V Ravery

Paris Diderot University, Lutetia Parisorum, Île-de-France, France

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Publications (248)661.2 Total impact

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    ABSTRACT: To define immunoscore in bladder cancer studying T helper 1 (Th1) immunoreaction. To define a cancer-specific survival model based on Th1 cells infiltration. A total of 252 patients underwent primary transurethral resection of bladder tumour at our Institution. A retrospective review of a selected cohort with pT1 and muscle-invasive bladder cancer (MIBC) lesions was performed. Pathology blocks were marked with CD3 and CD8 antibodies. Immune cells density in stromal reaction (SR) was measured on five distinct high-power field (HPF) by two dedicated uro-pathologist blinded for patients' evolution. Student test or non-parametric Wilcoxon test as appropriate to compare means between two groups. Receiver operating characteristics (ROC) curve to define markers threshold. Cox model to assess survival's predictors. Ten pT1 and 20 MIBC consecutive cases were analysed. Median follow-up was 33.4 months. Immunohistological analysis for pT1 lesions featured limited SR. For MIBC, the mean density of lymphocytes in the SR was of 105/HPF (CD3) and 86/HPF (CD8). Survivors harboured higher lymphocytes densities versus non survivors (CD3: p = 0.0319; CD8: p = 0.0279). CD3 (p = 0.034) and CD8 (p = 0.034) lymphocytes densities were independently associated with cancer-specific survival on Cox model analyses. The retrospective design and small size of cohorts are the study limitations. High CD3 and CD8 lymphocytes SR densities are associated with better cancer-specific survival for MIBC. Th1 reaction against the tumour seems to be protective for bladder cancer. Further evaluation is warranted.
    ecancermedicalscience 12/2014; 8:486. DOI:10.3332/ecancer.2014.486 · 1.20 Impact Factor
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    ABSTRACT: Introduction and objective Compared to the 2007 edition, the 2010 French urological association onco-urology guidelines boarded the indications of partial nephrectomy (PN) as long as the procedure is technically feasible. The aim of this study was to assess national practice with respect to kidney surgery in the 2 years before and after current guidelines. Materials and methods The national database of the Agence Technique de l’Information sur l’Hospitalisation (ATIH) was queried for procedures performed between 2009 and 2010 (era 1) and between 2011 and 2012 (era 2). The coding system of the Classification Commune des Actes Médicaux (CCAM) was used to extract kidney related procedures. For each era, procedures were sorted into partial versus radical nephrectomy (RN), laparoscopic/robotic versus open approach, and private versus public hospital. The two eras were then compared. Results Overall, 28,000 and 28,907 procedures were reported in era 1 and 2 with mean 14,000 and 14,450 procedures per year respectively. PN increased from 30% to 35% (P < 0.0001) between the two eras. This uptake was similar in public and private hospitals. Accordingly, laparoscopic/robotic approach has significantly increased between the two eras (35% versus 39%, P < 0.0001) and even more importantly in public hospitals (P = 0.0017). There was a significant increase in laparoscopic/robotic PN as well as a decrease in open RN over the years of the study period. Conclusion This study showed the development of PN and the minimally invasive approach. Over the study period, minimally invasive procedure uptake was higher in public hospitals.
    Progrès en Urologie 04/2014; 24(5):257–261. DOI:10.1016/j.purol.2013.08.033 · 0.77 Impact Factor
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    ABSTRACT: Compared to the 2007 edition, the 2010 French urological association onco-urology guidelines boarded the indications of partial nephrectomy (PN) as long as the procedure is technically feasible. The aim of this study was to assess national practice with respect to kidney surgery in the 2years before and after current guidelines. The national database of the Agence Technique de l'Information sur l'Hospitalisation (ATIH) was queried for procedures performed between 2009 and 2010 (era 1) and between 2011 and 2012 (era 2). The coding system of the Classification Commune des Actes Médicaux (CCAM) was used to extract kidney related procedures. For each era, procedures were sorted into partial versus radical nephrectomy (RN), laparoscopic/robotic versus open approach, and private versus public hospital. The two eras were then compared. Overall, 28,000 and 28,907 procedures were reported in era 1 and 2 with mean 14,000 and 14,450 procedures per year respectively. PN increased from 30% to 35% (P<0.0001) between the two eras. This uptake was similar in public and private hospitals. Accordingly, laparoscopic/robotic approach has significantly increased between the two eras (35% versus 39%, P<0.0001) and even more importantly in public hospitals (P=0.0017). There was a significant increase in laparoscopic/robotic PN as well as a decrease in open RN over the years of the study period. This study showed the development of PN and the minimally invasive approach. Over the study period, minimally invasive procedure uptake was higher in public hospitals.
