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https://www.readbyqxmd.com/read/28211006/surgical-margins-in-nephron-sparing-surgery-for-renal-cell-carcinoma
#1
REVIEW
Dean D Laganosky, Christopher P Filson, Viraj A Master
The oncologic impact of positive surgical margins after nephron-sparing surgery is controversial. Herein, we discuss current data surrounding surgical margins in the operative management of renal cell carcinoma. The prevalence, risk factors, outcomes, and subsequent management of positive surgical margins will be reviewed. Literature suggests that the prevalence of positive surgical margins following kidney surgery varies by practice setting, tumor characteristics, and operation type. For patients undergoing nephron-sparing surgery, it is not necessary to remove a margin of healthy tissue...
January 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28161843/validation-of-3d-volumetric-based-renal-function-prediction-calculator-for-nephron-sparing-surgery
#2
Renato Corradi, Aashish Kabra, Melissa Suarez, Jacob Oppenheimer, Zhamshid Okhunov, Hugh White, Stephanie Nougaret, Hebert A Vargas, Jaime Landman, Jonathan Coleman, Michael A Liss
OBJECTIVE: To evaluate a recently published volume-based renal function prediction calculator intended to be used in small renal mass surgical counseling. METHODS: Retrospective data collection included three-dimensional calculation of renal mass and parenchyma of patients who have undergone extirpative therapy. The predicted glomerular filtration rate (GFR) was calculated using the online calculator. The predicted GFR was compared with the actual 6-month GFR. The Pearson correlation coefficient, paired t test and root-mean-square error (RMSE) are utilized for statistical analysis...
February 4, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28127175/management-of-bilateral-wilms-tumor-our-experience
#3
Raghunath Bv, Vinay Jadhav, Gowri Shankar, Narendrababu M, Ramesh S
Management of bilateral Wilms' tumor is particularly challenging, considering the chances of recurrence and long-term renal function for affected patients. Aggressive surgical resection to prevent recurrence must be balanced with the desire to preserve renal function. We evaluated our experience in the management of bilateral Wilms' tumor stressing the challenges encountered in decision making and the role of nephron sparing surgery. We had four children presenting with bilateral Wilms' tumor. All of them were appropriately staged and given standard chemotherapy as per NWTS-5 guidelines...
March 2017: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28124281/a-single-centre-experience-of-zero-ischaemia-laparoscopic-partial-nephrectomy-in-ireland
#4
C Browne, P E Lonergan, E M Bolton, F D'Arcy, T H Lynch
BACKGROUND: Nephron-sparing surgery in the form of partial nephrectomy is increasingly becoming the standard of care in patients with small renal tumours. Oncological outcomes for partial nephrectomy are equivalent to radical nephrectomy, however, clamping of the hilar vessels to allow resection of tumours during partial nephrectomy may cause ischaemic damage to the kidney and result in long-term renal impairment. AIM: We carried out a retrospective review of 43 patients undergoing laparoscopic partial nephrectomy (LPN) and assessed functional and oncological outcomes...
January 25, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28117608/robotic-partial-nephrectomy-expanding-utilization-advancing-innovation
#5
Christopher J D Wallis, Alaina Garbens, Sameer Chopra, Raj Satkunasivam, Inderbir Singh Gill
Robotic partial nephrectomy (RPN) is gaining increasing prominence for nephron sparing surgery in the treatment of patients with localized kidney tumors. RPN offers the benefits of minimally invasive surgery with a shorter learning curve compared to its laparoscopic counterpart. While long-term data are awaited, RPN does provide short-term oncological and functional outcomes comparable to open and laparoscopic PN. Further, robotic surgery has facilitated technical innovation including the elimination of warm ischemia, provided minimally invasive alternatives to patients with complex tumors and importantly, has fuelled increased dissemination of PN surgery amongst community urologists...
