102 results on '"Brureau, L."'
Search Results
2. French AFU Cancer Committee Guidelines - Update 2022-2024: prostate cancer - Management of metastatic disease and castration resistance
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Ploussard, G., Roubaud, G., Barret, E., Beauval, J.-B., Brureau, L., Créhange, G., Dariane, C., Fiard, G., Fromont, G., Gauthé, M., Renard-Penna, R., Rozet, F., Ruffion, A., Sargos, P., Mathieu, R., and Rouprêt, M.
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- 2022
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3. Active surveillance in prostate cancer is possible for Afro-Caribbean population: Comparison of oncological outcomes with a Caucasian cohort
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Percot, M., Robert, G., Bladou, F., Ferrière, J.-M., Bensadoun, H., Bernhard, J.-C., Alezra, E., Capon, G., Sénéchal, C., Gourtaud, G., Brureau, L., Roux, V., Blanchet, P., and Eyraud, R.
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- 2020
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4. Prostate cancer clinical presentation, incidence, mortality and survival in Guadeloupe over the period 2008–2013 from a population-based cancer registry
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Deloumeaux, J., Bhakkan, B., Eyraud, R., Braud, F., M’Ebobisse, N. Manip, Blanchet, P., and Brureau, L.
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- 2017
5. How PET-CT is Changing the Management of Non-metastatic Castration-resistant Prostate Cancer?: Comment la TEP-TDM Peut Modifier la Prise en Charge du Cancer de la Prostate Non Métastatique Résistant à la Castration ?
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Baboudjian, M., Gauthé, M., Barret, E., Brureau, L., Rocchi, P., Créhange, G., Dariane, C., Fiard, G., Fromont, G., Beauval, J.-B., Mathieu, R., Renard-Penna, R., Roubaud, G., Ruffion, A., Sargos, P., Rouprêt, M., and Ploussard, G.
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- 2022
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6. Narrative review of PET/CT performances at biochemical recurrence in prostate cancer after radical prostatectomy and impact on patient disease management: Revue narrative à propos des performances de la TEP/TDM en cas de récidive biochimique après prostatectomie radicale dans le cancer de la prostate et impact sur la prise en charge des patients
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Lasserre, M., Sargos, P., Barret, E., Beauval, J.-B., Brureau, L., Créhange, G., Dariane, C., Fiard, G., Fromont, G., Mathieu, R., Renard-Penna, R., Roubaud, G., Ruffion, A., Rouprêt, M., Ploussard, G., and Gauthé, M.
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- 2022
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7. Predictors of biochemical recurrence after radical prostatectomy in an Afro-Caribbean population in Guadeloupe (French West Indies)
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Brureau, L., Emeville, E., Multigner, L., and Blanchet, P.
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- 2018
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8. UP08 - Associated factors for postoperative infections after urological surgery. Results from the national and multicenter TOCUS study
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Kutchukian, S., Gondran-Tellier, B., Robin, H., Bigot, P., Francot, M., De Vergie, S., Rigaud, P., Chapuis, M., Brureau, L., Jousseaume, C., Karrav, O., Kosseifi, F.T., Descazeaud, A., Chicaud, M., Asare, H-J., Gaullier, M., Poussot, B., Tricard, T., Borojeni, S., Baboudjian, M., Lechevallier, E., Delpech, P-O., Ayoub, E., Ducousso, H., Bernardeau, S., Dinh, A., Bruyère, F., and Vallée, M.
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- 2023
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9. Predictors of biochemical recurrence after Check for radical prostatectomy in an Afro-Caribbean daros population in Guadeloupe (French West Indies)
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Brureau, L., Emeville, E., Multigner, Luc, Blanchet, P., Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), CHU Pointe-à-Pitre/Abymes [Guadeloupe], Université de Rennes (UR), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)
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Prostate cancer ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,Afro-Caribbean ,Radical prostatectomy ,ComputingMilieux_MISCELLANEOUS ,Biochemical recurrence ,Predictive factors - Abstract
International audience
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- 2018
10. A0112 - Risk factors of infectious complications after benign prostatic hyperplasia surgery: Preliminary results from the retrospective and multicenter TOCUS cohort.
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Brureau, L., Chapuis, M., Robin, H., Bigot, P., Baboudjian, M., Françot, M., De Vergie, S., Rigaud, J., Jousseaume, C., Karray, O., Kosseifi, F., Borojeni, S., Lechevallier, E., Bernardeau, S., Gondran-Tellier, B., Bruyère, F., Kutchukian, S., and Vallée, M.
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BENIGN prostatic hyperplasia , *SURGERY - Published
- 2022
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11. Corrigendum to “French ccAFU guidelines–update 2020–2022: Prostate cancer” [Prog. Urol 30 (12 S) (2020), pp S136-S251]
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Rozet, F., Mongiat-Artus, P., Hennequin, C., Beauval, J.B., Beuzeboc, P., Cormier, L., Fromont-Hankard, G., Mathieu, R., Ploussard, G., Renard-Penna, R., Brenot-Rossi, I., Bruyere, F., Cochet, A., Crehange, G., Cussenot, O., Lebret, T., Rebillard, X., Soulié, M., Brureau, L., and Méjean, A.
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- 2021
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12. 1728P Evaluation of medical practices in oncology in a context of COVID-19 pandemic in France: Point of view of physicians, PRATICOVID study
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Helissey, C., Cessot, A., Boudin, L., Romeo, E., Prieux, C., Ghebriou, D., Schernberg, A., Grellier, N., Joly, C., Bauduceau, O., Thibault, C., Mamou, E., Raynal, G., Setey Eiffel, S., Le Floch, H., Ricard, D., and Brureau, L.
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- 2020
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13. 645P Prediction of BRCA2 mutations in prostate cancer patients according early onset, metastatic phenotypes or family history of breast/ovary cancer
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Cancel-Tassin, G., Leon, P., Bourdon, V., Buecher, B., Oudard, S., Brureau, L., Jouffe, L., Blanchet, P., Stoppa-Lyonnet, D., Coulet, F., Sobol, H.H., and Cussenot, O.
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- 2020
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14. 646P Prostate cancer metastatic profiles correlate with molecular alterations
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Cussenot, O., Perrot, E., Brureau, L., Blanchet, P., Diedhiou, A., Comperat, E., Iliev, D., Pruss, D., Timms, K.M., and Cancel-Tassin, G.
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- 2020
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15. PT048 - Follow up of mostly Afro-Caribbean patients with prostate cancer under active surveillance
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Stempfer, G., Blanchet, P., Brureau, L., Gourtaud, G., Roux, V., Sénéchal, C., Moureaux, C., Seddik, S., Percot, M., and Eyraud, R.
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- 2019
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16. 358 - Molecular phenotypes in DNA repair deficiency correlate with specific clinical outcomes subtypes and genetic background
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Cussenot, O., Perrot, E., Brureau, L., Blanchet, P., Diedhiou, A., Comperat, E., Iliev, D., Pruss, D., Timms, K.M., and Cancel-Tassin, G.
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- 2019
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17. Chemotherapy feasibility in older patients with metastatic bladder cancer: The Multicenter prospective cohort study Agevim
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Laurent, M., Brureau, L., El Demery, M., Flechon, A., Le Thuaut, A., Carvalho Verlinde, M., Bastuji Garin, S., Paillaud, E., Canoui Poitrine, F., and Culine, S.
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- 2014
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18. 981 Should the primary site be treated in patients with de novo metastatic prostate cancer?
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Brureau, L., Patrikidou, A., Casenave, J., Albiges, L., Di Palma, M., Patard, J-J., Baumert, H., Blanchard, P., Bossi, A., Massard, C., Fizazi, K., Blanchet, P., and Loriot, Y.
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- 2014
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19. 87 Morbidity, functional and oncological outcomes after nephron sparing surgery for cT2 renal tumours
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Bigot, P., Hetet, J.F., Fardoun, T., Rouffilange, J., Xylinas, E., Ploussard, G., Ouzaid, I., Robine, E., Audenet, F., Merigot De Treigny, O., Maurin, C., Ammi, M., Lebdai, S., Brureau, L., Bastien, L., Long, J.A., Rouprêt, M., Neuzillet, Y., Mongiat-Artus, P., Verhoest, G., Zerbib, M., Ravery, V., Rigaud, J., Bellec, L., Baumert, H., Bensalah, K., Escudier, B., Grenier, N., Paparel, P., Rioux-Leclercq, N., Bernhard, J.C., Azzouzi, A-R., Soulié, M., and Patard, J.J.
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- 2013
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20. 940 Polymorphisms of the enzymes of the metabolism of oestrogens and prostate cancer
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Brureau, L., Romana, M., Blanchet, P., and Multigner, L.
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- 2012
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21. A0823 - Should patients with PIRADS 5 lesions be recommended against active surveillance? A multicenter retrospective European study.
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Peyrottes, A., Ducrot, Q., Vitard, C., Baudewyns, A., Windisch, O., Anract, J., Dariane, C., Tricard, T., Baboudjian, M., Sarkis, J., Sadreux, Y., Oderda, M., De La Taille, A., Olivier, J., Brureau, L., Diamand, R., Rouviere, O., Ruffion, A., Desgrandchamps, F., and Roumiguie, M.
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WATCHFUL waiting , *RETROSPECTIVE studies - Published
- 2024
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22. P104 - Asymptomatic bacteriuria prior to partial and radical nephrectomy: To screen or not to screen?