    Progrès en Urologie 04/2014; 24(5):257-61. DOI:10.1016/j.purol.2013.09.027 · 0.77 Impact Factor
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    ABSTRACT: The sub Comittee prostate of the CCAFU established guidelines for diagnostic, treatment, evaluation and standart of care of prostate cancer. Guidelines 2010 were updated based on systematic literature search performed by the sub-Comittee in Medline and PubMed databases to evaluate references, levels of evidence and grade of recommandation. Pathological examination of the tissue specimens was defined specifically for Gleason score according to ISP 2005 recommandations. Prostate and pelvis RMN became the reference in terms of radiological exam. Individual and early diagnosis of prostate cancer was defined and role of PSA was precised. Active surveillance became one of the standart of care of low-risk tumors, radical prostatectomy remained one of the options for all risk group tumors, length of hormonotherapy in association with radiotherapy was precised according to the risk group. Side effects of hormonotherapy treament needed specific supervision ; hormonotherapy had no indication in case of non metastatic tumors and intermittent hormonotherapy in metastatic tumors. New hormonal drugs in pre and post chemotherapy and bone target drugs opened new therapeutics pathways. From 2010 to 2013, standarts of care of prostate cancer were modified because of results of prospective studies and new therapeutics. They allowed precise treatments for each specific clinical situation. In the future, multidisciplinary treatments for high risk tumors, time of adjuvant treatment and sequencies of new hormonal treatment had to be defined.
    Progrès en Urologie 11/2013; 23 Suppl 2:S69-S101. DOI:10.1016/S1166-7087(13)70048-4 · 0.77 Impact Factor
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    ABSTRACT: The purpose of this study was to evaluate morbidity, functional, and oncological outcomes after NSS in renal tumors > 7 cm. We retrospectively analyzed data from 168 patients with tumors > 7 cm who were treated using NSS between 1998 and 2012. Imperative and elective indications accounted for 76 (45.2%) and 92 (54.8%) patients, respectively. Major perioperative complications and renal function deterioration occurred in 33 (19.6%) and 51 patients (30.4%), respectively. In multivariate analysis, age older than 60 years (P = .001; hazard ratio [HR], 5) and tumor malignancy (P = .014; HR, 6.7) were prognostic factors for renal function deterioration whereas imperative indication was a risk factor for major postoperative complications (P = .0019; HR, 2.7). In 126 (75%) patients with malignant tumors, after a median follow-up of 30 months (range, 1-254 months), 25 patients (20.2%) died. In multivariate analysis, imperative indication (P = .023; HR, 4.2), positive surgical margin (P = .021; HR, 3.3), and Fuhrman grade > II (P = .013; HR, 3.7) were prognostic indicators for cancer-free survival (CFS). Imperative indication (P = .04; HR, 8.5) and Fuhrman grade > II (P = .04; HR, 3.9) were predictive factors of cancer-specific survival (CSS). In case of elective indication, positive surgical margin, local recurrence, and cancer-related death occurred in 4 (7.6%), 1 (1.1%), and 1 (1.1%) cases, respectively. For elective indication, 5-year estimates of CFS, CSS, and overall survival rates were: 85.7%, 98%, and 93.9%, respectively. In this selected population, imperative vs. elective indication status seems to play a critical role in oncologic outcomes. Oncologic results for elective indications are close to those reported with radical nephrectomy.
