Annoot A., Olivier J., Valtille P., Deken V., Leroy X., Puech P., Villers A.   Extra-target low-risk prostate cancer: implications for focal high-intensity focused ultrasound of clinically significant prostate cancer.  World J Urol.  2018

PURPOSE: To analyse the impact of the presence of extra-target non-clinically significant cancer (NCSC) after high-intensity focused ultrasound (HIFU) hemiablation on oncological results. To analyse radical treatment free survival (RTFS) rates at 2-3 years follow-up. METHODS: Retrospective single-centre study of 55 patients treated by primary HIFU hemiablation from 2010 to 2016. Inclusion criteria were unilateral MRI detected CSC, stage /= 7 or maximum cancer core length > 5 mm, any GS. RESULTS: Mean follow-up was 33 months (SD: 17-49 months). Presence or not of an extra-target NCSC in the untreated part of the gland had no impact on RTFS at univariate analysis (p = 0.29). 10 (18%) patients had a salvage whole-gland treatment after a median follow-up of 26 months (IQR 17-28). RTFS at 2 and 3 years were 92% and 80%. CONCLUSION: Presence or not of an extra-target NCSC in the untreated part of the gland had no impact on RTFS. NCSC lesion can be left untreated and actively monitored. RTFS was 80% at 3 years which support the concept of focal/partial treatment as a treatment option of CSC prostate cancer.

Aboukaïs R., Bonne N. X., Touzet G., Vincent C., Reyns N., Lejeune J. P.   Progression of vestibular schawnnoma after GammaKnife radiosurgery: A challenge for microsurgical resection.  Clin Neurol Neurosurg.  2018 ;168 :77-82

OBJECTIVE: We aimed to evaluate the outcome of patients who underwent salvage microsurgery for vestibular schwannoma (VS) that failed primary Gammaknife radiosurgery (GKS). PATIENTS AND METHODS: Among the 1098 patients who received GKS for the treatment of VS in our center between January 2004 and December 2012, the follow-up was organized in our institution for 290 patients who lived in our recruitment area. Tumor progression was noted in 23 patients. A salvage microsurgical resection was performed in 11 patients, who were included in our study. Grading of facial function was done according to the House & Brackman scale. RESULTS: The mean age at diagnosis was 50.2 years (19-68 years) and the mean follow-up was 9.4 years (4-13 years). The mean dose was 11.8Gy (11-12Gy) and the mean volume was 922mm3 (208-2500mm3). The mean period between GKS and diagnosis of tumor progression was 32 months (18-72 months). Concerning salvage microsurgery, complete resection was obtained in 8 patients. Small residual tumor on the facial nerve was deliberately left in 3 patients and no tumor progression was noted with a mean follow-up of 26 months. At last follow-up, facial nerve function was grade 1 in 4 patients, grade 2 in 3 patients, grade 3 in 1 patient and grade 4 in 3 patients. CONCLUSION: Salvage surgery of recurrent vestibular schwannoma after failed initial GKS remains a good treatment. However, facial nerve preservation is more challenging in this case and small tumor remnant could be sometimes deliberately left.

Leroy V., Templier C., Faivre J. B., Scherpereel A., Fournier C., Mortier L., Wemeau-Stervinou L.   Pembrolizumab-induced pneumonitis.  ERJ Open Res.  2017 ;3

Three cases of pembrolizumab-induced pneumonitis are described, two being consistent with organising pneumonia

Villers A., Puech P., Flamand V., Haber G. P., Desai M. M., Crouzet S., Leroy X., Chopra S., Lemaitre L., Ouzzane A., Gill I. S.   Partial Prostatectomy for Anterior Cancer:Short-term Oncologic and Functional Outcomes.  Eur. Urol..  2017 ;72 :333-342
Dabi Y., Uzan J., Bendifallah S., Ouldamer L., Lavoue V., Canlorbe G., Raimond E., Coutant C., Graesslin O., Collinet P., Bricou A., Darai E., Ballester M., Haddad B., Touboul C.   Prognostic value of local relapse for patients with endometrial cancer.  EJSO.  2017 ;43 :2143-2149

