Abstract:
BACKGROUND:The survival impact of metastasectomy for metastatic renal cell carcinoma (mRCC) is still an active research field, particularly in the multimodal/targeted therapy era. OBJECTIVE:To determine the survival impact of clinical prognostic factors and their application to stratification of patients according to their prognosis so clinicians may be aided in their management of mRCC. DESIGN, SETTING, AND PARTICIPANTS:Retrospective, bi-institutional cohort study of 109 consecutive patients (71 male and 38 female; median age: 62 yr (range: 25-82 yr) with renal cell carcinoma (RCC) who underwent partial or radical nephrectomy and at least one metastasectomy for mRCC. INTERVENTION:Metastasis resection from various anatomic sites with the aim of completely removing detected lesions. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS:Univariable and multivariable Cox regression models were used to analyse the impact of clinical prognostic factors on cancer-specific survival (CSS). Kaplan-Meier analysis with the log-rank test was used to compare CSS. Receiver operating characteristic (ROC) analysis was performed to test accuracy of prognostic groups. The α error for statistical significance was set at 0.05. RESULTS AND LIMITATIONS:Multivariable analysis revealed that primary tumour T stage ≥ 3 (hazard ratio [HR]: 2.8; p<0.01), primary tumour Fuhrman grade ≥ 3 (HR: 2.3; p<0.03), nonpulmonary metastases (HR: 3.1; p<0.03), disease-free interval ≤ 12 mo (HR: 2.3; p<0.058), and multiorgan metastases (HR: 2.5; p<0.04) were independent pretreatment prognostic factors. Leuven-Udine (LU) prognostic groups based on these covariates were created and analysed with Kaplan-Meier and log-rank tests. The 2- and 5-yr CSS were significantly different; the respective group A CSS rates were 95.8% and 83.1%; group B, 89.9% and 56.4%; group C, 65.6% and 32.6%; and group D, 24.7% and 0% (p<0.0001). ROC analysis on the accuracy of prognostic grouping revealed respective areas under the curve of 0.87 and 0.88 at 2 and 5 yr. Main limitations to present study are the retrospective design and the presence of different metastasis sites. CONCLUSIONS:LU prognostic groups could be considered an accurate clinical tool to stratify patients according to prognosis and aid clinicians in the management of mRCC.
journal_name
Eur Uroljournal_title
European urologyauthors
Tosco L,Van Poppel H,Frea B,Gregoraci G,Joniau Sdoi
10.1016/j.eururo.2012.09.037subject
Has Abstractpub_date
2013-04-01 00:00:00pages
646-52issue
4eissn
0302-2838issn
1873-7560pii
S0302-2838(12)01105-0journal_volume
63pub_type
杂志文章相关文献
EUROPEAN UROLOGY文献大全abstract::Bipolar androgen therapy (BAT) is a paradoxical treatment for castrate-resistant prostate cancer whereby testosterone levels are rapidly alternated between supraphysiologic and near-castrate concentrations. Initial studies demonstrated that BAT is safe and produces clinical responses. A trial comparing enzalutamide ag...
journal_title:European urology
pub_type: 社论
doi:10.1016/j.eururo.2017.03.022
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:Prostate cancer (PCa) is the second most common disease among men worldwide. It is important to know survival outcomes and prognostic factors for this disease. Recruitment for the largest therapeutic randomised controlled trial in PCa--the Systemic Therapy in Advancing or Metastatic Prostate Cancer: Evaluati...
journal_title:European urology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.eururo.2014.09.032
更新日期:2015-06-01 00:00:00
abstract:OBJECTIVES:Preoperative low serum testosterone (TS) level has been reported to be associated with adverse pathologic results in patients with clinically localized prostate cancer (pCA) treated with radical prostatectomy (RP). However, prior studies failed to show prognostic impact of preoperative low TS in these patien...
journal_title:European urology
pub_type: 杂志文章
doi:10.1016/j.eururo.2007.03.052
更新日期:2007-09-01 00:00:00
abstract::The origin, differential diagnosis and therapy of rare testicular tumors are reviewed. 5% of all testicular tumors are rare tumors. Most of these rare tumors are of non-germ cell origin. ...
journal_title:European urology
pub_type: 杂志文章,评审
doi:10.1159/000472622
更新日期:1986-01-01 00:00:00
abstract:BACKGROUND:Limited data exist on long-term outcomes among men with prostate cancer (PCa) from population-based cohorts incorporating information on clinical risk category. OBJECTIVE:To assess 15-yr mortality for men with PCa treated with noncurative intent according to clinical stage, Gleason score (GS), serum levels ...
journal_title:European urology
pub_type: 杂志文章
doi:10.1016/j.eururo.2012.08.001
更新日期:2013-01-01 00:00:00
abstract::An improved shock wave source is required for the extended application of extracorporeal lithotripsy in proven and anticipated novel fields of therapy. Fundamental research was performed in the domains: disintegration efficiency; hydrophone stability; absolute calibration, and source optimization. The combined experie...
