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Copyright of Revista Chilena de Urologia is the property of Sociedad Chilena de Urologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Among urinary tract tumors, renal cancer is the most common, and regarding histopathological subtype, the clear cell type ranks first. We present the case of a patient who developed two types of solid tumors over an 11-year period. This case also highlights the role of preexisting renal lesions in the development of this cancer, the impact of early intervention on the subsequent course of the disease, as well as the importance of a multidisciplinary team in the treatment of patients with metastatic kidney cancer. Furthermore, despite the complications arising from me - tastatic renal cancer, the patient maintained a preserved quality of life almost two years after diagnosis. [ABSTRACT FROM AUTHOR]

Introducere. Cancerul renal e o tumoare frecventă a sistemului urinar și ocupă circa 3% în structura morbidității oncologice la adulți. Are o morbiditate semnificativă mondială – circa 200 mii și o mortalitate de circa 100 mii anual. Aceste tendințe sunt caracteristice și pentru țările europene și românești. Scopul lucrării – realizarea unei analize a managementului de tratament inclusiv multimodal al cancerului renal. Material și metode. Pentru evidențierea metodelor tratamentului multimodal al cancerului renal, au fost analizate surse bibliografice și cazuri clinice din literatura de specialitate cu aria europeană și euroasiatică, America de Nord, România, Republica Moldova și 256 fișe ale bolnavilor cu cancer renal supuși tratamentelor oncologice specializate. Concluzii. Tratamentul multimodal al cancerului renal include – metoda chirurgicală, metoda oncologică – chimioterapia, radioterapia, tratamentul biologic și genomic – personalizat în perspectivă.

Introdução: A incidência de carcinoma de células renais no rim transplantado é extremamente rara. Relato de caso: Mulher de 42 anos foi submetida a transplante renal, com doadora viva relacionada, de sua mãe de 60 anos, devido a glomerulonefrite, levando a doença renal em estágio terminal.Ultrassonografia, 9 anos após a transplante, revelou tumor renal de pólo inferior no enxerto renal com imagem suspeita de neoplasia maligna na tomografia computadorizada. A paciente foi submetida à nefrectomia parcial e a análise histológica revelou carcinoma de células claras.Considerações finais: Após um ano de seguimento, os níveis séricos de creatinina estão normais e não há sinais de metástases ou recorrência tumoral.

Obiective. Cancerul renal este al 6-lea cel mai diagnosticat cancer în lume, cu o rată a mortalității de 4,4%. Tumorile renale maligne se caracterizează prin extindere cu tromb tumoral la nivelul sistemului venos în 4-14% din numărul total de cazuri diagnosticate. Scopul lucrării a fost evidențierea importanței aplicării tratamentului chirurgical în cancerele renale cu tromb metastatic în vasele magistrale și optimizarea tehnicilor chirurgicale aplicate. Material și metode. Lucrarea reprezintă un studiu retrospectiv, fiind analizate fișele medicale ale 39 pacienți. Abordul chirurgical a fost realizat prin laparotomie xifo-pubiană în 29 (74,36%) cazuri, laparotomie Leclerc – 6 (15,38%), sternolaparotomie Leclerc (Mercedes) – 3 (7,69%), sternolaparotomie – 1 (2,56%). Rezultate. Durata medie a intervențiilor chirurgicale a fost de 315±18,7 minute. Hemoragia intraoperatorie în medie a constituit 1900±158 ml. Durata medie de spitalizare postoperatorie a fost de 10±2,1 zile. Au fost înregistrate 2 (5,12%) decese perioperatorii. Perioada postoperatorie precoce a decurs fără complicații în 35 cazuri și a implicat reintervenție pentru hemostază chirurgicală în 4 (10,25%) cazuri. Invazia celulelor tumorale în peretele venei cave inferioare a fost confirmată histologic. Concluzii. Abordul și tehnicile chirurgicale aplicate (laparotomie cu mobilizarea venei cave inferioare retrohepatic) în cadrul clinicii, sunt standardul de bază în atingerea unei siguranțe maxime intraoperatorii pentru minimalizarea riscului hemoragic, a trombembolismului pulmonar și decesului intraoperator.

