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Biomarqueurs urinaires du cancer de prostate
Urinary biomarkers in prostate cancer: An update
2010
- Articles de revue
- Réf : Prog Urol, 2010, 13, 20, 1184-1191


Introduction



Widespread screening for prostate cancer has led to an increased incidence, an improved disease specific survival, but also to overdiagnosis and overtreatment. The limitations of screening tools, especially PSA, have led to active investigation of new biomarkers in recent years. Urinary markers, suitable for large scale use, minimally invasive collected, arouse of particular interest. Numerous protein, DNA or RNA markers are explored in order to improve detection and prognostic evaluation of prostate cancer. Some of them have already shown clinical values. PCA3 provided particularly encouraging results for the specific population of patients having a first set of negative biopsy, for which using PCA3 assay could allow to avoid unnecessary repeated biopsy. Fusion genes showed promising abilities in prostate cancer detection. New research methods are also emerging, and high-throughput technologies will facilitate high-dimensional biomarker discovery. Future approaches will probably integrate proteomic, transcriptomic and multiplex approaches to identify combinations of multiple biomarkers to optimize the detection of prostate cancer. In the near future, these markers would probably be able to provide prognostic data to discriminate significant cancers, a major challenge for prostate cancer treatment.

Mots clés:
cancer de prostate / dépistage / Biomarqueurs / PCA3
Mots-clés:
prostate cancer / Screening / Biomarker / PCA3
Dérivation urinaire rectale à basse pression et anti-reflux : technique simplifiée
Urinary diversion to the augmented and valved rectum: Simplified technique
2010
- Articles originaux
- Réf : Prog Urol, 2010, 13, 20, 1217-1221


Introduction



Objective

Description of the Ghoneim’s low pressure rectal bladder, without colo-colic valve and colostomy.


Method

Thirty-six patients underwent this simplified technique.


Results

The simplification of the technique did not increase the complication. The operating time has been lessened. The closing colostomy was avoided.

Mots clés:
Cystectomie / Dérivation urinaire / vessie rectale / Anti-reflux / Colostomie
Mots-clés:
Cystectomy / urinary diversion / rectal bladder / Antireflux
Étude de l'expression des kinases Aurora dans le carcinome à cellules rénales
Study of the expression of Aurora kinases in renal cell carcinoma
2010
- Articles originaux
- Réf : Prog Urol, 2010, 13, 20, 1200-1205


Introduction



Objectives

The Aurora kinase family plays a crucial role in the regulation of mitosis. Over-expression of Aurora A and B has been reported in many malignant tumors. The objective of this study was to analyze the expression of Aurora A and B in renal cell carcinoma (RCC) and its correlation with usual clinical and pathological parameters.


Methods

In a retrospective study, have been studied the tumoral samples of 40 consecutive patients who had been operated between 2003 and 2006 for a renal tumor. RNA was extracted from frozen corresponding tumoral samples. Thirty-one samples were retained based on RNA quality. RT-PCR was done on each of these samples to assess the expression of Aurora A and B genes. Statistical analysis was performed using Chi-square test to compare Aurora A and B levels.


Results

Median age was 65 years (35–82). Seven (22%) patients had nodal invasion and eight (26%) had distant metastases. Most of the tumors (74%) were grade 3 or 4. Eighteen patients (58%) had clear cell cancer histology, 12 (39%) had papillary histology, and one a Bellini type tumor. Aurora A overexpression was associated with lymph node invasion (p =0.001). Aurora B over-expression was associated with both nodal involvement (p =0.02) and histologic subtype (significantly over-expressed in clear cell tumors; p =0.001).


Conclusions

Aurora A and B were differentially over-expressed in clear cell RCC and primary tumors of patients with lymph node involvement.

Mots clés:
carcinome à cellules rénales / Kinases Aurora / Thérapies ciblées / Envahissement ganglionnaire
Mots-clés:
Renal cell carcinoma / Aurora kinases / Targeted therapy / Lymph node invasion
Incontinence urinaire de la femme : profil épidémiologique au sud du Sahara
Urinary incontinence in woman: Epidemiologic profile in Sub Saharian countries
2010
- Articles originaux
- Réf : Prog Urol, 2010, 13, 20, 1213-1216


Introduction



The objective of this study was to describe the epidemiologic profile of urinary incontinence of the African woman of three Sub Saharan African countries.


