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L’étude VISION a montré que le [177Lu]Lu-PSMA-617 en association au traitement de référence prolonge la survie sans progression radiologique et la survie globale des patients CPRCm exprimant le PSMA, pré-traités avec au moins une ligne de chimiothérapie par taxane et une hormonothérapie de nouvelle génération (NHT). Cette étude rétrospective décrit les données d’efficacité et de tolérance des patients CPRCm traités par [177Lu]Lu-PSMA-617 en accès précoce.

Peu de données existent quant aux patients âgés traités pour un cancer de la prostate résistant à la castration métastatique (CPRCM). L’objectif était d’analyser la prise en charge des patients d’au moins 80 ans traités par docétaxel pour un CPRCM.

Le protocole de chimiothérapie périopératoire optimal pour les patients présentant un cancer de vessie infiltrant reste discuté. L’essai VESPER a montré une amélioration de la survie sans progression (PFS) à 3 ans dans le schéma dd-MVAC versus GC. Dans le groupe néoadjuvant, il existait un meilleur contrôle local et surtout une différence significative sur la PFS à 3 ans dans le bras dd-MVAC (p=0,025)

Nous présentons un retour d’expérience rétrospectif de notre utilisation de 177Lu-PSMA-1 radiomarqué sur place pour traiter des patients atteints de cancer de la prostate métastatique résistant à la castration (mCRPC) progressant après des traitements conventionnels.

Several agents have demonstrated an overall survival (OS) benefit in metastatic castration-resistant prostate cancer (mCRPC); however, optimal sequencing is unknown. Retrospective analysis of data from 574 mCRPC patients showed increasing OS with the number of therapies provided; a sequence including docetaxel, cabazitaxel (CABA), and an androgen receptor–targeted agent (ART) provided the greatest benefit. Prior administration of ART did not appear to influence CABA activity. These findings will help guide treatment decisions in daily practice.

Aider à la prise en charge des lésions testiculaires non palpables. Mise au point du groupe organes génitaux externes du comité de cancérologie de l’Association française d’urologie.

Few treatments with a distinct mechanism of action are available for patients with platinum-refractory advanced or metastatic urothelial carcinoma. We assessed the efficacy and safety of treatment with docetaxel plus either ramucirumab—a human IgG1 VEGFR-2 antagonist—or placebo in this patient population.

La TEP-PSMA sera dans un avenir proche un outil clef de la prise en charge en routine et à tous les stades des patients présentant un adénocarcinome prostatique. Elle sera complémentaire de l’IRM pour le bilan d’extension locorégional et pour la délinéation des volumes tumoraux pour la radiothérapie externe. Elle va supplanter la TEP-choline et l’imagerie standard par scanner et scintigraphie osseuse tant pour le bilan d’extension que pour le diagnostic de récidive des adénocarcinomes de prostate. Au stade métastatique, elle sélectionnera les patients pour la radiothérapie interne vectorisée utilisant les ligands du PSMA radiomarqués par des émetteurs d’électrons et pourra en évaluer l’efficacité. L’évaluation de l’efficacité du blocage androgénique par TEP-PSMA doit être faite avec précaution du fait d’un possible effet flare-upengendré par l’hormonothérapie. Les antagonistes ciblant les récepteurs de la bombésine sont en cours de développement clinique pour les mêmes applications.