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Ayoub, E., Kutchukian, S., DINH, A., Bigot, P., Robin, H., Bernardeau, S., Ducousso, H., Gondran-Tellier, B., Françot, M., DE VERGIE, S., Chapuis, M., Brureau, L., Lechevallier, E., Poussot, B., Borojeni, S., Kosseifi, F., Gaullier, M., Thibault, T., Baboudjian, M., and Rigaud, J.
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BACTERIURIA , *NEPHRECTOMY - Published
- 2024
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23. A0114 - Risk factors for postoperative infections after urological surgery: Preliminary results from the national and multicenter TOCUS study.
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Stessy, K., Robin, H., Bigot, P., Baboudjian, M., Françot, M., De Vergie, S., Rigaud, J., Chapuis, M., Brureau, L., Jousseaume, C., Karray, O., Kosseifi, F., Borojeni, S., Lechevallier, E., Bernardeau, S., Bruyère, F., Gondran-Tellier, B., and Vallée, M.
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PREOPERATIVE risk factors , *UROLOGICAL surgery , *INFECTION - Published
- 2022
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24. Overall and metastasis-free survival of Afro-Caribbean patients with biochemical recurrence after radical prostatectomy.
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Barriere H, Kaulanjan K, Stempfer G, Mollard P, Laguerre M, Senechal C, Gourtaud G, Roux V, Sadreux Y, Blanchet P, and Brureau L
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- Humans, Male, Middle Aged, Retrospective Studies, Aged, Prostate-Specific Antigen blood, Disease Progression, Disease-Free Survival, Black People statistics & numerical data, Caribbean Region, Prostatectomy methods, Prostatic Neoplasms pathology, Prostatic Neoplasms surgery, Prostatic Neoplasms mortality, Prostatic Neoplasms radiotherapy, Neoplasm Recurrence, Local, Salvage Therapy
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Introduction: Early salvage radiotherapy is indicated for patients with biochemical recurrence after radical prostatectomy. However, for various reasons, certain patients do not benefit from this treatment (OBS) or only at a late stage (LSR). There are few studies on this subject and none on a "high-risk" population, such as patients of African descent. Our objective was to estimate the metastasis-free (MFS) and overall survival (OS) of patients who did not receive salvage radiotherapy, and to identify risk factors of disease progression., Patients and Methods: This was a single-center retrospective study that included 154 patients, 99 in the OBS group and 55 in the LSR group. All were treated by total prostatectomy for localized prostate cancer between January 2000 and December 2020 and none received early salvage radiotherapy after biochemical recurrence., Results: Baseline characteristics were similar between groups, except for the time to biochemical recurrence. The median follow-up was 10.0 and 11.8 years for the OBS and LSR groups, respectively. The median time from surgery to LSR was 5.1 years. The two groups did not show a significant difference in MFS: 90.6% at 10 years for the OBS group and 93.3% for the LSR group. The median MFS was 19.8 and 19.6 years for the OBS and LSR groups respectively. OS for the OBS group was significantly higher than that for the LSR group (HR: 2.14 [1.07-4.29]; p = 0.03), with 10-year OS of 95.9% for the OBS group and 76.1% for the LSR group. Median OS was 16 and 15.6 years for the OBS and LSR groups, respectively., Conclusion: In this study, we observed satisfactory metastasis-free and OS rates relative to those reported in the scientific literature. The challenge is not to question the benefit of early salvage radiotherapy, but to improve the identification of patients at risk of progression through the development of molecular and genomic tests for more highly personalized medicine., (© 2024 The Authors. The Prostate published by Wiley Periodicals LLC.)
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- 2024
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25. Asymptomatic Bacteriuria and Urological Surgery: Risk Factor or Not? Results From the National and Multicenter TOCUS Database.
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Kutchukian S, Gondran-Tellier B, Dinh A, Robin H, Bigot P, Françot M, de Vergie S, Rigaud J, Chapuis M, Brureau L, Jousseaume C, Karray O, Kosseifi FT, Borojeni S, Descazeaud A, Chicaud M, Asare HJ, Gaullier M, Poussot B, Tricard T, Baboudjian M, Lechevallier É, Delpech PO, Ayoub E, Ducousso H, Bernardeau S, Bruyère F, and Vallée M
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- Humans, Retrospective Studies, Male, Female, Middle Aged, Risk Factors, Aged, Postoperative Complications epidemiology, Postoperative Complications microbiology, Postoperative Complications etiology, Surgical Wound Infection epidemiology, Surgical Wound Infection microbiology, Risk Assessment, Databases, Factual, Urinary Tract Infections epidemiology, Urinary Tract Infections microbiology, Urinary Tract Infections diagnosis, Adult, Asymptomatic Infections epidemiology, Bacteriuria epidemiology, Bacteriuria diagnosis, Urologic Surgical Procedures adverse effects
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Purpose: Current guidelines recommend screening and treatment of asymptomatic bacteriuria prior to all urological surgeries breaching the mucosa. But little evidence supports this recommendation. At the least, risk stratification for postoperative UTI to support this strategy is lacking. The aim of this study was to define the associated factors for postoperative febrile infectious complications (UTI or surgical site infection) in urological surgery., Materials and Methods: We conducted a retrospective, multicentric study including all consecutive patients undergoing any urological surgery with preoperative urine culture. The primary outcome was the occurrence of a UTI or surgical site infection occurring within 30 days after surgery., Results: From 2016 to 2023, in 10 centers, 2389 patients were included with 838 (35%) positive urine cultures (mono-/bi-/polymicrobial). Postoperative infections occurred in 106 cases (4.4%), of which 44 had negative urine cultures (41%), 42 had positive mono-/bimicrobial urine cultures (40%), and 20 had polymicrobial urine cultures (19%). In multivariable analysis, UTI during the previous 12 months of surgery (odds ratio [OR] 3.43; 95% CI 2.07-5.66; P < .001), monomicrobial/bimicrobial preoperative urine culture (OR 3.68; 95% CI 1.57-8.42; P = .002), polymicrobial preoperative urine culture (OR 2.85; 95% CI 1.52-5.14; P < .001), and operative time (OR 1.09; 95% CI 1.04-1.15; P < .001) were independent associated factors for postoperative febrile infections., Conclusions: Positive urine culture, including preoperative polymicrobial urine culture, prior to urological surgery was associated with postoperative infection. Additionally, patients experiencing infectious complications also had a higher incidence of other complications. The effectiveness of systematic preventive antibiotic therapy for a positive urine culture has not been conclusively established.
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- 2024
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26. Tumour-based Mutational Profiles Predict Visceral Metastasis Outcome and Early Death in Prostate Cancer Patients.
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Cussenot O, Timms KM, Perrot E, Blanchet P, Brureau L, Solimeno C, Fromont G, Comperat E, and Cancel-Tassin G
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- Humans, Male, Aged, Middle Aged, Aged, 80 and over, Adenomatous Polyposis Coli Protein genetics, beta Catenin genetics, Tumor Suppressor Protein p53 genetics, Prognosis, BRCA2 Protein genetics, Kaplan-Meier Estimate, Bone Neoplasms secondary, Bone Neoplasms genetics, Bone Neoplasms mortality, Neoplasm Metastasis, Proportional Hazards Models, Lymphatic Metastasis genetics, Microsatellite Instability, Prostatic Neoplasms genetics, Prostatic Neoplasms pathology, Prostatic Neoplasms mortality, Mutation
- Abstract
Background: Visceral metastases are known to occur in advanced prostate cancer, usually when the tumour is resistant to androgen deprivation and, have worse outcomes regardless of therapies., Objective: To analyse genomic alterations in tumour samples according to their lymphatic, bone, and visceral metastatic stages and overall survival., Design, Setting, and Participants: We selected 200 patients with metastatic prostate cancer. Genomic profiling of 111 genes and molecular signatures (homologous recombination deficiency [HRD], microsatellite instability, and tumour burden mutation) was performed with the MyChoice test (Myriad Genetics, Inc, Salt Lake City, UT, USA)., Outcome Measurements and Statistical Analysis: The association between genomic profiles and visceral metastatic evolution was evaluated using logistic regression. Kaplan-Meier and Cox proportional hazard analyses were used for analyses of early death., Results and Limitations: A total of 173 (87%) genomic profiles were obtained. Eighty-four (49%) patients died during the follow-up period (median duration = 76 mo). TP53 was the most frequently mutated gene, followed by FANC genes, including BRCA2, and those of the Wnt-pathway (APC/CTNNB1). TP53 gene mutations were more frequent in patients of European (42%) than in those of African (16%) ancestry. An HRD score of >25 was predictive of FANC gene mutations. The mutational status of TP53 (p < 0.001) and APC (p = 0.002) genes were significantly associated with the risk of visceral metastases. The mutational status of CTNNB1 (p = 0.001), TP53 (p = 0.015), BRCA2 (p = 0.027), and FANC (p = 0.005) genes were significantly associated with an earlier age at death. The limitations are the retrospective study design based on a selection of genes and the low frequency of certain molecular events., Conclusions: Mutations in the TP53 gene and genes (APC/CTNNB1) related to the Wnt pathway are associated with metastatic visceral dissemination and early death. These genomic alterations could be considered as markers to identify prostate cancer patients at a high risk of life-threatening disease who might benefit from more intensified treatment or new targeted therapies., Patient Summary: In this report, we evaluated the relationships between genomic profiles (gene mutations and molecular signatures) of tumour samples from patients with metastatic prostate cancer and early death. We found that mutations of specific genes, notably TP53 and APC/CTNNB1 related to the Wnt pathway, are associated with visceral metastatic progression and an earlier age at death., (Copyright © 2023 European Association of Urology. Published by Elsevier B.V. All rights reserved.)
