Search

Your search keyword '"Laurent Bellec"' showing total 26 results
Start Over Author "Laurent Bellec" Topic medicine.medical_treatment
26 results on '"Laurent Bellec"'

1. Corticosteroids in patients hospitalized for COVID-19 pneumonia who require oxygen: observational comparative study using routine care data

Author

Viet-Thi Tran, Matthieu Mahévas, Firouze Bani-Sadr, Olivier Robineau, Thomas Perpoint, Elodie Perrodeau, Laure Gallay, Philippe Ravaud, François Goehringer, François-Xavier Lescure, Sophie Ismaël, Cédric Laouénan, Jennifer Soulier, Oriane Puéchal, Eric D’Ortenzio, Yazdan Yazdanpanah, Laurence Maulin, Stéphanie Martinez, Diane Sanderink, Pascale Fialaire, Séverine Ansart, Lucas Perez, Anne - Laure Destrem, Chloé Moulin, Pascal Gicquel, Frédéric Rivière, Martin Martinot, Mahsa Mohseni Zadeh, Tomasz Chroboczek, Thibaut Challan Belval, Lionel Piroth, Thibault Sixt, Florian Moretto, André Cabié, Jérémie Pasquier, Ornella Cabras, Marine Morrier, Jean Reuter, Thomas Henin, Pierre Braquet, Helene Desmurs-Clavel, Arnaud Hot, Boris Bienvenu, Belkacem Asselate, Nicolas Vignier, Steve Nguala, Sylvain Diamantis, Guillemette Frémont, Pierre Louis Nivose, Mathilde Thiébaut, Benjamin Lefevre, Hélène Auge, Paul le Turnier, Naila Benkalfate, Olivier Grossi, Samuel Pineau, Elisa Demonchy, Julie Merindol, Claire Durand, Nathalie Tieulié, Viviane Queyrel, Didier Laureillard, Paul Loubet, Ségolène Greffe, Nathalie Dournon, Youssouf Mohamed Kassim, Cyrille Gourjault, Alexandre Lahens, Paul Legendre, Caroline Morbieu, Matthieu Mahevas, Giovanna Melica, Jean-Daniel Levièvre, Frédéric Schlemmer, Simone Tunesi, Claire Leblanc, Anne Bourgarit-Durand, Alexandre Bleibtreu, Gianpiero Tebano, Jérôme Pacanowski, Jean-Benoit Zabbe, Mathilde Devaux, Laurent Bellec, Marine Gosset-Woimant, Céleste Lambert, Maxime Hentzien, Amélie Servettaz, Kevin Alexandre, Manuel Etienne, Romain Leguillon, Marion Dollat, Rémi Lefrancois, Anne Pouvaret, Yvon Ruch, Yannick Dieudonné, Guillaume Martin-Blondel, Xavier Boumaza, Margaux Lafaurie, Macha Tetart, Adrien Lemaignen, Nicole Ferreira-Maldent, Amélie Duréault, Marie Gousseff, Claire Chantepie, Francesca Bisio, Fanny Pommeret, Emeline Colomba Blamble, and Claire Ara Somohano

Subjects
0301 basic medicine, Adult, Male, Microbiology (medical), medicine.medical_specialty, Adolescent, medicine.medical_treatment, Therapeutic evaluation, 030106 microbiology, Population, Severity of Illness Index, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Prednisone, Adrenal Cortex Hormones, Internal medicine, Observational study, Severity of illness, Medicine, Intubation, Corticosteroids, Humans, 030212 general & internal medicine, education, Aged, Mechanical ventilation, Aged, 80 and over, education.field_of_study, business.industry, Mortality rate, Hazard ratio, Oxygen Inhalation Therapy, COVID-19, General Medicine, Middle Aged, medicine.disease, Respiration, Artificial, COVID-19 Drug Treatment, Pneumonia, C-Reactive Protein, Infectious Diseases, Original Article, Female, business, medicine.drug
Abstract

OBJECTIVE: To assess the effectiveness of corticosteroids on outcomes of patients with COVID-19 pneumonia requiring oxygen without mechanical ventilation. METHODS: We used routine care data from 51 hospitals in France and Luxembourg to assess the effectiveness of corticosteroids at 0.8 mg/kg/day eq. prednisone (CTC group) versus standard of care (no-CTC group) among adults 18 to 80 years old with confirmed COVID-19 pneumonia requiring oxygen without mechanical ventilation. The primary outcome was intubation or death by day 28. In our main analysis, characteristics of patients at baseline (i.e., time when patients met all inclusion criteria) were balanced by using propensity-score inverse probability of treatment weighting. RESULTS: Among the 891 patients included in the analysis, 203 were assigned to the CTC group. Use of corticosteroids was not significantly associated with risk of intubation or death by day 28 (weighted hazard ratio [wHR] 0.92, 95% CI 0.61 to 1.39) or cumulative death rate (wHR 1.03, 95% CI 0.54 to 1.98). However, use of corticosteroids was associated with reduced risk of intubation or death by day 28 in the prespecified subgroups of patients requiring oxygen ≥ 3 L/min (wHR 0.50, 95% CI 0.30 to 0.85) or C-reactive protein level ≥ 100 mg/L (wHR 0.44, 95%CI 0.23 to 0.85). Number of hyperglycaemia events was higher for patients with than without corticosteroids, but number of infections was similar. CONCLUSIONS: We found no association between the use of corticosteroids and intubation or death in the broad population of patients 18 to 80 years old with COVID-19 hospitalized in non-intensive care unit settings. However, the treatment was associated with reduced risk of intubation or death for patients with ≥ 3 L/min oxygen or C-reactive protein level ≥ 100 mg/L at baseline. Further research need to confirm the right timing of corticosteroids for patients with COVID-19 requiring oxygen only.

Published
2021
Full Text
View/download PDF

2. Nephron-sparing surgery is superior to radical nephrectomy in preserving renal function benefit even when expanding indications beyond the traditional 4-cm cutoff

Author

Michel Soulié, Julien Drai, Jérôme Rigaud, Nicolas Mottet, Christian Pfister, Jean Marie Ferriere, Roberto Bertini, Fabien Bouliere, Olivier Bouchot, Jean-Christophe Bernhard, Thomas Bessede, Laurent Bellec, Allan J. Pantuck, Géraldine Pignot, Arie S. Belldegrun, Marc Colombel, Karim Bensalah, Laurent Salomon, Jean Jacques Patard, Pierre Bigot, Arnauld Villers, Francesco Montorsi, Pignot, G, Bigot, P, Bernhard, Jc, Bouliere, F, Bessede, T, Bensalah, K, Salomon, L, Mottet, N, Bellec, L, Soulié, M, Ferrière, Jm, Pfister, C, Drai, J, Colombel, M, Villers, A, Rigaud, J, Bouchot, O, Montorsi, Francesco, Bertini, R, Belldegrun, A, Pantuck, Aj, and Patard, Jj

Subjects
Adult, Male, medicine.medical_specialty, Multivariate analysis, Urology, medicine.medical_treatment, Renal function, Kaplan-Meier Estimate, Nephrectomy, Young Adult, Renal cell carcinoma, medicine, Humans, Cutoff, Carcinoma, Renal Cell, Aged, Proportional Hazards Models, Retrospective Studies, Aged, 80 and over, Univariate analysis, Tumor size, business.industry, Nephrons, Middle Aged, medicine.disease, Kidney Neoplasms, Surgery, Oncology, Multivariate Analysis, Female, Nephron sparing surgery, business, Glomerular Filtration Rate
Abstract