IMPORTANCE: The optimal total number of docetaxel cycles in patients with metastatic castration resistant prostate cancer (mCPRC) has not been investigated yet. It is unknown whether it is beneficial for patients to continue treatment upon 6 cycles. OBJECTIVE: To investigate whether the number of docetaxel cycles administered to patients deriving clinical benefit was an independent prognostic factor for overall survival (OS) in a post hoc analysis of the Mainsail trial. DESIGN, SETTING, AND PARTICIPANTS: The Mainsail trial was a multinational randomized phase 3 study of 1059 patients with mCRPC receiving docetaxel, prednisone, and lenalidomide (DPL) or docetaxel, prednisone, and a placebo (DP). Study patients were treated until progressive disease or unacceptable adverse effects occurred. Median OS was found to be inferior in the DPL arm compared with the DP arm. As a result of increased toxic effects with the DPL combination, patients on DPL received fewer docetaxel cycles (median, 6) vs 8 cycles in the control group. As the dose intensity was comparable in both treatment arms, we investigated whether the number of docetaxel cycles administered to patients deriving clinical benefit on Mainsail was an independent prognostic factor for OS. We conducted primary univariate and multivariate analyses for the intention-to-treat population. Additional sensitivity analyses were done, excluding patients who stopped treatment for reasons of disease progression and those who received 4 or fewer cycles of docetaxel for other reasons, minimizing the effect of confounding factors. MAIN OUTCOMES AND MEASURES: Total number of docetaxel cycles delivered as an independent factor for OS. RESULTS: Overall, all 1059 patients from the Mainsail trial were included (mean [SD] age, 68.7 [7.89] years). Treatment with 8 or more cycles of docetaxel was associated with superior OS (hazard ratio [HR], 1.909; 95% CI, 1.660-2.194; P < .001), irrespective of lenalidomide treatment (HR, 1.060; 95% CI, 0.924-1.215; P = .41). Likewise, in the sensitivity analysis, patients who received a greater number of docetaxel cycles had superior OS; patients who received more than 10 cycles had a median OS of 33.0 months compared with 26.9 months in patients treated with 8 to 10 cycles; and patients who received 5 to 7 cycles had a median OS of 22.8 months (P < .001). CONCLUSIONS AND RELEVANCE: These findings suggest that continuation of docetaxel chemotherapy contributes to the survival benefit. Prospective validation is warranted.

Los tumores germinales no seminomatosos (TGNS) del testículo son un grupo heterogéneo de neoplasias malignas que afectan a adultos jóvenes. Su evaluación diagnóstica se realiza con una metodología bien codificada, que incluye la orquiectomía total. El tratamiento de los estadios I se basa en una estrategia adaptada al riesgo de recidiva retroperitoneal postorquiectomía. El seguimiento o la quimioterapia adyuvante son las dos opciones principales que deben comentarse con el paciente. El tratamiento de los estadios metastásicos se realiza según una estrategia multimodal. Requieren siempre un tratamiento citotóxico sistémico mediante bleomicina-etopósido-cisplatino (BEP), según protocolos adaptados al grupo pronóstico de la enfermedad. La persistencia de una diana morfológica retroperitoneal supracentimétrica requiere una linfadenectomía complementaria. El carácter completo de la resección de todas las localizaciones metastásicas potencialmente afectadas es un elemento pronóstico fundamental. Los casos de recidiva posquimioterapia o de progresión durante el tratamiento con citotóxicos requieren una segunda línea de quimioterapia, asociada si es necesario a una cirugía de resección amplia, que sólo si es completa permite mejorar el pronóstico desfavorable de estas formas raras. El pronóstico global de los TGNS se aproxima al 85% de supervivencia global (SG), siempre que se respeten estrictamente los estándares de evaluación diagnóstica y que se apliquen las indicaciones terapéuticas. Las situaciones complejas más desfavorables deben remitirse a centros expertos para utilizar moléculas o protocolos innovadores en el marco de ensayos terapéuticos.

Little is known about the prognostic impact of prior paclitaxel therapy and response to induction chemotherapy defined as the regimen preceding high-dose chemotherapy (HDCT) for the salvage therapy of advanced germ cell tumors. Twenty European Society for Blood and Marrow Transplantation centers contributed data on patients treated between 2002 and 2012. Paclitaxel used in either prior lines of therapy or in induction-mobilization regimens was considered. Multivariable Cox analyses of prespecified factors were undertaken on PFS and overall survival (OS). As of October 2013, data for 324 patients had been contributed to this study. One hundred and ninety-two patients (59.3%) had received paclitaxel. Sixty-one patients (19%) had a progression to induction chemotherapy, 234 (72%) a response (29 (9%) missing or granulocyte colony-stimulating factor without chemotherapy). Both progression to induction chemotherapy and prior paclitaxel were significantly associated with shorter OS univariably (P<0.001 and P=0.032). On multivariable analysis from the model with fully available data (N=216) progression to induction was significantly prognostic for PFS and OS (P=0.003), but prior paclitaxel was not (P=0.674 and P=0.739). These results were confirmed after multiple imputation of missing data. Progression to induction chemotherapy could be demonstrated as an independent prognostic factor, in contrast to prior paclitaxel.

