International Variations and Trends in Renal Cell Carcinoma Incidence and Mortality

ObjectivesTo assess differences in complications after robot-assisted (RAPN) and open partial nephrectomy (OPN) among experienced surgeons. Patients and MethodsWe identified patients in our institutional review boardapproved, prospectively maintained database who underwent OPN or RAPN for management of unifocal, T1a renal tumours at our institution between January 2011 and August 2015. The primary outcome measure was the rate of 30-day overall postoperative complications. Baseline patient factors, tumour characteristics and peri-operative factors, including approach, were evaluated to assess the risk of complications. ResultsPatients who underwent OPN were found to have a higher rate of overall complications (30.3% vs 18.2%; P = 0.038), with wound complications accounting for the majority of these events (11.8% vs 1.8%; P < 0.001). Multivariable logistic regression analysis showed the open approach to be an independent predictor of overall complications (odds ratio 1.58, 95% confidence interval 1.03-2.43; P = 0.035). Major limitations of the study include its retrospective design and potential lack of generalizability. ConclusionsThe open surgical approach predicts a higher rate of overall complications after partial nephrectomy for unifocal, T1a renal tumours. For experienced surgeons, the morbidity associated with nephron-sparing surgery may be incrementally improved using the robot-assisted approach.

show abstract

“…The incidence of RCC continues to increase as the world population ages [1]. The majority of such tumours are <4 cm in size at diagnosis [2].…”

Section: Introductionmentioning

confidence: 99%

Predicting complications in partial nephrectomy for T1a tumours: does approach matter?

et al. 2016

View full text Add to dashboard Cite

show abstract

“…U 2012. godini najveća učestalost zabilježena je u Češkoj (22/100.000 muškaraca odnosno 9,9/100.000 žena). Smrtnost prati učestalost bolesti pa je tako ona najveća u Češkoj (9,1/100.000 muškaraca odnosno 3,6/100.000 žena) 4 . Analiza podataka u Hrvatskoj pokazala je kako spadamo u red zemalja u kojima raste i incidencija i mortalitet od KB-a 4 .…”

Section: Uvodunclassified

“…Smrtnost prati učestalost bolesti pa je tako ona najveća u Češkoj (9,1/100.000 muškaraca odnosno 3,6/100.000 žena) 4 . Analiza podataka u Hrvatskoj pokazala je kako spadamo u red zemalja u kojima raste i incidencija i mortalitet od KB-a 4 . Godine 2011. bilo je 405 novooboljelih muškaraca, odnosno 265 novooboljelih žena 5 .…”

Section: Uvodunclassified

“…Smrtnost je bila 6,5/100.000 u muš-karaca odnosno 1,8/100.000 kod žena. Također, u posljednjih 10 godina pokazao se godišnji porast učestalosti od 4,1 % (muškarci) odnosno 2,6 % (žene) dok je smrtnost godišnje porasla za 3,0 % (muškarci) odnosno 1,5 % (žene) 4 . Cilj ovog rada je prikazati učestalost i kliničke značajke operiranih pacijenata s KB-om s posebnim naglaskom na preživljenje.…”

Section: Uvodunclassified

See 1 more Smart Citation

Incidence, clinical evaluation and surgical treatment of patients with renal cell cancer: 40-years of experience in the University Hospital Rijeka

et al. 2017

View full text Add to dashboard Cite

Sažetak. Cilj: Ispitati učestalost, kliničku evaluaciju i kirurško liječenje pacijenata s karcinomom bubrega (KB). Pacijenti i metode: Retrospektivnim istraživanjem bili su obuhvaćeni svi pacijenti u Kliničkom bolničkom centru Rijeka koji su između 1. siječnja 1972. i 31. prosinca 2012. godine operirani zbog KB-a. Rezultati: U promatranom razdoblju u našem centru zbog KB-a bilo je operirano 1045 pacijenata. Broj pacijenata se tijekom vremena povećao, s 5 pacijenata godišnje početkom 70-ih godina na preko 50 posljednjih nekoliko godina. Broj asimptomatskih pacijenata povećao se s 6 % na 75 %. Prosječna dob pacijenata bila je 63 godine (raspon 21 -86 godina). Nefrektomija je učinjena u 95,3 % pacijenata, u 2,6 % parcijalna nefrektomija, a u 2,1 % eksplorativna lumbotomija. U promatranom razdoblju 5-godišnje preživljenje bilo je u 64 %, a 10-godišnje preživljenje 47 %. Zaključak: Učestalost KB-a se tijekom posljednja četiri desetljeća višestruko povećala. Novije dijagnostičke metode omogućuju njegovo otkrivanje u ranijoj fazi, a samim time se omogućuje poštednije kirurško liječenje, ne umanjujući onkološki učinak.Ključne riječi: incidencija; karcinom bubrega; nefrektomija; parcijalna nefrektomija; preživljenje Abstract. Aim: To evaluate incidence, clinical evaluation and surgical treatment of our patients with renal cell cancer (RCC). Patients and methods: We retrospectively analyzed all patients with RCC operated in University Hospital Rijeka from January 1 st 1972 to December 31 st 2012. Results: In observed period 1045 patients were operated because of RCC. Number of operated patients has increased during time from 5 in the begining of 70-ties to more than 50 in the few last years. The number of asymptomatic patients has increased from 6% to 75%. The mean age was 63 years (range 21-86). Nephrectomy wasperformed in 95.3% patients, nephron sparing surgery in 2.6% and explorative lumbotomy in 2,1% of patients. The 5-year survival was 64% and 10-year survival 47%. Conclusion: The incidence of RCC substantialy increased during time. The new diagnostic methods found RCC in earlier phase and the nephron sparing surgery can be performed without negative influence on oncological outcome.

