Biomedical subjects

Vincent Ravery

Publications and source records attributed to Vincent Ravery.

22 records · Page 2Linked to original sources

PubMed2002

[Main grade of Gleason's 7 score of the surgical sample correlated with biologic progression in patients treated for total prostatectomy].

OBJECTIVES: To analyse the influence of the main grade of Gleason score 7 of the operative specimen correlated with the blood PSA level on the laboratory progression-free survival of patients treated by radical prostatectomy. MATERIALS AND METHODS: 331 patients consecutively treated by radical prostatectomy and presenting a Gleason score 7 were analysed. Exclusion criteria were the use of radiotherapy and/or preoperative and/or postoperative endocrine therapy. The main grade (3 or 4), histological stage, and blood PSA level were analysed for their predictive value of laboratory progression-free survival. The mean follow-up was 3.5 years (range: 13.6 to 72.8 months). Laboratory recurrence was defined by a PSA > 0.4 ng/ml. RESULTS: The main grade of Gleason score 7 was 3 in 199 (60%) patients and 4 in 132 (40%) patients with a mean follow-up of 3.6 years. Laboratory progression-free survival rates were 89% and 72% for main grades 3 and 4, respectively (p = 0.03). When the cancer was confined to the prostate, the progression-free survival rates were 96% and 88% for main grades 3 and 4, respectively (p = 0.01). For a PSA < 10 ng/ml, main grade 3 was associated with a better laboratory progression-free survival rate than main grade 4 (p = 0.0007). No difference in terms of laboratory progression was observed in the presence of extraprostatic extension or PSA > 10 ng/ml. CONCLUSION: A high correlation was observed between the main grade of Gleason score 7 and laboratory progression-free survival. Main grade 3 constituted a factor of better prognosis than main grade 4.

Disease Progression↗

PubMed2002

[Biopsies of the transitional zone: impact on the detection of prostatic cancer and prognostic value].

OBJECTIVE: To analyse the value of biopsies of the transitional zone (TZ) in the detection of prostate cancer and their prognostic value. METHODS: The authors reviewed the literature on directed biopsies of the TZ and discuss the most recent publications concerning the impact of these biopsies on prostatic cancer detection and the prognosis of cancers of the TZ. RESULTS: There are currently few arguments in favour of biopsies of the TZ during a first series of prostatic biopsies, as the incidence of cancers situated exclusively in the TZ is low and first-line biopsies of the TZ do not significantly increase the cancer detection rate. However, when a suspicion of cancer persists after a first series of negative biopsies, or in patients with a large prostate, biopsies of the TZ can be indicated, as some authors consider that they considerably increase the cancer detection rate. Some authors have suggested that cancers of the TZ have a better prognosis than peripheral cancers because of their more favourable histological characteristics. These results need to be confirmed on larger scale studies. CONCLUSIONS: There are two situations in which biopsies of the TZ have a potential value: (1) as a second-line investigation in the case of persistent suspicion of prostate cancer after a first series of negative peripheral biopsies; (2) in patients with a very large prostate. The prognosis of cancers situated exclusively in the TZ is still poorly known, and the management of this type of cancer must remain the same as that of peripheral cancer.

Biopsy↗

PubMed2002

[Renal tuberculosis and renal adenocarcinoma: a misleading association].

The association of renal cancer and renal tuberculosis is uncommon. While the incidental discovery of renal cell carcinoma in a tuberculous kidney is a classical finding, the discovery of tuberculous lesions after nephrectomy for cancer is exceptional. The authors describe the case of a patient operated for renal cancer in whom histological examination revealed associated renal tuberculosis.

Adenocarcinoma↗

PubMedDate not supplied

Prognostic value of EGF receptor and tumor cell proliferation in bladder cancer: therapeutic implications.

Changes in growth factor receptor expression may confer a growth advantage on tumour cells. Epidermal growth factor-receptor (EGF-R) has been associated with the genesis of bladder tumours. We sought a link between EGF-R expression and MIB-1 cell proliferation and examined their prognostic value in the progression of bladder cancer. Fresh frozen samples from 113 transitional cell carcinomas (TCC) of the bladder and 10 healthy bladders were studied by immunohistochemistry, using monoclonal antibodies for EGF-R expression and MIB-1 for cell proliferation. Qualitative and quantitative immunostaining were analyzed in relation to time to progression and compared with clinical and pathologic parameters for prognostic significance in univariate and multivariate analysis (stepwise logistic regression). EGF-R stained more intensively in invasive tumours. Median nuclear over-expression of MIB-1 was 28%. Progression free survival rate estimates (log rank test) were significantly lower in patients EGF-R positive and with MIB-1 score above 28% (P < 0.0001, P < 0.0001, respectively). Multivariate analysis indicated that MIB-1 immunostaining was the most significant independent variable and EGF-R expression had no additional prognostic value over clinical stage and grade and cell proliferation. The MIB-1 proliferation index is a stronger predictor of bladder tumour progression than is EGF-R over-expression. This marker yield significant prognostic information in addition to stage and grade and may be of value for the clinical management of superficial and invasive bladder carcinomas. The pattern of EGF-R immunostaining and its association with tumour progression makes it a candidate for antigrowth factor therapy.

Adult↗