Adrenal tumours are more predominant in females regardless of their histological subtype: a review.

Objectives: Adrenal tumours are a heterogeneous group of rare tumours. The aim of this article was to critically review gender-specific differences in the incidence, prognosis and symptoms of the different subtypes of adrenal tumours.

Methods: Data acquisition regarding gender differences in adrenal tumours was performed using MEDLINE searches with combinations of the following keywords: adrenal tumours, gender, sex differences, adrenocortical carcinoma, pheochromocytoma, incidentaloma, risk factors and genetic aspects.

Neoadjuvant treatment in advanced renal cell carcinoma: current situation and future perspectives.

Neoadjuvant approaches in renal cell carcinoma are currently under investigation, following the demonstration of targeted therapy efficacy in the metastatic setting. It raises the issues of downsizing locally advanced or nonresectable tumor and offering organ-sparing surgery, safety and its potential role in early micrometastatic disease. Relevant studies of the neoadjuvant setting in renal cell carcinoma with targeted therapies were identified from the literature, clinical trial databases and conference abstracts.

Synthesis, configuration assignment, and simultaneous quantification by liquid chromatography coupled to tandem mass spectrometry, of dihydroanatoxin-a and dihydrohomoanatoxin-a together with the parent toxins, in axenic cyanobacterial strains and in environmental samples.

We have synthesized cis- and trans-dihydroanatoxin-a and cis- and trans-dihydrohomoanatoxin-a using a short synthetic route. The relative configuration of N-tert-butoxycarbonyl-cis-dihydroanatoxin-a was determined by X-ray crystallography, while that of N-tert-butoxycarbonyl-trans-dihydroanatoxin-a was confirmed by epimerization leading to the cis-diastereoisomer. The relative configuration of N-tert-butoxycarbonyl-trans- and cis-dihydrohomoanatoxin-a was inferred from their NMR spectra.

[Are therapeutics decisions homogeneous in multidisciplinary onco-urology staff meeting? Comparison of therapeutic options taken in four departments from Paris].

Objective: One of the priorities of the "Plan against the Cancer" in France is to ensure the discussion of all cancer cases in a multidisciplinary meeting staff (RCP). The multidisciplinary collaboration is proposed to guarantee a discussion between specialists in every cases, particularly in complex cases. The aim of this study was to compare the therapeutic decision taken in four RCP in Paris Île-de-France academic centres for three identical cases.

Very long-term follow-up of living kidney donors.

Knowledge of the very long-term consequences of kidney donors has not been previously reported extensively. The 398 persons who had donated a kidney between 1952 and 2008 at Necker hospital were contacted. Among the 310 donors who were located, the survival probabilities for this population were similar to those of the general population and end stage renal disease incidence was 581 per million population per year.

Factors impacting survival in patients with upper tract urothelial carcinoma undergoing radical nephroureterectomy.

Introduction: This study aims to assess the influence of different prognostic factors on survival of upper tract urothelial carcinoma (UTUC) managed by nephroureterectomy and to investigate whether these factors have an independent prognostic significance.

Materials And Methods: A retrospective review of institutional databases from two teaching hospitals identified 269 consecutive patients with UTUC managed with nephroureterctomy between 1985 and 2005. Mean follow up was 80.

Renal malacoplakia: Case report of a differential diagnosis for renal cell carcinoma.

Background: Renal malacoplakia is a very rare chronic inflammatory disorder characterized by specific infiltration of tissue by inflammatory cells, and presents similar radiological characteristics to those of renal cell carcinoma.

Case Report: A 54-year old woman, with a 37-year history of smoking, weight loss, anorexia, asthenia, and night sweats, was included in an antiangiogenesis clinical trial. Clinical signs of inflammation were apparent in the right lumbar region without functional limitations.

Insights into the reaction mechanism of the prolyl-acyl carrier protein oxidase involved in anatoxin-a and homoanatoxin-a biosynthesis.

