Pathologic Outcome of Unilateral Low Risk Prostate Cancers on Multi-(≥ 12) Core Prostate Biopsy After Radical Prostatectomy

Hong, Sung Kyu; Min, Kyung Eun; Lee, Seung Tae; Jeong, Sung‐Jin; Byun, Seok-Soo; Kim, Myung; Ha, Seung Bum; Hwang, In Sik; Cho, Sung Yong; Lee, Hak Jong; Choe, Gheeyoung; Lee, Sang Eun

doi:10.1016/s0022-5347(09)60167-1

Cited by 1 publication

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“…During a median follow up of 4 years, 609 patients experienced a cardiovascular event and 892 patients died. After adjusting for pre-operative demographic and co-morbidity variables, RN was associated with a 1.38 times increased risk of overall mortality and a 1.4 times greater number of cardiovascular events (Huang et al, 2009). Similar results were reported in patients undergoing laparoscopic RN and PN (Foyil et al, 2008).…”

Section: Renal Tumor Surgery and New Concerns For Ckdmentioning

confidence: 99%

“…Using the surveillance epidemiology and end results (SEER) data base, investigators from the University of Michigan reported that only 20% of all renal cortical tumors between 2 and 4 cm were treated by PN (Miller et al, 2006a). Using the SEER data base linked to Medicare claims, MSKCC investigators reported a PN utilization rate of only 19% for T1a tumors (4 cm or less; Huang et al, 2009). Interestingly and for uncertain reasons, women and elderly patients are more likely to be treated with RN (Dulabon et al, 2010).…”

Section: Radical Nephrectomy Is Over-utilizedmentioning

confidence: 99%

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End Stage and Chronic Kidney Disease: Associations with Renal Cancer

Russo

2012

Front. Oncol.

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There is a well known association between end stage renal disease and the development of kidney cancer in the native kidney of patients requiring renal replacement therapy. There is now emerging evidence that lesser degrees of renal insufficiency (chronic kidney disease, CKD) are also associated with an increased likelihood of cancer in general and kidney cancer in particular. Nephropathological changes are commonly observed in the non-tumor bearing portions of kidney resected at the time of partial and radical nephrectomy (RN). In addition, patients with renal cancer are more likely to have CKD at the time of diagnosis and treatment than the general population. The exact mechanism by which renal insufficiency transforms normal kidney cells into tumor cells is not known. Possible mechanisms include uremic immune inhibition or increased exposure to circulating toxins not adequately cleared by the kidneys. Surgeons managing kidney tumors must have an increased awareness of their patient’s renal functional status as they plan their resection. Kidney sparing approaches, including partial nephrectomy (PN) or active surveillance in older and morbidly ill patients, can prevent CKD or delay the further decline in renal function which is well documented with RN. Despite emerging evidence that PN provides equivalent local tumor control to RN while at the same time preventing CKD, this operation remains under utilized in the United States and abroad. Increased awareness of the bi directional relationship between kidney function and kidney cancer is essential in the contemporary management of kidney cancer.

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Section: Renal Tumor Surgery and New Concerns For Ckdmentioning

confidence: 99%