Table of Contents
1
UI - 11534400
AU - Lopez-Costea MA; Gonzalez-Satue C; Franco Miranda E; Arbelaez Arango S;
TI -
Riera Canals L; Prats de Puig JM; Serrallach Mila N
[Partial nephrectomy in renal cell carcinoma]
SO - Actas Urol Esp 2001 Jul-Aug;25(7):482-8
AD - Servicio de Urologia, Ciutat Sanitaria i Universitaria de Bellvitge
(CSUB), Barcelona.
INTRODUCTION AND OBJECTIVES: Renal Cell Carcinoma (RCC) represents 3% of
all neoplasm. The growing incidental diagnosis of small renal tumor has
allowed the application of nephron sparing surgery (NSS), even in those
cases with a normal contralateral kidney. We present the results of NSS
at our center in the last decade. MATERIAL AND METHODS: A retrospective
analysis of all NSS that were made at our center in cases of renal
masses. Difference is made between elective surgery (tumors less than 4
cm with a normal contralateral kidney) and obligatory surgery (all other
cases). RESULTS: From 1990 since 2000 a total of 65 NSS were made from a
total of 436 surgeries for renal tumors (14.9%). In 22 patients NSS was
obligatory, while in 43 was elective. Mean (SD) age was 59.1 years (+/-
11.7), mean tumor size 3.4 cm (+/- 1.4), mean hospital staying was 9.2
days (+/- 7). Renal normothermic ischaemia was use during surgery in all
cases, with a mean ischaemic time of 25.7 min. Nine tumors (13.8%) were
benign. Morbidity: 10.8%. Mortality: 1.5%. The cancer specific survival
at 36 months of follow-up (mean 37.4) is 98.4% and global survival is
90.3%. CONCLUSIONS: Nephron Sparing Surgery is a valid alternative in
the treatment of RCC, specially for tumors less than 4 cm in diameter
and having a normal contralateral kidney; NSS is also an effective
technique for patients bearing renal tumors in a solitary kidney.
2
UI - 11851621
AU - Kamai T; Arai K; Koga F; Abe H; Nakanishi K; Kambara T; Furuya N; Tsujii
TI -
T; Yoshida KI
Higher expression of K-ras is associated with parathyroid
hormone-related protein-induced hypercalcaemia in renal cell carcinoma.
SO - BJU Int 2001 Dec;88(9):960-6
AD - Department of Urology, Dokkyo University School of Medicine, Mibu,
Tochigi, Japan. kamait@dokkyomed.ac.jp
OBJECTIVES: To determine whether the K-ras oncogene is associated with
parathyroid hormone-related protein (PTHrP) production in renal cell
carcinoma (RCC) and whether the serum value of PTHrP is related to the
patients' survival. PATIENTS AND METHODS: The serum levels of PTHrP and
corrected serum calcium levels were analysed in 51 consecutive patients
(29 men and 22 women, mean age 63.7 years, range 33-82) with newly
diagnosed RCC. Matched pairs were analysed of the mRNA levels of K-ras
and PTHrP in tumour and in corresponding non-tumour tissue originating
from the same patient, using the polymerase chain reaction after reverse
transcription. RESULTS: Seven patients had elevated serum PTHrP values
at the diagnosis of RCC. The mRNA expression of K-ras and PTHrP were
detected in both tumour and non-tumour tissues, with K-ras mRNA levels
being higher in the former than the latter (P < 0.05), and correlated
with tumour stage (P < 0.05). There were no differences in PTHrP mRNA
levels between the tissues. Furthermore, the mRNA levels of K-ras and
PTHrP in seven tumours from patients with high serum values of PTHrP
were higher than in tumours from those with normal values (both P <
0.01). The expression of mRNAs of K-ras and PTHrP was positively
correlated (r = 0.771, P < 0.001). In seven patients with high serum
PTHrP values the mRNA levels of PTHrP correlated with serum values of
PTHrP and calcium (r = 0.875, P < 0.01 and r = 0.762, P < 0.05,
respectively). Kaplan-Meier plots of survival rate in patients with
elevated or normal serum PTHrP showed that high serum PTHrP was
associated with a shorter overall survival (P < 0.05). The Cox
proportional hazards model showed that serum PTHrP was an independent
predictor of overall survival (P < 0.05). CONCLUSIONS: These findings
suggest that K-ras may be associated with PTHrP-induced hypercalcaemia
and that PTHrP levels may reflect the aggressiveness of tumour cells
through the K-ras oncogene in RCC.
