3 mg/dl (p = 0.018) as significant risk factors. Cases were classified into 3 groups based on the number of risk factors, including low risk-28 with 0 or 1 risk factor, intermediate risk-26 with 2 risk factors and high risk-40 with 3 to 5 risk factors. This grouping clearly separated survival among these groups (each p <
0.001). It also confirmed the usefulness of the Memorial-Sloan Kettering Cancer Center classification system.
Conclusions: Our risk classification incorporating 5 risk factors enables accurate prediction of survival, which can be helpful to make clinical decisions in cases of renal cell carcinoma with bone metastasis.”
“Purpose: In a population based cohort we determined whether an increase in the number of lymph nodes removed is associated with improved ASP2215 disease specific survival of patients with renal cell carcinoma treated with nephrectomy.
Materials and Methods: Patients in the Surveillance, Epidemiology and End Results database with renal cell carcinoma and no evidence of distant metastases were identified. Those patients included in the study underwent radical or partial nephrectomy with lymphadenectomy. Cox regression analyses were MK-0518 datasheet performed to identify factors associated with disease specific survival including an interaction between lymph node status and the number of lymph nodes removed.
Results: Between 1988 and 2006, 9,586 patients with renal cell carcinoma
met the study inclusion criteria. Median followup was 3.5 years (range 1.4 to 6.8). Of the patients 2,382 (25%) died of renal cell carcinoma, including 1,646 (20%) with lymph node negative disease and 736 (58%) with
lymph node positive disease. There was no effect on disease specific survival with increasing the extent of lymphadenectomy in patients with negative lymph nodes (HR 1.0, 95% CI 0.9-1.1, p = 0.93). However, patients with positive lymph nodes had increased disease specific survival with extent of lymphadenectomy (HR 0.8 per 10 lymph nodes removed, 95% CI 0.7-1.0, p = 0.04). An increase of 10 lymph nodes in a patient with 1 positive lymph learn more node was associated with a 10% absolute increase in disease specific survival at 5 years (p = 0.004).
Conclusions: This study shows an association between increased lymph node yield and improved disease specific survival of patients with lymph node positive nonmetastatic renal cell carcinoma who underwent lymphadenectomy. Patients at high risk for nodal disease should be considered for regional or extended lymphadenectomy. Clinical variables to predict risk and validation of dissection templates are important areas for future research.”
“Purpose: We analyzed the prognostic impact of hydronephrosis grade on disease specific survival and evaluated whether hydronephrosis grade could preoperatively predict worse pathological outcomes in cases of upper tract urothelial carcinoma treated surgically.