25 results on '"Patricio García Marchiñena"'
Search Results
2. PD02-02 MULTI INSTITUTIONAL VALIDATION OF A NEW KIDNEY MODEL FOR LAPAROSCOPIC NEPHRON SPARING SURGICAL TRAINING
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Nicolas Bonanno, Santiago Birkner de Miguel, Carlos Ameri, Gonzalo Vitagliano, Matias Biancucci, Leandro Blas, Patricio García Marchiñena, Alberto Jurado, Hernando Rios Pita, Maximiliano Ringa, and Lucas Mey
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medicine.medical_specialty ,Kidney ,medicine.anatomical_structure ,business.industry ,Urology ,medicine.medical_treatment ,medicine ,Nephron sparing surgery ,business ,Surgical training ,Nephrectomy ,Surgery - Abstract
INTRODUCTION AND OBJECTIVE:Laparoscopic partial nephrectomy (LPN) is a very demanding procedure and a large proportion of complications occur during the surgeon's initial learning curve. There is a...
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- 2021
3. Flexible Fiber Optic vs Digital Ureteroscopy and Enhanced vs Unenhanced imaging for Diagnostic and Treatment of Upper Tract Urothelial Carcinoma: Results from the Clinical Research Office of the Endourology Society (CROES)-UTUC Registry
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Morgan Rouprêt, Patricio García-Marchiñena, Paolo Gontero, Francesco Soria, M. Pilar Laguna, Erkan Erkan, Jean de la Rosette, Anthony C. H. Ng, Mariano Sebastian González, Tomonori Habuchi, Università degli studi di Torino (UNITO), Groupe de Recherche Clinique Onco-Urologie Prédictive [CHU Tenon] (GRC 5), CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'Urologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Akita University, and The Chinese University of Hong Kong [Hong Kong]
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Male ,medicine.medical_specialty ,fiber optic ureteroscopy ,Urology ,[SDV]Life Sciences [q-bio] ,030232 urology & nephrology ,Kidney ,Disease-Free Survival ,03 medical and health sciences ,Narrow Band Imaging ,0302 clinical medicine ,medicine ,Overall survival ,Ureteroscopy ,Humans ,In patient ,Registries ,#utuc ,digital ureteroscopy ,fibre-optic ureteroscopy ,Image1-S ,narrow-band imaging ,upper tract urothelial carcinoma ,Aged ,Carcinoma, Transitional Cell ,Female ,Image Enhancement ,Kidney Neoplasms ,Middle Aged ,Organ Sparing Treatments ,Survival Rate ,Ureteral Neoplasms ,Image 1-S ,Urothelial carcinoma ,medicine.diagnostic_test ,business.industry ,Carcinoma ,3. Good health ,Clinical research ,Upper tract ,030220 oncology & carcinogenesis ,Treatment strategy ,Transitional Cell ,business ,Cohort study - Abstract
Objectives To compare the oncological outcomes of patients with upper tract urothelial carcinoma (UTUC) undergoing kidney-sparing surgery (KSS) with fibre-optic (FO) vs digital (D) ureteroscopy (URS). To evaluate the oncological impact of image-enhancement technologies such as narrow-band imaging (NBI) and Image1-S in patients with UTUC. Patients and Methods The Clinical Research Office of the Endourology Society (CROES)-UTUC registry is an international, multicentre, cohort study prospectively collecting data on patients with UTUC. Patients undergoing flexible FO- or D-URS for diagnostic or diagnostic and treatment purposes were included. Differences between groups in terms of overall survival (OS) and disease-free survival (DFS) were evaluated. Results The CROES registry included 2380 patients from 101 centres and 37 countries, of whom 401 patients underwent URS (FO-URS 186 and D-URS 215). FO-URS were performed more frequently for diagnostic purposes, while D-URS was peformed when a combined diagnostic and treatment strategy was planned. Intra- and postoperative complications did not differ between the groups. The 5-year OS and DFS rates were 91.5% and 66.4%, respectively. The mean OS was 42 months for patients receiving FO-URS and 39 months for those undergoing D-URS (P = 0.9); the mean DFS was 28 months in the FO-URS group and 21 months in the D-URS group (P < 0.001). In patients who received URS with treatment purposes, there were no differences in OS (P = 0.9) and DFS (P = 0.7). NBI and Image1-S technologies did not improve OS or DFS over D-URS. Conclusions D-URS did not provide any oncological advantage over FO-URS. Similarly, no differences in terms of OS and DFS were found when image-enhancement technologies were compared to D-URS. These findings underline the importance of surgeon skills and experience, and reinforce the need for the centralisation of UTUC care.
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- 2021
4. Laparoscopic Ureterolysis without Omentoplasty in the Management of the Uropathy Secondary to Idiopathic Retroperitoneal Fibrosis
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Alberto Jurado, Miguel Angel Bergero, Carlos David, Guillermo Gueglio, Patricio García Marchiñena, and Fernando Dipatto
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medicine.medical_specialty ,Uropathy ,business.industry ,medicine ,Surgery ,Ureterolysis ,Idiopathic Retroperitoneal Fibrosis ,medicine.disease ,business - Published
- 2019
5. Current Trends in Management of Renal Cell Carcinoma with Venous Thrombus Extension
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Alberto Jurado, Guillermo Gueglio, Patricio García Marchiñena, and Agustin Romeo
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Pyeloplasty ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Vena Cava, Inferior ,Nephrectomy ,Inferior vena cava ,Renal Veins ,03 medical and health sciences ,Renal Artery ,0302 clinical medicine ,Robotic Surgical Procedures ,Renal cell carcinoma ,Humans ,Medicine ,Neoplasm Invasiveness ,Robotic surgery ,Heart Atria ,Carcinoma, Renal Cell ,Thrombectomy ,Venous Thrombosis ,business.industry ,Prostatectomy ,General Medicine ,medicine.disease ,Embolization, Therapeutic ,Thrombosis ,Kidney Neoplasms ,Surgery ,Review article ,medicine.vein ,030220 oncology & carcinogenesis ,cardiovascular system ,Laparoscopy ,business - Abstract
To review the evidence regarding the current trends in surgical management of renal cell carcinoma (RCC) with inferior vena cava (IVC) thrombosis. Recent published series have shown the role of minimally invasive surgery in IVC thrombectomy. This review article evaluates the present RCC with venous extent literature to assess the role of open and minimally invasive surgery in this scenario. Robotic urological surgery has shown to have known benefits in radical prostatectomy, partial nephrectomy, and pyeloplasty. Recent published series showed feasibility of robotic IVC thrombectomy even for level IV cases. With growing number of robot-assisted and laparoscopic surgeries worldwide, there is a current tendency to treat this complex and challenging pathology with a minimally invasive approach, without compromising oncological outcomes.
