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Annick Vieillefond

Publications and source records attributed to Annick Vieillefond.

At least 19 recordsLinked to original sources
PubMed2006

Can pT0 stage of prostate cancer be predicted before radical prostatectomy?

OBJECTIVES: To report our experience with biopsy-proven pT0 prostate cancer over the last 10 yr. METHODS: We retrospectively analysed a series of 1950 consecutive patients treated with radical prostatectomy (RP) for clinically localized prostate cancer between 1996 and 2005 at our institution. The patients without residual tumour on RP specimen were defined as pT0 patients. The group of pT0 patients was compared with a control group of 295 patients operated consecutively during the same period. RESULTS: Overall, 11 (0.5%) patients were classified as pT0 on pathologic examination of the RP specimen. There was no pT0 tumour in the control group. Among the pT0 patients, five characteristics were particularly frequent: T1c clinical stage (90.9%), prostate-specific antigen (PSA) or=60 g (100%). All these characteristics were present in 8 of the 11 (72.7%) pT0 patients, while they were present in only 12 of the 295 (4.1%) controls. These parameters, when combined together, had a sensitivity of 72%, a specificity of 96%, and an accuracy of 99% for the prediction of pT0 stage. With a mean follow-up of 30 months after RP, no pT0 patient had clinical or biologic evidence of prostate cancer. CONCLUSIONS: In our experience, the rate of pT0 tumours after RP is 0.5%. The combination of clinical stage, preoperative PSA, number of positive biopsy cores, Gleason score, and prostate weight could help to predict pT0 stage after RP.

Aged↗
PubMed2006

Is quantitative real-time RT-PCR an adjunct to immunohistochemistry for the evaluation of ErbB2 status in transitional carcinoma of the bladder?

OBJECTIVE: To test different approaches of evaluation of the ErbB2 status in a large series of human transitional cell carcinoma (TCC) of the bladder with the prospect of finding targeted therapies. METHODS: ErbB2 status of 73 human TCC samples was analyzed by both immunohistochemistry (IHC) and by quantification of mRNA levels of expression using real-time reverse transcription-polymerase chain reaction (RT-PCR). Additionally, 18 bladder samples were studied for ERBB2 gene amplification by real-time quantitative PCR. RESULTS: Twenty-five tumors (34.2%) overexpressed ERBB2 mRNA compared to normal bladder samples; this alteration appeared in low-grade and low-stage tumors (pTaG1). Twenty-four (32.9%) tumors showed moderate (++) or strong (+++) immunostaining. A very strong agreement was found between the two methods (kappa = 0.97, 95% confidence interval, 0.90-1). ErbB2 status was not associated with tumor stage. Of the 18 bladder samples tested for ERBB2 gene amplification, only one showed ERBB2 DNA amplification. CONCLUSIONS: ErbB2 overexpression occurs in about one third of bladder TCCs. This overexpression can be detected by RT-PCR with a very good correlation with IHC. RT-PCR can therefore be used for cases considered doubtful on IHC rather than gene amplification studies because, in TCC, gene amplification is not the predominant mechanism of both mRNA and protein overexpression. Accurate quantification of ErbB2 status is mandatory for the use of anti-ErbB2-targeted therapies in bladder TCC.

Adult↗
PubMed2006

Management of a malignant urinary fistula by ureteral embolization with coils.

We report the case of a 42-year-old man with a synovial sarcoma of the prostate, metastatic at presentation, who after aggressive chemotherapy followed by extensive surgery developed a complex pelvic fistula involving the lower ureter, bladder, and enteral structures. The patient was a poor candidate for surgery because of his short life expectancy and poor health status. Conservative management with bilateral nephrostomy tubes did not allow sufficient fistulous output for symptomatic relief. Using the percutaneous access already in place, we performed bilateral ureteral embolization with coils. Complete ureteral occlusion was obtained with a minimally invasive procedure and allowed total symptomatic relief.

