Biomedical subjects

Alexandre de la Taille

Publications and source records attributed to Alexandre de la Taille.

41 records · Page 3Linked to original sources

PubMed2002

[Study of intermittent endocrine therapy in patients presenting with biologic recurrence after radical prostatectomy or radiotherapy].

INTRODUCTION: Study of the efficacy of intermittent endocrine therapy after failure of local treatment. MATERIAL AND METHODS: 74 patients were treated for biochemical recurrence after radical prostatectomy (n = 30), radiotherapy (n = 28) or radical prostatectomy followed by radiotherapy (n = 16). Treatment (63 patients were treated by antiandrogens alone, 8 by LHRH analogue and 3 by complete androgen suppression) was continued for 6 months after obtaining undetectable PSA levels for patients after radical prostatectomy (and restarted when PSA > 4 ng/ml) or a PSA nadir < 4 ng/ml for the other patients (and restarted for PSA > 10 ng/ml). RESULTS: The duration of periods without treatment represented 50% of the total treatment cycle. With a mean follow-up of 43.8 months, the overall 5-year biochemical progression-free survival rate was 54.6%. On multivariate analysis, factors predictive of biochemical progression were age less than 70 years (p = 0.05), Gleason score greater than or equal to 8 (p = 0.038) and the presence of lymph node metastases (p = 0.05). CONCLUSION: Intermittent endocrine therapy is a treatment option for patients with recurrence after local treatment. Candidates for intermittent endocrine therapy must be over the age of 70, with localized adenocarcinoma and a Gleason score less than or equal to 7.

Age Factors↗

PubMed2002

[Fibromyxoid tumor of the bladder: report of 3 cases].

Fibromyxoid tumours are rare inflammatory bladder tumours. These benign tumours are responsible for minimal symptoms. The diagnosis is based on histological examination showing spindle cells infiltrating the detrusor associated with more or less abundant inflammatory infiltrates. It is important to demonstrate the myofibroblastic nature of these cells, which constantly express specific muscle actin and smooth muscle actin on immunohistochemistry. The differential diagnoses are high-grade sarcomatoid spindle cell urothelial carcinoma, leiomyosarcoma and embryonal rhabdomyosarcoma in children. Treatment is surgical, comprising complete endoscopic resection or partial or total cystectomy. The authors report 3 new cases of fibromyxoid tumours treated conservatively by complete endoscopic resection or partial cystectomy. No recurrence was observed. The authors present a review of the literature and a discussion of the differential diagnoses.

Adult↗

PubMed2002

[Seminal vesicle invasion afer radical prostatectomy: study of risk factors for progression].

OBJECTIVE: Seminal vesicle invasion (pT3b) is a known factor of poor prognosis after radical prostatectomy. The authors retrospectively studied the course of stage pT3b tumours, and the clinical, laboratory and histological factors that could influence this course. METHODS: From 1988 to 2001, out of a total of 538 radical prostatectomies, 62 (11.5%) cases with isolated seminal vesicle invasion were analysed according to the Stanford technique. Half-yearly postoperative surveillance was based on physical examination and PSA assay. Progression was defined as PSA greater than 0.2 ng/ml or when complementary treatment was performed. Actuarial progression-free survival was studied according to the Kaplan-Meier method. Actuarial survivals were compared by the Log-rank method, and a difference was considered to be significant for p < 0.05. Multivariate analysis using the Cox model was performed. RESULTS: The mean Gleason score of the radical prostatectomy specimen was 6.9, and the mean tumour volume was 2.7 cm3. Forty eight (77.4%) specimens showed capsular effraction and 33 (53.2%) had positive surgical margins. The 5-year laboratory progression-free survival was 16%. A low preoperative PSA, a radical prostatectomy specimen Gleason score less than 7 and capsular effraction were factors of good prognosis on multivariate analysis. CONCLUSION: Prostatic tumours with seminal vesicle invasion have a high risk of progression after radical prostatectomy. A preoperative PSA level less than 10 ng/ml, a Gleason score of the operative specimen less than 7 and effraction of the prostatic capsule can be used to identify a subpopulation of patients with a better prognosis.

Disease Progression↗

PubMed2002

[Localization of positive surgical margins after retropubic, perineal and laparoscopic radical prostatectomy].

OBJECTIVE: To study the sites of positive surgical margins after radical prostatectomy according to the technique used: retropubic, perineal or laparoscopic. MATERIAL AND METHODS: 538 radical prostatectomies were performed between 1988 and 2001: 184 via a retropubic approach, 119 via a perineal approach and 235 by laparoscopy. Clinical examination, PSA assay (Hybritech, Normal < 4 ng/ml) and transrectal biopsies were performed in all patients. The radical prostatectomy specimen was examined by the same pathologist according to the Stanford protocol. The frequency and site of positive surgical margins were studied as a function of pathological stage. RESULTS: The positive surgical margins rate was 32%, 18.5% and 26.4% for the retropubic, perineal and laparoscopic techniques, respectively. The most frequent site of positive surgical margins was the apex for retropubic (41.1%) and perineal (41.6%) prostatectomy and the posterolateral part of the prostate for laparoscopic prostatectomy (41.9%). The most frequent site of positive surgical margins in pT2 tumours was the apex for the retropubic approach (50%), the base of the prostate (bladder neck) for the perineal approach (41.6%) and the apex and posterolateral part of the prostate for the laparoscopic approach (44.4% and 41.6%). CONCLUSION: Each radical prostatectomy technique corresponds to a preferential site of positive surgical margins: the apex for the retropubic approach, the bladder neck for the perineal approach and the posterolateral part of the prostate for the laparoscopic approach.

Biomarkers, Tumor↗

PubMedDate not supplied

Sexual dysfunction is common and overlooked in female patients with hypertension.

Our objective was to investigate sexual activity, behavior, dysfunction, and satisfaction in hypertensive women. Sixty-seven patients with a mean age of 60.4 years completed a detailed questionnaire. Of these women, 81.3% had a sex partner; 42.6% had untreated sexual dysfunction with a duration of more than 5 years in 70.9% and a duration of more than 10 years in 41.7%; 5.3% initiated sexual activity; 36.6% reported less sexual activity than desired; and 54.8% reported sexual activity as important. Our study revealed highly prevalent untreated sexual dysfunction of long duration. It also showed low frequency of sexual activity in spite of the high availability of partners. There was low frequency of initiation of sexual activity. In spite of the high prevalence of sexual dysfunction, more than a third of patients reported sexual activity to be less than desired, and more than half of patients reported sexual activity as important.

Adolescent↗