    Clinical Genitourinary Cancer 09/2013; DOI:10.1016/j.clgc.2013.09.004 · 1.69 Impact Factor
  • Vincent Ravery
    European Urology 08/2013; 64(2):337. DOI:10.1016/j.eururo.2013.05.009 · 12.48 Impact Factor
  • Annales de Pathologie 08/2013; 33(4):298-300. · 0.29 Impact Factor
  • Annales de Pathologie 08/2013; 33(4):298–300. DOI:10.1016/j.annpat.2013.06.008 · 0.29 Impact Factor
  • Amine Benchikh, Vincent Ravery
    La Revue du praticien 04/2013; 63(4):478.
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    European Urology Supplements 03/2013; 12(1):e87–e88. DOI:10.1016/S1569-9056(13)60579-5 · 3.37 Impact Factor
  • Article: Reply.
    Urology 01/2013; 81(1):16. DOI:10.1016/j.urology.2012.06.086 · 2.13 Impact Factor
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    ABSTRACT: Objective Recently, new agents have been developed in the treatment of prostate cancer. Our aim was to review phase III studies that involved novel agents in the treatment of castration resistant prostate cancer. Methods PubMed databases were searched for original articles published with the search terms: prostate cancer, castration resistant, metastatic, targeted therapy, biologic agents, immunotherapy and clinical trials. Proceedings from 2008 of conferences of the American Society of Clinical Oncology, American Urological Association, and the European Association of Urology were also searched. We included phase III studies that involved: abiraterone, MDV 3100, cabazitaxel, sipuleucel-T, radium-223, and denosumab. Results Abiraterone and MDV 3100 are two new hormotherapies that showed an increased overall survival of 15 and 18 months respectively before after docetaxel based chemotherapy in randomized trials. Cabazitaxel became the standard second line chemotherapy after docetaxel. Sipuleucel-T has emerged as the first approved vaccine in prostate cancer. It showed a 22 % reduction of mortality and a prolonged survival time of 4.1 months compared to placebo. A radium-223 based metabolic radiotherapy has showed a better overall survival, delayed and reduced skeletal-related events in placebo controlled randomized trials. Denosumab also delayed the first skeletal-related event in a zoledronic acid controlled trial (20.7 versus 17.1 months, P = 0.0002). Moreover, Denosumab delays bone metastases by 4.1 months compared to placebo. Conclusion The novel agents that emerged in the treatment of prostate cancer showed an efficacy in placebo controlled trials. They added new tools in the armamentarium of therapies of castration resistant prostate cancer.
    Progrès en Urologie 01/2013; 23(1):1–7. DOI:10.1016/j.purol.2012.07.007 · 0.77 Impact Factor
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    ABSTRACT: We evaluated the effect of the presence of a double J stent on the efficacy of extracorporeal shock wave lithotripsy (ESWL) in the treatment of lumbar ureteral stones. Between January 2007 and February 2012, we performed a retrospective cohort study. Forty-four patients were treated by ESWL for lumbar ureteral stones and included into two groups for the analysis: group 1, non-stented (n = 27) and group 2, stented patients (n = 17). Treatment efficacy was evaluated by abdominal X-ray or CT-scan at 1 month. Stone-free patients and those with a residual stone ≤4 mm were considered to be cured. Mean stone size and density in groups 1 and 2 were 8.2mm/831HU, and 9.7 mm/986HU respectively. Both groups were comparable for age, BMI, stone size and density, number, and power of ESWL shots given. The success rates in groups 1 and 2 where 81.5% and 47.1%, respectively (p = 0.017). There was no difference between the groups for stones measuring 8 mm or less (p = 0.574). For stones >8 mm, the success rates were respectively 76% and 22.2% for groups 1 and 2 (p = 0.030). Logistic regression analysis revealed a higher failure rate when a double J stent was associated with a stone >8 mm (p = 0.033). The presence of a double J stent affects the efficacy of ESWL in the treatment of lumbar ureteral stones. This effect is significant for stones >8 mm. Ureteroscopy should be considered as the first-line treatment in such patients.
