Purpose. To report outcome data for patients with penile cancer treated surgically with glansectomy and skin grafting. Materials and Methods. We retrospectively reviewed data on all patients undergoing surgical management of penile cancer by a single surgeon between 1998 and 2008. Outcomes in patients who underwent glansectomy and skin grafting were analysed. Results. Between 1998 and 2008 a total of 25 patients with a mean age 60 (39–83) underwent glansectomy and skin grafting. Six patients had carcinoma in situ (CIS); the stage in the remaining patients ranged from T1G1 to T3G3. Mean followup for patients was 28 months (range 6–66). Disease specific survival was 92% with 2 patients who had positive nodes at lymph node dissection developing groin recurrence. One patient developed a local recurrence requiring a partial penectomy. Conclusions. Penile preserving surgery with glansectomy and skin grafting is a successful technique with minimal complications for local control of penile carcinoma arising on the glans. Careful followup to exclude local recurrence is required.
Introduction: To describe oncological outcomes, effects on renal function and complications with radiofrequency ablation (RFA) of T1 renal tumors in an 8-year experience. Materials and Methods: A retrospective study of RFA in 89 consecutive patients between 2005 and 2013 was undertaken. Those with metastatic disease, incomplete follow-up, genetic pre-disposition to renal tumors and biopsy proven benign pathology were excluded, with 79 patients meeting inclusion criteria. Data was collected on demographics, oncological outcomes, complications and effects on renal function. Results: We demonstrate 94% disease-free survival at median follow-up of 29 months in a population consisting of 42 T1a and 37 T1b tumors. No disease related deaths were recorded in the follow-up period. Post-RFA decline in renal function was shown to correlate with tumor size and increased age (p = 0.0009/0.0021). Pre-existing renal impairment was a risk for post-RFA function decline (p < 0.005). Two complications were encountered in the series. Conclusion: RFA produces durable oncological outcomes in T1 tumors with a minimal effect on renal function and low risk of complications. Patients at risk of developing renal impairment can be identified from described risk factors.
Subclavian vein thrombosis is an uncommon clinical condition which is often associated with venous catheterization or secondary to excessive effort. We present a 54-year-old female with subclavian vein thrombosis as a first presentation of renal cell carcinoma. Although this is an unusual presentation, malignancy should be considered in the differential diagnosis. Hypercoagulability as part of a paraneoplastic syndrome was considered a possible etiology. In patients with otherwise unexplained subclavian vein thrombosis, full systemic examination and radiological evaluation of the abdomen, retroperitoneum and pelvis should be pursued. A review of the literature relevant to this unusual case is provided.
Subclavian vein thrombosis is an uncommon clinical condition which is often associated with venous catheterization or secondary to excessive effort. We present a 54-year-old female with subclavian vein thrombosis as a first presentation of renal cell carcinoma. Although this is an unusual presentation, malignancy should be considered in the differential diagnosis. Hypercoagulability as part of a paraneoplastic syndrome was considered a possible etiology. In patients with otherwise unexplained subclavian vein thrombosis, full systemic examination and radiological evaluation of the abdomen, retroperitoneum and pelvis should be pursued. A review of the literature relevant to this unusual case is provided.
Objective: To describe oncology outcomes and complications with radiofrequency ablation (RFA) for T1 renal cell carcinoma in a centre with 14 years of experience. Method: Retrospective study of 95 consecutive patients from 2005 to 2013 who underwent RFA. Those with metastatic disease at time of treatment, incomplete follow up, proven benign pathology, genetic underlying genetic pre-disposition were excluded. 48 patients with 49 tumours met the inclusion criteria. Data was collected on demographics oncological outcomes and complications. Primary outcome measures were disease free survival and cancer specific survival at five and eight years. Results: Median follow up was 83 months. We demonstrate an 87% 5-year disease free survival (DFS) and 70% eight-year DFS. Mean time to progression was 45 months. Cancer specific survival was demonstrated as 97.9% at five years and 93.6% at eight years – all cancer-related deaths had an initial tumour of > 3 cm diameter. 42.9% of the recurrences occurred beyond five years The median time to progression for secondary failure was 50.7 months. One Clavien-Dindo Grade 2 complication was encountered in the series. Outcome: RFA produces comparable long-term oncological outcomes to other modalities for T1 tumours with a low complication rate. Follow up should be considered beyond five years as a significant proportion of the recurrences (42.9%) in this study occurred beyond this point. Level of evidence: 4
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