Antecedentes: El manejo quirúrgico de los tumores renales pequeños es la cirugía conservadora de nefronas, este tipo de manejo se reservaba para pacientes seleccionados, con riñón solitario, enfermedad renal crónica o tumores bilaterales. La evidencia sugiere que la nefrectomía parcial laparoscópica es equivalente en términos de resultados oncológicos y superior en las mediciones de calidad de vida comparada al abordaje abierto. Objetivos: Determinar los resultados oncológicos en cuanto a bordes libres del tumor y complicaciones quirúrgicas en pacientes sometidos a nefrectomía parcial y enucleación de tumor renal laparoscópico “Zero isquemia”. Metodología: Estudio retrospectivo, observacional, y comparativo, que fueron sometidos a nefrectomía parcial laparoscópica, se agruparon en dos grupos: Grupo I: nefrectomía parcial y Grupo II: enucleación, se analizaron: tamaño y localización del tumor, RENAL score, tiempo quirúrgico, sangrado, días de estancia, complicaciones y reporte histopatológico. Resultados: Se evaluaron 17 pacientes, 3 fueron excluidos por terminar en cirugía radical, 6 parciales (Grupo I) y 8 enucleaciones (Grupo II). Edad promedio de 45.7 (± 8.6) vs 51.2 (± 6.3) años. Tamaño del tumor 7.8 (2.5-10) vs 3.2 (1-5.7) cm, El RENAL score en global de todos los pacientes fue de baja a moderada. Hubo diferencias a favor del grupo II (enucleación) en cuanto a tiempo quirúrgico y sangrado transoperatorio, en cuanto a los bordes quirúrgicos, se tuvo 2 (14.2%) casos con bordes positivos 1 para cada abordaje, los cuales se mantienen en vigilancia estrecha. Conclusiones: el abordaje laparoscópico es una opción equiparable al abierto, se obtuvieron iguales resultados en cuanto a control oncológico en relación a bordes libres y con menos complicaciones.

Copyright of Gaceta Médica Boliviana is the property of Universidad Mayor de San Simon, Facultad de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: Piloleiomyomas are the most common cutaneous leiomyomas. This rare benign tumor can appear as one or multiple lesions. Typically, they are localized in the thorax and extremities, accompanied by pain. They are associated to uterine leiomyomas and renal cancer. CLINICAL CASES: A 54 and 64-year-old female patients, with multiple nodular skin lesions in the anterior thorax, associated to pain. One with personal history of hysterectomy due to uterine leiomyomas, and family history of father and two sisters having the same type of lesions. CONCLUSIONS: When there are multiples piloleiomyomas, it is of importance to make a complete clinical evaluation an include a thorough investigation of personal and family history. All this to rule out their associated to uterine leiomyomas and kidney cancer. [ABSTRACT FROM AUTHOR]

Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

El cáncer renal es una neoplasia con una tasa de incidencia de 4,4% por 100 000 habitantes a nivel mundial; el carcinoma de células renales representa el 90% de los tumores renales malignos. Las infecciones urinarias recurrentes tienen una prevalencia del 19% y constituyen infecciones de al menos dos episodios en seis meses, o al menos tres episodios en un año. Presentamos el caso de una paciente mujer de 25 años que presentó cuadros de infecciones urinarias recurrentes y que en un estudio tomográfico se evidenció una tumoración renal izquierda. Se le realizó nefrectomía radical cuya pieza operatoria confirmó diagnóstico patológico de carcinoma renal de células clara. En pacientes jóvenes el carcinoma renal es una tumoración aún más rara, que representa 8,7% del total de pacientes diagnosticados de cáncer renal. Se debe promover en la consulta médica la sospecha clínica a mujeres jóvenes con infecciones urinarias recurrentes solicitando exámenes de imagen, con la finalidad de garantizar un temprano diagnóstico y tratamiento adecuado si se tratara de un tumor renal.

Managing a malignant renal tumor requires, first of all, a reflection on the necessity of its treatment. It must consider the renal function, altered at the time of diagnosis in 50% of cases. The treatment method chosen depends on many factors, in particular, the predicted residual renal function, the risk of chronic kidney disease, the need for temporary or long-term dialysis, and overall long-term survival. Other factors include the size, position, and number of tumors and a hereditary tumor background. When a renal-sparing management alternative is available, total nephrectomy should no longer be performed in patients with small malignant renal masses (cT1a). This may consist of surgery (partial nephrectomy or lumpectomy), percutaneous thermo-ablation (by radiofrequency, microwave, or cryotherapy). In patients with limited life expectancy, imaging-based surveillance may be proposed to suggest treatment in case of local progression. Good coordination between urologist, radiologist, nephrologist, and sometimes radiotherapist should allow optimal management of patients with a malignant renal tumor with or without underlying renal failure., (Copyright © 2023 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)

