[12-year history of radical surgery indications for the treatment of prostate cancer]. / Évolution sur 12 ans des indications de prostatectomie totale pour cancer.

AIM: To analyze the indications of radical prostatectomy and lymph node dissection retained during the last 12 years in an academic surgical center in the Paris region in order to ensure their adequacy in relation to the current clinical guidelines. METHOD: Monocentric retrospective study of prospectively collected data, between 2007 and 2019. Analysis of the clinical and pathological characteristics which were taken into account during multidisciplinary meeting discussion for the treatment decision, and comparison of their evolution over the four 3-year period corresponding to the clinical guideline updates. RESULTS: Two thousand eighty-eight consecutive patients treated by radical prostatectomy between 16/03/2007 and 17/03/2019 were included. The proportion of patients classified as low, intermediate or high risk according to D'Amico system was 13.2%, 80.8% and 6.0% respectively. An increase in the frequency of surgical treatment of high-risk cancers has been observed. At the same time, there has been a decrease in the frequency of prostatectomies to treat low-risk cancers. CONCLUSION: The indications for radical prostatectomy and lymph node dissection have evolved in line with the current clinical guidelines which were taken into consideration in a onco-urological multidisciplinary meeting. LEVEL OF EVIDENCE: 3.

[Does the delay from prostate biopsy to radical prostatectomy influence the risk of biochemical recurrence?] / Le delai entre biopsies de prostate et prostatectomie radicale influence-t-il le risque de recidive ?

INTRODUCTION: The influence of the delay between prostate biopsy and radical prostatectomy for patients with localized prostate cancer is controversial. The objective of this study was to establish a time limit between prostate biopsy and radical prostatectomy beyond which the risks of upgradging and biochemical recurrence (BCR) are increased. MATERIAL AND METHODS: Between January 2013 and January 2017, a retrospective analysis of the clinical, biological and histological data of 513 patients treated with radical prostatectomy for localized prostate cancer was performed in a single center. The primary endpoint was the assessment of the risk of BCR by the difference between post-biopsy USCF-CAPRA and post-surgical CAPRA-S scores. The secondary endpoint was the evaluation of the upgrading by the difference between the Gleason score on biopsy and on surgical specimen. The risks of BCR and upgrading were compared by Student test according to different delays between prostate biopsy and radical prostatectomy. The shortest delays for which a significant difference was found were reported. RESULTS: In this study, 513 patients were included. The median age at the time of the biopsy was 65 years (IQR: 60-69). The median preoperative PSA was 7.30ng/mL (IQR: 5.60-9.94). The median time between biopsy and surgery was 108 days (IQR: 86-141). For the entire cohort, the risk of BCR was significantly higher above a threshold of 90 days (P=0.039). No threshold was found for Gleason 6(3+3) patients. A 90-day threshold was found for Gleason 7(3+4) patients (P=0.038). Gleason patients≥8 had more upgrading beyond a 60-day threshold (P=0.040). CONCLUSION: Our study showed that after a 3 months delay, the risk of BCR was significantly higher for localized prostate cancer. It seemed possible to extend this period for low-risk patients, whereas it seemed necessary to keep it for intermediate-risks and to reduce it to 2 months for high-risks. LEVEL OF EVIDENCE: 4.

[Functional evaluation of the orthotopic Z-shaped ileal detubulated neobladder with a minimal 5-year follow-up]. / Evaluation fonctionnelle de la néovessie iléale détubulée orthotopique en Z avec cinq ans de recul minimum.

OBJECTIVE: Study and evaluate the orthotopic Z-shaped neobladder in the long term and life quality of patients bearing this type of replacement. METHODS: Based on 162 medical records of patients who have undergone total cystoprostatectomy and orthotopic Z-shaped replacement because of bladder cancer with a minimal 5-year follow-up. Forty patients (113-month average follow-up) residing in the region were notified for a clinical consultation and were the basis for the target population of this study. A physical examination, a Pad test and a specific consultation allowed for continence evaluation whereas three validated surveys allowed for life quality appreciation. RESULTS: Continence was satisfactory for 82% of the patients during the day and 55% during the night. There was a significant negative correlation between a patient's age at the time of the cystoprostatectomy and diurnal continence. Life quality was estimated as good in the long term. CONCLUSION: The functional results of the Z-shaped ileal detubulated neobladder in the long term are satisfactory. It allows for good urination quality and satisfactory quality of life for patients subject to total cystoprostatectomy because of cancer as well as body schema's conservation.