3
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
UI - 11851623
AU - Miyata Y; Koga S; Nishikido M; Hayashi T; Kanetake H
TI -
Relationship between serum ferritin levels and tumour status in patients
with renal cell carcinoma.
SO - BJU Int 2001 Dec;88(9):974-7
AD - Department of Urology, Nagasaki University School of Medicine, Nagasaki
city, Japan.
OBJECTIVE: To assess the relationship between serum ferritin levels (a
useful marker for diagnosing and staging renal cell carcinoma, RCC) and
tumour status in RCC of
UI - 11855835
AU - Teratani T; Watanabe T; Yamahara K; Kumagai H; Ishikawa A; Arai K;
TI -
Nozawa R
Restricted expression of calcium-binding protein S100A5 in human kidney.
SO - Biochem Biophys Res Commun 2002 Mar 1;291(3):623-7
AD - Laboratory of Host Defenses, University of Shizuoka, Shizuoka, Japan.
Reverse transcription--polymerase chain reaction (RT-PCR) identified the
expression of calcium-binding protein S100A5 in the noncancerous parts
of resected samples from renal cell carcinoma (RCC) patients (n = 7) but
not in the carcinoma lesions. Rabbit anti-S100A5 antibody
immunohistochemically detected the antigen in the thick ascending limb
of Henle, distal convoluted tubule, and collecting duct system. No
apparent immunopositivity was observed in the glomerulus, proximal
tubules, interstitial cells, or RCC cells. Thus, it was suggested that
S100A5 protein plays an inherent functional role to the post-thick
ascending limb of Henle portion in the nephron. Further, the carcinomas
tested were originated probably not in the S100A5-positive distal
epithelium but in the -negative epithelium of proximal tubules. Then,
total RNA was extracted by phenol/chloroform from 1 ml urine of healthy
volunteers, and S100A5 was amplified by RT-PCR from all samples (n =
12), indicating that the transcript of S100A5 is detectable even in the
cells released into urine. B)2002 Elsevier Science (USA).
UI - 11831831
AU - Little B; Young M; Ho KJ
TI -
Current clinical practice of induction and maintenance immunotherapy for
metastatic renal cell carcinoma.
SO - Int J Clin Pract 2002 Jan-Feb;56(1):36-9
AD - Department of Urology, Craigavon Area Hospital, Co Armagh, UK.
Current systemic treatment of metastatic renal cell carcinoma revolves
around the use of interleukin-2 and interferon-alpha, often in
combination with 5-fluorouracil. This article looks at the currently
reported response rates for these modalities. It also looks at current
practice as regards maintenance treatment, i.e. the continued
therapeutic regimen following the initial response to the induction
immunotherapy cycles.
UI - 11875741
AU - Sasamura H; Takahashi A; Miyao N; Yanase M; Masumori N; Kitamura H; Itoh
TI -
N; Tsukamoto T
Inhibitory effect on expression of angiogenic factors by antiangiogenic
agents in renal cell carcinoma.
SO - Br J Cancer 2002 Mar 4;86(5):768-73
AD - Department of Urology, Sapporo Medical University School of Medicine,
S-1, W-16, Chuo-ku, Sapporo 060-8543, Japan.
Since it has been widely recognised that renal cell carcinoma is
refractory to standard therapies such as chemotherapy and radiotherapy,
a new modality of treatment is needed. One of the potential alternative
therapies for renal cell carcinoma may be inhibition of angiogenesis. In
this study, we analysed the inhibitory effects of several potential
agents on expression of angiogenic factors such as vascular endothelial
growth factor and basic fibroblast growth factor, which are the main
mediators in angiogenesis of renal cell carcinoma. We used
medroxyprogesterone acetate, interferon-alpha, interferon-gamma,
minocycline hydrochrolide and genistein, which are known to be
antiangiogeneic. Northern blot analyses revealed that, among the five
agents examined, genistein had a strong inhibitory effect on expression
of vascular endothelial growth factor mRNA and basic fibroblast growth
factor mRNA. Medroxyprogesterone acetate and interferon-alpha did not
significantly decrease the level of either vascular endothelial growth
factor mRNA or basic fibroblast growth factor mRNA. Interferon-gamma and
minocycline had mild inhibitory effects on vascular endothelial growth
factor mRNA and basic fibroblast growth factor mRNA expression.