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- 2021
6. Thoracoscopic Transdiaphragmatic Approach for Isolated Adrenal Gland Metastasis from Renal Cell Carcinoma
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David Carlos, Hernán Pfeiffer, Patricio García Marchiñena, Miguel Angel Bergero, and Fernando Dipatto
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Urology ,Adrenal gland metastasis ,Gold standard (test) ,Case Reports ,medicine.disease ,Renal cell carcinoma ,medicine ,Thoracoscopy ,In patient ,Laparoscopy ,business ,Adrenal tumors ,Transdiaphragmatic approach - Abstract
Background: Since its first description, laparoscopic adrenalectomy has become the gold standard for the surgical treatment of adrenal tumors. In patients who have previously undergone major transperitoneal or retroperitoneal surgeries, a retroperitoneal access through a virgin thoracic cavity might be the only alternative for a minimally invasive approach. Case Presentation: We report a case of a 61-year-old man with a history of retroperitoneal nephrectomy caused by renal cell carcinoma. He then developed a cancer recurrence in the left renal fossa, which was rescued with a transperitoneal laparotomy. During surveillance, a CT scan revealed two lung nodules and an adrenal tumor, a biopsy of which confirmed as relapsed kidney cancer. The patient had a good performance status so pazopanib (800 mg/day) was initiated, with a partial response in the adrenal tumor. Considering the patient's background, he was regarded as an appropriate candidate for a thoracoscopic transdiaphragmatic adrenalectomy. The patient was operated under general anesthesia, with selected double-lumen endotracheal intubation in lateral decubitus position. Once transthoracic ports were placed, the diaphragm was incised, exposing the retroperitoneal space. At this stage, the adrenal mass was identifiable and dissected free from surrounding structures. There were no intraoperative and postoperative complications. The patient was discharged after surgery without opioid requirement. The pathology report confirmed the relapsed renal cancer with negative surgical margins. The patient was alive and without a kidney cancer relapse at his last follow-up visit. Conclusions: As we described in our case, thoracoscopic transdiaphragmatic adrenalectomy might be taken into consideration in patients with a history of previous major transabdominal or retroperitoneal surgeries. In addition, the lateral decubitus position might be advantageous for anesthetists unfamiliar with the prone position.
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- 2020
7. Bilateral pheochromocytoma after kidney transplantation in neurofibromatosis type 1
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Patricia Fainstein-Day, Andrea Paissan, Alberto Jurado, Mariana Isola, José Alfie, Valeria de Miguel, and Patricio García Marchiñena
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Nephrology ,medicine.medical_specialty ,endocrine system diseases ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,030209 endocrinology & metabolism ,Normetanephrine ,lcsh:Diseases of the endocrine glands. Clinical endocrinology ,Pheochromocytoma ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Internal medicine ,Internal Medicine ,Medicine ,Neurofibromatosis ,neoplasms ,Kidney transplantation ,Insight into Disease Pathogenesis or Mechanism of Therapy ,lcsh:RC648-665 ,business.industry ,Adrenalectomy ,Metanephrines ,medicine.disease ,Surgery ,Transplantation ,chemistry ,030220 oncology & carcinogenesis ,business ,hormones, hormone substitutes, and hormone antagonists - Abstract
Summary We present the case of a 25-year-old male with a history of neurofibromatosis type 1 and bilateral pheochromocytoma 4 years after kidney transplantation that was successfully treated with simultaneous bilateral posterior retroperitoneoscopic adrenalectomy. Learning points: Hypertensive patients with NF1 should always be screened for pheochromocytoma. Pheochromocytoma is rarely associated with transplantation, but it must be ruled out in patients with genetic susceptibility. Posterior retroperitoneoscopic adrenalectomy (PRA) allows more direct access to the adrenal glands, especially in patients with previous abdominal surgeries.
