Author: "Gaelle Fiard" / Topic: 030220 oncology & carcinogenesis - Searchworks@Jio Institute Digital Library Search Results

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1. Annual nationwide analysis of costs and post-operative outcomes after radical prostatectomy according to the surgical approach (open, laparoscopic, and robotic)

Author: Guilhem Roubaud, Eric Barret, Gilles Créhange, Mathieu Gauthé, Laurent Brureau, Charles-Edouard Lequeu, Romain Mathieu, Alain Ruffion, Jean-Baptiste Beauval, Morgan Rouprêt, Gaëlle Fromont, Gaelle Fiard, Annabelle Grabia, Guillaume Ploussard, Charles Dariane, Paul Sargos, Raphaële Renard-Penna, Clinique La Croix du Sud, Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Mutualiste de Montsouris (IMM), CHU Pointe-à-Pitre/Abymes [Guadeloupe], Institut de recherche en santé, environnement et travail (Irset), Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA), École des Hautes Études en Santé Publique [EHESP] (EHESP), Institut Curie [Paris], Immunologie et Neurogénétique Expérimentales et Moléculaires (INEM), Centre National de la Recherche Scientifique (CNRS)-Université d'Orléans (UO), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre Hospitalier Universitaire [Grenoble] (CHU), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Equipe 5 : METHODS - Méthodes de l’évaluation thérapeutique des maladies chroniques (CRESS - U1153), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CHU Pontchaillou [Rennes], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Bergonié [Bordeaux], UNICANCER, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Ciblage thérapeutique en Oncologie (EA3738), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, 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 Toulouse (UT)-Université de Toulouse (UT)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Institut National de la Santé et de la Recherche Médicale (INSERM), 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 ), Université d'Orléans (UO)-Centre National de la Recherche Scientifique (CNRS), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), and Centre pour l'innovation en cancérologie de Lyon (CICLY)
Subjects: Male, medicine.medical_specialty, Cost, [SDV]Life Sciences [q-bio], Urology, medicine.medical_treatment, 030232 urology & nephrology, law.invention, 03 medical and health sciences, Indirect costs, 0302 clinical medicine, Robotic Surgical Procedures, law, Humans, Medicine, Post operative, Laparoscopy, Prostatectomy, Prostate cancer, Surgical approach, medicine.diagnostic_test, Volume, business.industry, Robotics, Radical prostatectomy, Intensive care unit, Treatment Outcome, Robotic systems, Cost driver, 030220 oncology & carcinogenesis, Emergency medicine, business, Complication, Readmission
Abstract: International audience; 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.
Published: 2021
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2. IMAGINE-IMpact Assessment of Guidelines Implementation and Education: The Next Frontier for Harmonising Urological Practice Across Europe by Improving Adherence to Guidelines

Author: Philip Cornford, Emma Jane Smith, Steven MacLennan, Nuno Pereira-Azevedo, Monique J. Roobol, Nicolaas Lumen, Louise Fullwood, Eilidh Duncan, Jennifer Dunsmore, Karin Plass, Maria J. Ribal, Thomas Knoll, Anders Bjartell, Hendrick Van Poppel, James N’Dow, Alberto Briganti, Karl Dorfinger, Irene Resch, Mischinger Johannes, Isabel Heidegger, Christophe Assenmacher, Thierry Roumeguère, Karel Decaestecker, Lieven Goeman, Thomas Adams, Marincho Georgiev, Krassimir Yanev, Aleksandar Timev, Igor Tomašković, Tomislav Kuliš, Stavros Charalampous, Dimitris Kontaxis, Marko Babjuk, Roman Zachoval, Tomáš Pitra, Vojtěch Novák, Lars Lund, Martin Kivi, Peep Baum, Toomas Tamm, Pritt Veskimae, Rauno Okas, Kanerva Lahdensuo, Kimmo Taari, Heikki Seikkula, Pyry Jämsä, Xavier Gamé, George Fournier, Alexandre Ingels, Gaelle Fiard, Guillaume Ploussard, Jens Rassweiler, Stefanie Schmidt, Jennifer Kranz, Susanne Krege, Ioannis Gkialas, Anthanasios Dellis, Nikolaos Ferakis, Dionysios Mitropoulos, Peter Ryan, John Paul Sweeney, Eamonn Rogers, Derek Hennessy, Niall. F. Davis, Walter Artibani, Francesco Porpiglia, Salvatore Giuseppe Voce, Maurizio Brausi, Maria A. Cerruto, Francesco Esperto, Matteo Manfredi, Mindaugas Jievaltas, Aušvydas Patašius, Albertas Čekauskas, Stasys Auškalnis, Peter Mulders, Frank Martens, Kathleen W.M. D'Hauwers, Piotr Chlosta, Anna Katarzyna Czech, Katarzyna Gronostaj, Mikołaj Przydacz, Pedro Coelho Nunes, Luís Abranches-Monteiro, Ricardo Pereira e Silva, Frederica Furriel, Pedro Gomes Monteiro, Ioanel Sinescu, Cristian Surcel, Catalin Baston, Robert Ionut Stoica, Vlad Olaru, Boris Kollárik, Ivan Mincik, Ľuboš Rybár, Viktor Kováčik, Ivan Perečinský, Boris Kosuta, Marko Zupancic, Milena Taskovska, Uros Kacjan, Andraz Miklavzina, Manuel Esteban Fuertes, Mario Alvarez-Maestro, Antoni Vilaseca, Rodrigo García-Baquero, Lotta Renström Koskela, Johan Styrke, Gezim Galiqi, Bilbil Hoxha, Evisa Zhapa, Rezart Xhani, Sergey Fanarjyan, Ruben Hovhannisyan, Avoyan E. Armen, Rafael Badalyan, Mustafa Hiroš, Davor Tomić, Damir Aganović, Archil Chkhotua, David Nikoleishvili, Zara Tchanturaia, Sigurdur Gudjónsson, Eirikur Orri Gudmundsson, Rafn Hilmarsson, Emil Ceban, Vitalii Ghicavii, Adrian Tanase, Vladislav Vasiliev, Dragoljub Perovic, Marko Vukovic, Stanisavljevic Rade, Nenad Radovic, Emil Nasufovic, Yuri Alyaev, Igor Korneyev, Sergei Kotov, Vigen Malkhasyan, Dragoslav Basic, Miodrag Aćimović, Saša Vojinov, Aleksandar Vuksanovic, Uroš Bumbaširević, Bojan Čegar, Branko Stanković, Hansjörg Danuser, Tullio Sulser, Valentin Zumstein, Ates Kadioglu, Hakan Kilicarslan, Nusret Can Cilesiz, Erhan Demirelli, Bülent Önal, Aydin Mungan, Serdar Tekgül, Levent Türkeri, Adil Esen, Oleksandr Shulyak, Sergiy Vozianov, Alexandr Shulyak, Serhii Volkov, Andrii Nesterchuk, Urology, Cornford, P., Smith, E. J., Maclennan, S., Pereira-Azevedo, N., Roobol, M. J., Lumen, N., Fullwood, L., Duncan, E., Dunsmore, J., Plass, K., Ribal, M. J., Knoll, T., Bjartell, A., Van Poppel, H., N'Dow, J., and Briganti, A.
Subjects: Supplementary data, Physicians', Impact assessment, business.industry, Urology, 030232 urology & nephrology, MEDLINE, Guideline, Practice Patterns, Clinical Practice, Europe, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], 03 medical and health sciences, Frontier, 0302 clinical medicine, Reconstructive and regenerative medicine Radboud Institute for Molecular Life Sciences [Radboudumc 10], Nursing, 030220 oncology & carcinogenesis, Urological cancers Radboud Institute for Molecular Life Sciences [Radboudumc 15], Medicine, Humans, Guideline Adherence, Practice Patterns, Physicians', Baseline (configuration management), business
Abstract: Contains fulltext : 237261.pdf (Publisher’s version ) (Closed access) Adherence to national and international clinical practice guidelines is suboptimal throughout Europe. The European Association of Urology Guidelines Office project "IMAGINE" (IMpact Assessment of Guidelines Implementation and Education) has been developed to measure baseline adherence to urological guideline recommendations across Europe and to identify issues that drive nonadherence.
Published: 2021

3. Use of prostate systematic and targeted biopsy on the basis of multiparametric MRI in biopsy-naive patients (MRI-FIRST): a prospective, multicentre, paired diagnostic study

Author: Athivada Soto Thammavong, Raphaële Renard-Penna, Gilles Pasticier, Jean-Philippe Fendler, Flavie Bratan, Romain Boutier, Hervé Lang, Pascal Eschwege, Jochen Walz, Arnault Viller, Myriam Decaussin-Petrucci, Alain Ruffion, Nicolas Barry Delongchamps, Y. Lebras, François Cornud, Pierre Mozer, Jean-Michel Correas, Olivier Rouvière, Laurent Lemaitre, Michel Claudon, Paul C. Moldovan, Marine Dubreuil-Chambardel, Fanny Cros, Pierre Colin, Bernard Malavaud, Sebastien Crouzet, Hocine Habchi, Ahmed Khairoune, F Lefèvre, Anne-Marie Schott, Nicolas Grenier, G. Pagnoux, S. Brunelle, Marc Colombel, Laurent Magaud, Laurent Remontet, Philippe Camparo, Philippe Puech, François Cornelis, Florence Mège-Lechevallier, Muriel Rabilloud, Pierre Nevoux, E. Potiron, Daniel Portalez, Marc-Olivier Timsit, Nicolas Mottet, Gaelle Fiard, Jean-Luc Descotes, Catherine Roy, Philippe Hallouin, Hospices Civils de Lyon (HCL), Therapies Interventionnelles Assistees Par l'Image et la Simulation, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé, Thérapies Laser Assistées par l'Image pour l'Oncologie - U 1189 (ONCO-THAI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Université de Lille, Service d'urologie et transplantation rénales [CHU Pitié-Salpétrière], CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Département de Radiologie adultes [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Université de Lorraine (UL), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), CHU Strasbourg, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Service de Biostatistiques [Lyon], Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Hôpital Edouard Herriot [CHU - HCL], Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre Léon Bérard [Lyon], Centre Léon Bérard [Lyon], Service d'urologie [Centre Hospitalier Lyon Sud - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Centre de recherche cerveau et cognition (CERCO), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut des sciences du cerveau de Toulouse. (ISCT), Université Toulouse - Jean Jaurès (UT2J)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Toulouse - Jean Jaurès (UT2J)-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Biostatistiques santé, Département biostatistiques et modélisation pour la santé et l'environnement [LBBE], Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Imagerie moléculaire et fonctionnelle: de la physiologie à la thérapie, Université Bordeaux Segalen - Bordeaux 2-IFR8-Centre National de la Recherche Scientifique (CNRS), Centre de Recherches en Cancérologie de Toulouse (CRCT), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hospices Civils de Lyon, Departement de Neurologie (HCL), Institut Paoli-Calmettes, Fédération nationale des Centres de lutte contre le Cancer (FNCLCC), CHU Amiens-Picardie, Service de radiologie [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Bordeaux (UB), Service Maladies infectieuses et tropicales [AP-HP Hôpital Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-IMAG-GMCAO), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Centre Hospitalier Universitaire [Grenoble] (CHU), Service d'Urologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre hospitalier Saint Joseph - Saint Luc [Lyon], Centre Hospitalier Universitaire de Reims (CHU Reims), CHU Necker - Enfants Malades [AP-HP], Service d'urologie [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHU Bordeaux [Bordeaux], Centre d'Energétique et de Thermique de Lyon (CETHIL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS), Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'urologie, andrologie et transplantation rénale, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Service d'Hématologie [IUCT Toulouse], Université Fédérale Toulouse Midi-Pyrénées-Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Lille 2 - Faculté de Médecine, Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université Paris Descartes - Paris 5 (UPD5), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Therapies Interventionnelles Assistees Par l'Image et la Simulation - U 703 (Thiais), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut des sciences du cerveau de Toulouse. (ISCT), Université Toulouse - Jean Jaurès (UT2J), Université de Toulouse (UT)-Université de Toulouse (UT)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Toulouse - Jean Jaurès (UT2J), Université de Toulouse (UT)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre National de la Recherche Scientifique (CNRS), MRI-FIRST Investigators: Nicolas Barry Delongchamps, Romain Boutier, Flavie Bratan, Serge Brunelle, Philippe Camparo, Pierre Colin, Jean-Michel Corréas, François Cornélis, François Cornud, Fanny Cros, Jean-Luc Descotes, Pascal Eschwege, Gaelle Fiard, Jean-Philippe Fendler, Hocine Habchi, Philippe Hallouin, Ahmed Khairoune, Hervé Lang, Yann Lebras, Frédéric Lefèvre, Bernard Malavaud, Paul Cezar Moldovan, Nicolas Mottet, Pierre Mozer, Pierre Nevoux, Gaele Pagnoux, Gilles Pasticier, Daniel Portalez, Eric Potiron, Athivada Soto Thammavong, Marc-Olivier Timsit, Arnault Viller, Jochen Walz, Thérapies Laser Assistées par l'Image pour l'Oncologie (ONCO-THAI), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Université de Lorraine (UL), Centre de Recherche en Cancérologie de Lyon (CRCL), Université de Lyon-Université de Lyon-Centre Léon Bérard [Lyon]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP], Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Service d'Urologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Toulouse - Jean Jaurès (UT2J)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre National de la Recherche Scientifique (CNRS), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Toulouse - Jean Jaurès (UT2J)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre National de la Recherche Scientifique (CNRS), and CCSD, Accord Elsevier
Subjects: Adult, Image-Guided Biopsy, Male, medicine.medical_specialty, Adolescent, [SDV]Life Sciences [q-bio], 030232 urology & nephrology, Prostatitis, Young Adult, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, Prostate, Biopsy, medicine, Humans, Prospective Studies, Multiparametric Magnetic Resonance Imaging, Stage (cooking), Prospective cohort study, Ultrasonography, Interventional, Aged, medicine.diagnostic_test, Urinary retention, business.industry, Prostatic Neoplasms, Cancer, Middle Aged, Prostate-Specific Antigen, medicine.disease, 3. Good health, [SDV] Life Sciences [q-bio], medicine.anatomical_structure, Oncology, 030220 oncology & carcinogenesis, Radiology, medicine.symptom, business
Abstract: Summary Background Whether multiparametric MRI improves the detection of clinically significant prostate cancer and avoids the need for systematic biopsy in biopsy-naive patients remains controversial. We aimed to investigate whether using this approach before biopsy would improve detection of clinically significant prostate cancer in biopsy-naive patients. Methods In this prospective, multicentre, paired diagnostic study, done at 16 centres in France, we enrolled patients aged 18–75 years with prostate-specific antigen concentrations of 20 ng/mL or less, and with stage T2c or lower prostate cancer. Eligible patients had been referred for prostate multiparametric MRI before a first set of prostate biopsies, with a planned interval of less than 3 months between MRI and biopsies. An operator masked to multiparametric MRI results did a systematic biopsy by obtaining 12 systematic cores and up to two cores targeting hypoechoic lesions. In the same patient, another operator targeted up to two lesions seen on MRI with a Likert score of 3 or higher (three cores per lesion) using targeted biopsy based on multiparametric MRI findings. Patients with negative multiparametric MRI (Likert score ≤2) had systematic biopsy only. The primary outcome was the detection of clinically significant prostate cancer of International Society of Urological Pathology grade group 2 or higher (csPCa-A), analysed in all patients who received both systematic and targeted biopsies and whose results from both were available for pathological central review, including patients who had protocol deviations. This study is registered with ClinicalTrials.gov, number NCT02485379, and is closed to new participants. Findings Between July 15, 2015, and Aug 11, 2016, we enrolled 275 patients. 24 (9%) were excluded from the analysis. 53 (21%) of 251 analysed patients had negative (Likert ≤2) multiparametric MRI. csPCa-A was detected in 94 (37%) of 251 patients. 13 (14%) of these 94 patients were diagnosed by systematic biopsy only, 19 (20%) by targeted biopsy only, and 62 (66%) by both techniques. Detection of csPCa-A by systematic biopsy (29·9%, 95% CI 24·3–36·0) and targeted biopsy (32·3%, 26·5–38·4) did not differ significantly (p=0·38). csPCa-A would have been missed in 5·2% (95% CI 2·8–8·7) of patients had systematic biopsy not been done, and in 7·6% (4·6–11·6) of patients had targeted biopsy not been done. Four grade 3 post-biopsy adverse events were reported (3 cases of prostatitis, and 1 case of urinary retention with haematuria). Interpretation There was no difference between systematic biopsy and targeted biopsy in the detection of ISUP grade group 2 or higher prostate cancer; however, this detection was improved by combining both techniques and both techniques showed substantial added value. Thus, obtaining a multiparametric MRI before biopsy in biopsy-naive patients can improve the detection of clinically significant prostate cancer but does not seem to avoid the need for systematic biopsy. Funding French National Cancer Institute.
Published: 2019
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4. The Mayo Adhesive Probability score can help predict intra- and postoperative complications in patients undergoing laparoscopic donor nephrectomy

Author: Xavier Matillon, Lionel Badet, Q. Franquet, Thomas Jouve, Ricardo Codas-Duarte, Sebastien Crouzet, Gaelle Fiard, Hakim Fassi-Fehri, D. Poncet, Lionel Rostaing, Jean-Luc Descotes, Nicolas Terrier, Paolo Malvezzi, Jean-Jacques Rambeaud, Johan Noble, Jean-Alexandre Long, Centre Hospitalier Universitaire [Grenoble] (CHU), Service d'urologie [CHU Grenoble], Université Grenoble Alpes (UGA), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-GMCAO), Translational Innovation in Medicine and Complexity / Recherche Translationnelle et Innovation en Médecine et Complexité - UMR 5525 (TIMC ), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), and Université Grenoble Alpes (UGA)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )
Subjects: Adult, Male, Nephrology, medicine.medical_specialty, Multivariate analysis, Urology, medicine.medical_treatment, laparoscopy, 030232 urology & nephrology, living donor, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, Living donor, Adipose capsule of kidney, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, nephrectomy, postoperative complications, medicine, Humans, In patient, intraoperative complications, Laparoscopy, ComputingMilieux_MISCELLANEOUS, Retrospective Studies, medicine.diagnostic_test, business.industry, Middle Aged, Nephrectomy, 3. Good health, Surgery, Dissection, 030220 oncology & carcinogenesis, Tissue and Organ Harvesting, Female, business
Abstract: Living donor nephrectomy is a high-stake procedure involving healthy individuals, therefore every effort should be made to define each patient’s individualized risk and improve potential donors’ information. The aim of this study was to evaluate the interest of the Mayo adhesive probability (MAP) score, an imaging-based score initially designed to estimate the risk of adherent perinephric fat in partial nephrectomy, to predict intra- and postoperative complications of living donor nephrectomy. We retrospectively reviewed the imaging, clinical, and follow-up data of 452 kidney donors who underwent laparoscopic donor nephrectomy in two academic centers. Imaging and follow-up data were available for 307 kidney donors, among which 44 (14%) had a high MAP score (≥ 3). Intraoperative difficulties were encountered in 50 patients (16%), including difficult dissection (n = 35) and bleeding (n = 17). Conversion to open surgery was required for 13 patients (4.2%). On multivariate analysis, a MAP score ≥ 3 was significantly associated with the risk of intraoperative difficulty [OR 14.12 (5.58–35.7), p
Published: 2020
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5. Does whole-body bone SPECT/CT provide additional diagnostic information over [18F]-FCH PET/CT for the detection of bone metastases in the setting of prostate cancer biochemical recurrence?