    01/2013; 66(3):309-13. DOI:10.5173/ceju.2013.03.art14
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    ABSTRACT: To assess the quality of specimens obtained from prostate biopsies performed by urology residents and evaluate the number of procedures required to perform high-quality transrectal ultrasound (TRUS)-guided prostate biopsies. Between 2006 and 2009, 770 patients underwent TRUS-guided prostate biopsies in our academic center. During the 6 semesters of this period, 24 residents (4 per semester) performed 1 session of 5.6 ± 1.5 procedures each month for a total of 33.6 ± 9 procedures during the study. The first session was performed with a senior urologist. Prostate cancer detection rate and standards of quality (average length of prostatic core biopsy specimens and absence of prostatic tissue) were retrospectively studied between the beginning and the end of each semester. A total of 12,760 biopsy cores were performed for 770 procedures. Mean patient age (64.5 ± 6.1 years), and median prostate-specific antigen (8.7 ± 3.7 ng/mL) were comparable between the study periods. The average length of biopsy cores significantly improved (+10%) from the first (12 ± 2.7 mm) to the last month (13.2 ± 2.1 mm) with a plateau after 12 procedures. Overall, cancer detection rate was 47% and was stable during the semester (41.3% the first month vs 44.1% the last month; P = .39). On univariate and multivariate analysis the mean length of biopsy specimens was associated with the number of procedures (P <.001) and the number of cores performed (P <.001). Twelve procedures are necessary to perform high-quality TRUS-guided prostate biopsies without compromising prostate cancer detection. In current training programs, we strongly recommend that residents have direct supervision for a minimum of 12 cases before they are allowed to perform TRUS-guided biopsies with indirect supervision.
    Urology 01/2013; 81(1):12-6. DOI:10.1016/j.urology.2012.06.084 · 2.13 Impact Factor
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    ABSTRACT: Recently, new agents have been developed in the treatment of prostate cancer. Our aim was to review phase III studies that involved novel agents in the treatment of castration resistant prostate cancer. PubMed databases were searched for original articles published with the search terms: prostate cancer, castration resistant, metastatic, targeted therapy, biologic agents, immunotherapy and clinical trials. Proceedings from 2008 of conferences of the American Society of Clinical Oncology, American Urological Association, and the European Association of Urology were also searched. We included phase III studies that involved: abiraterone, MDV 3100, cabazitaxel, sipuleucel-T, radium-223, and denosumab. Abiraterone and MDV 3100 are two new hormotherapies that showed an increased overall survival of 15 and 18 months respectively before after docetaxel based chemotherapy in randomized trials. Cabazitaxel became the standard second line chemotherapy after docetaxel. Sipuleucel-T has emerged as the first approved vaccine in prostate cancer. It showed a 22 % reduction of mortality and a prolonged survival time of 4.1 months compared to placebo. A radium-223 based metabolic radiotherapy has showed a better overall survival, delayed and reduced skeletal-related events in placebo controlled randomized trials. Denosumab also delayed the first skeletal-related event in a zoledronic acid controlled trial (20.7 versus 17.1 months, P=0.0002). Moreover, Denosumab delays bone metastases by 4.1 months compared to placebo. The novel agents that emerged in the treatment of prostate cancer showed an efficacy in placebo controlled trials. They added new tools in the armamentarium of therapies of castration resistant prostate cancer.