Objectives To analyze to what extent partial nephrectomy (PN) is superior to radical nephrectomy (RN) in preserving renal function outcome in relation to tumor size indication. Methods and materials Clinical data from 973 patients operated at 9 academic institutions were retrospectively analyzed. Glomerular filtration rate (GFR) before and after surgery was calculated with the abbreviated Modification of the Diet in Renal Disease equation. For a fair comparison between the 2 techniques, all imperative indications for PN were excluded. A shift to a less favorable GFR group following surgery was considered clinically significant. Results Median age at diagnosis was 60 years (19–91). Tumor size was smaller than 4 cm in 665 (68.3%) cases and larger than 4 cm in 308 (31.7%) cases. PN and RN were performed in 663 (68.1%) and 310 (31.9%) patients, respectively. In univariate analysis, patients undergoing PN had a smaller risk for developing significant GFR change following surgery than those undergoing RN did. This was true for tumors≤4 cm ( P = 0.0001) and for tumors>4 cm ( P = 0.0001). In multivariate analysis, the following criteria were independent predictive factors for developing significant postoperative GFR loss: the use of RN ( P = 0.0001), preoperative GFR P = 0.0001), tumor size≥4 cm ( P = 0.0001), and older age at diagnosis ( P = 0.0001). Conclusions The renal function benefit carried out by elective PN over RN persists even when expanding nephron-sparing surgery indications beyond the traditional 4-cm cutoff.

Published
2014

3. Are warm ischemia and ischemia time still predictive factors of poor renal function after partial nephrectomy in the setting of elective indication?

Author

Michel Soulié, Jean-Marie Ferriere, Laurent Salomon, Pierre Bigot, B. Albouy, Frédéric Pouliot, Nicolas Mottet, Géraldine Pignot, Fabien Bouliere, Thomas Bessede, Karim Bensalah, Maxime Crepel, Thierry Dujardin, Laurent Bellec, Christian Pfister, Gregory Verhoest, Jean-Jacques Patard, and Jean-Christophe Bernhard

Subjects
Adult, Male, Nephrology, medicine.medical_specialty, Urology, medicine.medical_treatment, Operative Time, Renal function, urologic and male genital diseases, Nephrectomy, Constriction, Risk Factors, Renal cell carcinoma, Internal medicine, medicine, Carcinoma, Humans, Warm Ischemia, Renal Insufficiency, Chronic, Carcinoma, Renal Cell, Aged, Retrospective Studies, Aged, 80 and over, integumentary system, business.industry, Incidence, Patient Selection, Retrospective cohort study, Nephrons, Middle Aged, medicine.disease, Warm ischemia, Kidney Neoplasms, Surgery, Elective Surgical Procedures, Cardiology, Female, business, Glomerular Filtration Rate
Abstract

To evaluate renal function and to identify factors associated with renal dysfunction in the elective indications setting of nephron-sparing surgery (NSS).We retrospectively reviewed operative data and glomerular filtration rate (GFR) of 519 patients treated by NSS in an elective indications setting between 1984 and 2006 in eight academic institutions. A GFR decrease under the thresholds of 60 or 45 ml/min at last follow-up was considered a significant renal dysfunction. Univariate and multivariate regression models were used to assess multiple factors of renal function.Median age, tumor size, preoperative, and final GFR were 59.5 years (27-84), 2.7 cm (0.9-11), 79 (45-137), and 69 ml/min (p0.0001), respectively, with a median follow-up of 23 months (1-416). Hilar clamping was performed in 375 procedures (72.3 %). Significant GFR decrease was observed in 89 patients (17.1 %). Median operating time, hilar clamping duration, and blood loss were 137 min (55-350), 22 min (0-90), and 150 ml (0-4150), respectively. At univariate analysis, age (p = 0.002), preoperative GFR (p = 0.001), pedicular clamping (p = 0.01), and ischemia time (p = 0.0001) were associated with renal dysfunction. Age (p = 0.004; HR 1.2), pedicular clamping (p = 0.04; HR 1.3), and ischemia time (p = 0.0001; HR 1.8) remained independent risk factors for renal function deterioration in multivariate analysis.Non- or time-limited clamping techniques are associated with preservation of renal function in the elective indications setting of NSS.

Published
2014

4. The use of partial nephrectomy: results from a contemporary national prospective multicenter study

Author

P. Gimel, Hervé Baumert, Michel Soulié, Pascal Mouracade, J.-P. Couapel, Karim Bensalah, Christophe Vaessen, Laurent Salomon, Morgan Rouprêt, Marc-Olivier Timsit, Jean-Christophe Bernhard, Jean-Jacques Patard, Laurent Bellec, Pierre Bigot, Jean-Marie Ferriere, Herve Lang, Marc Zerbib, Arnauld Villers, Jérôme Rigaud, Géraldine Pignot, and Arnaud Mejean

Subjects
Adult, Male, Nephrology, medicine.medical_specialty, Urology, medicine.medical_treatment, Operative Time, Population, Nephrectomy, Young Adult, Robotic Surgical Procedures, Renal cell carcinoma, Internal medicine, medicine, Humans, Prospective Studies, Warm Ischemia, Prospective cohort study, Laparoscopy, education, Carcinoma, Renal Cell, Aged, Aged, 80 and over, education.field_of_study, medicine.diagnostic_test, business.industry, General surgery, Middle Aged, medicine.disease, Kidney Neoplasms, Surgery, Treatment Outcome, Cohort, Female, Observational study, France, business
Abstract

Despite benefits in functional renal outcome and favorable oncological efficacy, previous studies show marked underuse of partial nephrectomy (PN). We investigated national utilization of partial and radical nephrectomy (RN) using a contemporary, prospective population-based cohort.Between June and December 2010, 1,237 patients were treated by PN or RN for renal cell carcinoma in 56 French centers. Data were prospectively collected, and statistical analyses were performed.Overall, 667 (53.9 %) and 570 patients (46.1 %) underwent RN and PN, respectively. In case of PN, surgical approach was an open PN in 63.3 % of cases, a laparoscopic PN in 21.0 % of cases and a robot-assisted PN in 15.7 % of cases. PN was used in T1a, T1b, T2 and T3 tumors in 395 (76.7 %), 131 (38.2 %), 29 (14.7 %) and 7 (4.6 %), respectively. Median ischemia time was 16 min [0-60], and mean blood loss was 280.4 ml (±339.9). Tumor characteristics and operative features were significantly different according to the surgical approach. Warm ischemia time was significantly higher in case of laparoscopic or robot-assisted procedure (p0.001). There was no statistical significant difference in blood loss and transfusion rate according to surgical approach. Postoperative medical and surgical complications occurred in 8.2 and 10.0 % of PN, respectively, with no significant difference according to surgical approach.Partial nephrectomy for renal cell carcinoma is commonly used in this French centers sample. Mini-invasive approaches represent also a significant part of all partial nephrectomies with no difference in terms of complication rates.