Author: Julie Roux, Christopher Montemagno, Carole Iriart, J.P. Vuillez, Olivier Phan Sy, Gaelle Fiard, Jean-Luc Descotes, Jean-Alexandre Long, Loïc Djaileb, Nicolas De Leiris, Laurent Riou, Mathieu Laramas, Julien Leenhardt, Bastien Boussat, Alexandre Seiller, and Camille Verry
Subjects: Biochemical recurrence, Male, lcsh:Medical physics. Medical radiology. Nuclear medicine, Diagnostic information, Single Photon Emission Computed Tomography Computed Tomography, PET/CT, lcsh:R895-920, Molecular imaging, Bone Neoplasms, lcsh:RC254-282, 030218 nuclear medicine & medical imaging, Choline, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, Positive predicative value, Positron Emission Tomography Computed Tomography, parasitic diseases, 18F-FCH, Medicine, Humans, Radiology, Nuclear Medicine and imaging, Aged, PET-CT, Radiological and Ultrasound Technology, business.industry, Bone metastases, Significant difference, Prostatic Neoplasms, General Medicine, Middle Aged, medicine.disease, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Oncology, 030220 oncology & carcinogenesis, Concomitant, Bone SPECT/CT, Radiopharmaceuticals, business, Whole body, Nuclear medicine, Research Article
Abstract: Background To assess whether whole-body (WB) bone SPECT/CT provides additional diagnostic information over [18F]-FCH PET/CT for the detection of bone metastases in the setting of prostate cancer biochemical recurrence (PC-BR). Methods Patients referred for a PC-BR and whom benefited from a WB bone SPECT/CT and FCH PET/CT were retrospectively included. Tests were classified as positive, equivocal, or negative for bone metastases. A best valuable comparator (BVC) strategy including imaging and follow-up data was used to determine the metastatic status in the absence of systematic histological evaluation. Results Between January 2011 and November 2017, 115 consecutive patients with a PC-BR were evaluated. According to the BVC, 30 patients had bone metastases and 85 patients did not present with bone lesions. The sensitivity, specificity, positive and negative predictive values were respectively 86.7% [69.3–96.2], 98.8% [93.6–100.0], 96.3% [78.7–99.5], and 95.5% [89.4–98.1] for WB bone SPECT/CT and 93.3% [77.9–99.2], 100.0% [95.8–100.0], 100.0 and 97.7% [91.8–99.4] for FCH PET/CT. There was no significant difference in diagnostic accuracy of bone metastases between WB Bone SPECT/CT (AUC 0.824 [0.74–0.90]) and FCH PET/CT (AUC 0.829 [0.75–0.90], p = 0.41). Conclusion Despite good performances for the diagnosis of bone metastases in PC-BR, WB bone SPECT/CT does not provide additive diagnostic information over concomitant FCH PET/CT.
Published: 2020
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6. Observation vs. early drainage for grade IV blunt renal trauma: a multicenter study

Author: Ines Dominique, P. Patard, Axelle Boehm, K. Guleryuz, Q. Langouet, R. Betari, X. Rod, Christian Pfister, Anthony Giwerc, P. Panayatopoulos, L. Sabourin, Jonathan Olivier, Thomas Caes, N. Brichart, Charles Dariane, Lucas Freton, Gaelle Fiard, S. Bergerat, Benoit Peyronnet, Benjamin Pradere, Cedric Lebacle, J. Rizk, A. Chebbi, Alexandre Gryn, Marina Ruggiero, M. Hutin, François-Xavier Nouhaud, N. Szabla, C. Millet, X. Matillon, and François-Xavier Madec
Subjects: Adult, Male, Nephrology, medicine.medical_specialty, Multivariate analysis, Adolescent, Urology, medicine.medical_treatment, 030232 urology & nephrology, Kidney, Wounds, Nonpenetrating, Young Adult, 03 medical and health sciences, Injury Severity Score, 0302 clinical medicine, Blunt, Early Medical Intervention, Internal medicine, medicine, Clinical endpoint, Humans, Watchful Waiting, Retrospective Studies, Upper urinary tract, business.industry, Stent, Middle Aged, Nephrectomy, Surgery, 030220 oncology & carcinogenesis, Cohort, Drainage, Female, business
Abstract: The aim of this study was to compare observation and early drainage by ureteral stenting in patients with blunt renal trauma and urinary extravasation.A retrospective national multicenter study was performed including all patients admitted for renal trauma at 17 hospitals between 2005 and 2015. Patients presenting with a urinary extravasation on initial imaging were considered for inclusion. Patients were divided in two groups according to the initial approach: observation vs. early drainage by ureteral stent (within 48 h after admission). The primary endpoint was the persistence of urinary extravasation on follow-up imaging.Out of 1799 patients with renal trauma, 238 were included in the analysis (57 in the early drainage and 181 in the observation group). In the early drainage group, 29 patients had persistent urinary extravasation vs. 77 in the observation group (50.9% vs. 42.5%; p value = 0.27). The rates of secondary upper urinary tract drainage did not differ significantly between the early drainage group (26.4%) and the observation group (16%) (p = 0.14). There were no statistically significant differences between the two groups in terms of secondary nephrectomy (0% vs. 2.8%; p = 0.34), and death from trauma (0% vs. 1.8%; p = 0.99). In multivariate analysis, early drainage remained not statistically associated with persistence of urinary extravasation on follow-up imaging (OR = 1.35; p = 0.36) CONCLUSION: In this multicenter cohort, observation was not different from early drainage in terms of persistent urinary extravasation after grade IV blunt renal trauma. Further randomized controlled prospective trials are needed to confirm these findings.
Published: 2020
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7. Oncologic Impact and Safety of Pre-Operative Radiotherapy in Localized Prostate and Bladder Cancer: A Comprehensive Review from the Cancerology Committee of the Association Française d’Urologie

Author: Morgan Rouprêt, Guilhem Roubaud, Romain Mathieu, Gaëlle Fromont-Hankard, Yann Neuzillet, Gilles Créhange, Alain Ruffion, Jean-Baptiste Beauval, Raphaële Renard-Penna, Mathieu Gauthé, Guillaume Ploussard, Laurent Brureau, Gaelle Fiard, Charles Dariane, Paul Sargos, Stéphane Supiot, Eric Barret, Institut Bergonié [Bordeaux], UNICANCER, Institut de Cancérologie de l'Ouest [Angers/Nantes] (UNICANCER/ICO), Institut Curie [Paris], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Institut Mutualiste de Montsouris (IMM), Clinique La Croix du Sud, 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 ), École des Hautes Études en Santé Publique [EHESP] (EHESP), CHU Pointe-à-Pitre/Abymes [Guadeloupe], Institut Necker Enfants-Malades (INEM - UM 111 (UMR 8253 / U1151)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Translational Innovation in Medicine and Complexity / Recherche Translationnelle et Innovation en Médecine et Complexité - UMR 5525 (TIMC ), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA), Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), CHU Pontchaillou [Rennes], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Centre pour l'innovation en cancérologie de Lyon (CICLY), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Foch [Suresnes], Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Ciblage thérapeutique en Oncologie (EA3738), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), 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 ), and Chard-Hutchinson, Xavier
Subjects: Cancer Research, medicine.medical_specialty, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Population, Context (language use), Review, preoperative, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, medicine, Radical surgery, education, RC254-282, radiotherapy, education.field_of_study, Bladder cancer, business.industry, neoadjuvant, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, medicine.disease, prostate cancer, Primary tumor, 3. Good health, Review article, Radiation therapy, [SDV] Life Sciences [q-bio], Oncology, 030220 oncology & carcinogenesis, bladder cancer, Radiology, business
Abstract: Simple Summary Radiotherapy may have an interesting role of reinforcing the loco-regional control of cancer, in addition to surgery, when used as a preoperative treatment. This sequence has demonstrated its efficacy and safety in various malignancies, but no strong data exist in the era of uro-oncology. In this review article, we aim to highlight the potential usefulness of preoperative radiotherapy in prostate and muscle-invasive bladder cancer, aiming to enhance pathological response and local control and to prevent intraoperative tumor seeding. We also emphasize the need for further clinical studies assessing the functional safety of subsequent surgical procedures in a competitive context of new systemic agents that have proven to demonstrate a survival benefit in locally advanced urologic cancers. Abstract Preoperative radiotherapy (RT) is commonly used for the treatment of various malignancies, including sarcomas, rectal, and gynaecological cancers, but it is preferentially used as a competitive treatment to radical surgery in uro-oncology or as a salvage procedure in cases of local recurrence. Nevertheless, preoperative RT represents an attractive strategy to prevent from intraoperative tumor seeding in the operative field, to sterilize microscopic extension outside the organ, and to enhance the pathological and/or imaging tumor response rate. Several clinical works support this research field in uro-oncology. In this review article, we summarized the oncologic impact and safety of preoperative RT in localized prostate and muscle-invasive bladder cancer. Preliminary studies suggest that both modalities can be complementary as initial primary tumor treatments and that a pre-operative radiotherapy strategy could be beneficial in a well-defined population of patients who are at a very high-risk of local relapse. Future prospective trials are warranted to evaluate the oncologic benefit of such a combination of local treatments in addition to new life-prolonging systemic therapies, such as immunotherapy, and new generation hormone therapies. Moreover, the safety and the feasibility of salvage surgical procedures due to non-response or local recurrence after pelvic RT remain poorly evaluated in that context.
Published: 2021
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8. External validation of a prostate biopsy simulator

Author: Sonia-Yuki Selmi, J. Lefrancq, Jocelyne Troccaz, Tamara Dupuy, Jean-Alexandre Long, Emmanuel Promayon, Maxime Chabenes, Gaelle Fiard, Jean-Luc Descotes, Service d'urologie [CHU Grenoble], Centre Hospitalier Universitaire [Grenoble] (CHU), Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-GMCAO), Translational Innovation in Medicine and Complexity / Recherche Translationnelle et Innovation en Médecine et Complexité - UMR 5525 (TIMC ), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA), and ANR-19-P3IA-0003,MIAI,MIAI @ Grenoble Alpes(2019)
Subjects: Male, Prostate biopsy, Urology, Biopsy, 030232 urology & nephrology, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, 03 medical and health sciences, 0302 clinical medicine, Interquartile range, medicine, Humans, Computer Simulation, Biopsy procedure, Simulation Training, Simulation, medicine.diagnostic_test, business.industry, External validation, Prostate, Evidence-based medicine, Continuous training, Learning curve, 030220 oncology & carcinogenesis, Clinical Competence, business, Learning Curve
Abstract: Summary Introduction Simulation-based training has proven to be a promising option allowing for initial and continuous training while limiting the impact of the learning curve on the patient. The Biopsym simulator was developed as a complete teaching environment for the prostate biopsy procedure. This paper presents the results of an external validation of this simulator, involving urology residents recruited during a regional teaching seminar. Methods Residents from 4 academic urology departments of the French Auvergne Rhone-Alpes region, who did not take part in the previous simulator validation studies, were enrolled. After a short presentation and standardized initiation session, residents carried out a simulated systematic 12-core biopsy procedure and were asked to fill in a questionnaire collecting their expectations and evaluation of the Biopsym simulator. The number of biopsies reaching each targeted sector, the total score provided by the simulator and the duration of the procedure were recorded. Results Twenty-three residents were recruited. The overall added value (/100) for learning was rated at a median of 100 (interquartile range 83-100), overall realism of the biopsy procedure at 80 (65-89). The median percentage of biopsies reaching the targeted sector was 66.7% (62-75). The median score provided by the simulator was 50% (37-60). For both, the difference between residents with or without prior biopsy experience was not statistically significant. The median duration of the simulated biopsy procedure was 4:58 (minutes: seconds) (3:49–6:00). Resident with prior experience required less time to complete the biopsy procedure 3:53 (3:39–4:56) vs. 5:10 (4:59–7:10), P = 0.01. Conclusion This external validation study confirms a high acceptance of the simulator by the target audience. To our knowledge, the Biopsym simulator is the only prostate biopsy simulator that demonstrated such validity as evaluated by clinicians, outside the center involved in its early development. Level of evidence 3.
Published: 2021
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9. Superselective Ischemia in Robotic Partial Nephrectomy Does Not Provide Better Long-term Renal Function than Renal Artery Clamping in a Randomized Controlled Trial (EMERALD): Should We Take the Risk?

Author: C. Lanchon, Jean-Luc Bosson, Amina Fontanell, Yann Teyssier, D. Poncet, Joris Giai, Jean-Alexandre Long, Gaelle Fiard, Jean-Luc Descotes, C. Overs, Alexandre Moreau-Gaudry, Jean-Jacques Rambeaud, Tarek Ittobane, and Assilah Bouzit
Subjects: medicine.medical_specialty, Urology, medicine.medical_treatment, 030232 urology & nephrology, Renal function, Kidney, Nephrectomy, law.invention, 03 medical and health sciences, 0302 clinical medicine, Renal Artery, Randomized controlled trial, Robotic Surgical Procedures, law, Ischemia, medicine.artery, medicine, Clinical endpoint, Humans, Single-Blind Method, Renal artery, Retrospective Studies, business.industry, Robotics, Interim analysis, Constriction, Surgery, medicine.anatomical_structure, Treatment Outcome, 030220 oncology & carcinogenesis, business, Artery
Abstract: Background Superselective clamping of tumor-targeted arteries aims to eliminate ischemia of the remnant kidney while keeping tumor bed bloodless during excision. Objective To evaluate the impact of superselective clamping on long-term renal function, compared with renal artery early unclamping. Design, setting, and participants A randomized monocentric single-blind trial (1:1) was conducted from February 2018 to August 2019. Patients with a single renal tumor were candidates for a robot-assisted partial nephrectomy (RAPN) in a referral center. EMERALD (NCT03679572) was powered to include 50 patients with an interim analysis after 30 cases. Intervention Superselective RAPN (SS-RAPN) with near-infrared fluorescence (NIRF) or conventional RAPN with renal artery early unclamping. Outcome measurements and statistical analysis The primary endpoint was the percent change of estimated glomerular filtration rate (eGFR) in the operated kidney after 6 mo (combination of eGFR and relative function on 99mTc-DMSA scintigraphy). Secondary endpoints assessed feasibility and safety of the technique. Results and limitations Relative eGFR reduction in the operated kidney at 6 mo did not differ significantly (–21.4% vs –23.4%, p = 0.66). This absence of difference remained after adjusting on percentage of kidney volume preserved, which was an independent predictor of functional preservation. There were no significant differences in terms of blood loss, change in hemoglobin, postoperative complications, transfusion, and conversion to radical nephrectomy (two vs zero) or to open surgery (one vs zero). Despite a good accrual, the steering committee interrupted the trial after the interim analysis for futility given the absence of trend in favor of SS-RAPN. Conclusions SS-RAPN using NIRF does not provide better renal function preservation than renal artery clamping, questioning the interest of this technique at a higher risk of bleeding. Patient summary In this randomized controlled trial, superselective clamping of tumor feeding arteries did not show any advantage in terms of long-term renal function compared with conventional artery clamping.
Published: 2021

10. Improving vision for surgeons during laparoscopy: the Enhanced Laparoscopic Vision System ELViS

Author: Gaelle Fiard, Bertrand Trilling, Marion Decrouez, Pierre Alain Barraud, Christel Schwartz, Sinara Vijayan, Jean Luc Faucheron, Mathias Tummers, Sandrine Voros, Adrian Mancini, Sophie Silvent, Voros, Sandrine, Appel à projets générique - Dispositif et systEmes ciblés pour la PrOstatectomie Radicale Robotisée Augmentée #2 - - DEPORRA22014 - ANR-14-CE17-0009 - Appel à projets générique - VALID, Gestes Médico-Chirurgicaux Assistés par Ordinateur - - CAMI2011 - ANR-11-LABX-0004 - LABX - VALID, Translational Innovation in Medicine and Complexity / Recherche Translationnelle et Innovation en Médecine et Complexité - UMR 5525 (TIMC ), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA), Département de chirurgie digestive et de l'urgence, CHU Grenoble-Hôpital Michallon, Service d'urologie [CHU Grenoble], Centre Hospitalier Universitaire [Grenoble] (CHU), Surgiqual Institute, Centre d'Investigation Clinique [Grenoble] (CIC Grenoble), CHU Grenoble-Hôpital Michallon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes (UGA), ANR-14-CE17-0009,DEPORRA2,Dispositif et systEmes ciblés pour la PrOstatectomie Radicale Robotisée Augmentée #2(2014), ANR-11-LABX-0004,CAMI,Gestes Médico-Chirurgicaux Assistés par Ordinateur(2011), and Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications Grenoble - UMR 5525 (TIMC-IMAG)
Subjects: medicine.medical_specialty, [SDV.BIO]Life Sciences [q-bio]/Biotechnology, Endoscope, [SDV.MHEP.CHI] Life Sciences [q-bio]/Human health and pathology/Surgery, Swine, medicine.medical_treatment, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, Trocar prototype, Proof of Concept Study, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, 03 medical and health sciences, 0302 clinical medicine, [SDV.CAN] Life Sciences [q-bio]/Cancer, Laparotomy, medicine, Animals, Medical physics, Animal model, Laparoscopy, Endoscopes, Surgeons, medicine.diagnostic_test, Distributed Laparoscopy, business.industry, Phase 0 medical device evaluation, System usability scale, Debriefing, Usability, Equipment Design, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, Endoscopy, [SDV.BIO] Life Sciences [q-bio]/Biotechnology, Enhanced visualisation, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Surgery, business, Abdominal surgery
Abstract: 12 mois d'embargo sur la version "Author Accepted Manuscript" (celle déposée ici); International audience; Background: For many abdominal surgical interventions, laparotomy has gradually been replaced by laparoscopy, with numerous benefits for the patient in terms of post-operative recovery. However, during laparoscopy, the endoscope only provides a single viewpoint to the surgeon, leaving numerous blind-spots and opening the way to peri-operative adverse events. Alternative camera systems have been proposed, but many lack the requisite resolution/robustness for use during surgery or cannot provide real-time images. Here, we present the added value of the Enhanced Laparoscopic Vision System (ELViS) which overcomes these limitations and provides a broad view of the surgical field in addition to the usual high-resolution endoscope. Methods: Experienced laparoscopy surgeons performed several typical procedure steps on a live pig model. The time-to-completion for surgical exercises performed by conventional endoscopy and ELViSassisted surgery was measured. A debriefing interview following each operating session was conducted by an ergonomist, and a System Usability Scale (SUS) score was determined. Results: Proof of concept of ELVIS was achieved in an animal model with 7 expert surgeons without peroperative adverse events related to the surgical device. No differences were found in time-tocompletion. Mean SUS score was 74.7, classifying the usability of the ELViS as "good". During the debriefing interview, surgeons highlighted several situations where the ELViS provided a real advantage (such as during instrument insertion, exploration of the abdominal cavity or for orientation during close work), and also suggested avenues for improvement of the system. Conclusions: This first test of the ELViS prototype on a live animal model demonstrated its usability and provided promising and useful feedback for further development.
Published: 2021
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11. External Validation of a Multiparametric Magnetic Resonance Imaging–based Nomogram for the Prediction of Extracapsular Extension and Seminal Vesicle Invasion in Prostate Cancer Patients Undergoing Radical Prostatectomy