Adult↗
PubMed2006

[Does transrectal MRI before radical prostatectomy modify the operative technique to decrease the positive margin rate?].

OBJECTIVE: To determine the value of magnetic resonance imaging (MRI) in the surgical management of prostate cancer patients. PATIENTS AND METHODS: 159 patients with prostate cancer underwent transrectal MRI before retropubic radical prostatectomy (RP). Patients operated despite a suspicion of extraprostatic extension on MRI had a modified non-nerve-sparing surgical technique. Postoperative histological findings were compared to MRI data. RESULTS: 34/159 patients (21.4%) had suspected extraprostatic extension in MRI. The pT3 rate on the RP specimen was significantly higher for patients with abnormal MRI than for patients with normal MRI (61% versus 39%, p = 0.02). Among pT3 patients, the positive surgical margin rate was significantly lower in the group with abnormal MRI than in the group with normal MRI (24% versus 51%, p = 0.035). CONCLUSIONS: Among patients with stage pT3 on the RP specimen, those in whom extraprostatic extension was suspected on MRI were treated by a modified surgical technique resulting in a lower positive surgical margin rate.

Aged↗
PubMed2005

Immunohistochemical expression of p63, p53 and MIB-1 in urinary bladder carcinoma. A tissue microarray study of 158 cases.

P63 is a member of the p53 family, which plays a role in the differentiation of urothelium and is supposed to play a role in urothelial carcinogenesis. P53 and MIB-1 are recognised in many studies as predictive markers of progression, but few studies in the literature have examined p63. The aims of our study were to explore the expression of p63 in bladder carcinomas and to compare this expression to p53 and MIB-1, as well as to stage and grade. Tissue microarrays were performed on 158 urothelial carcinomas (56 pTa, 45 pT1 and 57>or=pT2). Immunohistochemical studies were performed with p63, p53 and MIB-1 antibodies. In our study we observed that p63 immunostaining is present in all cell layers in papillary urothelial neoplasm of low malignant potential (PUNLMP), but partially lost in non-invasive papillary urothelial carcinoma low grade (NILGC) and in pT1/>or=pT2 bladder cancers. P53 and MIB-1 displayed lower expression in PUNLMP/NILGC vs non-invasive papillary urothelial carcinoma high grade (NIHGC)/pT1, but there was no correlation between the expression of p63, p53 and MIB-1. Our study demonstrates that p63 expression distinguishes between PUNLMP/NILGC and NIHGC/pT1 (p=4.10(5)). A statistical difference disserving pTa and pT1/>or=pT2 with a statistical significance (p<10(-6)) could also be observed. P63 should be considered as an additional biomarker that might help pathologists to classify their patients.

Adult↗
PubMed2005

Mucinous tubular and spindle cell carcinoma: a report of 15 cases and a review of the literature.

Mucinous tubular and spindle cell carcinomas are low-grade renal epithelial neoplasms, which were first recognized as a specific entity in the World Health Organization 2004 classification. Forty-five documented cases have been reported. We present 15 additional cases that were incidentally discovered in ten women and five men, with a mean age of 53 years. The tumor is characteristically made up of large eosinophilic regular spindle cells separated by a myxoid stroma with intercellular alcian-blue-positive clear droplets. In peripheral areas, elongated tubules and papillae covered by cubic cells are found. Until this entity had been defined, pathologists used to classify these tumors as variants of solid papillary carcinomas with compressed and elongated papillae, metanephric adenomas, and sarcomatoid carcinomas. In the literature, cytogenetic data indicate various chromosomal losses and gains, but no loss of 3p or trisomy 7 and/or trisomy 17. In two cases, we demonstrate chromosomal loss involving chromosomes 1, 4, 6, 11, 8, 13, 14, 15, 18, and 22. In our 15 cases, immunohistochemistry favored a distal tubule origin (EMA(+), AE1/AE3(+), CK7(+), CK19(+), E-cadherin(+), AMACR(+), and CD10(-)). Prognosis was favorable in our cases, while in the literature, two metastatic cases were reported. Further investigations are required to determine the frequency and true prognosis of these tumors, which are easily identifiable morphologically.