Introduction: To describe the perioperative outcomes in patients treated with radical nephrectomy with cava thrombectomy at all thrombi levels using a multidisciplinary approach, with or without extracorporeal circulation (ECC), and to identify factors associated with perioperative morbidity., Methods: We retrospectively identified 42 patients who were diagnosed with renal cell carcinoma (RCC) and a vena cava thrombus and treated with radical nephrectomy and cava thrombectomy by a double surgical team at Lyon University Hospital from 2008 through 2021. The surgeons operated in the cardiothoracic operating theater to proceed with median sternotomy or ECC, if necessary. The primary endpoint of this study was perioperative morbidity and mortality assessed using the Clavien-Dindo scale. Complications were recorded until 90 days after surgery, and those classified as grade IIIa or higher were considered high-grade complications., Results: Overall, 32 (76%) patients required ECC. No intraoperative mortality occurred; however, two patients (5%) died within 30 days. Complications occurred within 30 days in 30 patients (72%), with severe complications observed in 10 patients (24%). No further complications occurred between 30 and 90 days. Multivariate analysis revealed that age, thrombus level, ECC, American Society of Anesthesiologists physical status, symptoms, and metastasis at presentation were not significantly associated with high-grade complications (P>0.05)., Conclusions: Multidisciplinary approach is essential and frequent use of ECC, when achieved by a trained team, may facilitate surgery, and is associated with low perioperative morbidity, especially for patients with high-level thrombi., Level of Evidence: IV., (Copyright © 2024. Published by Elsevier Masson SAS.)

Copyright of Revista Chilena de Urologia is the property of Sociedad Chilena de Urologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Chilena de Urologia is the property of Sociedad Chilena de Urologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: Pilar leiomyoma is a rare skin tumor, which is divided according to the smooth muscle from which it is originated. The most common cutaneous leiomyoma is the pilar leiomyoma in 3-5%, followed by angioleiomyomas and genital leiomyomas. It's more common in women, being more frequent in the trunk and extremities. They usually present as multiple lesions and may be associated to syndromes or malignancy. CLINICAL CASE: A 46-year-old female patient, with hysterectomy due to uterine myomatosis and her father with pilar leiomyoma. CONCLUSIONS: In a patient with pilar leiomiomatosis a directed questioning regarding family history must be done and initiate the approach in search of associated syndromes in the case of women with uterine leiomyomas and kidney cancer. [ABSTRACT FROM AUTHOR]

La obesidad se ha convertido en una epidemia mundial, y se ha proyectado que su prevalencia se incrementrá en un 40% en la próxima década. Esta creciente prevalencia supone implicaciones tanto para el riesgo de desarrollo de diabetes y enfermedades cardiovasculares como para el desarrollo de enfermedad renal crónica. Un elevado índice de masa corporal es uno de los factores de riesgo más importantes para el desarrollo de enfermedad renal crónica. En individuos afectados por la obesidad, tiene lugar una hiperfiltración compensatoria necesaria para alcanzar la alta demanda metabólica secundaria al aumento del peso corporal. El incremeno de la presión intraglomerular puede generar daño renal y elevar el riesgo de desarrollar enfermedad renal crónica a largo plazo. La incidencia de glomerulopatía asociada a obesidad se ha incrementado 10 veces en los últimos años. Así mismo se ha demostrado que la obesidad es un factor de riesgo para el desarrollo de nefrolitiasis y un número de neoplasias, incluyendo cáncer renal. Este año, el Día Mundial del Riñón promueve la educación acerca de las consecuencias nocivas de la obesidad y su asociación con la enfermedad renal, abogando por un estilo de vida saludable y la implementación de políticas publicas de salud que promuevan medidas preventivas alcanzables.

Obesity has become a worldwide epidemic, and its prevalence has been projected to grow by 40% in the next decade. This increasing prevalence has implications for the risk of diabetes, cardiovascular disease and also for Chronic Kidney Disease. A high body mass index is one of the strongest risk factors for new-onset Chronic Kidney Disease. In individuals affected by obesity, a compensatory hyperfiltration occurs to meet the heightened metabolic demands of the increased body weight. The increase in intraglomerular pressure can damage the kidneys and raise the risk of developing Chronic Kidney Disease in the long-term. The incidence of obesityrelated glomerulopathy has increased ten-fold in recent years. Obesity has also been shown to be a risk factor for nephrolithiasis, and for a number of malignancies including kidney cancer. This year the World Kidney Day promotes education on the harmful consequences of obesity and its association with kidney disease, advocating healthy lifestyle and health policy measures that makes preventive behaviors an affordable option.

Introducción: La metástasis tumor a tumor es muy rara con menos de 50 casos descritos en la literatura. Este artículo informa de un caso de metástasis de cáncer de mama en un tumor renal de células claras. Caso clínico: El caso corresponde a una mujer de 61 años de edad con antecedente de cáncer de mama, libre de enfermedad por 23 años. Por control, se solicita Tomografía computarizada (TC) simple y contrastada observándose a nivel de pelvis renal izquierda imagen nodular hipercaptante heterogénea de 2.4 cm, de bordes definidos, no infiltrante a tejidos adyacentes, por localización de lesión es sometida a nefrectomía radical izquierda. El examen patológico demostró un carcinoma de mama metastásico de 3 mm, mal definido, dentro de un carcinoma de células renales claras de 2,5x2x2cm. Este caso pone de relieve la importancia de los antecedentes previos de neoplasia maligna de un paciente, así como del muestreo adecuado de las neoplasias renales.