Author: Giuseppe Simone, Julien Van Damme, Grégoire Assenmacher, Thierry Roumeguere, Alexandre Peltier, Mathieu Roumiguié, Marco Oderda, Thierry Quackels, Guillaume Ploussard, Romain Diamand, Gaelle Fiard, Daniel Benamran, Jean-Luc Descotes, Christophe Iselin, Jean-Baptiste Roche, Simone Albisinni, Bernard Malavaud, UCL - SSS/IREC/IMAG - Pôle d'imagerie médicale, and UCL - (SLuc) Service d'urologie
Subjects: Male, medicine.medical_specialty, Urology, medicine.medical_treatment, 030232 urology & nephrology, External validation, Extracapsular extension, Nomogram, Prostate cancer, Seminal vesicle invasion, Aged, Humans, Middle Aged, Neoplasm Invasiveness, Prostatectomy, Prostatic Neoplasms, Seminal Vesicles, Extranodal Extension, Multiparametric Magnetic Resonance Imaging, Nomograms, 03 medical and health sciences, 0302 clinical medicine, Biopsy, medicine, medicine.diagnostic_test, ddc:617, business.industry, Magnetic resonance imaging, medicine.disease, Settore MED/24, 030220 oncology & carcinogenesis, Concomitant, Partin Tables, Radiology, business
Abstract: The nomogram reported by Gandaglia et al (The key combined value of multiparametric magnetic resonance imaging, and magnetic resonance imaging-targeted and concomitant systematic biopsies for the prediction of adverse pathological features in prostate cancer patients undergoing radical prostatectomy. Eur Urol 2020;77:733-41) predicting extracapsular extension (ECE) or seminal vesicle invasion (SVI) has been developed using multiparametric magnetic resonance imaging (MRI) parameters and MRI-targeted biopsy. We aimed to validate this nomogram externally by analyzing 566 patients harboring prostate cancer diagnosed on MRI-targeted biopsy followed by radical prostatectomy. At final pathology, 37% and 12% patients had ECE and SVI, respectively. Performance of the nomogram, in comparison with the Memorial Sloan Kettering Cancer Center (MSKCC) model and Partin tables, was evaluated using discrimination, calibration, and decision curve analysis. Regarding ECE prediction, the nomogram showed higher discrimination (71.8% vs 69.8%, p = 0.3 and 71.8% vs 61.3%, p
Published: 2021

12. Cooperative Blockade of CK2 and ATM Kinases Drives Apoptosis in VHL-Deficient Renal Carcinoma Cells through ROS Overproduction

Author: Yann Wallez, Laurent Guyon, Caroline Roelants, Christophe Battail, Q. Franquet, Frédéric Chalmel, Irinka Séraudie, Claude Cochet, Caroline Barette, Odile Filhol, Sofia Giacosa, Nicolas Peilleron, Marie-Odile Fauvarque, Catherine Pillet, Emmanuelle Soleilhac, Clément Sarrazin, Bertrand Evrard, Gaelle Fiard, Jean-Luc Descotes, Jean-Alexandre Long, BioSanté (UMR BioSanté), Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Recherche Interdisciplinaire de Grenoble (IRIG), Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Direction de Recherche Fondamentale (CEA) (DRF (CEA)), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Grenoble Alpes (UGA), Invasion mechanisms in angiogenesis and cancer (IMAC), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Université Grenoble Alpes (UGA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Recherche Interdisciplinaire de Grenoble (IRIG), Inovarion, 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 ), Genetics and Chemogenomics (GenChem), CHU Grenoble, Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-GMCAO), Translational Innovation in Medicine and Complexity / Recherche Translationnelle et Innovation en Médecine et Complexité - UMR 5525 (TIMC ), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA), UMR1036, Institut National de la Santé et de la Recherche Médicale, 2018, Groupement des Entreprises Françaises dans la lutte contre le Cancer, Isère, Ligue Contre le Cancer, 2017, Association Française d'Urologie, 2019, Centre Hospitalier Universitaire de Grenoble Alpes, ANR-17-EURE-0003,CBH-EUR-GS,CBH-EUR-GS(2017), 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 ), and Chard-Hutchinson, Xavier
Subjects: Cancer Research, kinase inhibitor, CK2, [SDV.CAN]Life Sciences [q-bio]/Cancer, Biology, urologic and male genital diseases, lcsh:RC254-282, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, Article, NOX4, 03 medical and health sciences, 0302 clinical medicine, Mediator, [SDV.CAN] Life Sciences [q-bio]/Cancer, medicine, ROS pathway, tumor tissue slices, 030304 developmental biology, 0303 health sciences, Kinase, ccRCC, apoptosis, Cancer, HIF-2α, medicine.disease, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, 3. Good health, Clear cell renal cell carcinoma, Oncology, Apoptosis, Cell culture, 030220 oncology & carcinogenesis, [SDV.SP.PHARMA] Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, ATM, Cancer research, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, Ex vivo
Abstract: Simple Summary Renal cell carcinoma (RCC) is the eighth leading malignancy in the world, accounting for 4% of all cancers with poor outcome when metastatic. Protein kinases are highly druggable proteins, which are often aberrantly activated in cancers. The aim of our study was to identify candidate targets for metastatic clear cell renal cell carcinoma therapy, using chemo-genomic-based high-throughput screening. We found that the combined inhibition of the CK2 and ATM kinases in renal tumor cells and patient-derived tumor samples induces synthetic lethality. Mechanistic investigations unveil that this drug combination triggers apoptosis through HIF-2α-(Hypoxic inducible factor HIF-2α) dependent reactive oxygen species (ROS) overproduction, giving a new option for patient care in metastatic RCC. Abstract Kinase-targeted agents demonstrate antitumor activity in advanced metastatic clear cell renal cell carcinoma (ccRCC), which remains largely incurable. Integration of genomic approaches through small-molecules and genetically based high-throughput screening holds the promise of improved discovery of candidate targets for cancer therapy. The 786-O cell line represents a model for most ccRCC that have a loss of functional pVHL (von Hippel-Lindau). A multiplexed assay was used to study the cellular fitness of a panel of engineered ccRCC isogenic 786-O VHL− cell lines in response to a collection of targeted cancer therapeutics including kinase inhibitors, allowing the interrogation of over 2880 drug–gene pairs. Among diverse patterns of drug sensitivities, investigation of the mechanistic effect of one selected drug combination on tumor spheroids and ex vivo renal tumor slice cultures showed that VHL-defective ccRCC cells were more vulnerable to the combined inhibition of the CK2 and ATM kinases than wild-type VHL cells. Importantly, we found that HIF-2α acts as a key mediator that potentiates the response to combined CK2/ATM inhibition by triggering ROS-dependent apoptosis. Importantly, our findings reveal a selective killing of VHL-deficient renal carcinoma cells and provide a rationale for a mechanism-based use of combined CK2/ATM inhibitors for improved patient care in metastatic VHL-ccRCC.
Published: 2021
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13. Cellular senescence as a possible link between prostate diseases of the ageing male

Author: Emma S. Chambers, Rhys Ball, Vasilis Stavrinides, Susan Heavey, Arne N. Akbar, Mark Emberton, Gaelle Fiard, Alex Freeman, Service d'urologie [CHU Grenoble], Centre Hospitalier Universitaire [Grenoble] (CHU), Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-GMCAO), Translational Innovation in Medicine and Complexity / Recherche Translationnelle et Innovation en Médecine et Complexité - UMR 5525 (TIMC ), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA), Division of Surgery and Interventional Science [London, UK], University College of London [London] (UCL), and Queen Mary University of London (QMUL)
Subjects: Male, Senescence, Aging, Prostatic Diseases, Prostate Diseases, Urology, Prostatic Hyperplasia, [SDV.BC.BC]Life Sciences [q-bio]/Cellular Biology/Subcellular Processes [q-bio.SC], [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, Prostate, Tumor Microenvironment, medicine, Humans, Cellular Senescence, 030304 developmental biology, Inflammation, 0303 health sciences, Mechanism (biology), business.industry, fungi, Prostatic Neoplasms, Hyperplasia, medicine.disease, Phenotype, medicine.anatomical_structure, Cellular Microenvironment, Ageing, 030220 oncology & carcinogenesis, Cancer research, Cytokines, Senescence-Associated Secretory Phenotype, business
Abstract: International audience; Senescent cells accumulate with age in all tissues. Although senescent cells undergo cell-cycle arrest, these cells remain metabolically active and their secretomeknown as senescence-associated secretory phenotype (SASP)-is responsible for a systemic pro-inflammatory state, which contributes to an inflammatory microenvironment. Senescent cells can be found in the ageing prostate and the SASP and can be linked to benign prostatic hyperplasia and prostate cancer. Indeed, a number of signalling pathways provide biological plausibility for the role of senescence in both BPH and prostate cancer, although proving causality is difficult. The theory of senescence as a mechanism for prostate disease has a number of clinical implications, and could offer opportunities for targetting in the future.
Published: 2021
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14. Indications for and complications of pelvic lymph node dissection in prostate cancer: accuracy of available nomograms for the prediction of lymph node invasion

Author: Antonio Luigi Pastore, Giuseppe Simone, Alessandro Marquis, Cinzia Parola, Marco Oderda, Romain Diamand, Simone Albisinni, Gaelle Fiard, Giorgio Gandaglia, Thierry Roumeguere, Salvatore Smelzo, Paolo Gontero, Alexandre Peltier, Antonio Carbone, Giancarlo Marra, John H. Witt, Giorgio Calleris, Marco Falcone, Rafael Sanchez-Salas, Guillaume Ploussard, Oderda, M., Diamand, R., Albisinni, S., Calleris, G., Carbone, A., Falcone, M., Fiard, G., Gandaglia, G., Marquis, A., Marra, G., Parola, C., Pastore, A., Peltier, A., Ploussard, G., Roumeguere, T., Sanchez-Salas, R., Simone, G., Smelzo, S., Witt, J. H., and Gontero, P.
Subjects: Male, #PCSM, #ProstateCancer, #uroonc, lymphadenectomy, nomogram, pelvic lymph node dissection, prostate cancer, Lymphocele, medicine.medical_treatment, 030232 urology & nephrology, Prostate cancer, 0302 clinical medicine, Lymphedema, Lymph node, medicine.diagnostic_test, Prostatectomy, Middle Aged, 3. Good health, Dissection, medicine.anatomical_structure, Area Under Curve, 030220 oncology & carcinogenesis, Radiology, medicine.medical_specialty, Urology, Hemorrhage, Pelvis, 03 medical and health sciences, Sepsis, Biopsy, medicine, Humans, Neoplasm Invasiveness, Aged, Retrospective Studies, business.industry, Prostatic Neoplasms, Nomogram, medicine.disease, Nomograms, Settore MED/24, ROC Curve, Lymph Node Excision, Lymphadenectomy, Lymph Nodes, business
Abstract: Objectives: To externally validate the currently available nomograms for predicting lymph node invasion (LNI) in patients with prostate cancer (PCa) and to assess the potential risk of complications of extended pelvic lymph node dissection (ePLND) when using the recommended threshold. Methods: A total of 14921 patients, who underwent radical prostatectomy with ePLND at eight European tertiary referral centres, were retrospectively identified. After exclusion of patients with incomplete biopsy or pathological data, 12009 were included. Of these, 609 had undergone multiparametic magnetic resonance imaging-targeted biopsies. Among ePLND-related complications we included lymphocele, lymphoedema, haemorrhage, infection and sepsis. The performances of the Memorial Sloan Kettering Cancer Centre (MSKCC), Briganti 2012, Briganti 2017, Briganti 2019, Partin 2016 and Yale models were evaluated using receiver-operating characteristic curve analysis (area under the curve [AUC]), calibration plots, and decision-curve analysis. Results: Overall, 1158 patients (9.6%) had LNI, with a mean of 17.7 and 3.2 resected and positive nodes, respectively. No significant differences in AUCs were observed between the MSKCC (0.79), Briganti 2012 (0.79), Partin 2016 (0.78), Yale (0.80), Briganti 2017 (0.81) and Briganti 2019 (0.76) models. A direct comparison of older models showed that better discrimination was achieved with the MSKCC and Briganti 2012 nomograms. A tendency for underestimation was seen for all the older models, whereas the Briganti 2017 and 2019 nomograms tended to overestimate LNI risk. Decision-curve analysis showed a net benefit for all models, with a lower net benefit for the Partin 2016 and Briganti 2019 models. ePLND-related complications were experienced by 1027 patients (8.9%), and 12.6% of patients with pN1 disease. Conclusions: The currently available nomograms have similar performances and limitations in the prediction of LNI. Miscalibration was present, however, for all nomograms showing a net benefit. In patients with only systematic biopsy, the MSKCC and Briganti 2012 nomograms were superior in the prediction of LNI.
Published: 2021

15. Factors Predictive of Selective Angioembolization Failure for Moderate- to High-grade Renal Trauma: A French Multi-institutional Study

Author: C. Millet, Thomas Caes, A. Chebbi, Charles Dariane, Lucas Freton, Ines Dominique, N. Szabla, J. Rizk, Marina Ruggiero, Benoit Peyronnet, François-Xavier Madec, Benjamin Pradere, François-Xavier Nouhaud, Bastien Gondran-Tellier, R. Betari, P. Patard, Gaelle Fiard, M. Hutin, X. Rod, Jonathan Olivier, X. Matillon, Cedric Lebacle, Paul Panayotopoulos, S. Bergerat, Michael Baboudjian, and L. Sabourin
Subjects: medicine.medical_specialty, Urology, medicine.medical_treatment, 030232 urology & nephrology, Logistic regression, Kidney, Wounds, Nonpenetrating, Nephrectomy, 03 medical and health sciences, 0302 clinical medicine, parasitic diseases, Medicine, Humans, In patient, Embolization, Patient summary, Hematuria, Retrospective Studies, medicine.diagnostic_test, business.industry, Odds ratio, Confidence interval, Surgery, 030220 oncology & carcinogenesis, Angiography, business
Abstract: Background Angiography with selective angioembolization (SAE) is safe and effective in addressing bleeding in patients with renal trauma. However, there are no validated criteria to predict SAE efficacy. Objective To evaluate factors predictive of SAE failure after moderate- to high-grade renal trauma. Design, setting, and participants TRAUMAFUF was a retrospective multi-institutional study including all patients who underwent upfront SAE for renal trauma in 17 French hospitals between 2005 and 2015. Outcome measurements and statistical analysis The primary outcome was SAE efficacy, defined as the absence of repeat SAE, salvage nephrectomy, and/or death for each patient. Results and limitations Out of 1770 consecutive patients with renal trauma, 170 (9.6%) with moderate- to high-grade renal trauma underwent SAE. Overall upfront SAE was successful in 131 patients (77%) and failed in 39 patients: six patients died after the embolization, ten underwent repeat SAE, 22 underwent open nephrectomy, and one underwent open surgical exploration. In multivariate logistic regression analysis, gross hematuria (odds ratio [OR] 3.16, 95% confidence interval [CI] 1.29–8.49; p = 0.015), hemodynamic instability (OR 3.29, 95% CI 1.37–8.22; p = 0.009), grade V trauma (OR 2.86, 95% CI 1.06–7.72; p = 0.036), and urinary extravasation (OR 3.49, 95% CI 1.42–8.83; p = 0.007) were predictors of SAE failure. The success rate was 64.7% (22/34) for patients with grade V trauma and 59.6% (31/52) for those with hemodynamic instability. The study was limited by its retrospective design and the lack of a control group managed with either surgery or surveillance. Conclusions We found that gross hematuria, hemodynamic instability, grade V trauma, and urinary extravasation were significant predictors of SAE failure. However, success rates in these subgroups remained relatively high, suggesting that SAE might be appropriate for those patients as well. Patient summary Selective angioembolization (SAE) is a useful alternative to nephrectomy to address bleeding in patients with renal trauma. Currently, there are no validated criteria to predict SAE efficacy. We found that gross hematuria, hemodynamic instability, grade V trauma, and urinary extravasation were significant predictors of SAE failure.
Published: 2020

