ECOG performance status 0 or 1 and symptom classification do not improve the ability to predict renal cell carcinoma-specific survival.

Objectives: We tested and compared the improvement in prognostic ability related to the consideration of either ECOG performance status (ECOGPS) and/or symptom classification (S-CLASS) in renal cell carcinoma specific mortality (RCC-SM) predictions.

Methods: Univariate and multivariate Cox regression analyses targeted RCC-SM in 2570 RCC patients treated with either partial or radical nephrectomy. The increment in predictive accuracy related to the addition of either ECOGPS, S-CLASS or both was quantified using Harrell's concordance index.

[Medical management of uncomplicated benign prostatic hyperplasia: a new decision algorithm].

Management of benign prostatic hyperplasia (BPH) is currently undergoing profound changes. Medical treatment is not only symptomatic, but may also seek to modify the natural history of the disease, especially by reducing the risk of acute urinary retention. Medical treatment is no longer limited to a single drug: the combination of 2 different drugs from different treatment categories appears superior to single-drug treatment in some patients.

Collecting duct renal cell carcinoma: a matched analysis of 41 cases.

Objectives: Collecting duct renal cell carcinoma (CDRCC) is a rare but reportedly aggressive histologic subtype. We assessed the stage and histologic features of patients with CDRCC and compared cancer-specific mortality in CDRCC and matched patients with clear-cell renal cell carcinoma (CRCC).

Methods: Forty-one (0.

Fluctuating prostate-specific antigen levels in patients with initial negative biopsy: should we be reassured?

Objective: To evaluate whether the risk of having a positive repeat prostate biopsy is lower in patients with fluctuating prostate-specific antigen (PSA) levels than in patients with a steady or steadily increasing PSA level.

Patients And Methods: Files were extracted from the 2000-2003 databases of two teaching hospitals; 191 patients who had a first negative biopsy followed by one or more sets of biopsies and at least two PSA measurements were included. A 'fluctuating PSA level' in a patient was defined as a PSA series including at least one PSA value lower than the one immediately preceding it.

Prognostic relevance of tumour size in T3a renal cell carcinoma: a multicentre experience.

Objective: To evaluate the prognostic role of tumour size in pathological stage T3a renal cell carcinoma (RCC) with fat invasion only and to assess whether this subgroup maintains its relevance over the other pathological stages.

Methods: We retrospectively studied 2113 patients from eight international institutions who were treated by surgical resection for T2-4 RCC. Disease-specific survival (DSS) was evaluated with univariate and multivariate analyses.

Prognostic ability of simplified nuclear grading of renal cell carcinoma.

Background: The Fuhrman grading system is an established predictor of survival in patients with renal cell carcinoma (RCC). The predictive accuracy of various Fuhrman grading schemes was tested with the intent of improving the prediction of RCC-specific survival (RCC-SS).

Methods: The analyses targeted 5453 patients from 14 institutions.

Morbidity and clinical outcome of nephron-sparing surgery in relation to tumour size and indication.

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.

Renal cell carcinoma with nodal metastases in the absence of distant metastatic disease: prognostic indicators of disease-specific survival.

Objectives: Outcome of patients with exclusive renal cell carcinoma (RCC) nodal metastases without distant metastases is not extensively described. We explored the ability of standard risk factors such as tumour size, Fuhrman grade, histologic subtype and symptom classification to predict renal cell carcinoma-specific survival (RCC-SS).

Methods: Analyses targeted 171 patients with RCC nodal metastases and absence of distant metastases.

[The role of the IPSS (International Prostate Symptoms Score) to evaluate the frequency of disability induced by each of the 7 symptoms. (CTMH-AFU study)].

Introduction: Evaluation of a patient with voiding disorders related to benign prostatic hyperplasia is theoretically performed by means of the IPSS score, which comprises only one global quality of life question. This study used a questionnaire to evaluate the frequency of disability induced by each of the symptoms of the IPSS in a representative sample of the French population and then proposed a weighting of the IPSS score by the statistical weight of disability of each symptom without having to increase the number of questions.

Methods: A survey on the voiding behaviour of French men was performed by TNS Sofres Healthcare by questionnaire between 18/4/03 and 27/5/03 in a panel of 3877 men aged 50 to 80 years representative of the French population.

[Role of prostatic stents and transurethral microwave thermotherapy in the treatment of voiding disorders related to benign prostatic hyperplasia (CTMH-AFU forum 2005)].

Prostatic stents and microwave thermotherapy are minimally invasive techniques for the treatment of voiding disorders related to benign prostatic hyperplasia. A review of the literature evaluates the place of these treatments in 2006. Permanent prostatic stenting is rarely used, but remains a treatment option for patients with obstructive disorders and a formal anaesthetic contraindication.

