1259 PARTIAL NEPHRECTOMY PROVIDES EQUAL OVERALL SURVIVAL RATES AND CANCER-SPECIFIC SURVIVAL RATES TO RADICAL NEPHRECTOMY FOR T1B KIDNEY CANCER

2011 ◽  
Vol 185 (4S) ◽  
Author(s):  
Dan Lewinshtein ◽  
Sandra Koo ◽  
Paul Kozlowski
2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 323-323 ◽  
Author(s):  
S. Vourganti ◽  
W. Linehan ◽  
G. Bratslavsky

323 Background: As growing evidence indicates the importance of renal functional preservation, there is an increased utilization of partial nephrectomy (PN) performed for small renal masses (SRM). The optimal cutoff size for PN has been based on historical observation of low metastatic rates for SRM and increasing metastatic potential with increase in size of the primary tumor. We aim to evaluate the outcomes of patients treated by PN or radical nephrectomy (RN) for tumors greater than 7 cm. Methods: SEER 17 database was queried to identify patients treated for kidney tumors between 1983 and 2007. We excluded cases treated for non-RCC histology, not treated surgically, and those without specified size. Patients were included if treated by PN or RN with tumor size between 7 and 20 cm. Demographic information included age, gender, and race. The comparison of RCC-specific and overall survival was performed for the entire cohort and stratified by SEER stage (localized, regional, or distant). The survival was compared using Kaplan-Meier method with log rank test to identify significant differences. Results: We identified a total of 18,927 patients treated for RCC that included 18,575 cases of RN and 352 treated with PN. There were no differences in age, gender, or race (Caucasian vs. non-Caucasian) between patients treated by RN or PN (p>0.05). The mean size for tumors treated by PN was 9.7 cm vs. 10.2 cm for RN (p<0.01) and there was more localized disease in the PN group (p<0.01). The overall median survival for patients treated with PN was 108 months vs. 80 months for patients treated with RN (p<0.01). The cancer-specific survival for the entire cohort treated with PN was 195 months vs. 145 months for RN (p<0.01). When stratified by stage, there were no differences in the cancer specific survival between PN and RN groups (p>0.05). Conclusions: PN for tumors 7 to 20 cm is not associated with inferior oncologic outcomes but may provide survival advantage. While patient selection may have influenced overall survival outcomes, PN may provide survival advantage by maximizing renal reserve. These findings may be best answered in a randomized trial to establish if there should be a size cutoff for nephron sparing surgery. No significant financial relationships to disclose.


2021 ◽  
Vol 23 (3) ◽  
pp. 133-140
Author(s):  
Sergey A. Rakul ◽  
Pavel N. Romashchenko ◽  
Kirill V. Pozdnyakov ◽  
Nikolay A. Maistrenko

Studied herein are the long-term results after surgical treatment of stage cT1 kidney cancer. The study includes 278 surgeries for kidney tumors. Partial nephrectomy was performed in 199 (71.6%) cases and radical nephrectomy in 79 (28.4%). Surgeries were performed using the open, laparoscopic, and robotic approaches. Surgical treatment and long-term oncological results were studied. Open approach for partial nephrectomy was used in 2.01% of cases, laparoscopic in 27.64%, and robotic in 70.34%; and radical nephrectomy in 2.53%, 87.34%, and 10.13%, respectively. Incidence postoperative complications after partial and radical nephrectomy were 16.58% and 3.8%, respectively. Сomplications (Clavien Dindo 3) occurred in 11.56% and 3.8% cases, respectively. Positive surgical margin occurred after partial nephrectomy in 1.51%, whereas undetermined for radical nephrectomy. The 5-year disease-free survival for partial and radical nephrectomy was 94.98 1.77% vs. 86.96% 4.11%; 5-year overall survival was 96.2% 1.55% vs. 88.15% 3.96%; 10-year overall survival was 90.82% 4.19% vs. 76.32 6.1%; and 5-year cancer-specific survival was 99.16% 0.84% vs. 94.09% 2.87%, respectively. Our study demonstrates that partial nephrectomy is a safe and effective method for surgical treatment in stage cT1 kidney cancer. A minimally invasive approach is a priority. The nephron-sparring technique demonstrates superior long-term results compared with radical nephrectomy.


2021 ◽  
Vol 53 (11) ◽  
pp. 2273-2280
Author(s):  
Michele Marchioni ◽  
Petros Sountoulides ◽  
Maria Furlan ◽  
Maria Carmen Mir ◽  
Lucia Aretano ◽  
...  

