Interferon Adjuvant to Radical Nephrectomy in Robson Stages II and III Renal Cell Carcinoma: A Multicentric Randomized Study

2001 ◽  
Vol 19 (2) ◽  
pp. 425-431 ◽  
Author(s):  
Giorgio Pizzocaro ◽  
Luigi Piva ◽  
Maria Colavita ◽  
Sonia Ferri ◽  
Raffaella Artusi ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Prognostic Factors ◽  
Protective Effect ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Radical Nephrectomy ◽  
Rank Test ◽  
Event Free Survival ◽  
Free Survival ◽  
Log Rank Test

PURPOSE: Because interferon gave promising results in the management of metastatic renal cell carcinoma in the 1980s, a multicentric randomized controlled trial was planned to compare adjuvant recombinant interferon alfa-2b (rIFNα2b) with observation after radical nephrectomy in patients with Robson stages II and III renal cell carcinoma. Overall and event-free survival were to be evaluated together with prognostic factors. PATIENTS AND METHODS: Overall and event-free survival curves for 247 patients (124 controls and 123 treated) were estimated by the Kaplan-Meier method and compared using the log-rank test. Cox’s multiple regression models were adopted to perform a joint analysis of treatment and prognostic factors. RESULTS: The 5-year overall and event-free survival probabilities were 0.665 and 0.671, respectively, for controls and 0.660 and 0.567, respectively, for the treated group; the differences were not statistically significant (2P = .861 for overall and 2P = .107 for event-free survival with the log-rank test). Regarding prognostic factors, only grade, pT, and pN demonstrated a significant prognostic role. First-order interactions of treatment with pT and pN category were investigated; a significant interaction was found between pN and treatment. A harmful effect of rIFNα2b in the 97 treated pN0 patients and a protective effect in the 13 treated pN2/pN3 patients were statistically significant. CONCLUSION: Adjuvant rIFNα2b is not indicated after radical nephrectomy for renal cell carcinoma. The protective effect in the small group of pN2/pN3 patients requires further investigation.

scholarly journals Comparison of Long-Term Results After Nephron-Sparing Surgery and Radical Nephrectomy in Treating 4- to 7-cm Renal Cell Carcinoma

Medicina ◽  
2013 ◽  
Vol 49 (5) ◽  
pp. 36 ◽  
Author(s):  
Daimantas Milonas ◽  
Giedrius Skulčius ◽  
Ruslanas Baltrimavičius ◽  
Stasys Auškalnis ◽  
Marius Kinčius ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Radical Nephrectomy ◽  
Nephron Sparing Surgery ◽  
Rank Test ◽  
Cancer Specific Survival ◽  
Log Rank Test ◽  
Nephron Sparing

Objective. The aim of our study was to compare long-term oncological outcomes following nephron-sparing surgery (NSS) and radical nephrectomy (RN) for renal cell carcinoma (RCC) 4 to 7 cm in diameter. Material and Methods. The study included patients who underwent RN or NSS for RCC 4 to 7 cm in diameter between 1998 and 2009. The studied groups were compared with respect to the patients’ age, sex, physical status according to the American Society of Anesthesiologists Physical classification, histological type, stage, tumor size, grade, duration of the operation, and complications. Survival was established using the Kaplan-Meier method. The risk factors for survival were analyzed using a multivariate Cox regression model. Results. During the study, 351 patients underwent surgery: 317 patients (90.3%) underwent RN, and 34 (9.7%), NSS. The compared groups differed with respect to tumor size (P=0.001) and stage (P=0.006). The overall estimated 12-year survival was 53.7% after RN and 55.2% after NSS (log-rank test P=0.437). The 12-year cancer-specific survival in the RN and NSS groups was 69.6% and 80.6%, respectively (log-rank test P=0.198). Pathological stage and patients’ age were the major factors affecting both overall and cancer-specific survival. The type of surgery (NSS or RN) had no effect on survival. Conclusions. Our study showed that nephron-sparing surgery is a safe technique compared with radical nephrectomy that ensures good oncological control in the treatment of renal cell carcinoma measuring 4 to 7 cm and may be proposed as the treatment of choice for renal tumors not only up to 4 cm, but also 4 to 7 cm in size.

Radical Nephrectomy for Renal Cell Carcinoma: Long-Term Results and Prognostic Factors on a Series of 328 Cases

1997 ◽  
Vol 31 (1) ◽  
pp. 40-48 ◽  
Author(s):  
C. Giberti ◽  
F. Oneto ◽  
G. Martorana ◽  
S. Rovida ◽  
G. Carmignani
Keyword(s):  
Renal Cell Carcinoma ◽  
Prognostic Factors ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Radical Nephrectomy ◽  
Long Term Results

Oncological and functional outcomes after radical nephrectomy for renal cell carcinoma: A comprehensive analysis of prognostic factors

2012 ◽  
Vol 20 (4) ◽  
pp. 382-389 ◽  
Author(s):  
Takehiro Sejima ◽  
Hideto Iwamoto ◽  
Toshihiko Masago ◽  
Shuichi Morizane ◽  
Nobuyuki Hinata ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Prognostic Factors ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Radical Nephrectomy ◽  
Functional Outcomes ◽  
Comprehensive Analysis

Prognostic factors for the recurrence of renal cell carcinoma after radical nephrectomy

