Trimodal therapy for invasive bladder cancer: is it really equal to radical cystectomy?

PURPOSE OF REVIEW: Trimodal therapy (TMT) is considered the most effective bladder-sparing approach for muscle-invasive urothelial carcinoma of the bladder (MIBC) and an alternative to radical cystectomy. The purpose of this article was to review and summarize the current knowledge on the equivalence of TMT and radical cystectomy based on the recent literature. RECENT FINDINGS: TMT consists of a maximal transuretral resection of the bladder, followed by a concurrent radiotherapy and chemotherapy, limiting salvage radical cystectomy to nonresponder tumors or muscle-invasive recurrence. In large population studies, less than 6% of the patients with nonmetastatic MIBC receive a chemoradiation therapy and this rate is stable. A growing body of evidence exists that TMT provides good oncologic outcomes with low morbidity when compared with radical cystectomy. TMT requires, however, a close follow-up because of the high risk of local recurrence and salvage radical cystectomy in up to 30% of the patients. Salvage radical cystectomy can be performed with adequate results but does not offer the same opportunity of reconstruction and functional outcomes than primary radical cystectomy. SUMMARY: Although radical cystectomy is still the treatment of reference for most of the patients with localized MIBC, TMT represents a reasonable alternative in highly selected patients. Any firm conclusion on the equivalence or superiority of one treatment to the other is still limited by the lack of randomized controlled trials and the heterogeneity of the available literature. Future studies and multidisciplinary approach are mandatory to optimize the patient selection and regimen of TMT.

Le sentiment de gratitude en soins palliatifs : un facteur contribuant au bien-être et à la qualité de vie ? [Gratitude in palliative care: is it a psychological factor contributing to well-being and quality of life?]

En s'appuyant sur la littérature scientifique et l'état de la recherche, cet article a pour objectif de montrer pourquoi la prise en compte du sentiment de gratitude peut s'avérer utile dans le contexte palliatif en mettant en évidence dans quelle mesure cette émotion ou disposition individuelle: 1) entre en résonance avec le concept de croissance posttraumatique et certains enjeux relationnels chez les patients en fin de vie; 2) représente un facteur favorisant le bien-être et la qualité de vie; 3) peut être considérée comme un facteur protecteur contre les troubles psychopathologiques. Based on the scientific literature and the state of research, this article aims to show why the feeling of gratitude may represent a point of interest for palliative care. We will highlight the following in this article: 1) why this feeling of gratitude resonates with the concept of post-traumatic growth and relational challenges in end-of-life patients; 2) in which measure this feeling represents a factor contributing to well-being and quality of life; 3) in which measure this feeling may be considered as a protective factor against psychopathological troubles.

Who's fault is it ? : An analysis of the press coverage of football betting scandals in France and the United Kingdom

Sport betting is a lucrative business for bookmakers, for the lucky (or wise) punters, but also for governments and for sport. While not new or even recent, the deviances linked to sport betting, primarily match-fixing, have gained increased media exposure in the past decade. This exploratory study is a qualitative content analysis of the press coverage of sport betting-related deviances in football in two countries (UK and France), using in each case two leading national publications over a period of five years. Data analysis indicates a mounting coverage of sport betting scandals, with teams, players and criminals increasingly framed as culprits, while authorities and federations primarily assume a positive role. As for the origin of sport betting deviances, French newspapers tend to blame the system (in an abstract way); British newspapers, in contrast, focus more on individual weaknesses, notably greed. This article contributed to the growing body of literature on the importance of these deviances and on the way they are perceived by sport organizations, legislators and the public at large.