Introduction: Malignant tumors of the urinary tract are associated with high morbidity and mortality, and their prevalence can vary worldwide. Recently, the IDENTIFY study has published results on the prevalence of urinary tract cancer at a global level. This study evaluates the prevalence of cancer within the Spanish cohort of the IDENTIFY study to determine whether the published results can be extrapolated to our population., Patients and Methods: An analysis of the data from the Spanish cohort of patients in the IDENTIFY study was performed. This is a prospective cohort of patients referred to secondary care with suspected cancer, predominantly due to hematuria. Patients were recruited between December 2017 and December 2018., Results: A total of 706 patients from 9 Spanish centers were analyzed. Of these, 277 (39.2%) were diagnosed with cancer: 259 (36.7%) bladder cancer, 10 (1.4%) upper tract urothelial carcinoma, 9 (1.2%) renal cancer and 5 (0.7%) prostate cancer. Increasing age (OR 1.05 (95% CI 1.03-1.06; P < 0.001)), visible hematuria (VH) OR 2.19 (95% CI 1.13-4.24; P = 0.02)) and smoking (ex-smokers: OR 2.11(95% CI 1.30-3.40; P = 0.002); smokers: OR 2.36 (95% CI 1.40-3.95; P = 0.001)) were associated with higher probability of bladder cancer., Conclusion: This study highlights the risk of bladder cancer in patients with VH and smoking habits. Bladder cancer presented the highest prevalence; higher than the prevalence reported in previous series and presented in the IDENTIFY study. Future work should evaluate other associated factors that allow us to create cancer prediction models to improve the detection of cancer in our patients., (Copyright © 2023. Published by Elsevier España, S.L.U.)

El carcinoma renal constituye una de las neoplasias más frecuentes y letales. El uso extendido de los métodos por imágenes, particularmente la ecografía y la tomografía computada multicorte (TCMC), por su mayor sensibilidad, ha generado un gran número de diagnósticos incidentales. La nefrectomía parcial (NP) es una técnica quirúrgica cuya indicación se ha incrementado en los últimos años, siendo la de preferencia para remover pequeños tumores renales debido a que ofrece una mejor función renal residual. Con el fin de evaluar la posibilidad de realizar una NP y estimar el grado de dificultad de la cirugía, Kutikov y Uzzo desarrollaron un sistema de puntuación llamado RENAL score (RS). Este se basa en las características anatómicas quirúrgicamente más relevantes de las neoplasias renales sólidas. Evalúa el radio tumoral máximo (R), la proporción de componente exofítico/endofítico (E), el nearness o cercanía al sistema colector (N), su posición anterior/posterior respecto al eje hiliar (A) y la localización relativa a las líneas polares (L). Cuatro de estos componentes suman puntos para el cálculo de la nefrometría y su resultado clasifica a los tumores según su complejidad quirúrgica en baja, moderada o alta. Los radiólogos deben conocer el RS e incluir la puntuación en sus informes, ya que provee información anatómica muy completa para una posible cirugía. El objetivo de este trabajo es describir los componentes y la forma de calcular el sistema de puntuación RS, utilizando imágenes de TCMC.

Introducción: el cáncer renal, como toda patología oncológica, tiene un mejor pronostico si es diagnosticada tempranamente, de manera general los médicos especialistas no son la puerta de entrada de esta enfermedad al sistema de salud, por lo que es indispensable tener ciertos indicios clínicos en médicos no especialistas o de diferentes especialidades. Objetivo: Evaluar el nivel de conocimientos de los Médicos Ecuatorianos sobre el Cáncer Renal. Metodología: Se realizó un estudio de corte transversal, la información fue recolectada a través de una encuesta diseñada para esta investigación. se calcula la muestra en base a prevalencias de conocimientos regionales con un nivel de confianza de 95%. Resultados: en general los aciertos a las preguntas de conocimientos fueron elevados (61%), el puntaje fue más alto en especialidades directamente relacionadas. El componente más afectado fue el de tratamiento (38%). El 78% de los médicos percibe que no existe medicación adecuada en el mercado ecuatoriano y más de la mitad piensa que la tecnología es aún insuficiente. Un 15% de profesionales aún cree que el manejo de Cáncer Renal debe hacerse exclusivamente por un médico oncólogo. Conclusiones: Existen vacíos de conocimiento en los profesionales de la salud, éstos se dan en todos los componentes evaluados, es necesario fortalecer los esfuerzos de Educación continua para evitar retrasos en el diagnóstico de patologías cuyo pronóstico depende de un manejo temprano.

