[Show abstract] [Hide abstract]
ABSTRACT: Purpose: To study the surgical outcomes of radical nephrectomy with thrombectomy and to determine prognostic factors for survival of Korean patients with renal cell carcinoma (RCC) and venous tumor thrombus. Materials and Methods: A total of 124 patients with RCC and venous tumor thrombus who underwent radical nephrectomy and thrombectomy were included in this retrospective study. Cancer-specific survival (CSS) and recurrence-free survival (RFS) rates were analyzed retrospectively according to various prognostic factors. Results: The median overall follow-up period for all patients was 29.0 months; the median survival period was 50.0 months. The 2-, 5- and 10-year CSS rates for all patients were 64.2%, 47.1% and 31.7%, respectively. Those for 76 patients (pN0/xM0) without metastasis at presentation were 80.9%, 64.5% and 44.9%, respectively. For all patients, lower body mass index (BMI), higher Fuhrman grade, presence of symptoms, perinephric fat invasion, invasion of inferior vena cava (IVC) wall, lymph node (LN) involvement and distant metastasis at presentation were independent predictors for decreased CSS on multivariate analysis, while thrombus level was not. For non-metastatic patients, lower BMI, presence of symptoms and tumor size were independently associated with decreased CSS. In terms of RFS, lower BMI, presence of perinephric fat invasion were prognostic factors for recurrence. Conclusions: Our data suggest that obesity is independently associated with better survival or lower risk of tumor recurrence in Korean patients undergoing radical nephrectomy with tumor thrombectomy. Also, our results indicate that Fuhrman grade, presence of symptoms, perinephric fat invasion and invasion of IVC wall, LN involvement and distant metastasis at presentation are independent predictors for survival.
International braz j urol: official journal of the Brazilian Society of Urology 01/2013; 39(3):353-363.
[Show abstract] [Hide abstract]
ABSTRACT: Study Type - Prognosis (cohort series) Level of Evidence 2b. What's known on the subject? and What does the study add? This study reports that patients aged 70 years or older have a higher possibility of locally advanced cancer than younger patients. Instead of conservative management, radical eradication of clinically localized prostate cancer should be actively considered in well-selected healthy patients older than 70 years.
• To analyse the differences in the clinicopathological results between two groups of Korean patients aged younger or older than 70 years with clinically localized prostate cancer.
• A cohort of consecutive male patients who underwent radical prostatectomy was retrospectively analysed. In total, 995 patients (74.6%) were younger than 70 years, and 338 patients (25.4%) were 70 years or older. • Biochemical recurrence (BCR) -free survival was evaluated in the patients, who were followed up for more than 24 months. • The Kaplan-Meier method was used to calculate survival estimates for BCR-free survival. Multivariate Cox proportional hazard regression analysis was performed to predict non-organ-confined status and BCR.
• Mean preoperative prostate-specific antigen (PSA) levels and biopsy or pathological Gleason scores showed no differences between the two age groups. • Older patients, aged more than 70 years, displayed significantly higher risk of locally advanced prostate cancer and BCR than younger patients. • Subgroup analysis showed that the risk of the presence of locally advanced disease was significantly increased in patients of 70 years or older when we compared the proportion of locally advanced disease only in patients with PSA <4 ng/mL. • Multivariate analysis showed that old age, high PSA and high Gleason score were significantly associated with non-organ confined status and BCR.
• Patients aged 70 years or older had a higher possibility of locally advanced cancer than younger patients. • Radical eradication of clinically localized prostate cancer should be actively considered in well-selected healthy patients older than 70 years.
BJU International 02/2012; 110(4):505-9. · 3.13 Impact Factor
The Journal of Urology 04/2010; 183(4). · 3.75 Impact Factor