January 24, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28106241/optimising-renal-cancer-patients-for-nephron-sparing-surgery-a-review-of-pre-operative-considerations-and-peri-operative-techniques-for-partial-nephrectomy
#6
Hani Ertemi, Pramit Khetrapal, Nevil M Pavithran, Faiz Mumtaz
Nonmodifiable factors including pre-operative renal function and amount of healthy renal tissue preserved are the most important predictive factors that determine renal function after partial nephrectomy. Ischaemia time is an important modifiable risk factor and cold ischaemia time should be used if longer ischaemia time is anticipated. New techniques may have a role in maximising postoperative kidney function, but more robust studies are required to understand their potential benefits and risks.
January 16, 2017: Urologia
https://www.readbyqxmd.com/read/28063109/mutation-screening-of-ackr3-and-cops8-in-kidney-cancer-cases-from-the-confirm-study
#7
Maryam Mahmoodi, Tu Nguyen-Dumont, Fleur Hammet, Bernard J Pope, Daniel J Park, Melissa C Southey, John M Darlow, Fiona Bruinsma, Ingrid Winship
An apparently balanced t(2;3)(q37.3;q13.2) translocation that appears to segregate with renal cell carcinoma (RCC) has indicated potential areas to search for the elusive genetic basis of clear cell RCC. We applied Hi-Plex targeted sequencing to analyse germline DNA from 479 individuals affected with clear cell RCC for this breakpoint translocation and genetic variants in neighbouring genes on chromosome 2, ACKR3 and COPS8. While only synonymous variants were found in COPS8, one of the missense variants in ACKR3:c...
January 6, 2017: Familial Cancer
https://www.readbyqxmd.com/read/28061038/laparoscopic-partial-nephrectomy-supported-by-training-involving-personalized-silicone-replica-poured-in-three-dimensional-printed-casting-mold
#8
Adam Golab, Tomasz Smektala, Krystian Kaczmarek, Remigiusz Stamirowski, Michal Hrab, Marcin Slojewski
BACKGROUND: Most kidney neoplasms are found incidentally and qualify for nephron-sparing surgery. Laparoscopic approach is beneficial to these patients because of its minimally invasive approach. However, these operations are both difficult and require plenty of experience and extended training. Some stages of the operation are limited by permissible time of transient ischemia. We applied three-dimensional (3D) printing technology to create individual silicone models of kidney to be used for training in laparoscopic procedures before the actual surgeries...
January 6, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28057999/nephron-sparing-surgery-in-bilateral-wilms-tumor-a-report-of-two-cases
#9
Sohrab Arora, Sharmad Kudchadkar, Priyank Yadav, M S Ansari
Nephron-sparing surgery (NSS) has been proposed by many as an alternative to bilateral nephrectomies and renal replacement therapy in bilateral Wilms' tumor (BWT). NSS is not without significant recurrence, morbidity, and mortality. Long-term follow-up, especially with regard to the renal function, remains lacking. Preoperative computed tomography angiogram can help prepare a roadmap for NSS but can underestimate the salvageable parenchyma due to compression of normal adjacent parenchyma. Intraoperative ultrasound can delineate the boundary of surgical margin and help achieve negative margins...
October 2016: Urology Annals
https://www.readbyqxmd.com/read/28054101/management-of-bilateral-wilms-tumours
#10
REVIEW
Alastair J W Millar, Sharon Cox, Alan Davidson
Wilms tumour is named after Max Wilms. It is an embryonal tumour derived from the metanephros. It is the commonest childhood renal tumour and the third commonest paediatric malignancy. Synchronous bilateral Wilms tumours (BWT) represent 4-7% of all Wilms tumours (WT) and present at a younger age than unilateral Wilms tumours. At least 10% of synchronous BWTs have unfavourable histology, and up to 22% are associated with genitourinary abnormalities, aniridia, WAGR syndrome, Denys-Drash Syndrome, hemihypertrophy, or one of the other overgrowth syndromes...