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- 2024
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27. PARP inhibitors in prostate cancers, is it time for combinations?
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Teyssonneau D, Dariane C, Barret E, Beauval JB, Brureau L, Fiard G, Fromont G, Créhange G, Gauthé M, Ruffion A, Renard-Penna R, Mathieu R, Sargos P, Rouprêt M, Ploussard G, and Roubaud G
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Despite several improvements in outcomes, metastatic prostate cancer remains deadly. Alterations in the homologous recombination repair (HRR) pathway are associated with more aggressive disease. Olaparib and rucaparib, two poly-ADP-ribose polymerase (PARP) inhibitors, have received approval from the authorities of several countries for their anti-tumoral effects in patients with metastatic castration-resistant prostate cancers harboring HRR gene alterations, in particular BRCA2 . More recently, it has been hypothesized that new hormonal therapies (NHTs) and PARP inhibitors (PARPi) could have synergistic actions and act independently of HRR deficiency. This review proposes to discuss the advantages and disadvantages of PARPi used as monotherapy or in combination with NHTs and whether there is a need for molecular selection., Competing Interests: The authors declare that there is no conflict of interest., (© The Author(s), 2024.)
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- 2024
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28. Asymptomatic bacteriuria prior to partial and radical nephrectomy: To screen or not to screen? Results from the national and multicenter TOCUS database.
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Ayoub E, Kutchukian S, Bigot P, Dinh A, Gondran-Tellier B, Robin H, Françot M, de Vergie S, Rigaud J, Chapuis M, Brureau L, Jousseaume C, Karray O, Kosseifi FT, Borojeni S, Descazeaud A, Asare HJ, Gaullier M, Poussot B, Tricard T, Baboudjian M, Lechevallier É, Delpech PO, Ducousso H, Bernardeau S, Bruyère F, and Vallée M
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- Humans, Retrospective Studies, Urinalysis, Surgical Wound Infection, Anti-Bacterial Agents therapeutic use, Bacteriuria diagnosis, Bacteriuria epidemiology, Bacteriuria microbiology, Urinary Tract Infections diagnosis, Urinary Tract Infections epidemiology, Urinary Tract Infections microbiology
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Introduction: In the era of increased bacterial resistance, the main strategy is to reduce the prescription of antibiotics when possible. Nowadays, it is highly recommended to screen for asymptomatic bacteriuria (ABU), prior to urological surgery with potential mucosal breach or urine exposure. Screening and treating urinary colonization is a strategy widely adopted before radical and partial nephrectomy but without any evidence. Our main end point in this study is to analyze the relationship between preoperative urine culture and the risk of postoperative febrile urinary tract infection (UTI) or surgical-site infection (SSI) in partial or radical nephrectomy patients., Methods: We conducted a multicenter retrospective cohort study between January 2016 and January 2023 in 11 French tertiary referral hospitals (TOCUS database). We collected the data for 269 patients including several pre-, intra-, and post-operative variables that could potentially increase the risk of postoperative UTI and SSI including preoperative urinary culture results., Results: The incidence rate of postoperative UTI and SSI was 8.9% in our study. After conducting a logistic multivariate analysis, a propensity score matching analysis, and a subgroup analysis, we found no significant correlation between the urine culture and the postoperative UTI risk [OR = 1.2 (0.5-2.7) (p = 0.7)]. Only the postoperative non-infectious complications were related to a higher risk of postoperative UTI [OR = 12 (4-37), p < 0.001)]., Conclusion: Our research shows that screening and treating for ABU prior to radical or partial nephrectomy seems to be unnecessary to prevent postoperative UTI and SSI., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
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- 2024
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29. Characterizing prostate cancer risk through multi-ancestry genome-wide discovery of 187 novel risk variants.
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Wang A, Shen J, Rodriguez AA, Saunders EJ, Chen F, Janivara R, Darst BF, Sheng X, Xu Y, Chou AJ, Benlloch S, Dadaev T, Brook MN, Plym A, Sahimi A, Hoffman TJ, Takahashi A, Matsuda K, Momozawa Y, Fujita M, Laisk T, Figuerêdo J, Muir K, Ito S, Liu X, Uchio Y, Kubo M, Kamatani Y, Lophatananon A, Wan P, Andrews C, Lori A, Choudhury PP, Schleutker J, Tammela TLJ, Sipeky C, Auvinen A, Giles GG, Southey MC, MacInnis RJ, Cybulski C, Wokolorczyk D, Lubinski J, Rentsch CT, Cho K, Mcmahon BH, Neal DE, Donovan JL, Hamdy FC, Martin RM, Nordestgaard BG, Nielsen SF, Weischer M, Bojesen SE, Røder A, Stroomberg HV, Batra J, Chambers S, Horvath L, Clements JA, Tilly W, Risbridger GP, Gronberg H, Aly M, Szulkin R, Eklund M, Nordstrom T, Pashayan N, Dunning AM, Ghoussaini M, Travis RC, Key TJ, Riboli E, Park JY, Sellers TA, Lin HY, Albanes D, Weinstein S, Cook MB, Mucci LA, Giovannucci E, Lindstrom S, Kraft P, Hunter DJ, Penney KL, Turman C, Tangen CM, Goodman PJ, Thompson IM Jr, Hamilton RJ, Fleshner NE, Finelli A, Parent MÉ, Stanford JL, Ostrander EA, Koutros S, Beane Freeman LE, Stampfer M, Wolk A, Håkansson N, Andriole GL, Hoover RN, Machiela MJ, Sørensen KD, Borre M, Blot WJ, Zheng W, Yeboah ED, Mensah JE, Lu YJ, Zhang HW, Feng N, Mao X, Wu Y, Zhao SC, Sun Z, Thibodeau SN, McDonnell SK, Schaid DJ, West CML, Barnett G, Maier C, Schnoeller T, Luedeke M, Kibel AS, Drake BF, Cussenot O, Cancel-Tassin G, Menegaux F, Truong T, Koudou YA, John EM, Grindedal EM, Maehle L, Khaw KT, Ingles SA, Stern MC, Vega A, Gómez-Caamaño A, Fachal L, Rosenstein BS, Kerns SL, Ostrer H, Teixeira MR, Paulo P, Brandão A, Watya S, Lubwama A, Bensen JT, Butler EN, Mohler JL, Taylor JA, Kogevinas M, Dierssen-Sotos T, Castaño-Vinyals G, Cannon-Albright L, Teerlink CC, Huff CD, Pilie P, Yu Y, Bohlender RJ, Gu J, Strom SS, Multigner L, Blanchet P, Brureau L, Kaneva R, Slavov C, Mitev V, Leach RJ, Brenner H, Chen X, Holleczek B, Schöttker B, Klein EA, Hsing AW, Kittles RA, Murphy AB, Logothetis CJ, Kim J, Neuhausen SL, Steele L, Ding YC, Isaacs WB, Nemesure B, Hennis AJM, Carpten J, Pandha H, Michael A, De Ruyck K, De Meerleer G, Ost P, Xu J, Razack A, Lim J, Teo SH, Newcomb LF, Lin DW, Fowke JH, Neslund-Dudas CM, Rybicki BA, Gamulin M, Lessel D, Kulis T, Usmani N, Abraham A, Singhal S, Parliament M, Claessens F, Joniau S, Van den Broeck T, Gago-Dominguez M, Castelao JE, Martinez ME, Larkin S, Townsend PA, Aukim-Hastie C, Bush WS, Aldrich MC, Crawford DC, Srivastava S, Cullen J, Petrovics G, Casey G, Wang Y, Tettey Y, Lachance J, Tang W, Biritwum RB, Adjei AA, Tay E, Truelove A, Niwa S, Yamoah K, Govindasami K, Chokkalingam AP, Keaton JM, Hellwege JN, Clark PE, Jalloh M, Gueye SM, Niang L, Ogunbiyi O, Shittu O, Amodu O, Adebiyi AO, Aisuodionoe-Shadrach OI, Ajibola HO, Jamda MA, Oluwole OP, Nwegbu M, Adusei B, Mante S, Darkwa-Abrahams A, Diop H, Gundell SM, Roobol MJ, Jenster G, van Schaik RHN, Hu JJ, Sanderson M, Kachuri L, Varma R, McKean-Cowdin R, Torres M, Preuss MH, Loos RJF, Zawistowski M, Zöllner S, Lu Z, Van Den Eeden SK, Easton DF, Ambs S, Edwards TL, Mägi R, Rebbeck TR, Fritsche L, Chanock SJ, Berndt SI, Wiklund F, Nakagawa H, Witte JS, Gaziano JM, Justice AC, Mancuso N, Terao C, Eeles RA, Kote-Jarai Z, Madduri RK, Conti DV, and Haiman CA
- Subjects
- Humans, Male, Black People genetics, Genome-Wide Association Study, Hispanic or Latino genetics, Polymorphism, Single Nucleotide, Risk Factors, White People genetics, Asian People genetics, Genetic Predisposition to Disease, Prostatic Neoplasms genetics
- Abstract
The transferability and clinical value of genetic risk scores (GRSs) across populations remain limited due to an imbalance in genetic studies across ancestrally diverse populations. Here we conducted a multi-ancestry genome-wide association study of 156,319 prostate cancer cases and 788,443 controls of European, African, Asian and Hispanic men, reflecting a 57% increase in the number of non-European cases over previous prostate cancer genome-wide association studies. We identified 187 novel risk variants for prostate cancer, increasing the total number of risk variants to 451. An externally replicated multi-ancestry GRS was associated with risk that ranged from 1.8 (per standard deviation) in African ancestry men to 2.2 in European ancestry men. The GRS was associated with a greater risk of aggressive versus non-aggressive disease in men of African ancestry (P = 0.03). Our study presents novel prostate cancer susceptibility loci and a GRS with effective risk stratification across ancestry groups., (© 2023. The Author(s), under exclusive licence to Springer Nature America, Inc.)