Adult↗
PubMed2005

Trastuzumab (Herceptin) in metastatic transitional cell carcinoma of the urinary tract: report on six patients.

OBJECTIVE: To report our preliminary experience with trastuzumab (Herceptin) in the management of metastatic transitional cell carcinoma of the urinary tract. PATIENTS AND METHODS: From november 2001 to august 2002, six patients received trastuzumab for metastatic transitional cell carcinoma of the bladder (n=5) or renal pelvic cancer (n=1). Trastuzumab was administered as a first-line therapy in 2 patients, a second-line therapy in 3, and a third-line therapy in 1. Each patient received a weekly intravenous administration of trastuzumab (initial dose of 4 mg/kg, followed by 2mg/kg for other courses). A total of 6 courses was given. In 4 patients, trastuzumab was administered in association with paclitaxel (175 mg/m2) and carboplatin (area under the curve of 6). One patient received the same combination of trastuzumab and paclitaxel, but without carboplatin. The remaining patient received only trastuzumab. RESULTS: The trastuzumab-based regimen achieved partial regression of metastases in all patients. Initial regression of metastases varied between 30% and 80%. The therapy was well tolerated. Treatment-related toxicity was moderate in all patients, except for one who experienced transient grade 4 neutropenia. Five patients died from cancer. The interval between trastuzumab initiation and patient death ranged from 8 to 22 months. The remaining patient was still alive 28 months after trastuzumab initiation. CONCLUSIONS: Our preliminary data suggest that trastuzumab-based therapy may be safe and effective in metastatic transitional cell carcinoma of the urinary tract. Prospective trials are needed to further investigate this therapeutic option.

Aged↗
PubMed2005

Characterization of quantitative chromosomal abnormalities in renal cell carcinomas by interphase four-color fluorescence in situ hybridization.

Renal cell carcinomas (RCC) in adults are histologically heterogeneous solid tumors with specific chromosomal abnormality patterns included in the World Health Organization (WHO) classification. To overcome some of the drawbacks of cytogenetic and comparative genomic hybridization (CGH) analyses, we designed a first-generation cytogenetic diagnostic test using four-color fluorescence in situ hybridization (FISH) on interphase nuclei. We selected 51 bacterial artificial chromosome and P1-derived artificial chromosome clones covering 17 chromosomal regions involved in the abnormalities of the adult RCC histologic subtypes. An initial set of probes allowed the identification of clear-cell RCC, papillary RCC, and other RCC on a single slide. A second test allowed the detection of additional chromosomal abnormalities or aberrations specific to chromophobic RCC and oncocytomas. We tested 25 cases of RCC, and the results were in agreement with those of cytogenetic techniques and/or CGH methods. The techniques appeared to be very sensitive, because small tumoral cell clones that were undetected by other cytogenetic methods were identified with this method. It was concluded that the multicolor FISH test was specific and sensitive, easy to perform, and could be part of the investigation process in RCC.

Adult↗
PubMed2005

[Tumors of the kidneys: new entities].

Since 1998 new entities have surfaced in renal tumor classification and have been included in the WHO 2004 classification. In this article, we will discuss the following entities: multilocular clear cell renal carcinoma, Xp11 translocation carcinoma, low grade mucinous tubular carcinoma, epithelioid angiomyolipoma, benign mixed epithelial and stromal tumor. We will investigate new concepts of hybrid oncocytoma and chromophobe renal cell carcinoma and the syndrome of Birt-Hogg-Dube which is associated to kidney tumors. At least, we will touch on new elements in the Bellini carcinoma definition.

Adenocarcinoma, Clear Cell↗
PubMed2005

Adult papillary renal tumor with oncocytic cells: clinicopathologic, immunohistochemical, and cytogenetic features of 10 cases.