Material and methods

A multicentric study summarized the epidemiological data collected in female from Nouakchott, Dakar and Ndjamena using a questionnaire. All participants filled an anonymous questionnaire including demographic data and marital status, medical, surgical, gynecological and obstetrical history and the characteristics of the urinary incontinence.


Results

Overall, 3021 questionnaires were distributed, only 2070 answers (69%) could be processed. Mean age of the overall population was 28 years. Adult women aged less than 30 years accounted for 56% of the study population. The age group 30–49 years accounted for 42% of the population and only 2% of the study group had more than 50 years. The prevalence of incontinence was 367 cases over 2070 (17,7%). The types of incontinence found were: urgency in 28.6% of cases, stress incontinence in 38.4% of cases and mixed in 33% of cases. Approximately 23,9% of nulliparous and 23,5% of the multiparous had urinary incontinence. The leakage was occasional in 75% of the cases and regular in 25% of the cases. According to gravity, in 31% of cases the volume of urines lost necessitated a change of underwear. Of the women presenting urinary incontinence, 85 (23%) consulted a doctor. A psychosocial repercussion was found in 31% of the cases.


Conclusion

Urinary incontinence is much more frequent in our areas than it was thought to be because it was rarely acknowledged.

Mots clés:
incontinence urinaire de la femme / Pays au sud du Sahara
Mots-clés:
Female urinary incontinence / Sub Saharian countries
Les dérivations urinaires transrectales ont-elles encore une place en 2010 ?
Do trans-rectal urinary derivation techniques still have a place in our armamentarium in 2010?
2010
- Articles originaux
- Réf : Prog Urol, 2010, 13, 20, 1221-1222

Mots clés:
A.
Mots-clés:
Cystectomy / urinary diversion / rectal bladder / Antireflux
Néphrectomie partielle : un risque de stagnation ?
Partial nephrectomy: Is there a risk of stagnation?
2010
- Lettre à la rédaction
- Réf : Prog Urol, 2010, 13, 20, 1192-1193


Le champ de la chirurgie partielle du rein s’est considérablement élargi ces dernières années. Au fil des publications, le dogme de la taille limite a quasiment disparu des recommandations des sociétés savantes, dont l’AFU [1 Méjean A., et al. Tumeurs du rein Prog Urol 2007 ;  17 (6) : 1101-1144

Mots clés:
Néphrectomie partielle / cancer du rein
Mots-clés:
partial nephrectomy / Kidney cancer
Néphrolithotomie percutanée bilatérale en un temps : série de 60 cas
Simultaneous bilateral percutaneous nephrolithotomy: Series of 60 cases
2010
- Articles originaux
- Réf : Prog Urol, 2010, 13, 20, 1194-1199


Introduction



Objective

Retrospective evaluation of the efficacy and morbidity of simultaneous bilateral percutaneous nephrolithotomy (SB-PCNL).


Methods

From January1993 to July2009, 60 patients have undergone SB-PCNL over a series of 1709 PCNL. Thirty men and 30 women, mean age 45years old (13–78), were treated for bilateral renal stones (120 kidneys) of 1177mm2 (268–4972mm2); 25 were complete staghorn stones.


Results

Operating time for the first side of PCNL was 80min (30–270) and 45min (10–90) for the opposite side. Overall OR occupation was 188min (90–360). Forty-five patients were stone free after one session; 15 patients (25%) have a complementary treatment to be stone free: five PCNL (one bilateral); eight ESWL (four with JJ stent) and two flexible ureteroscopy. No blood transfusion was required. Renal function was unchanged at 1 month. Clavien grade for complications were as follows: two grade IIIb, one grade IVa and one grade IVb. Hospitalization stay was 4±4.9days (2–35) taking account of two major sepsis (one pulmonary and one septicemia).


Conclusion

SB-PCNL was well tolerated with comparable morbidity and efficacy to PCNL performed on each side in two separate sessions. Nevertheless, SB-PCNL has to be performed for selected patients in expert centers.

