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L’âge médian de diagnostic d’un cancer de la prostate (CaP) en France est de 68 ans et ses facteurs de risque, en dehors de l’âge, sont représentés par l’ethnie afro-américaine, les antécédents familiaux ou une mutation germinale de BRCA1/2-HOXB13. Dans ces situations, le CaP peut être diagnostiqué à un âge plus jeune. Cette étude avait pour but d’analyser les caractéristiques des patients européens de moins de 55 ans atteints d’un CaP et d’étudier les modalités d’analyse génomique proposées.

Background: In recent years, the use of Indocyanine Green (ICG) fluorescence-guided surgery during open and laparoscopic procedures has exponentially expanded across various clinical settings. The European Association of Endoscopic Surgery (EAES) initiated a consensus development conference on this topic with the aim of creating evidence-based statements and recommendations for the surgical community. Methods: An expert panel of surgeons has been selected and invited to participate to this project. Systematic reviews of the PubMed, Embase and Cochrane libraries were performed to identify evidence on potential benefits of ICG fluorescence-guided surgery on clinical practice and patient outcomes. Statements and recommendations were prepared and unanimously agreed by the panel; they were then submitted to all EAES members through a two-rounds online survey and results presented at the EAES annual congress, Barcelona, November 2021. Results: A total of 18,273 abstracts were screened with 117 articles included. 22 statements and 16 recommendations were generated and approved. In some areas, such as the use of ICG fluorescence-guided surgery during laparoscopic cholecystectomy, the perfusion assessment in colorectal surgery and the search for the sentinel lymph nodes in gynaecological malignancies, the large number of evidences in literature has allowed us to strongly recommend the use of ICG for a better anatomical definition and a reduction in post-operative complications. Conclusions: Overall, from the systematic literature review performed by the experts panel and the survey extended to all EAES members, ICG fluorescence-guided surgery could be considered a safe and effective technology. Future robust clinical research is required to specifically validate multiple organ-specific applications and the potential benefits of this technique on clinical outcomes.

Les patients présentant une lésion PIRADS 5 ont un surrisque de cancer de la prostate (CaP) cliniquement significatif. Dans ce contexte, la découverte d’un CaP à faible risque peut remettre en cause la décision de surveillance active (SA), notamment en raison du risque d’upstagingsur la pièce de prostatectomie. Cette étude rapporte la survie de patients présentant un CaP avec une lésion PIRADS 5 traités par SA.

Introduction:Multiparametric magnetic resonance imaging (MRI) has been included in prostate cancer (PCa) diagnostic pathway and may improve disease characterization. The aim of this systematic review is to assess the added value of MRI-targeted biopsy (TB) in pre-therapeutic risk assessment models over existing tools based on systematic biopsy (SB) for localized PCa. Evidence acquisition: A systematic search was conducted using Pubmed (Medline), Scopus and ScienceDirect databases according to Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. We included studies through October 2021 reporting on TB in pretherapeutic risk assessment models.

Evaluar la precisión de las biopsias guiada y sistemática para la detección del cáncer de próstata (CP) y CP clínicamente significativo (CPCS) en la práctica diaria, analizando el requerimiento de biopsias sistemáticas adicionales en el momento de la biopsia guiada.

L’utilisation croissante de l’imagerie par résonance magnétique multiparamétrique (IRMmp) de prostate s’accompagne d’une hétérogénéité dans la qualité des images, malgré un suivi des recommandations PI-RADS v2.1. Le score PI-QUAL (Prostate Imaging Quality) est en cours d’étude pour évaluer sa pertinence, et sa relation avec les résultats cliniques.

Prostate cancer is one of the most common malignancies in the world; more and more men are being diagnosed with prostate cancer worldwide. According to epidemiological studies, prostate cancer will become the most common male cancer by 2010, with 900,000 cases per year. Nevertheless, although the constant increase in incidence, knowledge about the aetiology and risk factors of this tumour is still poor. Several important issues could foster the understanding and prevention of this disease, such as the variation in incidence of prostate cancer between ethnic populations, studies on migrants, dietary and genetic factors. Here we provide an update on epidemiology and risk factors of prostate cancer.

Neuroendocrine bladder cancer is extremely rare, with an estimated incidence of 0.5%- 0.7%. In bladder cancers there is no evident connection between the neuroendocrine phenotypic expression and the clinical history. However, prognosis is usually poor and the survival rate at 5 years does not exceed 8%, if untreated.Methods. We are here describing three case reports of bladder carcinoma with neuroendocrine differentiation, which is extremely aggressive and leads rapidly to death. At the present time, the local control of these tumors is achieved by radical cystectomy and radiotherapy; they can be both associated to chemotherapy. However, since these lesions are fairly rare, there is no gold standard therapy and there are no prospective studies on the management of these tumors.Conclusions. Considering the quick evolution and progression of any variant of the neuroendocrine tumors of the bladder, urologists and anesthetists should see them as real oncological emergencies. A prompt intervention through radical surgery with cystectomy and linfadenectomia, and the anathomo-pathologist's systematic investigation of the scraps could make the approach therapeutic and not only palliative. Prospective studies on neo-adjuvant chemotherapy as well as experimental studies about target therapies may yield new guidelines on the tumor management.

Le nomogramme récemment publié par Gandaglia et al. prédit le risque d’effraction extra-capsulaire (ECE) et d’invasion des vésicules séminales (SVI) en se basant sur les données d’imagerie par résonance magnétique (IRM) et des biopsies ciblées. Le but de notre étude était de faire la validation externe de ce modèle et de le comparer aux modèles précédemment décrit.

L’influence du délai entre le diagnostic de cancer prostatique et la prise en charge chirurgicale par prostatectomie radicale sur les résultats oncologiques est controversée. Le but de notre étude d’évaluer l’effet de ce délai en utilisant une cohorte contemporaine de patients diagnostiqués par image par résonance magnétiques et biopsies ciblées.

Le score PIRADS a été développé afin de standardiser l’interprétation des IRM prostatiques, et une probabilité croissante de détecter un cancer lors des biopsies mise en évidence avec l’augmentation du score PIRADS, plus de 80 % des lésions PIRADS 5 correspondant à un cancer significatif. Nous avons cherché à évaluer le rôle pronostique potentiel de ce score PIRADS 5 chez des patients traités par prostatectomie totale.

La réalisation de biopsies ciblées (BC) par fusion IRM-échographie pose la question de la nécessité des biopsies systématiques (BS) pour le diagnostic du cancer de prostate. L’objectif de cette étude a été d’identifier des facteurs prédictifs de détection d’un cancer cliniquement significatif (CaPcs) par des BC seules.

Primary and secondary artery-ureteral fistulas are a rare condition. In this case report we describe a case of misunderstood iliac artery-ureteral fistula, with negative radiological preoperative imaging, which occurred in a man as late complication of ureterocutaneostomy.