Abstract:
OBJECTIVE:To analyse our long-term oncological outcomes with active surveillance in patients with positive surgical margins (PSMs) after nephron-sparing surgery (NSS) for renal cell carcinoma (RCC), as this situation is a difficult therapeutic dilemma. PATIENTS AND METHODS:We performed open NSS for renal masses with frozen-section analysis of any suspicious zone of the surgical bed, followed by extensive argon-beam coagulation. In patients where the final histopathological examination of the renal mass revealed PSMs, follow-up consisted of computed tomography (CT) every 6 months in the first 2 years and then annually up to 5 years, and thereafter we alternated ultrasonography with CT. RESULTS:From 1995 to 2003 we had 11 cases of microscopic definitive PSMs after NSS for RCC. Two patients required nephrectomy (one for postoperative bleeding and another as an elective procedure), so nine were followed. These patients were either operated under elective (seven) or imperative (two) conditions. The histological subtype was clear cell carcinoma in three, papillary in two, chromophobe in two and hybrid oncocytic RCC in two, with a Furhman grade of 2 in six and 3 in three. The mean size was 31.4 mm, and the stage was pT1a in six, pT1b in one and pT3a in two. After a median follow-up of 80.5 months, there was no local recurrence or distant progression. CONCLUSIONS:In our experience, microscopic PSMs in NSS specimens can be managed conservatively with active surveillance, achieving excellent results and avoiding extensive reoperation without compromising long-term oncological outcomes.
journal_name
BJU Intjournal_title
BJU internationalauthors
Lopez-Costea MA,Fumadó L,Lorente D,Riera L,Miranda EFdoi
10.1111/j.1464-410X.2009.09174.xsubject
Has Abstractpub_date
2010-09-01 00:00:00pages
645-8issue
5eissn
1464-4096issn
1464-410Xpii
BJU9174journal_volume
106pub_type
杂志文章abstract:OBJECTIVE:To determine the sensitivity of the direct radionuclide cystogram (DRC) in detecting vesico-ureteric reflux compared with the micturating cysto-urethrogram (MCU) in the same initial setting, in infants younger than one year. PATIENTS AND METHODS:The results from the dual cystograms of 62 refluxing infants < ...
journal_title:BJU international
pub_type: 杂志文章
doi:10.1046/j.1464-410x.2001.00997.x
更新日期:2001-01-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2007.07232.x
更新日期:2008-02-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1464-410X.2006.06560.x
更新日期:2007-02-01 00:00:00
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journal_title:BJU international
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更新日期:1999-04-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章,评审
doi:10.1046/j.1464-410x.2001.02243.x
更新日期:2001-07-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1464-410X.2010.09801.x
更新日期:2011-07-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/bju.14426
更新日期:2019-04-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1046/j.1464-410x.2003.04264.x
更新日期:2003-07-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2008.07921.x
更新日期:2008-12-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2010.09704.x
更新日期:2011-05-01 00:00:00
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journal_title:BJU international
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更新日期:2013-05-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/bju.12940
更新日期:2016-01-01 00:00:00
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journal_title:BJU international
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doi:10.1111/j.1464-410X.2009.08356.x
更新日期:2009-06-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1464-410x.2003.04609.x
更新日期:2004-02-01 00:00:00
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doi:10.1111/j.1464-410X.2009.09046.x
更新日期:2010-06-01 00:00:00
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journal_title:BJU international
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2005-05-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
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更新日期:2012-02-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
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更新日期:2005-12-01 00:00:00
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更新日期:2012-03-01 00:00:00
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journal_title:BJU international
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更新日期:1999-11-01 00:00:00
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journal_title:BJU international
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doi:10.1111/j.1464-410X.2012.11340.x
更新日期:2013-04-01 00:00:00
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pub_type: 杂志文章
doi:10.1046/j.1464-410x.2003.04009.x
更新日期:2003-01-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2010-03-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
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更新日期:2012-12-01 00:00:00
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pub_type: 杂志文章,多中心研究
doi:10.1111/bju.13926
更新日期:2018-03-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/bju.12329
更新日期:2014-05-01 00:00:00
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doi:10.1111/bju.13448
更新日期:2016-10-01 00:00:00
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journal_title:BJU international
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更新日期:2004-04-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2011.10578.x
更新日期:2012-06-01 00:00:00