Should patients with low‐risk renal cell carcinoma be followed differently after nephron‐sparing surgery vs radical nephrectomy?

Abu-Ghanem, Yasmin; Schmid, Peter; Capitanio, Umberto; Beisland, Christian; Järvinen, Petrus; Stewart, Grant D.; Guðmundsson, Eirikur; Lam, Thomas; Fernández-Pello, Sergio; Nísen, Harry; Meijer, Richard P.; Volpe, Alessandro; Ljungberg, Börje; Klatte, Tobias; Bensalah, Karim; Dabestani, Saeed; Bex, Axel

doi:10.1111/bju.15415

Cited by 8 publications

(3 citation statements)

References 15 publications

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“…This should include patients with a positive margin after PN since their risk of local recurrence is higher than for patients without a positive margin. The type of surgery performed and histological RCC type also affect the risk of recurrent disease [77].…”

Section: Follow-up Surveillance Following Nephrectomy or Ablative The...mentioning

confidence: 99%

European Association of Urology Guidelines on Renal Cell Carcinoma: The 2019 Update

et al. 2019

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Section: Follow-up Surveillance Following Nephrectomy or Ablative The...mentioning

confidence: 99%

European Association of Urology Guidelines on Renal Cell Carcinoma: The 2019 Update

et al. 2019

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“…Enucleation was performed according to the most familiar technique for each surgeon, and in no case was a mono/bipolar resectoscope used for haemostasis. Guidelines appropriate for the study type were followed [13]. Ethical committee approval for this prospective study was obtained in February 2013 (ASLMI2 n°39/2013).…”

Section: Methodsmentioning

confidence: 99%

Prognostic Factors Predicting Bleeding After Discharge Requiring Readmission After Thulium Laser Enucleation of the Prostate (ThuLEP)

Perri,

Pacchetti,

Morini

et al. 2023

Soc Int Urol J

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ObjectivesPostoperative haematuria is a feared complication following prostate enucleation, and it may occur even weeks after discharge. We evaluated the risk of bleeding after discharge and its predictive factors in patients who underwent Thulium laser enucleation of the prostate (ThuLEP).MethodsBetween January 2015 and December 2018, patients with surgical indication for benign prostatic hyperplasia underwent ThuLEP in 4 urology departments. All procedures were performed by experienced urologists. Postoperative haematuria was defined as macroscopic haematuria occurring 7 days after discharge. Readmission rate due to macroscopic haematuria was assessed. Logistic regression models tested for predictors of postoperative bleeding requiring readmission.ResultsOverall, 748 patients were included, and 52 (6.9%) of them were readmitted after discharge because of macroscopic haematuria. No cases of deep venous thrombosis or pulmonary embolism were diagnosed. Mean length of stay for surgical treatment was 2.1 days, and mean hospitalization for readmission was 5.6 days. None of the readmitted patients required reintervention, while 46.1% of them required blood transfusions. Diabetes mellitus (P < 0.05), a long bridge of oral anticoagulant drugs with low molecular weight heparin (LMWH) (P < 0.05) and history of constipation (P < 0.05) were significant predictors of readmission after discharge due to macroscopic haematuria.ConclusionsPatients with a clinical history of diabetes mellitus or constipation and patients who undergo a long bridge of oral anticoagulant therapy with LMWH are at higher risk of bleeding requiring readmission after ThuLEP.

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“…At present, surgical resection is the main treatment for patients with RCC (2,3). However, about 1/3 of patients have metastases at the time of diagnosis, and 1/5 patients have metastases or recurrences after radical treatment (4). RCC has a poor sensitivity to radiotherapy and chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

Identification of a Somatic Mutation-Derived Long Non-Coding RNA Signatures of Genomic Instability in Renal Cell Carcinoma

et al. 2021

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BackgroundRenal cell carcinoma (RCC) is a malignant tumor with high morbidity and mortality. It is characterized by a large number of somatic mutations and genomic instability. Long non-coding RNAs (lncRNAs) are widely involved in the expression of genomic instability in renal cell carcinoma. But no studies have identified the genome instability-related lncRNAs (GInLncRNAs) and their clinical significances in RCC.MethodsClinical data, gene expression data and mutation data of 943 RCC patients were downloaded from The Cancer Genome Atlas (TCGA) database. Based on the mutation data and lncRNA expression data, GInLncRNAs were screened out. Co-expression analysis, Gene Ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis were conducted to explore their potential functions and related signaling pathways. A prognosis model was further constructed based on genome instability-related lncRNAs signature (GInLncSig). And the efficiency of the model was verified by receiver operating characteristic (ROC) curve. The relationships between the model and clinical information, prognosis, mutation number and gene expression were analyzed using correlation prognostic analysis. Finally, the prognostic model was verified in clinical stratification according to TCGA dataset.ResultsA total of 45 GInLncRNAs were screened out. Functional analysis showed that the functional genes of these GInLncRNAs were mainly enriched in chromosome and nucleoplasmic components, DNA binding in molecular function, transcription and complex anabolism in biological processes. Univariate and Multivariate Cox analyses further screened out 11 GInLncSig to construct a prognostic model (AL031123.1, AC114803.1, AC103563.7, AL031710.1, LINC00460, AC156455.1, AC015977.2, ‘PRDM16-dt’, AL139351.1, AL035661.1 and LINC01606), and the coefficient of each GInLncSig in the model was calculated. The area under the curve (AUC) value of the ROC curve was 0.770. Independent analysis of the model showed that the GInLncSig model was significantly correlated with the RCC patients’ overall survival. Furthermore, the GInLncSig model still had prognostic value in different subgroups of RCC patients.ConclusionOur study preliminarily explored the relationship between genomic instability, lncRNA and clinical characteristics of RCC patients, and constructed a GInLncSig model consisted of 11 GInLncSig to predict the prognosis of patients with RCC. At the same time, our study provided theoretical support for the exploration of the formation and development of RCC.

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Should patients with low‐risk renal cell carcinoma be followed differently after nephron‐sparing surgery vs radical nephrectomy?

Abstract: S.D. and A.B. contributed equally to the work. ObjectiveTo investigate whether pT1 renal cell carcinoma (RCC) should be followed differently after partial (PN) or radical nephrectomy (RN) based on a retrospective analysis of a multicentre database (RECUR).

Cited by 8 publications

References 15 publications

European Association of Urology Guidelines on Renal Cell Carcinoma: The 2019 Update

European Association of Urology Guidelines on Renal Cell Carcinoma: The 2019 Update

Prognostic Factors Predicting Bleeding After Discharge Requiring Readmission After Thulium Laser Enucleation of the Prostate (ThuLEP)

Identification of a Somatic Mutation-Derived Long Non-Coding RNA Signatures of Genomic Instability in Renal Cell Carcinoma

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