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- 2019
8. von Hippel-Lindau mutants in renal cell carcinoma are regulated by increased expression of RSUME
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Martin Palazzo, Mariana Fuertes, Maria J. Labanca, Belén Elguero, Alberto Jurado, Patricio García Marchiñena, Eduardo Arzt, Patricio Yankilevich, Lucas Tedesco, Mariana Isola, Cora Pollak, Sergio A. Senin, and David Gonilski Pacin
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0301 basic medicine ,Male ,Cancer Research ,von Hippel-Lindau Disease ,endocrine system diseases ,Mutant ,Elongin ,SUMO protein ,Mice, SCID ,Gene mutation ,medicine.disease_cause ,urologic and male genital diseases ,purl.org/becyt/ford/1 [https] ,Mice ,0302 clinical medicine ,Mice, Inbred NOD ,Chlorocebus aethiops ,Missense mutation ,Regulation of gene expression ,Mutation ,Neovascularization, Pathologic ,lcsh:Cytology ,Kidney Neoplasms ,female genital diseases and pregnancy complications ,Renal cell carcinoma ,Gene Expression Regulation, Neoplastic ,Von Hippel-Lindau Tumor Suppressor Protein ,030220 oncology & carcinogenesis ,COS Cells ,Gene mutations ,Immunology ,Mutation, Missense ,Biology ,Article ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,Downregulation and upregulation ,Cell Line, Tumor ,medicine ,Human Umbilical Vein Endothelial Cells ,Animals ,Humans ,lcsh:QH573-671 ,purl.org/becyt/ford/1.6 [https] ,Carcinoma, Renal Cell ,neoplasms ,Sumoylation ,Cell Biology ,030104 developmental biology ,Tumor progression ,Culture Media, Conditioned ,Cancer research ,Gene expression ,von Hippel-Lindau ,Transcription Factors - Abstract
Renal cell carcinoma (RCC) is the major cause of death among patients with von Hippel-Lindau (VHL) disease. Resistance to therapies targeting tumor angiogenesis opens the question about the underlying mechanisms. Previously we have described that RWDD3 or RSUME (RWD domain-containing protein SUMO Enhancer) sumoylates and binds VHL protein and negatively regulates HIF degradation, leading to xenograft RCC tumor growth in mice. In this study, we performed a bioinformatics analysis in a ccRCC dataset showing an association of RSUME levels with VHL mutations and tumor progression, and we demonstrate the molecular mechanism by which RSUME regulates the pathologic angiogenic phenotype of VHL missense mutations. We report that VHL mutants fail to downregulate RSUME protein levels accounting for the increased RSUME expression found in RCC tumors. Furthermore, we prove that targeting RSUME in RCC cell line clones carrying missense VHL mutants results in decreased early tumor angiogenesis. The mechanism we describe is that RSUME sumoylates VHL mutants and beyond its sumoylation capacity, interacts with Type 2 VHL mutants, reduces HIF-2α-VHL mutants binding, and negatively regulates the assembly of the Type 2 VHL, Elongins and Cullins (ECV) complex. Altogether these results show RSUME involvement in VHL mutants deregulation that leads to the angiogenic phenotype of RCC tumors. Fil: Tedesco, Lucas. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigación en Biomedicina de Buenos Aires - Instituto Partner de la Sociedad Max Planck; Argentina Fil: Elguero, María Belén. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigación en Biomedicina de Buenos Aires - Instituto Partner de la Sociedad Max Planck; Argentina Fil: Gonilski Pacin, David Nicolás. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigación en Biomedicina de Buenos Aires - Instituto Partner de la Sociedad Max Planck; Argentina Fil: Senin, Sergio Ariel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigación en Biomedicina de Buenos Aires - Instituto Partner de la Sociedad Max Planck; Argentina Fil: Pollak, Cora Noemí. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigación en Biomedicina de Buenos Aires - Instituto Partner de la Sociedad Max Planck; Argentina Fil: Garcia Marchiñena, Patricio A.. Hospital Italiano; Argentina Fil: Jurado, Alberto M.. Hospital Italiano; Argentina Fil: Isola, Mariana. Hospital Italiano; Argentina Fil: Labanca, María J.. Hospital Italiano; Argentina Fil: Palazzo, Martin. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigación en Biomedicina de Buenos Aires - Instituto Partner de la Sociedad Max Planck; Argentina Fil: Yankilevich, Patricio. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigación en Biomedicina de Buenos Aires - Instituto Partner de la Sociedad Max Planck; Argentina Fil: Fuertes, Mariana. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigación en Biomedicina de Buenos Aires - Instituto Partner de la Sociedad Max Planck; Argentina Fil: Arzt, Eduardo Simon. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigación en Biomedicina de Buenos Aires - Instituto Partner de la Sociedad Max Planck; Argentina
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- 2019
9. V09-06 POSTERIOR RETROPERITONEOSCOPIC ADRENALECTOMY: HOW AND WHEN
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Diego Santillan, Ignacio Costabel, Guillermo Gueglio, Agustin Romeo, Patricio García Marchiñena, and Alberto Jurado
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medicine.medical_specialty ,business.industry ,Urology ,Adrenalectomy ,medicine.medical_treatment ,medicine ,business ,Surgery - Published
- 2019
10. American Confederation of Urology (CAU) experience in minimally invasive partial nephrectomy
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Mario Alvarez-Maestro, Marcelo Featherston, Oscar Rodriguez Faba, Rene Sotelo, Alberto Jurado Navarro, Oscar Schatloff, Patricio García Marchiñena, Pablo Holst, Luis Martínez-Piñeiro, José Cocisfran Alves Milfont, Ivar Vidal-Mora, Alberto Villaronga, Gustavo Villoldo, J. Rozanec, Juan Ignacio Monzó Gardiner, Hugo Dávila, Octavio A. Castillo, Victor T. Dubeux, Diego Abreu Clavijo, Fernando P. Secin, Ricardo Decia, Stênio de Cássio Zequi, Gustavo Cardoso Guimarães, Anamaria Autran, Andres Hernández-Porrás, Rodrigo Frota, Joan Palou, Humberto Villavicencio Mavric, Félix Santaella-Torres, Luciano A. Nunez Bragayrac, Agustin Rovegno, Diana Finkelstein, R. Sanchez-Salas, and Emilio T. Quesada