[The impact of partial nephrectomy on morbidity and on long-term oncological outcomes]. / Impact de l'indication impérative sur la morbidité et les résultats carcinologiques à long terme après néphrectomie partielle.

OBJECTIVE: To evaluate the impact of imperative indication on the rate of complications and long term carcinological results after partial nephrectomy (PN). PATIENTS AND METHOD: Between 1985 and 2005, all patients who had a PN for localized cancer in two centers were reviewed. The rates of global, hemorrhagic and urinary complications were compared between group I (elective indication) and group II (imperative indication). Rates of survival without recurrence and specific at 5, 10 and 20 years were compared between these two groups. A multivariate analysis using the Cox model was carried out to research factors associated with recurrence and death on the whole of the series. RESULTS: Three hundred and five patients were included in the study. No significant difference was found between group I and group II as far as global complications were concerned (17 vs 20%), the rate of hemorrhagic complications (3.5 vs 3.8%) and the rate of urinary complications (3.9 vs 2.5%). The patients who had been operated on for an imperative indication had survived specifically and without recurrence which was significantly lower at 5, 10 and 20 years. On the whole of the series, the imperative indication was the only independent factor associated with recurrence and death in a multivariate analysis. CONCLUSIONS: Even if the rate of complication does not appear to be significantly associated with the indication for operating, patients of imperative indication represented a heterogeneous group with a poorer prognosis. This factor should be taken into account in studies on the subject of PN.

Preoperative low serum testosterone is associated with high-grade prostate cancer and an increased Gleason score upgrading.

BACKGROUND: To compare histological feature of prostate cancer (PCa) according androgenic status in patients who underwent radical prostatectomy (RP). METHODS: Between March 2007 and September 2013, we prospectively analysed 937 patients who were referred to our centre for RP. Clinical, pathological and biological data have been prospectively collected. Preoperative total testosterone (TT) and bioavailable testosterone (BT) serum determinations were carried out. The threshold for low serum testosterone was set at TT<3 ng/ml. Preoperative PSA value was registered. Gleason score (GS) and predominant Gleason pattern were determined in prostate biopsies and in prostate tissue specimens, crosschecked by two uro-pathologists. RESULTS: Nine hundred and thirty-seven consecutive patients were included. In all, 14.9% patients had low TT in the population. An exact match between biopsy and prostate specimens in GS grading was observed for 50.6% patients (n=474). Also, 40.9% of all patients were upgraded (n=383): 45.3% (n=63) in low serum testosterone patients and 40.1% (n=320) in normal serum testosterone patients. For prostate specimens, the proportion of patients with predominant Gleason pattern 4 was higher in patients with low TT compared with normal TT (41.7% vs 29.1%, P=0.0029). In all, 20.1% were upgraded from predominant Gleason pattern 3 on biopsies specimen to predominant Gleason 4 pattern on the prostate specimen in patients with low TT, whereas 11.6% were upgraded for normal TT patients (P=0.002). CONCLUSIONS: Low serum testosterone is an independent risk factor for predominant Gleason pattern 4 on prostate specimen after RP and for upgrading from low- to high-grade cancer between prostate needle biopsies and RP specimen. This observation should be taken into account in localised PCa management, especially for active surveillance or when a nerve-sparing approach is considered.

Electrovaporization of the prostate with the Gyrus device.

PURPOSE: To assess the efficacy and the safety of a new transurethral endoscopic device using bipolar electrocautery, the Gyrus system. This system permits rapid prostate tissue removal by endoscopic vaporization with little bleeding and no pad return using saline irrigation and therefore eliminating TURP syndrome. PATIENTS AND METHODS: Forty-two patients (mean age 70; range 49-90 years) with symptomatic benign prostatic hyperplasia (BPH) without suspected cancer, confirmed by digital rectal examination and PSA tests, were treated between October 1998 and February 1999 with the Gyrus and evaluated at 1 and 3 months postoperatively by the International Prostate Symptom Score (IPSS) and maximum urinary flow rate. RESULTS: No postoperative bleeding necessitating catheterization for postoperative retention occurred. The duration of the procedure was < or = 30 minutes in 12 patients, 30 to 60 minutes in 27 patients, and >60 minutes in 3 patients. The mean time of postoperative continuous bladder irrigation was 1.2 days (0.5-3 days). The mean catheterization time was 1.4 days (range 0.5-5 days). Urethral stricture requiring treatment occurred in two patients. Dysuria was reported by four patients (mild two, severe two). The postoperative hospitalization was a mean of 2.2 days. The mean peak flow rate increased from 7.9 to 19.7 mL/sec at 3 months, and the IPSS decreased from 16 to 9 at 3 months. CONCLUSION: Our preliminary results with a bipolar electrode for electrovaporization of the prostate using the Gyrus suggest that it is a useful and safe endoscopic device. It appears to be an effective treatment for BPH; however, long-term results (i.e., 1-year follow-up) should be evaluated. This pilot series permits a comparative study with TURP to assess the benefits for patients and the health care system.

