Nephron-Sparing Surgery

Poppel, H. P. Van; Baert, Luc

doi:10.1007/978-3-642-59839-5_6

Cited by 4 publications

(2 citation statements)

References 113 publications

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“…Series reported to date show excellent local control by NSS [17] with a reported local recurrence after elective NSS as low as 1%, which is dramatically lower than seen after imperative NSS [17]. The overall risk of unsuspected multifocality of RCC can be as high as 25%, although in a surgical setting it is only ≈ 6% [17]. This multifocality may be responsible for ipsilateral recurrence.…”

Section: Surgical Treatment Of Localized Diseasementioning

confidence: 99%

Recent advances in kidney cancer and metastatic disease

2001

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Section: Surgical Treatment Of Localized Diseasementioning

confidence: 99%

Recent advances in kidney cancer and metastatic disease

2001

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“…Multiple reports from many centers throughout the world confirm that nephronsparing surgery (NSS) has been widely implemented for the management of small renal tumors over the last few decades (253)(254)(255)(256)(257)(258)(259)(260)(261)(262)(263)(264). There are several reasons for this (265). The increasing use of abdominal ultrasound and other diagnostic techniques has resulted in a stage migration phenomenon (266).…”

Section: Introductionmentioning

confidence: 99%

Precancerous Lesions in the Kidney

Poppel

Nilsson

Algaba

et al. 2000

Scandinavian Journal of Urology and Nephrology

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Scand J Urol Nephrol Suppl 205: 136-165, 2000 Renal cell carcinoma (RCC), although occurring less frequently than prostate and bladder cancer, is actually the most malignant urologic disease, killing >35% of affected patients. Therefore, investigation of the nature of premalignant lesions of the kidney is a relevant issue. Following the most recent histological classification RCC can be subdivided into four categories: conventional RCC; papillary RCC; chromophobe RCC; and collecting duct carcinoma.In contrast to many genitourinary malignancies, premalignant alterations in the kidney are scarcely described. Intratubular epithelial dysplasia has been recognized as the most common precursor of RCC. In analogy to prostatic intraepithelial neoplasia (PIN), the premalignant lesions of the kidney are described as high or low-grade renal intratubular neoplasia. In contrast, precancerous lesions have been described as part of the von Hippel-Lindau syndrome (VHL) where the evolution from a simple cyst to an atypical cyst with epithelial hyperplasia to cystic or solid conventional-type RCC is well documented. Finally, in the genesis of papillary RCC an adenoma-carcinoma sequence has been recognized with specific genetic changes. There are no data on the epidemiology of premalignant lesions of the kidney, but research into the etiology of RCC has been extended substantially. Familial and genetic factors are well documented in VHL disease, in hereditary papillary RCC, in the tuberous sclerosis complex and in familial RCC. Cigarette smoking and obesity are established risk factors for RCC. Hypertension or its medication has also been associated with an increased risk. Among dietary factors an inverse relation between risk and consumption of vegetables and fruit has been found. Occupational exposure to substances such as asbestos and solvents has been linked to an increased risk of RCC.Specific RCC variants have distinctive chromosome alterations and several genes have been implicated in the development of RCC. Loss of material from the 3p chromosome characterizes conventional RCC and the deletion of the VHL suppressor gene plays an important role in the genesis of this RCC variant. In contrast, numerical changes with trisomy of chromosomes 7 and 17 and loss of the sex chromosome are typical changes in papillary tumors, whereas papillary RCC have additional trisomies. Chromophobe RCC is characterized by loss of chromosomes with a combination of monosomies. Less consistent genetic alterations are associated with collecting duct carcinoma.The traditional treatment of RCC is surgery by radical or partial nephrectomy. The latter approach carries a risk of tumor recurrence as a result of unrecognized satellite lesions or premalignant lesions that might have been present at the time of surgery. However, the reported recurrence rates after partial nephrectomy are <1% and therefore the possible presence of premalignant disease does not alter the actual treatment strategy advocated. Although multifocality and bilateral occurrence of...

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Renal‐cell Carcinoma

2014

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A significant problem for clinicians who treat cancer is the application of the known determinants of disease outcome to the individual patient. The clinical course can be affected by the inherent properties of the tumor, the host‐related factors, and the treatment applied. Renal‐cell carcinoma (RCC) has the reputation of an individual unpredictable outcome with rare cases of spontaneous tumor regression and extended survival despite the presence of metastases. This unpredictable outcome is determined by the genotypic biological behavior and the tumor‐host interaction. Refinement of our ability to predict the outcome should facilitate the rational choice of treatment alternatives and provide more reliability in the interaction with the patient. In case of RCC the absence of other effective treatment modalities besides surgery, renders these considerations even more important.

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Nephron-Sparing Surgery

Cited by 4 publications

References 113 publications

Recent advances in kidney cancer and metastatic disease

Recent advances in kidney cancer and metastatic disease

Precancerous Lesions in the Kidney

Renal‐cell Carcinoma

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