16. Towards real-time free-hand biopsy navigation

Author: Jocelyne Troccaz, Gaelle Fiard, Clément Beitone, Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-GMCAO), Translational Innovation in Medicine and Complexity / Recherche Translationnelle et Innovation en Médecine et Complexité - UMR 5525 (TIMC ), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA), Service d'urologie [CHU Grenoble], Centre Hospitalier Universitaire [Grenoble] (CHU), ANR-11-LABX-0004,CAMI,Gestes Médico-Chirurgicaux Assistés par Ordinateur(2011), and ANR-19-P3IA-0003,MIAI,MIAI @ Grenoble Alpes(2019)
Subjects: Male, Prostate biopsy, Similarity (geometry), Computer science, [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging, 3D/2D image registration, Biopsy, Context (language use), [SDV.CAN]Life Sciences [q-bio]/Cancer, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, Imaging, Three-Dimensional, Prostate, medicine, Humans, Computer vision, prostate biopsy, Ultrasonography, Ground truth, medicine.diagnostic_test, business.industry, ultrasound, Prostatic Neoplasms, General Medicine, medicine.disease, medicine.anatomical_structure, 030220 oncology & carcinogenesis, [INFO.INFO-TI]Computer Science [cs]/Image Processing [eess.IV], Artificial intelligence, Fiducial marker, business
Abstract: International audience; Purpose: Performing a transrectal ultrasound (TRUS) prostate biopsy is at the heart of the current prostate cancer detection procedure. With today's 2D live ultrasound (US) imaging equipment, this task remains complex due to the poor visibility of cancerous tissue on TRUS images and the limited anatomical context available in the 2D TRUS plane. This paper presents a rigid 2D/3DUS registration method for navigated prostate biopsy. This allows continuous localization of 15 the biopsy trajectory during the procedure. Methods: We proposed an organ-based approach to achieve real-time rigid registration without the need for any probe localization device. The registration method combines image similarity and geometric proximity of detected features. Additions to our previous work include a multi-level approach and the use of a rejection rate favouring the best matches. Their aim is to increase the 20 accuracy and time performances. These modifications and their in-depth evaluation on real clinical cases and comparison to this previous work are described. We performed static and dynamic evaluations along biopsy trajectories on a very large amount of data acquired under uncontrolled routine conditions. The computed transforms are compared to a ground truth obtained either from corresponding manually detected fiducials or from an already evaluated registration method. Results: All results show that the current method outperforms its previous version, both in terms of accuracy (the average error reported here is 12 to 17% smaller depending on the experiment) and processing time (from 20 to 60 times faster compared to the previous implementation). The dynamic registration experiment demonstrates that the method can be successfully used for continuous tracking of the biopsy location w.r.t the prostate at a rate that varies between 5 and 15 30 Hz. Conclusions: This work shows that on the fly 2D/3DUS registration can be performed very efficiently on biopsy trajectories. This allows us to plan further improvements in prostate navigation and a clinical transfer.
Published: 2020
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17. Early discharge in selected patients with low-grade renal trauma

Author: Lucas, Freton, Lucie-Marie, Scailteux, Marine, Hutin, Jonathan, Olivier, Quentin, Langouet, Marina, Ruggiero, Ines, Dominique, Clémentine, Millet, Sébastien, Bergerat, Paul, Panayatopoulos, Reem, Betari, Xavier, Matillon, Ala, Chebbi, Thomas, Caes, Pierre-Marie, Patard, Nicolas, Szabla, Nicolas, Brichart, Axelle, Boehm, Laura, Sabourin, Kerem, Guleryuz, Charles, Dariane, Cédric, Lebacle, Jérome, Rizk, Alexandre, Gryn, François-Xavier, Madec, François-Xavier, Nouhaud, Xavier, Rod, Emmanuel, Oger, Gaelle, Fiard, Karim, Bensalah, Benjamin, Pradere, Benoit, Peyronnet, Hôpital Pontchaillou, Recherche en Pharmaco-épidémiologie et Recours aux Soins (REPERES), Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP), University Hospital of Montpellier, Université de Lille, Université de Tours (UT), Université Paris-Sud - Paris 11 (UP11), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), CHU Pontchaillou [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP), and Université de Tours
Subjects: Nephrology, Adult, Male, medicine.medical_specialty, Time Factors, Adolescent, Propensity score, Urology, 030232 urology & nephrology, Psychological intervention, Kidney, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, law.invention, 03 medical and health sciences, 0302 clinical medicine, Injury Severity Score, Randomized controlled trial, law, Renal trauma, Internal medicine, medicine, Humans, Child, Early discharge, Retrospective Studies, business.industry, Absolute risk reduction, Outpatient, Length of Stay, Patient Discharge, 3. Good health, Management, 030220 oncology & carcinogenesis, Propensity score matching, Cohort, Wounds and Injuries, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Complication, business
Abstract: International audience; Introduction: the aim of this study was to assess whether early discharge could be non-inferior to inpatient management in selected patients with low-grade renal trauma (AAST grades 1–3).Materials and methods: A retrospective national multicenter study was conducted including all patients who presented with renal trauma at 17 hospitals between 2005 and 2015. Exclusion criteria were iatrogenic and AAST grades 4 and 5 trauma, non-conservative initial management, Hb 48 h (inpatient). The primary outcome was “Intervention” defined as any interventional procedure needed within the first 30 days. A Stabilized Inverse Probability of Treatment Weighting (SIPTW) propensity score based binary response model was used to estimate risk difference.Results: Out of 1764 patients with renal trauma, 311 were included in the analysis (44 in the early discharge and 267 in the inpatient group). In the early discharge group, only one patient required an intervention within the first 30 days vs. 10 in the inpatient group (3.7% vs. 5.2%; p = 0.99). Adjusted analysis using SIPTW propensity score showed a risk difference of − 2.8% [− 9.3% to + 3.7%] of “interventions” between the two groups meeting the non-inferiority criteria.Conclusion: In a highly selected cohort, early discharge management of low-grade renal trauma was not associated with an increased risk of early “intervention” compared to inpatient management. Further prospective randomized controlled trials are needed to confirm these findings.
Published: 2020
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18. External evaluation of the Briganti nomogram to predict lymph node metastases in intermediate-risk prostate cancer patients

Author: Caroline Herault, Jean-Alexandre Long, Michel Bolla, Jean-Jacques Rambeaud, Gaelle Fiard, Jean-Luc Descotes, Arnaud Seigneurin, Camille Verry, Nicolas Peilleron, Service d'urologie [CHU Grenoble], Centre Hospitalier Universitaire [Grenoble] (CHU), Biologie Computationnelle et Modélisation (TIMC-BCM ), Translational Innovation in Medicine and Complexity / Recherche Translationnelle et Innovation en Médecine et Complexité - UMR 5525 (TIMC ), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA), Unité de qualitique et d'évaluation médicale - pole Santé Publique, CHU Grenoble, Département de cancérologie et radiothérapie, and Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-GMCAO)
Subjects: Male, medicine.medical_specialty, Urology, medicine.medical_treatment, Population, 030232 urology & nephrology, lymph node dissection, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, Risk Assessment, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, Pelvis, nomogram, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, medicine, Humans, education, Lymph node, Aged, Retrospective Studies, education.field_of_study, Prostatectomy, business.industry, Prostatic Neoplasms, Reproducibility of Results, Retrospective cohort study, Middle Aged, Nomogram, medicine.disease, radical prostatectomy, 3. Good health, Nomograms, Dissection, medicine.anatomical_structure, Lymphatic Metastasis, 030220 oncology & carcinogenesis, Lymph Node Excision, Lymph, Radiology, business
Abstract: International audience; Purpose: The Briganti nomogram can be used with a threshold of 5% to decide when to offer lymph node dissection during radical prostatectomy. The objective of the study was to assess the accuracy of the Briganti nomogram on intermediate-risk prostate cancer patients managed in a single academic department. Methods: We retrospectively reviewed the files of all patients managed by radical prostatectomy (RP) and bilateral pelvic lymph node dissection (BPLND) in our center between 2005 and 2017. The overall accuracy of the model in predicting metastatic lymph node disease was quantified by the construction of a receiver-operator characteristic (ROC) curve. A calibration plot was drawn to represent the relationship between the predicted and observed frequencies.Results: We included 285 patients, among whom 175 (61.4%) were classified as intermediate risk as defined by D’Amico. The median follow-up was 60 (34-93) months. Twenty-seven patients (9.5%) were diagnosed with lymph node metastases. The median number of lymph nodes removed was 10 (7-14). The mean Briganti score was 19.3% in patients with lymph node involvement (LNI) and 6.3% in patients without LNI. Focusing on intermediate-risk patients, 91(52%) and 84 (48%) had a Briganti score
Published: 2020
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19. Validating the Transfer of Skills Acquired on a Prostate Biopsy Simulator: A Prospective, Randomized, Controlled Study

Author: Alexandre Bellier, Emmanuel Promayon, Sonia-Yuki Selmi, Manon Maigron, Jocelyne Troccaz, Gaelle Fiard, Jean-Luc Descotes, Service d'urologie [CHU Grenoble], Centre Hospitalier Universitaire [Grenoble] (CHU), Gestes Medico-chirurgicaux Assistés par Ordinateur [2020-....] (TIMC-GMCAO [2020-....]), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 [2020-....] (TIMC [2020-....]), IMAG-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2020-....] (UGA [2020-....])-Institut polytechnique de Grenoble - Grenoble Institute of Technology [2020-....] (Grenoble INP [2020-....]), Université Grenoble Alpes [2020-....] (UGA [2020-....])-IMAG-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2020-....] (UGA [2020-....])-Institut polytechnique de Grenoble - Grenoble Institute of Technology [2020-....] (Grenoble INP [2020-....]), Université Grenoble Alpes [2020-....] (UGA [2020-....]), and Université Grenoble Alpes - UFR Médecine (UGA UFRM)
Subjects: Male, Students, Medical, Prostate biopsy, Urology department, Biopsy, [SDV]Life Sciences [q-bio], education, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, Education, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Cadaver, law, medicine, Humans, Computer Simulation, 3D ultrasound, Prospective Studies, 030212 general & internal medicine, Simulation, Training curriculum, Human cadaver, Surgical education, Median score, Prostate cancer, medicine.diagnostic_test, business.industry, Computer-assisted training, Practice-Based Learning and Improvement, Prostate, 030220 oncology & carcinogenesis, Systems-Based Practice, Surgery, [SDV.IB]Life Sciences [q-bio]/Bioengineering, [INFO.EIAH]Computer Science [cs]/Technology for Human Learning, Clinical Competence, Patient Care, business, Medical Knowledge
Abstract: International audience; OBJECTIVES: To evaluate the ability of students to reproduce the skills acquired on a prostate biopsy simulator in a real-life situation. DESIGN: A prospective randomized controlled study was conducted. Medical students with no experience of prostate biopsy were randomized between arm A « conventional training » and arm B « simulator-enhanced training. » The training was performed for both groups on the simulator. The students in arm B were provided with visual and numerical feedback. The transfer of skills was assessed by recording the position of the 12 biopsies performed by each student on an unembalmed human cadaver using a 3D ultrasound mapping device. SETTING: The study was conducted in an academic urol-ogy department and the cadaver experiments in the adjoining anatomy laboratory. RESULTS: Twenty-four students were included, and 22 completed the study. The median score obtained on the simulator at the end of the training was 57% (53-61) for arm A and 66% (59-71) for arm B. The median score obtained on the cadaver by students trained with the simulator was 75% (60-80), statistically superior to the score obtained by students trained conventionally of 45% (30-60), p < 0.0001. The median score obtained by all students when performing biopsies in a real-life situation was 63% (50-80) versus 60% (56-70) for their last training on the simulator. CONCLUSION: These results support the transfer of skills acquired on the simulator, and the superiority of a training curriculum integrating simulation, and performance feedback. (J Surg Ed 77:953À960. Ó 2020 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.)
Published: 2020
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20. Timing and delay of radical prostatectomy do not lead to adverse oncologic outcomes: results from a large European cohort at the times of COVID-19 pandemic

Author: J.L. Descotes, Giuseppe Simone, Alexandre Peltier, Christophe Iselin, Mathieu Roumiguié, Thierry Quackels, Julien Van Damme, Thierry Roumeguere, Romain Diamand, Guillaume Ploussard, Daniel Benamran, Jean Baptiste Roche, Simone Albisinni, Bernard Malavaud, Marco Oderda, Gaelle Fiard, Service d'urologie [CHU Grenoble], Centre Hospitalier Universitaire [Grenoble] (CHU), Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-GMCAO), Translational Innovation in Medicine and Complexity / Recherche Translationnelle et Innovation en Médecine et Complexité - UMR 5525 (TIMC ), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), and Université Grenoble Alpes (UGA)
Subjects: Male, Outcome Assessment, medicine.medical_treatment, Oncology Service, 030232 urology & nephrology, Kaplan-Meier Estimate, Biochemical recurrence, COVID-19, Delay, Oncologic outcomes, Prostate cancer, Aged, Europe, Humans, Infection Control, Neoplasm Grading, Neoplasm Staging, Organizational Innovation, Outcome Assessment, Health Care, Risk Assessment, SARS-CoV-2, Oncology Service, Hospital, Prostatectomy, Prostatic Neoplasms, Time-to-Treatment, urologic and male genital diseases, Logistic regression, 0302 clinical medicine, Medicine, ComputingMilieux_MISCELLANEOUS, ddc:617, humanities, 3. Good health, 030220 oncology & carcinogenesis, Cohort, Original Article, medicine.medical_specialty, Urology, [SDV.CAN]Life Sciences [q-bio]/Cancer, Hospital, 03 medical and health sciences, Internal medicine, Adjuvant therapy, Pathological, business.industry, Proportional hazards model, medicine.disease, Health Care, Settore MED/24, business
Abstract: Purpose The current COVID-19 pandemic is transforming our urologic practice and most urologic societies recommend to defer any surgical treatment for prostate cancer (PCa) patients. It is unclear whether a delay between diagnosis and surgical management (i.e., surgical delay) may have a detrimental effect on oncologic outcomes of PCa patients. The aim of the study was to assess the impact of surgical delay on oncologic outcomes. Methods Data of 926 men undergoing radical prostatectomy across Europe for intermediate and high-risk PCa according to EAU classification were identified. Multivariable analysis using binary logistic regression and Cox proportional hazard model tested association between surgical delay and upgrading on final pathology, lymph-node invasion (LNI), pathological locally advanced disease (pT3–4 and/or pN1), need for adjuvant therapy, and biochemical recurrence. Kaplan–Meier analysis was used to estimate BCR-free survival after surgery as a function of surgical delay using a 3 month cut-off. Results Median follow-up and surgical delay were 26 months (IQR 10–40) and 3 months (IQR 2–5), respectively. We did not find any significant association between surgical delay and oncologic outcomes when adjusted to pre- and post-operative variables. The lack of such association was observed across EAU risk categories. Conclusion Delay of several months did not appear to adversely impact oncologic results for intermediate and high-risk PCa, and support an attitude of deferring surgery in line with the current recommendation of urologic societies.
Published: 2020
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21. Stratifying patients with intermediate-risk prostate cancer: Validation of a new model based on MRI parameters and targeted biopsy and comparison with NCCN and AUA subclassifications

Author: Jean-Baptiste Roche, Georges Fournier, Guillaume Ploussard, Simone Albisinni, Bernard Malavaud, Alexandre Fourcade, Romain Diamand, Mathieu Roumiguié, Daniel Benamran, Paolo Gontero, Giuseppe Simone, Alexandre Peltier, Thierry Roumeguere, Christophe Iselin, Marco Oderda, Gaelle Fiard, and Jean-Luc Descotes
Subjects: Biochemical recurrence, Image-Guided Biopsy, Male, medicine.medical_specialty, Urology, medicine.medical_treatment, 030232 urology & nephrology, Disease, Risk Assessment, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, Interquartile range, medicine, Adjuvant therapy, Humans, Aged, Retrospective Studies, medicine.diagnostic_test, ddc:617, Prostatectomy, business.industry, Prostatic Neoplasms, Magnetic resonance imaging, Odds ratio, Unfavorable disease, Middle Aged, Models, Theoretical, medicine.disease, Intermediate, MRI, Targeted biopsy, Magnetic Resonance Imaging, Settore MED/24, Oncology, 030220 oncology & carcinogenesis, Radiology, business
Abstract: Intermediate-risk prostate cancer regroups heterogeneous patients with different oncologic outcomes. Aim of the study is to validate a novel intermediate-risk subclassification ("magnetic resonance imaging [MRI] subclassification") that defines favorable and unfavorable diseases based on multiparametric MRI parameters and compare it to NCCN and AUA intermediate-risk subclassifications.A total of 429 patients treated with radical prostatectomy for NCCN intermediate-risk prostate cancer were identified. Using MRI subclassification, a favorable disease was defined as an organ-confined disease on MRI and international society of urological pathology Grade Group 1 to 2 on targeted biopsy. Remaining was classified as unfavorable. Univariable and multivariable analysis tested MRI subclassification in predicting overall unfavorable disease (OUD: pT3-4 and/or pN1 and/or International Society of Urological Pathology Grade Group ≥ 3), the need for adjuvant therapy and early biochemical recurrence (eBCR). Performance of NCCN, AUA, and MRI models was compared in term of OUD proportion and eBCR prediction using Harrell's c-index, calibrations plots, and decision curve analysis.Median (interquartile range) follow-up was 12 months (4-28). In multivariable analysis, MRI subclassification was an independent factor for OUD (odds ratio [OR]: 4.54 [2.85-7.22], P0.001), the need for adjuvant therapy (OR: 3.42 [1.36-8.57], P = 0.009), and eBCR (HR: 2.62 [1.18-5.83], P = 0.018). Using this model, the proportion of unfavorable disease decreased from 73.7% and 63.9% to 35.9% (P0.001) associated to an increasing proportion of OUD when compared to NCCN and AUA models (63.9% and 67.1%-77.9% respectively, P0.001). Performance of the 3 models for eBCR prediction tended to be similar with a poor accuracy ranged from 58.7% to 66.7% (P0.05), permanent miscalibration and a net benefit at decision curve analysis.We validated an intermediate-risk subclassification based on MRI and targeted biopsy that potentially improves patient selection by reducing the number of patients considered at unfavorable risk while increasing proportion of patients harboring poor oncologic outcomes. Its performance for eBCR detection was comparable to NCCN and AUA models.
Published: 2020

22. Trifecta Outcomes of Partial Nephrectomy in Patients Over 75 Years Old: Analysis of the REnal SURGery in Elderly (RESURGE) Group