Following the demonstration of high levels of interferon-gamma (IFN-γ) synthesis by the pig trophectoderm around implantation, an adequate experimental system was established so as to study the regulation of endogenous IFN-γ gene. Several stable cell lines have been isolated from Day 14 and 15 pig trophoblast, that could withstand indefinite growth when cultured on collagen-coated supports. Since no feeder cells were used for culture, and cell lines could be successfully cloned, these lines represent the first pure porcine trophoblastic (TB) cell lines isolated so far. These cells were shown to exhibit most differentiation markers of epithelial cells and in addition to express the porcine trophectoderm-specific antigen SN1-38. The TB cell line A (TBA) was characterized in more details upon culture on microporous filters, where a high apico-basal polarity could be obtained. In those conditions, a transient and acute interferon-gamma secretion was detected only in the apical medium. Moreover, the two trophoblast-specific mRNA of 1.3 and 1.4kb that have been described in the blastocyst collected in vivo were shown to be synchronously transcribed. This polarized synthesis and secretion of IFN-γ was correlated with the acquisition of maximal levels of electric resistance of TBA monolayers on filters, and was not observed on the same cells cultured on plastic. This differentiation was maintained over 30 passages, demonstrating that the induction of IFN-γ secretion by pig conceptus is not maternally controlled. This cellular model will be of prime importance for studies on the developmental regulation of the IFN-γ gene, and more generally for studies on relationship between secretion and polarity in transporting epithelia.

We present a retrospective feedback of PSMA-targeted radioligands therapy (PRLT) using onsite radiolabeled 177Lu-PSMA-1 to treat metastatic castration-resistant prostate cancer patients (mCRPC) progressing after conventional treatments.

Définir le schéma optimal de chimiothérapie péri-opératoire pour les patients présentant un cancer de la vessie infiltrant. (clinicaltrials.gov NCT01812369).

Four novel neutral copper(I) compounds were prepared, based on the chelating phosphine bis(2-(diphenylphosphino)phenyl)ether, (DPEPhos), and a series of nitrogen-containing heterocycles as ancillary ligands. The optical properties can be tuned according to the ancillary ligand and their emissions at room temperature in aprotic solvent (CH2Cl2) go from greenish blue to orange. Their photoluminescence in solid state is particularly attractive and make their employment in opto-electronic devices very appealing. In particular, the low-cost preparation method of solution-processed light emitting devices is suitable for copper(I) complexes. In order to choose a suitable device architecture, the electrochemical characteristics were investigated and the frontier orbitals values were determined. Preliminary results on solution-processed OLED are presented.

Évaluer la toxicité de la chimiothérapie néoadjuvante (CNA), son impact sur le délai préopératoire et la morbidité périopératoire de la cystectomie pour les tumeurs de vessie infiltrant le muscle (TVIM).

L’objectif de cet article a été de faire une mise au point sur les particularités anatomopathologiques, cliniques et thérapeutiques des différentes formes de tératomes testiculaires de l’adulte.

We realize a declarative practices survey about the management of testicular cancer. A total of 31.8% of 289 urologists who returned the questionnaires, declared that they performed the minimum assessment required by guidelines. Clinical practice did not comply with guidelines, and ask the question of what measures can be taken to ensure better application.

Gemcitabine, a deoxycytidine analogue, is an inhibitor of DNA synthesis. With myelosupression being its most serious toxicity, gemcitabine has, however, a favourable toxicity profile. It was tested in urothelial bladder cancer at different stages of the disease. In superficial BacillusCalmette-GuÉrin (BCG)-resistant bladder cancer as well as in BCG-intolerant patients, intravesical gemcitabine instillation has demonstrated a significant activity. In the adjuvant setting, the combination of gemcitabine and cisplatin (GC) has proved to be a feasible protocol. In locally advanced and metastatic disease, GC is admitted as a standard alternative first-line regimen. Gemcitabine is also an interesting choice for unfit patients when used as a single treatment or in combination with other chemotherapeutic agents as carboplatin or taxanes. This article reviews most of the studies performed in order to promote the usefulness of gemcitabine in bladder cancer.

Introduction

La chimiothérapie néoadjuvante est fortement recommandée pour les patients présentant un carcinome vésical infiltrant le muscle de stade localisé avant cystectomie, néanmoins le schéma optimal de cette chimiothérapie reste à ce jour discuté.

