Publications by authors named "Lebret T"
Objective: Renal oncocytoma is a benign renal tumour whose management remains heterogeneous and poorly codified. The aim of this study was to describe the management strategies and evolution of a cohort of biopsied renal oncocytomas.
Materials And Methods: We retrospectively reviewed renal oncocytomas biopsied in 2 French academic centres between 2009 and 2016.
Nail-patella syndrome (NPS) is a rare genetic disease characterized by dysplastic nails, patella abnormalities, skeletal malformation, and chronic pain. Although chronic pain in NPS is mainly due to bone and musculoskeletal symptoms, it can also result from neurological dysfunction. Conventional analgesics are often insufficient to relieve NPS-associated chronic pain.
View Article and Find Full Text PDFBackground: A significant proportion of trans women is demanding for a genital gender-affirming surgery, with vulvo-vaginoplasty being the most frequently requested procedure. The gold standard for primary vaginoplasty in trans women is the penile skin inversion technique with scrotal skin graft, which allows for increased depth of the vaginal cavity.
Aims: The assessment of vulvo-vaginoplasty outcomes utilizing penile skin inversion and scrotal skin graft in individuals assigned male at birth in the surgeon's learning curve involves evaluating aesthetics, functionality, and sexual aspects.
Article Synopsis
- Urethral stricture has a prevalence of about 0.9%, and while endoscopic treatments have been the primary approach, their effectiveness has led to a shift towards urethroplasty as the preferred treatment from 2013 to 2022.
- Data from the Scansanté platform shows that while endoscopic procedures remain common, urethroplasties have increased noticeably since 2019, rising from 1,100 to 1,600 cases from 2020 to 2022.
- Despite urethrotomies still outnumbering urethroplasties by a large margin, the gap is narrowing, and urethroplasty, particularly with augmentation techniques, is now recognized as
Article Synopsis
- JCO CheckMate 274 is a phase III trial comparing adjuvant nivolumab to placebo for high-risk muscle-invasive urothelial carcinoma (MIUC) post-surgery, showing improved disease-free survival (DFS) metrics with nivolumab treatment.
- The study documented results at a median follow-up of 36.1 months, with larger survival benefits noted for patients with positive PD-L1 expression.
- No new safety issues were discovered, reinforcing the role of nivolumab as standard treatment for high-risk MIUC following radical resection.
Article Synopsis
- In 2022, nivolumab was approved for high-risk patients with localized invasive muscle urothelial carcinoma after surgery, prompting a study to explore its real-world use.
- Conducted at two hospitals from July 2022 to January 2024, the study included 200 patients; 70 were deemed high-risk, but nearly half did not receive treatment due to various reasons.
- The outcomes showed a median disease-free survival of 11.34 months for treated patients, and while nivolumab was well-tolerated, 25% discontinued it due to side effects, with findings supporting prior research on its effectiveness.
Background And Objective: Failure rates after first-line treatment of localized prostate cancer (PCa) treatment remain high; therefore, it is essential to improve the selection and identification of at-risk patients to reduce mortality. The aim of the ANDROCAN study was to evaluate the biochemical recurrence (BCR) in patients with localized PCa treated by total prostatectomy at 5 yr after surgery, according to their presurgery gonadal status.
Methods: A prospective cohort study was conducted including 1318 patients undergoing total prostatectomy for localized PCa with a 5-yr postoperative follow-up.
Article Synopsis
- End-stage renal disease poses challenges for lung transplant patients, leading to the consideration of combined kidney-lung transplantation (CKLT) and kidney after lung transplantation (KALT) as potential solutions.
- A study reviewing outcomes of 26 patients showed that CKLT had a 30-day and 1-year survival rate of 75.6%, while no KALT patients died during follow-up, highlighting KALT's safety.
- The study found that kidney graft functions were similar between both strategies, but CKLT's success is significantly impacted by post-lung transplant complications, emphasizing the need for careful consideration of transplant options.
Article Synopsis
- - This systematic review aimed to assess the occurrence of genital prolapse in trans women undergoing vulvovaginoplasty, analyzing studies published since 1995 to identify prevalence, risk factors, and treatment options.
- - The review included 24 studies with over 3,000 patients, showing an overall prolapse rate of 2.7%, with lower rates associated with penile skin inversion techniques compared to intestinal vaginoplasty.
- - The main risk factor for developing genital prolapse post-surgery was identified as a high body mass index, while surgical prevention techniques often included fixation to the sacrospinous ligament and vaginal packing.
Background: Advances in chromatography and mass spectrometry have allowed us to develop a novel technique for measuring intraprostatic hormone concentrations directly on prostate needle biopsies, rather than using traditional punch excision. This has significant clinical implications as intraprostatic dihydrotestosterone and testosterone levels could help monitor prostate growth, neoplasia and castration resistance.
Methods: Patients undergoing radical cystoprostatectomy for bladder cancer were prospectively included.
Background: The KEYNOTE-057 trial evaluated activity and safety of pembrolizumab in patients with BCG-unresponsive high-risk non-muscle-invasive bladder cancer who were ineligible for or declined radical cystectomy. In cohort A (patients with carcinoma in situ, with or without papillary tumours) of the KEYNOTE-057 study, pembrolizumab monotherapy led to a complete response rate of 41% at 3 months, and 46% of responders maintained a response lasting at least 12 months. Here, we evaluate pembrolizumab monotherapy in cohort B of patients with papillary tumours without carcinoma in situ.
