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C Peyret

Publications and source records attributed to C Peyret.

At least 19 recordsLinked to original sources

[Limitations of ultrasonography in the detection of small cancers of the left kidney].

Renal ultrasound seems to be more difficult on the left than on the right side. In a retrospective analysis of 343 patients in whom a radical nephrectomy for renal tumor diagnosed by abdominal ultrasonography had been carried out, we analyzed the characteristics of these tumors. TNM classification was used. Right kidney tumors (n = 170) were smaller than the left ones (n = 172), 58 +/- 31.7 mm and 66.8 +/- 31.5 mm respectively, the difference being statistically significant (p = 0.01). Right kidney tumors of a less advanced stage (p < 0.05). Asymptomatic renal tumors were found more frequently on the right side (58.7%) than on the left (41.3%) (p = 0.03) and were smaller on the right (44 mm +/- 19.6 vs 54.5 mm +/- 27.2) (p = 0.04). In conclusion, Ultrasound exploration of the left kidney seems to be more difficult, mostly because the exploration of the right kidney is facilitated by the acoustic window of the liver.

Aged↗

Phenotypic and functional analysis of tumour-infiltrating lymphocytes from patients with renal cell carcinoma.

Twenty renal cell carcinomas were cultured in the presence of 200 IU/ml of recombinant interleukin-2; tumour-infiltrating lymphocytes (TIL) developed in 70% of cases; the phenotypic profile was heterogeneous in 11 TIL tested on day 30: 4 were mostly CD8 positive, 4 mostly CD4 and 3 showed CD4-CD8-CD56 mixed phenotypes. The cytotoxic activity was also heterogeneous, and no TIL developed a tumour-specific cytotoxic activity. The phenotypic profile and cytotoxic activity were also tested after thawing, and this study demonstrated that TIL can be frozen at the time of the nephrectomy, then thawed and cultured for the purposes of therapeutic trials when metastases appear. The differences between TIL derived from renal cell carcinoma and TI1 derived from melanoma are discussed.

Carcinoma, Renal Cell↗

[CD4 TIL (Tumor Infiltrating Lymphocytes) induce complete response in patients treated with IL-2 (Interleukin-2). Preliminary study].

This study analyzed clinical response induced by TIL in patients with renal cell carcinoma previously treated by interleukin-2. Six patients (4 men, 2 women, mean age 44.3 years) with measurable metastatic localizations have been treated by TIL reinjection (0.02 to 7.6 x 10(10) cells). TIL phenotype was a combination of CD4 and CD8 in 3 patients, predominantly CD4 in two patients and predominantly CD8 in one patient. Previous treatment by interleukin-2 induced one partial response, 2 stabilizations of the disease and 3 tumoral progressions. TIL led to an amelioration for 4 patients: 2 were in complete response, 2 were stabilized and 2 had tumoral progression and decreased. This study shows that CD4 TIL may improve an initially response induced by IL-2 therapy.

Adult↗

[Circumstances of the detection of kidney cancer. Current part of accidental discoveries].

Kidney cancer accounts for 3% of all cancers, with approximately 85% of tumors arising in the renal parenchyma (renal cell carcinoma). To evaluate the part of the incidental detection of the renal carcinoma, we performed a retrospective review of the 302 patients treated for this reason in our department between April 1981 and October 1992. For the purpose of a historical comparison, 2 periods of 6 years were compared: 1981-1986 and 1987-1992. During 1981 to 1992, 71 patients (25.8%) were totally asymptomatic, with a significant improvement of the incidentally detected tumors from 1981-1986 (15%) to 1987-1992 (33.7%) (p < 0.001). Renal ultrasonography, which is responsible for 97% of the incidental diagnosis, allow for a better detection in the right kidney (60.3% vs. 39.7% in the left kidney) (p < 0.05). Primary tumor size and clinical stage (with Robson or the TNM 1992 classification) were significantly smaller (47.3 +/- 19.9 mm for the asymptomatic group vs. 71.6 +/- 34.1 mm for the symptomatic tumors) and lower respectively, in the asymptomatic group than in the symptomatic group (p < 0.001). The five-year survival rate (actuarial method) of the incidental cases tended to the better for the asymptomatic cases (87.5% vs. 39% for the symptomatic tumors) (p < 0.05). Most of the authors agree that incidental diagnosis has led to lower tumor size and stage and possibly better survival rate compared to cases where the diagnosis was suspected clinically. However, prospective studies on a large scale are needed to evaluate the role of nephron sparing surgery for incidental cancer of the kidney. Nowadays, the treatment remains radical nephectomy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma, Clear Cell↗