[Value of nephron preservation in conservative surgery of renal tumors]. / Intérêt de la préservation néphronique dans la chirurgie conservatrice des tumeurs rénales.

The increasing use of abdominal ultrasonography and computed tomography results in the increasingly early diagnosis of subclinical renal tumours. These asymptomatic tumours can sometimes be treated conservatively. This technique raises the problem of the multifocal nature of renal tumours In order to assess the real benefit of nephron-sparing surgery in relation to the risk of recurrence, this study evaluates the repercussions of exclusive tumour resection on the nephron number. From 1990 to 1995, 28 patients underwent partial nephrectomy for suspected renal cell carcinoma. Computed tomography was use to estimate the volume and therefore the weight of the kidney and the tumour: weight (g) = volume (mL) = length x width x height/2. The mean age of the patients was 59.1 years. The contralateral kidney was normal in 20 patients (group 1) and the tumour affected a solitary kidney in 8 patients (group 2). The initial serum creatinine level was normal (between 78 and 96) in all patients. The mean weight of the tumour was 16.1 g (13.6 g for group 1 and 22.3 g for group 2), and corresponded to 3.84% of the total kidney weight in group 1 and 9.73% in group 2. 1,400,000 nephrons were preserved in group 1 versus 900,000 nephrons in group 2, equivalent to a glomerular filtration rate of 89 mL/min and 58 mL/min, respectively. Partial nephrectomy therefore constitutes a real nephron-sparing technique. It allows sparing of a sufficient number of nephrons to ensure normal renal function and, most importantly, allows the possibility of subsequent partial surgery in view of the potential risk of multifocal tumours.

[Cystic cancer of the kidney]. / Les cancers kystiques du rein.

Four cases of cystic renal adenocarcinoma in adults free of renal dysfunction are reported. The authors propose a diagnostic approach for atypical cysts that takes the new imaging techniques into account (ultrasonography and CT scan initially, MRI subsequently). A practical therapeutic strategy is also described: because intraoperative histologic diagnosis is difficult partial nephrectomy to allow an intraoperative study of the entire cyst is advocated; extensive nephrectomy, which is the only procedure that ensures total exeresis of the carcinoma, is performed either immediately if the intraoperative study of the cyst or of its aseptic necrotic and hemorrhagic content is positive, or later if subsequent histologic studies reveal a malignancy.

[Results of treatment of superficial vesical tumors by transurethral resection alone and transurethral resection followed by an intravesical instillation of Calmette-Guerin bacillus]. / Résultat du traitement des tumeurs superficielles de la vessie par résection transuréthrale seule et résection transuréthrale suivie d'instillation endovésicale de bacille Calmette-Guérin.

Superficial bladder tumors treated at the Henri Mondor Hospital from 1984 through 1988 were analyzed for recurrence and progression using the following prognostic parameters: stage (TNM classification, 1978), grade (G1, G2, G3), size, number of tumors, and tumor malignancy index as defined by the Besançon group. Forty-five patients were treated with transurethral resection alone (TUR group) whereas 30 had TUR followed by the prophylactic instillation of fresh Calmette-Guérin bacillus in the bladder (BCG group). In TUR patients, parameters predictive of progression included grade G3, multiple tumors, stage T1, recurrence within 6 months of TUR, and a tumor malignancy index above 455. None of these criteria were predictive of a response to BCG. Results obtained in the BCG group were comparable to those reported in the literature and confirmed the efficacy of BCG instillations to prevent recurrence and progression of superficial carcinomas of the bladder.