January 4, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/27988238/collaborative-review-of-risk-benefit-trade-offs-between-partial-and-radical-nephrectomy-in-the-management-of-anatomically-complex-renal-masses
#11
REVIEW
Simon P Kim, Steven C Campbell, Inderbir Gill, Brian R Lane, Hein Van Poppel, Marc C Smaldone, Alessandro Volpe, Alexander Kutikov
BACKGROUND: While partial nephrectomy (PN) is the recommended treatment for many small renal masses, anatomically complex tumors necessitate a clear understanding of the potential risks and benefits of PN and radical nephrectomy (RN). OBJECTIVE: To critically review the comparative effectiveness evidence of PN versus RN; to describe key trade-offs involved in this treatment decision; and to highlight gaps in the current literature. EVIDENCE ACQUISITION: A collaborative critical review of the medical literature was conducted...
December 14, 2016: European Urology
https://www.readbyqxmd.com/read/27955941/health-status-and-use-of-partial-nephrectomy-in-older-adults-with-early-stage-kidney-cancer
#12
Hung-Jui Tan, Timothy J Daskivich, Joseph D Shirk, Christopher P Filson, Mark S Litwin, Jim C Hu
INTRODUCTION: The long-term benefits of nephron-sparing surgery for kidney cancer depend on patient health. Accordingly, we examined whether receipt of partial nephrectomy varied with baseline comorbidity or functionality among older adults with stage I kidney cancer. MATERIALS AND METHODS: Using Surveillance, Epidemiology, and End Results (SEER)-Medicare data from 2000 to 2009, we identified patients treated with partial or radical nephrectomy for stage I kidney cancer...
December 7, 2016: Urologic Oncology
https://www.readbyqxmd.com/read/27955727/wilms-tumor-state-of-the-art-update-2016
#13
Sabine Irtan, Peter F Ehrlich, Kathy Pritchard-Jones
Despite an impressive increase in survival rate over the past decades, there is still a need to improve the survival of specific subgroups of Wilms tumor (anaplastic, metastatic, and bilateral) and to decrease the late effects of treatment in terms of renal function and heart toxicity. We aim to explore new areas of improvement, from diagnosis to treatment: in the field of radiology the increased use of MRI and exploration of its diffusion-weighted imaging capabilities to predict WT histology at diagnosis and for preoperative assessment; in biology the emergence of new biomarkers that could be integrated into the decision-making process; and surgical techniques with more accurate indication of nephron-sparing surgery that is no longer reserved for bilateral WT and the minimally invasive approach...
October 2016: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/27942067/anaesthetic-management-of-a-patient-with-huntington-s-chorea-undergoing-robot-assisted-nephron-sparing-surgery
#14
Ankita Batra, Neeru Sahni, Uttam K Mete
No abstract text is available yet for this article.
November 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27911068/-laparoscopic-nephron-sparing-surgery-for-wilms-tumor-description-of-two-cases
#15
L López, M Copete, P Villamizar
Surgical resection is the mainstay of treatment for Wilms tumor. The research progress of the large study groups worldwide has reduced mortality. However, searching to minimize morbidity, the minimally invasive approach has been applied in selected patients. This article describes two cases of Wilms tumor managed with laparoscopic nephron sparing surgery. The case 1 with Beckwith-Wiedemann syndrome and bilateral disease, and the case 2 non-syndromic unilateral. The approach was intraperitoneally, without intraoperative complications...
January 25, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/27908908/double-trouble-pelvi-ureteric-junction-obstruction-and-renal-cell-carcinoma-in-right-to-left-crossed-fused-ectopia
#16
Sumit Saini, Siddharth Yadav, Brusabhanu Nayak
Crossed renal ectopia is a rare occurrence. The majority of the crossed units are fused to their ipsilateral mate. Pelvi-ureteric junction obstruction (PUJO) in crossed fused moieties has been reported very rarely. Similarly, malignancy arising in the crossed over moieties is a rare occurrence too. Only a few cases have been reported earlier. We are here reporting an unusual case with coexistent PUJO and renal cell carcinoma in the crossed over moiety of right to left crossed fused ectopia. To the best of our knowledge, this is the first reported case with both these pathologies, coexisting, in the crossed over moiety...