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- 2023
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30. Salvage Radical Prostatectomy for Recurrent Prostate Cancer: A Systematic Review (French ccAFU).
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Saouli A, Ruffion A, Dariane C, Barret E, Fiard G, Hankard GF, Créhange G, Roubaud G, Beauval JB, Brureau L, Renard-Penna R, Gauthé M, Baboudjian M, Ploussard G, and Rouprêt M
- Abstract
The aim of this study was to systematically review the current evidence regarding the oncological and functional outcomes of salvage radical prostatectomy (sRP) for recurrent prostate cancer. A systematic review was conducted throughout September 2022 using the PubMed, Science Direct, Scopus, and Embase databases. Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines were followed to identify eligible studies. A total of 55 studies (3836 patients) met our eligibility criteria. The vast majority of men included had radiation therapy (including brachytherapy) as their first-line treatment ( n = 3240, 84%). Other first-line treatments included HIFU ( n = 338, 9%), electroporation ( n = 59, 2%), proton beam therapy ( n = 54, 1.5%), cryotherapy ( n = 34, 1%), focal vascular targeted photodynamic therapy ( n = 22, 0.6%), and transurethral ultrasound ablation ( n = 19, 0.5%). Median preoperative PSA, at the time of recurrence, ranged from 1.5 to 14.4 ng/mL. The surgical approach was open in 2300 (60%) cases, robotic in 1465 (38%) cases, and laparoscopic in 71 (2%) cases. Since 2019, there has been a clear increase in robotic versus conventional surgery (1245 versus 525 cases, respectively). The median operative time and blood loss ranged from 80 to 297 min and 75 to 914 mL, respectively. Concomitant lymph node dissection was performed in 2587 cases (79%). The overall complication rate was 34%, with a majority of Clavien grade I or II complications. Clavien ≥ 3 complications ranged from 0 to 64%. Positive surgical margins were noted in 792 cases (32%). The median follow-up ranged from 4.6 to 94 months. Biochemical recurrence after sRP ranged from 8% to 51.5% at 12 months, from 0% to 66% at 22 months, and from 48% to 59% at 60 months. The specific and overall survival rates ranged from 13.4 to 98% and 62 to 100% at 5 years, respectively. Urinary continence was maintained in 52.1% of cases. sRP demonstrated acceptable oncological outcomes. These results, after sRP, are influenced by several factors, and above all by pre-treatment assessment, including imaging, with the development of mpMRI and metabolic imaging. Our results demonstrated that SRP can be considered a suitable treatment option for selected patients, but the level of evidence remains low.
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- 2023
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31. Simplified antibiotic guidelines in urology are associated with decreased multidrug-resistant Enterobacterales.
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Roger PM, Bastian S, Breurec S, Saliège M, Blanchet P, and Brureau L
- Abstract
Purpose: A simplified therapeutic guideline (STG) was established in our urology ward in 2019 for urinary infections. Our aim was to describe the level of physician adherence to STG and the impact of a limited number of antibiotic compounds on the rate of multidrug-resistant (MDR) bacteria. As guidelines should improve patient care, unfavorable outcomes were also reported., Methods: The STG for community-acquired and nosocomial urinary infections, including six antibiotics, was established in November 2019 and has been officially applied since January 2020. Treatment duration has to be ≤14 days. We conducted a before-after study to measure physician adherence to the STG for bacteremia treatment between January 2017 and December 2022. Adherence was defined as exclusive use of STG antibiotics. All isolated bacteria from blood cultures were recorded, including MDR Enterobacterales, defined as AmpC β-lactamase- or ESBL-producing strains. Unfavorable outcomes were defined as uncontrolled infection, a second surgical procedure, ICU requirement, and/or death., Results: Seventy-six cases of bacteremia occurred between January 2017 and December 2019, and ninety between January 2020 and December 2022. The main comorbid condition was urological cancer (46%). The main reason for surgery was ureteral stent (32%). Antibiotic management in accordance with STG increased from 18% to 52%, p < 0.001, and treatments > 14 days decreased from 53% to 28%, p < 0.001. MDR Enterobacterales bacteremia was reduced from 52% to 35%, p = 0.027. The rate of unfavorable outcomes was unchanged., Conclusion: STG adherence in urology was satisfactory and associated with reduced MDR Enterobacterales bacteremia., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)
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- 2023
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32. What is the ideal combination therapy in de novo, oligometastatic, castration-sensitive prostate cancer?
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Baboudjian M, Roubaud G, Fromont G, Gauthé M, Beauval JB, Barret E, Brureau L, Créhange G, Dariane C, Fiard G, Mathieu R, Ruffion A, Rouprêt M, Renard-Penna R, Sargos P, and Ploussard G
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- Male, Humans, Docetaxel, Androgen Antagonists therapeutic use, Combined Modality Therapy, Castration, Prostatic Neoplasms pathology
- Abstract
Purpose: To review current evidence regarding the management of de novo, oligometastatic, castration-sensitive prostate cancer (PCa)., Methods: A literature search was conducted on PubMed/Medline and a narrative synthesis of the evidence was performed in August 2022., Results: Oligometastatic disease is an intermediate state between localized and aggressive metastatic PCa defined by ≤ 3-5 metastatic lesions, although this definition remains controversial. Conventional imaging has limited accuracy in detecting metastatic lesions, and the implementation of molecular imaging could pave the way for a more personalized treatment strategy. However, oncological data supporting this strategy are needed. Radiotherapy to the primary tumor should be considered standard treatment for oligometastatic PCa (omPCa). However, it remains to be seen whether local therapy still has an additional survival benefit in patients with de novo omPCa when treated with the most modern systemic therapy combinations. There is insufficient evidence to recommend cytoreductive radical prostatectomy as local therapy; or stereotactic body radiotherapy as metastasis-directed therapy in patients with omPCa. Current data support the use of intensified systemic therapy with androgen deprivation therapy (ADT) and next-generation hormone therapies (NHT) for patients with de novo omPCa. Docetaxel has not demonstrated benefit in low volume disease. There are insufficient data to support the use of triple therapy (i.e., ADT + NHT + Docetaxel) in low volume disease., Conclusion: The present review discusses current data in de novo, omPCa regarding its definition, the increasing role of molecular imaging, the place of local and metastasis-directed therapies, and the intensification of systemic therapies., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
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- 2023
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33. Prostate biopsy approach and complication rates.
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Mate K, Nedjim S, Bellucci S, Boucault C, Ghaffar N, Constantini T, Marvanykovi F, Vestris PG, Sadreux Y, Laguerre M, Stempfer G, Blanchet P, Istvan B, and Brureau L
- Abstract
Prostate biopsy is the gold standard to confirm prostate cancer. In addition to standard 12-core biopsies, magnetic resonance imaging (MRI)-guided prostate biopsies have recently been introduced to improve the detection of clinically significant prostate cancer. The present study aimed to compare the complications after standard transrectal ultrasound-guided and standard plus targeted (MRI-guided) prostate biopsies, to study the impact of the number of biopsy cores on complication rates, and to compare complication rates after transrectal ultrasound-guided prostate biopsies with those following transperineal prostate biopsies from the literature. A prospective study was performed, which included 135 patients who underwent transrectal ultrasound-guided prostate biopsies between April 1 and June 30, 2022, at the Urology Department of the University Hospital of Pointe à Pitre (Pointe à Pitre, Guadeloupe). A total of 51 patients were excluded because of missing information concerning their post-biopsy surveillance. The median age at the time of biopsy was 69 years, median prostate-specific antigen value was 8.9 ng/ml, median prostate volume was 57.5 ml, and median number of cores was 15. A total of 35 of the 84 included patients (41.7%) had a standard biopsy only and 49 (58.3%) had targeted (MRI-guided) plus standard biopsies. A total of 53 patients (63.1%) experienced early side effects, whereas only 24 patients (28.6%) experienced late side effects. Three patients (3.6%) required hospitalization for post-biopsy complications. Early side effects, especially hematuria and hematospermia, occurred significantly more frequently in the targeted plus standard group, with more cores taken, with no significant difference concerning late side effects or infectious complications between the standard and standard plus targeted groups. The admission rate for sepsis after transperineal biopsy has been reported to vary between 0 and 1%, whereas the present study had an admission rate of 2.29% using the transrectal approach. Further studies are required to analyze the complications requiring hospitalization after transrectal and transperineal biopsies., Competing Interests: The authors declare that they have no competing interests., (Copyright: © Mate et al.)
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- 2023
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34. Evidence of Novel Susceptibility Variants for Prostate Cancer and a Multiancestry Polygenic Risk Score Associated with Aggressive Disease in Men of African Ancestry.
