Renal Cell Carcinoma: Evaluation of the  1997 TNM System and Recommendations  for Follow&amp;ndash;Up after Surgery

Gofrit, Ofer N.; Shapiro, Amos; Kovalski, Nahum; Landau, Ezekiel H.; Shenfeld, Ofer Z.; Pode, Dov

doi:10.1159/000052525

Cited by 47 publications

(18 citation statements)

References 24 publications

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“…[8][9][10][11][12][13] Among patients who recur, the median time to recurrence ranges from 11 to 22 months. 8,9,[12][13][14] If oncological efficacy can be demonstrated, a minimally invasive approach to pT3 disease would be preferred. However, current literature examining outcomes in this patient population are limited to small, single-centre analyses.…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes following laparoscopic management of pT3 renal masses: A large, multi-institutional cohort

Nayak

Patel

Bjazevic

et al. 2015

CUAJ

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Introduction: We described the clinical and oncological outcomes of patients treated by laparoscopic surgery for non-metastatic pT3 renal cell carcinoma (RCC). Methods: We queried a multi-institutional database for patients diagnosed with non-metastatic pathological T3 RCC from 13 Canadian centres treated laparoscopically (radical or partial nephrectomy) between 2008 and 2014. Clinical and pathological outcomes were evaluated. Progression was defined as the development of recurrence or metastatic disease. Log-rank testing and Kaplan-Meier statistical methods assessed for differences and estimated progression-free survival (PFS). Results: In total, 176 patients were identified with a median age of 64 years. The median tumour size was 7.0 cm. Pre-clinical stage was cT1 to cT4 in 39%, 28%, 30% and 3%, respectively. The median blood loss was 150 mL (range: 0-6000) and the median operative time was 124 minutes (range: 60-360). Most lesions were clear cell RCC (80%). After a median follow-up of 17.6 months (range: 0.2-75.0), disease progression occurred in 26% (46/176) of patients, consisting of local recurrence in 7% (3/46), and metastatic disease in 93% (43/46). The 3-year PFS was 67%, with a median PFS of 49 months. Of those who progressed, the median time to progression was 10.3 months. Conclusions: This study is the largest cohort of pT3 RCC patients treated laparoscopically in the literature and suggests that for properly selected patients, laparoscopic management of locally advanced renal masses yields acceptable short-term oncological outcomes.

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Section: Introductionmentioning

confidence: 99%

Clinical outcomes following laparoscopic management of pT3 renal masses: A large, multi-institutional cohort

Nayak

Patel

Bjazevic

et al. 2015

CUAJ

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“…Because recurrence is uncommon but does occur among stage I patients (Ljungberg et al, 1999;Gofrit et al, 2001;Pantuck et al, 2001;Zisman et al, 2002), we included these patients in our trial. Owing to the small number of events and the short follow-up, it is not feasible to assess these patients statistically.…”

Section: Discussionmentioning

confidence: 99%

Perioperative immunomodulation with interleukin-2 in patients with renal cell carcinoma: results of a controlled phase II trial

Klatte

Ittenson

et al. 2006

Br J Cancer

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We conducted a non-randomised controlled phase II trial to investigate the role of preoperative administration of interleukin-2 (IL-2) in patients with renal cell carcinoma undergoing tumour nephrectomy. A total of 120 consecutive patients were allocated alternately to the two study groups: perioperative immunomodulation with IL-2 (IL-2 group; n ¼ 60) and perioperative immunomonitoring without immunomodulation (control group; n ¼ 60). Patients from the IL-2 group received four doses of 10 Â 10 6 IU m À2 twice daily subcutaneously a week before operation followed by a daily maintenance dose of 3 Â 10 6 IU m À2 subcutaneously until a day before the operation. Parameters of cellular and humoral immunity (leucocytes, T-cell markers CD3, CD4, and CD8, B-cell marker CD19, monocyte marker CD14, natural killer (NK) cell markers CD16, CD56, and CD57, activation markers CD6, CD25, CD28, and CD69, progenitor cell marker CD34, as well as IL-2, IL-6, IL-10, soluble IL-2 receptor, IL-1 receptor antagonist, transforming growth factorb1, and vascular endothelial growth factor) were measured in peripheral venous blood at various intervals. Interleukin-2-related toxicity was WHO grade 1 (24%), 2 (67%), and 3 (9%). In the postoperative period, T-cell markers, activation markers, and NK cell markers decreased, and IL-6 and IL-10 increased. However, all these alterations were significantly less accentuated in patients who had been pretreated with IL-2. Median follow-up was 40 months. Tumour-specific survival in the IL-2 group and the control group was 98 vs 81% after 1 year and 86 vs 73% after 5 years (P ¼ 0.04). A similar effect was found for progression-free survival. We conclude that IL-2 can be safely administered in the perioperative period and modulates immunological parameters. However, to validate the survival data, a larger randomised phase III trial is needed.

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“…(Gofrit et al, 2001;Hafez, Fergany, and Novick, 1999) More contemporary analyses have shown that regardless of the form of surgical intervention, namely partial or radical nephrectomy, patients with tumors larger than 4cm have a higher risk of relapse. (Lau et al, 2000;Lesage et al, 2007;Margulis et al, 2007;Mitchell et al, 2006;Zini et al, 2009) On the basis of these precedents, there has been a clear impetus to determine whether elective nephron-sparing surgery may be an option for patient with localized T1b (4-7cm) tumors.…”

Section: Partial Nephrectomy Is Increasingly Being Utilized In Mediummentioning

confidence: 99%

Renal Cortical Neoplasms and Associated Renal Functional Outcomes

Badalato¹,

Kates²,

Sadeghi³

et al. 2012

Diseases of Renal Parenchyma

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Renal Cell Carcinoma: Evaluation of the 1997 TNM System and Recommendations for Follow–Up after Surgery

Cited by 47 publications

References 24 publications

Clinical outcomes following laparoscopic management of pT3 renal masses: A large, multi-institutional cohort

Clinical outcomes following laparoscopic management of pT3 renal masses: A large, multi-institutional cohort

Perioperative immunomodulation with interleukin-2 in patients with renal cell carcinoma: results of a controlled phase II trial

Renal Cortical Neoplasms and Associated Renal Functional Outcomes

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