Relationship between age at diagnosis and clinicopathologic features of renal cell carcinoma.

Objectives: To analyse the influence of age at diagnosis on tumour characteristics and cancer-specific survival in renal cell carcinoma (RCC).

Methods: Data on age, tumour characteristics, and survival for 4774 patients from 12 European RCC databases were recorded. Patients were divided into four groups according to age at diagnosis: < or =40, >40 and <60, > or =60 and <80, and > or =80 yr.

Saturation biopsy protocol enhances prediction of pT3 and surgical margin status on prostatectomy specimen.

A 21-samples saturation biopsy procedure (SBP) was developed in order to improve prostate cancer detection rate. Out of 650 patients who underwent this protocol, 150 had a clinically localized prostate cancer and underwent a radical prostatectomy. The number of cores positive for tumor was assessed in the SBP, and also in the sextant component of the SBP (SC) and in the non-sextant component of the SBP (NSC).

Management of non-complicated BPH: proposition of a renewed decision tree.

Nowadays the management of benign prostatic hypertrophia (BPH) is undergoing striking changes. The standard medical treatments are represented by three families which are the phytotherapy, the alpha-blockers and the 5-alpha-reductase inhibitors. These treatments were deemed as symptomatic and used only as monotherapy.

[Complications of retroperitoneal laparoscopy based on a series of 500 cases].

Objective: To evaluate the complications of retroperitoneal laparoscopy for upper urinary tract surgery.

Methods: From 1994 to 2003, 500 retroperitoneal laparoscopy procedures were performed: 143 radical nephrectomies, 104 simple nephrectomies, 95 adrenalectomies, 47 ureteropelvic junction plasties, 44 partial nephrectomies, 22 nephroureterectomies, 20 cyst resections, 9 diverticulectomies, 8 lymphadenectomies, 4 pyelotomies and 4 ureteric procedures. The standardized technique uses 5 trocars.

Other therapies for BPH patients: desmopressin, anti-cholinergic, anti-inflammatory drugs, and botulinum toxin.

The usual treatments of benign prostate hyperplasia (BPH) including the alpha-blockers, the inhibitors of the 5-alpha reductase and the phytotherapy drugs allow significant improvements of the lower urinary tracts symptoms (LUTS). However, some patients are not responders or have side effects due to the treatments. Other therapeutic approaches described in the literature are possible in order to alleviate the LUTS.

Protocadherin-PC promotes androgen-independent prostate cancer cell growth.

Background: Protocadherin-PC (PCDH-PC) expression is upregulated in apoptosis-resistant sublines of the LNCaP human prostate cancer (CaP) cell line. Here, we assess the role of PCDH-PC in CaP cells and its mRNA expression in human prostate tissues.

Methods: LNCaP cells transfected with PCDH-PC were tested for their ability to grow in vitro and in vivo in androgen-deprived conditions.

Characterization of ZAG protein expression in prostate cancer using a semi-automated microscope system.

Objective: Zinc-alpha-2-glycoprotein 1 (ZAG) is a 41-kD secreted protein that is known to stimulate lipid degradation in adipocytes. The aim of this study was to determine how ZAG protein expression is associated with prostate cancer (PCa).

Materials And Methods: An immunohistochemistry analysis was performed on a 227 PCa tissue microarray cases.

The management of acute urinary retention in France: a cross-sectional survey in 2618 men with benign prostatic hyperplasia.

Objective: To evaluate current practice in the management of acute urinary retention (AUR) in men with benign prostatic hyperplasia (BPH) in France.

Patients And Methods: In all, 2618 men (median age 72 years) presenting with non-febrile AUR were enrolled by 658 French urologists in a prospective cross-sectional survey. The patients' demography, history of BPH, type of AUR and its management (trial without catheter, TWOC, use of alpha(1)-blockers, immediate or elective surgery, other alternatives) were collected.

Tumor size improves the accuracy of TNM predictions in patients with renal cancer.

Objectives: Current staging for renal cancer (RC) does not directly rely on tumor size. We examined the increment in accuracy related to inclusion of pathologically determined tumor size in prediction of nodal metastases (N+), distant metastases (M+), and cancer-specific survival (CSS).

Methods: Partial or radical nephrectomy was performed in 2245 patients with clear cell histology.

Simulation training in video-assisted urologic surgery.

The current system of surgical education is facing many challenges in terms of time efficiency, costs, and patient safety. Training using simulation is an emerging area, mostly based on the experience of other high-risk professions like aviation. The goal of simulation-based training in surgery is to develop not only technical but team skills.