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Chen F, Madduri RK, Rodriguez AA, Darst BF, Chou A, Sheng X, Wang A, Shen J, Saunders EJ, Rhie SK, Bensen JT, Ingles SA, Kittles RA, Strom SS, Rybicki BA, Nemesure B, Isaacs WB, Stanford JL, Zheng W, Sanderson M, John EM, Park JY, Xu J, Wang Y, Berndt SI, Huff CD, Yeboah ED, Tettey Y, Lachance J, Tang W, Rentsch CT, Cho K, Mcmahon BH, Biritwum RB, Adjei AA, Tay E, Truelove A, Niwa S, Sellers TA, Yamoah K, Murphy AB, Crawford DC, Patel AV, Bush WS, Aldrich MC, Cussenot O, Petrovics G, Cullen J, Neslund-Dudas CM, Stern MC, Kote-Jarai Z, Govindasami K, Cook MB, Chokkalingam AP, Hsing AW, Goodman PJ, Hoffmann TJ, Drake BF, Hu JJ, Keaton JM, Hellwege JN, Clark PE, Jalloh M, Gueye SM, Niang L, Ogunbiyi O, Idowu MO, Popoola O, Adebiyi AO, Aisuodionoe-Shadrach OI, Ajibola HO, Jamda MA, Oluwole OP, Nwegbu M, Adusei B, Mante S, Darkwa-Abrahams A, Mensah JE, Diop H, Van Den Eeden SK, Blanchet P, Fowke JH, Casey G, Hennis AJ, Lubwama A, Thompson IM Jr, Leach R, Easton DF, Preuss MH, Loos RJ, Gundell SM, Wan P, Mohler JL, Fontham ET, Smith GJ, Taylor JA, Srivastava S, Eeles RA, Carpten JD, Kibel AS, Multigner L, Parent MÉ, Menegaux F, Cancel-Tassin G, Klein EA, Andrews C, Rebbeck TR, Brureau L, Ambs S, Edwards TL, Watya S, Chanock SJ, Witte JS, Blot WJ, Michael Gaziano J, Justice AC, Conti DV, and Haiman CA
- Subjects
- Male, Humans, Genome-Wide Association Study, Risk Factors, Black People genetics, Genetic Predisposition to Disease, Prostatic Neoplasms genetics, Prostatic Neoplasms epidemiology
- Abstract
Background: Genetic factors play an important role in prostate cancer (PCa) susceptibility., Objective: To discover common genetic variants contributing to the risk of PCa in men of African ancestry., Design, Setting, and Participants: We conducted a meta-analysis of ten genome-wide association studies consisting of 19378 cases and 61620 controls of African ancestry., Outcome Measurements and Statistical Analysis: Common genotyped and imputed variants were tested for their association with PCa risk. Novel susceptibility loci were identified and incorporated into a multiancestry polygenic risk score (PRS). The PRS was evaluated for associations with PCa risk and disease aggressiveness., Results and Limitations: Nine novel susceptibility loci for PCa were identified, of which seven were only found or substantially more common in men of African ancestry, including an African-specific stop-gain variant in the prostate-specific gene anoctamin 7 (ANO7). A multiancestry PRS of 278 risk variants conferred strong associations with PCa risk in African ancestry studies (odds ratios [ORs] >3 and >5 for men in the top PRS decile and percentile, respectively). More importantly, compared with men in the 40-60% PRS category, men in the top PRS decile had a significantly higher risk of aggressive PCa (OR = 1.23, 95% confidence interval = 1.10-1.38, p = 4.4 × 10
-4 )., Conclusions: This study demonstrates the importance of large-scale genetic studies in men of African ancestry for a better understanding of PCa susceptibility in this high-risk population and suggests a potential clinical utility of PRS in differentiating between the risks of developing aggressive and nonaggressive disease in men of African ancestry., Patient Summary: In this large genetic study in men of African ancestry, we discovered nine novel prostate cancer (PCa) risk variants. We also showed that a multiancestry polygenic risk score was effective in stratifying PCa risk, and was able to differentiate risk of aggressive and nonaggressive disease., (Copyright © 2023 European Association of Urology. Published by Elsevier B.V. All rights reserved.)- Published
- 2023
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35. Effectiveness of electronic patient reporting outcomes, by a digital telemonitoring platform, for prostate cancer care: the Protecty study.
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Helissey C, Parnot C, Rivière C, Duverger C, Schernberg A, Becherirat S, Picchi H, Le Roy A, Vuagnat P, Pristavu R, Vanquaethem H, and Brureau L
- Abstract
Research Aim and Purpose: The benefits of Electronic Patient -Reported Outcomes (e-PRO) for telemonitoring are well established, allowing early detection of illnesses and continuous monitoring of patients. The primary objective of the PROTECTY study was to assess the compliance with patient use of the telemonitoring platform Cureety. An exploratory objective was to assess if the first-month health status is a prognostic factor of progression free-survival (PFS) and overall survival (OS) for prostate cancer patient., Methods: This prospective study was conducted at the Military Hospital Bégin on prostate cancer patients. Patients were allowed to respond to a symptomatology questionnaire based on CTCAE v.5.0, personalized to their pathology and treatment. An algorithm evaluates the health status of the patient based on the reported adverse events, with a classification into 2 different states: Good Health Status (GHS) and Poor Health status (PHS)., Results: Sixty-one patients were enrolled between July 1st, 2020 and September 30th, 2021. The median age was 74.0 (range 58.0-94.0). 78% presented a metastatic stage, and the most represented cancer was mHSPC. Overall, 2,457 questionnaires were completed by the patients, 4.0% resulted in a health classification in to monitor or critical state. 87% of patients were classified in the GHS group. The compliance was 72% in the overall population during the first month, 71% in GHS group and 75% in PHS group. The median follow-up was 8 months. PFS at 6 months was 84% in GHS group vs. 57% in PHS group, p = 0.19. OS at 6 months was 98% in GHS group vs. 83% in PHS group, p = 0.31., Conclusions: Our study showed that compliance was satisfactory. The feasibility of remote monitoring for prostate cancer patients means that they should benefit from its implementation. Our study is also the first to assess the correlation between treatment tolerance and survival. The initial results suggest that e-PRO assessment could help identify in the early stages the patients that require further health assessment and potential therapeutic changes. While further follow-up of more patients will be required, our study highlights the importance of e-PRO in cancer patient care., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Helissey, Parnot, Rivière, Duverger, Schernberg, Becherirat, Picchi, Le Roy, Vuagnat, Pristavu, Vanquaethem and Brureau.)
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- 2023
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36. Micro-ultrasound-guided biopsies versus systematic biopsies in the detection of prostate cancer: a systematic review and meta-analysis.
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Dariane C, Ploussard G, Barret E, Beauval JB, Brureau L, Créhange G, Fromont G, Gauthé M, Mathieu R, Renard-Penna R, Roubaud G, Ruffion A, Sargos P, Rouprêt M, and Fiard G
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- Male, Animals, Mice, Humans, Prospective Studies, Image-Guided Biopsy methods, Ultrasonography, Ultrasonography, Interventional, Prostatic Neoplasms diagnostic imaging, Prostatic Neoplasms pathology
- Abstract
Purpose: The diagnosis of prostate cancer (PCa) still relies on the performance of both targeted (TB) and systematic biopsies (SB). Micro-ultrasound (mUS)-guided biopsies demonstrated a high sensitivity in detecting clinically significant prostate cancer (csPCa), which could be comparable to that of magnetic resonance imaging (MRI)-TB, but their added value has not been compared to SB yet., Methods: We conducted a systematic review and meta-analysis, based on Medline, EMBASE, Scopus, and Web of Science, in accordance with PRISMA guidelines, to compare mUS-guided biopsies to SB., Results: Based on the literature search of 2957 articles, 15 met the inclusion criteria (2967 patients). Most patients underwent mUS-guided biopsies, followed by MRI-TB and SB. Respectively 5 (n = 670) and 4 (n = 467) studies, providing raw data on SB, were included in a random-effect meta-analysis of the detection rate of csPCa, i.e. Gleason Grade Group (GGG) ≥ 2 or non-csPCa (GGG = 1). Overall, PCa was detected in 56-71% of men, with 31.3-49% having csPCa and 17-25.4% having non-csPCa. Regarding csPCa, mUS-guided biopsies identified 196 and SB 169 cases (Detection Ratio (DR): 1.18, 95% CI 0.83-1.68, I
2 = 69%), favoring mUS-guided biopsies; regarding non-csPCa, mUS-guided biopsies identified 62 and SB 115 cases (DR: 0.55, 95% CI 0.41-0.73, I2 = 0%), also favoring mUS-guided biopsies by decreasing unnecessary diagnosis., Conclusion: Micro-ultrasound-guided biopsies compared favorably with SB for the detection of csPCa and detected fewer non-csPCa than SB. Prospective trials are awaited to confirm the interest of adding mUS-guided biopsies to MRI-TB to optimize csPCa detection without increasing overdiagnosis of non-csPCa., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)- Published
- 2023
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37. Effectiveness of a digital telemonitoring platform for cancer care of older patients: The ConnectElderlyPatientToDoctor study.