Anatoxin-a and homoanatoxin-a are two potent cyanobacterial neurotoxins. We recently reported the identification of the gene cluster responsible for the biosynthesis of these toxins as well as the in-vitro reconstitution of the first steps of this biosynthesis. We now report experimental evidence supporting the proposed reaction mechanism of AnaB, a flavoprotein homologous to acyl-CoA dehydrogenase.

Horizontal transmission of Streptococcus pneumoniae in the surgical ward: a rare source of nosocomial wound infection.

Streptococcus pneumoniae is rarely isolated from nosocomial infections. We report an outbreak of 4 nosocomial-acquired surgical site infections due to S pneumoniae after retropubic simple prostatectomy. The likely source was detected in the rhinopharynx of the surgeon.

Prophylactic embolization of renal angiomyolipomas: evaluation of therapeutic response using CT 3D volume calculation and density histograms.

Purpose: To evaluate the efficacy and tolerance of prophylactic embolization of angiomyolipomas (AMLs) and to analyze the therapeutic response by using three-dimensional 3D volume calculation and 3D quantification of fatty and angiomyogenic components during computed tomography (CT) follow-up.

Materials And Methods: Over a 51-month period, 30 patients with 34 AMLs (mean diameter, 82 mm ± 37; range, 30-173 mm) underwent 37 prophylactic embolization procedures. The protocol included supraselective arterial embolization with a combination of absolute alcohol, microparticles, and coils.

[Renal-pleural fistula after radiofrequency ablation of renal tumor in VHL patient].

Radiofrequency is a minimally invasive therapy allowing tumor destruction by applying physical means to the core of the lesion. There is a particular indication for the hereditary already surgically treated renal carcinomas like Von Hippel-Lindau's disease. We present a case of renal-pleural fistula developed after a percutaneous radiofrequency ablation under computed tomography (CT) guidance of a renal tumor in a VHL female patient with a renal cell carcinoma of the upper pole of the left kidney.

[Physiopathology and new therapeutic strategies in the management of bone metastases of prostate cancer].

Prostate cancer (PCa) is one of the most common human malignancies that have a strong propensity to spread in the bones. Despite the progress in the diagnosis and the treatment of prostate cancer, bone metastases are present in nearly 95% of men with metastatic PCa at autopsy. Bone metastases are a major cause of skeletal complications which may negatively affect the quality of life and increase morbidity and mortality in men with advanced PCa.

Progress in nephron sparing therapy for renal cell carcinoma and von Hippel-Lindau disease.

Purpose: Patients with von Hippel-Lindau disease frequently have early, multiple and recurrent renal cell carcinoma. Renal cell carcinoma treatment, which must prevent metastatic disease and spare nephrons, has changed in the last 2 decades. We evaluated renal cell carcinoma treatments in the long term in a large series of patients with von Hippel-Lindau disease.

[Case report of kidney cancer from JOUM 2010].

Three clinical cases have shown the superiority of sunitinib in first line therapy intermediate risk metastatic clear cell renal carcinoma and a best safety of bevacizumab plus interferon, the current lack of high level of evidence arguments for the neo-adjuvant treatment of kidney cancer, the importance to prevent mucositis during a mTOR inhibitors treatment and the diagnostic pitfalls of its pulmonary complications.

Novel FH mutations in families with hereditary leiomyomatosis and renal cell cancer (HLRCC) and patients with isolated type 2 papillary renal cell carcinoma.

Background: Hereditary leiomyomatosis and renal cell cancer (HLRCC) is an autosomal dominant disorder predisposing humans to cutaneous and uterine leiomyomas; in 20% of affected families, type 2 papillary renal cell cancers (PRCCII) also occur with aggressive course and poor prognosis. HLRCC results from heterozygous germline mutations in the tumour suppressor fumarate hydratase (FH) gene.

Methods: As part of the French National Cancer Institute (INCa) 'Inherited predispositions to kidney cancer' network, sequence analysis and a functional study of FH were preformed in 56 families with clinically proven or suspected HLRCC and in 23 patients with isolated PRCCII (5 familial and 18 sporadic).

Renal cell carcinoma (RCC) in patients with end-stage renal disease exhibits many favourable clinical, pathologic, and outcome features compared with RCC in the general population.