The objectives of this study were to define clinical problems and treatment strategies in vertebral metastases of prostate cancer. The clinical files of 634 patients with prostate cancer seen in a comprehensive cancer center during a 4-year period were retrospectively reviewed. One hundred nineteen patients (18.8%) had 212 significant episodes of osseous spinal metastases. Pain was nearly universal (93%), and motor and bladder impairment occurred in 25% and 3.1% of patients, respectively. Bone scan and magnetic resonance imaging (MRI) were performed in 197 and 64 episodes, respectively. Fifteen episodes of spinal cord compression were treated surgically. Other treatments included hormonal therapy (163 episodes), chemotherapy (70 episodes), and radiation therapy (103 episodes). Osteolytic lesions were observed alone and in combination with osteoblastic pattern in 18% and 26% of episodes, respectively. Bone scan was the most effective screening procedure of vertebral involvement, and MRI effectively showed epidural involvement. Overall treatment led to improvements in pain and motor impairment in 77% and 50% of patients, respectively. However, clinical episodes were recurrent (1.78 episodes per patient; range, 1-8). Median survival after vertebral metastasis episode was 14 months compared with only 4 months after surgery for spinal cord compression. Vertebral metastases strongly alter quality of life in patients with prostate cancer. Pain and neurologic complications are the major problems. Careful early screening with bone scan and MRI may help to define better treatment strategy. However, further prospective studies of clinical management are needed to determine the optimal timing of radiation therapy, medical treatments, and surgery.

Nonseminomatous germ-cell tumors of the testis, the most common cancer in young adult males, are highly curable. Clinical Stage I disease represents almost a third of the patients. Three treatment strategies are currently available: surveillance, postorchiectomy chemotherapy and retroperitoneal lymph node dissection. Factors predictive of extratesticular involvement have been described, thus making it possible to tailor treatment to risk. New imaging procedures also permit staging and prediction of outcome. Decision-making is shared between the patient and his oncologist. Economic issues are better understood but should be further studied.

Nuclear matrix or nucleoskeleton is thought to provide structural basis for intranuclear order. However, the nature of this structure is still uncertain because of numerous technical difficulties in its visualization. To reveal the “real” morphology of the nucleoskeleton, and to identify possible sources of structural artifacts, three methods of nucleoskeleton preparations were compared. The nucleoskeleton visualized by all these techniques consists of identical elements: nuclear lamina and an inner network comprising core filaments and the “diffuse” nucleoskeleton. We then tested if the nucleoskeleton is a stable structure or a transient transcription-dependent structure. Incubation with transcription inhibitors (α-amanitin, actinomycin D, and DRB) for various periods of time had no obvious effect on the morphology of the nucleoskeleton. A typical nucleoskeleton structure was observed also in a physiological model—in transcriptionally inactive mouse 2-cell embryos and in active 8- to 16-cell embryos. Our data suggest that the nucleoskeleton is a permanent structure of the cell nucleus regardless of the nuclear transcriptional state, and the principal architecture of the nucleoskeleton is identical throughout the interphase.

De nouvelles combinaisons d’antiangiogéniques tyrosine kinase (ITK) et d’immunothérapie ou des doublets d’immunothérapie ont montré leur efficacité dans des essais de phase III par rapport au sunitinib en première ligne dans le cancer du rein métastatique. Si la double immunothérapie est déjà utilisée dans d’autres indications, les combinaisons ITK/immunothérapie sont plus récentes et la gestion de leurs effets indésirables moins bien connue, notamment vis-à-vis de l’imputabilité de chaque classe thérapeutique. L’objectif de cet article est d’analyser les données de tolérance des principales études de phase III afin de proposer aux cliniciens des conseils pratiques pour gérer les effets indésirables de ces combinaisons. Leur prise en charge dépend, en grande partie, du type d’association et de leur grade. S’il s’agit d’une association ITK/immunothérapie, l’interruption des deux molécules est envisagée dès le grade 2. Une amélioration rapide des symptômes suggère que l’effet indésirable est lié à l’ITK. Il est alors possible, après résolution, de réintroduire l’ITK en réduisant éventuellement la dose, et de poursuivre l’immunothérapie. Sinon, l’imputabilité revient plutôt à l’immunothérapie et le traitement repose généralement sur des corticoïdes. La prise en charge dépend aussi du type d’effet indésirable et de sa gravité. Dans certains cas (dysthyroïdie), le traitement par ITK/immunothérapie peut être poursuivi. Dans d’autres situations (toxicité cardiaque ou neurologique), il est interrompu dès le grade 1 et l’hospitalisation et la corticothérapie sont à envisager immédiatement. Dans tous les cas, l’information et l’éducation font partie intégrante de la prévention et de la bonne prise en charge des effets indésirables potentiels.