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Rivière C, Brureau L, Parnot C, Becherirat S, Duverger C, Picchi H, Le Roy A, Vuagnat P, Schernberg A, Vanquaethem H, and Helissey C
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- Humans, Neoplasms therapy, Telemedicine
- Abstract
While telemedicine has been shown to improve the quality of care for cancer patients, it remains underused for older patients (OP), partly due to the assumption that OPs are unabled or unwilling to use digital tools. However, more than 50% of new cancers are diagnosed in people over 70. The ConnectElderlyPatientToDoctor study aimed to evaluate the OP compliance with the use of the digital telemonitoring platform Cureety in oncology. All cancer patients followed at the Military Hospital Bégin were eligible for the study. Patients were invited to respond to a symptomatology questionnaire personalized to their pathology and treatment. An algorithm evaluated the health status of the patient based on the reported adverse events. The population was divided into two groups, OP and younger patients (YP), based on a cut-off at 70 years. The primary endpoint was to assess the compliance of OPs with the use of the digital oncology platform Cureety, compared to YP. From July 2020 to September 2021, a total of 117 patients were included in our study. We found that 66% of the patients were compliant, with no difference between the two groups (71.2% of YP, 61.7% of OP, P = .29). In OPs, progression free survival (PFS) ratio at 6-months was 64.6% in the tolerant patients vs 23.4% in the nontolerant patients (HR = 0.1980, 95% CI = 0.04431-0.8845, P = .0339). The median PFS was 23.3 months in the tolerant group vs 3.3 months in the nontolerant group (P = .0339). The data of overall survival are immature. OPs had a clear benefit from using this platform, similar to what was observed for YP. Patients felt less isolated and felt that they benefited from personalized care with early ambulatory medical care of adverse events. We also found that the health indicators collected with the platform in the first month of treatment are predictive of the progression of the disease. This solution makes it possible to streamline and improve the care pathway of OP., (© 2022 UICC.)
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- 2023
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38. Heterogeneity of contemporary grade group 4 prostate cancer in radical prostatectomy specimens.
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Martini A, Touzani A, Beauval JB, Ruffion A, Olivier J, Gasmi A, Dariane C, Thoulouzan M, Barret E, Brureau L, Créhange G, Fiard G, Gauthé M, Renard-Penna R, Roubaud G, Sargos P, Roumiguié M, Timsit MO, Mathieu R, Villers A, Rouprêt M, Fromont G, and Ploussard G
- Subjects
- Male, Humans, Prostatectomy, Neoplasm Grading, Prostate pathology, Margins of Excision, Neoplasm Recurrence, Local pathology, Prostate-Specific Antigen, Prostatic Neoplasms surgery, Prostatic Neoplasms pathology
- Abstract
Purpose: The aim was to evaluate the prognostic role of sub-categories of ISUP 4 prostate cancer (PCa) on final pathology, and assess the tumor architecture prognostic role for predicting biochemical recurrence (BCR) after radical prostatectomy., Methods: From a prospectively-maintained database, we included 370 individuals with ISUP 4 on final pathology. The main outcomes were to evaluate the relationship between different ISUP patterns within the group 4 with pathological and oncological outcomes. Binary logistic regression and Kaplan-Meier estimator were used to evaluate the role of the different categories (3 + 5, 4 + 4, 5 + 3) and tumor architecture (intraductal and/or cribriform) on pathological and oncological outcomes., Results: Among the 370 individuals with ISUP considered for the study, 9, 85 and 6% had grade 3 + 5, 4 + 4 and 5 + 3 PCa, respectively. Overall, 74% had extracapsular extension, while lymph node invasion (LNI) was documented in 9%. A total of 144 patients experienced BCR during follow-up. After adjusting for PSA, pT, grade group, LNI and positive surgical margins (PSM), grade 3 + 5 was a protective factor (HR: 0.30, 95% CI: 0.13,0.68, p = 0.004) in predicting BCR relative to grade 4 + 4. Intraductal or cribriform architecture was correlated with BCR (HR: 5.99, 95% CI: 2.68, 13.4, p < 0.001) after adjusting for PSA, pT, grade group, LNI and PSM., Conclusions: Patients with tumor grade 3 + 5 had better pathological and prognostic outcomes compared to 4 + 4 or 5 + 3. When accounting for tumor architecture, the sub-stratification into subgroups lost its prognostic role and tumor architecture was the sole predictor of poorer prognosis in terms of biochemical recurrence., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
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- 2022
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39. Perioperative outcomes after radical prostatectomy: does the surgical approach change the impact of hospital volume? A nationwide analysis.
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Baboudjian M, Gondran-Tellier B, Grabia A, Barret E, Beauval JB, Brureau L, Crehange G, Dariane C, Fiard G, Fromont G, Gauthe M, Mathieu R, Renard-Penna R, Roubaud G, Ruffion A, Sargos P, Lequeu CE, Roupret M, and Ploussard G
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- Hospitals, Humans, Male, Prostate surgery, Prostatectomy
- Published
- 2022
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40. Change of the Neutrophil-to-Lymphocyte Ratio during Treatment: A Potential Prognostic Biomarker in Metastatic Prostate Cancer Treated with Radium-223 Dichloride.
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Kaulanjan K, Dahan J, Charrois-Durand C, Saad F, Brureau L, Delouya G, Taussky D, and Auclin E
- Abstract
The neutrophil to lymphocyte ratio (NLR) at baseline has been shown to have prognostic value in metastatic prostate cancer. Little is known about the importance of a change in the NLR during treatment in patients treated with Radium-223 (223Ra). We investigated the prognostic value of the NLR at baseline and during therapy in patients with metastatic prostate cancer treated with 223Ra and also in patients treated with Docetaxel. We reviewed all patients treated with 223Ra in our center and randomly chosen patients treated with Docetaxel. Patients were stratified according to NLR ≤ 5 and >5 at baseline and at 12 weeks of therapy. The relationship between NLR measured at baseline and at 12 weeks and overall survival (OS) were evaluated. A total of 149 patients treated with 223Ra and 170 with Docetaxel were evaluated. For patients treated with 223Ra, overall survival was significantly better in patients that had both an NLR ≤ 5 at baseline and at 12 weeks. No such effect of NLR was found in patients treated with Docetaxel. In the present study, NLR at baseline and after 12 weeks of therapy was found to be prognostic factor in patients treated with 223Ra but not in those treated with Docetaxel.
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- 2022
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41. DNA damage repair gene germline profiling for metastatic prostate cancer patients of different ancestries.
- Author
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Abdi B, Basset N, Perrot E, Benderra MA, Khalil A, Oudard S, Blanchet P, Brureau L, Coulet F, Cussenot O, and Cancel-Tassin G
- Subjects
- DNA Damage, DNA Repair genetics, Genes, BRCA2, Germ Cells pathology, Germ-Line Mutation, Humans, Male, BRCA2 Protein genetics, Prostatic Neoplasms genetics, Prostatic Neoplasms pathology
- Abstract
Background: Germline and somatic mutations in DNA damage repair genes (DDRg) are now recognized as new biomarkers for the management of metastatic prostate cancers (mPC). We evaluate the frequency of germline DDRg mutations among French mPC patients of European and African ancestries., Methods: Targeted next-generation sequencing of 21 DDRg was performed on germline DNA from 557 mPC patients, including 15.1% of cases with an African origin., Results: Forty-seven germline mutations in 11 DDR genes were identified in 46 patients of the total cohort (8.3%). BRCA2 (4.1%) and ATM (2.0%) were the most frequently mutated genes. There was no difference in DDRg mutation frequency between mPC patients of European ancestry and those of African origin. Germline mutations of BRCA2 were associated with a positive family history of breast cancer (p = 0.02). The mean age at metastatic stage (59.7 vs. 67.0; p = 0.0003) and the mean age at death (65.2 vs. 73.9; p = 0.0003) were significantly earlier for carriers of BRCA2 mutation than for non-carriers. Moreover, the Cox model showed that BRCA2 positive status was statistically associated with poorer survival (hazard ratio: 0.29; 95% confidence interval 0.18-0.48; p < 0.0001)., Conclusion: We showed that, in France, BRCA2 and ATM are the main predisposing DDR genes in mPC patients, with a particular aggressiveness for BRCA2 leading to early metastatic stage and death., (© 2022 Wiley Periodicals LLC.)
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- 2022
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42. Impact of Hospital volume on postoperative outcomes after radical prostatectomy: A 5-Year nationwide database analysis.
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Ploussard G, Grabia A, Beauval JB, Mathieu R, Brureau L, Rozet F, Rouprêt M, and Lequeu CE
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- Male, Humans, Treatment Outcome, Prostatectomy methods, Hospitals, Prostate pathology, Prostatic Neoplasms surgery, Prostatic Neoplasms pathology
- Abstract
Background: Hospital volume is considered to be a quality measure for outcomes after major oncological surgery. However, countrywide data are lacking for radical prostatectomy (RP)., Objective: To assess the impact of hospital volume on postoperative outcomes after RP performed using an open (ORP) versus a minimally invasive surgery (MIS, including pure and robot-assisted RP) approach., Design, Setting, and Participants: Data for patients undergoing RP in France from 2014 to 2019 were extracted from the central database of the national health care system., Outcome Measurements and Statistical Analysis: Primary endpoints were length of hospital stay (LOS), complications (measured as severity index [SI] scores), and hospital readmission rates at 30 and 90 d., Results and Limitations: The median annual hospital volume was 19 RPs (interquartile range 1-40) in the overall cohort. MIS was associated with better outcomes than ORP. Greater hospital volume was correlated with shorter LOS (p < 0.001), high SI scores (SI3: p < 0.001; SI4: p < 0.001), and 30-d (p < 0.001) and 90-d readmission rates (p < 0.001). Incidence rates for SI3 and SI4 scores, and 30-d and 90-d readmission were 12.8 %, 5.8 %, 29.8 %, and 35.4 % in very low-volume centres (<10 annual cases) compared with 8.1 %, 1.9 %, 18.1 %, and 23.9 %, respectively, in other centres (all p < 0.001). Hospital volume was an independent risk factor for all outcomes after taking into account age, lymph node dissection, year of surgery, and surgical approach (ORP vs MIS). The main limitation is the lack of post-RP oncological and functional data., Conclusions: This nationwide analysis of RP procedures shows a significant correlation between hospital volume and postoperative outcomes irrespective of the surgical approach. Very low case volume (<10 annual procedures per centre) is associated with the highest risk of complications, readmission, and prolonged LOS. Greater hospital volume is directly correlated with shorter LOS even beyond this threshold., Patient Summary: In this study we analysed the French nationwide database for removal of the prostate for prostate cancer. We found that the number of these cases that a hospital carries out per year was associated with outcomes after surgery, with better outcomes for higher annual case numbers., (Copyright © 2021 European Association of Urology. Published by Elsevier B.V. All rights reserved.)