Introducción: el cáncer renal, como toda patología oncológica, tiene un mejor pronostico si es diagnosticada tempranamente, de manera general los médicos especialistas no son la puerta de entrada de esta enfermedad al sistema de salud, por lo que es indispensable tener ciertos indicios clínicos en médicos no especialistas o de diferentes especialidades. Objetivo: Evaluar el nivel de conocimientos de los Médicos Ecuatorianos sobre el Cáncer Renal. Metodología: Se realizó un estudio de corte transversal, la información fue recolectada a través de una encuesta diseñada para esta investigación. se calcula la muestra en base a prevalencias de conocimientos regionales con un nivel de confianza de 95%. Resultados: en general los aciertos a las preguntas de conocimientos fueron elevados (61%), el puntaje fue más alto en especialidades directamente relacionadas. El componente más afectado fue el de tratamiento (38%). El 78% de los médicos percibe que no existe medicación adecuada en el mercado ecuatoriano y más de la mitad piensa que la tecnología es aún insuficiente. Un 15% de profesionales aún cree que el manejo de Cáncer Renal debe hacerse exclusivamente por un médico oncólogo. Conclusiones: Existen vacíos de conocimiento en los profesionales de la salud, éstos se dan en todos los componentes evaluados, es necesario fortalecer los esfuerzos de Educación continua para evitar retrasos en el diagnóstico de patologías cuyo pronóstico depende de un manejo temprano.

Résumé Le carcinome rénal est une tumeur maligne agressive avec un potentiel métastatique important. Il peut notamment envahir la veine rénale, la veine cave inférieure et peut alors s’étendre par voie endoluminale jusqu’au cœur droit. Nous rapportons le cas d’un patient de 71 ans chez qui on découvre fortuitement une impressionnante masse polylobée des cavités droites et de la veine cave inférieure révélatrice d’une néoplasie surréno-rénale extensive. Renal carcinoma is an aggressive cancer with a high metastatic tendency. It may invade the renal vein, inferior vena cava and potentially extend in some cases to the right heart cavities. We report a case of a 71-year-old male presenting with an impressive polylobular tissular mass inside the right atrium and the right ventricle revealing an aggressive renal carcinoma extending through the inferior vena cava. [ABSTRACT FROM AUTHOR]

Copyright of Nefrologia is the property of Revista Nefrologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Le cancer du rein représente 3% des cancers. Il est classé au troisième rang des cancers urologiques après celui de la prostate et de la vessie. Depuis la néphrectomie totale élargie de Robson en 1963, on assiste à un changement continu de la prise en charge de ce cancer. En 1990, on a mis en question le curage ganglionnaire systématique. En 1993, on a mis en question la surrénalectomie systématique. En 1995, on a commencé à proposer la chirurgie conservatrice pour les tumeurs dont le diamètre est inférieur à 4 cm. A partir de 2004, on l’a proposée pour les tumeurs

La obesidad se ha convertido en una epidemia mundial, y se ha proyectado que su prevalencia se incrementará en un 40 % en la próxima década. Esta creciente prevalencia supone implicaciones tanto para el riesgo de desarrollo de diabetes y enfermedades cardiovasculares como para el desarrollo de Enfermedad Renal Crónica. Un elevado índice de masa corporal es uno de los factores de riesgo más importantes para el desarrollo de Enfermedad Renal Crónica. En individuos afectados por la obesidad, tiene lugar una hiperfiltración compensatoria necesaria para alcanzar la alta demanda metabólica secundaria al aumento del peso corporal. El incremento de la presión intraglomerular puede generar daño renal y elevar el riesgo de desarrollar Enfermedad Renal Crónica a largo plazo. La incidencia de glomerulopatía asociada a obesidad se ha incrementado 10 veces en los últimos años. Así mismo se ha demostrado que la obesidad es un factor de riesgo para el desarrollo de nefrolitiasis y un número de neoplasias, incluyendo cáncer renal. Este año, el Día Mundial del Riñón promueve la educación a cerca de las consecuencias nocivas de la obesidad y su asociación con la enfermedad renal, abogando por un estilo de vida saludable y la implementación de políticas públicas de salud que promuevan medidas preventivas alcanzables.