journal_title:European urology
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract:BACKGROUND:Although active surveillance is increasingly used for the management of low-risk prostate cancer, many eligible patients are still nonetheless subject to curative treatment. One argument for considering surgery rather than active surveillance is that the probability of postoperative recovery of erectile func...
journal_title:European urology
pub_type: 杂志文章
doi:10.1016/j.eururo.2017.08.007
更新日期:2018-01-01 00:00:00
abstract::Rats fed with 2% oxamide diet were considered as a model for the patient with a tendency to stone formation. Polyglycolic acid (Dexon) sary stream caused formation of oxamide deposits in a percentage as high as that observed with silk sutures. A high degree of toxicity was observed with the chosen concentration of oxa...
journal_title:European urology
pub_type: 杂志文章
doi:
更新日期:1975-01-01 00:00:00
abstract::A prospective randomised study was performed to test the hypothesis that total androgen ablation, achieved by combining an LHRH analogue, goserelin acetate (Zoladex), with an antiandrogen, cyproterone acetate (Cyprostat), is more effective than conventional monotherapy in delaying the time to progression of metastatic...
journal_title:European urology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1159/000473717
更新日期:1996-01-01 00:00:00
abstract:CONTEXT:We addressed the question whether the change of serum prostate-specific antigen (PSA) in men who use 5α-reductase inhibitor (5-ARI) dutasteride is sensitive for the detection of aggressive prostate cancer (PCa). OBJECTIVE:The case of a man using dutasteride diagnosed with Gleason 7 transition zone cancer at bi...
journal_title:European urology
pub_type: 杂志文章,评审
doi:10.1016/j.eururo.2010.09.035
更新日期:2011-02-01 00:00:00
abstract::Comparison of the use of autosuture surgiclips and Mersilene for occlusion of the vas deferens showed a significantly lower number of complications, such as local infections, granuloma and fistula, within a month following vasectomy, when autosuture surgiclips were used (0.005 less than p less than 0.01). After 6 mont...
journal_title:European urology
pub_type: 杂志文章
doi:
更新日期:1988-01-01 00:00:00
abstract:BACKGROUND:Previous studies on coronavirus disease 2019 (COVID-19) have focused on populations with normal immunity, but lack data on immunocompromised populations. OBJECTIVE:To evaluate the clinical features and outcomes of COVID-19 pneumonia in kidney transplant recipients. DESIGN, SETTING, AND PARTICIPANTS:A total...
journal_title:European urology
pub_type: 杂志文章
doi:10.1016/j.eururo.2020.03.039
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:To describe a new surgical technique for the repair of bulbar urethral strictures to preserve the bulbospongiosum muscle and its perineal innervation. OBJECTIVE:Surgical steps of muscle- and nerve-sparing bulbar urethroplasty are described. The outcome is provided regarding semen sequestration and postvoidi...
journal_title:European urology
pub_type: 杂志文章
doi:10.1016/j.eururo.2008.03.018
更新日期:2008-08-01 00:00:00
abstract::This study of the effects of long-term tamoxifen administration on semen analysis of oligospermic males confirms the potential therapeutic efficacy in normogonadotrophic oligospermia. 38 out of the 56 patients responded well to long-term treatment with 30 mg tamoxifen daily. According to the nomenclature of Eliasson, ...
journal_title:European urology
pub_type: 杂志文章
doi:10.1159/000473241
更新日期:1981-01-01 00:00:00
abstract:OBJECTIVES:We performed a retrospective analysis of first relapses after cisplatin-based chemotherapy in patients with advanced germ-cell tumors, in order to better define the appropriate follow-up. METHODS:These patients were treated between 1986 and 1998 in two institutions. They were either followed after first-lin...
journal_title:European urology
pub_type: 杂志文章
doi:10.1016/j.eururo.2005.06.018
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND:Open partial nephrectomy (OPN) remains the gold standard for treatment of small renal masses (SRMs). Laparoscopic cryoablation (LCA) has provided encouraging outcomes. Robotic partial nephrectomy (RPN) represents a new promising option but is still under evaluation. OBJECTIVE:Compare the outcomes of RPN and...
journal_title:European urology
pub_type: 杂志文章
doi:10.1016/j.eururo.2012.01.007
更新日期:2012-05-01 00:00:00
abstract:CONTEXT:In 2005, fusions between the androgen-regulated transmembrane protease serine 2 gene, TMPRSS2, and E twenty-six (ETS) transcription factors were discovered in prostate cancer. OBJECTIVE:To review advances in our understanding of ETS gene fusions, focusing on challenges affecting translation to clinical applica...
journal_title:European urology
pub_type: 杂志文章,评审
doi:10.1016/j.eururo.2009.04.036
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:Laparoendoscopic single-site (LESS) surgery is challenging. To help overcome current technical and ergonomic limitations, the da Vinci robotic platform can be applied to LESS. OBJECTIVES:Our aim was to describe the surgical technique and to report the early outcomes of robotic LESS (R-LESS) radical prostate...