show abstract

“…Naar schatting 980 patiënten overleden in dat jaar aan de gevolgen van niercelcarcinoom. Niercelcarcinomen vormen 2 % van alle oncologische tumoren en 90 % van de maligne niertumoren, waarbij het heldercellig niercelcarcinoom (60-70 %) en het papillaire niercelcarcinoom (15-30 %) het meest frequent voorkomen [1,2]. Door frequenter gebruik van beeldvormende technieken worden de tumoren vaker en eerder ontdekt.…”

Section: Introductieunclassified

Case report. Perioperatieve anticoagulantia voor de behandeling van een vena cava inferior tumor trombus bij patiënten met niercelcarcinoom

Leeuwen

Verhagen

2017

Tijdschr Urol

View full text Add to dashboard Cite

Samenvatting Een 71-jarige patiënt met een niertumor met uitbreiding in de vena cava inferior (VCI) werd één dag voor de geplande operatiedatum, met uitgebreide longembolieën opgenomen op de intensive care. Trombolyse is ternauwernood succesvol, maar hij wordt toch alsnog geopereerd op een later tijdstip. Naar schatting heeft 4-10 % van de patiënten met een nieuw gediagnosticeerd niercelcarcinoom een tumortrombus in de (VCI). Dit geeft een verhoogde kans op trombo-embolische complicaties. Naar de effectiviteit van perioperatieve anticoagulantia bij patiënten met een lokaal uitgebreid niercelcarcinoom is echter nog geen gerandomiseerd onderzoek verricht. Op basis van expert opinion zijn anticoagulantia (low molecular weight heparins (LMWH) therapeutisch gedoseerd) bij patiënten met een niercelcarcinoom met uitbreiding in de VCI geïn-diceerd vanaf het moment van diagnose tot en met drie tot zes maanden na operatieve behandeling. Op basis van een literatuuronderzoek wordt aanbevolen om bij patiënten met een niercelcarcinoom met uitbreiding in de VCI direct te starten met therapeutische antistolling. Abstract A 71-year-old patient was diagnosed with a renal cell carcinoma with extension in the IVC. Patient was admitted to the intensive care one day before his planned surgery because of massive pulmonary embolism. Trombolysis was eventually effective and later a radical nephrectomy was successfully performed. Inferior vena caval (IVC) tumor thrombus occurs in 4-10% of patients diagnosed with renal cell carcinoma. These patients have an increased risk of venous thromboembolism. There is no randomized trial investigating the role of anticoagulants in this patient group. Based on expert opinion it is advised to start Low Molecular Weight Heparins (LMWH), in a therapeutic dose, at time of diagnosis up to three to six months following surgery. Based on a literature search on this subject immediate treatment with therapeutic LMWH is recommended in patients with a renal cell carcinoma extending in the IVC. Keywords renal cell carcinoma · tumor thrombus · pulmonary embolism · anticoagulants IntroductieHet niercelcarcinoom is de meest voorkomende maligne niertumor. In 2016 werden naar schatting 2.300 patiën-ten gediagnosticeerd met niercelcarcinoom. Naar schatting 980 patiënten overleden in dat jaar aan de gevolgen van niercelcarcinoom. Niercelcarcinomen vormen 2 % van alle oncologische tumoren en 90 % van de maligne niertumoren, waarbij het heldercellig niercelcarcinoom (60-70 %) en het papillaire niercelcarcinoom (15-30 %) het meest frequent

show abstract

International Variations and Trends in Renal Cell Carcinoma Incidence and Mortality

Cited by 810 publications

References 34 publications

Predicting complications in partial nephrectomy for T1a tumours: does approach matter?

Predicting complications in partial nephrectomy for T1a tumours: does approach matter?

Incidence, clinical evaluation and surgical treatment of patients with renal cell cancer: 40-years of experience in the University Hospital Rijeka

Case report. Perioperatieve anticoagulantia voor de behandeling van een vena cava inferior tumor trombus bij patiënten met niercelcarcinoom

Contact Info

Product

Resources

About