PURPOSE: To report the 5-year oncological outcomes of patients undergoing laparoscopic radical nephrectomy for renal cancer compared to a cohort of patients undergoing open radical nephrectomy. METHODS: We retrospectively analyzed the data of 88 patients undergoing radical nephrectomy for renal cell carcinoma prior to January 2000. Of these, 45 patients underwent laparoscopic radical nephrectomy, and 43 patients underwent open radical nephrectomy. Inclusion criteria comprised clinically organ-confined tumors of 15 cm or less in size without concomitant lymphadenopathy or vena cava thrombus. Oncological follow-up data were obtained from charts, radiological reports, and phone calls to patients or their families, and were calculated from the date of surgery to the date of last appointment with physician or date of death. RESULTS: All laparoscopic procedures were completed without open conversion. On comparing the laparoscopic radical nephrectomy and open radical nephrectomy groups, mean tumor size was 5. 8 vs 6.2 cm (P = . 44), mean blood loss was 183 vs 461 mL (P = . 004), and mean operative time was 2.8 vs 3.7 hrs (P < . 001). Over a mean follow-up of 5 years in the laparoscopic radical nephrectomy group and 6 years in the open radical nephrectomy group, the overall survival was 81% vs 79% (P = . 47), and cancer-specific survival was 90% vs 92% (P = . 70) , respectively. CONCLUSIONS: Laparoscopic radical nephrectomy for renal cancer confers equivalent 5-year oncological outcomes to those of open surgery.OBJETIVO: Relatar os resultados oncológicos após 5 anos de seguimento em pacientes submetidos a nefrectomia radical laparoscópica para tratamento do câncer renal, comparando esses com os resultados obtidos com um grupo de pacientes submetidos a nefrectomia radical aberta. MÉTODOS: Foram analisadas retrospectivamente as informações obtidas de 88 pacientes submetidos a nefrectomia radical para o tratamento do carcinoma renal realizadas previamente a Janeiro de 2000. Destes pacientes, 45 foram tratados com nefrectomia radical laparoscópica e 43 com nefrectomia radical aberta. Foram incluídos pacientes com tumores localizados com tamanho máximo de 15 cm, sem adenopatia ou sinal de envolvimento de veia renal na avaliação radiologica pré-operatória. As informações sobre o seguimento dos pacientes foram obtidas a partir de prontuários, laudos de exames radiológicos e ligações telefônicas para pacientes e/ou familiares. O seguimento foi calculado desde a data da cirurgia até a última consulta médica ou data de falecimento. RESULTADOS: Todos os procedimentos laparoscópicos foram realizados sem conversão para a técnica aberta. O tamanho médio tumoral foi de 5.8 e. 6.2 cm (P=0.44), perda sanguínea estimada de 183 e. 461 mL (P=0.004), e tempo operatório de 2.8 e. 3.7 horas (P

Objective: To investigate the reproducibility and interobserver agreement for R.E.N.A.L. nephrometry scoring system. Materials and Methods: Two independent radiologists retrospectively analyzed 46 consecutive patients with renal masses, between 2008 and 2012, using the R.E.N.A.L. nephrometry score (RENAL-NS), which is based on the evaluation of five anatomical features of the tumor, as evaluated with computed tomography or magnetic resonance imaging: Radius, Exophytic/endophytic properties, Nearness to the collecting system, Anterior or posterior descriptor, and Location relative to the polar line. Tumor complexity was graded as low, intermediate, or high. The interobserver agreement was calculated for the total score and for the score for each parameter. Surgical excision of the tumors was used as the standard of reference. Results: The interobserver agreement for each of the RENAL-NS parameters, respectively, a hilar location, and the total score was 98%, 80%, 100%, 89%, 85%, 89%, and 93% of patients, corresponding to kappa values of 0.96, 0.65, 1.00, 0.75, 0.72, 0.78, and 0.88, respectively. The Nearness, Radius, and total score showed the best agreement. For the cases that were discordant in terms of the final score, no major implications in surgical planning were observed. Conclusion: The RENAL-NS is a structured, useful system to assess the anatomical features of renal tumors. It is easily applicable and reproducible, even for less experienced radiologists. [ABSTRACT FROM AUTHOR]

Renal cell carcinoma (RCC) is the seventh most common histological type of cancer in the Western world and has shown a sustained increase in its prevalence. The histological classification of RCCs is of utmost importance, considering the significant prognostic and therapeutic implications of its histological subtypes. Imaging methods play an outstanding role in the diagnosis, staging and follow-up of RCC. Clear cell, papillary and chromophobe are the most common histological subtypes of RCC, and their preoperative radiological characterization, either followed or not by confirmatory percutaneous biopsy, may be particularly useful in cases of poor surgical condition, metastatic disease, central mass in a solitary kidney, and in patients eligible for molecular targeted therapy. New strategies recently developed for treating renal cancer, such as cryo and radiofrequency ablation, molecularly targeted therapy and active surveillance also require appropriate preoperative characterization of renal masses. Less common histological types, although sharing nonspecific imaging features, may be suspected on the basis of clinical and epidemiological data. The present study is aimed at reviewing the main clinical and imaging findings of histological RCC subtypes. [ABSTRACT FROM AUTHOR]