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Male ,Nephrology ,Databases, Factual ,medicine.medical_treatment ,Blood Loss, Surgical ,030232 urology & nephrology ,Kaplan-Meier Estimate ,Nephrectomy ,Postoperative Complications ,0302 clinical medicine ,Robotic Surgical Procedures ,Adenoma, Oxyphilic ,Partial nephrectomy ,Warm Ischemia ,Laparoscopy ,medicine.diagnostic_test ,Margins of Excision ,Kidney cancer ,Middle Aged ,Conversion to Open Surgery ,Kidney Neoplasms ,Tumor Burden ,030220 oncology & carcinogenesis ,Female ,medicine.medical_specialty ,Urology ,Angiomyolipoma ,Operative Time ,03 medical and health sciences ,Internal medicine ,medicine ,Hand-Assisted Laparoscopy ,Humans ,Minimally Invasive Surgical Procedures ,Carcinoma, Renal Cell ,Mexico ,Aged ,Neoplasm Staging ,Proportional Hazards Models ,business.industry ,Proportional hazards model ,Postoperative complication ,Perioperative ,Length of Stay ,South America ,medicine.disease ,Confidence interval ,Surgery ,Nephron sparing ,Logistic Models ,Spain ,Multivariate Analysis ,business - Abstract
To describe the perioperative and oncology outcomes in a series of laparoscopic or robotic partial nephrectomies (PN) for renal tumors treated in diverse institutions of Hispanic America from the beginning of their minimally invasive (MI) PN experience through December 2014. Seventeen institutions participated in the CAU generated a MI PN database. We estimated proportions, medians, 95 % confidence intervals, Kaplan-Meier curves, multivariate logistic and Cox regression analyses. Clavien-Dindo classification was used. We evaluated 1501 laparoscopic (98 %) or robotic (2 %) PNs. Median age: 58 years. Median surgical time, warm ischemia and intraoperative bleeding were 150, 20 min and 200 cc. 81 % of the lesions were malignant, with clear cell histology being 65 % of the total. Median maximum tumor diameter is 2.7 cm, positive margin is 8.2 %, and median hospitalization is 3 days. One or more postoperative complication was recorded in 19.8 % of the patients: Clavien 1: 5.6 %; Clavien 2: 8.4 %; Clavien 3A: 1.5 %; Clavien 3B: 3.2 %; Clavien 4A: 1 %; Clavien 4B: 0.1 %; Clavien 5: 0 %. Bleeding was the main cause of a reoperation (5.5 %), conversion to radical nephrectomy (3 %) or open partial nephrectomy (6 %). Transfusion rate is 10 %. In multivariate analysis, RENAL nephrometry score was the only variable associated with complications (OR 1.1; 95 % CI 1.02-1.2; p = 0.02). Nineteen patients presented disease progression or died of disease in a median follow-up of 1.37 years. The 5-year progression or kidney cancer mortality-free rate was 94 % (95 % CI 90, 97). Positive margins (HR 4.98; 95 % CI 1.3-19; p = 0.02) and females (HR 5.6; 95 % CI 1.7-19; p = 0.005) were associated with disease progression or kidney cancer mortality after adjusting for maximum tumor diameter. Laparoscopic PN in these centers of Hispanic America seem to have acceptable perioperative complications and short-term oncologic outcomes.
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- 2016
11. Renal fossa recurrence after radical nephrectomy: Current management, and oncological outcomes
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Alberto Jurado, Guillermo Gueglio, Patricio García Marchiñena, and Agustin Romeo
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Male ,medicine.medical_specialty ,Fossa ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Nephrectomy ,03 medical and health sciences ,0302 clinical medicine ,Interquartile range ,Renal cell carcinoma ,medicine ,Humans ,Stage (cooking) ,Carcinoma, Renal Cell ,Aged ,Retrospective Studies ,Kidney ,biology ,business.industry ,Cryoablation ,Middle Aged ,biology.organism_classification ,medicine.disease ,Survival Analysis ,Kidney Neoplasms ,Surgery ,Log-rank test ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,Female ,Neoplasm Recurrence, Local ,business - Abstract
Kidney cancers represent 2% of cancers worldwide; the most common type is renal clear cell carcinoma (RCC). Surgical treatment remains the only effective therapy for localized renal cell carcinoma. Approximately 20% to 38% of patients undergoing radical nephrectomy (RN) for localized RCC will have subsequent disease progression, with 0.8% to 3.6% of local recurrences within the ipsilateral retroperitoneum (RFR). The main objective of this study is to evaluate prognostic features, oncological outcomes, and current management for renal fossa recurrence in patients with history of RN for RCC.We retrospectively analyzed 733 patients who underwent open or laparoscopic RN for unilateral T1-T4 N0 M0 RCC between 2010 and 2016 at the Urology Department of Hospital Italiano de Buenos Aires.During the mentioned period, of a total of 733 RNs (open/laparoscopic), 561 patients with RCC were included in the study. After a median follow-up time of 24 months (12-36) (interquartile range), 21 (3.74%) patients out of 561, developed renal fossa recurrence. Of these, 13 (2.31%) patients were diagnosed with isolated local renal fossa recurrence and different treatment approaches were adopted; 11 patients underwent open surgical resection, 1 patient laparoscopic surgical resection, and 1 case was treated with cryoablation. Regarding cancer-specific survival, estimated 4-year cancer-specific survival in patients without RFR, with isolated RFR (iRFR) and not isolated RFR (niRFR) was 82.7% (CI 95% 70.2-95.2), 69.2% (IC 44.2-94.2) and 0%, respectively (log rank test P0.0001 being niRFR group different to others. Non isolated RFR was a death risk factor with a HR of 11.4 (4.8-27.2) compared with iRFR or no recurrence. Overall, 51% (IC 26.6-71.2) of patients with any RFR died at 4 years follow-up.Although RFR is a rare condition, in the absence of distant metastatic disease, aggressive surgical resection should be our aim. High pathological tumoral stage at original nephrectomy and high tumoral grade are independent risk factors for RFR. This group of patients needs closer follow-up to detect earlier recurrences and decide a treatment strategy.
