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Marc de Fromont

Publications and source records attributed to Marc de Fromont.

5 recordsLinked to original sources
PubMed2006

[Management of positive margins after total prostatectomy for localized prostate cancer].

Positive margins after total prostatectomy are frequently observed (10% to 40% of cases) in the everyday practice of urologists treating prostate cancer The presence of positive margins is correlated with the presence of residual tumour in about 50% of cases. It is difficult to clearly define optimal management in view of the marked heterogeneity of the published data concerning the significance and prognosis of positive margins. The objective of this review article was to analyse the various aspects of this situation and to propose practical management guidelines. This analysis was based on data of the literature derived from Medline. In practice, it is essential to more precisely define the concept of positive margins in histological terms by specifying the unifocal or multfocal nature, the total length of positive margins and their site. The decision to perform adjuvant or deferred therapy is based on these histopathological elements together with other prognostic criteria determined after total prostatectomy: pathological stage and Gleason score, tumour volume and postoperative PSA.

Humans↗
PubMed2005

Multicenter determination of optimal interobserver agreement using the Fuhrman grading system for renal cell carcinoma: Assessment of 241 patients with > 15-year follow-up.

BACKGROUND: The Fuhrman system is the most widely used nuclear grading system for renal cell carcinoma (RCC). Although Fuhrman nuclear grade is widely accepted as a significant prognostic factor, its reproducibility, as reported in the limited number of series available in the literature, appears to be low. METHODS: Between 1980 and 1990, 255 cases of RCC (pT1-3bN0M0) were treated with radical nephrectomy at the Department of Urology, University Hospital, Strasbourg, France. In a retrospective multicenter study, 3 pathologists independently classified 241 of these 255 cases according to the Fuhrman grading system. The authors searched for optimal interobserver agreement by collapsing the grading system to a three-tiered scheme and then to a two-tiered scheme. In addition, overall survival curves were generated according to the classic four-tiered scheme and also according to the best collapsed scheme. The kappa index was used to assess the level of agreement between each pair of observers, and the Cox model was used for multivariate survival analyses. RESULTS: The mean interobserver kappa value was 0.22 (range, 0.09-0.36). The best concordance was obtained by collapsing to a system in which low-grade (Grade 1-2) disease was compared with high-grade (Grade 3-4) disease. Doing so improved the mean interobserver kappa value to 0.44 (range, 0.32-0.55). Fuhrman grade was an independent prognostic factor for all 3 pathologists (P = 0.01, P < 0.0001, and P = 0.004, respectively), and nuclear grade continued to have independent prognostic value after the optimal collapsing algorithm was performed (P = 0.004, P = 0.0003, and P = 0.005). CONCLUSIONS: Collapsing of the Fuhrman grading system to a two-tiered scheme led to an improvement in interobserver agreement while preserving the independent prognostic value of nuclear grade.

Adult↗
PubMed2005

[Renal oncocytoma associated with renal cell carcinoma].

Renal oncocytoma is a benign tumour that can be associated with renal cell carcinoma in rare genetic syndromes. The authors report the case of a 62-year-old patient with no medical history, in whom assessment of low back pain in 1999 demonstrated a 40 mm tumour of the lower pole of the left kidney. Percutaneous needle biopsy of the tumour demonstrated oncocytoma confirmed by Hale's stain. Follow-up ultrasound demonstrated an increase in size (88 mm) and a nine-fold increase in volume over four years (210 cm3 in April 2003). Surgery was indicated in view of the rapid increase of the tumour volume. Histological examination of the operative specimen demonstrated a combination of oncocytoma and Fuhrman grade III renal cell carcinoma.

Adenoma, Oxyphilic↗
PubMed2004

[Kidney tumors].

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Humans↗