Introduction: Radical nephrectomy is the gold standard treatment for kidney tumors. In Mexico the laparoscopic technique is done in few hospitals, so there are not many Mexican published series. Objective: To estimate the surgical and oncologic efficacy of laparoscopic radical nephrectomy vs. open radical nephrectomy, both performed in the General Hospital of the State of Sonora, Mexico. Material and methods: Comparison of outcomes between patients undergoing open radical nephrectomy from 2008 to 2011, vs. laparoscopic radical nephrectomy from 2011 to 2014. Results: Data from a total of 44 patients, 20 treated by laparoscopy and 24 with radical open surgery were analyzed. The average laparoscopic surgical time was higher (177.2 vs. 148 min); however, average intraoperative bleeding (925 vs. 762 mL) and the mean hospital stay (2-4 vs. 3 days) were lower using the laparoscopic technique. The surgical margins were negative in all laparoscopic cases. Conclusion: The results of the laparoscopic radical nephrectomy were better than those obtained with the open technique as demonstrated by intraoperative bleeding and hospital stay, without difference in the oncologic outcomes. Progress during the learning curve improves surgical time and reduces complications. [ABSTRACT FROM AUTHOR]

The goal of this study was to understand roles of nucleoside and nucleobase transport processes in capecitabine pharmacology in cells derived from human renal proximal tubule cells (hRPTCs) and three human renal cell carcinoma (RCC) cell lines, A498, A704, and Caki-1. Human equilibrative nucleoside transporters 1 and 2 (hENT1 and hENT2) mediated activities and a sodium-independent nucleobase activity were present in hRPTCs. In hRPTCs, uptake of 5′-deoxy-5-fluorouridine (DFUR), a nucleoside metabolite of capecitabine, was pH dependent with highest uptake seen at pH 6.0. In RCC cell lines, hENT1 was the major nucleoside transporter. Nucleobase transport activity was variable among the three RCC cell lines, with Caki-1 showing the highest and A498 showing the lowest activities. Treatment of RCC cell lines with interferon alpha (IFN-α) increased thymidine phosphorylase levels and prior treatment of RCC cell lines with IFN-α followed by 5-FU or DFUR resulted in enhanced sensitivity of all cell lines to 5-FU and two of three cell lines to DFUR. We report for the first time a nucleobase transport activity in hRPTCs and RCC cell lines. In addition, our in vitro cytotoxicity results showed that RCC cell lines differed in their response to 5-FU and DFUR and prior treatment with IFN-α potentiated cytotoxic response to metabolites of capecitabine. [ABSTRACT FROM AUTHOR]

Aims: Evaluate the role of clinic pathologic variables in patients of 70 years or older with renal carcinoma that were surgically treated. Material and methods: We made a retrospective analysis of 147 patients with renal cell carcinoma. The evaluation included clinical and histopathologic variables. The evaluation also included cancer-specific survival and comorbidities of these patients, it was determined using the Kaplan-Meier method. Univariate and multivariate analysis were carried out. Results: A total of 147 patients of 70 years and older with renal carcinoma and treatment with radical nephrectomy, were the followed up for 38 months. There was 23.2% mortality due to cancer and those presented with larger tumors, of higher grade, and with a greater frequency of lymphovascular invasion. We observed cardiovascular mortality on 8% and significant elevation on renal chronic disease. The cancer-specific survival at five years was 97.2% in stage I, 77.8% in stage II, 62.7% in stage III, and 18.4% in stage IV. All variables were associated with cancer-specific survival in the univariate analysis and in the multivariate analysis, the nuclear grade, lymph node invasion, tumor diameter, and the presence of metastasis maintained an independent association with survival. Conclusions: We corroborated the worse prognostic factors and the presence of comorbidities on older patients. [ABSTRACT FROM AUTHOR]