[Detubulized Z-shaped +enterocystoplasty following total prostato-cystectomy]. / Entérocystoplastie détubulée en Z après prostato-cystectomie totale.

After the completion of the radical cystoprostatectomy and a thorough survey of the dissected pelvis, a small bowel segment 50 to 60 cm long is resected, 20 cm proximal to Bauhin's valve. The small bowel resected is left as it is and as we find it, without rotation folding or twist, forming a Z. It is incised at its antimesenteric border and then the ileal plate is formed with running 3/0 vicryl sutures. The urethra is anastomosed in the lower part of the pouch and there after each ureter is implanted directly in a very simple way. The ureteral catheters are brought directly through the anterior abdominal wall lateral to the rextus muscle. When the omentum is large enough and covers all the dissected pelvis, drainage of the operative site will not be necessary.

[Bilateral malignant mesothelioma of the tunica vaginalis testis. Apropos of a case]. / Mésothéliome malin bilatéral de la vaginale testiculaire. A propos d'un cas.

The authors report the first case of synchronous bilateral malignant mesothelioma of the tunica vaginalis. Despite bilateral radical orchidectomy completed by unilateral inguinal radiotherapy, the patient developed an uncontrolled recurrence three years after initial treatment of the second tumour. The prognosis of malignant mesothelioma is very poor with a median survival of 28 months reported in the literature.

[Can primary kidney clear cell adenocarcinoma be differentiated from kidney metastasis with computed tomography?]. / Peut-on différencier les adénocarcinomes rénaux primitifs à cellules claires des métastases rénales en tomodensitométrie?

PURPOSE: To determine if CT scan provides morphologic criteria allowing differentiation between primary renal cell cancer of the clear type (PRCCCT) and renal metastasis (RM). MATERIALS AND METHODS: Twenty cases of PRCCCT and 20 cases of RM from various origins (excluding lymphomatous origin) were retrospectively analyzed by two independent readers. CT scans were evaluated with respect to tumor size, shape, location and number of tumors, encapsulation, contour sharpness, presence of calcification, and extrarenal involvement by tumor. RESULTS: A tumor size > 3 cm was more frequently seen in PRCCCT than in RM (100% vs 70% respectively, P < .05). Rounded shape was more frequent in PRCCCT than in RM (90% vs 50% respectively, P < .01). Encapsulation was more frequent in PRCCCT than in RM (70% vs 10%, P < .01, respectively). Calcification was depicted only in PRCCCT (35% vs 0%, P < .01). Enlarged perirenal lymph nodes were less frequent in PRCCCT than in RM (20% vs 55% respectively, P < 0.05). CONCLUSION: Results of our study show that a constellation of morphologic features suggest the diagnosis of PRCCCT rather than that of RM. Our study suggests that calcification is highly specific for the diagnosis of PRCCCT. However, percutaneous biopsy remains indicated to ascertain the diagnosis.

[Isolated ureteral metastasis of prostatic adenocarcinoma. Apropos of a case]. / Métastase urétérale isolée d'un adénocarcinome de prostate. A propos d'un cas.

A ureteric tumour was discovered in a patient presenting with an episode of renal colic and a history of prostatectomy for prostatic adenocarcinoma. Segmental ureterectomy was performed. Histological examination showed a metastasis from prostatic adenocarcinoma. This is a rare site of secondaries: less than 40 cases have been reported in the literature, essentially based on autopsy series. Metastatic spread occurs via lymphatics or the blood stream, and the secondary tumour develops from the adventitia before invading the ureteric wall. Although this diagnosis may be suggested by the clinical features and imaging, it can only be confirmed by histology. After ureterectomy, treatment can combine all of the recognized treatment modalities against prostatic adenocarcinoma: endocrine therapy and adjuvant radiotherapy.

[T1 G3 bladder tumors: the respective role of BCG and cystectomy]. / Tumeur de vessie T1 G3: la place respective du B.C.G. et de la cystectomie.

