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Resume Objectif L’objectif de cette etude est de presenter l’evolution de l’epidemiologie du cancer du rein dans l’Herault a partir des donnees collectees par le registre des tumeurs de l’Herault (RTH) sur une periode de 30 ans. Materiels et methodes A partir de la base de donnees du RTH, nous avons etudie l’evolution du cancer du rein de 1987 a 2016. Nous avons analyse les donnees concernant l’incidence, la mortalite, l’anatomopathologie des tumeurs et leur stade au diagnostic. Nous avons compare ces resultats aux donnees nationales et internationales. Resultats Nous avons recense 3769 nouveaux cas de cancers du rein: 2628 chez l’homme (69,7 %) et 1141 chez la femme (30,3 %). En 2016, le cancer du rein etait le 8e cancer tous sexes confondus, le 7e cancer chez l’homme et le 11e chez la femme. Entre 1987 et 2016 le nombre de nouveaux cas de cancer du rein a ete multiplie par 4,2 chez l’homme et par 3,3 chez la femme. Le nombre de formes localisees a augmente de 9 % en 20 ans. En 2016 la probabilite, d’etre atteint d’un cancer du rein avant 75 ans est de 2,11 % pour un homme et de 0,62 % pour une femme. Conclusion En 30 ans, l’incidence du cancer du rein a fortement augmente dans l’Herault alors que l’on observe une diminution de sa mortalite. Ces donnees analytiques seront ameliorees par le developpement du Registre de l’Herault Specialise en Onco Urologie (RHESOU) Niveau de preuve 3.

Objectifs Le registre des tumeurs de l’Herault (RTH) est un registre general qualifie par le comite national des registres depuis 1987. L’objectif de cette etude est de presenter l’evolution de l’epidemiologie du cancer de la vessie dans le departement de l’Herault a partir des donnees collectees par le RTH sur une periode de 30 ans. Methodes A partir de la base de donnees du RTH, nous avons etudie l’incidence, les taux d’incidence standardises sur la population mondiale (TSM), la frequence relative, le sex-ratio, l’âge moyen au diagnostic, les donnees anatomopathologiques et les primo-traitements pour toutes les tumeurs de la vessie ≥ T1 dans la population de l’Herault entre 1987 et 2016. Les donnees de mortalite proviennent du service SC8 de l’INSERM (CepiDC). Nous avons compare ces resultats aux donnees nationales et internationales. Les estimations francaises proviennent des donnees FRANCIM et les donnees mondiales des registres sont regroupees par le Centre international de recherche sur le cancer (CIRC), situe a Lyon. Resultats Les TSM du cancer de la vessie pour 100 000 sont passes de 11,1 en 1987–1988 (21 hommes, 3,1 femmes) a 8,2 en 2015–2016 (15,2 hommes, 2,5 femmes). Sur 30 ans, le RTH a recense 5580 cas et 2718 deces. Le rapport mortalite/incidence etait de 48,7 % (45,9 % chez l’homme, 62,1 % chez la femme) et le sex-ratio etait de 4,7 hommes pour une femme. En 2016, il etait le 7e cancer dans l’Herault (5e chez l’homme). Les carcinomes urotheliaux representaient 91,7 % des cancers. En 2016, l’âge moyen au diagnostic etait de 74,8 ans (74,2 ans chez l’homme, 76,9 ans chez la femme) et la probabilite d’avoir un cancer de la vessie avant l’âge de 75 ans etait de 1,81 % pour un homme (1/55) et 0,26 % pour une femme (1/382) ( Fig. 1 ). Discussion L’incidence des tumeurs de la vessie a faiblement diminue chez l’homme dans l’Herault. Les registres ne recueillent que les tumeurs ≥ T1, ce qui differe des recommandations cliniques. En 2018, le Registre de l’Herault Specialise en Onco-Urologie (RHESOU) a vu le jour, dans le but d’apporter plus de coherence entre les donnees epidemiologiques et la pratique clinique actuelle. Conclusion L’incidence des tumeurs de la vessie a faiblement diminue chez l’homme dans l’Herault. Les registres ne recueillent que les tumeurs ≥ T1, ce qui differe des recommandations cliniques. En 2018, le Registre de l’Herault Specialise en Onco-Urologie (RHESOU) a vu le jour, dans le but d’apporter plus de coherence entre les donnees epidemiologiques et la pratique clinique actuelle.

An increasing number of patients with prostate cancer (PC) are diagnosed and treated. The aim of this study was to investigate urinary incontinence (UI) and sexual dysfunction (SD) two years after treatment for localized prostate cancer (PC).This study followed all cases of localized PC diagnosed between 2008 and 2009 in men aged≤65years old and still alive two years after treatment. In total, 437 men were recruited. Data were collected using a standardized questionnaire and by cross-checking with data from the cancer registry. Descriptive and comparative analyses were performed to evaluate persisting UI and SD at 2years.At two years after treatment, UI was persistent in 48.8%; 41.2% had used urinary protections, and 39.2% had used at least 1 pad/day; 55.2% reported financial difficulties for purchasing protective pads. In total, 22.7% did not consult a specialist for UI. SD was persistent in 82.8%; 30.4% did not consult a specialist for SD. SD had a negative impact on the sex life of patients and their partners. After adjustment for cancer stage, prostatectomy was significantly associated with persisting UI and SD at two years.Two years after treatment, rates of persisting UI and/or SD remain high. Treatment by prostatectomy was significantly associated with an increased risk of persisting adverse effects at two years. The different toxicities between treatments should be presented to patients before initiating therapy in order to encourage the patient to contributed to shared treatment decision-making.