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- 2020
12. V10-07 LAPAROSCOPIC APPROACH FOR VESICOUTERINE FISTULA: STEPPED TECHNIQUE
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Juan Carlos Tejerizo, Gabriel Favre, Patricio García Marchiñena, Agustin Romeo, and Matías Ignacio González
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medicine.medical_specialty ,business.industry ,Urology ,Medicine ,business ,Vesicouterine fistula ,Surgery - Published
- 2018
13. V07-08 LAPAROSCOPIC RADICAL NEPHRECTOMY WITH INFERIOR VENA CAVA THROMBECTOMY
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Diego Santillan, Alberto Jurado, Patricio García-Marchiñena, Miguel Basualdo, and Guillermo Gueglio
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medicine.medical_specialty ,medicine.vein ,business.industry ,Urology ,Medicine ,Laparoscopic radical nephrectomy ,business ,Inferior vena cava ,Surgery - Published
- 2018
14. V6-03 SYNCHRONOUS AND SIMULTANEOUS POSTERIOR REROPERITONEOSCOPIC BILATERAL ADRENALECTOMY
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Miguel Basualdo, Oscar Damia, Alberto Jurado, Guillermo Gueglio, and Patricio García Marchiñena
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medicine.medical_specialty ,business.industry ,Urology ,Medicine ,Bilateral adrenalectomy ,business ,Surgery - Published
- 2017
15. V11-06 POSTERIOR RETROPERITONEOSCOPIC BILATERAL ADRENALECTOMY IN ECTOPIC CUSHIN'S SYNDROME
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José Ignacio Costabel, Oscar Damia, Jorge Jaunarena, Alberto Jurado Navarro, Guillermo Gueglio, and Patricio García Marchiñena
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medicine.medical_specialty ,S syndrome ,business.industry ,Urology ,medicine ,Bilateral adrenalectomy ,business ,Surgery - Published
- 2016
16. Functional and oncologic outcomes after nephron-sparing surgery in a solitary kidney: 10 years of experience
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Federico Tirapegui, Alberto Jurado, Augusto Dantur, Guillermo Gueglio, José Ignacio Costabel, and Patricio García Marchiñena
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Male ,Fistula ,medicine.medical_treatment ,030232 urology & nephrology ,Kaplan-Meier Estimate ,lcsh:RC870-923 ,Nephrectomy ,Body Mass Index ,0302 clinical medicine ,Postoperative Complications ,Risk Factors ,Renal carcinoma ,Postoperative Period ,Warm Ischemia ,Cold Ischemia ,solitary kidney ,Age Factors ,nephron-sparing surgery ,Middle Aged ,Prognosis ,Kidney Neoplasms ,Survival Rate ,030220 oncology & carcinogenesis ,Female ,Original Article ,Glomerular Filtration Rate ,Adult ,medicine.medical_specialty ,partial nephrectomy ,Urology ,Renal function ,Statistics, Nonparametric ,03 medical and health sciences ,medicine ,Carcinoma ,Humans ,Renal Insufficiency, Chronic ,Survival rate ,Carcinoma, Renal Cell ,Dialysis ,Aged ,Retrospective Studies ,business.industry ,Retrospective cohort study ,lcsh:Diseases of the genitourinary system. Urology ,medicine.disease ,Surgery ,business ,Body mass index ,Organ Sparing Treatments - Abstract
Objectives: To evaluate functional and oncologic outcomes of partial nephrectomy (PN) in patients with a solitary kidney. Materials and Methods: A retrospective analysis of patients with a solitary kidney undergoing nephron-sparing surgery between March 2003 and March 2013 was performed. GFR was recorded before the procedure and 3 months after surgery, thus establishing a change (cGFR). Several variables that may influence cGFR were analyzed. Complications are herein described, namely bleeding, fistula, acute renal failure and end-stage renal disease (ESRD). Local recurrence and margin status are also described. Survival rates were calculated using the Kaplan Meier method (2 patients with metastasis at the time of surgery were excluded from the analysis). Results: Forty-five patients were available for analysis. Median follow-up was 27.56 months (r 3-96). Mean cGFR was-7.12mL/min (SD 2.1). Variables significantly related with lower GFR after surgery were loss of renal mass (p=0.01)) and male gender (p=0.03). Four patients (8.8%) experienced hemorrhage. Nine patients (20%) developed a urinary fistula. Only one patient with bleeding required open surgery. Two patients (4.4%) needed transient dialysis. Three patients (6.6%) developed ESRD. Four patients (8.8%) had positive surgical margins (PSMs) and four patients (88%) had local recurrence (2 of these had PSMs). Five patients (11.1%) died during follow-up. Four patients (8.8%) died because of renal cancer. Estimated 2-year overall survival, disease-free survival and cancer specific survival rates were 88.4% (CI 95% 70.5-96); 87.7% (CI 95% 68.1-96) and 92.4% (CI 95% 75-98), respectively. Conclusion: Loss of renal mass and male gender were associated with lower postoperative GFR. Our outcomes were comparable with those in the World literature.
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- 2016
17. [Current patterns of presentation of renal tumors]
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José, Costabel, Patricio, García Marchiñena, Luis, Uría, Sebastián, Tirapegui, Alberto, Jurado, and Guillermo, Gueglio
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Male ,Risk Factors ,Argentina ,Humans ,Female ,Prospective Studies ,Middle Aged ,Kidney Neoplasms - Abstract
The aim of this paper is to describe the epidemiological characteristics, clinical management and pathologic patterns in a population with renal tumors in our institution. Prospective data collection was performed over a period of 4.5 years, from January 2010 to June 2014. A total of 819 cases (796 patients) were treated for renal mass during this period. The mean age was 60.7 years (SD 13.1). There were 553 (69.5%) males (male to female ratio: 2.2: 1). Twenty nine per cent (230 patients) were obese (BMI = 30). The diagnosis was incidental in 653 cases (79.7%), 48.8% presented one or more risk factors, being smoking the most frequent (34%). In 238 patients (29.9%) there was more than one comorbidity; 18% had preoperative creatinine = 1.3 mg/dl. Lesions were = 4 cm (cT1a) in 45% of the patients, and 10.8% (86) had metastases at diagnosis. The lesions were resected in 93.5% and actively monitored in 6.5% (not resected). In surgery treated patients, radical nephrectomy was performed in 51.5% of cases, and nephron sparing surgery in 48.5% of them. The laparoscopic approach was used in 56.2%. The pattern of presentation of renal masses is characterized by incidental diagnosis in early disease stages. Nephron sparing surgery is the first choice in nearly half of patients. Active surveillance has been used in a greater percentage than previously reported.