Author: Sunil Patel, Toshio Takagi, Andrew Tracey, Cosimo De Nunzio, Ali Abdel Raheem, Estefania Linares, Riccardo Autorino, Gaelle Fiard, Stephen Ryan, Nicola Pavan, Jean−Alexandre A. Long, Alessandro Antonelli, Bo Yang, Koon Ho Rha, Thomas Amiel, Carlotta Palumbo, Maria Carmen Mir, Simone Crivellaro, Alessandro Larcher, Luigi Schips, Riccardo Bertolo, Ahmet Bindayi, Carlo Trombetta, Chao Zhang, Francesco Montorsi, Tobias Maurer, Francesco Porpiglia, Umberto Capitanio, Estevão Lima, Ithaar Derweesh, Zachary Hamilton, Ryan W. Dobbs, Kazunari Tanabe, Antonio Celia, Joan Palou, Roberto Castellucci, Alberto Breda, Bindayi, A., Autorino, R., Capitanio, U., Pavan, N., Mir, M. C., Antonelli, A., Takagi, T., Bertolo, R., Maurer, T., Ho Rha, K., Long, J. -A., Yang, B., Schips, L., Lima, E., Breda, A., Linares, E., Celia, A., De Nunzio, C., Dobbs, R., Patel, S., Hamilton, Z., Tracey, A., Larcher, A., Trombetta, C., Palumbo, C., Tanabe, K., Amiel, T., Raheem, A., Fiard, G., Zhang, C., Castellucci, R., Palou, J., Ryan, S., Crivellaro, S., Montorsi, F., Porpiglia, F., Derweesh, I. H., Department of urology, Università Vita-Salute San Raffaele, Institute of Information Engineering [Beijing] (IIE), Chinese Academy of Sciences [Beijing] (CAS), Department of Urology, Medical University Graz, Sant'Andrea Hospital - Sapienza University of Rome, Cancer Prognostics and Health Outcomes Unit, Université de Montréal [Montréal], Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-IMAG-GMCAO), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), China Agricultural University (CAU), servicio de urologia, Fundación Puigvert, Centre d'Études Biologiques de Chizé - UMR 7372 (CEBC), Institut National de la Recherche Agronomique (INRA)-Université de La Rochelle (ULR)-Centre National de la Recherche Scientifique (CNRS), Université de Montréal (UdeM), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), and Université de La Rochelle (ULR)-Centre National de la Recherche Scientifique (CNRS)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)
Subjects: Male, Urologic Diseases, medicine.medical_specialty, Outcome Assessment, Urology, medicine.medical_treatment, [SDV]Life Sciences [q-bio], 030232 urology & nephrology, Renal function, Kidney, Nephrectomy, 03 medical and health sciences, Postoperative Complications, Text mining, 0302 clinical medicine, Elderly, Chronic Kidney Disease, medicine, Carcinoma, Humans, In patient, Stage (cooking), Trifecta, Survival analysis, Retrospective Studies, Aged, MESH: Carcinoma, Partial Nephrectomy, Renal Cell, Aged, 80 and over, business.industry, Renal surgery, Age Factors, Margins of Excision, renal carcinoma, medicine.disease, Kidney Neoplasms, 3. Good health, Surgery, Treatment Outcome, 030220 oncology & carcinogenesis, business, Glomerular Filtration Rate, Kidney disease
Abstract: Background: Partial nephrectomy (PN) in elderly patients is underutilized with concerns regarding risk of complications and potential for poor outcomes. Objective: To evaluate quality and functional outcomes of PN in patients >75 yr using trifecta as a composite outcome of surgical quality. Design, setting, and participants: Multicenter retrospective analysis of 653 patients aged >75 yr who underwent PN (REnal SURGery in Elderly [RESURGE] Group). Intervention: PN. Outcome measurements and statistical analysis: Primary outcome was achievement of trifecta (negative margin, no major [Clavien ≥3] urological complications, and ≥90% estimated glomerular filtration rate [eGFR] recovery). Secondary outcomes included chronic kidney disease (CKD) stage III and CKD upstaging. Multivariable analysis (MVA) was used to assess variables for achieving trifecta and functional outcomes. Kaplan-Meier survival analysis (KMA) was used to calculate renal functional outcomes. Results and limitations: We analyzed 653 patients (mean age 78.4 yr, median follow-up 33 mo; 382 open, 157 laparoscopic, and 114 robotic). Trifecta rate was 40.4% (n = 264). Trifecta patients had less transfusion (p < 0.001), lower intraoperative (5.3% vs 27%, p < 0.001) and postoperative (25.4% vs 37.8%, p = 0.001) complications, shorter hospital stay (p = 0.045), and lower ΔeGFR (p < 0.001). MVA for predictive factors for trifecta revealed decreasing RENAL nephrometry score (odds ratio [OR] 1.26, 95% confidence interval 1.07–1.51, p = 0.007) as being associated with increased likelihood to achieve trifecta. Achievement of trifecta was associated with decreased risk of CKD upstaging (OR 0.47, 95% confidence interval 0.32–0.62, p < 0.001). KMA showed that trifecta patients had improved 5-yr freedom from CKD stage 3 (93.5% vs 57.7%, p < 0.001) and CKD upstaging (84.3% vs 8.2%, p < 0.001). Limitations include retrospective design. Conclusions: PN in elderly patients can be performed with acceptable quality outcomes. Trifecta was associated with decreased tumor complexity and improved functional preservation. Patient summary: We looked at quality outcomes after partial nephrectomy in elderly patients. Acceptable quality outcomes were achieved, measured by a composite outcome called trifecta, whose achievement was associated with improved kidney functional preservation. Partial nephrectomy in elderly patients provides quality outcomes as measured by trifecta. Tumor complexity is a key determinant for trifecta achievement, and trifecta attainment is associated with improved function. Increasing utilization of robotics has benefits in recovery without compromising quality.
Published: 2020
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23. Prise en charge des pseudo-anévrismes rénaux intraparenchymateux post-traumatiques : à propos d’une série de 325 patients traumatisés rénaux

Author: C. Thuillier, Gaelle Fiard, B. Boillot, Jean-Alexandre Long, V. Arnoux, J.-L. Descotes, R. Guyot, N. Terrier, J.-J. Rambeaud, CHU Clermont-Ferrand, Service d'urologie, CHU Grenoble-Hôpital Michallon, CHU Annecy, Centre Hospitalier Universitaire [Grenoble] (CHU), Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-IMAG-GMCAO), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), and Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])
Subjects: Gynecology, medicine.medical_specialty, Traumatisme rénal fermé, business.industry, [SDV]Life Sciences [q-bio], Urology, 030232 urology & nephrology, Blunt renal trauma, Pseudoaneurysm, Pseudoanévrisme, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, Medicine, business
Abstract: Resume Introduction L’objectif a ete de decrire la prise en charge des pseudo-anevrismes (PA) post-traumatiques, intraparenchymateux, dans notre centre ; de la comparer aux donnees de la litterature afin de proposer un algorithme de prise en charge. Materiel et methodes Les dossiers de 325 traumatises renaux inclus dans une base de donnees prospective entre janvier 2004 et mai 2016 ont ete revus. Une revue des cas publies de PA a ete realisee sur Pubmed a l’aide des termes « blunt renal trauma » et « pseudoaneurysm » (excluant les cas de fistules arterioveineuses, de traumatismes ouverts et de PA extraparenchymateux) a permis l’analyse de 29 cas supplementaires. La prise en charge des traumatises renaux dans notre centre est decrite. Resultats Parmi les 325 patients traumatises renaux, 160 (49,3 %) etaient des traumatismes de grade IV et V. Un traitement conservateur a ete realise dans 93,2 % des cas. Huit cas de PA ont ete recenses, soit une incidence de 2,5 %. Quatre ont ete embolises d’emblee. Parmi les 4 cas surveilles, on a note 2 cas de thrombose spontanee, 1 cas d’absence de regression motivant une embolisation et 1 cas de recidive hemorragique occulte. Les PA surveilles ayant evolue favorablement avaient tous une taille inferieure a 1 cm. La fonction relative scintigraphique moyenne a 6 mois des reins ayant presente un PA embolise etait de 71,6 %. La revue de la litterature a permis de rapporter 29 cas publies, embolises pour 26 d’entre eux, avec un taux de succes de 84,6 %. Deux patients ont ete surveilles, mais l’un a finalement ete embolise devant la persistance de la lesion. Conclusion La formation d’un PA post-traumatique est une complication rare (2,5 %) des traumatismes fermes du rein. L’embolisation en presence de symptomes ou a fortiori d’une instabilite hemodynamique permet une bonne preservation renale. Les PA detectes de maniere fortuite (imagerie de suivi) et de taille inferieure a 1 cm semblent pouvoir etre surveilles. Niveau de preuve 5.
Published: 2017
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24. Stent Allium urétéral dans la prise en charge des sténoses urétérales. Étude rétrospective multicentrique

Author: M. Guandalino, M. Hutin, S. Droupy, Gaelle Fiard, A. Ruffion, B. Pereira, Jean-Etienne Terrier, Philippe Paparel, and D. Poncet
Subjects: Gynecology, 03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, business.industry, 030220 oncology & carcinogenesis, Urology, 030232 urology & nephrology, Medicine, Prosthesis design, business, 3. Good health
Abstract: Resume Introduction Les lesions ureterales post-traumatiques sont majoritairement traitees par sonde double J. Une minorite necessite des prises en charges complementaires. Les stents ureteraux presentent une alternative chirurgicale. Pour evaluer les resultats de la mise en place des protheses Allium ® ureterales dans la prise en charge des patients porteurs de sonde double J au long cours pour des stenoses ureterales. Materiels et methodes Etude de cohorte retrospective, multicentrique, de 36 patients ayant beneficies de la pose de 37 stents ureteraux Allium ® (metallique 24 Ch) de septembre 2011 a janvier 2015 dans trois centres hospitalo-universitaire francais. La moyenne d’âge des patients operes etait de 63,8 ans (33 a 88 ans). La majorite des patients etaient des femmes (70 %). Un pourcentage de 5,6 presentaient une fistule ureterale et 94,4 % une stenose. La longueur moyenne de la stenose etait de 4,15 cm (0,5 a 12 cm). Toutes les analyses ont ete realisees en formulation bilaterale pour un risque d’erreur de premiere espece de 5 %. Une difference a ete consideree comme statistiquement significative quand le degre de signification ( p ) etait inferieur a 0,05 (risque α = 5 %). Les resultats sont exprimes en termes d’hasard-ratios (HR), intervalles de confiance a 95 % associes et p -values. Resultats Trente-sept pour cent des stents ont ete retire au decours du suivi pour des complications a type de migration (18,9 %), d’infection (10,8 %) et d’intolerance (8,1 %). Les autres stents ont ete retires au bout d’un an. L’efficacite de la mise en place du stent, definie comme l’absence de recidive de la stenose ou de la fistule, etait de 52,8 % avec un suivi moyen de 7,1 mois. Conclusions La mise en place des stents Allium ureteraux offre une alternative chez les patients en sonde double J a demeure avec une efficacite de plus de 50 %. Niveau de preuve 4.
Published: 2017
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25. Prostatic Fragment Requiring Endoscopic Management After Prostatic Artery Embolization for Indwelling Bladder Catheter

Author: Jean Alexandre Long, Aurélie Delouche, Christian Sengel, Benedicte Guillaume, D. Poncet, Gilbert Ferretti, Julien Ghelfi, Stéphane Charara, Gaelle Fiard, Université Grenoble Alpes - UFR Médecine (UGA UFRM), Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service central de radiologie et d'imagerie médicale, CHU Grenoble-Hôpital Michallon, Clinique Universitaire de Radiologie et Imagerie Médicale, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-IMAG-GMCAO), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Centre Hospitalier Universitaire [Grenoble] (CHU), CHU Grenoble, and Pôle d'imagerie
Subjects: Male, medicine.medical_specialty, business.industry, [SDV]Life Sciences [q-bio], Prostatic Hyperplasia, Arteries, Endoscopic management, Prostatic artery embolization, 030218 nuclear medicine & medical imaging, Surgery, Urinary Bladder Neck Obstruction, 03 medical and health sciences, Catheters, Indwelling, 0302 clinical medicine, Text mining, 030220 oncology & carcinogenesis, Humans, Medicine, Radiology, Nuclear Medicine and imaging, Cardiology and Cardiovascular Medicine, business, Indwelling bladder catheter, ComputingMilieux_MISCELLANEOUS
Abstract: International audience
Published: 2018
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26. Outcomes of Partial and Radical Nephrectomy in Octogenarians – A Multicenter International Study (Resurge)

Author: Alessandro Larcher, Tommaso Silvestri, Cosimo De Nunzio, Andrea Tubaro, Alberto Breda, Alessandro Antonelli, Bo Yang, Joao Nuno Torres, Oscar Rodriguez Faba, Nicola Pavan, Riccardo Autorino, Kazunari Tanabe, L. Bevilacqua, Koon Ho Rha, Andrew Tracey, Francesco Porpiglia, Estefania Linares, Ahmet Bindayi, Francesco Montorsi, Jean Alexandre Long, Luigi Schips, Sisto Perdonà, Pierluigi Bove, Ottavio De Cobelli, Alexandre Mottrie, Claudio Simeone, Lance J. Hampton, Umberto Capitanio, Carmen Mir, Carlo Trombetta, Cristian Fiori, Ithaar Derweesh, Estevão Lima, Joan Palou, Antonio Celia, Salvatore Micali, Tobias Maurer, Matteo Ferro, Carlotta Palumbo, Giuseppe Quarto, Toshio Takagi, Gaelle Fiard, Chao Zhang, Roberto Castellucci, Alessandro Veccia, China Agricultural University (CAU), Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-IMAG-GMCAO), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Department of Urology, Sant'Andrea Hospital - Sapienza University of Rome, Medical University Graz, Cancer Prognostics and Health Outcomes Unit, Université de Montréal (UdeM), OLVG Hospital, servicio de urologia, Fundación Puigvert, Institute of Information Engineering [Beijing] (IIE), Chinese Academy of Sciences [Beijing] (CAS), Department of Clinical and Molecular Medicine, Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome], Department of urology, Università Vita-Salute San Raffaele, Department of Endocrinology and Medical Oncology, Genitourinary Cancer Section, Università degli studi di Napoli Federico II, chair and department of urology, Antonelli, A., Veccia, A., Pavan, N., Mir, C., Breda, A., Takagi, T., Rha, K. H., Maurer, T., Zhang, C., Long, J. -A., De Nunzio, C., Lima, E., Ferro, M., Micali, S., Quarto, G., Linares, E., Celia, A., Schips, L., Bove, P., Larcher, A., Fiori, C., Mottrie, A., Bindayi, A., Trombetta, C., Silvestri, T., Palou, J., Faba, O. R., Tanabe, K., Yang, B., Fiard, G., Tubaro, A., Torres, J. N., De Cobelli, O., Bevilacqua, L., Castellucci, R., Tracey, A., Hampton, L. J., Montorsi, F., Perdona, S., Simeone, C., Palumbo, C., Capitanio, U., Derweesh, I., Porpiglia, F., and Autorino, R.
Subjects: Male, Laparoscopic surgery, medicine.medical_treatment, [SDV]Life Sciences [q-bio], 030232 urology & nephrology, Aged, 80 and over, Asia, Carcinoma, Renal Cell, Europe, Female, Follow-Up Studies, Humans, Incidence, Kidney Neoplasms, Neoplasm Staging, Nephrectomy, Postoperative Complications, Retrospective Studies, Survival Rate, United States, resurge, 0302 clinical medicine, Retrospective Studie, Renal cell carcinoma, 80 and over, renal-cell carcinoma, kidney tumor, Kidney Neoplasm, 3. Good health, 030220 oncology & carcinogenesis, Human, Cohort study, medicine.medical_specialty, renal cell carcinoma, partial nephrectomy, Urology, elderly, Follow-Up Studie, 03 medical and health sciences, medicine, Survival rate, Aged, Cancer staging, business.industry, Carcinoma, Renal Cell, Postoperative complication, Retrospective cohort study, medicine.disease, Surgery, Settore MED/24, Postoperative Complication, business, elderly, renal cell carcinoma
Abstract: OBJECTIVE To analyze the outcomes of partial nephrectomy (PN) and radical nephrectomy (RN) in octogenarian patients. METHODS The RESURGE (REnal SUrgery in the Eldely) multi-institutional database was queried to identify patients >= 80 years old who had undergone a PN or RN for a renal tumor. Multivariable binary logistic regression estimated the association between type of surgery and occurrence of complications. Multivariable Cox regression model assessed the association between type of surgery and All-Causes Mortality. RESULTS The study analyzed 585 patients (median age 83 years, IQR 81-84), 364 of whom (62.2%) underwent RN and 221 (37.8%) PN. Patients undergoing RN were older (P = .0084), had larger tumor size (P < .0001) and higher clinical stage (P < .001). At multivariable analysis for complications, the only significant difference was found for lower risk of major postoperative complications for laparoscopic RN compared to open RN (OR: 0.42; P = .04). The rate of significant (>25%) decrease of eGFR in PN and RN was 18% versus 59% at 1 month, and 23% versus 65% at 6 months (P < .0001). After a median follow-up time of 39 months, 161 patients (31%) died, of whom 105 (20%) due to renal cancer. CONCLUSION In this patient population both RN and PN carry a non-negligible risk of complications. When surgical removal is indicated, PN should be preferred, whenever technically feasible, as it can offer better preservation of renal function, without increasing the risk of complications. Moreover, a minimally invasive approach should be pursued, as it can translate into lower surgical morbidity. (C) 2019 Elsevier Inc.
Published: 2019
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27. A multicentric study on accurate grading of prostate cancer with systematic and MRI/US fusion targeted biopsies: comparison with final histopathology after radical prostatectomy

Author: Thierry Piechaud, David Eldred-Evans, Giuseppe Simone, Marco Oderda, Mariaconsiglia Ferriero, Gaelle Fiard, Jean-Luc Descotes, Emanuela Altobelli, Romain Diamand, Thierry Roumeguere, Giovanni Muto, Valerio Beatrici, Alexandre Peltier, R. Van Velthoven, Jean Baptiste Roche, Giuseppe Fasolis, Rocco Papalia, Alessandro Giacobbe, Pardeep Kumar, W. Al Hajj Obeid, V. Lacetera, Antonio Luigi Pastore, Paolo Gontero, Simone Albisinni, Antonio Carbone, Giancarlo Marra, CHU Grenoble, Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-IMAG-GMCAO), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), National Physical Laboratory [Teddington] (NPL), Dipartimento di Scienze della Terra e dell'Ambiente [Pavia], Università degli Studi di Pavia, Dipartimento di Matematica e Informatica, Università di Catania, Università degli studi di Catania [Catania], Observatoire Volcanologique du Piton de la Fournaise (OVPF), and Institut de Physique du Globe de Paris
Subjects: Image-Guided Biopsy, Male, medicine.medical_specialty, Urology, medicine.medical_treatment, Concordance, Biopsy, [SDV]Life Sciences [q-bio], 030232 urology & nephrology, MRI/US fusion, Prostate cancer, Targeted, Aged, Humans, Multimodal Imaging, Neoplasm Grading, Prostatic Neoplasms, Reproducibility of Results, Retrospective Studies, Magnetic Resonance Imaging, Interventional, Prostatectomy, Ultrasonography, Interventional, 03 medical and health sciences, 0302 clinical medicine, McNemar's test, medicine, Grading (tumors), Ultrasonography, Interventional, medicine.diagnostic_test, business.industry, Retrospective cohort study, medicine.disease, Magnetic Resonance Imaging, 3. Good health, 030220 oncology & carcinogenesis, Histopathology, Radiology, business
Abstract: International audience; OBJECTIVE:To evaluate the accuracy in histologic grading of MRI/US image fusion biopsy by comparing histopathology between systematic biopsies (SB), targeted biopsies (TB) and the combination of both (SB + TB) with the final histopathologic outcomes of radical prostatectomy specimens.MATERIALS AND METHODS:Retrospective, multicentric study of 443 patients who underwent SB and TB using MRI/US fusion technique (Urostation® and Trinity®) prior to radical prostatectomy between 2010 and 2017. Cochran's Q test and McNemar test were conducted as a post hoc test. Uni-multivariable analyses were performed on several clinic-pathological variables to analyze factors predicting histopathological concordance for targeted biopsies.RESULTS:Concordance in ISUP (International Society of Urological Pathology) grade between SB, TB and SB + TB with final histopathology was 49.4%, 51.2%, and 63.2% for overall prostate cancer and 41.2%, 48.3%, and 56.7% for significant prostate cancer (ISUP grade ≥ 2), respectively. Significant difference in terms of concordance, downgrading and upgrading was found between SB and TB (ISUP grade ≥ 2 only), SB and SB + TB, TB and SB + TB (overall ISUP grade and ISUP grade ≥ 2) (p
Published: 2019
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28. Simulation-based training for prostate biopsies: towards the validation of the Biopsym simulator

