[The REVELA13 observatory to study new cases of bladder tumor among women living in Bouches-du-Rhône county]. / Rôle de l'observatoire REVELA13 dans l'épidémiologie des tumeurs de vessie des femmes dans les Bouches-du-Rhône.

INTRODUCTION: The REVELA13 observatory is a unique epidemiological tool listing the new cases of kidney tumors, bladder tumors and acute leukaemias in the Bouches-du-Rhône county (France). Aim was to exploit for the first time data from this observatory regarding new cases of bladder tumors≥T1 in women from 2012 to 2014. MATERIALS: This epidemiological study was observational and descriptive. Fifteen non-nominative variables from the REVELA13 database were analyzed in order to describe the clinical and pathological characteristics of the incident cases as well as their spatial and temporal distribution. The incidence rates expressed in new cases per year per 100000 inhabitants were standardized on the world age, calculated with 95 % confidence intervals and compared to national estimates for the same period. RESULTS: Incident bladder tumor cases were recorded in 291 women, corresponding to a standardized incidence on the world age of 3.85 [3.32-4.37] new cases per year per 100,000 population, 54 % higher than the national estimates of 2012 and 2015. Median age of diagnostic was 75.9 years. Sex ratio was 19.41 % (W/M). Tumors were predominantly non-muscle-invasive (52 %), high grade (69 %) and without associated carcinoma in situ (Cis) (49 %). The two most affected territories were Marseille and Aubagne-La Ciotat. CONCLUSION: The REVELA13 observatory has improved our epidemiological knowledge on female bladder tumors in Bouches-du-Rhône county and highlighted a local over incidence. LEVEL OF EVIDENCE: 3.

[Surgical treatment of La Peyronie's disease]. / Le traitement chirurgical de la maladie de Lapeyronie.

Lapeyronie disease is responsible for curvature of the penis, making sexual intercourse painful or even impossible. Surgical treatment can be proposed when the plaque has remained stable for at least 6 months and after failure of medical treatment. It is designed to restore erection allowing penetration. Examination after an intracavernous test allows assessment of the deformity and the quality of erection. These two objective parameters appear to be decisive in the choice of the most appropriate technique. Two types of methods are available: cavernoplasties (resection-plication of the tunica albuginea, excision-graft) and prosthesis implantations (semirigid, inflatable and flexible implants). This paper reviews the various surgical techniques and proposes a decisional flow-chart based on the results of the intracavernous test.

[What is the role of the correspondence of free PSA/total PSA in the staging of local prostate cancer? Series of 50 radical prostatectomy cases]. / Le rapport PSA libre/PSA total a-t-il sa place dans la stadification du cancer localisé de la prostate? A propos d'une série de 50 prostatectomies radicales.

OBJECTIVE: To refine the pretreatment staging of localized prostate cancers. MATERIAL AND METHOD: Prospective study on 50 total prostatectomy specimens from men with apparently prostate-confined adenocarcinoma. Preoperative assay of the free PSA/total PSA ratio and analysis of this ratio according to the presence of capsular effraction, capsular invasion and positive margins. RESULTS: Significant difference of this ratio according to the presence or absence of capsular effraction (13.2% versus 18.9%), capsular invasion (12.4% versus 17.5%) and positive margins (11.6% versus 16.3%). CONCLUSION: The free PSA/total PSA ratio can be useful for staging of prostate cancer, but this needs to be confirmed by a large-scale prospective study.

Prognostic significance of incidental renal cell carcinoma.

From 1980 to 1991, 236 patients with renal cell carcinoma were treated in our department. We studied the characteristics and the prognostic significance of 74 patients with incidental renal cancer in comparison with those with symptomatic tumors. The mean age of the patients was 59.8 years and the sex ratio 2 males/1 female. The incidence of incidental tumors increased from 14% in 1980 to 48% in 1991. Incidental tumors were discovered mainly during examination for cardiovascular diseases (26%), hepatobiliary diseases (22%) and general health examination (23%). Local tumoral stage and histologic grade were significantly lower for the incidental tumors than for symptomatic ones (p = 0.002 and p = 0.001). In the same way, the rates of the patients with metastases or nodal involvement were lower for those with incidental tumors than for those with symptomatic tumors (p = 0.008 and p = 0.001). The mean tumoral size was 5.7 +/- 3 cm for incidental tumors and 7.6 +/- 3.5 cm for symptomatic tumors (p = 0.0001). The survival was significantly different according to the circumstances of detection of the tumors (p < 0.001); the 5- and 10-year actuarial survival rates was 85% for the patients with incidental tumors and respectively 61 and 44% for the patients with symptomatic tumors. The multivariate analysis by Cox proportional hazard model showed three important and independent prognostic factors: the presence of metastases (relative risk (RR): 6.7), nodal involvement (RR: 4.6) and symptomatic tumors (RR: 1.7). The patients with incidental tumors had a better prognosis than those with symptomatic tumors because of lower tumoral size and local stage. The early diagnosis of renal cell carcinoma improved the prognosis of the patients.