We report a series of 10 oncocytic renal papillary tumors, with the aim of determining their clinicopathologic features. All patients were male (median age, 71 years), treated by radical nephrectomy and free of recurrence or metastasis (median follow-up, 62 months). Tumors (median size, 3.3 cm) were intrarenal and well limited, with no extrarenal extension. They consisted of thin, nonfibrotic papillae lined by a single layer of oncocytic cells, with finely granular eosinophilic cytoplasm and round regular nucleus exhibiting central nucleolus (Fuhrman grade II, except for one grade III). Foci of necrosis were present in most cases. All tumors were immunoreactive for alpha-methylacyl-coenzyme A racemase, vimentin, and CD10; 4 expressed renal cell carcinoma antigen and 3 cytokeratin 7. There were a low number of cytogenetic changes in the 5 analyzed cases (median, 4; range, 1-7), with no trisomy 7 or 17. Papillary architecture, necrosis, and immunohistochemical profiles argued against the diagnosis of oncocytoma and suggested our cases to be part of the papillary renal cell carcinoma group. However, the cases were atypical for type 1 papillary carcinoma (due to oncocytic cells and absence of trisomy 17) and for type 2 (due to a good outcome). These results suggest that adult papillary renal tumors with oncocytic cells might be a distinct variant in the papillary renal cell carcinoma group.

Adenoma, Oxyphilic↗
PubMed2005

[Small round cell desmoplastic tumour presenting as a testicular mass].

The authors report a case of small round cell desmoplastic tumour presenting as a testicular mass. This is a rare tumour arising from serosal tissues, especially the tunica vaginalis. It is characterized by a specific reciprocal translocation t(11;22) (p13;q12) inducing fusion of the EWS and WT1 genes. Treatment of this tumour consists of a combination of surgical resection, as complete as possible, and intensive chemotherapy (P6 protocol or Institut Gustave Roussy protocol) and possibly radiotherapy. However, the prognosis remains very poor.

Adult↗
PubMed2004

Collecting duct carcinoma: an entity to be redefined?

Collecting duct carcinomas (CDCs) are highly aggressive tumors with poor survival at 1 year and are often metastatic at the time of diagnosis. It has been shown that patients may have better survival when treated with a chemotherapy regimen used for urothelial carcinoma. Such tumors must therefore be recognized, but their pathological diagnosis remains difficult. The two main differential diagnoses are renal pelvis urothelial carcinoma with infiltration of the kidney and/or high-grade and high-stage papillary renal cell carcinoma. The aim of our study was to compare the immunophenotype of 14 CDCs with 6 renal pelvis urothelial carcinomas (RPUC) infiltrating the medulla. The following markers were evaluated: ulex europeus aglutinin (UEA), peanuts aglutinin, vimentin and aquaporin 3 (AQP-3), a membrane component of normal collecting duct and urothelial cells. We were able to define a reproductive urothelial phenotype AQP-3+, vimentin- and UEA+. Among the 14 CDCs, 10 cases demonstrated this immunophenotype. It coincided with an urothelial-like trabecular and tubular pattern. In contrast, the 4 remaining papillary CDCs had the inverse pattern, AQP-3-, vimentin+ and UEA-. These results suggest that: (1) the trabecular and tubular variant of CDC with the urothelial AQP-3+, vimentin- phenotype can be included in the spectrum of urothelial diseases; (2) the papillary variant probably does not belong to the same entity; (3) AQP-3 is a marker of interest for improving the histological classification of CDC and unclassified aggressive renal tumors.

Aged↗
PubMed2004

Non-Leydig sex-cord tumors of the testis. The place of immunohistochemistry in diagnosis and prognosis. A study of twenty cases.