[TULIP: transurethral ultrasound-guided laser-induced prostatectomy. One-year clinical results].

The TULIP (transurethral ultrasound-guided laser-induced prostatectomy) system combines a real-time ultrasound transducer and a Nd:YAG laser delivery system with a 1.064 microns wavelength within a 22 F urethral probe. The goal is to produce a coagulation necrosis of the prostatic parenchyma, with a subsequent elimination of tissue in the urine. 29 patients have been included in this study, and 13 have a minimal one year follow-up. No complication occurred. 2 patients underwent a transurethral resection of the prostate secondary to the TULIP treatment. All patients complained of irritative urinary symptoms (frequency, burning on urination...) in the days or weeks following the treatment, and suprapubic catheterization tube had to be left in place for a mean duration of 13.8 days. Inclusion/exclusion criteria and evaluation modalities have been the same as in the American national study published elsewhere. At one year, our success rate for at least one criteria has been 84.6%, but only 2 (15%) out of 13 patients have been successful both in symptom score and flow rate.

Aged↗

[TULIP: transurethral ultrasound-guided laser-induced prostatectomy. Clinical results after on year].

The TULIP (Transurethral Ultrasound-guided Laser-Induced Prostatectomy) system combines a real-time ultrasound transducer and a Nd:YAG laser delivery system with a 1.064 micron wavelength within a 22 F urethral probe. The goal is to produce a coagulation necrosis of the prostatic parenchyma, with a subsequent elimination of tissue in the urine. 29 patients have been included in this study, and 13 have a minimal one year follow-up. No complication occurred. 2 patients underwent a transurethral resection of the prostate secondary to the TULIP treatment. All patients complained of irritative urinary symptoms (frequency, burning on urination...) in the days or weeks following the treatment, and suprapubic catheterization tube had to be left in place for a mean duration of 13.8 days. Inclusion/exclusion criteria and evaluation modalities have been the same as in the American national study published elsewhere. At one year, our success rate for at least one criteria has been 84.6%, but only 2 (15%) out of 13 patients have been successful both in symptom score and flow rate.

Follow-Up Studies↗

[Retrograde endopyelotomy in the treatment of iterative stenoses of the pyeloureteral junction].

This work is a report on our preliminary experience with the treatment of iterative stenosis of the pyeloureteral junction (JPU) through a retrograde endoscopic approach. From June, 1991, to June, 1992, we used this method to operate 6 cases of failed surgical pyeloplasty due to abnormalities of the JPU. The success of this operation depends, on one hand, on the systematic dilatation of the intramural portion of the ureter, and on the other hand, on the possible installation of a double pigtail stent a few weeks before endopyelotomy. We have noted no complication. The stay in hospital lasted 3 days in average (2 to 5 days). Clinical and radiological results include: 4 successes, 1 improvement and 1 failure. The average time elapsed is of 9 months (6 to 18 months). This technique, which has a proven feasibility, is a good alternative for this indication, in the absence of associated calculi and particularly in women. Its efficacy remains to be demonstrated by larger series with a longer follow-up.

Endoscopy↗

[Renal oncocytoma. Retrospective study of 38 cases].