Mots clés:
Humain / calcul rénal / néphrostomie / Chirurgie percutanée / Bilatéral
Mots-clés:
Humans / Kidney calculi / néphrostomy / Simultaneous / Bilateral surgery
Place de la chirurgie (néphrectomie cytoréductrice et métastasectomie) dans la prise en charge du cancer du rein métastatique : revue de la littérature
Role of surgery (cytoreductive nephrectomy and metastasectomy) in the management of metastatic renal cell carcinoma: A literature review
2010
- Articles de revue
- Réf : Prog Urol, 2010, 13, 20, 1175-1183


Introduction



Cytoreductive nephrectomy is an established treatment option prior immunotherapy in well-selected patients with metastatic renal cell carcinoma. With the recent introduction of new targeted agents, the role of surgery has been source of controversy. This review examines the role of cytoreductive nephrectomy during the immunotherapy era, then in the new targeted therapies era. This review also summarizes the optimal timing of these treatments, the prognostic factors predicting outcome following cytoreductive nephrectomy, the role of metastasectomy, partial and laparoscopic cytoreductive nephrectomy.

Mots clés:
Néphrectomie cytoréductrice / Cancer du rein métastatique / Métastasectomie / Thérapie ciblée
Mots-clés:
Cytoreductive nephrectomy / Metastatic renal cell carcinoma / Metastasectomy / Targeted therapy
Résultats carcinologiques après prostatectomie totale pour cancer : validation française de la classification de D'Amico
Oncologic outcomes after radical prostatectomy: French validation of the D'Amico risk group classification
2010
- Articles originaux
- Réf : Prog Urol, 2010, 13, 20, 1206-1212


Introduction



Purpose

To validate the D’Amico risk group classification in French consecutive series and to analyse recurrence risk factor after radical prostatectomy (RP) for prostate cancer.


Material

We retrospectively analyzed data collected from 10/2000 to 05/2009 for 730 consecutive patients who underwent RP for clinically localized or locally advanced prostate cancer (cT1–cT3) in our institution. Biochemical recurrence (BCR) was defined by prostate-specific antigen (PSA) of greater than 0.1ng/ml, with rising PSA at two consecutive dosages. Postoperative survival was estimated using the Kaplan–Meier method after D’Amico’s group stratification. The accuracy of the model was evaluated using the Harrell’s concordance index. The impact on outcomes of preoperative PSA and pathological features was evaluated using a monovariate and multivariate Cox analysis.


Results

Median follow-up was 30 months [interquartile range: 13–51]. The overall 3-year and 5-year probability of freedom from BCR was 85% (95% Confidence Interval (CI), 81–88%) and 78% (95% CI, 74–83%), respectively. For low, intermediate, and high-risk group, the 5-year freedom from BCR was 92% (95% CI, 88–97%), 73% (95% CI, 65–81%) and 44% (95% CI, 28–59%), respectively (p<0.001). Harrell’s concordance index was 0.71. Surgical margins were positive in 31% of all cases. In a multivariate analysis, preoperative PSA, pathological tumor stage, Gleason score and surgical margins status predicted BCR after RP.


Conclusions

We externally validated the ability of the D’Amico’s risk group stratification to predict disease progression following RP in European patients. Preoperative PSA, pathological stage, Gleason score and surgical margins status predicted BCR after RP in our series through a multivariate analysis.

Mots clés:
Antigène spécifique de prostate / Cancer de la prostate / Long terme / Prostatectomie / facteur de risque
Mots-clés:
prostate specific antigen / prostate cancer / Long term / Prostatectomy / risk factor
Syndrome de persistance des canaux de Müller
Persistent Müllerian ducts syndrome
2010
- Cas cliniques
- Réf : Prog Urol, 2010, 13, 20, 1227-1229


Introduction



Persistent Müllerian ducts syndrome is a rare form of internal male pseudohermaphroditism, characterized by the presence of the uterus, fallopian tubes and upper vagina in an otherwise normally virilised male with a 46 XY karyotype. It is the result of a deficiency in anti-Müllerian hormone or abnormality of this hormone receptor. Often, the diagnosis is made incidentally during surgical exploration for cryptorchidism or herniorrhaphy, and exceptionally during cancer of ectopic testis. We discuss a rare case of this syndrome revealed by a bilateral intra-abdominal gonadal tumor.

Mots clés:
Canaux de Müller / Cancer testiculaire / Pseudo-hermaphrodisme / cryptorchidie
Mots-clés:
Müllerian ducts / testis tumour / Pseudohermaphroditism / cryptorchidism
Tumeurs rénales hybrides : à propos de deux patients
Hybrid renal tumors: A report of two patients
2010
- Cas cliniques
- Réf : Prog Urol, 2010, 13, 20, 1223-1226


Introduction



Purpose

Renal hybrid tumors (HT) are characterized by the association of both oncocytes- and chromophobe-cells within the same tumor. They have been reported in patients with Birt-Hogg-Dube (BHD) syndrome. The aim of this report was to describe two cases of HT and summarize recent literature.