Forty eight patients with T1 G3 bladder cancer were treated between 1975 and 1991. An associated carcinoma in situ in one third of cases. Twenty six patients received intravesical BCG instillations (an average of 2.5 courses of 6 instillations) with no local recurrence or metastases in 50% of cases (mean follow-up: 54 months). Thirteen patients developed recurrence after a mean disease-free interval of 8 months (range: 3 to 18 months: 7 with disease progression, 5 at an identical stage and 1 Ta. Six cystectomies were performed in this group over the following two years: 3 patients were cured with a mean follow-up of 33 months, 2 died from their cancer, 1 patient is alive with an urethral redux. In view of age and/or clinical context, 7 patients were treated by repeated resections and other local treatments: 3 relapsed without progression, 2 died from their cancer and 2 have been lost to follow-up. Twenty one cystectomies were performed as first-line treatment: 20 patients are recurrence-free with a mean follow-up of 47 months and one patient died from cancer within 6 months. T1 G3 bladder cancer should be considered to be a lesion with a poor prognosis, requiring active treatment. First-line BCG therapy is effective in 50% of cases, but cystectomy is required in the absence of response to BCG.

[Infectious risks of outpatient cystoscopy in men with sterile urine]. / Risques infectieux de la fibroscopie urétro-vésicale en ambulatoire chez l'homme à urines stériles.

OBJECTIVE: To prospectively assess the inherent risk of infection associated with outpatient cystoscopy performed in men with sterile urine without antibiotic prophylaxis. MATERIAL AND METHODS: 298 cystoscopies were performed in men corresponding to these criteria, with the exclusion of patients at risk of bacterial endocarditis. The equipment consisted of three cystoscopes prepared according to the recommendations of the Société Française d'Hygiène Hospitalière. The disease justifying the examination was specified for each patient. The sterility of the urine was verified during the week preceding the examination and 48 hours later by urine culture. RESULTS: Out of 281 evaluable patients, an infection was observed in 22 cases (7.8%), and was symptomatic in only one case. Escherichia coli was the organism most frequently isolated (50%) and no multiresistant bacteria were detected. A particularly high infection rate was observed in enterocystoplasty patients (21.7%). CONCLUSION: The infectious risk of cystoscopy in the presence of sterile urine, performed according to recommendations, appears to be higher than previously reported. This risk appears to be significantly higher in the case of enterocystoplasty than for other diseases.

[The absence of metabolic disorders 8 years after detubulized Z entero-cystoplasty]. / Absence de trouble métabolique 8 ans après entéro-cystoplastie en Z détubulée.

Intestinal resection can lead to decreased gastrointestinal absorption of various metabolic substances. The use of these intestinal segments as materials for urinary tract reconstruction can also induce metabolic disorders. The authors studied the long-term metabolic consequences of replacement enterocystoplasty after radical cystectomy for bladder cancer.

[Extra-corporeal lithotripsy in the treatment of Peyronie's disease. Use of a standard lithotriptor (Multiline Siemens) on "young" (less then 6 months old) plaques]. / Lithotripsie extra corporelle (LEC) dans le traitement de la maladie de La Peyronie. Utilisation d'un lithotripteur standard (Multiline Siemens) sur des plaques "jeunes" (moins de 6 mois).

OBJECTIVE: The treatment of La Peyronie disease is still controversial. ESWL has been recently proposed to treat symptomatic plaques. The results, although discordant and often based on subjective assessment criteria, appear to show a certain degree of efficacy on so-called young plaques, i.e. during the acute phase of the disease. This study was designed to evaluate the results obtained with a classical lithotriptor (Siemens Multiline) on plaques present for less than 6 months. MATERIAL AND METHOD: 26 patients were included in this prospective study. All presented a painful plaque on erection. The plaque was palpated under general anaesthesia and 0.5 to 2 ml of contrast agent were injected to allow radiological visualization. All patients received 3000 impacts at a power of 7 kilojoules in 1 session and all were reviewed 1 month and 3 months after the ESWL session. RESULTS: Treatment was perfectly tolerated. Among the 26 patients treated: 19 patients (73%) reported a very marked reduction of pain on erection and 8 (31%) reported a reduction of curvature on erection, but this reduction was demonstrated objectively (by tracing or photographs) for only 3 patients (11%). Seven patients (27%) experienced softening of the plaque. Six (37%) of the patients suffering from erectile dysfunction reported improvement of the quality of erection, as reflected by the HEF score. CONCLUSION: A standard lithotriptor can be used to treat La Peyronie plaques. ESWL appears to have a marked analgesic effect, but its efficacy on correction of curvature of the penis was not demonstrated in this study.

[Erectile dysfunction after radical prostatectomy: value of preoperative programming of intracavernous injections]. / Dysfonction érectile après prostatectomie radicale: intérêt de la programmation des injections intracaverneuses avant l'intervention.

