Inferior vena cava involvement in renal cell carcinoma: Comparison of survival rates between patients with thrombus and infiltration

Objective. In 4?10% of cases of renal cell carcinoma (RCC), involvement of the inferior vena cava (IVC) is present. IVC involvement may be due to either a pure thrombus or tumor extension. This study indicates that there is no significant difference in survival rates between patients with thrombus and those with infiltration of the IVC. Material and methods. The records of 84 patients who presented to our institution with RCC and IVC involvement and received surgical treatment between July 1973 and June 2006 were examined. The postoperative observation period was 120 months. Statistical analysis was performed using the Kaplan?Meier method and the log-rank test. Results. Sixty-one patients demonstrated thrombus involvement of the IVC, while the remaining 23 exhibited infiltration. Over the observation period, an average survival time of 64.0 months was observed. The median survival time was 35.2 months. No significant difference in survival rates was observed between patients with thrombus and those with malignant infiltration of the IVC. Conclusions. It is stated in the contemporary literature that IVC infiltration is an important prognostic factor in cases of RCC. This study indicates that there is no significant difference in survival rates between patients with thrombus and those with infiltration of the IVC. Lymph node metastases and undifferentiated RCC remain the only important prognostic factors that have a significant influence on the general survival of a patient

Clinical and Surgical Experience with Wilms' Tumor. Long-term Results of a Single Institution

Background: Although the NWTSG and SIOP studies have included the largest number of patients, several individual institutions have made likewise important contributions to the optimization of Wilms' tumor therapy. The purpose of this study is to present our personal experience obtained in the last 42 years by treating Wilms' tumor in childhood. Patients and Methods: Throughout the period 1965-2006, 65 children with histological confirmation of Wilms' tumour were treated in the Department of Urology, University of Erlangen Medical Centre. The records of all patients presenting to our institution with Wilms' tumour were examined. Results: The results obtained by this study group indicate that prognosis according to age demonstrated no significance, but prognosis according to tumor size, lymph node involvement and distant metastasis was significant. After a 10-year follow-up, our data revealed an 89.4% survival rate. Furthermore, the statistical evaluation performed in order to evaluate the significance of surgical complications following neoadjuvant therapy in comparison to non adjuvant therapy, indicates that there is a significant increase in complications in patients who are not treated with neoadjuvant therapy. Discussion: Although clinicians in the U.S.A. and Europe have different philosophies on preoperative chemotherapy, most patients with Wilms' tumor survive long term, regardless of the sequence of therapeutic interventions. In the absence of a clear choice between up-front nephrectomy and preoperative chemotherapy, it is reasonable to base the timing of resection on factors such as tumor size, the patient's clinical condition, and the experience of the surgeon

Renal cell carcinoma under 35 years of age: comparison of survival rates for symptomatic and asymptomatic patients

Introduction: Recent studies suggest that RCC detected in young adults is likely to be more symptomatic and potentially aggressive, since young patients are less likely to undergo radiologic examinations unless they have symptoms. The aim of this study is to identify the clinical, biological and histological entities of RCC in young patients, and to compare survival rates for symptomatic and asymptomatic patients. Patients and methods: A review of 2,510 records of patients with RCC from 1965 to 2007 was conducted. Thirty-four patients under 35 years old were identified. The Kaplan?Meier system was used to calculate the cumulative survival rate at five and ten years post-surgery as well as the survival prognoses for patients who presented with symptoms and for patients for whom RCC was incidentally diagnosed. Results: The differences in cumulative survival rates at five and ten years between patients who presented with symptoms and patients whom RCC was incidentally diagnosed were not significant (P = 0.06). The Kaplan?Meier system used to calculate the cumulative survival rate at five and ten years post-surgery yielded survival rates of 79.4% at five years and 73.5% at ten years, respectively. Discussion: The biological and histological entities as well as the survival prognosis for RCC in young patients are similar to those for patients who present with RCC in the sixth and seventh decades of life. Additionally, young adults are likely to be more symptomatic, but the difference in survival between patients with symptoms and those without symptoms is not statistically significant