Small renal cell carcinoma-active surveillance and ablation.
[Small renal cell carcinoma-active surveillance and ablation]. Urologe A. 2018 May 23;: Authors: Wendler JJ, Damm R, Liehr UB, Brunner T, Pech M, Schostak M Abstract The incidence of renal cell carcinoma has been rising for years. At the same time there is an increasing prevalence of chronic renal failure with subsequent higher morbidity and shorter life expectancy in those affected. In the last decades the gold standard has thus shifted from radical to partial nephrectomy or tumor enucleation. A treatment alternative can be advantageous for selected patients with high morbidity and an increased risk of complications in anesthesia or surgery. Active surveillance represents a controlled delay in the initiation of treatment with a curative intention. Percutaneous radiofrequency ablation and laparoscopic cryoablation are currently the most commonly used treatment alternatives. Newer ablation procedures, such as high-intensity focused ultrasound, irreversible electroporation, microwave ablation, stereotactic ablative radiotherapy and high-dose brachytherapy have a high potential in some cases but are still considered experimental for the treatment. PMID: 29796702 [PubMed - as supplied by publisher]
CONCLUSIONS: Radical nephrectomy with thrombectomy in the vena cava is a technique susceptible to severe complications and has, to date, been performed in few centres. We believe that the technique is reproducible and has clear advantages for our patients. PMID: 29699882 [PubMed - as supplied by publisher]
Though radical cytoreductive nephrectomy has been shown to improve overall survival in patients with metastatic renal cell carcinoma, the impact this treatment has on renal function has not been adequately assessed. Radical nephrectomy in patients with localized cancer has been associated with risk of chronic kidney disease development. Using patients enrolled in ADAPT trial that received cytoreductive nephrectomy in the metastatic setting, we intend to study the effect of this procedure on overall renal function in patients without kidney disease.
Conclusions: All mRCC patients after nephrectomy were recommended to undergo biochemical monitoring with inclusion of TGF-β and IL-17A, as well as radionuclide monitoring (CRS) to determine the RF risk at an early stage. PMID: 29201463 [PubMed]
Conclusions OPN shows equivalent safety and efficacy for both intrarenal RCC tumors and exophytic tumors of the same size and type.
Conclusions: Elective indication was associated with fewer complications than PN for relative or absolute indications.
This study describes the natural history of renal function after radical and partial nephrectomy and explores factors associated with postoperative decline in renal function. METHODS: This is a multi-institutional cohort study of patients in the Canadian Kidney Cancer Information System who underwent partial or radical nephrectomy for RCC. Estimated glomerular filtration rate (eGFR) and stage of chronic kidney disease were determined preoperatively and at 3, 12, and 24 months postoperatively. Linear regression was used to determine the association between postoperative eGFR and type of surgery (radical vs. partial), d...
DISCUSSION: During the past decade, the gold standard shifted from radical to partial nephrectomy. Depending on the surgeon's experience, the patient's constitution and the tumor's location, the intervention can be performed laparoscopically with the corresponding advantages of lower invasiveness. A treatment alternative can be advantageous for selected patients with high morbidity and/or an increased risk of complications associated with anesthesia or surgery. Corresponding risk stratification necessitates previous confirmation of the small renal mass (cT1a) by histological examination of biopsy samples. Active surve...
Abstract: Renal cell carcinoma arising from renal allograft is a rare condition. A 56-year-old man with a history of 3 renal transplantation due to renal failure presented poor appetite and weight loss for 3 months. Possibility of tumor of unknown origin was suspected. For this reason, an FDG PET/CT was performed, and the images showed a hypermetabolic focus in the lower pole of the left renal transplant, suggestive of a malignant lesion. Subsequent pathological examination following allograft nephrectomy confirmed grade 4 renal cell carcinoma.
Authors: Lee KH, Chen YT, Chung HJ, Liu JS, Hsu CC, Tarng DC Abstract OBJECTIVES: To compare the renal outcomes in patients of unilateral renal cell carcinoma (RCC) with upper tract urothelial carcinoma (UTUC) following surgical resection of the tumor-bearing kidney, and to investigate the potential predictors in renal function decline. PATIENTS AND METHODS: In this retrospective cohort study, 319 RCC patients undergoing radical nephrectomy (RN) and 297 UTUC patients undergoing radical nephroureterectomy were recruited from a tertiary medical center between 2001 and 2010. Demographic data, co-morbidity, smoking...
CONCLUSION: Partial nephrectomy allows most of the patients presenting with renal cell carcinoma on solitary kidney to be free of hemodialysis. Tumor complexity, tumor size and preoperative GFR seems to play a determinant role on postoperative functional outcome. These non-modifiable predictive factors should be recognized and taken into account to better select patients with high risk of postoperative renal failure. LEVEL OF EVIDENCE: 5. PMID: 26654468 [PubMed - as supplied by publisher]