Author: Gaelle Fiard, Jean-Luc Descotes, Emmanuel Promayon, Jocelyne Troccaz, Sonia-Yuki Selmi, Service d'urologie [CHU Grenoble], Centre Hospitalier Universitaire [Grenoble] (CHU), Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-IMAG-GMCAO), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Projet FUI MIRAS, and ANR-11-LABX-0004,CAMI,Gestes Médico-Chirurgicaux Assistés par Ordinateur(2011)
Subjects: Male, genetic structures, surgery, 03 medical and health sciences, User-Computer Interface, 0302 clinical medicine, Prostate, Biopsy, Medicine, Computer Simulation, biopsy, Prospective Studies, Simulation based, Biopsy procedure, Simulation Training, Simulation, prostate, medicine.diagnostic_test, business.industry, medicine.anatomical_structure, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Clinical Competence, business, computer-assisted training
Abstract: International audience; Objectives: The Biopsym simulator, a virtual-reality simulator for prostate biopsies, was designed to offer enhanced teaching of the biopsy procedure. The objectives of the present article are to describe the new version of the simulator and report the results of a new validation study. Material and methods: A prospective validation study was conducted between January and March 2017. The new version of the simulator, with improved physical realism, ultrasound image deformation, and a new scoring system, was evaluated by novice and confirmed users. Results: Twenty-one users evaluated the simulator, including ten novices and 11 confirmed users. The overall realism of the biopsy procedure was rated at 7.7/10 (IQR 5.7-9). The differences between the rates given by confirmed users and novices were not statistically significant. The median overall score obtained for the performance of 12 systematic ultrasound-guided biopsies was 43% (IQR 33-55). The median score obtained by confirmed users was 54% (IQR 46-62), and the median score obtained by novices was 31% (IQR 20-35). The difference between the scores was statistically significant (p = 0.005). Conclusions: This study allowed us to gather evidence towards the validation, and particularly towards the construct validation of the new version of the Biopsym simulator.
Published: 2019
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29. Partial versus radical nephrectomy in very elderly patients: a propensity score analysis of surgical, functional and oncologic outcomes (RESURGE project)

Author: Kazunari Tanabe, Toshio Takagi, Ryan W. Dobbs, Maria Furlan, Gaelle Fiard, Matteo Ferro, Antonio Celia, Simone Crivellaro, Alberto Breda, Andrea Tubaro, Pierluigi Bove, Salvatore Micali, J. Torres, Paolo Umari, Ottavio De Cobelli, Alexandre Mottrie, Ali Abdel Raheem, Giulia Barbati, Umberto Capitanio, Francesco Porpiglia, Estefania Linares, Caterina Gregorio, Riccardo Autorino, Estevão Lima, Alessandro Antonelli, Bo Yang, Maria Carmen Mir, Tommaso Silvestri, Sisto Perdonà, Alfredo Aguilera, Thomas Amiel, Giuseppe Quarto, Jean Alexandre Long, Francesco Montorsi, Bernardino De Concilio, Zachary Hamilton, L. Bevilacqua, Ahmet Bindayi, Koon Ho Rha, Chao Zang, Carlotta Palumbo, Luigi Schips, Ithaar Derweesh, Nicola Pavan, Cosimo De Nunzio, Carlo Trombetta, Andrew Tracey, Joan Palou, Oscar Rodriguez-Faba, Roberto Castellucci, Christian Fiori, Alessandro Larcher, Tobias Maurer, Mir, Maria C, Pavan, Nicola, Capitanio, Umberto, Antonelli, Alessandro, Derweesh, Ithaar, Rodriguez-Faba, Oscar, Linares, Estefania, Takagi, Toshio, Rha, Koon H, Fiori, Christian, Maurer, Tobia, Zang, Chao, Mottrie, Alexandre, Umari, Paolo, Long, Jean-Alexandre, Fiard, Gaelle, De Nunzio, Cosimo, Tubaro, Andrea, Tracey, Andrew T, Ferro, Matteo, De Cobelli, Ottavio, Micali, Salvatore, Bevilacqua, Luigi, Torres, João, Schips, Luigi, Castellucci, Roberto, Dobbs, Ryan, Quarto, Giuseppe, Bove, Pierluigi, Celia, Antonio, De Concilio, Bernardino, Trombetta, Carlo, Silvestri, Tommaso, Larcher, Alessandro, Montorsi, Francesco, Palumbo, Carlotta, Furlan, Maria, Bindayi, Ahmet, Hamilton, Zachary, Breda, Alberto, Palou, Joan, Aguilera, Alfredo, Tanabe, Kazunari, Raheem, Ali, Amiel, Thoma, Yang, Bo, Lima, Estevão, Crivellaro, Simone, Perdona, Sisto, Gregorio, Caterina, Barbati, Giulia, Porpiglia, Francesco, Autorino, Riccardo, Mir, M. C., Pavan, N., Capitanio, U., Antonelli, A., Derweesh, I., Rodriguez-Faba, O., Linares, E., Takagi, T., Rha, K. H., Fiori, C., Maurer, T., Zang, C., Mottrie, A., Umari, P., Long, J. -A., Fiard, G., De Nunzio, C., Tubaro, A., Tracey, A. T., Ferro, M., De Cobelli, O., Micali, S., Bevilacqua, L., Torres, J., Schips, L., Castellucci, R., Dobbs, R., Quarto, G., Bove, P., Celia, A., De Concilio, B., Trombetta, C., Silvestri, T., Larcher, A., Montorsi, F., Palumbo, C., Furlan, M., Bindayi, A., Hamilton, Z., Breda, A., Palou, J., Aguilera, A., Tanabe, K., Raheem, A., Amiel, T., Yang, B., Lima, E., Crivellaro, S., Perdona, S., Gregorio, C., Barbati, G., Porpiglia, F., Autorino, R., Department of urology, Università Vita-Salute San Raffaele, OLVG Hospital, Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-IMAG-GMCAO), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Department of Urology, Sant'Andrea Hospital - Sapienza University of Rome, Department of Clinical and Molecular Medicine, Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome], Medical University Graz, Cancer Prognostics and Health Outcomes Unit, Université de Montréal (UdeM), servicio de urologia, Fundación Puigvert, La Paz University Hospital, Institute of Information Engineering [Beijing] (IIE), Chinese Academy of Sciences [Beijing] (CAS), Department of Endocrinology and Medical Oncology, Genitourinary Cancer Section, and Università degli studi di Napoli Federico II
Subjects: Nephrology, Male, medicine.medical_specialty, Asia, Urology, medicine.medical_treatment, [SDV]Life Sciences [q-bio], 030232 urology & nephrology, Renal function, Nephrectomy, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Elderly, Interquartile range, Internal medicine, medicine, Humans, Partial nephrectomy, Propensity Score, Carcinoma, Renal Cell, elderly, kidney cancer, nephrectomy, partial nephrectomy, Aged, Neoplasm Staging, Retrospective Studies, business.industry, Incidence, Age Factors, Retrospective cohort study, Kidney cancer, Middle Aged, medicine.disease, Kidney Neoplasms, Europe, Survival Rate, Settore MED/24, Treatment Outcome, 030220 oncology & carcinogenesis, Propensity score matching, Cohort, North America, Female, business, Glomerular Filtration Rate
Abstract: International audience; PURPOSE:To compare the outcomes of PN to those of RN in very elderly patients treated for clinically localized renal tumor.PATIENTS AND METHODS:A purpose-built multi-institutional international database (RESURGE project) was used for this retrospective analysis. Patients over 75 years old and surgically treated for a suspicious of localized renal with either PN or RN were included in this database. Surgical, renal function and oncological outcomes were analyzed. Propensity scores for the predicted probability to receive PN in each patient were estimated by logistic regression models. Cox proportional hazard models were estimated to determine the relative change in hazard associated with PN vs RN on overall mortality (OM), cancer-specific mortality (CSM) and other-cause mortality (OCM).RESULTS:A total of 613 patients who underwent RN were successfully matched with 613 controls who underwent PN. Higher overall complication rate was recorded in the PN group (33% vs 25%; p = 0.01). Median follow-up for the entire cohort was 35 months (interquartile range [IQR] 13-63 months). There was a significant difference between RN and PN in median decline of eGFR (39% vs 17%; p
Published: 2019
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30. Detailing sexual outcomes after treatment of localised prostate cancer with focal therapy using various energy sources: protocol for a mixed-methods study

Author: Gaelle Fiard, Tet Yap, Daniel Kelly, Mark Emberton, Service d'urologie [CHU Grenoble], Centre Hospitalier Universitaire [Grenoble] (CHU), Division of Surgery and Interventional Science [London, UK], University College of London [London] (UCL), Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-GMCAO), Translational Innovation in Medicine and Complexity / Recherche Translationnelle et Innovation en Médecine et Complexité - UMR 5525 (TIMC ), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP ), Université Grenoble Alpes (UGA), Cardiff University, and Guy's and St Thomas' Hospital [London]
Subjects: Male, medicine.medical_specialty, erectile dysfunction, [SDV]Life Sciences [q-bio], Urology, 030232 urology & nephrology, [SDV.CAN]Life Sciences [q-bio]/Cancer, State Medicine, 03 medical and health sciences, 0302 clinical medicine, Informed consent, Surveys and Questionnaires, medicine, Humans, Prospective Studies, Prospective cohort study, ComputingMilieux_MISCELLANEOUS, Retrospective Studies, Reproductive health, business.industry, Prostatic Neoplasms, Retrospective cohort study, General Medicine, 3. Good health, Sexual desire, Sexual dysfunction, sexual dysfunction, 030220 oncology & carcinogenesis, Family medicine, Medicine, medicine.symptom, Thematic analysis, business, Energy source, qualitative research, prostate disease
Abstract: IntroductionFocal therapy has emerged as a promising treatment option for men with localised prostate cancer. However, most of the evaluation of postoperative function has taken place at a relatively high, non-granular level. Most of the data we use to provide informed consent for our patients is obtained from retrospective series, or derived from prospective studies whose primary outcome was oncological. Finally, most studies have focused on erectile function and overlooked other, presumably important, elements of male sexual function. The present study aims at studying in-depth the sexual consequences of focal therapy with various energy sources.Methods and analysisThis will be a mixed-methods research study based on a retrospective and prospective cohort, recruited in parallel. The retrospective cohort will consist of patients treated with focal irreversible electroporation, and the prospective cohort of patients treated with three focal therapy energies. Participants will be recruited from two UK urology centres, one National Health Service and one private. On consent, patients will fill in self-administered validated questionnaires (International Index of Erectile Function-15 (IIEF-15), Male Sexual Health Questionnaire-Ejaculatory Dysfunction-Short Form (MSHQ-EjD-SF)) and semistructured interviews will be organised to collect patients’ expectations and postoperative changes in domains such as erection, ejaculation, orgasm, libido/sexual desire, masculinity/virility, penile morphology, pain or discomfort, regret, shame, cancer-related stress, overall impact and partner satisfaction. An exploratory thematic analysis will be performed to detail recurring themes that will be grouped into clusters of experiences. We will then be able to find clusters of agreement and disagreement that will be illustrated using exemplar patient quotations.Ethics and disseminationEthical approval was obtained (Regional Ethics Committee reference 20/NW/0335), as well as Health Research Authority approval. Results will be published in open-access peer-reviewed journals. Findings will also be translated into patient information resources (leaflets, online information sheets).Trial registration numberISRCTN11634296; Pre-results.
Published: 2020
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31. External validation of the Briganti nomogram predicting lymph node invasion in patients with intermediate and high-risk prostate cancer diagnosed with magnetic resonance imaging-targeted and systematic biopsies: A European multicenter study

Author: Simone Albisinni, Maxime Rossi, Alexandre Fourcade, Marco Oderda, Grégoire Assenmacher, Gaelle Fiard, Ilyas Svistakov, Daniel Benamran, Jean Louis Bonnal, Romain Diamand, Georges Fournier, Giuseppe Simone, Jean Baptiste Roche, Christophe Iselin, Giacomo Di Cosmo, Thierry Roumeguere, Paolo Gontero, Eric Mandron, J.L. Descotes, Alexandre Peltier, and Julien Van Damme
Subjects: Image-Guided Biopsy, Male, medicine.medical_specialty, Urology, medicine.medical_treatment, 030232 urology & nephrology, Risk Assessment, Nomogram, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, Humans, Medicine, Neoplasm Invasiveness, Lymph node, Aged, Retrospective Studies, medicine.diagnostic_test, Receiver operating characteristic, business.industry, Prostatectomy, Prostatic Neoplasms, Magnetic resonance imaging, Middle Aged, Prognosis, medicine.disease, Magnetic Resonance Imaging, Europe, Nomograms, Dissection, Settore MED/24, medicine.anatomical_structure, Oncology, Targeted biopsy, Lymphatic Metastasis, 030220 oncology & carcinogenesis, Cohort, Lymph node invasion, MRI, Radiology, business
Abstract: To validate a nomogram predicting lymph node invasion (LNI) in prostate cancer patients undergoing radical prostatectomy taking into consideration multiparametric-magnetic resonance imaging (mp-MRI) parameters and targeted biopsies in a western European cohort.A total of 473 men diagnosed by targeted biopsies, using software-based MRI-ultrasound image fusion system, and operated by radical prostatectomy with extended pelvic lymph node dissection across 11 Europeans centers between 2012 and 2019 were identified. Area under the curve of the receiver operator characteristic curve, calibration plot and decision curve analysis were used to evaluated the performance of the model.Overall, 56 (11.8%) patients had LNI on final pathologic examination with a median (IQR) of 13 (9-18) resected nodes. Significant differences (all P0.05) were found between patients with and without LNI in terms of preoperative PSA, clinical stage at DRE and mp-MRI, maximum diameter of the index lesion, PI-RADS score, Grade Group on systematic and targeted biopsies, total number of dissected lymph nodes, final pathologic staging and Grade Group. External validation of the prediction model showed a good accuracy with an area under the curve calculated as 0.8 (CI 95% 0.75-0.86). Graphic analysis of calibration plot and decision curve analysis showed a slight underestimation for predictive probability for LNI between 3% and 22% and a high net benefit. A cut-off at 7% was associated with a risk of missing LNI in 2.6%, avoiding unnecessary surgeries in 55.9%.We report an external validation of the nomogram predicting LNI in patients treated with extended pelvic lymph node dissection in a western European cohort and a cut-off at 7% seems appropriate.
Published: 2020
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32. Stopping or maintaining oral anticoagulation in patients undergoing photoselective vaporization of the prostate (SOAP) surgery for benign prostate obstruction: study protocol for a multicentre randomized controlled trial

Author: L. Corbel, Emmanuel Della Negra, Abdel-Rahmène Azzouzi, Marie Pasquie, Sébastien Vincendeau, Valerie Fuzier, Franck Bruyère, Benoit Peyronnet, Benjamin Pradere, Atul Pathak, Georges Fournier, Aurélien Descazeaud, Thibaut Culty, Hélène Charbonneau, Pierre Albaladejo, Gilles Karsenty, C. Thuillier, Audrey Hesbois, Gaelle Fiard, Jean-Luc Descotes, Souhil Lebdai, C. Ballereau, Nicolas Savy, Nicolas Barry-Delongchamps, J. Calves, Vincent Misrai, Romain Mathieu, Pierre Colin, Charles Marc Samama, Felipe Guerrero, Jean-Alexandre Long, Clinique Pasteur [Toulouse], Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service d'urologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Privé des Côtes d'Armor (HPCA), Chirurgie urologique et transplantation rénale [Hôpital de la Conception - APHM], Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-IMAG-GMCAO), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Service d'urologie [CHU Grenoble], Centre Hospitalier Universitaire [Grenoble] (CHU), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Service d'urologie [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau, Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), AP-HP - Hôpital Cochin Broca Hôtel Dieu [Paris], Laboratoire d'Annecy de Physique des Particules (LAPP), Institut National de Physique Nucléaire et de Physique des Particules du CNRS (IN2P3)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Centre National de la Recherche Scientifique (CNRS), Institut de Mathématiques de Toulouse UMR5219 (IMT), Université Toulouse Capitole (UT Capitole), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National des Sciences Appliquées - Toulouse (INSA Toulouse), Institut National des Sciences Appliquées (INSA)-Université de Toulouse (UT)-Institut National des Sciences Appliquées (INSA)-Université Toulouse - Jean Jaurès (UT2J), Université de Toulouse (UT)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Centre National de la Recherche Scientifique (CNRS), Techniques pour l'Evaluation et la Modélisation des Actions de la Santé (TIMC-IMAG-ThEMAS), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Institut National des Sciences Appliquées - Toulouse (INSA Toulouse), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Université Toulouse 1 Capitole (UT1), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Université Toulouse - Jean Jaurès (UT2J)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS), CHU Toulouse [Toulouse], Service d'urologie [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Centre National de la Recherche Scientifique (CNRS)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Université Toulouse - Jean Jaurès (UT2J)-Université Toulouse 1 Capitole (UT1), Université Fédérale Toulouse Midi-Pyrénées-Institut National des Sciences Appliquées - Toulouse (INSA Toulouse), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA), Université Toulouse 1 Capitole (UT1), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National des Sciences Appliquées - Toulouse (INSA Toulouse), Institut National des Sciences Appliquées (INSA)-Université Fédérale Toulouse Midi-Pyrénées-Institut National des Sciences Appliquées (INSA)-Université Toulouse - Jean Jaurès (UT2J)-Université Toulouse III - Paul Sabatier (UT3), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10
Subjects: Male, medicine.medical_specialty, Time Factors, Complications, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Prostatic Hyperplasia, 030232 urology & nephrology, Oral anticoagulation, Administration, Oral, Medicine (miscellaneous), Laser, Equivalence Trials as Topic, Drug Administration Schedule, law.invention, Study Protocol, 03 medical and health sciences, 0302 clinical medicine, Lower Urinary Tract Symptoms, Randomized controlled trial, law, Prostate, Lower urinary tract symptoms, medicine, Humans, Multicenter Studies as Topic, Pharmacology (medical), Transurethral resection of the prostate, lcsh:R5-920, business.industry, Anticoagulants, GreenLight, Perioperative, Evidence-based medicine, Heparin, medicine.disease, Confidence interval, 3. Good health, Surgery, Treatment Outcome, medicine.anatomical_structure, 030220 oncology & carcinogenesis, France, Laser Therapy, Benign prostatic obstruction, lcsh:Medicine (General), business, medicine.drug
Abstract: Lower urinary tract symptoms related to benign prostatic obstruction (BPO) are frequent in men aged > 50 years. Based on the use of innovative medical devices, a number of transurethral ablative techniques have recently been developed for the surgical treatment of BPO. In recent years, GreenLight photoselective vaporization of the prostate (PVP) has been considered as a non-inferior alternative to transurethral resection of the prostate. The GreenLight PVP is usually considered as an interesting surgical option for patients treated via oral anticoagulants (OACs) with regard to its haemostatic properties. The aim of this study was to assess the impact of maintaining OAC treatment in patients undergoing PVP. This study is a multicentre, open-label, randomized controlled trial (RCT) designed to show the non-inferiority of PVP surgery in patients with BPO treated with OACs. This study is designed to enrol 386 OAC-treated patients (treated with vitamin K antagonists and direct oral anticoagulants) who are undergoing PVP for BPO. Patients will be randomized (1:1) to either maintain or stop OAC treatment during the perioperative course. The intervention group will maintain OAC treatment until the day before surgery and resume OAC treatment the day after surgery, whereas the control group will stop OAC treatment (with or without low-molecular-weight heparin bridging therapy) according to the anaesthesia guidelines. The primary outcome of interest to be assessed is the 30-day complications rate according to the Clavien-Dindo classification. The secondary endpoint will examine the 30-day rate of haemorrhagic and thrombotic events. This study will provide 80% power to show non-inferiority, defined as not worse than a 10% (non-inferiority margin) inferior change in the proportion of patients with good outcomes (Clavien-Dindo score
Published: 2018
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33. Accuracy of elastic fusion biopsy in daily practice: Results of a multicenter study of 2115 patients

