INTRODUCTION & OBJECTIVES: To present our findings in our series of pTla RCC treated by elective simple enucleation and to specifically report on the incidence of local recurrence, progression-free and disease-specific survival rate. MATERIAL & METHODS: 232 patients who had elective NSS performed by simple enucleation from January 1986 and September 2004 for sporadic, unilateral, pathologically confirmed, ≤ 4 cm RCC, were studied retrospectively. The patients' status was evaluated last in September 2005. The mean (median, range) follow up was 76 (61, 12-225) months. RESULTS: Mean (SD, median, range) tumour greatest dimension was 2.8 (0.78, 2.85, 0.6-4) cm. On the basis of Fuhrman nuclear grading 32.3% (75/232) of tumours were G 1 , 51.3% (119/232) G2 and 16.4% (38/232) G3/G4. The histopathologic review according to the new classification (UICC and AJCC 1997) revealed 198 clear cell (85.3%), 18 papillary (7.8%), 15 chromophobe (6.5%) and 1/232 (0.4%) collecting system RCC. None of the patients died in the immediate postoperative period. Twelve patients (5.2%) developed postoperative bleeding requiring transfusions and 6 (2.6%) had postoperative prolonged urinary leakage from the drainage requiring double-J stent insertion. There were no major complications, such as prolonged acute tubular necrosis/chronic renal insufficiency and bleeding requiring reoperation. The 5- and 10-year cancer specific survival was 96.7% and 94.7%, respectively. The 5- and 10-year progression free survival was 96% and 94%, respectively. Overall,13 patients experienced progressive disease (5.6%) of whom 5 (2.1%) had local recurrence either alone or associated with distant metastases. Three of these had local recurrence alone, elsewhere in the kidney, showing a "kidney" recurrence rate of 1.3%. CONCLUSIONS: We confirm on a larger series that simple tumour enucleation is a safe and acceptable approach for elective NSS, provides excellent long-term progression free and cancer specific survival rates and is not associated with an increased risk of local recurrence compared to partial nephrectomy

PROGRESSION AND LONG-TERM SURVIVAL AFTER SIMPLE ENUCLEATION FOR THE ELECTIVE TREATMENT OF PT1A RENAL CELL CARCINOMA (RCC): OUR EXPERIENCE OVER 25 YEARS / Lapini A.; Minervini A.; Serni S.; Masieri L.; Nelli E; Giubilei G.; Tosi N.; Carini M.. - In: EUROPEAN UROLOGY. SUPPLEMENTS. - ISSN 1569-9056. - STAMPA. - 5:(2006), pp. 183-183. (Intervento presentato al convegno Annual EAU Congress, 2006 tenutosi a Parigi nel 5-8 aprile).

PROGRESSION AND LONG-TERM SURVIVAL AFTER SIMPLE ENUCLEATION FOR THE ELECTIVE TREATMENT OF PT1A RENAL CELL CARCINOMA (RCC): OUR EXPERIENCE OVER 25 YEARS

MINERVINI, ANDREA;SERNI, SERGIO;Masieri L.;CARINI, MARCO
2006

Abstract

INTRODUCTION & OBJECTIVES: To present our findings in our series of pTla RCC treated by elective simple enucleation and to specifically report on the incidence of local recurrence, progression-free and disease-specific survival rate. MATERIAL & METHODS: 232 patients who had elective NSS performed by simple enucleation from January 1986 and September 2004 for sporadic, unilateral, pathologically confirmed, ≤ 4 cm RCC, were studied retrospectively. The patients' status was evaluated last in September 2005. The mean (median, range) follow up was 76 (61, 12-225) months. RESULTS: Mean (SD, median, range) tumour greatest dimension was 2.8 (0.78, 2.85, 0.6-4) cm. On the basis of Fuhrman nuclear grading 32.3% (75/232) of tumours were G 1 , 51.3% (119/232) G2 and 16.4% (38/232) G3/G4. The histopathologic review according to the new classification (UICC and AJCC 1997) revealed 198 clear cell (85.3%), 18 papillary (7.8%), 15 chromophobe (6.5%) and 1/232 (0.4%) collecting system RCC. None of the patients died in the immediate postoperative period. Twelve patients (5.2%) developed postoperative bleeding requiring transfusions and 6 (2.6%) had postoperative prolonged urinary leakage from the drainage requiring double-J stent insertion. There were no major complications, such as prolonged acute tubular necrosis/chronic renal insufficiency and bleeding requiring reoperation. The 5- and 10-year cancer specific survival was 96.7% and 94.7%, respectively. The 5- and 10-year progression free survival was 96% and 94%, respectively. Overall,13 patients experienced progressive disease (5.6%) of whom 5 (2.1%) had local recurrence either alone or associated with distant metastases. Three of these had local recurrence alone, elsewhere in the kidney, showing a "kidney" recurrence rate of 1.3%. CONCLUSIONS: We confirm on a larger series that simple tumour enucleation is a safe and acceptable approach for elective NSS, provides excellent long-term progression free and cancer specific survival rates and is not associated with an increased risk of local recurrence compared to partial nephrectomy
2006
European Urology Supplements
Annual EAU Congress, 2006
Parigi
Lapini A.; Minervini A.; Serni S.; Masieri L.; Nelli E; Giubilei G.; Tosi N.; Carini M.
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Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/679937
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