Saint Doulchard

Minimally invasive surgery has greatly changed surgical practices since the 1980s, especially in urology where laparoscopy and robot-assisted surgery have advanced treatment of conditions like prostate cancer. In France and other countries, robotic surgery became widespread without strong studies confirming its benefits or guidelines on quality and access. This trial aims to carefully evaluate robot-assisted prostate removal compared to traditional laparoscopic and open surgery techniques to provide clear evidence for patients and healthcare decision-makers. Participants will undergo radical prostatectomy using one of three approaches: robot-assisted laparoscopy, conventional laparoscopy, or open surgery (laparotomy). Urinary and erectile functions will be assessed before and after surgery to compare outcomes across the three groups. This large prospective study is conducted at multiple centers to gather reliable data on the benefits and impacts of each surgical method. During the study, patients will be evaluated for urinary function using the EPIC 50 score 45 days after surgery. Researchers will also assess erectile and urinary functions before and after the prostatectomy. The study focuses on understanding how each surgical technique affects recovery and function, helping to inform patients and health authorities about the real advantages of robot-assisted surgery. Participants must be hospitalized for planned radical prostatectomy and will be monitored throughout their treatment and recovery.

Hemorrhoidal disease causes symptoms like pain, bleeding, prolapse, or oozing when the hemorrhoids inside or around the anus become troublesome. This research compares two minimally invasive treatments for hemorrhoidal disease grade II or III after other medical treatments have failed. It aims to evaluate quality of life improvements and safety between radiofrequency treatment and arterial ligation with recto-anal repair using Doppler guidance. The study evaluates the Rafaelo radiofrequency technique, which uses a low-temperature 4 MHz radiofrequency wave delivered by a special needle to treat hemorrhoidal blood vessels. The comparison treatment is arterial ligation followed by recto-anal repair guided by Doppler to reduce blood flow to hemorrhoids without blocking venous return. Both methods are minimally invasive surgical options. Participants will be adults aged 18 to under 75 years with hemorrhoidal disease grade II or III. Researchers will assess quality of life improvements one month after the procedure to compare treatments. The study also monitors safety and treatment tolerance. Eligible participants must be covered by health insurance and provide informed consent. Certain medical conditions and pregnancy exclude participation.

Researchers are evaluating treatments for low and intermediate risk prostate cancer, focusing on erectile dysfunction. This multicenter study compares two radiation therapies: brachytherapy with Iodine 125 and stereotactic body radiotherapy (SBRT). The study aims to analyze the cost and quality of life differences between these treatments over three years, with additional evaluations up to five years including erectile dysfunction, urinary and gastrointestinal side effects, and overall quality of life. Participants are randomly assigned to one of two groups. One group receives brachytherapy delivering a total of 144 Gy to the prostate using Iodine 125. The other group receives SBRT, which delivers 7.25 Gy in five sessions for a total dose of 36.25 Gy, with small markers implanted in the prostate to guide treatment. About 240 patients will be enrolled over two years from approximately twenty centers. During the study, participants will be monitored for erectile dysfunction, treatment side effects, and quality of life for up to five years after treatment. Researchers will perform cost-utility and cost-effectiveness analyses, including measuring quality adjusted life years and erectile dysfunction avoided. Safety and long-term effects will also be assessed to provide comprehensive information for healthcare decision makers.

Researchers are evaluating the use of olaparib in adult male patients with metastatic castration-resistant prostate cancer (mCRPC) in a real-world setting across multiple centers in France. This observational longitudinal study aims to understand how olaparib is used in treatment sequences, its effectiveness, safety, and patterns of BRCA genetic testing to help improve future clinical care for this condition. The study includes patients who have started olaparib treatment within the last two months before joining the study or who participated in an early access program funded for olaparib use. Treatment decisions are made by the patients' physicians, and researchers observe and collect data without intervening. The study follows patients for up to 24 months from the start of olaparib treatment to track how long they continue the treatment and other outcomes. Participants will be monitored through their routine medical care, and data will be collected on treatment duration, safety, and BRCA testing patterns. The main outcome measured is the time until patients stop olaparib treatment, observed over a period of up to two years. The study relies on patient records and does not involve additional experimental procedures, focusing on real-life treatment experiences and outcomes.

This research aims to observe patients in France who have HER2-negative early breast cancer and are treated with olaparib. The study focuses on understanding how many patients complete the full planned course of olaparib treatment, which is given as adjuvant therapy following initial cancer treatment. It is a national, multicenter, prospective cohort study conducted without altering the usual care provided by doctors. Patients enrolled will be those starting adjuvant olaparib treatment based on their doctor's decision. There are no experimental interventions or treatment changes imposed by the study. The study captures real-world use of olaparib across multiple centers in France. Participants will be followed for at least 18 months after joining the study to see if they complete the full duration of olaparib treatment. Researchers will collect data on treatment adherence and other relevant clinical information during this period. The main outcome measured is the proportion of patients who receive olaparib for the entire planned treatment period.

Brain metastases are a common complication in cancer patients, and their incidence is increasing. Treatment options include whole-brain radiotherapy, surgery, and stereotactic radiosurgery (SRS). Researchers are investigating the concept of "oligometastatic" brain disease, which involves a limited number of metastases, aiming to preserve neurological function and independence for as long as possible. This trial compares two stereotactic radiotherapy methods for patients with up to 5 brain metastases from solid tumors, focusing on treatment effectiveness and economic evaluation. The study compares hypofractionated stereotactic radiotherapy (HSRT), delivering 3 doses of 10 Gy over one week, to historical single-dose stereotactic radiosurgery (SRS), delivering 20 to 25 Gy in one session. Both treatments are precisely targeted to destroy tumor tissue while sparing normal brain tissue. Patients are selected based on specific criteria including tumor size and number, and treatments are decided after multidisciplinary committee evaluation. Participants will be monitored for local tumor control over 12 months using established criteria. Assessments include neuropsychological evaluations, blood tests, and imaging such as brain MRI with contrast. The study also tracks patient cooperation during treatment, potential side effects like radionecrosis, and overall treatment safety. The total participation duration includes treatment and follow-up assessments to evaluate treatment outcomes and side effects.