journal_title:European urology
pub_type: 杂志文章
doi:10.1016/j.eururo.2010.06.040
更新日期:2010-10-01 00:00:00
abstract::Castration or antiandrogen monotherapies remain options for prostate cancer treatment as only marginal benefits have been demonstrated with combined androgen blockade, although it may be that certain subgroups of patient may benefit. Of the nonsteroidal antiandrogens, bicalutamide 150 mg was as effective as castration...
journal_title:European urology
pub_type: 杂志文章,评审
doi:10.1159/000052291
更新日期:1998-01-01 00:00:00
abstract::Calcium metabolism was studied in 37 patients with "idiopathic hypercalciuria" on a home diet and after 10 days of low calcium dietary intake (less than 400 mg/24h). After low calcium intake, urinary calcium excretion returned to within normal limits in 70% of the cases. In the group of patients which failed to respon...
journal_title:European urology
pub_type: 杂志文章
doi:10.1159/000473258
更新日期:1981-01-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to compare the efficacy or transurethral resection of the prostate (TURP) versus four less invasive treatment options during a 2-year follow-up. MATERIAL AND METHODS:95 elderly men with lower urinary tract symptoms due to benign prostatic hyperplasia (BPH) were assigned prospectivel...
journal_title:European urology
pub_type: 临床试验,杂志文章
doi:10.1159/000020220
更新日期:2000-06-01 00:00:00
abstract:OBJECTIVES:To evaluate the long-term results of the transvaginal needle suspension operation for urinary stress incontinence. MATERIALS AND METHODS:A total of 88 women with proved genuine stress incontinence were treated with transvaginal needle suspension with fixation of suspension sutures to the rectus fascia using...
journal_title:European urology
pub_type: 杂志文章
doi:10.1159/000052364
更新日期:2000-03-01 00:00:00
abstract:OBJECTIVES:Hyaluronic acid is a protective barrier of the urothelium. A damaged glycosaminoglycan layer may increase the possibility of bacterial adherence and infection. This damage is proposed to be a causative factor in the development of interstitial cystitis, common urinary tract infections, and hemorrhagic cystit...
journal_title:European urology
pub_type: 杂志文章,评审
doi:10.1016/j.eururo.2007.03.020
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVES:To know the incidence of tumoural pathology among our cases of horseshoe kidney (HK), a congenital anomaly occurring in 0.25% of the population, as well as their prognostic factors and follow-up. METHODS:A total of 82 patients admitted at our Centre between 1967 and 1996 with an HK diagnosis were retrospect...
journal_title:European urology
pub_type: 杂志文章
doi:10.1159/000019551
更新日期:1998-01-01 00:00:00
abstract:OBJECTIVE:With current treatments, men usually survive many years after being diagnosed with prostate cancer. However, without supportive care, the systemic effects of prostate cancer and therapies such as androgen deprivation therapy (ADT) can undermine skeletal integrity, resulting in skeletal complications that may ...
journal_title:European urology
pub_type: 杂志文章,评审
doi:10.1016/j.eururo.2004.08.016
更新日期:2004-12-01 00:00:00
abstract::Although a single ectopic ureter opening into the vagina has frequently been reported in literature, lateralized lumbar pain during sexual intercourse and urinary incontinence after pregnancy due to a single ectopic ureter are uncommon. The etiology and pathogenesis are unknown but some clinical, pathological and embr...
journal_title:European urology
pub_type: 杂志文章
doi:10.1159/000473017
更新日期:1988-01-01 00:00:00
abstract:BACKGROUND:Prior to the introduction and dissemination of robot-assisted radical prostatectomy (RARP), population-based studies comparing open radical prostatectomy (ORP) and minimally invasive radical prostatectomy (MIRP) found no clinically significant difference in perioperative complication rates. OBJECTIVE:Assess...
journal_title:European urology
pub_type: 杂志文章
doi:10.1016/j.eururo.2011.12.027
更新日期:2012-04-01 00:00:00
abstract::Sentinel lymph node (SLN) detection techniques have the potential to change the standard of surgical care for patients with prostate cancer. We performed a lymphatic mapping study and determined the value of fluorescence SLN detection with indocyanine green (ICG) for the detection of lymph node metastases in intermedi...
journal_title:European urology
pub_type: 杂志文章
doi:10.1016/j.eururo.2016.01.034
更新日期:2016-11-01 00:00:00
abstract:OBJECTIVES:TIMPs control the activity of MMPs, one of the key molecules for tumor invasion and metastasis. The aim of this study was to assess the usefulness of MMP-2 and MMP-9 in relation to their inhibitor (TIMP2) as noninvasive diagnostic tests for bilharzial bladder cancer. MATERIAL AND METHODS:Voided urine sample...
journal_title:European urology
pub_type: 杂志文章
doi:10.1016/j.eururo.2007.04.006
更新日期:2007-11-01 00:00:00
abstract::We compared the history of 100 consecutive women complaining of incontinence with their urodynamic findings. The real urodynamic situation proved unpredictable on the basis of the medical history. A good correlation between history and urodynamics was found in 80% of the women complaining of stress incontinence. The i...
journal_title:European urology
pub_type: 杂志文章
doi:10.1159/000472986
更新日期:1988-01-01 00:00:00