Age-specific survival data for patients with rectal cancer treated with curative intent do not support an overall survival benefit from NCCN guideline-driven therapy for stage II and III patients younger than 50 years. These data suggest that early-onset disease may differ biologically and in its response to multimodality therapy.

VASCULAR AND INTERVENTIONAL RADIOLOGYP ercutaneous cryoablation (PCA) is an increasingly utilized treatment option for stage I renal cell carcinoma (RCC). The American Urologic Association included ablation in its treatment guidelines for stage I RCC in 2009, albeit with cautionary references to increased risk for local recurrence compared with surgery (1). The National Comprehensive Cancer Network added ablation to its own guidelines in 2018 (2). These recommendations were based on meta-analyses of mostly small retrospective studies (3,4). Notwithstanding the lack of definitive evidence, patients with small renal masses are increasingly referred for ablation. The impetus behind the increasing utilization of PCA is mainly due to the changing epidemiologic landscape of RCC.The expected number of RCC in the United States in 2019 is 74 000, with an increasing lifetime risk currently standing at 1.7%, and comprising 4.2% of all cancers (5). Furthermore, the proportion of patients diagnosed with stage I RCC continues to increase (currently 65%-75%) as well ( 6). This migration toward lower clinical stage is partly due to increase in incidental detection (utilization of crosssectional imaging) and recognized risk factors, mainly obesity and smoking (7). These trends are emulated by European statistics on the epidemiology of RCC (8). The growth in (both relative and absolute) numbers of patients with RCC diagnosed at stage I is making nephron-sparing surgery (the current standard of care) and ablation increasingly important. Despite the mounting number of published studies supporting the use of ablation for small renal masses, most have limitations that include small number of patients, lack of histologic proof, retrospective design, and/ or short follow-up time.

The majority of patients with ICC in the United States continue to be managed non-surgically. RFA was associated with improved survival only in stage I disease. XRT was associated with improved survival in stage I & III disease, while RI was associated with improved survival in stage III and IV disease.

BackgroundA small subset of patients with presumed idiopathic intracranial hypertension are found to have isolated internal jugular vein stenosis (IJVS).ObjectiveTo review the current interventions used in patients who present with intracranial hypertension secondary to IJVS.MethodsIn December 2020, we performed a literature search on Pubmed/Medline and Scopus databases for original articles studying surgical and endovascular interventions used for intracranial hypertension in the setting of internal jugular vein stenosis. No date, patient population, or study type was excluded.ResultsAll studies that included at least one case in which a surgical or endovascular intervention was used to treat IJVS were included. Selection criteria for patients varied, most commonly defined by identification of compression of the internal jugular vein. The 17 studies included in this review ranged from case reports to large single-center cohort studies. The most used surgical intervention was styloidectomy. Styloidectomy had an overall better outcome success rate (79%) than angioplasty/stenting (66%). No complications were recorded in any of the surgical cases analyzed. Outcome measures varied, but all studies recorded clinical symptoms of the patients.ConclusionFew current large cohort studies analyze surgical and endovascular interventions for patients with IJVS. Notably, the most common intervention is styloidectomy, followed by internal jugular vein stenting. By understanding the trends and experience of interventionalists and surgeons, more focused and larger studies can be performed to determine effective strategies with the best clinical outcomes.