Oncological risk of laparoscopic surgery in urothelial carcinomas.

Objective: To assess the oncological safety of laparoscopic procedures for the management of urothelial carcinomas of the urinary tract.

Methods: Data on laparoscopic management of urothelial carcinomas in the literature were analysed using MEDLINE and by matching the following keywords: urological malignancies, upper tract tumours, bladder carcinomas, laparoscopic approach, recurrence, follow-up and metastasis site.

Results: Minimally invasive techniques are being used increasingly in the management of these tumours and successfully achieving the benefits of lower blood loss and more rapid patient recovery.

Prognostic variables to predict cancer-related death in incidental renal tumours.

Objective: To identify, in a large multicentre series of incidental renal tumours, the key factors that could predict cancer-related deaths, as such tumours have a better outcome than symptomatic tumours and selected patients are increasingly being included in watchful-waiting protocols.

Patients And Methods: Data from 3912 patients were extracted from three international kidney-cancer databases. Age, gender, Eastern Cooperative Oncology Group (ECOG) performance status (PS), Tumour-Node-Metastasis (TNM) stage, tumour size, Fuhrman grade, and final pathology were recorded.

[What is the clinical practice of partial nephrectomy in France?].

Objective: To describe the practice of partial nephrectomy (PN) in France and assess its results in terms of morbidity and cancer control.

Material And Method: Seven French University Hospitals in which nephron sparing surgery represents at least 30% of the total number of nephrectomies for renal tumour, participated in this study. All centres included, as exhaustively as possible, all their PN cases.

[Do broader indications for partial nephrectomy result in excess morbidity?].

Objective: To evaluate the morbidity of partial nephrectomy (PN) according to tumour size and the type of indication based on a multicentre retrospective study.

Materials And Methods: Seven French teaching hospitals participated in this study. Data concerning tumour size, indication for PN (elective or necessity), age, gender, TNM stage, histological type, Fuhrman grade, ASA score and performance status (ECOG) were analysed.

["Superficial bladder cancers" do not exist anymore].

"Superficial bladder tumours" term is progressively abandoned in the urological community because of its ambiguity leading possibly to harmful confusions. The French Oncologic Society proposes to designate by non-infiltrating bladder neoplasm by the muscle Ta, T1 and Tis tumours.

[Elevation of total PSA after intravesical BCG instillations: granulomatous prostatitis or prostatic adenocarcinoma?].

Objective: The objective of this study was to evaluate the incidence of prostatic carcinoma in patients treated by intravesical BCG-therapy for superficial bladder cancer and presenting granulomatous prostatitis. The authors discuss the problems of interpretation of total PSA and the potential indications for prostatic biopsies in this population.

Material And Methods: A retrospective study was performed on the cases of symptomatic granulomatous prostatitis observed among patients treated with intravesical BCG instillations between January 1997 and December 2006.

Longevity can buffer plant and animal populations against changing climatic variability.

Both means and year-to-year variances of climate variables such as temperature and precipitation are predicted to change. However, the potential impact of changing climatic variability on the fate of populations has been largely unexamined. We analyzed multiyear demographic data for 36 plant and animal species with a broad range of life histories and types of environment to ask how sensitive their long-term stochastic population growth rates are likely to be to changes in the means and standard deviations of vital rates (survival, reproduction, growth) in response to changing climate.

Structured training in intraosseous infusion to improve potentially life saving skills in pediatric emergencies - Results of an open prospective national quality development project over 3 years.

Background: Children in emergencies need peripheral intravenous (IV) access in order to receive drugs or fluids. The success of IV access is associated with the age of patients and fails in up to 50% of children younger than 6 years. In such situations, it is essential that physicians and paramedics have a tool and easily learnable skills with a high chance of success.

Homer1a is a core brain molecular correlate of sleep loss.

Sleep is regulated by a homeostatic process that determines its need and by a circadian process that determines its timing. By using sleep deprivation and transcriptome profiling in inbred mouse strains, we show that genetic background affects susceptibility to sleep loss at the transcriptional level in a tissue-dependent manner. In the brain, Homer1a expression best reflects the response to sleep loss.

Are there attacking points in the eicosanoid cascade for chemotherapeutic options in benign meningiomas?

Object: The current treatment for recurrent or malignant meningiomas with adjuvant therapies has not been satisfactory, and there is an intense interest in evaluating new molecular markers to act as therapeutic targets. Enzymes of the arachidonic acid (AA) cascade such as cyclooxygenase (COX)-2 or 5-lipoxygenase (5-LO) are upregulated in a number of epithelial tumors, but to date there are hardly any data about the expression of these markers in meningiomas. To find possible targets for chemotherapeutic intervention, the authors evaluated the expression of AA derivatives at different molecular levels in meningiomas.

Cytoreductive nephron-sparing surgery does not appear to undermine disease-specific survival in patients with metastatic renal cell carcinoma.