BACKGROUND: The objective of our study was to determine survival and prognostic factors associated with isolated local recurrence of endometrial cancer. METHODS: Data of 1229 patients with endometrial carcinoma treated between 2000 and 2012 were extracted from maintained databases of nine French University Hospitals as well as from the Senti-Endo trial. Patients with isolated central pelvic and vaginal recurrence were selected for further analysis. RESULTS: Two hundreds and twenty five patients recurred during the inclusion period, 20 with isolated central pelvic recurrence and 23 with vaginal recurrence. Patients without recurrence had initially significantly less lymphovascular space invasion (p = 0.01), less advanced diseases (>stage II) (p < 0.001) and more often low or intermediate risk tumours than patients with local recurrence. Local recurrence was statistically associated with better overall survival than non-local recurrence (p = 0.028) but dramatically decreased overall survival when compared to patients without any recurrence (p < 0.001). The site of recurrence, i.e. vaginal or central pelvic, was significantly associated with overall survival (p = 0.015). Patients without brachytherapy at initial management were more likely to have local recurrence of their disease when compared to those without recurrence (p = 0.03). None of the prognostics factors for survival in patients with local recurrence was statistically significant in multivariate analysis. CONCLUSIONS: Local recurrence is a key event in endometrial cancer evolution severely impacting overall survival. Better understanding of the factors associated with prolonged survival is mandatory to improve our management of these patients.

Vignion-Dewalle A. S., Baert G., Thecua E., Vicentini C., Mortier L., Mordon S.   Photodynamic therapy for actinic keratosis: Is the European consensus protocol for daylight PDT superior to conventional protocol for Aktilite CL 128 PDT?.  J. Photochem. Photobiol. B-Biol..  2017 ;174 :70-77
Vignion-Dewalle A. S., Baert G., Devos L., Thecua E., Vicentini C., Mortier L., Mordon S.   Red Light Photodynamic Therapy for Actinic Keratosis Using 37 J/cm(2): Fractionated Irradiation With 12.3mW/cm(2) After 30 Minutes Incubation Time Compared to Standard Continuous Irradiation With 75mW/cm(2) After 3 Hours Incubation Time Using a Mathematic.  Lasers Surg. Med..  2017 ;49 :686-697
Bruinsma S. M., Zhang L., Roobol M. J., Bangma C. H., Steyerberg E. W., Nieboer D., Van Hemelrijck M.   The Movember Foundation's GAP3 cohort: A profile of the largest global prostate cancer active surveillance database to date.  BJU Int..  2017 ;121 :737-744

OBJECTIVES: The Movember Foundation launched the Global Action Plan Prostate Cancer Active Surveillance (GAP3) initiative to create a global consensus on the selection and monitoring of men with low-risk prostate cancer (PCa) on active surveillance (AS). The aim of this study is to present data on inclusion and follow-up for AS in this unique global AS database. PATIENTS AND METHODS: Between 2014 and 2016, the database was created by combining patient data from 25 established AS cohorts worldwide (USA, Canada, Australasia, UK and Europe). Data on a total of 15 101 patients were included. Descriptive statistics were used to report patients' clinical and demographic characteristics at the time of PCa diagnosis, clinical follow-up, discontinuation of AS and subsequent treatment. Cumulative incidence curves were used to report discontinuation rates over time. RESULTS: At diagnosis, the median (interquartile range [IQR]) patient age was 65 (60-70) years and the median prostate-specific antigen level was 5.4 (4.0-7.3) ng/mL. Most patients had clinical stage T1 disease (71.8%), a biopsy Gleason score of 6 (88.8%) and one tumour-positive biopsy core (60.3%). Patients on AS had a median follow-up time of 2.2 (1.0-5.0) years. After 5, 10 and 15 years of follow-up, respectively, 58%, 39% and 23% of patients were still on AS. The current version of GAP3 has limited data on magnetic resonance imaging (MRI), quality of life and genomic testing. CONCLUSIONS: GAP3 is the largest worldwide collaboration integrating patient data from men with PCa on AS. The results will allow individual patients and clinicians to have greater confidence in the personalized decision to either delay or proceed with active treatment. Longer follow-up and the evaluation of MRI, new genomic markers and patient-related outcomes will result in even more valuable data and eventually in better patient outcomes.

