Publications by authors named "Jean-Christophe Bernhard"
Article Synopsis
- Metastatic kidney cancer patients who respond well to immunotherapy are being reconsidered for primary surgery, particularly nephron-sparing surgery, due to their prolonged survival.
- A study analyzed 13 patients who had partial nephrectomy after achieving complete responses to immunotherapy, finding no positive surgical margins and acceptable complication rates.
- Results showed promising renal function and oncological outcomes, indicating that partial nephrectomy is feasible after immunotherapy, but more research is necessary for definitive conclusions.
Article Synopsis
- 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.
Introduction: The rising incidence of renal cell carcinoma (RCC) is a significant concern in cancer research. This study analyses the characteristics of RCC patients based on their socio-professional category and explores the role of chlorinated solvents as a risk factor.
Materials And Methods: A multicentre, descriptive epidemiological study was conducted using the UroCCR database.
Article Synopsis
- Laparoscopic adrenalectomy (LA) is a minimally invasive surgery that has become the preferred treatment for adrenal diseases, but its use in outpatient settings is still not widespread.
- A study reviewed 76 LA procedures for primary aldosteronism (PA) conducted between 2013-2021, with 60 being outpatient procedures; these had a success rate of 95% and no readmissions within 48 hours.
- Results showed low pain levels (average of 2.1/10) and high patient satisfaction (average of 9.4/10) after one day, with over half of patients cured or improved after six months, indicating outpatient LA is both feasible and effective for managing PA.
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.
Article Synopsis
- The study investigates the use of a radioactive monoclonal antibody, [Zr]Zr-girentuximab, for non-invasive detection of clear-cell renal cell carcinoma in patients with renal masses.
- Conducted across 36 sites in nine countries, the phase 3 trial involved 332 enrolled patients with suspicious renal masses, who received the antibody followed by PET-CT imaging.
- The primary goals of the trial were to assess the sensitivity and specificity of the imaging technique using histopathological confirmation as the standard, with findings from 300 patients eventually analyzed.
Objectives: The use of digital technology in surgery is increasing rapidly, with a wide array of new applications from presurgical planning to postsurgical performance assessment. Understanding the clinical and economic value of these technologies is vital for making appropriate health policy and purchasing decisions. We explore the potential value of digital technologies in surgery and produce expert consensus on how to assess this value.
View Article and Find Full Text PDFArticle Synopsis
- There is limited data on how often testicular germ cell tumors (TGCT) occur alongside venous tumor thrombus (VTT), and the study aims to provide insights on this rare condition and its management.
- Researchers analyzed records from the IBM Marketscan database, identifying a small prevalence of TGCT with VTT and gathered expert insights from surgeons on the patient management practices at multiple centers.
- Findings showed that approximately 0.3% to 3.1% of TGCT cases involved VTT, with surgical options being the primary treatment, emphasizing the complexity of managing this combination and the need for a multidisciplinary approach.
Robot-assisted Partial Nephrectomy for Hilar and Nonhilar Renal Masses: Comparison of Perioperative, Oncological, and Functional Results in a Multicentre Prospective Cohort (NEPRAH Study, UroCCR 175).
Eur Urol Oncol
December 2024
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).
Introduction: Pre-emptive access to the kidney transplant (KT) waiting list remains limited in France, with only 3.9% of patients on pre-emptive KT and 5.6% of patients registered at the time of initiation of dialysis.
View Article and Find Full Text PDFBackground 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.
View Article and Find Full Text PDFArticle Synopsis
- 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.
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.
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.
View Article and Find Full Text PDFIntroduction: Pre-emptive access to the kidney transplant (KT) waiting list remains limited in France, with only 3.9% of patients on pre-emptive KT and 5.6% of patients registered at the time of initiation of dialysis.
View Article and Find Full Text PDFPurpose: 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).
Article Synopsis
- 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.
Background: Partial nephrectomy (PN) is the gold standard treatment for cT1b renal tumors. Percutaneous guided thermal ablation (TA) has proven oncologic efficacy with low morbidity for the treatment of small renal masses (<3 cm). Recently, 3D image-guided robot-assisted PN (3D-IGRAPN) has been described, and decreased perioperative morbidity compared to standard RAPN has been reported.
View Article and Find Full Text PDFRobot-assisted partial nephrectomy (RAPN) is the standard of care for small, localized kidney tumors. This surgery is conducted within a short hospital stay and can even be performed as outpatient surgery in selected patients. In order to allow early rehabilitation of patients, an optimal control of postoperative pain is necessary.
View Article and Find Full Text PDFBackground: Differentiating benign from malignant renal tumors is important for patient management, and it may be improved by quantitative CT features analysis including radiomic.
Purpose: This study aimed to compare performances of machine learning models using bio-clinical, conventional radiologic and 3D-radiomic features for the differentiation of benign and malignant solid renal tumors using pre-operative multiphasic contrast-enhanced CT examinations.
Materials And Methods: A unicentric retrospective analysis of prospectively acquired data from a national kidney cancer database was conducted between January 2016 and December 2020.
Article Synopsis
- 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.
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.
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.