Genistein also inhibited both vascular endothelial growth factor mRNA
and basic fibroblast growth factor mRNA expression after treatment with
epidermal growth factor and hypoxia. These findings suggest that one of
the mechanisms of the inhibition of angiogenesis by genistein is
suppression of the expression of the angiogenic factors vascular
endothelial growth factor and basic fibroblast growth factor in renal
cell carcinoma. Copyright 2002 Cancer Research UK
UI - 11908255
AU - Wald M; Halachmi S; Amiel G; Madjar S; Mullerad M; Miselevitz I;
TI -
Moskovitz B; Nativ O
Bladder tumor antigen stat test in non-urothelial malignant urologic
conditions.
SO - Isr Med Assoc J 2002 Mar;4(3):174-5
AD - Department of Urology, Bnai Zion Medical Center, Haifa, Israel.
moshewald@hotmail.com
BACKGROUND: The bladder tumor antigen stat is a simple and fast one-step
immunochromatographic assay for the detection of bladder
tumor-associated antigen in urine. OBJECTIVES: To evaluate the BTA stat
in non-bladder cancer patients in order to identify the categories
contributing to its low specificity. METHODS: A single voided urine
sample was collected from 45 patients treated in the urology clinic for
conditions not related to bladder cancer. Each urine sample was examined
by the BTA stat test and cytology. RESULTS: The overall specificity of
the BTA stat test was 44%, which was significantly lower than that of
urine cytology, 90%. The false positive rates for the BTA stat test
varied among the different clinical categories, being highest in cases
of urinary tract calculi (90%), and benign prostatic hypertrophy (73%).
Exclusion of these categories from data analysis improved BTA stat
specificity to 66%. CONCLUSIONS: Clinical categories contributing to low
BTA stat specificity can be identified, and their exclusion improves the
specificity of this test.
UI - 11774101
AU - Wenzel C; Locker GJ; Schmidinger M; Mader R; Kramer G; Marberger M;
TI -
Rauchenwald M; Zielinski CC; Steger GG
Capecitabine in the treatment of metastatic renal cell carcinoma failing
immunotherapy.
SO - Am J Kidney Dis 2002 Jan;39(1):48-54
AD - Department of Internal Medicine I, Division of Oncology, the Ludwig
Boltzmann Institute for Clinical Oncology, University Hospital of
Vienna, Austria.
Capecitabine is a novel fluoropyrimidine carbamate, orally administered
and selectively activated to fluorouracil by a sequential triple-enzyme
pathway in liver and tumor cells. This prospective trial aims to
evaluate the therapeutic effects and systemic toxicities of capecitabine
in patients with metastatic renal cell carcinoma in which immunotherapy
failed. Twenty-six patients (median age, 58 years; range, 47 to 76
years) with disease in which first- or second-line immunotherapy
treatment failed entered the trial. Median time of observation was 13+
months (range, 3 to 25+ months). Capecitabine was administered in the
outpatient setting orally at a dose of 2,500 mg/m2/d divided into two
daily doses for 14 days, followed by 7 days of rest. This schedule was
repeated in 3-week intervals. Twenty-six patients are now assessable for
toxicity, and 23 patients, for response. We observed a partial response
to treatment in 2 patients (8.7%), minor response in 5 patients (21.7%),
stable disease in 13 patients (56.5%), and continued disease progression
despite treatment in only 3 patients (13.1%). Outpatient capecitabine
therapy was well tolerated, and World Health Organization (WHO) grade
III toxicity in these 26 patients consisted of hand-foot syndrome in 2
patients (7.7%) and anemia in 1 patient (3.8%). We did not observe WHO
grade IV toxicity. Oral capecitabine appears to be a promising treatment
with a favorable toxicity profile in patients with advanced renal cell
carcinoma and should be evaluated in first- and second-line treatment
schedules as monotherapy, as well as in combination with immunotherapy
agents. Copyright 2002 by the National Kidney Foundation, Inc.
UI - 11247069
AU - Panchev P; Kumanov H; Yanev K
TI -
[Urothelial tumors versus "endemic" nephropathy - myth or reality?]
SO - Khirurgiia (Sofiia) 1998;53(6):44-6
AD - "Aleksandrovska" Hospital, Higher Medical University, Urology
Department, Sofia, Bulgaria.