OBJECTIVES: Vasoactive drugs used for self-administered intracavernous injections are currently the reference treatments for erectile dysfunction after radical prostatectomy. The acceptability of and compliance with this treatment often limit their use. This study analysed these two parameters as a function of the type of andrological management decided before radical prostatectomy. MATERIAL AND METHOD: From January 1996 to January 1997, 45 sexually active patients, aged 52 to 69 years, requiring radical prostatectomy without preservation of the nervi erigentes, for localized prostate cancer, were included in this prospective study. Before the operation all 45 patients were informed about the high risk of erectile dysfunction following radical prostatectomy. Fifteen patients (group 1) did not receive any particular advice concerning the management of erectile dysfunction after radical prostatectomy, but were possibly referred for an andrology consultation depending on their complaints. Fifteen patients (group 2) were systematically referred for an andrology consultation three months after radical prostatectomy for information about the available treatment options. For 15 patients (group 3), the andrology consultation (3 months after the operation) had been planned before radical prostatectomy to perform a test injection of prostaglandin E1. The injections, started before the operation in this group 3, therefore constituted an integral part of the global management of prostate cancer. All these patients were followed for at least 1 year in the urology department. RESULTS: Only 7 of the 15 patients of group 1 consulted an andrologist. Five of these patients received a test intracavernous injection versus 14 in group 2 and 15 in group 3. The 5 patients of group 1 who received an intracavernous injection accepted this modality as treatment versus 8 in group 2 and 12 in group 3. After one year, 4, 5 and 9 patients in groups 1, 2 and 3, respectively, continued intracavernous injections. CONCLUSION: The management of erectile dysfunction after radical prostatectomy must start with the decision to operate. Systematic encouragement to use intracavernous injections after radical prostatectomy helps to improve access to this treatment for impotence. The acceptability, and especially the compliance, appear to be better in patients in whom intracavernous injections were integrated into the global management of their prostate cancer.

[Mixed secretory and obstructive azoospermia. Transseptal vasovasostomy by vas deferens transposition: a case report and review of the literature]. / Azoospermie mixte sécrétoire et obstructive. Vasovasostomie trans-septale par transposition des déférents: à propos d'un cas et revue de la littérature.

The authors report a case of complex azoospermia in a 35-year-old man, due to a combination of right testicular atrophy and an iatrogenic lesion of the contralateral vas deferens. Vasovasostomy with transseptal transposition of the vasa deferens restored fertile ejaculation.

[Study of the Ki-67 antibody immunolabeling of renal adenocarcinomas with or without renal vein thrombosis]. / Etude de l'immuno-marquage des adénocarcinomes rénaux, avec et sans thrombose de la veine rénale, par l'anticorps Ki67.

OBJECTIVES: The objective of this study was to compare the proliferation index (immunolabelling by monoclonal antibody Ki67 - MIB-1) of renal cell carcinomas as a function of the presence or absence of renal vein thrombus. Analysis of the numbers of Ki67-positive nuclei can be used to assess the degree of aggressiveness of the cell populations of these various carcinomas (tumour without thrombus, tumour with thrombus and neoplastic thrombus). METHODS: Twenty three renal cell carcinomas with renal vein thrombus were matched for Furhman grade (1st degree), tumour volume (2nd degree) and the patient's age (3rd degree) with 23 renal cell carcinomas not presenting any vascular embolus on histology. Monoclonal antibody MIB-1 immunolabelling was performed on 69 paraffin-embedded specimens: 23 tumours with thrombosis, the 23 corresponding neoplastic thrombi and 23 tumours without vascular embolus. RESULTS: A correlation between Furhman grade and the percentage of immunolabelled nuclei was observed (mean: 2.67% for low-grade tumours and 14.34% for high-grade tumours). No labelling difference was observed between the two populations of primary tumours (with thrombus/without embolus). Primary tumours presented significantly weaker Ki67 labelling than their corresponding neoplastic thrombus (mean of 2.47% versus 10.3%, p < 0.01). CONCLUSION: This study shows that there is no difference of the proliferation index between tumours with neoplastic venous thrombus and those with no histological vascular embolus. However, a difference of proliferation index was observed between the primary tumour and its corresponding thrombus, which presented a statistically higher immunolabelling. This finding suggests that the thrombus possesses more dividing cells than the primary tumour, i.e. has a shorter doubling time.