Published
2014

5. National prospective study on the use of local haemostatic agents during partial nephrectomy

Author

P. Gimel, Jean-Christophe Bernhard, Laurent Salomon, Christian Pfister, Arnaud Mejean, Pierre Bigot, Christophe Vaessen, Laurent Bellec, Franck Salomé, Jacques Hubert, Franck Bruyère, Géraldine Pignot, Xavier Martin, Jérôme Rigaud, J. Berger, E. Mourey, Jean L. Jung, Pascal Mouracade, Laurent Zini, Jean P. Ansieau, François Trifard, Hervé Lang, Marc Gigante, Hervé Baumert, Morgan Rouprêt, Jean Jacques Patard, and Maxime Crepel

Subjects
medicine.medical_specialty, Transfusion rate, business.industry, Urology, medicine.medical_treatment, Significant difference, Statistical difference, Perioperative, Nephrectomy, 3. Good health, Surgery, Blood loss, medicine, Observational study, business, Prospective cohort study
Abstract

OBJECTIVE: To assess the use of local haemostatic agents (HAs) in a prospective multicentre large series of partial nephrectomies (PNs). PATIENTS AND METHODS: Prospective National Observational Registry on the Practices of Haemostasis in Partial Nephrectomy (NEPHRON): the study was conducted in 54 French urological centres from 1 June to 31 December 2010. In all, 570 consecutive patients undergoing a PN were enrolled in this study in a prospective manner. The data was collected prospectively via an electronic case-report form: five different sheets were included for preoperative, perioperative, postoperative and follow-up data respectively. Information related to haemostasis was analysed. RESULTS: The median patient age was 60 years and the mean (range) tumour size was 3.68 (0.19-15) cm. An HA was primarily used in 71.4% of patients, with a statistically significant difference among surgical approaches (P = 0.024). In 91.8% of cases, a single use of a HA was sufficient for achieving haemostasis. The HA was used either alone (13.9%) or in association with sutures (80.3%). One or more additional haemostatic action(s) was needed in 12.3% of the cases. When comparing patients who received a HA with those who did not receive a HA, there was no statistical difference between the groups for tumour size (P = 0.542), collecting system drainage (P = 0.538), hospital stay (P = 0.508), operation time (P = 0.169), blood loss (P = 0.387) or transfusion rate (P = 0.713). CONCLUSION: HAs are widely used by urologists during PN. Progress is needed for standardising HA application, especially for the timing of application. For the time being, the role of the HA in nephron-sparing surgery is still to be evaluated.

Published
2013

6. Étude prospective chez 100 patients des résultats de la technique d’anastomose urétéro-iléale en double cheminée dans la néovessie de Hautmann

Author

R. de Petriconi, Q. Ballouhey, Laurent Bellec, M. Soulié, Pierre Plante, E. Huyghe, P. Lunardi, and Matthieu Thoulouzan

Subjects
Gynecology, Cystectomy, medicine.medical_specialty, Ureter, medicine.anatomical_structure, Ureter surgery, business.industry, Urology, medicine.medical_treatment, Follow up studies, Medicine, business, Surgical methods
Abstract

Resume Objectif Analyser de maniere prospective les resultats de l’anastomose uretero-ileale, modifiee en double cheminee dans la neovessie ileale selon Hautmann. Patients et methode Entre 1999 et 2009, 100 patients consecutifs (cinq femmes et 95 hommes) ont eu une cystectomie totale avec neovessie ileale pour carcinome urothelial de vessie. L’âge moyen des patients etait de 62 ans (± 10). La surveillance postoperatoire comportait un examen clinique, une creatininemie, un ECBU, une cytologie urinaire et alternativement une tomodensitometrie ou une echographie abdominopelvienne. Le suivi moyen a ete de 63 mois (± 28), avec un recul minimum de deux ans. Resultats Cent quatre vingt dix-sept unites renales (UR) ont ete analysees, 11 etaient dilatees en preoperatoire et ont ete ameliorees apres le geste chirurgical, dix autres sont restees legerement dilatees en postoperatoire et asymptomatiques. Le taux de stenose anastomotique a ete de 4 % concernant huit UR : cinq stenoses inflammatoires (2,5 %) et trois stenoses par recidive tumorale (1,5 %). Les cinq stenoses inflammatoires (un bilaterale, un precoce, un post-radique et un avec lesion de BCGite) chez quatre patients ont ete traitees par nephrostomie, puis dilatation de la stenose et sonde double J. Une reimplantation uretero-ileale a ete necessaire pour deux d’entre eux, ainsi que pour les trois stenoses tumorales. Conclusion L’anastomose uretero-ileale en double cheminee avait, dans cette serie, un taux de complication stenotique de 4 % avec un recul moyen de cinq ans. La modification apportee a la technique avec la spatulation de l’extremite ureterale semblait preserver la vascularisation distale, d’ou un faible taux de complications.

Published
2012

7. The accuracy of renal tumor biopsy: analysis from a national prospective study

Author

L. Salomon, M. Schneider, Jean-Christophe Bernhard, Maxime Crepel, R. Mallet, Laurent Zini, E. Rolland, F. Salome, Marc-Olivier Timsit, M. Rouprêt, E. Xylinas, J. L. Auberget, J.P. Ansieau, Pierre Bigot, Laurent Bellec, J. M. Legraverend, A. Mejean, Christian Pfister, P. Gimel, Géraldine Pignot, L. Le Pellec, Herve Lang, J. Berger, J.J. Patard, C. Castagnola, P. Monod, Philippe Paparel, F. Bruyère, and Hervé Baumert

Subjects
Nephrology, Adult, Male, medicine.medical_specialty, Urology, Concordance, medicine.medical_treatment, Malignancy, Nephrectomy, Young Adult, McNemar's test, Renal cell carcinoma, Internal medicine, Biopsy, medicine, Adenoma, Oxyphilic, Humans, Prospective Studies, Prospective cohort study, Carcinoma, Renal Cell, Aged, Aged, 80 and over, medicine.diagnostic_test, business.industry, Nephrons, Middle Aged, medicine.disease, Carcinoma, Papillary, Kidney Neoplasms, Female, Radiology, Biopsy, Large-Core Needle, France, business, Organ Sparing Treatments
Abstract

To assess preoperative renal tumor biopsy (RTB) accuracy. As part of the prospective NEPHRON study, data from 1,237 renal tumors were collected, including the use and results of RTB and final histology following nephrectomy. During the 6 months period of inclusion, 130 preoperative biopsies were performed. We used the kappa coefficient of the McNemar test to determine the concordance between the biopsy and the nephrectomy specimen (NS) regarding four parameters: malignant/benign status, histological subtype, Fuhrman grade and microscopic necrosis. Preoperative biopsies were performed in 9.7 and 11.4 % of the 667 radical and 570 partial nephrectomies, respectively. Tumor biopsy was inconclusive in 7.7 % of the cases. In 117 cases, a comparison between RTB and NS was available. Benign tumors accounted for three (2.6 %) and five (4.3 %) of the RTB and NS, respectively (κ = 0.769, good). With seven (6 %) discordant results in terms of histological subtype characterization between RTB and final pathology, RTB accuracy was considered excellent (κ = 0.882). In 33 cases (31.7 %), Fuhrman grade was underestimated at biopsy resulting in an intermediate concordance level (κ = 0.498). Tumor microscopic necrosis was identified in 12 RTB (10.4 %) versus 33 NS (28.4 %) (κ = 0.357, poor). RTB provides good to excellent diagnostic performance for discriminating malignancy and tumor histological subtype. However, its performance is intermediate or even poor when considering prognostic criteria like Fuhrman grade or microscopic necrosis. Thus, this possible inaccuracy should be taken into consideration when using RTB for accurate guidance of treatment strategy.