In 20 sex-cord tumors of the testes, we investigated immunohistochemistry as a possible method for histopathological diagnosis and evaluation of prognosis. We examined the following molecules: inhibin, CD99, cytokeratin, vimentin, MIB-1, estrogen receptors and progesterone receptors. These tumors of the testes comprised 18 Sertoli cell tumors (ScT) and two undifferentiated sex-cord tumors (USCT). Four tumors have been considered as malignant, because of metastatic spread. Inhibin was expressed by the tumor cells in 80% of sex cord tumors, without any correlation to the degree of differentiation and only in 25% of the malignant cases. Inhibin is a specific marker for sex-cord tumors of the testis and is particularly useful for the diagnosis of USCT. CD99, vimentin, keratin, progesterone and estrogen receptors were expressed in, respectively, 60%, 75%, 35%, 65% and 20% of cases; 95% expressed one of the three following markers: inhibin, CD99 or vimentin. Proliferation index MIB-1 was equal to or higher than 30% in the four malignant cases versus less than 20% in other cases. Lack of inhibin expression and a proliferation index (MIB-1) greater than 30% should be considered as a criterion in favor of malignancy.

Adolescent↗
PubMed2004

Chromophobe renal cell carcinoma: analysis of 61 cases.

BACKGROUND: Chromophobe renal cell carcinoma (CRCC) is often associated with a favorable prognosis. However, to the authors' knowledge, only few clinical data are available regarding this variant of tumor. In the current study, the authors report their experience with CRCC over the last 14 years. METHODS: Since 1989, 61 patients have been treated at the study institution for CRCC. Tumor characteristics and patient outcome were analyzed retrospectively. Data were obtained from the patients' medical records. RESULTS: The mean age of the patients was 58 years. Of the 61 tumors, 68.8% were discovered incidentally. The mean tumor size was 6.9 cm. Fifty-seven patients (93.4%) were treated with radical nephrectomy and 4 patients (6.6%) underwent partial nephrectomy. According to the 1997 TNM classification, the pathologic tumor stage was T1 in 65.6% of cases, T2 in 31.1% of cases, and T3a in 3.3% of cases. All tumors were staged as N0M0. Nuclear grade was low (1 or 2) in 88.5% of cases. In no case of CRCC was a sarcomatoid component observed. At a mean follow-up of 49.5 months (range, 5-135 months), no patient had experienced tumor recurrence or disease progression, and none had died of renal carcinoma. CONCLUSIONS: In the authors' experience, CRCC carries an excellent prognosis, possibly due to the high rate of low-stage and low-grade tumors.

Adult↗
PubMed2004

Confrontation of immunohistochemistry and fluorescent in situ hybridization for the assessment of HER-2/ neu (c-erbb-2) status in urothelial carcinoma.

Specific treatments targeted toward oncogenes expressed in cancer cells are currently under development. Patients with urothelial carcinomas showing HER-2/ neu (human epidermal growth factor receptor 2) overexpression are candidates for such a specific treatment (trastuzumab). However, to be effective, this therapeutic approach requires an extremely reliable evaluation of HER-2/ neu status in tumors. In order to assess the status of expression of this gene and to optimize its assessment, we analyzed a series of 64 primary urothelial carcinomas using immunohistochemistry (IHC) with the CB11 monoclonal antibody coupled with fluorescent in situ hybridization (FISH) in 21 cases. Strong HER-2/ neu overexpression was detected using IHC in 15 of the 64 (23%) cases analyzed, and this rate rose to 33% for patients with metastases. HER-2/ neu overexpression, as revealed using IHC, is strongly associated (95%) with gene amplification assessed using FISH. Patients with urothelial carcinomas overexpressing HER-2/ neu using IHC are potential candidates for targeted chemotherapy.

Adenocarcinoma↗
PubMed2004

[Late metastasis after a testicular Sertoli cell tumour].

The diagnosis of Sertoli cell tumors is sometimes difficult and can be improved using anti inhibin immunohistochemistry. It is also difficult to establish the prognostic of Sertoli cell tumors. In our observation a high Mib 1 rate (20%) could have be taken in account to decide a better survey or/and a lymphadenectomy, which could have avoided lymph node metastasis in our patient, which was discovered ten years after orchidectomy.

Humans↗