Author: Giuseppe Simone, Mauro Ciccariello, M. Rouprêt, Pierre Mozer, Alessandro Giacobbe, Pardeep Kumar, Thierry Piechaud, Paolo Gontero, Antonio Carbone, Olivier Rouvière, Mariaconsiglia Ferriero, Eduard Baco, Antonio Luigi Pastore, Giuseppe Fasolis, Vito Lacetera, Emanuela Altobelli, Marine Dubreuil-Chambardel, Roland Van Velthoven, Giancarlo Marra, A. Cantiani, J.L. Descotes, Valerio Beatrici, Valerio Forte, Alexandre Peltier, Marco Oderda, Gaelle Fiard, Giovanni Muto, Jean Baptiste Roche, David Eldred-Evans, Rocco Papalia, Simone Albisinni, Service de chirurgie, CHU Grenoble-Hôpital Michallon, Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-IMAG-GMCAO), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Division of Urology, San Lazzaro Hospital, Clinique Saint Augustin, Service d'urologie [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Edouard Herriot [CHU - HCL], and Hospices Civils de Lyon (HCL)
Subjects: Koelis, Adult, Image-Guided Biopsy, Male, medicine.medical_specialty, Multivariate analysis, Urology, [SDV]Life Sciences [q-bio], 030232 urology & nephrology, Magnetic Resonance Imaging, Interventional, Multimodal Imaging, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, Prostate, Predictive Value of Tests, Biopsy, medicine, Humans, Sampling (medicine), Stage (cooking), Fusion Biopsy, Multiparametric Magnetic Resonance Imaging, Ultrasonography, Interventional, Aged, Retrospective Studies, targeted, Aged, 80 and over, medicine.diagnostic_test, accuracy, business.industry, random, Prostatic Neoplasms, Reproducibility of Results, fusion biopsy, Middle Aged, Prostate-Specific Antigen, medicine.disease, 3. Good health, Europe, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Feasibility Studies, Radiology, Biopsy, Large-Core Needle, business
Abstract: International audience; OBJECTIVES:To assess the accuracy of Koelis fusion biopsy for the detection of prostate cancer and clinically significant prostate cancer in the everyday practice.METHODS:We retrospectively enrolled 2115 patients from 15 institutions in four European countries undergoing transrectal Koelis fusion biopsy from 2010 to 2017. A variable number of target (usually 2-4) and random cores (usually 10-14) were carried out, depending on the clinical case and institution habits. The overall and clinically significant prostate cancer detection rates were assessed, evaluating the diagnostic role of additional random biopsies. The cancer detection rate was correlated to multiparametric magnetic resonance imaging features and clinical variables.RESULTS:The mean number of targeted and random cores taken were 3.9 (standard deviation 2.1) and 10.5 (standard deviation 5.0), respectively. The cancer detection rate of Koelis biopsies was 58% for all cancers and 43% for clinically significant prostate cancer. The performance of additional, random cores improved the cancer detection rate of 13% for all cancers (P < 0.001) and 9% for clinically significant prostate cancer (P < 0.001). Prostate cancer was detected in 31%, 66% and 89% of patients with lesions scored as Prostate Imaging Reporting and Data System 3, 4 and 5, respectively. Clinical stage and Prostate Imaging Reporting and Data System score were predictors of prostate cancer detection in multivariate analyses. Prostate-specific antigen was associated with prostate cancer detection only for clinically significant prostate cancer.CONCLUSIONS:Koelis fusion biopsy offers a good cancer detection rate, which is increased in patients with a high Prostate Imaging Reporting and Data System score and clinical stage. The performance of additional, random cores seems unavoidable for correct sampling. In our experience, the Prostate Imaging Reporting and Data System score and clinical stage are predictors of prostate cancer and clinically significant prostate cancer detection; prostate-specific antigen is associated only with clinically significant prostate cancer detection, and a higher number of biopsy cores are not associated with a higher cancer detection rate.
Published: 2018
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34. Super-selective robot-assisted partial nephrectomy using near-infrared flurorescence versus early-unclamping of the renal artery: results of a prospective matched-pair analysis

Author: Q. Franquet, Jean-Jacques Rambeaud, J. Lefrancq, Nicolas Terrier, C. Lanchon, Gaelle Fiard, Jean-Luc Descotes, D. Poncet, Valentin Arnoux, C. Overs, Jean-Alexandre Long, Service d'urologie [CHU Grenoble], Centre Hospitalier Universitaire [Grenoble] (CHU), Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-IMAG-GMCAO), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), and Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])
Subjects: Male, medicine.medical_specialty, Matched Pair Analysis, medicine.medical_treatment, [SDV]Life Sciences [q-bio], 030232 urology & nephrology, Urology, Renal function, Scintigraphy, lcsh:RC870-923, Kidney, Nephrectomy, 03 medical and health sciences, 0302 clinical medicine, Renal Artery, Blood loss, Robotic Surgical Procedures, Ischemia, medicine.artery, medicine, Operating time, Humans, Minimally Invasive Surgical Procedures, Renal artery, Aged, Retrospective Studies, Postoperative Care, Spectroscopy, Near-Infrared, medicine.diagnostic_test, business.industry, Middle Aged, medicine.disease, lcsh:Diseases of the genitourinary system. Urology, Constriction, Kidney Neoplasms, Treatment Outcome, 030220 oncology & carcinogenesis, Original Article, Female, business, Kidney disease
Abstract: ARTICLE InFO ______________________________________________________________ ______________________ Introduction: Super-selective clamping of tumor-specific segmental arteries was developed to eliminate ischemia of the remnant kidney while limiting hemorrhage during partial nephrectomy. The objective is to evaluate the benefice of super-selective clamping on renal functional outcome, compared to early-unclamping of the renal artery. Materials and Methods: From March 2015 to July 2016, data from 30 patients undergoing super-selective robot-assisted PN (RAPN) for a solitary tumor by a single surgeon were prospectively collected. Tumor devascularization was assessed using indocyanine green near-infrared fluorescence. A matched-pair analysis with a retrospective cohort undergoing early-unclamping was conducted, adjusting on tumor complexity and pre-operative eGFR. Perioperative, oncologic and functional outcomes using DMSA-renal scintigraphy were assessed. Multivariate analysis was performed to identify predictors of postoperative renal function and de novo chronic kidney disease (CKD). Results: Super-selective RAPN was successful in 23/30 patients (76.7%), 5 requiring secondary main artery clamping due to persistent tumor fluorescence. Matched-pair analysis showed similar operating time, blood loss, positives margins and complication rates. Super-selective clamping was associated with an improved eGFR variation at discharge (p=0.002), 1-month (p=0.01) and 6-month post-op (-2%vs-16% p=0.001). It also led to a better relative function on scintigraphy (46%vs40% p=0.04) and homo-lateral eGFR (p=0.04), and fewer upstaging to CKD stage ≥3 (p=0.03). On multivariate analysis, super-selective clamping was a predictor of postoperative renal function. Conclusion: Super-selective RAPN leads to an improved preservation of renal function and a reduced risk of de novo CKD stage≥3, while keeping the benefit of main artery clamping on perioperative outcomes.
Published: 2018
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35. Transrectal ultrasound-guided prostate biopsies vs. magnetic resonance imaging ultrasound fusion targeted biopsies: Who are the best candidates?

Author: Q. Franquet, Elsa Bey, Gaelle Fiard, Jean-Luc Descotes, Jean-Alexandre Long, Jean-Jacques Rambeaud, Olivier Gaget, Centre Hospitalier Universitaire [Grenoble] (CHU), Service de chirurgie, CHU Grenoble-Hôpital Michallon, Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-IMAG-GMCAO), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Université Grenoble Alpes - UFR Médecine (UGA UFRM), and Université Grenoble Alpes [2016-2019] (UGA [2016-2019])
Subjects: medicine.medical_specialty, medicine.diagnostic_test, business.industry, Urology, [SDV]Life Sciences [q-bio], 030232 urology & nephrology, Cancer, Magnetic resonance imaging, Rectal examination, Odds ratio, medicine.disease, Confidence interval, 3. Good health, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, medicine.anatomical_structure, Oncology, Prostate, 030220 oncology & carcinogenesis, Biopsy, medicine, Radiology, business, Original Research
Abstract: Introduction: The aim of this study was to compare the results of ultrasound-guided prostate biopsies (US-PB) and magnetic resonance imaging-ultrasound fusion biopsies (MRI-PB) in two contemporary cohorts and to describe the parameters orienting the choice of technique.Methods: Two contemporary cohorts of patients undergoing US-PB or MR-PB using the Urostation® (Koelis, Grenoble, France) between November 2010 and July 2015 were analyzed retrospectively. Patients with metastatic cancer or recurrence after treatment, saturation biopsies, and US-PB performed after a negative MRI were excluded. Comparison of populations, biopsy results, and clinical and biological parameters guiding the choice of technique were studied on multivariate analysis (logistic regression) taking into account the following confounding factors: age, prostate-specific antigen (PSA) rate, prostatic volume, number of previous biopsies, and abnormal digital rectal examination.Results: One hundred fourteen patients were included in the US-PB group and 118 in the MR-PB group. Prostate cancer was diagnosed among 65 patients in the US-PB group (detection rate 57.0%) and 70 patients in the MR-PB group (detection rate 59.3%) (odds ratio [OR] 3.00; 95% confidence interval [CI] 1.52–6.17; p=0.002). Among the cancers diagnosed in the MR-PB group, 21 were diagnosed by the two targeted biopsy cores only (15.5%). Patients undergoing MR-PB were significantly younger (p=0.0005), with a higher number of previous biopsy sessions (p
Published: 2017
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36. Minimally invasive partial nephrectomy for elderly patients with renal mass: Morbidity, renal function and oncologic outcomes in the RESURGE collaborative database

Author: Juan Palou, Nicola Pavan, Tobias Maurer, Andrea Tubaro, C. De Nunzio, L. Bevilacqua, Ali Abdel Raheem, R.G. Bertolo, Bisheng Yang, P. Bove, Alessandro Larcher, C. Palumbo, Thomas Amiel, G. De Naeyer, Alexandre Mottrie, S. Perdonà, F. Porpiglia, Estefania Linares, J. Torres, Roberto Castellucci, G. Quarto, Kazunari Tanabe, Toshio Takagi, F. Montorsi, Luigi Schips, R. Autorino, Estevão Lima, B. De Concilio, Ithaar Derweesh, Maria Furlan, Gaelle Fiard, O. De Cobelli, Tommaso Silvestri, A. Antonelli, Oscar Rodríguez, Salvatore Micali, Alberto Breda, Carlo Trombetta, A. Aguilera, K.H. Rha, Jean-Alexandre Long, Matteo Ferro, Zachary Hamilton, Andrew Tracey, A. Celia, U. Capitanio, Carmen Mir, Ahmet Bindayi, and Chao Zang
Subjects: medicine.medical_specialty, business.industry, Urology, medicine.medical_treatment, 030232 urology & nephrology, Renal function, Nephrectomy, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, medicine, Renal mass, business
Published: 2018
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37. Surgical outcomes and predictors of complications in elderly patients undergoing partial or radical nephrectomy for clinically localized renal cancer: A multi-institutional analysis (RESURGE project)

Author: Joan Palou, Roberto Castellucci, Estefania Linares, Koon Ho Rha, Zachary Hamilton, Francesco Porpiglia, Jean Alexandre Long, Alexandre Mottrie, Giulia Barbati, Antonio Celia, J. Torres, Umberto Capitanio, Paolo Umari, Andrea Tubaro, Luigi Schips, R. Bertolo, Kazunari Tanabe, Estevão Lima, B. De Concilio, Oscar Rodriguez-Faba, Andrew Tracey, Riccardo Autorino, Alessandro Antonelli, Bo Yang, Alfredo Aguilera, Sisto Perdonà, Toshio Takagi, Thomas Amiel, Giuseppe Quarto, Maria Furlan, Tommaso Silvestri, Alessandro Larcher, Francesco Montorsi, Gaelle Fiard, Ahmet Bindayi, Maria Carmen Mir, Ithaar Derweesh, Ali Abdel Raheem, Caterina Gregorio, Chao Zang, Matteo Ferro, O. De Cobelli, C. De Nunzio, Alberto Breda, Carlo Trombetta, L. Bevilacqua, Salvatore Micali, Nicola Pavan, Tobias Maurer, Pierluigi Bove, and Carlotta Palumbo
Subjects: medicine.medical_specialty, business.industry, Urology, General surgery, medicine.medical_treatment, 030232 urology & nephrology, Cancer, medicine.disease, Nephrectomy, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, medicine, business
Published: 2018
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38. Devices and systems targeted towards augmented robotic radical prostatectomy

Author: Brahim Tamadazte, Marie-Paule Montmasson, Guillaume Custillon, Alexandre Moreau-Gaudry, Jean-Alexandre Long, Redha Heus, Clement Vidal, Françoise Giroud, Christian Pieralli, Gaelle Fiard, Jean-Luc Descotes, Sandrine Voros, An Nguyen-Dinh, Olivier Gaiffe, Philippe Cinquin, Université Joseph Fourier - Grenoble 1 (UJF), Centre d'Investigation Clinique - Innovation Technologique - INSERM - CHU de Grenoble (CIC-IT Grenoble (CIT803)), CHU Grenoble-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes (UGA), Franche-Comté Électronique Mécanique, Thermique et Optique - Sciences et Technologies (UMR 6174) (FEMTO-ST), Université de Technologie de Belfort-Montbeliard (UTBM)-Ecole Nationale Supérieure de Mécanique et des Microtechniques (ENSMM)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS), Service d'urologie [CHU Grenoble], Centre Hospitalier Universitaire [Grenoble] (CHU), Endocontrol-Medical S.A. (Endocontrol), Vermon S.A., Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-IMAG-GMCAO), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), CIC - Grenoble, Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Dynamique Cellulaire et Tissulaire- Interdisciplinarité, Modèles & Microscopies (TIMC-IMAG-DyCTiM), Service d'urologie, CHU Grenoble-Hôpital Michallon, Endocontrol-Medical S.A., entreprise, GMCAO, VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-CIC - Grenoble, Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Santé et de la Recherche Médicale (INSERM), and This work has been supported by French National Research Agency (ANR) through TecSan program (project DEPORRA no ANR-09-TECS-006)
Subjects: medicine.medical_specialty, medicine.medical_treatment, [INFO.INFO-OH]Computer Science [cs]/Other [cs.OH], laparoscopy, 030232 urology & nephrology, Biomedical Engineering, Biophysics, Context (language use), Urinary incontinence, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, medicine, Medical physics, [PHYS.PHYS.PHYS-OPTICS]Physics [physics]/Physics [physics]/Optics [physics.optics], Prostatectomy, business.industry, Public health, navigation systems, Cancer, ultrasonography, prostate cancer, medicine.disease, University hospital, 3. Good health, Surgery, Sexual dysfunction, computer-assisted, 030220 oncology & carcinogenesis, [SPI.OPTI]Engineering Sciences [physics]/Optics / Photonic, [SDV.IB]Life Sciences [q-bio]/Bioengineering, fluorescence, medicine.symptom, business
Abstract: International audience; Prostate cancer is the most frequent male cancer and the second cause of male cancer mortality in developed countries. Therefore, it represents a major public health issue. Health problem and the development of new therapeutic strategies to address this issue is essential. During a prostatectomy, the surgeon looks for a compromise between an exhaustive removal of pathologic tissue (to achieve the best carcinogenic prognosis) and the functional consequences linked to a wide excision (i.e.: avoid as much as possible urinary incontinence and sexual dysfunction). In this context, the ANR TecSan DEPORRA project regroups French research laboratories (TIMC-IMAG, FEMTO-ST), companies (Endocontrol-Medical, VERMON) and hospital departments (CIC-IT, Urology & pathology Department of the Grenoble University Hospital) to bring innovative tools for radical prostatectomy. These tools will provide to the surgeon new information from several imaging modalities (video, fluorescence and US imaging), and combine them in an augmented environment. We believe that this augmented environment will ultimately help the surgeon to perform his surgical gesture "optimally" and will improve the patient's carcinogenic and functional prognosis.
Published: 2013
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39. Are Magnetic Resonance Imaging-Transrectal Ultrasound Guided Targeted Biopsies Noninferior to Transrectal Ultrasound Guided Systematic Biopsies for the Detection of Prostate Cancer?