Experimental data related to the resistivity of chemically deposited silver films, and the TCR are interpreted from linearized equations in the framework of the three-dimensional conduction model. The electronic transmission coefficient at the grain boundary, t, and the electronic specular reflection coefficient at the film surface, p, are calculated from both resistivity and TCR measurements; no marked departure is observed. The high value of f agrees with crystallographic data.

Experimental data related to the variations with temperature in the film resistivity of amorphous nickel-boron layers (electrochemically deposited) and its temperature coefficient are used for identifying the temperature for the phase transition. Suggestions are presented for interpreting the observed shifts in the resistivity and in the product of resistivity and its temperature coefficient.

The effects of thermal treatment on the conductivity and the temperature coefficient of resistivity of thin amorphous layers of Ni-B metallic glasses (66% Ni, 34% B) are analysed in terms of the dependence on thickness and ageing temperature. The layer exhibits a macroscopical structure consisting of clusters in an amorphous medium; it is assumed that the cluster resistivity is temperature independent up to 350° C and that the amorphous medium is altered markedly by the ageing processes. These consequences are deduced which are in agreement with a previously proposed model for a layer structure.

Several peptide growth factors, including members of the fibroblast growth factor (FGF) superfamily, are potential inducers of mesoderm in vertebrates. Receptor binding of basic FGF (FGF-2) is promoted by cell surface or extracellular matrix proteoglycans. The substantial biosynthesis of proteoglycans by embryonic cells (called embryoglycans) and their potential role as ligands for growth factor receptors led us to examine the role of embryoglycans that carry the developmentally regulated oligosaccharide epitope TEC 1, in the binding of FGF-2 to cultured rabbit inner cell masses (ICMs). Culture of isolated ICMs in the presence of FGF-2 gave rise to well delimited colonies with migrating cells at the periphery. In these cells, TEC 1 staining shifts from a punctate pattern over the entire membrane, to an apical, finely granular distribution with some internalization. This shift occurs after 96 hours in culture. Here we show that: (1) migrating cells are mesoderm-like in phenotype; (2) antibodies against TEC 1 blocked FGF-2 mediated differentiation in vitro; (3) antibodies against TEC 1 selectively blocked binding of FGF-2 to ectodermal receptors and, vice versa, the binding of TEC 1-specific antibodies to ectodermal cells can be competed by excess FGF-2; (4) the same switch in TEC 1 staining patterns was observed in vivo, between the day 7 and the day 9 rabbit embryo. These data suggest the involvement of defined species of embryonic cell surface epitopes in the regulation of FGF-2 receptor binding. Moreover, this proposed binding activity is temporally restricted to ectodermal cells and disappears early during differentiation. Thus, the apical TEC 1 redistribution can be considered as the earliest indicator of mesoderm formation.

Several peptide growth factors, including members of the fibroblast growth factor (FGF) superfamily, are potential inducers of mesoderm in vertebrates. Receptor binding of basic FGF (FGF-2) is promoted by cell surface or extracellular matrix proteoglycans. The substantial biosynthesis of proteoglycans by embryonic cells (called embryoglycans) and their potential role as ligands for growth factor receptors led us to examine the role of embryoglycans that carry the developmentally regulated oligosaccharide epitope TEC 1, in the binding of FGF-2 to cultured rabbit inner cell masses (ICMs). Culture of isolated ICMs in the presence of FGF-2 gave rise to well delimited colonies with migrating cells at the periphery. In these cells, TEC 1 staining shifts from a punctate pattern over the entire membrane, to an apical, finely granular distribution with some internalization. This shift occurs after 96 hours in culture. Here we show that: (1) migrating cells are mesoderm-like in phenotype; (2) antibodies against TEC 1 blocked FGF-2 mediated differentiation in vitro; (3) antibodies against TEC 1 selectively blocked binding of FGF-2 to ectodermal receptors and, vice versa, the binding of TEC 1-specific antibodies to ectodermal cells can be competed by excess FGF-2; (4) the same switch in TEC 1 staining patterns was observed in vivo, between the day 7 and the day 9 rabbit embryo. These data suggest the involvement of defined species of embryonic cell surface epitopes in the regulation of FGF-2 receptor binding. Moreover, this proposed binding activity is temporally restricted to ectodermal cells and disappears early during differentiation. Thus, the apical TEC 1 redistribution can be considered as the earliest indicator of mesoderm formation.