Malignant tumors of the renal pelvis account for over 78 per cent of all
malignant tumors of the kidney, and less than 1 per cent of all
urogenital neoplasms. At the time of diagnosing, almost one third of
these patients present with tumor of the ipsilateral ureter or bladder,
and 40-50 per cent have ureteral tumor located elsewhere (D. Crawford,
S. Das, 1990). After World War Two, the frequency of publications on
cases of primary tumors of the pelvis show a noticeable increase, e.g.
in Yugoslavia and Bulgaria the ratio of parenchymatous renal tumors to
those of the renal pelvis is conspicuously altered. S. Petcovic (1970)
and S. Lambrev (1972) attribute this fact to the existence of endemic
"nephropathy" foci. It is the purpose of this work to analyze
twenty-nine patients presenting carcinoma of the upper urinary ways,
studied in the Chair of Urology in the period 1991 through 1997. Of them
only four come from "endemic" regions. Over the period 1972-1975,
fifty-nine patients with the same condition undergo treatment in the
aforementioned Chair. It is worth noting that patients from the
so-called "endemic" regions lack the typical signs of "endemic"
nephropathy. The assumption is warranted that "endemic" nephropathy is a
still not well enough clarified nosological entity, bearing resemblance
to contamination with radioactive elements with a "boom" during the
half-life period gradually subsiding.
UI - 11905872
AU - Goldberg BB; Pollack HM
TI -
Differentiation of renal masses using A-mode ultrasound. 1971.
SO - J Urol 2002 Feb;167(2 Pt 2):1022-6; discussion 1027
UI - 11905873
AU - Sagel SS; Stanley RJ; Levitt RG; Geisse G
TI -
Computed tomography of the kidney. 1977.
SO - J Urol 2002 Feb;167(2 Pt 2):1028-38; discussion 1039
UI - 11905913
AU - Harrison JH; Botsford TW; Tucker MR
TI -
The use of the smear of the urinary sediment in the diagnosis and
management of neoplasm of the kidney and bladder. 1951.
SO - J Urol 2002 Feb;167(2 Pt 2):864-71; discussion 872
UI - 11905914
AU - Robson CJ; Churchill BM; Anderson W
TI -
The results of radical nephrectomy for renal cell carcinoma. 1969.
SO - J Urol 2002 Feb;167(2 Pt 2):873-5; discussion 876-7
UI - 11905915
AU - Novick AC; Streem S; Montie JE; Pontes JE; Siegel S; Montague DK;
TI -
Goormastic M
Conservative surgery for renal cell carcinoma: a single-center
experience with 100 patients. 1989.
SO - J Urol 2002 Feb;167(2 Pt 2):878-82; discussion 883
UI - 11905916
AU - Lerner SE; Hawkins CA; Blute ML; Grabner A; Wollan PC; Eickholt JT;
TI -
Zincke H
Disease outcome in patients with low stage renal cell carcinoma treated
with nephron sparing or radical surgery. 1996.
SO - J Urol 2002 Feb;167(2 Pt 2):884-9; discussion 889-90
UI - 11902528
AU - Nathan PD; Eisen TG
TI -
The biological treatment of renal-cell carcinoma and melanoma.
SO - Lancet Oncol 2002 Feb;3(2):89-96
AD - Medical Oncology at the Royal Free Hospital, London, UK.
Biological therapies are claiming a place in the routine management of
some solid tumours. In this review we focus on the biological treatment
of melanoma and renal-cell carcinoma, identifying the background to
current practice and areas of promise that may be in routine clinical
use in the near future. Melanomas and renal-cell carcinomas are
particularly resistant to chemotherapy and radiotherapy and are
characterised by the host immune response to the tumours. For this
reason there has been particular interest in the biological therapy of
these diseases. Biological therapies differ from chemotherapeutic
approaches in their mechanism of action, time to response, and
side-effect profiles. Although biological treatment has a long history,
it is only with recent advances in immunology and molecular biology that
progress has been made. In the next few years investigators expect to
build on their research experience with biotherapeutic agents to provide
tangible benefits for patients.
UI - 11692915
AU - Panchev P; Ianev K; Georgiev M; Kirilov S; Kumanov Kh
TI -
["Fossa" carcinoma - a relapse or "rest" carcinoma of the kidney?]
SO - Khirurgiia (Sofiia) 2000;56(3-4):33-4
The local relapse represents a unique variant of the advanced stage of a
disease (A Esrig et 1992). Presumably, "fossa" carcinoma may result from
incomplete resection or persisting tumor in the regional contiguous
lymph nodes (JB D Kernion 1978). The average time interval for a relapse
to occur is 31 months after nephrectomy, and in most patients it becomes
manifest with symptoms, such as losing weight, fatigability and lumbar
discomfort (D Esrig et al 1992). In cases with local recurrence a
long-term survivorship may be attained by resorting to aggressive
surgical intervention (S Tanguag et al 1996). This is a report on
twenty-three patients with "fossa" carcinoma covering the period 1994
through 1999, with a total of 425 patients with renal carcinoma operated
during the same period of time. All patients undergo operation--lumbar
access is used in 22 cases, and transperitoneal--in one. In one patients
resection of colon is necessitated, whereas in five the neoplastic mass
hardly lends itself to complete excision, with enucleation alone being
done. At follow-up study the survival terms are as follows: up to 1
year--18 patients, up to 3 year--16 patients, up to 5 year--12 patients.