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 14629-14629
Author(s):  
C. H. Ohlmann ◽  
T. Schneider ◽  
S. Wille ◽  
U. Engelmann ◽  
A. Heidenreich
Keyword(s):  
Renal Cell Carcinoma ◽  
Prognostic Factors ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Radical Nephrectomy ◽  
Prognostic Significance ◽  
Flank Pain ◽  
Time Of Surgery ◽  
Asymptomatic Patients

14629 Background: Recurrence of renal cell carcinoma depends mainly on tumor stage at the time of radical nephrectomy and increases with increasing T-stage. Up to 30% of patients with T1–2 tumors will experience local or distant recurrence. Recommendations for the follow-up include chest x-ray every 6 months for stages T1–4 and abdominal CT-scan for pT3–4 for the first 3 years. The aim of our study was to identify prognostic factors predicting recurrence of RCC in order to individualize follow up strategies. Methods: We retrospectively analyzed the charts of 177 patients with RCC who underwent radical nephrectomy. In 163/177 (92%) of the patients the histology revealed renal cell carcinoma. The median-follow up was 4.5 (1–6) years. The prognostic significance of histology, gender, age, c-reactive protein, hemoglobin, hematuria, gross hematuria, weight loss, flank pain and metastases at the time of surgery for risk of recurrence was calculated by uni- and multivariate analysis. Cancer specific survival (CSS) was analyzed by the Kaplan-Meir method. Results: Logistic regression analysis identified presence of metastases at time of surgery (p ≤ 0.0005), hematuria (p ≤ 0.0005) and flank pain (p = 0.011) as independent prognostic factors for the recurrence of RCC. The risk of recurrent disease is 33.5% with one, 70 to 83% with two and 95.6% with the presence of all 3 markers. 3-year CSS is 69% vs. 82% in symptomatic vs. asymptomatic patients (p = 0.1352), 45% vs. 90% in M1/N1 vs. M0/N0 (p = 0.0001) and 78% vs. 88% in pT3b vs. <pT3b (p = 0.0102). Conclusions: In our study we were able to identify prognostic factors for the recurrence of renal cell carcinoma. Based on this model the follow-up of patients can be individualized according to the risk for recurrence after radical nephrectomy. No significant financial relationships to disclose.

Radical Nephrectomy for Renal Cell Carcinoma: Long-Term Results and Prognostic Factors on a Series of 328 Cases

1998 ◽  
Vol 159 (2S) ◽  
pp. 616-617
Author(s):  
C. Giberti ◽  
F. Oneto ◽  
G. Martorana ◽  
S. Rovida ◽  
G. Carmignani
Keyword(s):  
Renal Cell Carcinoma ◽  
Prognostic Factors ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Radical Nephrectomy ◽  
Long Term Results

scholarly journals The Immunoexpression of YAP1 and LATS1 Proteins in Clear Cell Renal Cell Carcinoma: Impact on Patients’ Survival

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
J. Godlewski ◽  
J. Kiezun ◽  
B. E. Krazinski ◽  
Z. Kozielec ◽  
P. M. Wierzbicki ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Prognostic Factors ◽  
Cell Carcinoma ◽  
Tumor Cells ◽  
Renal Cell ◽  
Cellular Localization ◽  
Cox Regression ◽  
Clear Cell ◽  
Rank Test ◽  
Cell Renal Cell Carcinoma

The aim of the study was to determine by immunohistochemistry cellular localization and immunoreactivity levels of YAP1 and LATS1 proteins in paired sections of tumor and unchanged renal tissues of 54 clear cell renal cell carcinoma (ccRCC) patients. Associations between clinical-pathological and overall survival (OS; median follow-up was 40.6 months) data of patients and YAP1 and LATS1 immunoreactivity were analyzed by uni- and multivariate Cox regression model and log-rank test. YAP1 immunoreactivity was found in the nuclei of tumor cells in 64.8% of ccRCC patients, whereas only 24.1% of tumors revealed cytoplasmic YAP1 expression. LATS1 immunoexpression was observed only in the cytoplasm of tumor cells in 59.3% of patients. LATS1 immunoreactivity in cancer cells negatively correlated with the size of primary tumor. The overall YAP1 immunoreactivity did not correlate with clinical-pathological data of patients. However, the subgroup of ccRCC patients who presented with cytoplasmic YAP1 immunoexpression had significantly shorter OS (median = 26.8 months) than patients without cytoplasmic YAP1 expression (median undefined). Multivariate Cox analysis revealed that increased cytoplasmic YAP1 (HR = 4.53) and decreased LATS1 immunoreactivity levels (HR = 0.90) were associated with worse prognosis, being independent prognostic factors. These results suggest that YAP1 and LATS1 can be considered as new prognostic factors in ccRCC.

The EORTC Intergroup Phase 3 Study Comparing the Oncological Outcome of Elective Nephron-Sparing Surgery and Radical Nephrectomy for Low-Stage Renal Cell Carcinoma

2021 ◽  
pp. 107-112
Author(s):  
Christopher Weight
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Radical Nephrectomy ◽  
Progression Free Survival ◽  
Oncological Outcome ◽  
Nephron Sparing Surgery ◽  
Renal Masses ◽  
Free Survival ◽  
Nephron Sparing

This chapter summarizes the findings of a notable non-inferiority trial comparing nephron-sparing surgery to radical nephrectomy for small renal masses suspected to be renal cell carcinoma. Overall survival results favored radical nephrectomy and progression-free survival was largely similar. Its findings remain controversial but suggest that the assumed benefits of nephron-sparing surgery over radical nephrectomy based on non-randomized studies may have been overstated and that in many cases both approaches may have similar outcomes.

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