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- 2015
18. PD29-04 HISPANO-AMERICAN EXPERIENCE IN MINIMALLY INVASIVE PARTIAL NEPHRECTOMY
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Diana Finkelstein, Pablo Holst, Gustavo Villoldo, Agustin Rovegno, Stênio de Cássio Zequi, Anamaria Autran, Rodolfo Sanchez Salas, Joan Palou Redorta, J. Rozanec, Rene Sotelo, Alberto Villaronga, Hugo Dávila, Oscar Rodriguez Faba, Mario Álvarez Maestro, Alberto Jurado Navarro, Ivar Vidal Mora, Félix Santaella Torres, Diego Abreu Clavijo, Humberto Villavicencio Mavrich, Octavio A. Castillo Cadiz, Andres Hernandez Porras, Oscar Schatloff, Marcelo Featherstone, Ricardo Faveretto, Juan Ignacio Monzó Gardiner, Luis Martinez Pineiro, Fernando P. Secin, Luciano A. Nunez Bragayrac, and Patricio García Marchiñena
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medicine.medical_specialty ,business.industry ,Urology ,medicine.medical_treatment ,General surgery ,medicine ,business ,Nephrectomy - Published
- 2015
19. High-sensitivity C-reactive protein as a predictor of locally advanced renal cell carcinoma
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Patricio, García-Marchiñena, Nicolas, Billordo-Perés, Ignacio, Tobía-González, Alberto, Jurado, Oscar, Damia, and Guillermo, Gueglio
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Adult ,Aged, 80 and over ,Male ,Smoking ,Middle Aged ,Kidney Neoplasms ,Young Adult ,C-Reactive Protein ,Cross-Sectional Studies ,Logistic Models ,Biomarkers, Tumor ,Disease Progression ,Humans ,Female ,Tomography, X-Ray Computed ,Carcinoma, Renal Cell ,Aged ,Neoplasm Staging ,Retrospective Studies - Abstract
To determine if elevated levels of high-sensitivity C-reactive protein (CRP) in plasma are associated with locally advanced renal cell carcinoma (LARCC) after surgery.Retrospective cross-sectional study conducted from May 2009 to January 2011. Altogether, 192 patients with non-disseminated disease and with preoperative quantitative determination of the CRP were evaluated. We evaluated the relation between age, gender, history of smoking, symptoms and CRP higher than 10 mg/L, with LARCC. The chi-square and Fisher's tests were used to compare categorical variables. For the multivariate analysis, we used logistic regression methods.The median age was 62 years (r=23-85), 72.4% were males. The median CRP was 2.40 mg/L (r=0.1-173). Of all the patients, 43.2% had a history of smoking and 81.8% were asymptomatic. As for the tumors, 77.1%were clear cell carcinoma, 14.6% chromophobe, 4.7% papillary, 2.6% oncocytomas, and 1% other varieties of renal cell carcinoma. As for the TNM classification, 45.8% corresponded to stage pT1a, 27.6% pT1b, 13% pT2, and 13.5% pT3, pT4 was not found. In the multivariate analysis, the presence of symptoms (p=0.002, OR=3.1) and the presence of CRP higher than 10 mg/L (p=0.006, OR=4) remained as the only prognostic variables of LARCC.Values of CRP higher than 10 mg/L increase 4 times the possibilities of finding LARCC in the pathological study of the surgical specimen. This variable should be taken into account when deciding what is the best surgical option.
- Published
- 2012
20. [CT SCAN as a predictor of composition and fragility of urinary lithiasis treated with extracorporeal shock wave lithotripsy in vitro]
- Author
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Patricio, García Marchiñena, Nicolás, Billordo Peres, Juan, Liyo, Jorge, Ocantos, Mariano, Gonzalez, Alberto, Jurado, and Francisco, Daels
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Crystallography ,Predictive Value of Tests ,Lithotripsy ,Humans ,Urinary Calculi ,Prospective Studies ,In Vitro Techniques ,Tomography, X-Ray Computed - Abstract
To evaluate the ability of non contrast computed tomography (NCCT) to predict stone composition and fragility for treatment with extracorporeal shock wave lithotripsy (ESWL).27 stones of about 10 mm from patients who had undergone different endourological procedures were collected. All patients had been evaluated with NCCT. To perform in vitro ESWL an experimental device was designed. Three thousand pulses were applied with 17.2 Kv intensity using an electromagnetic generator (Lithostar) to all stones. Composition of each fragment was studied with crystallographic study. Results were statistically analyzed with Student Test, Chi2 Test and multivariate study.In vitro ESWL had a success rate of 59.26%. Average stone HU, grouped by composition: cistine 1015 HU, Calcium monohydrate oxalate 1193 HU, uric acid 419 HU, dihydrate calcium oxalate 2122 HU, struvite 1543 HU and basic phosphate magnesium 1517 HU. A statistically significant relationship was found between values which were lower than 500 HU and uric acid composition (p=0.0006), as well as values higher than 2000 HU and composition of dihydrated calcium acid (p=0.0244). In the group of stones with less than 1000 HU (n=11) efficacy was 81.1%, whereas it was 43.75% in the others (p=0.0479). We found a statistically significant relationship between uric acid and effectiveness (p=0.021). There was not statistically significant relationship between size and treatment effectiveness.The use of NCCT will allow predicting stone composition and fragility.
