Publications by authors named "Doumerc N"

Background And Objective: Evidence regarding perioperative results and long-term functional outcomes of robotic-assisted kidney transplantation (RAKT) is limited. We evaluated perioperative surgical results and long-term functional outcomes of RAKT in patients receiving kidney transplants from living donors.

Methods: This retrospective analysis is based on a prospective multicenter cohort study conducted from July 2015 to October 2023 across ten European centers.

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  • The objective of the study was to update recommendations for managing kidney cancer based on recent literature from 2014 to 2024, focusing on diagnosis, treatment, and follow-up methods.
  • Key findings highlighted that kidney cancer linked to trichloroethylene exposure should be considered an occupational disease, and that contrast-enhanced CT scans are essential for diagnosis, while PET scans are not necessary.
  • The updated guidelines recommend specific classifications for tumors, advocate for less invasive strategies like biopsies to avoid unnecessary surgeries, and suggest various surgical and treatment options tailored to tumor size, patient age, and overall health.
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Background: In 2021, the EAU Guidelines implemented a novel, expert opinion-based follow-up scheme, with a three-risk-category system for clear cell (cc) and non-cc renal cell carcinoma (non-ccRCC) after surgery with curative intent. We aimed to validate the novel follow-up scheme and provide data-driven recurrence estimates according to risk groups, to confirm or implement the oncologic surveillance strategy.

Methods: We identified 5,320 patients from a prospectively maintained database involving 28 French referral centers.

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Background And Objective: A hilar location for a renal tumour is sometimes viewed as a limiting factor for safe partial nephrectomy. Our aim was to evaluate perioperative, oncological, and functional outcomes of robot-assisted partial nephrectomy (RAPN) for hilar tumours (RAPN-H) in comparison to RAPN for nonhilar tumours (RAPN-NH).

Methods: We conducted an observational, multicentre cohort study using prospectively collected data from the French Research Network on Kidney Cancer (UroCCR).

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Background And Objective: Orthotopic kidney transplantation (KT) has been proposed as an option for patients ineligible for heterotopic KT. In this scenario, orthotopic robot-assisted KT (oRAKT) represents a novel, minimally invasive alternative to the open approach. Here we describe the largest oRAKT series of patients, with a focus on the surgical technique, perioperative surgical outcomes, and functional results.

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Background And Objective: Data regarding open conversion (OC) during minimally invasive surgery (MIS) for renal tumors are reported from big databases, without precise description of the reason and management of OC. The objective of this study was to describe the rate, reasons, and perioperative outcomes of OC in a cohort of patients who underwent MIS for renal tumor initially. The secondary objective was to find the factors associated with OC.

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  • This study looked at how two types of kidney surgery (robotic and open) worked for obese patients.
  • Researchers found that the robotic surgery had fewer complications and required a shorter hospital stay compared to open surgery.
  • However, both surgery types had similar long-term results regarding the patient's health after the surgery.
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Background: There is no definitive evidence of the prognosis impact of histological variants (HVs) in patients who undergo surgical resection of a nonmetastatic renal cell carcinoma (nm-RCC) with venous tumor thrombus (TT).

Objective: To investigate the impact of HVs on the prognosis of patients with nm-RCC with TT after radical surgery.

Design Setting And Participants: Patients who underwent radical nephrectomy with the removal of the venous TT for an nm-RCC were included in a retrospective study.

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Renal cell carcinoma (RCC) is most often diagnosed at a localized stage, where surgery is the standard of care. Existing prognostic scores provide moderate predictive performance, leading to challenges in establishing follow-up recommendations after surgery and in selecting patients who could benefit from adjuvant therapy. In this study, we developed a model for individual postoperative disease-free survival (DFS) prediction using machine learning (ML) on real-world prospective data.

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Background: MRI-guided biopsy (MGB) contributes to the diagnosis of clinically significant Prostate Cancer (csPCa). However, there are no clear recommendations for the management of men after a negative MGB. The aim of this study was to assess the risk of csPCa after a first negative MGB.

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Purpose: Partial nephrectomy (PN) for large or complex renal tumors can be difficult and associated with a higher risk of recurrence than radical nephrectomy. We aim to evaluate the clinical useful of nephrometry scores for predicting oncological outcomes in a large cohort of patients who underwent PN for renal cell carcinomas.

Methods: Our analysis included patients who underwent PN for renal cell carcinoma in 21 French academic centers (2010-2020).