38 cases of renal oncocytoma were recognized at Cochin's hospital from 1982 to 1991. Accurate diagnosis was not possible before performing surgery. However, a benign tumor appearance on the preoperative morphologic investigations and an evocative peroperative macroscopic aspect of renal oncocytoma, allowed us to realize a conservative surgery in 4 cases. Follow-up of 27 patients (11 lost to follow-up) showed a benign clinical behaviour in all cases, de spite of invasion of the perirenal fat in 2 cases, and tumoral thrombosis of a proximal branch of the renal vein in 1 case. No metastases occurred after a mean follow-up of 32.5 months, within range from 11 to 101. Our experience as well as the literature leads us to believe that renal oncocytoma is a benign tumor. We conclude that conservative surgery must be systematically considered when peroperative histological examination assert the diagnosis of renal oncocytoma, especially when the tumoral diameter is less than 5 cm.

Adenoma↗

[Retroperitoneal benign schwannoma].

The authors report about one case of retroperitoneal benign schwannoma located near the right kidney and causing renovascular arterial hypertension. The diagnosis of benign schwannoma, which is unfrequent in the absence of Recklinghausen's disease, was established after the pathological study of the complete specimen including the right kidney.

Adult↗

[Association of angiomyolipoma and oncocytoma of the kidney. Apropos of two cases].

The association of an oncocytoma and of an angiomyolipoma within the same renal tumor is infrequent. The authors review the literature on the basis of two cases. Histogenesis and the clinicopathological analysis show that such an association is accidental. It makes up 0.5% of kidney tumors, and 1% of oncocytomas are associated with an angiomyolipoma. The risk to encounter a malignant tumor is of 25% in such cases.

Adenoma↗

[Urinary diversion by ureteral endoprosthesis during pregnancy].

Dilatation of the renoureteral cavities during pregnancy is a common occurrence, especially on the right side. Though generally asymptomatic, this dilatation can be unfrequently complicated by pain and/or urinary infections that may cause severe infectious and obstetrical complications. In such cases, drainage of the renal cavities may be indicated in very selected cases. The authors review their experience with renal bypass through an endoureteral prosthesis during pregnancy, and specify the technical aspects and the indications of this type of bypass.

Adult↗

Regulatory effects of interleukin-4 on tumor-infiltrating lymphocytes derived from human renal cell carcinoma.

We have studied the effects of interleukin-4 (IL-4) on the expansion, proliferation, phenotype, and antitumor activity of tumor-infiltrating lymphocytes (TIL) derived from human renal cell carcinoma. Cultures were obtained from three primary renal tumors and one group of tumor-invaded, regional lymph nodes. IL-4 induced a significant increase in lymphocyte expansion and proliferation, but the response was dependent on the concurrent dose of IL-2 in culture. Increased growth activity was only observed in those cultures receiving low doses (20 U/ml) of IL-2 (average increase of fold expansion of 6.5, P < 0.01) with no changes in growth activity in the high dose (1000 U/ml) cultures. The combination of low dose IL-2 and IL-4 (200 U/ml) promoted lymphocyte growth significantly better than high dose IL-2 alone, the current standard growth regimen for in vitro expansion of TIL. TIL grown in the presence of IL-4 significantly reduced the level of non-specific, non-major histocompatibility complex-restricted antitumor activity (P < 0.01 for allogeneic renal, nonrenal, and NK-sensitive K562 cells), while exhibiting no effect on the level of autologous killing. This is in contrast to previous findings of significant enhancement of autologous antitumor activity using IL-4 on tumor-specific, melanoma-derived TIL. We also evaluated the effects of irradiated autologous tumor stimulation (TIL:tumor ratio, 10:1) on TIL cultures. Addition of autologous tumor cells increased expansion and proliferation of all cultures regardless of concurrent lymphokines present in the culture media (average increase fold expansion of 2.21, P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinoma, Renal Cell↗

[Morbidity of radical prostatectomy for localized cancer of the prostate. Apropos of 100 cases].