UI - 11870181
AU - Zisman A; Pantuck AJ; Dorey F; Chao DH; Gitlitz BJ; Moldawer N;
TI -
Lazarovici D; deKernion JB; Figlin RA; Belldegrun AS
Mathematical model to predict individual survival for patients with
renal cell carcinoma.
SO - J Clin Oncol 2002 Mar 1;20(5):1368-74
AD - Division of Urologic Oncology, Department of Urology, University of
California School of Medicine, Los Angeles, CA 90095-1738, USA.
PURPOSE: To develop a multivariate model and mathematical formula
capable of calculating personalized survival for renal cell carcinoma
(RCC) patients with clinically available variables. PATIENTS AND
METHODS: A total of 477 patients out of 661 undergoing nephrectomy at
the University of California Los Angeles between 1989 and 1999 were
eligible for evaluation and formed the analyzed cohort for this
retrospective study. Time to death was the primary end point assessed.
Univariate analysis for 14 to 20 variables was conducted, followed by a
multivariate Cox analysis. The variables that provided independent
information as to the time of death for metastatic and nonmetastatic
patients were coded and incorporated into a function based on the Nadas
equation principle. RESULTS: For nonmetastatic patients, the significant
variables in the multivariate analysis were Fuhrman's grade and Eastern
Cooperative Oncology Group performance status. For the metastatic
patients, Fuhrman's grade, 1997 classification T stage, number of
symptoms, nodal involvement, and immunotherapy were independent
predictors for survival. These variables, based on the Cox multivariate
regression model, were implanted into an exponential Nadas equation. The
expected survival predicted by use of the Nadas equations faithfully
describes the actual survival based on Kaplan-Meier curves. CONCLUSION:
We have developed mathematical equations for estimating survival after
radical nephrectomy for RCC. The resulting formulas are capable of
better tailoring survival estimates for a specific patient and are based
on widely accepted clinical prognostic variables. On validation with
external data, this type of representation can be used as a tool for the
determination of personalized prognosis and may be useful for patient
education and counseling.
UI - 11870194
AU - Nathan PD; Gore ME; Eisen TG
TI -
Unexpected toxicity of combination thalidomide and interferon alpha-2a
treatment in metastatic renal cell carcinoma.
SO - J Clin Oncol 2002 Mar 1;20(5):1429-30
UI - 11875714
AU - Brinckmann A; Axer S; Jakschies D; Dallmann I; Grosse J; Patzelt T;
TI -
Bernier T; Emmendoerffer A; Atzpodien J
Interferon-alpha resistance in renal carcinoma cells is associated with
defective induction of signal transducer and activator of transcription
1 which can be restored by a supernatant of phorbol 12-myristate
13-acetate stimulated peripheral blood mononuclear cells.
SO - Br J Cancer 2002 Feb 1;86(3):449-55
AD - Department of Hematology and Oncology, Medizinische Hochschule,
Hannover, Germany.
Therapy of selected human malignancies with interferon-alpha is widely
accepted but often complicated by the emergence of interferon-alpha
resistance. Interferon is a pleiotropic cytokine with antiproliferative,
antitumour, antiviral and immunmodulatory effect; it signals through the
Jak-STAT signal transduction pathway where signal transducer and
activator of transcription 1 plays an important role. Here we report
both, a lack of signal transducer and activator of transcription
induction in interferon-alpha resistant renal cell carcinoma cells and
signal transducer and activator of transcription 1 reinduction of
phorbol 12-myristate 13-acetate-stimulated peripheral blood mononuclear
cells supernatant. Preliminary experiments on the identification of the
molecules that reinducing signal transducers and activators of
transcription 1 indicate that interferon-gamma may be the responsible
candidate cytokine, but several others may be involved as well. This
work provides the basis for therapeutic strategies directed at the
molecular modulation of interferon-alpha resistance in human neoplasms.