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  • The SPARE Nephrometry Score (NS) is proposed as an easier alternative for predicting renal function outcomes after robotic-assisted partial nephrectomy (RAPN) compared to the more established RENAL and PADUA scores.
  • A multicentric retrospective study analyzed data from 1171 patients who underwent RAPN, focusing on outcomes like acute kidney injury (AKI), chronic kidney disease (CKD) upstaging, and other renal function metrics.
  • Results indicated that all nephrometry scores and tumor size were equally effective in predicting adverse kidney outcomes, suggesting that tumor size might be the most straightforward factor for surgical decision-making.
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  • The study compared the trifecta achievement rates of robot-assisted partial nephrectomy between retroperitoneal (RRPN) and transperitoneal (TRPN) approaches using data from 15 medical centers in France.
  • Results showed that while TRPN had a trifecta achievement rate of 82.8% and RRPN 84.0% after matching, RRPN had shorter operative times and less blood loss.
  • The findings suggest that RRPN is a safe and effective alternative to TRPN, especially beneficial for treating posterior renal tumors.
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Purpose: To evaluate the feasibility, safety, and early oncologic outcomes after post-chemotherapy robot-assisted retroperitoneal lymph node dissection (PC-RARPLND) for metastatic germ cell tumors (mGCT).

Methods: We retrospectively analyzed patients from four tertiary centers who underwent PC-RARPLND for mGCT, from 2011 to 2021. Previous treatment of mGCT, intraoperative and postoperative complications, and early oncologic outcomes were assessed.

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Purpose: To compare the oncological and perioperative outcomes of robot-assisted partial nephrectomy (RPN) and percutaneous thermal ablation (PTA) for treatment of T1 renal cell cancer (RCC) in patients older than 75 years.

Materials And Methods: Retrospective national multicenter study included all patients older than 75 years treated for a T1 RCC by RPN or PTA between January 2010 and January 2021. Patients' characteristics, tumor data, and perioperative and oncological outcomes were compared.

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Objective: To evaluate prospectively the effects of surgical excision of renal tumours on blood pressure (BP).

Patients And Methods: In a multicentre prospective study, we evaluated 200 patients who underwent nephrectomy for renal tumour between 2018 and 2020 at seven departments of the French Network for Kidney Cancer, the UroCCR. All patients had localized cancer without pre-existing hypertension (HTN).

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Purpose: To describe the practice of robotic-assisted partial nephrectomy (RAPN) in France and prospectively assess the late complications and long-term outcomes.

Methods: Prospective, multicenter (n = 16), observational study including all patients diagnosed with a renal tumor who underwent RAPN. Preoperative, intraoperative, postoperative, and follow-up data were collected and stored in the French research network for kidney cancer database (UroCCR).

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Introduction: In the last 20 years, robotic assisted procedures were evaluated in the field of kidney transplantation to provide a mini-invasive approach for this particularly fragile population. As a relatively new issue, few studies compared open kidney transplantation (OKT) and robotic-assisted kidney transplantation (RAKT), mostly in small cohorts. To improve current knowledge, we wanted here to gather comparative data of OKT vs RAKT in a systematic review.

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Objectives: To assess the impact of pathological upstaging from clinically localized to locally advanced pT3a on survival in patients with renal cell carcinoma (RCC), as well as the oncological safety of various surgical approaches in this setting, and to develop a machine-learning-based, contemporary, clinically relevant model for individual preoperative prediction of pT3a upstaging.

Materials And Methods: Clinical data from patients treated with either partial nephrectomy (PN) or radical nephrectomy (RN) for cT1/cT2a RCC from 2000 to 2019, included in the French multi-institutional kidney cancer database UroCCR, were retrospectively analysed. Seven machine-learning algorithms were applied to the cohort after a training/testing split to develop a predictive model for upstaging to pT3a.

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Purpose: To describe clinical features of patients with oncocytoma on renal biopsy (RMB), correlation with final histology on surgically treated patients, and predictive factors of discrepancy between RMB and final histology.

Methods: This was a retrospective study conducted in the framework of the UroCCR project (NCT03293563). All tumors with oncocytoma on RMB were selected and all pathological reports were reviewed.

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Aim: To update the recommendations for the management of kidney cancers.

Methods: A systematic review of the literature was conducted from 2015 to 2022. The most relevant articles on the diagnosis, classification, surgical treatment, medical treatment and follow-up of kidney cancer were selected and incorporated into the recommendations.

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The oncological impact of positive surgical margins (PSM) after robot-assisted partial nephrectomy (RAPN) is still under debate. We compared PSM and Negative Surgical Margins (NSM) in terms of recurrence-free survival (RFS), metastasis-free survival (MFS) and overall survival (OS) after RAPN, and we identified predictive factors of PSM. Multi-institutional study using the UroCCR database, which prospectively included 2166 RAPN between April 2010 and February 2021 (CNIL DR 2013-206; NCT03293563).

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