Background: The role of nephron-sparing surgery (NSS) showed promise in patients with metastatic renal cell carcinoma (MRCC). The disease-specific survival of patients with MRCC was compared according to the type of surgery, NSS (N=45) versus radical nephrectomy (RN) (N=732), in unmatched and matched analyses.

Methods: Kaplan-Meier, life tables, log-rank test, and univariate as well as multivariate Cox regression analyses addressed disease-specific survival of NSS versus RN patients.

Unclassified renal cell carcinoma: an analysis of 85 cases.

Objectives: To compare cancer-specific mortality in patients with unclassified renal cell carcinoma (URCC) vs clear cell RCC (CRCC) after nephrectomy, as URCC is a rare but very aggressive histological subtype.

Patients And Methods: Eighty-five patients with URCC and 4322 with CRCC were identified within 6530 patients treated with either radical or partial nephrectomy at 18 institutions. Of 85 patients with URCC, 55 were matched with 166 of 4322 for grade, tumour size, and Tumour, Node and Metastasis stages.

Preliminary results of the Prostacox phase II trial in hormonal refractory prostate cancer.

Objectives: To assess in a phase II open multicentre study the efficacy and tolerance of docetaxel administered every 14 days combined with celecoxib, in patients with hormone-refractory prostate cancer (HRPC), and to test the hypothesis that this therapeutic combination would improve overall survival.

Patients And Methods: In all, 48 patients were included with a mean age of 70.4 years and Gleason score of 7.

Intertidal invertebrates locally enhance primary production.

The contribution of autochthonous vs. allochthonous inputs to productivity is an important determinant of ecosystem function across multiple habitats. In coastal marine systems, nutrients are thought to come primarily from the upwelling of deep, nutrient-rich water.

[Diagnosis and treatment of superficial bladder cancers].

By definition, superficial bladder tumours do not invade the bladder muscle. The two main risk factors are smoking and industrial carcinogens. Gross hematuria is the most common presenting sign of bladder tumour; its finding should always prompt a cystoscopy of the lower urinary tract.

Metachronous bilateral renal cell carcinoma: risk assessment, prognosis and relevance of the primary-free interval.

Purpose: We evaluated the prognosis, risk factors and relevance of the primary-free interval in a large cohort with metachronous bilateral renal cell carcinoma.

Materials And Methods: We studied 120 patients with metachronous, bilateral renal cell carcinoma who were treated at 12 international academic centers. Logistic regression was performed to evaluate risk factors for contralateral metachronous renal cell carcinoma during followup.

[Bladder cancer and occupation: a descriptive analysis in Haute Normandie in 2003].

Objective: Haute Normandie is characterized by the presence of a large number of industries likely to have exposed their employees to a risk of bladder cancer. The objective of the study performed by Assurance Maladie (national health insurance) and Réseau d'Onco-Urologie de Haute Normandie (ROUHN) (Haute Normandie Urological Oncology Network) was to describe the epidemiological characteristics of bladder cancers and to estimate the proportion of potentially work-related cancers.

Material: A questionnaire elaborated for the study and comprising demographic, clinical, environmental and occupational data was completed for all patients in whom exemption of co-payment for bladder cancer was requested in 2003.

Clinicopathological features and prognosis of synchronous bilateral renal cell carcinoma: an international multicentre experience.

Objective: To present a multicentre experience and the largest cohort to date of nonmetastatic (N0M0) synchronous bilateral renal cell carcinoma (RCC), as because it is rare the single-institutional experience is limited.

Patients And Methods: We retrospectively studied 10 337 patients from 12 urological centres to identify patients with N0M0 synchronous bilateral RCC; the clinicopathological features and cancer-specific survival were compared to a cohort treated for N0M0 unilateral RCC.

Results: In all, 153 patients had synchronous bilateral solid renal tumours, of whom 135 (88%) had synchronous bilateral RCC, 118 with nonmetastatic disease; 91% had nonfamilial bilateral RCC.

[Comparison of open and laparoscopic partial nephrectomy: a French multicentre experience].

Objectives: To compare open (OPN) and laparoscopic (LPN) partial nephrectomy (PN) techniques in the light of a French multicentre series.

Material And Methods: Data corresponding to 741 PN (91 laparoscopic and 650 open procedures) were compared in terms of the indications, tumour diameter, operative data, complication rates and length of hospital stay.

Results: Tumours were smaller in the LPN group (2.

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.

Pediatric urinary incontinence: evaluation of bladder wall wraparound sling procedure.

Purpose: In 1996 a surgical procedure for sphincter deficiency was reported in patients with neurogenic urinary incontinence. To our knowledge we report the first series that assesses this procedure since it was initially described.

Materials And Methods: Seven female and 7 male patients with spinal dysraphism and neurogenic intrinsic sphincter deficiency underwent surgery between 1997 and 2005.