Copyright 2002 The Cancer Research Campaign
UI - 11908479
AU - Nortier J
TI -
[Renal interstitial fibrosis and urotelial carcinomas after ingestion of
a Chinese herb (Aristolochia fangchi)]
SO - Nephrologie 2002;23(1):37-8
AD - Departement de nephrologie, dialyse et transplantation, CUB Hopital
Erasme, Bruxelles, Belgium. jnortier@ulb.ac.be.
UI - 11724120
AU - Doehn C; Fornara P; Fricke L; Jocham D
TI -
Laparoscopic nephroureterectomy to exclude upper urinary tract
malignancy associated with analgesic nephropathy.
SO - J Endourol 2001 Oct;15(8):809-14
AD - Department of Urology, Medical University of Lubeck, Germany.
doehn@medinf.mu-luebeck.de
BACKGROUND AND PURPOSE: Analgesic abuse is a potential cause of
end-stage renal disease. Such patients bear an elevated risk of
developing malignancies, predominantly transitional-cell carcinoma. We
report our experience with laparoscopic nephroureterectomy carried out
in patients with analgesic nephropathy to exclude upper urinary tract
malignancy. All patients were scheduled to be put on the waiting list
for cadaveric renal transplantation. PATIENTS AND METHODS: Since 1996,
nine women and two men with a long-term history of analgesic abuse have
undergone laparoscopic nephroureterectomy at our hospital. The median
age was 63 years (range 51-70 years). All patients had developed
end-stage renal failure secondary to heavy analgesic abuse with a median
duration of 14 years (range 7-40 years). The median interval from the
beginning of hemodialysis to laparoscopic nephroureterectomy was 36
months (range 6-76 months). RESULTS: The median operative time was 99
minutes (range 55-170 minutes). There were no conversions to open
surgery. Two complications occurred, and three patients required blood
transfusions. The median hospital stay lasted 5 days (range 2-12 days),
and the median convalescence was 20 days (range 6-44 days). In seven
patients, histopathologic examination of the kidney revealed changes
attributable to analgesic abuse. None of the patients had a
transitional-cell carcinoma, but in two patients, a renal-cell carcinoma
stage pT1cN0cM0 grade 2 was detected. CONCLUSION: Patients with
analgesic nephropathy bear an elevated risk for the development of
transitional-cell or renal-cell carcinoma. In these patients,
laparoscopic nephroureterectomy combines minimally operative
invasiveness with a maximum of diagnostic safety.
UI - 11194631
AU - Al-Khalil N; Panchev P; Kumanov Kh
TI -
[History of nephrectomy]
SO - Khirurgiia (Sofiia) 1999;55(5):38-9
AD - Government University Hospital "Aleksandrovska," Department of Urology,
Sofia, Bulgaria.
Following animal experiments (Combair 1803, Prevost and Dumas 1823) and
accidental removal of the kidney in humans (Spillgellberg 1867, Peaslee
1868, Wolcott 1886), it has been established that elimination of a
single kidney does not lead mandatorily to fatal outcome if the second
functioning kidney is preserved. The chronology of nephrectomy
development on a worldwide scale, and in Bulgaria as well, after the
first routinely scheduled nephrectomy performed by Gustav Simon (2 Aug
1869), is presented. In 1897, almost 30 years later, Ivan Mikhaylovsky
from the Plovdiv Hospital performed the first nephrectomy in this
country. In the late 19th and early 20th century, nephrectomy becomes
one of the most often used kidney operations (H Kumill, 1913--49.3 per
cent), but gradually parallel to improving the diagnostic technique it
is less frequently applied (W Lutzer et al, 1976--28 per cent) at the
expense of organ-salvaging interventions. The last decade marks the
introduction of laparoscopic nephrectomy (RV Clayman et al, 1991, AD
Joce et al, 1992, JJ Rassweller et al, 1993, Sy Nakada et al, 1996, CC
Abbou et al, 1998) which is a safe procedure even in patients with
malignant renal pathology and adequately selected cases presenting
various urological diseases.
UI - 11597529
AU - Nakada SY; Fadden P; Jarrard DF; Moon TD
TI -
Hand-assisted laparoscopic radical nephrectomy: comparison to open
radical nephrectomy.
SO - Urology 2001 Oct;58(4):517-20
AD - Department of Surgery, Division of Urology, University of Wisconsin
Medical School, Madison, Wisconsin 53792-3236, USA.