Background: Patients with end-stage renal disease (ESRD) are at risk of developing renal tumours.

Objective: Compare clinical, pathologic, and outcome features of renal cell carcinomas (RCCs) in ESRD patients and in patients from the general population.

Design, Setting, And Participants: Twenty-four French university departments of urology participated in this retrospective study.

[Kidney transplantation in the rat: An institutional technique].

Kidney transplantation in rats is a classic experimental model used in transplant research. As several methods have been previously reported without definition of a gold standard, we describe herein a simple institutional technique that has been used in more than 500 procedures and taught to medical students or surgeons without previous microsurgical experience. Our step-by-step illustrated report would allow French-speaking trainees to learn how to perform kidney transplantation in rats in a reproducible manner and add this valuable tool to their research protocols.

[Managing side-effects of targeted therapies in renal cancer:surgical complications].

The principal surgical complication feared in a patient under anti-angiogenic targeted therapy is gastrointestinal perforation. It is therefore important to be alert to situations "potentially at risk" of perforation: diverticulitis, carcinomatosis, intra-abdominal abscess, history of external radiotherapy, colonoscopy in the 4 weeks preceding the treatment, inflammatory disease and gastrointestinal mucosal ulceration, colonic stent, NSAID. It is essential to make an early diagnosis, and for treatment to be conservative if possible, with nasogastric aspiration without surgery.

Birt-Hogg-Dubé renal tumors are genetically distinct from other renal neoplasias and are associated with up-regulation of mitochondrial gene expression.

Background: Germline mutations in the folliculin (FLCN) gene are associated with the development of Birt-Hogg-Dubé syndrome (BHDS), a disease characterized by papular skin lesions, a high occurrence of spontaneous pneumothorax, and the development of renal neoplasias. The majority of renal tumors that arise in BHDS-affected individuals are histologically similar to sporadic chromophobe renal cell carcinoma (RCC) and sporadic renal oncocytoma. However, most sporadic tumors lack FLCN mutations and the extent to which the BHDS-derived renal tumors share genetic defects associated with the sporadic tumors has not been well studied.

A decrease of regulatory T cells correlates with overall survival after sunitinib-based antiangiogenic therapy in metastatic renal cancer patients.

Sunitinib, an antiangiogenic molecule, is one of the first-line standard of care in the treatment of patients with metastatic renal cell carcinoma. However, it only benefits to a subgroup of patients and no predictive markers of sunitinib efficacy have been identified. Twenty-eight metastatic renal cell carcinomas were treated with sunitinib-based therapy and another subgroup of 7 primary renal cell cancer patients were also treated by sunitinib in a neoadjuvant trial.

Kidney function following nephrectomy: similitude and discrepancies between kidney cancer and living donation.

Objectives: The reported long-term safety of kidney donation is inconsistent with the impairment of kidney function observed following nephrectomy for renal cell cancer. We aimed to investigate if indication for nephrectomy (kidney cancer vs. living donation) was an independent risk factor for kidney function deterioration.

Should routine pyeloureterostomy be advocated in adult kidney transplantation? A prospective study of 283 recipients.

Purpose: Ureteroneocystostomy surgical techniques have been repeatedly debated in the medical literature, in contrast to pyeloureterostomy, which is merely considered a salvage procedure. We assessed urological complications and their management after routine pyeloureterostomy in adult kidney transplantation cases.

Materials And Methods: We performed a 2-center, uncontrolled, prospective study from January to December 2007.

Integrating surgery with targeted therapies for renal cell carcinoma: current evidence and ongoing trials.

Context: Surgical intervention is the primary treatment for early-stage renal cell carcinoma (RCC), but alone it has limited benefit in patients with metastatic disease. The advent of targeted agents for RCC has improved the outcome in these patients, and there is increasing interest in exploring the efficacy and safety of these agents in combination with surgery in both early and advanced disease.

Objective: This article reviews approved and emerging targeted therapies for RCC and outlines the rationale and implications for combining these therapies with surgery.