To evaluate the morbidity of living donor kidney harvesting and the long-term medical consequences and impact on quality of life (QoL).Retrospective analysis of medical and surgical data for 114 living kidney donors in a single teaching hospital between 1977 and 2005. Complications were evaluated in relation to the surgical approach and body mass index (BMI) using a Chi-square test or Fisher's exact test. Changes in renal function (serum creatinine, creatinine clearance), proteinuria and blood pressure (BP) were studied by Student's t test or a Mann-Whitney U or Wilcoxon nonparametric test. Long-term QoL was evaluated by the MOS SF-36 questionnaire and a local questionnaire and was then compared to that of the French general population.The median follow-up was 63 months. The morbidity of kidney harvesting was significantly correlated with the surgical approach (p = 0.018) and a BMIor = 25 kg/m2 (p = 0.014). No mortality was observed in this series. A moderate elevation of serum creatinine was observed during follow-up (mean serum creatinine increased from 82.2 micromol/l [+/- 16.3] to 104.5 micromol/l [+/- 19.9]), and mean creatinine clearance decreased from 113.4 ml/min [+/- 27.6] to 76 ml/min [+/- 29.9]. Little impact was observed on proteinuria and BP and QoL was not altered by kidney harvesting.The perioperative complication rate is correlated with BMI and a flank incision. Kidney harvesting lowers glomerular filtration, but clearance remained stable during follow-up. Macroalbuminuria or hypertension may be observed, but their frequency is not higher than in the general population. The QoL of living donors is not altered. Clear information for the general public would allow promotion of living donor transplantation.

Chemotherapy occupies an increasingly important place in the management of hormone-resistant metastatic prostate cancer. For the first time in this disease, docetaxel increases the survival of patients, with a modest, but definite median gain of about 2 months. In everyday practice, the indication for second-line chemotherapy after immediate or delayed failure of first-line chemotherapy is sometimes considered, although objective data concerning its efficacy are limited. The objective of the present study was to retrospectively evaluate the results obtained with second-line chemotherapy in a patient cohort managed at the Montpellier Regional Cancer Centre.Clinical characteristics, treatments delivered and outcome of 43 patients who received two successive lines of chemotherapy were retrospectively collected by means of a standardized questionnaire. Three groups of patients were defined as a function of the chemotherapy protocols delivered: docetaxel alone or in combination, mitoxantrone and other protocols not comprising either docetaxel or mitoxantrone. Responses to chemotherapy were analysed according to three criteria: objective responses, laboratory responses and palliative responses.At the time of second-line chemotherapy, the median age of the patients was 69 years (range: 46 to 83). The median interval between the end of first-line chemotherapy and the start of second-line chemotherapy was 3 months (range: 1 to 15). The protocols administered comprised docetaxel alone (12 patients) or in combination with cisplatin (4 patients), mitoxantrone in 13 patients, or other cytotoxic molecules such as vinblastine, doxorubicin or etoposide in combination with a platinum salt (14 patients). The median number of cycles delivered was 4 (range: 1 to 10). No objective response was observed. Six (14%) patients obtained a laboratory response. A palliative response was observed in 16 (37%) patients, 7 of whom were treated with a docetaxel-based protocol, 6 were treated with mitoxantrone and 3 were treated by other protocols. The median duration of palliative response was 3 months (range: 1 to 6). The median survival was 8 months (range: 1 to 24), with no significant difference between the various protocols.In 2006, the objective of second-line chemotherapy in patients with hormone-resistant prostate cancer appears to be purely palliative. No reference protocol has been defined among currently available cytotoxic molecules. The indication must therefore take into account the benefit/risk balance to avoid compromising the patients quality of life. Therapeutic trials are essential to develop effective new molecules.

Tumours of the penis are potentially serious tumours, but are uncommon in western countries. Follow-up is based on clinical examination and thoracoabdominopelvic CT scan.

Intratubular neoplasia (ITN) of the testis is a precursor of germ cell tumour, apart from spermatocytic seminoma. It is often detected in testicular tissue adjacent to germ cell tumours, but is less common in the contralateral testis. Early diagnosis of ITN by testicular biopsy would allow earlier, conservative management. However, this approach remains highly controversial except in very specific indications.

The objective of this study is to present the characteristics of urological cancers in the Hérault department based on data of this department's cancer registry.We analysed the course of all urological data over a 14-year period, from 1987 to 2000, based on the Hérault cancer registry database. Incidence and mortality chronological trends, the risk of cancer before the age of 75 years, and regional estimations were calculated for each cancer site. Data for each cancer site were also compared to French, European and international data.9,556 urological cancers were reported over a period of fourteen years: 8,779 in males and 777 in females. Urological cancers represented 30.1% of all male cancers and 3.6% of all female cancers. The probability of developing a genital cancer before the age of 75 years for a man was 12.6% and the probability of a urinary tract cancer was 3.2% in males and 0.8% in females. The incidence of prostate cancer has more than tripled over this 14-year period, while the mortality has remained stable. The incidence of renal cancers in both sexes is also increasing, while that of bladder cancers is decreasing. The incidence of cancers of the penis, testis and upper urinary tract has remained stable over time.