OBJECTIVES: Hand-assisted laparoscopic surgery is easier to learn than
standard laparoscopy and simplifies intact specimen removal. We present
our experience performing hand-assisted laparoscopic radical nephrectomy
(HALRN) and compare it with contemporary open radical nephrectomy
performed at our institution. METHODS: We performed 18 HALRNs for renal
tumors ranging in size from 2 to 11 cm (average 4.5). Patients ranged in
age from 40 to 83 years (average 62.9). All patients underwent HALRN
with intact removal through a 7 to 8-cm vertical midline incision
through an impermeable wound protector. Two or three working ports were
used. We retrospectively compared our results with the results of 18
open radical nephrectomies performed during the same period, with the
patients matched for age, body mass index, and American Society of
Anesthesiologists' score. RESULTS: In the HALRN group, the average
operating room time was 220.5 minutes, average length of stay 3.9 days,
average time to return to normal activity 15.8 days, and average time to
return to work 26.8 days. The median time to return to 100% normal was
28.0 days. No conversions or re-explorations were necessary in the HALRN
series. The final pathologic examination revealed renal cell carcinoma
in 15, oncocytoma in 1, angiomyolipoma in 1, and a complex cyst in 1. At
a maximum of 48 months of follow-up (average 12.2), no recurrences were
identified. Three deaths occurred in the series; 2 patients died with no
evidence of disease and 1 patient died of metastatic disease (the
nephrectomy was palliative). In the open group, the average operating
room time was 117.8 minutes, average length of stay 5.1 days, average
time to return to normal activity 23.5 days, and average time to return
to work 52.2 days. The median time to return to 100% normal was 150
days, with 3 patients never returning to 100% normal. CONCLUSIONS: Our
series demonstrated that HALRN is a safe, effective, minimally invasive
option for treating renal cell carcinoma and provides a shorter hospital
stay (P = 0.02), earlier return to work (P = 0.04), and earlier return
to 100% normal (P = 0.0002) than open radical nephrectomy.
UI - 11927308
AU - Lau WK; Cheville JC; Blute ML; Weaver AL; Zincke H
TI -
Prognostic features of pathologic stage T1 renal cell carcinoma after
radical nephrectomy.
SO - Urology 2002 Apr;59(4):532-7
AD - Department of Urology, Mayo Clinic, Rochester, Minnesota 55905, USA.
OBJECTIVES: To assess the effect of renal cell carcinoma (RCC) subtype,
tumor size, and Fuhrman grade on clinical outcome in patients with
pathologic T1 (pT1) RCC treated with radical nephrectomy. METHODS:
Between 1970 and 1998, 840 patients underwent radical nephrectomy for
pT1 RCC. Tumors were subtyped and graded. Univariate and multivariate
Cox proportional hazards models were fitted to assess the features
associated with metastasis-free survival (MFS) and cancer-specific
survival (CSS). We identified a range of tumor sizes of clear cell RCC
in which a transition occurred from low to high risk. Cox proportional
hazards models were then fitted by using size cutoffs. RESULTS: The mean
follow-up (+/- SD) was 9.4 +/- 6.6 years among the patients alive at
latest follow-up. At 10 years, the CSS and MFS for clear cell RCC (n =
682) were 89.1% and 88.6%, respectively; for papillary RCC (n = 122),
they were 95.5% and 93.8%; and for chromophobe RCC (n = 33), they were
both 100%. The differences in CSS (P = 0.013) and MFS (P = 0.023)
between clear cell RCC and the other subtypes were statistically
significant. For clear cell RCC, tumor size and Fuhrman grade were
independently associated with CSS and MFS (P <0.001). A transition in
risk occurred for tumor sizes between 4.5 and 5.0 cm, and the tumor size
cutoff of 5.0 cm had the highest concordance index for predicting CSS
and MFS. CONCLUSIONS: RCC subtype is a strong independent prognostic
variable for patients with pT1 RCC treated with radical nephrectomy. For
clear cell RCC, Fuhrman grade and tumor size are independently
associated with CSS and MFS.
UI - 11927323
AU - Pautler SE; Harrington FS; McWilliams GW; Walther MM
TI -
A novel laparoscopic specimen entrapment device to facilitate
morcellation of large renal tumors.
SO - Urology 2002 Apr;59(4):591-3
AD - Urologic Oncology Branch, National Cancer Institute, National Institutes
of Health, Bethesda, Maryland 20892, USA.
A reusable laparoscopic instrument consisting of a flexible deployment
ring and a barrel was fabricated, and an impermeable sac was sutured to
the flexible ring before entrapment of the specimen and morcellation.
The laparoscopic specimen entrapment device facilitated placement of
large renal tumors within a sac for morcellation.