Published
2014

8. Nephron-sparing surgery for renal tumors measuring more than 7 cm: morbidity, and functional and oncological outcomes

Author

Idir Ouzaid, Yann Neuzillet, Michel Soulié, Vincent Ravery, Guillaume Ploussard, Hervé Baumert, Evanguelos Xylinas, Morgan Rouprêt, Tarek Fardoun, Nicolas Grenier, Olivier Merigot de Treigny, Karim Bensalah, Laurent Bellec, Denis Chautard, Gregory Verhoest, Edouard Robine, Laurent Brureau, Pierre Bigot, Jean-Jacques Patard, Bernard Escudier, C. Maurin, Jean-François Hetet, Jean-Christophe Bernhard, Abdel-Rahmène Azzouzi, Marc Zerbib, Thomas Bessede, Souhil Lebdai, Jean-Alexandre Long, Nathalie Rioux-Leclercq, Jean Rouffilange, Philippe Paparel, François Audenet, Jérôme Rigaud, N. Hoarau, Laurence Bastien, Pierre Mongiat-Artus, Géraldine Pignot, Service d'urologie, Université d'Angers ( UA ) -CHU Angers, Service d'urologie, andrologie et transplantation rénale, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Service d'urologie [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), 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 ), INSERM U955, équipe 7, Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ) -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 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -IFR10, Service d'urologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Cochin [AP-HP], Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications [Grenoble] ( 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 ), CHU Grenoble-Hôpital Michallon, CHU Angers, Service d'urologie et transplantation rénales [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Institut Mondor de recherche biomédicale ( IMRB ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), FLIRT, Fédération pour L'étude de l'Ischémie Reperfusion en Transplantation, Service d'Urologie [CHU Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Diderot - Paris 7 ( UPD7 ) -Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Institut de Génétique et Développement de Rennes ( IGDR ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Centre National de la Recherche Scientifique ( CNRS ) -Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), urology, Assistance publique - Hôpitaux de Paris (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Hôtel-Dieu, Service d'Urologie - Transplantation Rénale - Andrologie, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Hôpital Saint-Joseph, Oncologie génito-urinaire, Département de médecine oncologique [Gustave Roussy], Institut Gustave Roussy ( IGR ) -Institut Gustave Roussy ( IGR ), Service d'urologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] ( CHLS ), Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ), Imagerie moléculaire et fonctionnelle: de la physiologie à la thérapie, Université Bordeaux Segalen - Bordeaux 2-IFR8-Centre National de la Recherche Scientifique ( CNRS ), Service d'Imagerie Diagnostique et Interventionnelle de l'Adulte, CHU Bordeaux [Bordeaux], Service de Génétique Moléculaire, Jonchère, Laurent, Université d'Angers (UA)-Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), 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), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-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)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), 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 )-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), Centre Hospitalier Universitaire d'Angers (CHU Angers), Service d'Urologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Mondor de recherche biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Institut de Génétique et Développement de Rennes (IGDR), Université de Rennes (UR)-Centre National de la Recherche Scientifique (CNRS)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Bichat - Claude Bernard [Paris], Département d'Urologie-Andrologie et Transplantation Rénale [CHU Toulouse], Pôle Urologie - Néphrologie - Dialyse - Transplantations - Brûlés - Chirurgie plastique - Explorations fonctionnelles et physiologiques [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Institut Gustave Roussy (IGR)-Institut Gustave Roussy (IGR), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Université Bordeaux Segalen - Bordeaux 2-IFR8-Centre National de la Recherche Scientifique (CNRS), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Centre National de la Recherche Scientifique (CNRS)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and 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)

Subjects
Adult, Male, medicine.medical_specialty, Survival, Urology, medicine.medical_treatment, Population, 030232 urology & nephrology, Renal function, [SDV.GEN] Life Sciences [q-bio]/Genetics, Malignancy, Nephrectomy, Disease-Free Survival, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Renal cell carcinoma, Risk Factors, medicine, Humans, Risk factor, education, Carcinoma, Renal Cell, Aged, Retrospective Studies, Aged, 80 and over, education.field_of_study, [SDV.GEN]Life Sciences [q-bio]/Genetics, business.industry, Hazard ratio, Perioperative, Nephrons, Robotics, Middle Aged, medicine.disease, Kidney Neoplasms, 3. Good health, Survival Rate, Treatment Outcome, Oncology, 030220 oncology & carcinogenesis, Female, Laparoscopy, Neoplasm Recurrence, Local, business, [ SDV.GEN ] Life Sciences [q-bio]/Genetics
Abstract

International audience; BACKGROUND: The purpose of this study was to evaluate morbidity, functional, and oncological outcomes after NSS in renal tumors \textgreater 7 cm. MATERIALS AND METHODS: We retrospectively analyzed data from 168 patients with tumors \textgreater 7 cm who were treated using NSS between 1998 and 2012. RESULTS: Imperative and elective indications accounted for 76 (45.2%) and 92 (54.8%) patients, respectively. Major perioperative complications and renal function deterioration occurred in 33 (19.6%) and 51 patients (30.4%), respectively. In multivariate analysis, age older than 60 years (P = .001; hazard ratio [HR], 5) and tumor malignancy (P = .014; HR, 6.7) were prognostic factors for renal function deterioration whereas imperative indication was a risk factor for major postoperative complications (P = .0019; HR, 2.7). In 126 (75%) patients with malignant tumors, after a median follow-up of 30 months (range, 1-254 months), 25 patients (20.2%) died. In multivariate analysis, imperative indication (P = .023; HR, 4.2), positive surgical margin (P = .021; HR, 3.3), and Fuhrman grade \textgreater II (P = .013; HR, 3.7) were prognostic indicators for cancer-free survival (CFS). Imperative indication (P = .04; HR, 8.5) and Fuhrman grade \textgreater II (P = .04; HR, 3.9) were predictive factors of cancer-specific survival (CSS). In case of elective indication, positive surgical margin, local recurrence, and cancer-related death occurred in 4 (7.6%), 1 (1.1%), and 1 (1.1%) cases, respectively. For elective indication, 5-year estimates of CFS, CSS, and overall survival rates were: 85.7%, 98%, and 93.9%, respectively. CONCLUSION: In this selected population, imperative vs. elective indication status seems to play a critical role in oncologic outcomes. Oncologic results for elective indications are close to those reported with radical nephrectomy.

Published
2014

9. Is there a volume-outcome relationship for partial nephrectomy?

Author

F. Salome, Laurent Zini, Laurent Bellec, P. Gimel, Michel Soulié, Karim Bensalah, F. Bruyère, J.P. Ansieau, Hervé Baumert, A. Mejean, Christian Pfister, J.J. Patard, Pierre Bigot, Christophe Vaessen, Jean-Christophe Bernhard, Géraldine Pignot, L. Salomon, Jacques Hubert, E. Mourey, J.L. Jung, Jean-Baptiste Rigaud, Herve Lang, Marc-Olivier Timsit, M. Rouprêt, J.-P. Couapel, J. Berger, Service d'Urology [Rennes], CHU Pontchaillou [Rennes], service d'urologie [CHU Bordeaux], CHU Bordeaux [Bordeaux], 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'Urologie, andrologie et transplantation rénale [CHRU Lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service d'Urologie [Strasbourg], CHU Strasbourg, Service d'Urologie [Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), 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), Service d'Urologie - Transplantation Rénale - Andrologie, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Service d'Urologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service d'Urologie [Colmar], CH Colmar, Service d'Urologie [CHU de Dijon], Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service d'Urologie [Angers], Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Service d'urologie [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau, Service de Chirurgie urologique et andrologie [CHU Limoges], CHU Limoges, Service d'Urologie [Mulhouse], Centre Hospitalier Emile Muller [Mulhouse] (CH E.Muller Mulhouse), Groupe Hospitalier de Territoire Haute Alsace (GHTHA)-Groupe Hospitalier de Territoire Haute Alsace (GHTHA), Centre de Médecine Générale Avicenne [Cabestany], Polyclinique de Limoges - site François Chénieux [Limoges], Service d'Urologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'urologie [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Groupe Hospitalier Paris Saint Joseph, Service de Microbiologie [CHU GeorgesPompidou], 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), Service d'Urologie [CHU Georges Pompidou], 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)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Service d'Urologie [CHU de Bicêtre], AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)