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Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Romanian Journal of Urology is the property of Romanian Journal of Urology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction and Objectives: Comparative analysis of postoperative complications and survival between laparoscopic partial nephrectomy (PN) and radical nephrectomy (RN) in cT1 renal cell carcinoma (RCC)., Material and Method: Retrospective study of patients with two kidneys and single renal tumor cT1 treated in our center between 2005 and 2018 by laparoscopic PN or RN., Results: 372 patients met the inclusion criteria for the study. RN was performed in 156 (41.9%) patients and PN in 216 (58.1%). Clavien Dindo III-V complications were observed in 10 (4,6%) PN and 6 (3,9%) RN patients (p = 0.75). The comorbidity Charlson index (CCI) was identified as an independent predictor variable of complications (p = 0.02) and surgical approach did not affect multivariate analysis. Estimated overall survival (OS) was 81.2% and 56.8% at 5 and 10 years in the RN group and 90.2% and 75.7% in the PN group, respectively (p = 0.0001). Obesity (HR 2.77, p = 0.01), CCI ≥ 3 (HR 3.69, p = 0.001) and glomerular filtration rate (GFR) <60 mL/min/1.73 m 2 at discharge (HR 1.87, p = 0.03) were identified as predictors of overall mortality. Nephrectomy approach showed no influence on OS. Estimated recurrence-free survival (RFS) was 86.1% at 5 and 10 years in the RN group and 93.5% and 83.6% in the PN group, respectively (p = 0.22)., Conclusions: Laparoscopic PN is not inferior to RN in terms of oncologic and surgical safety in cT1 RCC. Nephrectomy approach did not influence patient OS, however, obesity, CCI ≥ 3 and GFR <60 mL/min/1.73 m 2 at discharge did behave as predictors., (Copyright © 2021 AEU. Published by Elsevier España, S.L.U. All rights reserved.)

Von Hippel-Lindau disease (VHL) is a rare entity (1/36.000 newborns), which is characterized by the occurrence of benign and malignant tumors in different regions. We present a case of a young VHL woman who developed several complications VHL related. Among them, multi and bilateral renal tumors of a mixt (cystic and solid) composition were noticed. Due to the fragile condition of the patient, it was decided to perform a radiofrequency ablation of the two bigger lesions (3.7 cm y 4.2 cm respectively).The subsequent result of the intraprocedural biopsy performed on the largest nodule confirmed the presumptive diagnosis showing confirmed the presence of a clear-cell tumor, stage 1 of Fuhrman. The procedure was technically successful reaching a complete coagulative necrosis of both tumors. The clinical evolution was uneventful with a clinic discharge on the following day. A CT scan two years later still confirms that the procedure has been successful. Renal function as estimated by the creatinine clearence (MDRD) was 119 at baseline and remains at 120 ml / min two years later. [ABSTRACT FROM AUTHOR]

Objective: To provide latest findings of Urologic Oncology on prostate, kidney, and bladder cancer, and analyze its impact on clinical practice as well as future schemes in the medium- and long-term., Methods: This document reviews the abstracts on Uro-Oncology presented at the 2020 Congresses (EUA, AUA, ASCO, ESMO and ASTRO), the publications with the highest impact and especially the new lines of development and progress in Uro-Oncology evaluated by the OncoForum committee., Results: The use of prostate-specific membrane antigen (PSMA) radioligands in the diagnosis of prostate cancer may have great potential and utility in the coming years due to their improved sensitivity and specificity. The genetic characterization of the tumor is important at both, germline and somatic levels, due to the significant role of BRCA2 mutations regarding risk. The cohort multiple randomised controlled trial is the most suitable study design at the genitourinary cancer level. The application of big data will lead to process improvements, savings in healthcare costs, and an empowerment of real-life studies through ease of data comparison, management, and storage., Conclusions: The use of new diagnostic techniques with PSMA ligands will provide a more comprehensive diagnostic modality, increase the number of studies about tumor genetic profiling, and enhance their quality. The practical application of artificial intelligence will improve the treatment genitourinary cancer., (Copyright © 2021 AEU. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction: The increased incidenceof diagnosis of kidney tumours has driveninvestigation in the area. It is known that the risk ofmalignancy is correlated with tumour size, but thereare still no specific and objective parameters to characterizethe degree of aggressiveness and to be ableto guide a treatment reliably. OBJECTIVE: To identify the relationship betweenrenal tumour size and the incidence of tumour aggressivecharacteristics., Patients and Methods: A retrospective analysisof our series of renal cancers operated between 1998and 2018 was performed. The specific and cumulativeincidence of aggressive characteristics was studied.The following where considered as aggressive characteristics:Presence of sarcomatoid or epidermoiddifferentiation, tumour necrosis, stage pT3-4, histologicalhigh grade (3-4) and the presence of histologicalaggressive variants., Results: A total of 651 patients that had undergonerenal mass surgery were analysed. In tumours below2 cm the appearance of aggressive characteristicsoccurred in less than 5%. For renal masses greaterthan 2 cm, each centimetre increase correlated with arise in cumulative incidence of 2-3% for each characteristicstudied., Conclusions: In tumours below 2cm and patientswith significant comorbidities active surveillance maybe a reliable alternative to surgery.