Abstract Objective To evaluate the survival outcomes of patients with local recurrence after radical nephrectomy (RN) and to test the effect of surgery, as monotherapy or in combination with systemic treatment, on cancer-specific mortality (CSM). Methods Patients with local recurrence after RN were abstracted from an international dataset. The primary outcome was CSM. Cox’s proportional hazard models tested the main predictors of CSM. Kaplan–Meier method estimates the 3-year survival rates. Results Overall, 96 patients were included. Of these, 44 (45.8%) were metastatic at the time of recurrence. The median time to recurrence after RN was 14.5 months. The 3-year cancer-specific survival rates after local recurrence were 92.3% (± 7.4%) for those who were treated with surgery and systemic therapy, 63.2% (± 13.2%) for those who only underwent surgery, 22.7% (± 0.9%) for those who only received systemic therapy and 20.5% (± 10.4%) for those who received no treatment (p < 0.001). Receiving only medical treatment (HR: 5.40, 95% CI 2.06–14.15, p = 0.001) or no treatment (HR: 5.63, 95% CI 2.21–14.92, p = 0.001) were both independently associated with higher CSM rates, even after multivariable adjustment. Following surgical treatment of local recurrence 8 (16.0%) patients reported complications, and 2/8 were graded as Clavien–Dindo ≥ 3. Conclusions Surgical treatment of local recurrence after RN, when feasible, should be offered to patients. Moreover, its association with a systemic treatment seems to warrantee adjunctive advantages in terms of survival, even in the presence of metastases.


BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhihao Lv ◽  
Yuqi Liang ◽  
Huaxi Liu ◽  
Delong Mo

Abstract Background It remains controversial whether patients with Stage II colon cancer would benefit from chemotherapy after radical surgery. This study aims to assess the real effectiveness of chemotherapy in patients with stage II colon cancer undergoing radical surgery and to construct survival prediction models to predict the survival benefits of chemotherapy. Methods Data for stage II colon cancer patients with radical surgery were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (1:1) was performed according to receive or not receive chemotherapy. Competitive risk regression models were used to assess colon cancer cause-specific death (CSD) and non-colon cancer cause-specific death (NCSD). Survival prediction nomograms were constructed to predict overall survival (OS) and colon cancer cause-specific survival (CSS). The predictive abilities of the constructed models were evaluated by the concordance indexes (C-indexes) and calibration curves. Results A total of 25,110 patients were identified, 21.7% received chemotherapy, and 78.3% were without chemotherapy. A total of 10,916 patients were extracted after propensity score matching. The estimated 3-year overall survival rates of chemotherapy were 0.7% higher than non- chemotherapy. The estimated 5-year and 10-year overall survival rates of non-chemotherapy were 1.3 and 2.1% higher than chemotherapy, respectively. Survival prediction models showed good discrimination (the C-indexes between 0.582 and 0.757) and excellent calibration. Conclusions Chemotherapy improves the short-term (43 months) survival benefit of stage II colon cancer patients who received radical surgery. Survival prediction models can be used to predict OS and CSS of patients receiving chemotherapy as well as OS and CSS of patients not receiving chemotherapy and to make individualized treatment recommendations for stage II colon cancer patients who received radical surgery.


2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Yuyun Wu ◽  
Ningbo Hao ◽  
Suming Wang ◽  
Xin Yang ◽  
Yufeng Xiao ◽  
...  

Gastric cancer (GC) is one of the most common malignancies worldwide, and the tumor metastasis leads to poor outcomes of GC patients. Long noncoding RNAs (lncRNAs) have emerged as new regulatory molecules that play a crucial role in tumor metastasis. However, the biological function and underlying mechanism of numerous lncRNAs in GC metastasis remain largely unclear. Here, we report a novel lncRNA, lnc-TLN2-4:1, whose expression is decreased in GC tissue versus matched normal tissue, and its low expression is involved in the lymph node and distant metastases of GC, as well as poor overall survival rates of GC patients. We further found that lnc-TLN2-4:1 inhibits the ability of GC cells to migrate and invade but does not influence GC cell proliferation and confirmed that lnc-TLN2-4:1 is mainly located in the cytoplasm of GC cells. We then found that lnc-TLN2-4:1 increases the mRNA and protein expression of TLN2 in GC cells and there is a positive correlation between the expression of lnc-TLN2-4:1 and TLN2 mRNA in GC tissue. Collectively, we identified a novel lncRNA, lnc-TLN2-4:1, in GC, where lnc-TLN2-4:1 represses cell migration and invasion. The low expression of lnc-TLN2-4:1 is associated with poor overall survival rates of GC patients. These suggest that lnc-TLN2-4:1 may be a tumor suppressor during GC metastasis.


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