Subjects
Nephrology, Adult, medicine.medical_specialty, Hospitals, Low-Volume, genetic structures, Urology, medicine.medical_treatment, 030232 urology & nephrology, Nephrectomy, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Hospital volume, Renal cell carcinoma, Internal medicine, medicine, Humans, Prospective Studies, Aged, Aged, 80 and over, Volume outcome, business.industry, Middle Aged, medicine.disease, Kidney Neoplasms, 3. Good health, Surgery, Treatment Outcome, 030220 oncology & carcinogenesis, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Hospitals, High-Volume
Abstract

International audience; OBJECTIVE:To investigate the impact of hospital volume on partial nephrectomy indications and outcomes.MATERIALS AND METHODS:Data were extracted from the National Observational Registry on the Practice and Hemostasis in Partial Nephrectomy registry. Four groups were created according to the number of partial nephrectomy (PN) performed: very high (VH, ≥ 19 PN), high (H, 10-18 PN), moderate (M, 4-9 PN) and low (L

Published
2013

10. 1845 NATIONAL SURVEY ON THE USE OF PARTIAL NEPHRECTOMY IN FRANCE. DATA FROM THE MULTICENTER PROSPECTIVE NEPHRON STUDY

Author

Laurent Zini, Hervé Lang, Maxime Crepel, Laurent Salomon, Franck Salomé, P. Gimel, Hervé Baumert, Morgan Rouprêt, Jean-Christophe Bernhard, Jérôme Rigaud, Christophe Vaessen, Pierre Bigot, Laurent Bellec, Nicolas Mottet, Xavier Martin, Franck Bruyère, J. Berger, Christian Pfister, Jean-Jacques Patard, Jacques Hubert, Jean-Luc Jung, Géraldine Pignot, Arnaud Mejean, and E. Mourey

Subjects
medicine.medical_specialty, medicine.anatomical_structure, business.industry, Urology, General surgery, medicine.medical_treatment, medicine, Nephron, business, Nephrectomy, Surgery
Published
2012

11. Predictive factors for ipsilateral recurrence after nephron-sparing surgery in renal cell carcinoma

Author

Karim Bensalah, Laurent Salomon, Clement Claude Abbou, Allan J. Pantuck, Maxime Crepel, Grégoire Robert, Laurent Bellec, Jacques Tostain, Jean-Marie Ferriere, B. Albouy, Michel Soulié, Arie S. Belldegrun, Jean-Christophe Bernhard, Bertrand Lacroix, D. Lopes, Sylvie Maurice-Tison, Christian Pfister, Jean-Jacques Patard, Alexandre de la Taille, Marc Colombel, Hervé Wallerand, Rodolphe Thuret, Gilles Pasticier, Service d'urologie, andrologie et transplantation rénale, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Department of Urology, University of California [Los Angeles] (UCLA), University of California-University of California, Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Service d'Urologie - Transplantation Rénale - Andrologie, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Service d'information médicale, CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Service d'urologie [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), 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), Service d'urologie-andrologie, CHU Saint-Etienne-Université Jean Monnet [Saint-Étienne] (UJM)-Hôpital nord, Service Urologie [Lapeyronie], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, Service d'urologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), University of California (UC)-University of California (UC), Département d'Urologie-Andrologie et Transplantation Rénale [CHU Toulouse], Pôle Urologie - Néphrologie - Dialyse - Transplantations - Brûlés - Chirurgie plastique - Explorations fonctionnelles et physiologiques [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CHU Saint-Etienne-Université Jean Monnet - Saint-Étienne (UJM)-Hôpital nord, De Villemeur, Hervé, Service d'urologie [Rennes], Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes]

Subjects
Male, MESH: Tumor Burden, [SDV.MHEP.CHI] Life Sciences [q-bio]/Human health and pathology/Surgery, medicine.medical_treatment, 030232 urology & nephrology, Nephrectomy, Surgery, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, MESH: Proportional Hazards Models, 0302 clinical medicine, Renal cell carcinoma, Risk Factors, MESH: Risk Factors, Local recurrence, Multicenter Studies as Topic, MESH: Aged, MESH: Middle Aged, MESH: Carcinoma, Renal Cell, MESH: Neoplasm Staging, Middle Aged, Prognosis, Kidney Neoplasms, Tumor Burden, 030220 oncology & carcinogenesis, Female, Nephron sparing surgery, MESH: Neoplasm Recurrence, Local, medicine.medical_specialty, Urology, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, MESH: Prognosis, 03 medical and health sciences, Text mining, [SDV.CAN] Life Sciences [q-bio]/Cancer, Carcinoma, medicine, Humans, In patient, Carcinoma, Renal Cell, Aged, Neoplasm Staging, Proportional Hazards Models, Retrospective Studies, MESH: Humans, business.industry, Proportional hazards model, fungi, Retrospective cohort study, MESH: Retrospective Studies, medicine.disease, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, MESH: Male, MESH: Nephrectomy, MESH: Multicenter Studies as Topic, Neoplasm Recurrence, Local, MESH: Kidney Neoplasms, business, MESH: Female
Abstract

Ipsilateral recurrence after nephron-sparing surgery (NSS) is rare, and little is known about its specific determinants.To determine clinical or pathologic features associated with ipsilateral recurrence after NSS performed for renal cell carcinoma (RCC).We analysed 809 NSS procedures performed at eight academic institutions for sporadic RCCs retrospectively.Age, gender, indication, tumour bilaterality, tumour size, tumour location, TNM stage, Fuhrman grade, histologic subtype, and presence of positive surgical margins (PSMs) were assessed as predictors for recurrence in univariate and multivariate analysis by using a Cox proportional hazards regression model.Among 809 NSS procedures with a median follow-up of 27 (1-252) mo, 26 ipsilateral recurrences (3.2%) occurred at a median time of 27 (14.5-38.2) mo. In univariate analysis, the following variables were significantly associated with recurrence: pT3a stage (p=0.0489), imperative indication (p0.01), tumour bilaterality (p0.01), tumour size4cm (p0.01), Fuhrman grade III or IV (p=0.0185), and PSM (p0.01). In multivariate analysis, tumour bilaterality, tumour size4cm, and presence of PSM remained independent predictive factors for RCC ipsilateral recurrence. Hazard ratios (HR) were 6.31, 4.57, and 11.5 for tumour bilaterality, tumour size4cm, and PSM status, respectively. The main limitations of this study included its retrospective nature and a short follow-up.RCC ipsilateral recurrence risk after NSS is significantly associated with tumour size4cm, tumour bilaterality (synchronous or asynchronous), and PSM. Careful follow-up should be advised in patients presenting with such characteristics.

Published
2010

12. 509 IS BASELINE RENAL FUNCTION A DECISION-MAKING CRITERION FOR CHOOSING AN ABLATIVE TECHNIQUE RATHER THAN A PARTIAL NEPHRECTOMY IN SMALL RENAL MASSES?