UI - 11927338
AU - Uchida T; Gao JP; Wang C; Jiang SX; Muramoto M; Satoh T; Minei S;
TI -
Shimura S; Irie A; Kameya T; Baba S
Clinical significance of p53, mdm2, and bcl-2 proteins in renal cell
carcinoma.
SO - Urology 2002 Apr;59(4):615-20
AD - Department of Urology, Kitasato University School of Medicine,
Sagamihara, Japan.
OBJECTIVES: To improve our understanding of the clinical relevance of
p53, mdm2, and bcl-2 protein overexpression in renal cell carcinoma, we
retrospectively investigated the immunohistochemical expression of p53,
murine double minute 2 (mdm2), and bcl-2 and the relationship of this
expression to clinicopathologic characteristics. p53 regulates the
transcription of downstream effectors such as the oncoprotein mdm2, and
bcl-2 has been shown to inhibit apoptosis triggered by wild-type p53.
METHODS: The expression of p53, mdm2, and bcl-2 protein was studied by
immunohistochemical methods in paraffin-embedded nephrectomy specimens
from 112 patients whose clinicopathologic data confirmed renal cell
carcinoma. RESULTS: The expression of the p53 and bcl-2 protein was
recognized in 15 (13.4%) and 52 (42.0%) cases, respectively; the
expression of the mdm2 protein, however, was seen in only 2 cases
(1.8%). No correlation was noted between these three proteins and any
clinicopathologic parameters, except p53 expression and Stage T1-2/T3-4
(P = 0.0208). However, in multivariate analysis, stage (hazard ratio
3.586; P = 0.0002), expression of p53 (hazard ratio 6.090; P = 0.0126)
and of mdm2 (hazard ratio 22.016; P = 0.0156), and coexpression of
p53/mdm2 (hazard ratio 6.146; P = 0.0005) demonstrated a statistically
significant effect on prognosis by proportional hazards regression
tests. CONCLUSIONS: Our results indicate that stage, p53 expression,
mdm2 expression, and coexpression of p53/mdm2 are useful to predict the
clinical outcome in patients with renal cell carcinoma.
UI - 11927344
AU - Yip SK; Tan YH; Cheng WS
TI -
Hand-assisted laparoscopic radical nephrectomy: comparison to open
radical nephrectomy.
SO - Urology 2002 Apr;59(4):632; discussion 633
UI - 11798900
AU - Zhang Q; Zhang Z; Chen L
TI -
[Cloning and identifying renal cell carcinoma differentially expressed
genes and their significance]
SO - Zhonghua Yi Xue Za Zhi 2001 Mar 25;81(6):356-9
AD - Department of Urology, The First Hospital, Peking University, Beijing
100034, China.
OBJECTIVE: To Clone study the differentially expressed new genes in
renal cell carcinoma (RCC). METHODS: Using a technique known as
suppression subtractive hybridization to construct the library which
contains the differently expressing cDNAs between RCC and normal kidney
cells. Then the RCC specifically expressed genes were cloned. RESULTS:
Human RCC subtractive library with high subtractive efficiency was set
up successfully. The amplified library contained 350 positive clones.
Sequence analysis were performed for 5 clones. All the sequences were
unknown previously and the cDNA insert GYLZ-RCC18 had three copies.
Northern blot analysis showed that GYLZ-RCC18 cDNA expressed highly in
RCC, but no signal could be detected in normal kidney. Using SMART RACE
technique, the full length of novel gene of GYLZ-RCC18 was obtained.
CONCLUSIONS: The highly efficient cDNA subtractive library may have
formed solid foundation for screening and cloning new and specific
oncogenes or tumor suppressor genes of RCC. The novel differentially
expressed genes may provide an important clue for studying the mechanism
of occurrence and development of RCC.
UI - 11890234
AU - Masood J; Lane T; Koye B; Vandal M T; Barua J M; Hill J T
TI -
Renal cell carcinoma: incidental detection during routine
ultrasonography in men presenting with lower urinary tract symptoms.
SO - BJU Int 2001 Nov;88(7):671-4
AD - Department of Urology, Harold Wood Hospital, Romford. Essex, UK.
OBJECTIVE: To compare renal cell carcinomas (RCCs) presenting
incidentally in patients referred for lower urinary tract symptoms
(LtJTS) with those presenting symptomatically, by stage, intervention
and outcome. PATIENTS AND METHODS: The case notes of all male patients
(100) diagnosed with RCC between 1991 and 1998 were reviewed an
About OncoLink Contact OncoLink Privacy statement Disclaimer Link to OncoLink Home