Paul Perrin

It has been suggested that urinary PCA3 and TMPRSS2:ERG fusion tests and serum PHI correlate to cancer aggressiveness-related pathological criteria at prostatectomy. To evaluate and compare their ability in predicting prostate cancer aggressiveness, PHI and urinary PCA3 and TMPRSS2:ERG (T2) scores were assessed in 154 patients who underwent radical prostatectomy for biopsy-proven prostate cancer. Univariate and multivariate analyses using logistic regression and decision curve analyses were performed. All three markers were predictors of a tumor volume ≥0.5 mL. Only PHI predicted Gleason score ≥7. T2 score and PHI were both independent predictors of extracapsular extension (≥pT3), while multifocality was only predicted by PCA3 score. Moreover, when compared to a base model (age, digital rectal examination, serum PSA, and Gleason sum at biopsy), the addition of both PCA3 score and PHI to the base model induced a significant increase (+12%) when predicting tumor volume >0.5 mL. PHI and urinary PCA3 and T2 scores can be considered as complementary predictors of cancer aggressiveness at prostatectomy.

Sarcoidosis is a multisystemic, non-caseous, benign granulomatous disease of unknown etiology that is sometimes associated with testicular cancer. This association, which does not appear to be accidental, can give rise to diagnostic problems because adenopathies or parenchymatous pulmonary nodules related to sarcoidosis can lead to the presumption of metastatic testicular cancer. The objective of this article was to assess the clinical, histological, and radiological characteristics of the association between sarcoidosis and testicular cancer to help clinicians avoid potentially fatal diagnostic traps and management errors. Literature review. A total of 64 cases of sarcoidosis concomitant with testicular cancer were described in the literature. In more than 50% of the cases (35/64), testicular cancer was diagnosed before sarcoidosis or sarcoid-like reaction. Cancer was diagnosed concomitantly in 31% of cases (20/64). Every anatomopathological type of testicular tumor was described in association with sarcoidosis. Seminoma was the most frequent tumor, occuring in 62% (40/64) of patients. In 80% of the cases (51/64) sarcoidosis regressed spontaneously. Testis cancer may be accompanied by a sarcoid-like reaction or can be associated with real sarcoidosis. The association of testicular cancer with sarcoidosis did not change the therapeutic management of either of these two pathologies. The presence of sarcoidosis does not change the cancer prognosis. Sarcoidosis is a benign disease that resolved favorably and spontaneously in 80% of the cases.

The IPSS score is a self-administered questionnaire considered to be the reference instrument to evaluate the impact of lower urinary tract symptoms in men. However; patients may encounter difficulties answering the standard questionnaire. This study was designed to analyse whether modification of these "standard" (or numerical, N) items by a choice of literal (L) answers induced any modifications of the psychometric characteristics of the IPSS questionnaire. This prospective single-centre study compared the two questionnaires applied in the same order to a cohort of 109 patients with voiding disorders. These questionnaires were administered to the patients on two occasions at an interval of 15 days. Cronbach's coefficient alphas calculated on D0 were 0.78 (L) and 0.81 (N). Pearson's correlation coefficients between the two IPSS scores on D0 and D15 were high (0.89 and 0.95). The comparison of the N and L questionnaires shows a mean difference -0.25 between the scores with a normal fluctuation interval [-7.6; 7.1] on D0 and -0.89 [-6.3; -4.5] on D15. Test-retest on the 15th day showed a good correlation for the two questionnaires (0.87 for N and 0.85 for L). The proposed modification of the choice of answers to the IPSS questionnaire does not alters its psychometric qualities. Patients appear to prefer the literal version of the questionnaire compared to the standard questionnaire (62% versus 31%).