Author

Pascal Rischmann, Jacques Tostain, Roberto Bertini, Claude C. Abbou, Jean-Christophe Bernhard, Allan J. Pantuck, Laurent Zini, Maxime Crepel, Karim Bensalah, Jérôme Rigaud, Francesco Montorsi, Marc Colombel, Arie S. Belldegrun, Christian Pfister, Olivier Bouchot, Jean-Jacques Patard, A. Villers, Alexandre de la Taille, Baptiste Albouy, Jean-Marie Ferriere, Michel Soulié, Laurent Salomon, Pierre Bigot, Laurent Bellec, and Gregory Verhoest

Subjects
medicine.medical_specialty, business.industry, Urology, medicine.medical_treatment, Ablative case, medicine, Renal function, business, Baseline (configuration management), Nephrectomy
Published
2010

13. Positive surgical margin appears to have negligible impact on survival of renal cell carcinomas treated by nephron-sparing surgery

Author

Romain Spie, Jérôme Rigaud, Jacques Tostain, Michel Soulié, Bastien Rambeaud, Hendrik Van Poppel, Alfredo Aguilera, Maxime Crepel, Laurent Zini, Ofer Nativ, Jean Marie Ferriere, Luis Martinez Pineiro, Steven Joniau, Patrick J. Bastian, Rodolphe Thuret, Jean Jacques Patard, Stefan C. Müller, Frédéric Pouliot, Jean-Christophe Bernhard, Amnon Zisman, Andreas H. Wille, Christian Pfister, Pascal Rischmann, Nicolas Mottet, Laurent Bellec, Alexandre de la Taille, Allan J. Pantuck, Laurent Guy, Thierry Dujardin, R. Avakian, Jan Roigas, François Richard, Nathalie Rioux-Leclercq, Christian Doehn, Pierre I. Karakiewicz, Arie S. Belldegrun, Roberto Bertini, Orit E. Raz, Karim Bensalah, Laurent Salomon, B. Albouy, T. Culty, Thierry Lebret, Morgan Rouprêt, A. Villers, Francesco Montorsi, Fabien Saint, Herve Lang, Roy Farfara, Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Department of Urology, University of California [Los Angeles] (UCLA), University of California-University of California, Service Urologie [Lapeyronie], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, Department of urology, Università Vita-Salute San Raffaele, Cancer Prognostics and Health Outcomes Unit, Université de Montréal (UdeM), Cancer Prognostics and Health Outcome Unit, Service d'urologie-andrologie, CHU Saint-Etienne-Université Jean Monnet [Saint-Étienne] (UJM)-Hôpital nord, Université Jean Monnet [Saint-Étienne] (UJM), Service d'urologie, Hôpital Huriez-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), 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), Service d'Urologie - Transplantation Rénale - Andrologie, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], 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), National and Kapodistrian University of Athens (NKUA), Service d'urologie, andrologie et transplantation rénale, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Université Fédérale Toulouse Midi-Pyrénées, Université de Nantes (UN), Service d'urologie [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Image Science for Interventional Techniques (ISIT), Université d'Auvergne - Clermont-Ferrand I (UdA)-Centre National de la Recherche Scientifique (CNRS)-Clermont Université, Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), Hôpital Foch [Suresnes], Université de Picardie Jules Verne (UPJV), Assaf Harofeh Medical Centre, Tel Aviv University [Tel Aviv]-Assaf Harofeh Medical Centre, CHU Strasbourg, Berlin Charity Hospital, La Paz University Hospital, Bnai Zion Hospital, Service d'Urologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Lubeck University Hospital, Bonn University Hospital, Institut de Génétique et Développement de Rennes (IGDR), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Centre National de la Recherche Scientifique (CNRS), University of California (UC)-University of California (UC), CHU Saint-Etienne-Université Jean Monnet - Saint-Étienne (UJM)-Hôpital nord, Université Jean Monnet - Saint-Étienne (UJM), Département d'Urologie-Andrologie et Transplantation Rénale [CHU Toulouse], Pôle Urologie - Néphrologie - Dialyse - Transplantations - Brûlés - Chirurgie plastique - Explorations fonctionnelles et physiologiques [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université d'Auvergne - Clermont-Ferrand I (UdA)-Clermont Université-Centre National de la Recherche Scientifique (CNRS), Tel Aviv University (TAU)-Assaf Harofeh Medical Centre, Université de Rennes (UR)-Centre National de la Recherche Scientifique (CNRS), De Villemeur, Hervé, Bensalah, Karim, Pantuck Allan, J., Rioux Leclercq, Nathalie, Thuret, Rodolphe, Montorsi, Francesco, Karakiewicz Pierre, I., Mottet, Nicola, Zini, Laurent, Bertini, Roberto, Salomon, Laurent, Villers, Arnaud, Soulie, Michel, Bellec, Laurent, Rischmann, Pascal, De La Taille, Alexandre, Avakian, Raffi, Crepel, Maxime, Ferriere Jean, Marie, Bernhard Jean, Christophe, Dujardin, Thierry, Pouliot, Frederic, Rigaud, Jerome, Pfister, Christian, Albouy, Baptiste, Guy, Laurent, Joniau, Steven, van Poppel, Hendrik, Lebret, Thierry, Culty, Thibault, Saint, Fabien, Zisman, Amnon, Raz, Orit, Lang, Herve, Spie, Romain, Wille, Andrea, Roigas, Jan, Aguilera, Alfredo, Rambeaud, Bastien, Martinez Pineiro, Lui, Nativ, Ofer, Farfara, Roy, Richard, Francoi, Roupret, Morgan, Doehn, Christian, Bastian Patrick, J., Muller Stefan, C., Tostain, Jacque, Belldegrun Arie, S., Patard Jean, Jacques, Service d'Urologie - Andrologie [CHU Saint-Etienne], Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E)-Université Jean Monnet - Saint-Étienne (UJM), Université de Toulouse (UT), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and University Hospital Bonn

Subjects
Surgical margin, medicine.medical_specialty, [SDV.MHEP.CHI] Life Sciences [q-bio]/Human health and pathology/Surgery, MESH: Survival Rate, Urology, medicine.medical_treatment, 030232 urology & nephrology, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, Nephrectomy, [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, Renal cell carcinoma, Predictive Value of Tests, medicine, Humans, Survival rate, Carcinoma, Renal Cell, MESH: Nephrons, Retrospective Studies, MESH: Humans, MESH: Middle Aged, Proportional hazards model, business.industry, Retrospective cohort study, MESH: Retrospective Studies, Nephrons, MESH: Carcinoma, Renal Cell, Middle Aged, medicine.disease, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, Kidney Neoplasms, MESH: Predictive Value of Tests, 3. Good health, Surgery, Survival Rate, MESH: Nephrectomy, 030220 oncology & carcinogenesis, Predictive value of tests, MESH: Kidney Neoplasms, business, Kidney cancer
Abstract

International audience; BACKGROUND: The occurrence of positive surgical margins (PSMs) after partial nephrectomy (PN) is rare, and little is known about their natural history. OBJECTIVE: To identify predictive factors of cancer recurrence and related death in patients having a PSM following PN. DESIGN, SETTING, AND PARTICIPANTS: Some 111 patients with a PSM were identified from a multicentre retrospective survey and were compared with 664 negative surgical margin (NSM) patients. A second cohort of NSM patients was created by matching NSM to PSM for indication, tumour size, and tumour grade. MEASUREMENTS: PSM and NSM patients were compared using student t tests and chi-square tests on independent samples. A Cox proportional hazards regression model was used to test the independent effects of clinical and pathologic variables on survival. RESULTS AND LIMITATIONS: Mean age at diagnosis was 61+/-12.5 yr. Mean tumour size was 3.5+/-2 cm. Imperative indications accounted for 39% (43 of 111) of the cases. Some 18 patients (16%) underwent a second surgery (partial or total nephrectomy). With a mean follow-up of 37 mo, 11 patients (10%) had recurrences and 12 patients (11%) died, including 6 patients (5.4%) who died of cancer progression. Some 91% (10 of 11) of the patients who had recurrences and 83% of the patients (10 of 12) who died belonged to the group with imperative surgical indications. Rates of recurrence-free survival, of cancer-specific survival, and of overall survival were the same among NSM patients and PSM patients. The multivariable Cox model showed that the two variables that could predict recurrence were the indication (p=0.017) and tumour location (p=0.02). No other variable, including PSM status, had any effect on recurrence. None of the studied parameters had any effect on the rate of cancer-specific survival. CONCLUSIONS: PSM status occurs more frequently in cases in which surgery is imperative and is associated with an increased risk of recurrence, but PSM status does not appear to influence cancer-specific survival. Additional follow-up is needed.