- Published
- 2022
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43. Vasectomy and Risk of Prostate Cancer: A Systematic Review and Meta-analysis.
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Baboudjian M, Rajwa P, Barret E, Beauval JB, Brureau L, Créhange G, Dariane C, Fiard G, Fromont G, Gauthé M, Mathieu R, Renard-Penna R, Roubaud G, Ruffion A, Sargos P, Rouprêt M, and Ploussard G
- Abstract
Context: Previous reports have shown an association between vasectomy and prostate cancer (PCa). However, there exist significant discrepancies between studies and systematic reviews due to a lack of strong causal association and residual confounding factors such as prostate-specific antigen (PSA) screening., Objective: To assess the association between vasectomy and PCa, in both unadjusted and PSA screen-adjusted studies., Evidence Acquisition: We performed a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses. The PubMed, Scopus, and Web of Science databases were searched in January 2022 for studies that analyzed the association between vasectomy and PCa., Evidence Synthesis: A total of 37 studies including 16 931 805 patients met our inclusion criteria. A pooled analysis from all studies showed a significant association between vasectomy and any-grade PCa (odds ratio [OR] 1.23; 95% confidence interval [CI], 1.10-1.37; p < 0.001; I
2 = 96%), localized PCa (OR 1.08; 95% CI, 1.06-1.11; p < 0.00001; I2 = 31%), or advanced PCa (OR 1.07; 95% CI, 1.02-1.13; p = 0.006; I2 = 0%). The association with PCa remained significant when the analyses were restricted to studies with a low risk of bias (OR 1.06; 95% CI, 1.02-1.10; p = 0.02; I2 = 48%) or cohort studies (OR 1.09; 95% CI, 1.04-1.13; p < 0.0001; I2 = 64%). Among studies adjusted for PSA screening, the association with localized PCa (OR 1.06; 95% CI, 1.03-1.09; p < 0.001; I2 = 0%) remained significant. Conversely, vasectomy was no longer associated with localized high-grade ( p = 0.19), advanced ( p = 0.22), and lethal ( p = 0.42) PCa., Conclusions: Our meta-analysis found an association between vasectomy and any, mainly localized, PCa. However, the effect estimates of the association were increasingly close to null when examining studies of robust design and high quality. On exploratory analyses including studies, which adjusted for PSA screening, the association for aggressive and/or advanced PCa diminished., Patient Summary: In this study, we found an association between vasectomy and the risk of developing localized prostate cancer without being able to determine whether the procedure leads to a higher prostate cancer incidence., (© 2022 The Author(s).)- Published
- 2022
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44. A Rare Germline HOXB13 Variant Contributes to Risk of Prostate Cancer in Men of African Ancestry.
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Darst BF, Hughley R, Pfennig A, Hazra U, Fan C, Wan P, Sheng X, Xia L, Andrews C, Chen F, Berndt SI, Kote-Jarai Z, Govindasami K, Bensen JT, Ingles SA, Rybicki BA, Nemesure B, John EM, Fowke JH, Huff CD, Strom SS, Isaacs WB, Park JY, Zheng W, Ostrander EA, Walsh PC, Carpten J, Sellers TA, Yamoah K, Murphy AB, Sanderson M, Crawford DC, Gapstur SM, Bush WS, Aldrich MC, Cussenot O, Petrovics G, Cullen J, Neslund-Dudas C, Kittles RA, Xu J, Stern MC, Chokkalingam AP, Multigner L, Parent ME, Menegaux F, Cancel-Tassin G, Kibel AS, Klein EA, Goodman PJ, Stanford JL, Drake BF, Hu JJ, Clark PE, Blanchet P, Casey G, Hennis AJM, Lubwama A, Thompson IM Jr, Leach RJ, Gundell SM, Pooler L, Mohler JL, Fontham ETH, Smith GJ, Taylor JA, Brureau L, Blot WJ, Biritwum R, Tay E, Truelove A, Niwa S, Tettey Y, Varma R, McKean-Cowdin R, Torres M, Jalloh M, Magueye Gueye S, Niang L, Ogunbiyi O, Oladimeji Idowu M, Popoola O, Adebiyi AO, Aisuodionoe-Shadrach OI, Nwegbu M, Adusei B, Mante S, Darkwa-Abrahams A, Yeboah ED, Mensah JE, Anthony Adjei A, Diop H, Cook MB, Chanock SJ, Watya S, Eeles RA, Chiang CWK, Lachance J, Rebbeck TR, Conti DV, and Haiman CA
- Subjects
- Case-Control Studies, Genetic Predisposition to Disease, Germ Cells pathology, Germ-Line Mutation, Homeodomain Proteins genetics, Humans, Male, Prostate-Specific Antigen genetics, Early Detection of Cancer, Prostatic Neoplasms genetics, Prostatic Neoplasms pathology
- Abstract
A rare African ancestry-specific germline deletion variant in HOXB13 (X285K, rs77179853) was recently reported in Martinican men with early-onset prostate cancer. Given the role of HOXB13 germline variation in prostate cancer, we investigated the association between HOXB13 X285K and prostate cancer risk in a large sample of 22 361 African ancestry men, including 11 688 prostate cancer cases. The risk allele was present only in men of West African ancestry, with an allele frequency in men that ranged from 0.40% in Ghana and 0.31% in Nigeria to 0% in Uganda and South Africa, with a range of frequencies in men with admixed African ancestry from North America and Europe (0-0.26%). HOXB13 X285K was associated with 2.4-fold increased odds of prostate cancer (95% confidence interval [CI] = 1.5-3.9, p = 2 × 10
-4 ), with greater risk observed for more aggressive and advanced disease (Gleason ≥8: odds ratio [OR] = 4.7, 95% CI = 2.3-9.5, p = 2 × 10-5 ; stage T3/T4: OR = 4.5, 95% CI = 2.0-10.0, p = 2 × 10-4 ; metastatic disease: OR = 5.1, 95% CI = 1.9-13.7, p = 0.001). We estimated that the allele arose in West Africa 1500-4600 yr ago. Further analysis is needed to understand how the HOXB13 X285K variant impacts the HOXB13 protein and function in the prostate. Understanding who carries this mutation may inform prostate cancer screening in men of West African ancestry. PATIENT SUMMARY: A rare African ancestry-specific germline deletion in HOXB13, found only in men of West African ancestry, was reported to be associated with an increased risk of overall and advanced prostate cancer. Understanding who carries this mutation may help inform screening for prostate cancer in men of West African ancestry., (Copyright © 2022. Published by Elsevier B.V.)- Published
- 2022
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45. Restaging of Patients with Persistently Elevated Prostate-specific Antigen After Radical Prostatectomy Using [ 68 Ga]-PSMA-11 Positron Emission Tomography/Computed Tomography: Impact on Disease Management.
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Gauthé M, Sargos P, Benziane Ouaritini N, Barret E, Beauval JB, Brureau L, Créhange G, Dariane C, Fiard G, Fromont G, Mathieu R, Renard-Penna R, Roubaud G, Ruffion A, Rouprêt M, and Ploussard G
- Subjects
- Disease Management, Edetic Acid, Humans, Male, Neoplasm Recurrence, Local surgery, Positron Emission Tomography Computed Tomography, Prostate-Specific Antigen, Prostatectomy, Retrospective Studies, Gallium Radioisotopes, Prostatic Neoplasms diagnostic imaging, Prostatic Neoplasms surgery
- Published
- 2022
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- View/download PDF
46. PARP Inhibitors as Monotherapy in Daily Practice for Advanced Prostate Cancers.
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Teyssonneau D, Thiery-Vuillemin A, Dariane C, Barret E, Beauval JB, Brureau L, Créhange G, Fiard G, Fromont G, Gauthé M, Ruffion A, Renard-Penna R, Mathieu R, Sargos P, Rouprêt M, Ploussard G, Roubaud G, and On Behalf Of The Cc-Afu Cancerology Committee Of The Association Française d'Urologie
- Abstract
Despite recent improvements in survival, metastatic castration-resistant prostate cancers (mCRPCs) remain lethal. Alterations in genes involved in the homologous recombination repair (HRR) pathway are associated with poor prognosis. Poly-ADP-ribose polymerase (PARP) inhibitors (PARPis) have demonstrated anti-tumoral effects by synthetic lethality in patients with mCRPCs harboring HRR gene alterations, in particular BRCA2 . While both olaparib and rucaparib have obtained government approvals for use, the selection of eligible patients as well as the prescription of these treatments within the clinical urology community are challenging. This review proposes a brief review of the rationale and outcomes of PARPi treatment, then a pragmatic vision of PARPi use in terms of prescription and the selection of patients based on molecular screening, which can involve potential genetic counseling in the case of associated germinal alterations.
