Purpose-Despite the proven efficacy of nephron sparing surgery, patients with hereditary renal cancer remain at risk for tumor recurrence. Management options for recurrent tumors include completion nephrectomy, ablation, and repeat partial nephrectomy (RPN). We examine the feasibility and outcomes of RPN performed on the same renal unit.Materials and Methods-We retrospectively reviewed the records of 51 attempted RPN cases on 47 patients from 1992 to 2006. Demographic information as well as intraoperative, perioperative, and renal functional outcome data were collected. Comparison of pre-and postoperative renal function was performed using the two tailed T-test.Results-Major perioperative complications or reoperations occurred in 10 of 51 (19.6%) cases that included one perioperative mortality (1.9%). In cases of successful RPN, there was a statistically significant increase in postoperative serum creatinine (1.35 vs. 1.16 mg/dL, p <0.05) and a significant decrease in creatinine clearance (84.6 mL/min vs. 95.3mL/min, p = 0.05) and renogram split function (52.3% vs. 54.8%, p <0.05). Two patients required long term hemodialysis (3.9%). Ten of the 51 renal units (19.6%) in our study required subsequent operations for additional local recurrence or de novo tumor formations with a median time to subsequent surgery of 50 months. Forty-six of fortyseven patients are alive at median follow up of 56 months.Conclusions-RPN is technically feasible. Although there is a statistically significant decrease in postoperative renal functional studies, most patients retained sufficient function to avoid hemodialysis. RPN may provide acceptable oncologic control despite the anticipated development of locally recurrent or de novo tumors. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. While repeat partial nephrectomy may maintain the balance between tumor control and renal preservation, the feasibility as well as functional and oncologic outcomes of patients undergoing RPN are not well established. There are a few reports of patients with hereditary kidney cancer that have undergone repeat NSS. [4][5][6] However, most of these series report limited numbers which may restrict the ability to make conclusions regarding repeat partial nephrectomy. Our ongoing clinical experience in patients with hereditary kidney cancer who are at risk for metachronous tumor formation has provided a unique opportunity to evaluate the feasibility and outcomes of repeat partial nephrectomy. Keywords NIH Public Access MATERIALS AND METHODSBetween 1992 and 2006, 51 cases of planned RPN on the same renal unit ...
Multiple myeloma (MM) is the second most frequent malignancy of blood, and information on disease burden of MM is limited in developing countries. We aimed to estimate the prevalence and incidence of MM in China. We used data from the national urban employee and urban resident basic medical insurance from 2012 to 2016 in China. MM cases were based on the primary diagnosis (International Classification of Diseases (ICD) code, ICD for oncology, or text of diagnosis) of patients. The crude prevalence and incidence were 6.88 per 100,000 population (95% CI, 5.75-8.00) and 1.60 per 100,000 person-years (1.28-1.92), respectively. The standardized prevalence and incidence were 5.68 (5.64-5.72) and 1.15 (1.11-1.19), respectively. Overall, the rates were higher in males compared with females for prevalence (7.89 vs. 5.79, P < 0.05) and incidence (1.84 vs. 1.30, P < 0.05). Both rates increased with age, and the mean age (SD) of MM patients was 57.9 (14.4) years. Prevalence peaked between 55 and 74 years old for both genders. The incidence in women aged 55-59 had a significantly high incidence of 5.53 (4.98-6.11). The prevalence and incidence were significantly lower than those in North America, Australia, and Western Europe but were in the same range as those in Japan or Korea. MM should be one of the cancers in the spotlight from both medical and socioeconomic perspectives in low-resource but populous countries because of the incidence of more elderly MM patients in the next decade. Further research is warranted to examine the potential pathophysiologic mechanism.
{ This paper presents a new approach to local instruction scheduling based on integer programming that produces optimal instruction schedules in a reasonable time, even for very large basic blocks. The new approach rst uses a set of graph transformations to simplify the datadependency graph while preserving the optimality of the nal schedule. The simpli ed g r aph results in a simpli ed integer program which can be solved much faster. A new integerprogramming formulation is then applied to the simpli ed graph. Various techniques are used to simplify the formulation, resulting in fewer integer-program variables, fewer integer-program constraints and fewer terms in some of the remaining constraints, thus reducing integer-program solution time. The new formulation also uses certain adaptively added c onstraints (cuts) to reduce solution time. The proposed optimal instruction scheduler is built within the Gnu Compiler Collection (GCC) and is evaluated experimentally using the SPEC95 oating point benchmarks. Although optimal scheduling for the target processor is considered i n t r actable, all of the benchmarks' basic blocks are o ptimally scheduled, including blocks with up to 1000 instructions, while total compile time increases by only 14%.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.