Pierre-Olivier Faïs

Publications (2)6.06 Total impact

• Source

  Available from: Pierre Bigot

  Article: Influence of previous or synchronous bladder cancer on oncologic outcomes after radical nephroureterectomy for upper urinary tract urothelialcarcinoma.

  Géraldine Pignot, Pierre Colin, Marc Zerbib, François Audenet, Michel Soulié, Sophie Hurel, Francky Delage, Jacques Irani, Aurélien Descazeaud, Stéphane Droupy, François Rozet, Véronique Phé, Alain Ruffion, Jean-Alexandre Long, Sebastien Crouzet, Alain Houlgatte, Pierre Bigot, Laurent Guy, Pierre-Olivier Faïs, Morgan Rouprêt
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  ABSTRACT: OBJECTIVE: The objective of the study was to evaluate the effect of a history of bladder cancer (BC) or synchronous BC on the prognosis and survival of patients who have undergone radical nephroureterectomy(RNU). METHODS AND MATERIALS: Using a multi-institutional, retrospective database, we identified 662 patients with upper urinary tract urothelial carcinoma (UUT-UC) treated by radical nephroureterectomy, between 1995 and 2010. We analyzed clinicopathologic characteristics and outcomes according to the history of BC or concomitant BC or both, at the time of diagnosis. BC was evaluated as a prognostic factor for bladder recurrence and survival. RESULTS: Overall, 83 (12.5%) patients had previous BC, 62 (9.4%) exhibited concomitant BC, and 75 (11.3%) presented with both previous and current BC. A history of BC was less seen in women and nonsmokers (P<0.0001 and P = 0.013, respectively). The patients with associated BC had more tumors located in the ureter (P<0.0001), as well as more multiple locations in the upper tract (P<0.0001). The tumors without concomitant BC were more likely to be associated with locally advanced stages (P = 0.024). At a median follow-up time of 37.3 months, 31.4% of patients experienced BC recurrence and 2.9% developed contralateral upper tract tumor. Using multivariate analyses, the previous or synchronous BC (P = 0.01) and positive surgical margins (P = 0.03) are independent prognostic factors for BC recurrence. The metastasis-free survival and cancer-specific survival rates did not significantly differ according to the associated BC status. CONCLUSIONS: In patients without previous or concomitant BC, the upper tract tumors are more frequently localized in the renal pelvis and are associated with a more invasive status at the time of diagnosis. Nevertheless, the presence of UUT-UC without previous or synchronous BC did not significantly affect the survival rates after nephroureterectomy.
  Urologic Oncology 02/2013; · 3.22 Impact Factor
• Article: A proportion of hereditary upper urinary tract urothelial carcinomas are misclassified as sporadic according to a multi-institutional database analysis: proposal of patient-specific risk identification tool.

  François Audenet, Pierre Colin, David R Yates, Adil Ouzzane, Géraldine Pignot, Jean-Alexandre Long, Michel Soulie, Véronique Phé, Henri Bensadoun, Laurent Guy, Alain Ruffion, Antoine Valeri, Luc Cormier, Stéphane Droupy, Alexandre de La Taille, Fabien Saint, Pierre-Olivier Faïs, Alain Houlgatte, Olivier Cussenot, Morgan Rouprêt
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  ABSTRACT: Study Type - Diagnostic (exploratory cohort) Level of Evidence 3a What's known on the subject? and What does the study add? Hereditary non-polyposis colorectal cancer (HNPCC), also known as Lynch syndrome, is an autosomal dominant multi-organ cancer syndrome. Upper urinary tract urothelial carcinomas belong to HNPCC-related tumours and rank third within this group after colorectal and endometrial cancer. However, many urologists are not aware of this association and it is presumed that some hereditary cancers are misclassified as sporadic and that their incidence is underestimated. Consequently, family members of patients with upper urinary tract urothelial carcinomas secondary to HNPCC may be denied appropriate surveillance and early detection. A significant proportion of patients (21.3%) with newly diagnosed upper urinary tract urothelial carcinomas may have underlying HNPCC. Demographic and epidemiological characteristics suggest different mechanisms of carcinogenesis among this population. Recognition of such potential is essential for appropriate clinical and genetic management of patients and family. In order to help to identify these patients, we propose a patient-specific checklist. OBJECTIVE: •  To identify, based on previously described clinical criteria, hereditary upper urinary tract urothelial carcinomas (UUT-UCs) that are likely to be misclassified as sporadic although they may belong to the spectrum of hereditary non-polyposis colorectal cancer (HNPCC) associated cancers. PATIENTS AND METHODS: •  We identified, using established clinical criteria, suspected hereditary UUT-UC among 1122 patients included in the French national database for UUT-UC. •  Patients were considered at risk for hereditary status in the following situations: age at diagnosis <60 years with no previous history of bladder cancer; previous history of HNPCC-related cancer regardless of age; one first-degree relative with HNPCC-related cancer diagnosed before 50 years of age or two first-degree relatives diagnosed regardless of age. RESULTS: •  Overall, 239 patients (21.3%) were considered to be at risk of hereditary UUT-UC. •  Compared with sporadic cases, hereditary cases are more likely to be female (P= 0.047) with less exposure to tobacco (P= 0.012) and occupational carcinogens (P= 0.037). A greater proportion of tumours were located in the renal pelvis (54.5% vs 48.4%; P= 0.026) and were lower grade (40% vs 30.1%; P= 0.015) in the hereditary cohort. •  The overall, cancer-specific and recurrence-free survival rates were similar in both cohorts. •  We propose a patient-specific risk identification tool. CONCLUSIONS: •  A significant proportion (21.3%) of patients with newly diagnosed UUT-UC may have underlying HNPCC as a cause. •  Recognition of such potential and application of a patient-specific checklist upon diagnosis will allow identification and appropriate clinical and genetic management for patient and family.
  BJU International 06/2012; · 2.84 Impact Factor