Author: Pierre Mozer, Olivier Rouvière, Nicolas Barry Delongchamps, Gaelle Fiard, Daniel Portalez, E. Bruguiere, Bernard Malavaud, Thomas Sanzalone, François Cornud, Service d'urologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'Hématologie [IUCT Toulouse], Université Fédérale Toulouse Midi-Pyrénées-Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM), Imagerie cardiovasculaire, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM), Hospices Civils de Lyon, Departement de Neurologie (HCL), Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-IMAG-GMCAO), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Service d'urologie [CHU Grenoble], Centre Hospitalier Universitaire [Grenoble] (CHU), Service Maladies infectieuses et tropicales [AP-HP Hôpital Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Université Paris Descartes - Paris 5 (UPD5), and Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)
Subjects: Adult, Image-Guided Biopsy, Male, medicine.medical_specialty, diagnosis, Urology, [SDV]Life Sciences [q-bio], 030232 urology & nephrology, prostatic neoplasms, Endosonography, 03 medical and health sciences, Prostate cancer, 0302 clinical medicine, Prostate, Biopsy, medicine, Humans, magnetic resonance imaging, biopsy, Aged, Retrospective Studies, medicine.diagnostic_test, business.industry, Rectum, Reproducibility of Results, Cancer, Magnetic resonance imaging, ultrasonography, Middle Aged, medicine.disease, 3. Good health, PI-RADS, Prostate-specific antigen, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Radiology, business
Abstract: International audience; PURPOSE: In men with suspicion of prostate cancer the standard of cancer detection is transrectal ultrasound guided 10 to 12-core systematic biopsy. The targeted biopsy only strategy using magnetic resonance imaging-transrectal ultrasound image registration is gaining in popularity. We assessed the noninferiority of targeted vs systematic biopsy.MATERIALS AND METHODS:Between June and October 2014 a total of 108 biopsy naïve patients with prostate specific antigen between 4 and 20 ng/ml, normal rectal examination and a single suspicious image on magnetic resonance imaging were included in study at 7 centers. Patients underwent systematic biopsy by a first operator blinded to magnetic resonance imaging, immediately followed by 3 targeted biopsies within the suspicious image by a second operator. The primary end point was the cancer detection rate. The noninferiority margin was set at -5%. The secondary end points were the detection rate of clinically significant prostate cancer (maximum cancer core length 5 mm or greater for Gleason 6 or any Gleason 7 or greater disease) and procedure duration.RESULTS:Systematic and targeted biopsies detected cancer in 66 (61.1%) and 61 patients (56.5%), respectively. The mean difference was -4.5% with a 95% CI lower bound of -11.8%. A total of 13 patients with protocol violations were excluded from the per protocol analysis, which showed a mean difference of -5.2% with a 95% CI lower bound of -13.1%. Clinically significant prostate cancer was detected in 50 (46.2%) and 52 patients (48.1%) with systematic and targeted biopsies, respectively (p = 0.69). The mean ± SD duration of image fusion plus targeted biopsy was 16.7 ± 7 minutes vs 7.4 ± 3 for systematic biopsy (p
Published: 2016
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40. Surgical Staff Radiation Protection During Fluoroscopy-Guided Urologic Interventions

Author: Gaelle Fiard, Maeva Rosec, François Galonnier, Philippe Paparel, C. Bassinet, Olivier Traxer, D. Celier, Alain Ruffion, Jean-Etienne Terrier, Jean-Baptiste Terrasa, Pascal Gouezel, Service d'urologie [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Tenon [APHP], Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Institut de Génomique Fonctionnelle de Lyon (IGFL), École normale supérieure - Lyon (ENS Lyon)-Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Centre de Recherche en Cancérologie de Lyon (CRCL), Centre Léon Bérard [Lyon]-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Applications des ultrasons à la thérapie, Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'urologie, CHU Grenoble-Hôpital Michallon, Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-IMAG-GMCAO), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-IMAG-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Recherche Agronomique (INRA)-École normale supérieure - Lyon (ENS Lyon), Centre de Recherche en Cancérologie de Lyon (UNICANCER/CRCL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and École normale supérieure de Lyon (ENS de Lyon)-Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL)
Subjects: Risk, medicine.medical_specialty, Operating Rooms, Patients, Urology, 030232 urology & nephrology, Psychological intervention, [SDV.CAN]Life Sciences [q-bio]/Cancer, Radiation Dosage, Urologic Surgical Procedure, methods, 03 medical and health sciences, 0302 clinical medicine, Radiation Protection, Occupational Exposure, Physicians, medicine, Fluoroscopy, Humans, Medical physics, Prospective Studies, Radiation Injuries, Radiometry, Nephrostomy, Percutaneous, Surgical team, medicine.diagnostic_test, Anthropometry, business.industry, Phantoms, Imaging, X-Rays, Occupational Injuries, 3. Good health, Surgery, Radiation exposure, 030220 oncology & carcinogenesis, Radiological weapon, Workforce, Urologic Surgical Procedures, Thermoluminescent Dosimetry, France, Radiation protection, business, Whole-Body Irradiation
Abstract: International audience; INTRODUCTION: Over the past 20 years, the use of fluoroscopy to guide urologic surgical interventions has been constantly growing. Thus, in their daily practice, urologists and other operating room (OR) staff are exposed to X-radiation increasingly frequently. This raises questions as to the risks they encounter and the actions needed to reduce them. OBJECTIVE: Evaluate X-ray dose exposure in the members of the surgical team and determine urologist radioprotection knowledge and practices. MATERIALS AND METHODS: A prospective bicenter study was conducted within AFUF (French urology resident association) and in association with The French Nuclear Safety Authority/The Institute for Radiological Protection and Nuclear Safety (ASN/IRSN). Radiation exposure was measured on 12 operators using dosimeters (seven per operator), in staff-occupied locations in the OR using ionization chambers, and on anthropomorphic phantoms. A survey was used to gather information on radiation knowledge and safety practices of the AFUF members. RESULTS: Annual whole-body radiation doses were low (0.1-0.8 millisieverts [mSv], mostly at around 0.3 mSv), and equivalent doses were low for the fingers (0.7-15 mSv, mostly at around 2.5 mSv), and low for the lens of the eye (0.3-2.3 mSv, mostly at around 0.7 mSv). In percutaneous nephrolithotomy, extremity doses were lower when the patient was placed in dorsal decubitus compared with ventral decubitus. Pulsed fluoroscopy reduced radiation dose exposure by a factor of 3 compared with continuous fluoroscopy with no image quality loss. Radiation safety practices were poor: only 15% of urologists wore dosimeters and only 5% had been trained in the handling of X-ray generators. CONCLUSION: In the present study, radiation exposure for urologists was low, but so was knowledge of radiation safety and optimization practices. This absence of training for radiation safety and reduction, teamed with novel techniques involving long fluoroscopy-guided interventions, could result in unnecessarily high exposure for patients and OR personnel
Published: 2016
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41. External validation of the RENAL nephrometry score in renal tumours treated by partial nephrectomy

Author: Alexandre Moreau-Gaudry, Nicolas Terrier, Jean-Jacques Rambeaud, A. Arvin-Berod, Jean-Alexandre Long, Bernard Boillot, Gaelle Fiard, Jean-Luc Descotes, Valentin Arnoux, and Riccardo Autorino
Subjects: medicine.medical_specialty, business.industry, Urology, medicine.medical_treatment, 030232 urology & nephrology, Renal function, Retrospective cohort study, Perioperative, Odds ratio, medicine.disease, Nephrectomy, Surgery, 03 medical and health sciences, 0302 clinical medicine, Interquartile range, 030220 oncology & carcinogenesis, Severity of illness, medicine, business, Kidney cancer
Abstract: What's known on the subject? and What does the study add? Using a standardized classification for renal tumours is a major step towards an objective comparison of the indications and expected outcomes of partial nephrectomy (PN). Several scores have been described, including the RENAL nephrectomy score (RNS), to evaluate the anatomical features of a renal tumour and predict the surgical challenges with particular regard to PN. Previous studies show discrepancies with regard to the effectiveness of using the RNS to predict postoperative outcomes. Although we showed that conversion to radical nephrectomy was predicted by the RNS, the occurence of complications was more difficult to predict. Objective To evaluate the RENAL nephrometry score (RNS) as a predictor of the perioperative outcomes of a partial nephrectomy. Patients and Methods A retrospective review of 177 consecutive patients who were candidates for an open partial nephrectomy (OPN, n = 159) or a laparoscopic partial nephrectomy (LPN, n = 18) from August 2008 to January 2011 was undertaken. Tumour complexity was stratified into three categories: low (4–6), moderate (7–9) and high (10–12) complexity. Complications, and surgical and renal outcomes were recorded and analysed. Predictors of conversion to radical nephrectomy (RN) and complications were assessed using univariate and multivariate logistic regression. Multiple linear regression was used to evaluate the prediction of postoperative estimated glomerular filtration rate (eGFR) and warm ischaemia time (WIT). Results The median RNS was 7 (interquartile range 6–9). Tumour complexity was assessed as low in 72 (40.6%), moderate in 87 (49.2%) and high in 18 patients (10.2%). There were no significant differences among the three groups with respect to demographic characteristics, operating time, estimated blood loss, transfusion, length of stay, complications and positive surgical margins. Conversion to RN occurred in 29 patients (16.3%). RNS was significantly associated with an increased risk of conversion to RN (odds ratio [OR] = 3.5, P = 0.01 and OR = 6.7, P = 0.005, respectively, for moderate vs low, and high vs low complexity groups). On multivariate analysis, RNS was the only independent predictor of WIT (P = 0.03) and conversion to RN (P = 0.008), but failed to predict postoperative eGFR (P = 0.84) and the occurrence of major complications (P = 0.91). Conclusions In the present series, RNS predicted an increased risk of conversion to RN and prolonged WIT. RNS was not a predictor of complications and postoperative renal function.
Published: 2012
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42. Initial validation of a virtual-reality learning environment for prostate biopsies: realism matters!

Author: Emmanuel Promayon, Lucile Vadcard, Gaelle Fiard, Jean-Luc Descotes, Sonia-Yuki Selmi, Jocelyne Troccaz, Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-IMAG-GMCAO), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), Laboratoire des Sciences de l'Éducation (Grenoble) (LSE), Université Pierre Mendès France - Grenoble 2 (UPMF), ANR and grants, ANR PROSBOT, and ANR CAMI
Subjects: FOS: Computer and information sciences, Male, medicine.medical_specialty, Urologic Surgical Procedures, Male, Computer science, Urology, Biopsy, [INFO.INFO-OH]Computer Science [cs]/Other [cs.OH], 030232 urology & nephrology, 03 medical and health sciences, User-Computer Interface, Computer Science - Computers and Society, 0302 clinical medicine, Ultrasound probe, Prostate, Surveys and Questionnaires, Computers and Society (cs.CY), medicine, Humans, Learning, Medical physics, Computer Simulation, prostate biopsy, Set (psychology), Reliability (statistics), medicine.diagnostic_test, ultrasound, Reproducibility of Results, simulation, computer-assisted education, medicine.anatomical_structure, 030220 oncology & carcinogenesis, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Knowledge of Results, Psychological
Abstract: International audience; : Introduction-objectives: A virtual-reality learning environment dedicated to prostate biopsies was designed to overcome the limitations of current classical teaching methods. The aim of this study was to validate reliability, face, content and construct of the simulator. Materials and methods: The simulator is composed of a) a laptop computer, b) a haptic device with a stylus that mimics the ultrasound probe, c) a clinical case database including three dimensional (3D) ultrasound volumes and patient data and d) a learning environment with a set of progressive exercises including a randomized 12-core biopsy procedure. Both visual (3D biopsy mapping) and numerical (score) feedback are given to the user. The simulator evaluation was conducted in an academic urology department on 7 experts and 14 novices who each performed a virtual biopsy procedure and completed a face and content validity questionnaire. Results: The overall realism of the biopsy procedure was rated at a median of 9/10 by non-experts (7.1-9.8). Experts rated the usefulness of the simulator for the initial training of urologists at 8.2/10 (7.9-8.3), but reported the range of motion and force feedback as significantly less realistic than novices (p=0.01 and 0.03 respectively). Pearson's r correlation coefficient between correctly placed biopsies on the right and left side of the prostate for each user was 0.79 (p
Published: 2013
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43. Using CamiTK for rapid prototyping of interactive Computer Assisted Medical Intervention applications

Author: Gaelle Fiard, Sandrine Voros, Emmanuel Promayon, Jocelyne Troccaz, Vincent Luboz, Johan Sarrazin, Philippe Cinquin, Nicolas Saubat, Aurélien Deram, Nikolai Hungr, Céline Fouard, Yohan Payan, Sonia-Yuki Selmi, Mathieu Bailet, Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-IMAG-GMCAO), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), Service d'urologie, CHU Grenoble-Hôpital Michallon, Centre d'Investigation Clinique [Grenoble] (CIC Grenoble), and Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Male, FOS: Computer and information sciences, Rapid prototyping, Engineering drawing, Biopsy, Other Computer Science (cs.OH), Brachytherapy, [INFO.INFO-OH]Computer Science [cs]/Other [cs.OH], Video Recording, Article, Field (computer science), 030218 nuclear medicine & medical imaging, User-Computer Interface, 03 medical and health sciences, 0302 clinical medicine, Robotic Surgical Procedures, Computer Science - Other Computer Science, Intervention (counseling), Humans, Diagnosis, Computer-Assisted, Instrumentation (computer programming), Signal processing, Prostatic Neoplasms, Endoscopy, Signal Processing, Computer-Assisted, Equipment Design, Robotics, Biomechanical Phenomena, 3. Good health, 030220 oncology & carcinogenesis, Female, Programming Languages, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Software
Abstract: Computer Assisted Medical Intervention (CAMI hereafter) is a complex multi-disciplinary field. CAMI research requires the collaboration of experts in several fields as diverse as medicine, computer science, mathematics, instrumentation, signal processing, mechanics, modeling, automatics, optics, etc. CamiTK is a modular framework that helps researchers and clinicians to collaborate together in order to prototype CAMI applications by regrouping the knowledge and expertise from each discipline. It is an open-source, cross-platform generic and modular tool written in C++ which can handle medical images, surgical navigation, biomedicals simulations and robot control. This paper presents the Computer Assisted Medical Intervention ToolKit (CamiTK) and how it is used in various applications in our research team.
Published: 2013
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44. Enhanced vision system for laparoscopic surgery

Author: Brahim Tamadazte, Gaelle Fiard, Jean-Alexandre Long, Philippe Cinquin, Sandrine Voros, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), Gestes Medico-chirurgicaux Assistés par Ordinateur (TIMC-IMAG-GMCAO), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), CIC - Grenoble, Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Urologie, CHU Grenoble, and Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble
Subjects: Distributed vision system, Laparoscopic surgery, medicine.medical_specialty, Clinical experiments, Machine vision, medicine.medical_treatment, Sus scrofa, 0206 medical engineering, ComputingMethodologies_IMAGEPROCESSINGANDCOMPUTERVISION, ComputerApplications_COMPUTERSINOTHERSYSTEMS, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, 02 engineering and technology, Surgical robotics, 03 medical and health sciences, 0302 clinical medicine, CMOS sensors, Photography, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, Animals, Medicine, Computer vision, Medical physics, Robotic surgery, Laparoscopy, medicine.diagnostic_test, business.industry, Open surgery, Optical Devices, Robotic endoscope holder, Oxides, Endoscopy, Robotics, 020601 biomedical engineering, Semiconductors, Metals, 030220 oncology & carcinogenesis, Computer-Aided Design, Artificial intelligence, business
Abstract: International audience; Laparoscopic surgery offers benefits to the patients but poses new challenges to the surgeons, including a limited field of view. In this paper, we present an innovative vision system that can be combined with a traditional laparoscope, and provides the surgeon with a global view of the abdominal cavity, bringing him or her closer to open surgery conditions. We present our first experiments performed on a testbench mimicking a laparoscopic setup: they demonstrate an important time gain in performing a complex task consisting bringing a thread into the field of view of the laparoscope.
Published: 2013
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45. Targeted MRI-guided Prostate Biopsies for the Detection of Prostate Cancer: Initial Clinical Experience With Real-time 3-Dimensional Transrectal Ultrasound Guidance and Magnetic Resonance/Transrectal Ultrasound Image Fusion

Author: Jean-Alexandre Long, Noelie Hohn, Jean-Jacques Rambeaud, Jocelyne Troccaz, Gaelle Fiard, Jean-Luc Descotes, Service d'urologie, CHU Grenoble-Hôpital Michallon, Pôle d'imagerie, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, CHU Grenoble-Ministère de la santé, GMCAO, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-Service d'urologie, and CHU Grenoble-Hôpital Michallon-CHU Grenoble-Hôpital Michallon
Subjects: Male, medicine.medical_specialty, Urology, [SDV]Life Sciences [q-bio], [INFO.INFO-OH]Computer Science [cs]/Other [cs.OH], 030232 urology & nephrology, Image registration, Magnetic Resonance Imaging, Interventional, Statistics, Nonparametric, 03 medical and health sciences, Prostate cancer, Imaging, Three-Dimensional, 0302 clinical medicine, Prostate, Biopsy, medicine, Humans, 3D ultrasound, biopsy, Endoscopic Ultrasound-Guided Fine Needle Aspiration, Aged, prostate, medicine.diagnostic_test, business.industry, Ultrasound, Prostatic Neoplasms, Cancer, Magnetic resonance imaging, Middle Aged, Prostate-Specific Antigen, medicine.disease, 3. Good health, image registration, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Radiology, business, Software, MRI
Abstract: International audience; OBJECTIVE: To prove the feasibility and evaluate the initial clinical results of targeted prostate biopsies using the Urostation novel platform using magnetic resonance imaging (MRI)/transrectal ultrasound (TRUS) registration to help steer the biopsy needle to suspicious areas. METHODS: We prospectively included 30 patients for suspicion of prostate cancer from November 2011 to August 2012. All patients were previously evaluated by a multiparametric MRI, interpreted by a single radiologist who attributed a Prostate Imaging-Reporting and Data System (PI-RADS) score to each lesion. A conventional 12-core randomized biopsy protocol was performed and 2 additional targeted biopsies were performed on suspicious area(s). The results of randomized and targeted biopsies were compared. RESULTS: Among the 30 patients, suspicious area(s) were found on MRI in 20 cases (67%). Median procedure time was 23 minutes. Targeting success rate (biopsy visualized inside the target) was 83%, with at least 1 biopsy reaching the target in all cases. Prostate cancer was detected in 14 cases (47%), including 11 cases with an abnormal MRI. Targeted biopsies detected cancer in all 11 cases and all but 1 were clinically significant. Randomized biopsies detected 10 of these 11 cases, and 3 more cases that MRI considered normal. Sensitivity to detect a significant cancer was 91% in both modalities. CONCLUSION: This initial clinical study showed encouraging results for targeted MRI-guided prostate biopsies using MRI-TRUS fusion. Although further studies are needed to determine the role of prostate MRI before biopsy and the relevance of targeted biopsies, the Urostation is an MRI-TRUS fusion device that has good accuracy for targeting suspicious areas on MRI.
Published: 2013
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