Manfredi M., Mele F., Garrou D., Walz J., Fütterer J. J., Russo F., Vassallo L., Villers A., Emberton M., Valerio M.   Multiparametric prostate MRI: technical conduct, standardized report and clinical use. A narrative review.  Minerva Urol Nefrol.  2017 ;70 :9-21

Multiparametric prostate MRI (mp-MRI) is an emerging imaging modality for diagnosis, characterization, staging, and treatment planning of prostate cancer (PCa). The technique, results reporting, and its role in clinical practice have been the subject of significant development over the last decade. Although mp-MRI is not yet routinely used in the diagnostic pathway, almost all urological guidelines have emphasized the potential role of mp-MRI in several aspects of PCa management. Moreover, new MRI sequences and scanning techniques are currently under evaluation to improve the diagnostic accuracy of mp-MRI. This review presents an overview of mp-MRI, summarizing the technical applications, the standardized reporting systems used, and their current roles in various stages of PCa management. Finally, this critical review also reports the main limitations and future perspectives of the technique.

Tsodikov A., Gulati R., Heijnsdijk E. A. M., Pinsky P. F., Moss S. M., Qiu S., de Carvalho T. M., Hugosson J., Berg C. D., Auvinen A., Andriole G. L., Roobol M. J., Crawford E. D., Nelen V., Kwiatkowski M., Zappa M., Lujan M., Villers A., Feuer E. J., de Koning H. J., Mariotto A. B., Etzioni R.   Reconciling the Effects of Screening on Prostate Cancer Mortality in the ERSPC and PLCO Trials.  Ann. Intern. Med..  2017 ;167 :449-+

Background: The ERSPC (European Randomized Study of Screening for Prostate Cancer) found that screening reduced prostate cancer mortality, but the PLCO (Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial) found no reduction. Objective: To evaluate whether effects of screening on prostate cancer mortality relative to no screening differed between the ERSPC and PLCO. Design: Cox regression of prostate cancer death in each trial group, adjusted for age and trial. Extended analyses accounted for increased incidence due to screening and diagnostic work-up in each group via mean lead times (MLTs), which were estimated empirically and using analytic or microsimulation models. Setting: Randomized controlled trials in Europe and the United States. Participants: Men aged 55 to 69 (ERSPC) or 55 to 74 (PLCO) years at randomization. Intervention: Prostate cancer screening. Measurements: Prostate cancer incidence and survival from randomization; prostate cancer incidence in the United States before screening began. Results: Estimated MLTs were similar in the ERSPC and PLCO intervention groups but were longer in the PLCO control group than the ERSPC control group. Extended analyses found no evidence that effects of screening differed between trials (P = 0.37 to 0.47 [range across MLT estimation approaches]) but strong evidence that benefit increased with MLT (P = 0.0027 to 0.0032). Screening was estimated to confer a 7% to 9% reduction in the risk for prostate cancer death per year of MLT. This translated into estimates of 25% to 31% and 27% to 32% lower risk for prostate cancer death with screening as performed in the ERSPC and PLCO intervention groups, respectively, compared with no screening. Limitation: The MLT is a simple metric of screening and diagnostic work-up. Conclusion: After differences in implementation and settings are accounted for, the ERSPC and PLCO provide compatible evidence that screening reduces prostate cancer mortality. Primary Funding Source: National Cancer Institute.