View Article and Find Full Text PDFIntroduction: Andrology and urogenital reconstruction are emerging disciplines in French urology. The aim of our study was to evaluate the evolution of andrological surgical procedures over the period 2013-2022 using national data.
Materials And Methods: We collected national common classification of medical acts (CCAM) coding data for all procedures involving andrological surgery from the Scansanté internet platform set up by the Technical Agency for Information on Hospitalisation, which collects prospectively from healthcare structures all procedures coded according to CCAM coding.
Purpose: This study aimed to evaluate the ability of Kidney Stone Calculator (KSC), a flexible ureteroscopy surgical planning software, to predict the lithotripsy duration with both holmium:YAG (Ho:YAG) and thulium fiber laser (TFL).
Methods: A multicenter prospective study was conducted from January 2020 to April 2023. Patients with kidney or ureteral stones confirmed at non-contrast computed tomography and treated by flexible ureteroscopy with laser lithotripsy were enrolled.
Introduction: With 50 years' experience, inflatable penile implants are the preferred option for erectile dysfunction refractory to pharmacological and mechanical treatment. Technical and surgical improvements have optimized patient success and satisfaction. However, multi-factorial dissatisfaction persists.
View Article and Find Full Text PDFObjective: AI-derived language models are booming, and their place in medicine is undefined. The aim of our study is to compare responses to andrology clinical cases, between chatbots and andrologists, to assess the reliability of these technologies.
Material And Method: We analyzed the responses of 32 experts, 18 residents and three chatbots (ChatGPT v3.
Article Synopsis
- The use of artificial intelligence (AI) in the medical field, especially in urology, is growing, enabling quicker access to current scientific knowledge which traditionally took years to master.
- In a study comparing the performance of AI tools (ChatGPT 3.5, ChatGPT 4.0, and Bard) against 736 human participants on a urological assessment, ChatGPT 4.0 performed the best, scoring 80 points and ranking near the top 10%.
- Despite showing promising results, the study emphasizes that current AI systems can make mistakes and highlights the need for careful evaluation of their role in medical education and information sharing.
Purpose: Bladder cancer is a complex disease with a wide range of outcomes. Clinicopathological factors only partially explain the variability between patients in prognosis and treatment response. There is a need for large cohorts collecting extensive data and biological samples to: (1) investigate gene-environment interactions, pathological/molecular classification and biomarker discovery; and (2) describe treatment patterns, outcomes, resource use and quality of life in a real-world setting.
View Article and Find Full Text PDFArticle Synopsis
- Recent clinical trials of new immune checkpoint protein-targeted antibodies failed to show significant results, primarily because patients weren't screened for target expression prior to treatment.* -
- The study utilized advanced methods like flow cytometry and single-cell RNA sequencing to analyze immune checkpoint expression on T-cells from various primary tumors, revealing extensive variability among patients.* -
- Results indicated that while CD4FoxP3 T-cells co-expressed both stimulatory and inhibitory checkpoints, the expression levels in CD8 T-cells were generally lower, suggesting a need for better-targeted therapies in future cancer immunotherapy trials.*
Background: An accurate estimation of the stone burden is the key factor for predicting retrograde intra-renal surgical outcomes. Volumetric calculations better stratify stone burden than linear measurements. We developed a free software to assess the stone volume and estimate the lithotrity duration according to 3D-segmented stone volumes, namely the Kidney Stone Calculator (KSC).
View Article and Find Full Text PDFBladder cancer (BC) is the 6th most common cancer worldwide, with tobacco smoking considered as its main risk factor. Accumulating evidence has found associations between genetic variants and the risk of BC. Candidate gene-environment interaction studies have suggested interactions between cigarette smoking and / gene variants.
View Article and Find Full Text PDFPurpose: Cytology and cystoscopy, the current gold standard for diagnosing urothelial carcinomas, have limits: cytology has high interobserver variability with moderate or not optimal sensitivity (particularly for low-grade tumors); while cystoscopy is expensive, invasive, and operator dependent. The VISIOCYT1 study assessed the benefit of VisioCyt for diagnosing urothelial carcinoma.
Methods: VISIOCYT1 was a French prospective clinical trial conducted in 14 centers.
Article Synopsis
- The study evaluated the effectiveness of a tension-free vaginal tape procedure for treating female stress urinary incontinence, aiming to compare its success with the occurrence of voiding dysfunction.
- Over a 1-year period, 93% of the 319 patients reviewed reported being dry, with a 10.9% incidence of voiding dysfunction noted.
- Factors linked to an increased risk of voiding dysfunction included having an underactive bladder, low preoperative urinary flow rate, and prior incontinence surgery, but overall, the procedure demonstrated a high cure rate and minimal serious complications.
Prostate cancer is the third cause of cancer-related deaths in men. Its early and reliable diagnosis is still a public health issue, generating many useless prostate biopsies. Prostate cancer cells detected in urine could be the target of a powerful test but they are considered too rare.
View Article and Find Full Text PDFPurpose: 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).
Background: Molecular understanding of muscle-invasive (MIBC) and non-muscle-invasive (NMIBC) bladder cancer is currently based primarily on transcriptomic and genomic analyses.
Objective: To conduct proteogenomic analyses to gain insights into bladder cancer (BC) heterogeneity and identify underlying processes specific to tumor subgroups and therapeutic outcomes.
Design, Setting, And Participants: Proteomic data were obtained for 40 MIBC and 23 NMIBC cases for which transcriptomic and genomic data were already available.