- Published
- 2009
21. Tomografía computada como predictor de composición y fragilidad de la litiasis urinaria al tratamiento con litotricia extracorporea por ondas de choque in vitro
- Author
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Francisco Pedro Juan Daels, Juan Cruz Liyo, Mariano Sebastian González, Alberto Jurado, Jorge Ocantos, Patricio García Marchiñena, and Nicolás Billordo Peres
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,Unidades Hounsfield ,business.industry ,Urology ,medicine.medical_treatment ,Urinary Lithiasis ,Litotricia extracorpórea ,Computed tomography ,General Medicine ,Lithotripsy ,Extracorporeal shock wave lithotripsy ,Surgery ,Tomography x ray computed ,X ray computed ,medicine ,Litiasis ,Cristalografía ,Nuclear medicine ,business - Abstract
Objetivo: Desde la aparición de la litotricia extracorpórea por ondas de choque (LEOC), esta se ha convertido en el tratamiento de elección para los cálculos renales menores de 2 cm. La tasa de éxito de la misma varía entre el 60 al 99 % dependiendo de factores tales como la composición, tamaño, tipo de generador, localización, entre otros. El objetivo de este trabajo es evaluar si la densidad del cálculo en unidades Hounsfield (UH) mediante una tomografía computada sin contraste (TCSC) es capaz de predecir composición y fragilidad de la litiasis al tratamiento con LEOC. Métodos: Prospectivamente fueron recolectados 27 litos de alrededor de 10 mm provenientes de pacientes sometidos a diferentes procedimientos endourológicos (19 litotricias percutaneas, 2 litotricias ureterales y 6 litotricias vesicales), los cuales habían sido evaluados tomográficamente, midiéndose en UH la densidad de sus cálculos. Los litos fueron sometidos a litotricia extracorporea por ondas de choque "in vitro", para lo cual se conformó un dispositivo experimental. Se aplicaron 3000 pulsos a una intensidad de 17.2 Kw utilizando un generador electromagnético (Lithostar) a todos los cálculos. Se evaluó la composición de cada uno de los fragmentos mediante un estudio cristalográfico. Los resultados obtenidos fueron analizados estadísticamente utilizando el test de Student, test de Chi² y análisis multivariado. Resultados: La LEOC "in vitro" fue efectiva en 16 casos (59.26 %). Del total de los cálculos estudiados, 11 fueron puros y 16 tuvieron una composición mixta. Las UH promedio de los cálculos, agrupados por composición fue: cistina 1015 UH, oxalato de calcio monohidratados 1193, ácido úrico 419 UH, oxalato de calcio dihidratado 2122 UH , estruvita 1543 UH y fosfato básico de magnesio 1517 UH. Se encontró una relación estadísticamente significativa entre valores menores de 500 UH y composición de ácido úrico (p=0.0006), así como también valores mayores a 2000 UH y composición de oxalato de calcio dihidratado (p=0.0244). En el grupo de cálculos con menos de 1000 UH (n=11) la efectividad fue del 81.8 %, mientras que en el resto fue del 43.75 % (p=0.0479). Al asociar composición del cálculo con efectividad, encontramos una relación estadísticamente significativa entre presencia de ácido úrico y efectividad (p=0.021). No se encontraron relaciones estadísticamente significativas entre tamaño y efectividad del tratamiento. Conclusiones: El uso de la TCSC permitiría predecir la composición de oxalato de calcio dihidratado y ácido úrico. Valores de UH menores a 1000, aumentan significativamente el éxito del tratamiento.
- Published
- 2009
22. [Penile fracture with associated urethra lesion: case report and bibliographic review]
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Patricio, García Marchiñena, Leandro, Capiel, Diego, Juarez, Juan, Liyo, Carlos, Giudice, Guillermo, Gueglio, and Oscar, Damia
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Adult ,Male ,Rupture ,Urethra ,Multiple Trauma ,Humans ,Penis - Abstract
Penile fracture is a rare lesion that occurs almost exclusively during erection. This lesion may be associated with rupture of the urethra in 20-30% of the cases. We describe a case that has been treated at our institution and review the literature.A-42-year-old patient suffered fracture of penis, with urethral section, during sexual intercourse. The patient underwent surgical exploration, the lesions of the corporal bodies and urethra were identified. Both lesions were repaired.patient's recovery was satisfactory without complications or esthetical or functional sequelae.Penile fracture with urethral section is an exceptional disease, the most frequent cause of which in occident is violent sexual activity. For diagnosis it is necessary in most cases a correct anamnesis and physical examination. Early surgical approach and closure of the albuginea's lesion and repair of the urethral lesion is the best way of treatment.
- Published
- 2008
23. Fractura de pene con lesión asociada de uretra: presentación de un caso y revisión de la literatura
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Leandro Capiel, Guillermo Gueglio, Oscar Damia, Juan Cruz Liyo, Diego Juarez, Carlos Giudice, and Patricio García Marchiñena
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Gynecology ,medicine.medical_specialty ,medicine.anatomical_structure ,Tratamiento quirúrgico temprano ,business.industry ,Urology ,Diagnostico diferencial ,Sección de uretra ,medicine ,General Medicine ,business ,Fractura de pene ,Penis - Abstract
Objetivo: La fractura de pene es una lesión que responde habitualmente a un traumatismo cerrado que ocurre con el pene en erección. Cerca del 20-30% de los casos en occidente, se asocian a lesión del cuerpo esponjoso. Presentamos el caso de un paciente atendido en nuestro servicio y realizamos una revisión de la literatura. Métodos: Se trata de un paciente de 42 años de edad, que luego de una relación sexual violenta, presentó una fractura de pene con lesión asociada de uretra. Se lo intervino quirúrgicamente, se constató la lesión de ambos cuerpos cavernosos y la sección completa de de la uretra. Ambas lesiones fueron reparadas en el mismo acto quirúrgico. Resultados: El paciente evolucionó satisfactoriamente sin complicaciones y sin secuelas estéticas ni funcionales. Conclusiones: La fractura de pene con lesión asociada de uretra es una patología excepcional, cuya etiología más frecuente en occidente se debe a una relación sexual violenta. Una correcta anamnesis y un examen físico correcto son suficientes en la mayoría de los casos para hacer diagnóstico. El abordaje quirúrgico temprano y el cierre de la albuginea junto a la reparación de la uretra, permite alcanzar los mejores resultados.