    Progrès en Urologie 01/2013; 23(1):1-7. · 0.77 Impact Factor
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    ABSTRACT: Treatments of pelvic organ prolapse are pelvic floor rehabilitation, surgery by abdominal or vaginal route, with or without prosthesis, and pessaries. Since last decade, increasing elderly patients seen for pelvic organ prolapse require to redefine the place of the obliterative vaginal surgery, among the existent surgical procedures. Our objectives were to describe the morbidity associated with colpocleisis, to determine the anatomical results of colpocleisis, and patient's satisfaction. Retrospective case series of 27 patients who underwent a vaginal closure (Lefort) between 2004 and 2010. Twenty-seven patients underwent an obliterative vaginal surgery for genital prolapse. The mean age was 79years (range 74.5-82.5). The mean surgical time was 70minutes (range: 60-87.5). We did not notice any per-surgical complication. During follow-up (median: 3years, extremes: 1-10years), the global satisfaction rate was 94%. Objective cure rate, defined as the absence of prolapse to the hymen, was 96% (26/27). Only one (3.7%) case of pelvic organ prolapse recurrence occurred and needed surgery. The current study showed that Lefort colpocleisis technique was associated with a good patients' satisfaction and functional results in a population aged over 75.
    Progrès en Urologie 12/2012; 22(17):1071-6. DOI:10.1016/j.purol.2012.09.021 · 0.77 Impact Factor
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    ABSTRACT: Objective To assess the frequency, circumstances, and possible medico-legal consequences of the pT0 prostate cancer, defined by the absence of tumor in a radical prostatectomy specimen. Methods Six centers retrospectively identified all cases of pT0 and selectionned those that occurred without prior hormone therapy or prostate resection. Preoperative data, histological report and clinical and biological outcome were analyzed. The lawsuits’ registry in pathology were consulted at insurance companies. Results Thirty cases of pT0 prostate cancer (0.4%) were reported on 7693 patients. The median age was 63 years, PSA 7.4 ng/mL. The number of positive preoperative biopsies ranged from one to four for a median tumor length of 1 mm (0.3 to 18 mm). The biopsy Gleason score was 3 + 3 for 23 patients, less than 5 for six others and included a contingent of grade 4 in two patients. With a median follow-up of 82 months, no clinical or biochemical recurrence was observed. One patient complaint for pT0 prostate was found in the insurances registry. Conclusion The occurrence of a prostate pT0 called into question all the diagnostic procedures and surgical indication. To avoid a forensic procedure, urologists should inform patients of the possibility of this situation before radical prostatectomy.
    Progrès en Urologie 12/2012; 22(16):1021–1025. DOI:10.1016/j.purol.2012.07.018 · 0.77 Impact Factor
  • Progrès en Urologie 11/2012; 22(13):748–749. DOI:10.1016/j.purol.2012.08.022 · 0.77 Impact Factor
  • European Urology Supplements 11/2012; 11(5):218. DOI:10.1016/S1569-9056(13)60453-4 · 3.37 Impact Factor

Publication Stats

3k Citations
661.20 Total Impact Points

Institutions

  • 2010–2014
    • Paris Diderot University
      Lutetia Parisorum, Île-de-France, France
  • 1996–2014
    • Hôpital Bichat - Claude-Bernard (Hôpitaux Universitaires Paris Nord Val de Seine)
      • Service d’Urologie
      Lutetia Parisorum, Île-de-France, France
  • 2006–2013
    • Assistance Publique – Hôpitaux de Paris
      Lutetia Parisorum, Île-de-France, France
  • 2011
    • Hospital São José
      Cresciúma, Santa Catarina, Brazil
  • 2009
    • Centre Hospitalier Universitaire de Toulouse
      • Service d'Urologie - Transplantation Rénale - Andrologie
      Toulouse, Midi-Pyrenees, France
  • 2008
    • Medical University of Vienna
      Wien, Vienna, Austria
    • Université René Descartes - Paris 5
      Lutetia Parisorum, Île-de-France, France
  • 1993–2008
    • Hôpital Henri Mondor (Hôpitaux Universitaires Henri Mondor)
      Créteil, Île-de-France, France
  • 2007
    • Drug Study Institute
      Юпитер, Florida, United States
  • 2001–2007
    • University of Vienna
      • Institute of Cancer Research
      Wien, Vienna, Austria
  • 2005
    • Université Paris-Est Créteil Val de Marne - Université Paris 12
      Créteil, Île-de-France, France
  • 2002
    • University of Hamburg
      Hamburg, Hamburg, Germany