Interferon-γ IFN-γ and a type I IFN (spl IFN) are transiently coexpressed by trophoblastic cells of pig conceptuses at implantation between day 12 and day 20 of gestation. The local effects of these trophoblastic IFNs were examined on endometrial cells and on trophoblast by measuring antiviral activity and the induction of (2′,5′)-oligoadenylate synthetase activity. Trophoblastic vesicles were shown to be susceptible to infection by vesicular stomatitis virus and transmissible gastroenteritis virus. Vesicular stomatitis virus multiplied by about 1000 times in trophoblastic vesicles, and endogenous trophoblastic IFNs or exogenous recombinant IFN-γ or spl IFN had no effect on virus production. No (2′,5′)-oligoadenylate synthetase activity could be measured on the trophoblast, even after treatment with IFN-γ or spl IFN. These results clearly show that trophoblastic IFNs cannot induce antiviral resistance or (2′,5′)-oligoadenylate synthetase activity in the trophoblast, suggesting that these IFNs have no autocrine function. Endometrial epithelial and stromal cells in primary cultures displayed distinct sensitivity to the antiviral effect of IFN-γ and spl IFN. Stromal fibroblasts were highly sensitive to spl IFN but weakly sensitive to IFN-γ; epithelial cells were sensitive to both IFNs. The same sensitivity pattern was obtained when measuring the (2′,5′)-oligoadenylate synthetase activity. Flushing fluid, containing IFN-γ and type I IFN, was a potent inducer of antiviral effect and (2′,5′)-oligoadenylate synthetase activity. It is therefore postulated that the endometrial epithelium is the most likely target of trophoblastic IFNs. It is possible that these IFNs play a role in the viral protection of conceptuses.

The testes and excurrent ducts of four bonnet macaques (Macaca radiata)were examined using scanning and transmission electron microscopy. The three layers of contractile and connective tissue composing the tunica albuginea, and the multilayered tunica propria of the seminiferous tubules were similar to that of man. Spermatids project from the epithelium or are found free in the lumen. The stages of the cycle of the germinal epithelium in the bonnet macaque were similar to that in other macaques. The epithelium of the rete testis consisted of thin brush‐bordered cells, whereas the epithelium of the efferent ducts consisted of tall, prismatic or cylindrical cells lined by kinocillia or short stereocilia and basal cells. The height of the epididymal epithelium and lumen diameter was maximal in the caput region and minimal at the cauda. Spermatozoa were found among clusters of stereocilia. The epithelium of the vas deferens showed gradual transition from the stereocilia covering typical of the epididymis to that of a shorter, apical microvilli covering.

The expression of cytokeratin- and vimentin-type intermediate filaments was studied by means of immunohistochemistry in Sertoli cells cultured on two types of reconstituted basement membrane in two-compartment culture chambers. In situ, the Sertoli cells of 17-day-old rats contained only vimentin intermediate filaments. During culture, a gradual reorganization of intermediate filaments accompanied by an increased cytokeratin immunoreactivity was observed. After 6 days, Sertoli cells contained both cytokeratin and vimentin, and the same cytokeratin type as in fetal and newborn testis was revealed by electrophoresis and immunoblotting. The present study shows that the isolation and culture of Sertoli cells causes, even in an improved culture system qualitative changes in the expression of intermediate filament proteins.

The Hall effect in nickel-phosphorus thin films prepared by oxydo-reduction in liquid phase, is greatly influenced by the phosphorus present in the deposit by an important effect in structure. The conductivity is electronic. The results are in agreement with the present theories of the Hall effect in ferromagnets.

The main objective of the French GETUG/AFU V05 VESPER randomized phase III study was to assess the efficacy of dd-MVAC and GC in term of progression-free survival in patients for whom chemotherapy has been decided, before or after surgery.

L’apoplexie hypophysaire est un diagnostic redouté des cliniciens car sévère, pour lequel de nombreux facteurs déclenchants ont été identifiés à ce jour [1]. Une dizaine de cas seulement, secondaire à l’administration d’analogues de la GnRH, sont rapportés dans la littérature.

Évaluation des critères conditionnant la récidive des patients présentant des masses résiduelles significatives après chimiothérapie de tumeur germinale (TG) et traités par curage ganglionnaire rétro-péritonéal (CGRP)