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- 2008
24. Abstract 12: Serum carbonic anhydrase IX (CAIX) as diagnostic biomarker in clear cell renal cell carcinoma (ccRCC) patients
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Elisa Bal de Kier Joffé, Mariano Brzesinski, Patricio García Marchiñena, L. Pasik, Alberto Jurado, Carla Pulero, Maria Natalia Gandur Quiroga, A. M. Alvarez, María Guadalupe Pallotta, Lydia Puricelli, Pedro Rondot Radío, Julieta Grasselli, Guillermo Gueglio, Myriam Nuñez, Gaston Boggio, H. Malagrino, and María Elena Knott
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Oncology ,Cancer Research ,medicine.medical_specialty ,Pathology ,business.industry ,Cellular biomarkers ,Cell ,Cancer ,Carbonic Anhydrase IX ,medicine.disease ,Clear cell renal cell carcinoma ,medicine.anatomical_structure ,Renal cell carcinoma ,Internal medicine ,medicine ,Diagnostic biomarker ,Metabolic disease ,business - Abstract
Clinicians face important pitfalls in the treatment of Renal cell carcinoma (RCC), such as absence of symptoms in early stages of the disease, its high metastatic potential and its resistance to conventional therapy. These facts emphasize the requirement of early diagnosis to optimize the chance of cure. ccRCC, the most common histological type of RCC, is considered a cell metabolic disease which develops from the activation of pseudohypoxic pathways. The transmembrane enzyme CAIX, involved in pH homeostasis and expressed in ccRCC tumors, is considered to be one of the best cellular biomarkers of hypoxia. Our aim was to study the role of serum CAIX as diagnostic biomarker of ccRCC, taking into account that serum contains a rich untapped source of disease-specific information. Employing a quantitative ELISA test (R&D System), the expression of serum CAIX of 30 ccRCC patients and 16 healthy controls was evaluated. Samples from cancer patients were taken before surgery, without any previous treatment (S1), and after tumor removal (S2). ccRCC patients showed significantly elevated values of serum CAIX (Median 75.89 pg/ml, range 30,8-1482,9) respect to the levels observed in healthy controls (23.29, 0.0-79.9). On the basis of the optimal cut-off point of 34,821 pg/ml serum CAIX, 22/30 cancer patients showed high values of CAIX versus only 1/15 healthy controls (p< 0.01, Chi square test). The assay of serum CAIX expression in our population exhibited a sensitivity of 93.8% and a specificity of 73.3%. Besides, we demonstrated that Stage I ccRCC patients showed significantly lower levels of the circulating enzyme (Md, range expressed in pg/ml CAIX: Stage I= 45.3, 30.8-107.9 vs Stage IV=102.9, 36.2-1482.9; MW test p We conclude that serum CAIX could be a useful diagnostic biomarker in ccRCC patients. This would be of relevant importance as there is a lack of molecular biomarkers for this pathology. Citation Format: Maria Elena Knott, Myriam Nuñez, Maria Natalia Gandur Quiroga, Gaston Boggio, Julieta Grasselli, Guillermo Gueglio, Pedro Rondot Radío, Mariano Brzesinski, Leonardo Pasik, Carla Pulero, Ana Alvarez, Hector Malagrino, Patricio Garcia Marchiñena, Alberto Jurado, Elisa Bal de Kier Joffe, Maria Guadalupe Pallotta, Lydia I. Puricelli. Serum carbonic anhydrase IX (CAIX) as diagnostic biomarker in clear cell renal cell carcinoma (ccRCC) patients . [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 12. doi:10.1158/1538-7445.AM2013-12
- Published
- 2013
25. Positive surgical margins are predictors of local recurrence in conservative kidney surgery for pT1 tumors
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Ignacio Tobía González, Alberto Jurado, Sebastián Tirapegui, Guillermo Gueglio, and Patricio García Marchiñena
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Adult ,Male ,medicine.medical_specialty ,Time Factors ,Urology ,030232 urology & nephrology ,Kidney ,lcsh:RC870-923 ,Nephrectomy ,Risk Assessment ,Disease-Free Survival ,Surgical Procedures, Neoplasms ,03 medical and health sciences ,0302 clinical medicine ,Predictive Value of Tests ,medicine ,Humans ,Clinical significance ,Kidney surgery ,Stage (cooking) ,Survival rate ,Pathological ,Carcinoma, Renal Cell ,Aged ,Neoplasm Staging ,Retrospective Studies ,business.industry ,Proportional hazards model ,Margins of Excision ,Reproducibility of Results ,Retrospective cohort study ,Middle Aged ,Prognosis ,lcsh:Diseases of the genitourinary system. Urology ,Kidney Neoplasms ,Tumor Burden ,Treatment Outcome ,030220 oncology & carcinogenesis ,Female ,Original Article ,Positive Surgical Margin ,Neoplasm Grading ,Neoplasm Recurrence, Local ,business ,Organ Sparing Treatments - Abstract
Objectives: The clinical significance of positive surgical margin (PSM) after a Nephron Sparing Surgery (NSS) is controversial. The aim of this study is to evaluate the association between PSM and the risk of disease recurrence in patients with pT1 kidney tumors who underwent NSS. Materials and Methods: Retrospective cohort study. A total of 314 patients submitted to a NSS due to stage pT1 renal tumor between January 2010 and June 2015 were included. Recurrence-free survival was estimated. The Cox model was used to adjust the tumor size, histological grade, pathological stage, age, surgical margins and type of approach. Results: Overall PSM was 6.3% (n=22). Recurrence was evidenced in 9.1% (n=2) of patients with PSM and 3.5% (n=10) for the group of negative surgical margin (NSM). The estimated local recurrence-free survival rate at 3 years was 96.4% (95% CI 91.9 to 100) for the NSM group and 87.8% (95% CI 71.9 to 100) for PSM group (p=0.02) with no difference in metastasis-free survival. The PSM and pathological high grade (Fuhrman grade III or IV) were independent predictors of local recurrence in the multivariate analysis (HR 12.9, 95%CI 1.8-94, p=0.011 / HR 38.3, 95%CI 3.1-467, p=0.004 respectively). Fuhrman grade proved to be predictor of distant recurrence (HR 8.1, 95%CI 1.6-39.7, p=0.011). Conclusions: The PSM in pT1 renal tumors showed to have higher risk of local recurrence and thus, worse oncological prognosis.
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