other areas have also been described. Using Pubmed and Cochrane the most exhaustive research possible has been carried out to list these secondary renal carcinoma lesions.

Mots clés:
Carcinome rénal / cancer du rein / Métastase / Épidémiologie
Mots-clés:
Renal cell carcinoma / Metastasis / epidemiology
Thérapies ciblées
2008
- Réf : Prog Urol, 2008, 12, 18, S228, suppl. S7

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The definition of targets in the metastatic process has been a major step. Targeted therapy is composed of molecules which block these targets including ligand-binding antibody or receptor–inhibitors. Their mechanisms of action are not limited to angiogenesis but also concern apoptosis, bone marrow progenitor stem cells, vascularisation and immune response. An important number of drugs is still approved. However the metastatic disease is not yet curable. A better understanding will lead to develop others new targeted molecules or more efficient combination therapy.

Mots clés:
Métastase / Traitement ciblé / angiogenèse / Inhibiteur de récepteur / Anticorps se liant à un récepteur cytoplasmique
Mots-clés:
Metastasis / Targeted therapy / Angiogenesis / Receptor-inhibitor / Ligand-binding antibody
Traitement chirurgical des métastases des os longs des cancers urologiques
2008
- Réf : Prog Urol, 2008, 12, 18, S246, suppl. S7

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Orthopedic surgery is an important part in the treatment of metastatic bone disease of urologic cancers. It integrates in with the multidisciplinary care focused on the improvement of the patient’s comfort and autonomy. The long bones affect presents a grave fractural risk that is sometimes difficult to evaluate. There are several different therapeutic possibilities: prophylactic internal fixation, stabilisation of pathologic fracture, orthopedic cement filling, resection arthroplasty and en bloc resection. The choice of surgical treatment stresses the survival and fonctional risk of the metastasis. From palliative to curative, surgical treatment is evolving with the use of newer chemotherapies.

Mots clés:
Métastase osseuse / Risque fracturaire / cancer de prostate / Chirurgie / Orthopédie
Mots-clés:
Bone metastasis / Fractural risk / Prostate cancer / surgery / Orthopedy
Traitement médical des tumeurs germinales testiculaires au stade métastatique
2008
- Réf : Prog Urol, 2008, 12, 18, S376, suppl. S7

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The treatment options in metastatic testicular germ cell cancer are based on prognostic the factor-based staging system from IGCCCG. Since 1987 (!), the optimal chemotherapy regimen has been BEP with a weekly administration of 30mg of bleomycine, and a 3 or 5-day schedule of 500mg/m2 etoposide and 100mg/m2 cisplatin. Dose reduction of this regimen or use of carboplatin provide lower efficacy and should be abandoned.

As a first line treatment, 3 cycles of BEP should be used in good-risk metastatic nonseminomatous germ cell tumours whereas 4 cycles of BEP are mandatory in poor-risk nonseminomatous cancers. No other chemotherapy regimen has proven superior efficacy. In the lack of specific controlled studies, metastatic seminoma should be treated as nonseminomatous tumours. As second line treatment, VeIP, high-dose chemotherapy with autologous stem cell transplantation and paclitaxel are the main options. Precise predictive factors of recurrence are needed to better define indications of first and other lines of treatment in specific situations such as non-resected residual seminoma.

Mots clés:
Tumeurs germinales testiculaires / Chimiotherapie / Métastases / BEP / Testis
Mots-clés:
Testicular germ cell / Chemotherapy / Metastasis / BEP / Testis
Y-a-t-il une place pour la chirurgie dans les tumeurs urothéliales métastasées ?
2008
- Réf : Prog Urol, 2008, 12, 18, S285, suppl. S7

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Although surgery has a limited role in the management of metastatic urothelial carcinoma patients, it can be envisaged in association with chemotherapy. In highly symptomatic patients and for complete response patients, cystectomy can be part of a multimodal approach. Metastasis resection can also be proposed in association with chemotherapy in case of complete response. In case of non responsive metastasis, metastasectomy can also de discussed in order to improve quality of life.

Mots clés:
carcinome urothélial / Cancer de vessie / Métastase / Chirurgie / Cystectomie
Mots-clés:
Urothelial carcinoma / Bladder carcinoma / Metastasis / surgery / Cystectomy