December 1, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27895733/improved-laparoscopic-nephron-sparing-surgery-for-renal-cell-carcinoma-based-on-the-precise-anatomy-of-the-nephron
#17
Gang Guo, Wei Cai, Xu Zhang
The aim of the present study was to investigate a method of laparoscopic nephron-sparing surgery (LNSS) for renal cell carcinoma (RCC) based on the precise anatomy of the nephron, and to decrease the incidence of hemorrhage and urinary leakage. Between January 2012 and December 2013, 31 patients who presented to the General Hospital of the People's Liberation Army (Beijing, China) were treated for RCC. The mean tumor size was 3.4±0.7 cm in diameter (range, 1.2-6.0 cm). During surgery, the renal artery was blocked, and subsequently, an incision in the renal capsule and renal cortex was performed, at 3-5 mm from the tumor edge...
November 2016: Oncology Letters
https://www.readbyqxmd.com/read/27893792/renal-cell-carcinoma-associated-with-xp11-2-translocation-tfe3-gene-fusions-clinical-features-treatments-and-prognosis
#18
Ning Liu, Zhen Wang, Weidong Gan, Lei Xiong, Baolei Miao, Xiancheng Chen, Hongqian Guo, Dongmei Li
To investigate the clinical characteristics, treatments and prognosis of renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusions (Xp11.2 tRCC), the epidemiological features and treatment results of 34 cases of Xp11.2 tRCC, which were diagnosed by immunohistochemistry staining of TFE3 and fluorescence in situ hybridization at our center, were retrospectively reviewed. The 34 patients included 21 females and 13 males aged 3 to 64 years (median age: 27 years). Four patients were children or adolescents (<18 years of age), and 26 patients were young or middle-aged adults (18-45 years)...
2016: PloS One
https://www.readbyqxmd.com/read/27889493/partial-vs-radical-nephrectomy-for-t1-t2-renal-masses-in-the-elderly-comparison-of-complications-renal-function-and-oncologic-outcomes
#19
Julie Y An, Mark W Ball, Michael A Gorin, Jiwon J Hong, Michael H Johnson, Christian P Pavlovich, Mohamad E Allaf, Phillip M Pierorazio
OBJECTIVE: To compare outcomes of partial nephrectomy (PN) and radical nephrectomy (RN) in patients 65 years and older. MATERIALS AND METHODS: Our institutional renal mass registry was queried for patients 65 and older with solitary cT1-T2 renal mass resected by PN or RN. Clinicopathologic features and perioperative outcomes were compared between groups. Renal function outcomes measured by change in estimated glomerular filtration rate (eGFR) and freedom from eGFR< 45 mL/min/1...
February 2017: Urology
https://www.readbyqxmd.com/read/27885452/the-zero-ischemia-index-zii-a-novel-criterion-for-predicting-complexity-and-outcomes-of-off-clamp-partial-nephrectomy
#20
Yaohui Li, Lin Zhou, Tingchang Bian, Zhuoyi Xiang, Yeqing Xu, Yanjun Zhu, Xiaoyi Hu, Shuai Jiang, Jianming Guo, Hang Wang
PURPOSES: Although several anatomical classification systems that aimed to standardize the description of renal tumors were previously reported, a special classification system is required to help predict the complexity and perioperative outcomes of off-clamp nephron-sparing surgery (NSS). We developed a novel criterion-zero ischemia index (ZII), aiming to help predict the perioperative outcomes after off-clamp NSS and guide patient selection. METHODS: We retrospectively evaluated 149 patients between June 2009 and July 2014 in our institution who underwent off-clamp NSS with available computed tomography images...
November 24, 2016: World Journal of Urology
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