Published
2010

14. 176 Partial nephrectomy: Is there a 'center effect'?

Author

P. Gimel, Franck Salomé, Laurent Bellec, J.J. Patard, M. Rouprêt, J-L. Jung, J-C. Bernhard, A. Mejean, Géraldine Pignot, Christophe Vaessen, Jean-Baptiste Rigaud, Herve Lang, F. Bruyère, Hervé Baumert, M. Soulié, J-P. Ansieau, Jacques Hubert, Pierre Bigot, J. Berger, Laurent Zini, J-P. Couapel, L. Salomon, C. Pfister, Karim Bensalah, and E. Mourey

Subjects
Center effect, medicine.medical_specialty, business.industry, Urology, medicine.medical_treatment, medicine, business, Nephrectomy, Surgery
Published
2013

15. 946 Proposal of model based on CKD-EPI to predict post-nephrectomy glomerular filtration rate

Author

Pascal Rischmann, Mathieu Roumiguié, Jean-Baptiste Beauval, X. Gamé, B. Delaunay, B. Malavaud, M. Soulié, Nicolas Doumerc, Laurent Bellec, G. Rollin, O. Merigot De Treigny, Matthieu Thoulouzan, J. Piechaud, E. Huyghe, P. Rouvellat, and F. Sallusto

Subjects
medicine.medical_specialty, business.industry, Urology, medicine.medical_treatment, medicine, Renal function, business, Nephrectomy
Published
2014

16. The effect of gender and age on kidney cancer survival: Younger age is an independent prognostic factor in women with renal cell carcinoma

Author

Christian Pfister, Luca Cindolo, Jean-Christophe Bernhard, Jean-Jacques Patard, Arnaud Mejean, Edward N. Rampersaud, Geoffrey D. Bass, Allan J. Pantuck, Laurent Bellec, Karim Bensaleh, Marc Colombel, Tobias Klatte, M. Böhm, Arie S. Belldegrun, Ernst P. Allhoff, Daniel J. George, Alexandre de la Taille, and Michel Soulié

Subjects
Adult, Male, Oncology, medicine.medical_specialty, Urology, medicine.medical_treatment, Kaplan-Meier Estimate, Cohort Studies, Age and gender, Sex Factors, Renal cell carcinoma, Internal medicine, Epidemiology, medicine, Humans, Carcinoma, Renal Cell, Aged, Proportional Hazards Models, Gynecology, Proportional hazards model, business.industry, Incidence (epidemiology), Age Factors, Middle Aged, Prognosis, medicine.disease, Kidney Neoplasms, Nephrectomy, Treatment Outcome, Cohort, Female, business, Kidney cancer
Abstract

Gender-specific differences in incidence of renal cell carcinoma (RCC) and its outcome have previously been reported. We used age as a surrogate to test whether this might be hormone-related in a large international RCC cohort.This study included patients treated by nephrectomy at 10 international academic centers. Clinicopathologic features were assessed using chi-square and the Student t-tests. Kaplan-Meier survival estimates and Cox proportional hazards models addressed the effect of gender and age on disease-specific survival.Of the 5,654 patients, 3,777 (67%) were men and 1,877 (33%) were women. Generally, women presented at lower T stages (P0.001), had fewer metastases (P0.001), and had lower-grade tumors (P0.001). Women more frequently had clear-cell (87% vs. 82%) and less frequently had papillary RCC (7% vs. 12%) than men (P0.001). Women had a 19% reduced risk of death from RCC than men (hazard ratio 0.81, 95% confidence interval 0.73-0.90, P0.001). The survival advantage for women was present to the greatest degree in the age group42 years (P = 0.0136) and in women aged 42 to 58 years (P0.001), but was not apparent in patients aged 59 years and older (P = 0.248). Age was an independent predictor of disease-specific survival in women (hazard ratio 1.011, 95% confidence interval 1.004-1.019, P = 0.004), but not in men.As a group, women present with less advanced tumors, leading to a 19% reduced risk of RCC-specific death compared with men. This survival difference is present only in patients aged59 years. Because this gender-based survival difference is not related to pathologic features, the role of hormonal effects on the development and progression of RCC needs to be investigated.

Published
2014

17. EARLY RENAL FUNCTION OUTCOMES FOLLOWING OPEN VS LAPAROSCOPIC PARTIAL NEPHRECTOMY: HOW DO THEY COMPARE?

Author

Jean-Jacques Patard, Thierry Dujardin, Karim Bensalah, Rodolphe Thuret, Pierre Bigot, Maxime Crepel, Laurent Salomon, Alexandre de la Taille, Claude C Abbou, Jacques Tostain, Laurent Bellec, Michel Soulié, Pascal Rischmann, Jean-Christophe Bernhard, Jean-Marie Ferrière, Christian Pfister, Baptiste Albouy, Marc Colombel, Laurent Zini, Frederic Pouliot, Roberto Bertini, Francesco Montorsi, Arie S Belldegrun, and Allan J Pantuck

Subjects
medicine.medical_specialty, business.industry, Urology, medicine.medical_treatment, Medicine, Renal function, business, Nephrectomy
Published
2009

18. NEPHRON-SPARING SURGERY VS. RADICAL NEPHRECTOMY IN PATIENTS WITH RENAL CELL CARCINOMA >7 CM. WITH NO EVIDENCE OF NODAL OR DISTANT METASTATSIS

Author

Jean-Marie Ferriere, Laurent Bellec, Claudio Jeldres, Karim Bensalah, Christian Pfister, Jean-Jacques Patard, D. Lopes, Jacques Tostain, R. Avakian, Nazareno Suardi, Alexandre de la Taille, Arie S. Belldegrun, Francois Guille, Maxime Crepel, Jean-Christophe Bernhard, Clément-Claude Abbou, John S. Lam, Bertrand Lacroix, Laurent Salomon, Allan J. Pantuck, Marc Colombel, Baptiste Albouy, and Pierre I. Karakiewicz

Subjects
medicine.medical_specialty, business.industry, Renal cell carcinoma, Urology, medicine.medical_treatment, Medicine, In patient, Nephron sparing surgery, business, NODAL, medicine.disease, Nephrectomy
Published
2008

19. 171 Partial nephrectomy (PN): Complications and warm ischemia time in a French multicentre study

Author

F. Bruyère, Hervé Baumert, Laurent Zini, J.M. Lang, E. Mourey, P. Gimel, J.L. Jung, Jean-Baptiste Rigaud, L. Salomon, Géraldine Pignot, F. Salome, C. Pfister, Laurent Bellec, N. Korahanis, Xavier Martin, R. Thanigasalam, J. Berger, Christophe Vaessen, Jacques Hubert, Maxime Crepel, A. Mejean, F. Trifard, J.J. Patard, M. Rouprêt, J.P. Ansieau, J-C. Bernhard, and Pierre Bigot

Subjects
medicine.medical_specialty, Warm Ischemia Time, business.industry, Urology, medicine.medical_treatment, Anesthesia, Medicine, business, Nephrectomy, Surgery
Published
2013