Adenocarcinoma of the prostate is the most frequent cancer of male over 60 years of age. Radical prostatectomy is one of the preferred modes of treatment for localized stages. Surgical morbidity decreases with experience and consists mainly in bleeding and rectal injury. Delayed morbidity comprises loss of erection, anastomosis stricture, incontinence. A retrospective study of 100 patients is reported.

Aged↗

[Resection of a pyelonephritic small kidney by celiosurgery].

The authors report about the exeresis of a pyelonephrictic left small kidney with laparoscopic surgery. First a ureteral tube was inserted to facilitate detection of the ureter by laparoscopy possible after reclining the colon. Dissection of the ureter was taken up to the hilum and pedicle, which was severed between rows of clamps by means of the endoscopic GIA stafler. The operation lasted 4 hours and 30 minutes. The blood loss was minimal and the stay in hospital was of three days.

Adult↗

The effects of interleukin-6 on tumor-infiltrating lymphocytes derived from human renal cell cancer.

Tumor-infiltrating lymphocytes (TIL) are a heterogeneous population of T cells with potent antitumor activity against a wide variety of tumors. TIL from renal cell cancer (RCC) typically exhibit diminished growth and antitumor activity after four weeks in vitro. We have therefore investigated effects of varying doses of interleukin-6 (IL-6) (0, 25, 100 units/ml.) on in vitro expansion, proliferation, cytotoxicity, and expression of cell surface phenotypes of long term renal TIL cultures from three RCC patients. Among the various conditions tested, three of three TIL cultures displayed a mild increase in cell expansion when grown in IL-2 with the addition of 100 units/ml. of IL-6. Two of three TIL cultures grown in IL-2 and 100 U/ml. of IL-6 demonstrated enhanced proliferation as determined by 3H-thymidine uptake. TIL could not be isolated or maintained in vitro when grown in the presence of IL-6 alone without IL-2. IL-6 was also found to enhance the long term non-specific cytotoxicity against an allogeneic nonrenal tumor target. No consistent effect on autologous tumor-specific cytotoxicity was demonstrated. We conclude that IL-6, when used in combination with IL-2, may modestly enhance the long-term growth of RCC-derived TIL.

Carcinoma, Renal Cell↗

Autologous tumor-specific cytotoxicity of tumor-infiltrating lymphocytes derived from human renal cell carcinoma.

Conditions for generating and expanding cytotoxic tumor-specific, tumor-infiltrating lymphocytes (TIL) were studied to improve the efficacy of adoptive cancer immunotherapy. Thus, we have examined the growth and cytolytic patterns of bulk culture TIL from human renal cell carcinoma (RCC) cultured in low (20 U/ml) or high (1,000 U/ml) dose interleukin (IL)-2, with or without irradiated autologous tumor stimulation. By 55 days in culture, TIL grown in the presence of IL-2 without tumor stimulation lost their lytic activity, whereas those exposed to tumor stimulation maintained high levels of cytotoxicity against autologous and/or nonautologous tumor targets. Only TIL grown with low dose IL-2 and autologous tumor maintained long-term (over 4 months in culture) specific cytotoxicity against the autologous tumor, even upon cryopreservation and regrowth. These TIL were 88-97% and 80% positive for CD3 and CD8, with a persistent subset exhibiting CD4+ CD8+ double positive staining. Their specific cytotoxic activity was major histocompatibility complex Class I-restricted and inhibited by pretreating the TIL with anti-CD3 monoclonal antibody. TIL exposed to the four types of culture conditions, low or high dose IL-2, with or without irradiated autologous tumors, and exhibiting different lytic specificities, all expressed mRNA for interferon-gamma and tumor necrosis factor (TNF)-alpha, but not for IL-1-beta, IL-4, IL-6, and granulocyte-macrophage colony stimulating factor. The degree of TNF-alpha mRNA expression correlated with the degree of autologous tumor-specific cytotoxicity of these TIL. This initial report demonstrates that antigen-specific cytotoxicity against the autologous tumor does, in fact, exist within the RCC tumors.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibody Specificity↗