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- 2022
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47. Metabolic syndrome and prostate cancer in Afro-Caribbean men.
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Lefebvre F, Blanchet-Deverly A, Michineau L, Blanchet P, Multigner L, and Brureau L
- Subjects
- Black People, Body Mass Index, Guadeloupe epidemiology, Humans, Male, Middle Aged, Neoplasm Grading, Prevalence, Prostate pathology, Prostate-Specific Antigen blood, Risk Factors, Metabolic Syndrome diagnosis, Metabolic Syndrome ethnology, Obesity diagnosis, Obesity ethnology, Prostatic Neoplasms blood, Prostatic Neoplasms ethnology, Prostatic Neoplasms pathology
- Abstract
Introduction and Objectives: Metabolic syndrome (MetS) is a group of risk factors that increases the likelihood of developing cardiovascular diseases. Although suggested, the relationship between MetS and prostate cancer (PCa) is still inconclusive. Very few studies have addressed this question in populations of African descent, which are disproportionately affected by PCa. This study aimed to assess the prevalence of MetS among incident cases of Afro-Caribbean PCa and estimate its association with adverse clinicopathological features and the risk of biochemical recurrence (BCR) after radical prostatectomy (RP)., Materials and Methods: We included 285 consecutive patients with incident cases of PCa attending the University Hospital of Guadeloupe (French West Indies). MetS was evaluated at the time of diagnosis by collecting information on blood pressure, glycaemic status, triglyceride and high-density lipoprotein cholesterol levels, and obesity through various surrogates, including two waist circumference indicators (≤94 cm, ≥102 cm), the waist-to-hip ratio (≥0.95), and body mass index (BMI; ≥30 kg/m
2 ). We followed 245 patients who underwent RP as primary treatment of localized PCa., Results: The prevalence of MetS varied greatly, from 31.6% to 16.4%, when a waist circumference ≥94 cm or BMI were used as obesity surrogates, respectively. No significant associations were found between MetS, regardless of the obesity criteria employed, and the risk of adverse pathological features or BCR., Conclusions: The high variability in MetS resulting from the diversity of obesity criteria used may explain the discordant associations reported in the literature. Further studies using strict and uniform criteria to define MetS on homogeneous ethnic groups are encouraged to clarify the association, if any, between MetS and PCa outcomes., (© 2021 Wiley Periodicals LLC.)- Published
- 2022
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48. Annual nationwide analysis of costs and post-operative outcomes after radical prostatectomy according to the surgical approach (open, laparoscopic, and robotic).
- Author
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Ploussard G, Grabia A, Barret E, Beauval JB, Brureau L, Créhange G, Dariane C, Fiard G, Fromont G, Gauthé M, Mathieu R, Renard-Penna R, Roubaud G, Ruffion A, Sargos P, Rouprêt M, and Lequeu CE
- Subjects
- Humans, Male, Prostatectomy methods, Treatment Outcome, Laparoscopy methods, Robotic Surgical Procedures methods, Robotics
- Abstract
Objective: Annual countrywide data are scarce when comparing surgical approaches in terms of hospital stay outcomes and costs for radical prostatectomy (RP). We aimed to assess the impact of surgical approach on post-operative outcomes and costs after RP by comparing open (ORP), laparoscopic (LRP), and robot-assisted (RARP) RP in the French healthcare system., Patients and Methods: Data from all patients undergoing RP in France in 2020 were extracted from the central database of the national healthcare system. Primary endpoints were length of hospital stay (LOS including intensive care unit (ICU) stay if present), complications (estimated by severity index), hospital readmission rates (at 30 and 90 days), and direct costs of initial stay., Results and Limitations: A total of 19,018 RPs were performed consisting in ORP in 21.1%, LRP in 27.6%, and RARP in 51.3% of cases. RARP was associated with higher center volume (p < 0.001), lower complication rates (p < 0.001), shorter LOS (p < 0.001), and lower readmission rates (p = 0.004). RARP was associated with reduced direct stay costs (2286 euros) compared with ORP (4298 euros) and LRP (3101 euros). The main cost driver was length of stay. The main limitations were the lack of mid-term data, readmission details, and cost variations due to surgery system., Conclusions: This nationwide analysis demonstrates the benefits of RARP in terms of post-operative short-term outcomes. Higher costs related to the robotic system appear to be balanced by patient care improvements and reduced direct costs due to shorter LOS., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
- Published
- 2022
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49. Overall and progression-free survival of Afro-Caribbean men with metastatic castration-resistant prostate cancer (mCRPC).
- Author
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Vestris PG, Gourtaud G, Senechal C, Sadreux Y, Roux V, Blanchet P, and Brureau L
- Subjects
- Antineoplastic Agents therapeutic use, Guadeloupe epidemiology, Humans, Male, Middle Aged, Neoplasm Staging, Progression-Free Survival, Prostate-Specific Antigen blood, Retrospective Studies, Treatment Outcome, Androstenes therapeutic use, Benzamides therapeutic use, Black People statistics & numerical data, Docetaxel therapeutic use, Neoplasm Metastasis diagnosis, Neoplasm Metastasis therapy, Nitriles therapeutic use, Phenylthiohydantoin therapeutic use, Prostatic Neoplasms, Castration-Resistant blood, Prostatic Neoplasms, Castration-Resistant ethnology, Prostatic Neoplasms, Castration-Resistant pathology, Prostatic Neoplasms, Castration-Resistant therapy
- Abstract
Introduction: Several studies in the Caucasian population have shown the benefit of using docetaxel, abiraterone, or enzalutamide for patients with metastatic prostate cancer at the castration-resistant stage (mCRPC). However, there are no strong data for men of African ancestry. The objective of this study was to estimate the overall and progression-free survival of patients according to these treatments at the mCRPC stage., Patients and Methods: This was a monocentric retrospective study that consecutively included 211 men with mCRPC between June 1, 2009 and August 31, 2020. The primary end point was overall survival (OS). The secondary end point was progression-free survival. Kaplan-Meier survival and Cox proportional hazard analyses were performed., Results: The present study included 180 patients for analyses. There was no difference in OS (log-rank test = 0.73), with a median follow-up of 20.7 months, regardless of the treatment administered in the first line. Men with mCRPC who received hormonotherapy (abiraterone or enzalutamide) showed better progression-free survival than those who received docetaxel (log-rank test = 0.004), with a particular interest for abiraterone hazard ratio (HR) = 0.51 (95% confidence interval: 0.39-0.67). The patient characteristics were similar, except for bone lesions, irrespective of the treatment administered in the first line. After univariate then multivariate analysis, only World Health Organization status and metastases at diagnosis were significantly associated with progression., Conclusion: Our results suggest the use of hormonotherapy (abiraterone or enzalutamide) with a tendency for abiraterone in first line for men with African ancestry at the mCRPC stage., (© 2021 Wiley Periodicals LLC.)
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- 2022
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50. Therapeutic failures of targeted antibiotic prophylaxis in urology.
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Curlier E, Sadreux Y, Markowicz S, Brureau L, Donat S, Blanchet P, and Roger PM
- Subjects
- Aged, Aged, 80 and over, Amoxicillin therapeutic use, Bacteria, Bacteriuria microbiology, Female, Humans, Male, Middle Aged, Prospective Studies, Stents, Trimethoprim, Sulfamethoxazole Drug Combination therapeutic use, Urinary Catheters, Urinary Tract Infections microbiology, Anti-Bacterial Agents therapeutic use, Antibiotic Prophylaxis methods, Treatment Failure, Urology
- Abstract
Targeted antibiotic prophylaxis (TAP) is required for patients with positive urine culture before urological surgery. Our aim was to determine the efficacy of TAP. This was a prospective single-center study performed in a urology department. All patients who underwent a programmed surgery were included. Urine culture was obtained before surgery requiring a prophylaxis: in the case of sterile urines, antibiotics were used in accordance with national recommendations; for positive urine culture, a TAP was used in accordance with susceptibility testing. The drugs were administered for 2 days before surgery until withdrawal of bladder catheter. The occurrence of healthcare-associated infections was registered until day 30 after surgery. Two hundred three patients were included for 8 non-consecutive weeks in 2020, among whom fifteen were lost of sight before day 30. Among the remaining 188 patients, most frequent surgeries were 75 prostatic diseases (40%), 50 endo-ureteral surgeries for JJ stent insertion (27%), and 23 bladder cancers (12%). One hundred forty-eight (79%) patients required a urine culture before procedure; 142/148 (96%) urine cultures were performed, leading to 74 TAP. The main isolated bacteria were 48 Enterobacteriaceae and 8 Enterococcus spp. TAP was cotrimoxazole (n = 30), aminoglycosides (n = 11), amoxicillin (n = 9), fluoroquinolones (n = 7), and others (n = 17). The rate of healthcare-associated infections was 14.8% (11/74), including six microbiologically documented antibiotic failures. The rate of healthcare-associated infection after urological surgery using TAP was high, implying to discuss the choice and the dosage of the antibiotic molecules., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
- Published
- 2022
- Full Text
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