Patient and method

Case study was summarized from the patient’s medical chart. Review of literature was performed using the National Center for Biotechnology Information (NCBI) database.


Results

Two patients were diagnosed with multiple but small tumors of the kidney, and were treated with partial nephrectomy. Pathological analysis of these tumors showed oncocytoma-like and chromophobe-like cells intermixed in the same stroma.


Conclusions

HT may constitute a spectrum of tumors between renal oncocytoma and chromophobe renal cell carcinoma. From a pragmatic management perspective, it would be appropriate to consider such tumors as chromophobe carcinoma. In case of HT, a genetic study for BHD syndrome can be proposed to family relatives.

Mots clés:
Birt-Hogg-Dubé / Oncocytome rénal / Carcinome chromophobe / Tumeur hybride
Mots-clés:
Birt-Hogg-Dubé / Renal oncocytoma / Chromophobe renal cell carcinoma / Hybrid tumor
Projection de l'incidence et de la mortalité par cancer urologique en France en 2010
2010
- Réf : Prog Urol, 2010, 13, 20, S211, suppl. S4


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Mots clés:
X. / P. / T. / J.-J. / C.
Mots-clés:
Müllerian ducts / testis tumour / Pseudohermaphroditism / cryptorchidism
Recommandations de bonnes pratiques cliniques : diagnostic, traitement et suivi des cancers urologiques chez l'homme et la femme
2010
- Réf : Prog Urol, 2010, 13, 20, S205, suppl. S4


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Mots clés:
M. / P. / J. / T. / J.-J.
Mots-clés:
Müllerian ducts / testis tumour / Pseudohermaphroditism / cryptorchidism
Recommandations en Onco-Urologie 2010 : Cancer de la prostate
2010
- Réf : Prog Urol, 2010, 13, 20, S217, suppl. S4


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Mots clés:
L. / D. / C. / P. / L.
Mots-clés:
Müllerian ducts / testis tumour / Pseudohermaphroditism / cryptorchidism
Recommandations en Onco-Urologie 2010 : Cancer du rein
2010
- Réf : Prog Urol, 2010, 13, 20, S319, suppl. S4


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Mots clés:
J.-J. / H. / J.-M. / B. / H.
Mots-clés:
Müllerian ducts / testis tumour / Pseudohermaphroditism / cryptorchidism
Recommandations en Onco-Urologie 2010 : Tumeurs germinales du testicule
2010
- Réf : Prog Urol, 2010, 13, 20, S297, suppl. S4


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Mots clés:
X. / J. / C. / P. / S.
Mots-clés:
Müllerian ducts / testis tumour / Pseudohermaphroditism / cryptorchidism
Recommandations en Onco-Urologie 2010 : Tumeurs malignes du pénis
2010
- Réf : Prog Urol, 2010, 13, 20, S279, suppl. S4


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Mots clés:
J. / C. / P. / S. / X.
Mots-clés:
Müllerian ducts / testis tumour / Pseudohermaphroditism / cryptorchidism
Recommandations en Onco-Urologie 2010 : Tumeurs urothéliales
2010
- Réf : Prog Urol, 2010, 13, 20, S255, suppl. S4


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Mots clés:
C. / M. / H. / J.-L. / H.
Mots-clés:
Müllerian ducts / testis tumour / Pseudohermaphroditism / cryptorchidism
Sarcomes du rétropéritoine : Contribution du CCAFU au référentiel INCa
2010
- Réf : Prog Urol, 2010, 13, 20, S290, suppl. S4


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Mots clés:
C. / J. / B. / P. / S.
Mots-clés:
Müllerian ducts / testis tumour / Pseudohermaphroditism / cryptorchidism
Tumeurs malignes de la surrénale : Contribution du CCAFU au référentiel INCa
2010
- Réf : Prog Urol, 2010, 13, 20, S310, suppl. S4


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Mots clés:
P. / J. / C. / L. / C.
Mots-clés:
Müllerian ducts / testis tumour / Pseudohermaphroditism / cryptorchidism