20. 144 Complications of partial nephrectomy (PN): Data from the prospective multicentric NEPHRON study

Author

Laurent Zini, J.P. Ansieau, Laurent Bellec, J-C. Bernhard, P. Gimel, A. Mejean, Xavier Martin, Géraldine Pignot, J. Berger, F. Salome, Pierre Bigot, L. Salomon, F. Bruyère, M. Rouprêt, C. Pfister, J.L. Jung, Jean-Baptiste Rigaud, Hervé Baumert, J.J. Patard, Maxime Crepel, Hajj A. El, J.M. Lang, E. Mourey, Christophe Vaessen, F. Trifard, and Jacques Hubert

Subjects
medicine.medical_specialty, medicine.anatomical_structure, business.industry, Urology, medicine.medical_treatment, medicine, Nephron, business, Nephrectomy
Published
2012

22. NEPHRON SPARING SURGERY (NSS) IS SUPERIOR TO RADICAL NEPHRECTOMY IN PRESERVING RENAL FUNCTION OUTCOME IN TUMORS LARGER THAN 4 CM

Author

Rodolphe Thuret, Olivier Bouchot, Marc Colombel, Claude C. Abbou, Pascal Rischmann, Alexandre de la Taille, Laurent Salomon, Baptiste Albouy, Karim Bensalah, Jacques Tostain, Arnauld Villers, Pierre Bigot, Allan J. Pantuck, Christian Pfister, Jean-Jacques Patard, Jean-Christophe Bernhard, Michel Soulié, Jean-Marie Ferriere, Maxime Crepel, Roberto Bertini, Laurent Bellec, Francesco Montorsi, Laurent Zini, Arie S. Belldegrun, and Jérôme Rigaud

Subjects
medicine.medical_specialty, business.industry, Urology, medicine.medical_treatment, medicine, Renal function, Nephron sparing surgery, business, Nephrectomy, Surgery
Published
2009

23. 319 NEPHRON SPARING SURGERY (NSS) IS SUPERIOR TO RADICAL NEPHRECTOMY IN PRESERVING RENAL FUNCTION OUTCOME: IS IT TRUE EVEN WHEN EXPANDING NSS TUMOUR SIZE INDICATIONS?

Author

Jérôme Rigaud, L. Salomon, A. De La Taille, C. Pfister, Laurent Zini, F. Montorsi, Allan J. Pantuck, B. Albouy, Laurent Bellec, Rodolphe Thuret, Olivier Bouchot, Jacques Tostain, Marc Colombel, Karim Bensalah, Pascal Rischmann, Arie S. Belldegrun, M. Soulié, J.M. Ferriere, Pierre Bigot, Clément-Claude Abbou, J-C. Bernhard, J.J. Patard, A. Villers, and Roberto Bertini

Subjects
medicine.medical_specialty, Tumour size, business.industry, Urology, medicine.medical_treatment, medicine, Renal function, Nephron sparing surgery, business, Nephrectomy, Surgery
Published
2009

24. PARTIAL NEPHRECTOMY FOR RENAL MASSES: CAN WE APPLY THE QUALITY OF CARE CONCERN ADDRESSED BY THE UROLOGICAL COMMUNITY, TO THE EUROPEAN POPULATION?

Author

John S. Lam, Laurent Zini, Nazareno Suardi, Jacques Tostain, Maxime Crepel, D. Lopes, Baptiste Albouy, Marc Colombel, Michel Soulié, Jean-Christophe Bernhard, Arie S. Belldegrun, Bertrand Lacroix, Allan J. Pantuck, Pierre I. Karakiewicz, Alexandre de la Taille, Christian Pfister, Jean-Jacques Patard, Jean-Marie Ferriere, Laurent Salomon, Guille Francois, and Laurent Bellec

Subjects
medicine.medical_specialty, business.industry, Urology, medicine.medical_treatment, medicine, European population, Quality of care, Intensive care medicine, business, Nephrectomy
Published
2008

25. RADICAL NEPHRECTOMY IS NOT SUPERIOR TO NEPHRON SPARING SURGERY IN PT1B-PT2N0M0 RENAL TUMOURS: A MATCHED COMPARISON ANALYSIS IN 546 CASES

Author

A. De La Taille, Jacques Tostain, R. Avakian, Tobias Klatte, Clément-Claude Abbou, P.I. Karakiewicz, Roberto Bertini, L. Cindolo, Sébastien Vincendeau, Francois Guille, Bertrand Lacroix, L. Salomon, Allan J. Pantuck, C. Pfister, M. Soulié, Andrea Manunta, B. Albouy, Laurent Bellec, J-C. Bernhard, V. Ficarra, Gregory Verhoest, Pascal Rischmann, J.M. Ferriere, J.J. Patard, Marc Colombel, Arie S. Belldegrun, Karim Bensalah, Maxime Crepel, and F. Montorsi

Subjects
medicine.medical_specialty, business.industry, Urology, medicine.medical_treatment, medicine, Nephron sparing surgery, business, Nephrectomy
Published
2008

26. MORBIDITY AND CLINICAL OUTCOME OF NEPHRON-SPARING SURGERY IN RELATION TO TUMOUR SIZE AND INDICATION

Author

Laurent Bellec, Michel Soulié, J. S. Lam, Francois Guille, D. Lopes, Bertrand Lacroix, Jacques Tostain, B. Albouy, L. Salomon, Clément-Claude Abbou, Arie S. Belldegrun, Christian Pfister, Robert A. Figlin, Allan J. Pantuck, Xavier Martin, Jean-Christophe Bernhard, Maxime Crepel, J.J. Patard, Bernard Lobel, A. De La Taille, Jean-Marie Ferriere, and Marc Colombel

Subjects
Nephrology, medicine.medical_specialty, Blood transfusion, business.industry, Urology, medicine.medical_treatment, medicine.disease, Nephrectomy, Surgery, Exact test, Internal medicine, Epidemiology, medicine, Carcinoma, Stage (cooking), Positive Surgical Margin, business
Abstract

Objective To analyse through a large multicentre series, morbidity of nephron-sparing surgery (NSS) in relation to tumour size and surgical indication. Methods The study included patients from eight international academic centres. Age, sex, TNM stage, tumour size, Fuhrman grade, Eastern Cooperative Oncology Group performance status (ECOG-PS), surgical margins, local and distant recurrences, and overall and cancer-specific survival rates were collected and analysed. Indication for elective or mandatory NSS, medical and surgical complication rates, mean blood loss, blood transfusion, and length of hospital stay were specifically recorded for the purpose of this study. Groups were compared for qualitative and quantitative variables by using χ 2 (Fischer exact test) and Student t tests, respectively. Results A total of 1048 NSS procedures were included in this study. Mean tumour size was 3.4±2.1cm. In 730 elective procedures mean operative time ( p =0.002), mean blood loss ( p =0.01), the need for blood transfusion ( p =0.001), and urinary fistula rate ( p =0.01) were significantly increased for tumours >4cm. However, these differences did not result in significantly increased medical ( p =0.4), surgical complication rates ( p =0.6), or length of hospital stay ( p =0.9). Finally, in elective procedures for malignant tumours, positive surgical margins, local or distant recurrence rates, and cancer-specific survival were not significantly different in tumours ≤4cm and >4cm. Conclusion Excellent cancer control and outcomes can be achieved with NSS in carefully selected patients with tumours >4cm. Expanding the size indication of elective NSS results in an increased but acceptable morbidity.

Published
2006

Catalog

Books, media, physical & digital resources
See catalog results