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Application of the revised Tumour Node Metastasis （TNM） staging system of clear cell renal cell carcinoma in eastern China： advantages and limitations

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Asian Journal of Andrology 2013年第4期15卷 550-557,I0011页

作者： Chao Qin Li-Jiang Sun Li Cui Qiang Cao Jian Zhu Pu Li Gui-Ming Zhang Xin Mao Peng-Fei Shao Mei-Lin Wang Zheng-Dong Zhang Min Gu Wei Zhang Chang-Jun Yin Department of Urology The First Affiliated Hospital of Nanjing Medical University Nanjing 210029 China Department of Urology The Affiliated Hospital of Medical College Qingdao University Qingdao 266001 China Department of Urology The Third Affiliated Hospital of Soochow University Changzhou 213003 China and Department of Molecular and Genetic Toxicology School of Public Health Nanjing Medical University Nanjing 210029 China

This study was designed to evaluate whether the revised 2010 Tumour Node Metastasis （TNM） staging system could lead to a more accurate prediction of the prognosis of renal cell carcinoma （RCC） patients. A total of 1216 patients who had undergone radical nephrectomy or partial nephrectomy for RCC from 2003 to 2011 were enrolled. All of the patients had pathologically confirmed clear cell RCC （ccRCC）. All cases were staged by both the 2002 and 2010 TNM staging systems after pathological review, and survival data were collected. Univariate and multivariate Cox regression models were used to evaluate cancer-specific survival （CSS） and progression-free survival （PFS） after surgery. Continuous variables, such as age and tumour diameter, were calculated as mean values and standard deviations （s.d.） or as median values. Survival was calculated by the Kaplan-Meier method, and the log-rank test assessed differences between groups. Statistically significant differences in CSS and PFS were noted among patients in T3 subgroups using the new 2010 staging system. Therefore, the revised 2010 TNM staging system can lead to a more accurate prediction of the prognosis of ccRCC patients. However, when using the revised 2010 staging system, we found that more than 92% of patients （288/313） with T3 tumours were staged in the T3a subgroup, and their survival data were not significantly different from those of patients with T2b tumours. In addition, T2 subclassification failed to independently predict survival in RCC patients.

关键词： kidney neoplasm prognosis renal cell carcinoma TNM stage

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Retroperitoneal laparoscopic partial nephrectomy for unilateral synchronous multifocal renal carcinoma with different pathological types:A case report

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World Journal of Clinical Cases 2021年第23期9卷 6879-6885页

作者： Ying-Ming Xiao Sheng-Ke Yang Ying Wang Dun Mao Fang-Lei Duan Shu-Kui Zhou Department of Urology Sichuan Cancer Hospital and InstituteSichuan Cancer CenterSchool of MedicineUniversity of Electronic Science and Technology of ChinaChengdu 610041Sichuan ProvinceChina Department of Urology Affiliated Sixth People’s HospitalShanghai Jiao Tong UniversityShanghai 200233China Department of Pathology Sichuan Cancer Hospital and InstituteSichuan Cancer CenterSchool of MedicineUniversity of Electronic Science and Technology of ChinaChengdu 610041Sichuan ProvinceChina

BACKGROUND The majority of renal cell carcinomas are single lesions;unilateral synchronous multifocal renal carcinoma(USMRC)is rarely reported and poses a treatment challenge for urological *** SUMMARY A 56-year-old man was hospitalized for pain and discomfort in the right kidney area for 6 ***-enhanced computed tomography demonstrated cT1a renal tumors at the lower pole of the right kidney and a cT1b renal tumor at the middle dorsal portion of the right *** patient underwent retroperitoneal laparoscopic partial nephrectomy(RLPN).There were no complications *** revealed a low-grade,pathologic stage T1a(pT1a),clear cell renal cell carcinoma at the lower pole of the right kidney and a pT1b,chromophobe renal cell carcinoma at the middle dorsal portion of the right *** tumor bed recurrence or metastasis was observed on imaging and his renal function remained stable during the 12-mo follow-up *** RLPN is a safe,effective,and feasible for the management of USMRC,which can obtain equivalent oncological results with optimal renal function preservation.

关键词： kidney neoplasm Multifocal Retroperitoneal laparoscopic operation Partial nephrectomy Case report

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Comparison of two different renorrhaphy techniques in retroperitoneal laparoscopic partial nephrectomy for complex tumor

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Chinese Medical Journal 2013年第24期126卷 4629-4632页

作者： SHANG Ji-wen MA Xin ZHANG Xu LI Hong-zhao SHI Tao-ping Department of Urology Chinese People's Liberation Army GeneralHospital Beijing 100853 China Department ot Urology Taiyuan City Center Hospital laiyuanShanxi 030009 China

Background Partial nephrectomy is currently the standard treatment for clinical T1 renal neoplasms, as it can provide oncologic outcomes equivalent to radical nephrectomy. The aim was to evaluate the efficacy of self-retaining suture （SRS） in renorrhaphy technique in retroperitoneal laparoscopic partial nephrectomy （LPN） for a single renal mass of moderate or high complexity by assessing peri-operative outcomes. Methods A retrospective analysis was done of 64 patients between 2010 and 2012 for complex renal mass （RENAL score 〉7） in whom retroperitoneal LPN was performed with two layers using continuous knotless barbed suture （Quill PDO SRS group; n=34） and absorbable vicryl （non-SRS group; n=30）, respectively. Cases were matched for RENAL score. All the surgical procedures were performed by the same surgeon with experience of more than 500 cases of LPN. Comparisons were made in patients and preoperative outcomes and peri-operative complications between SRS group and non-SRS group. Results Mean warm ischemia time （WIT） in SRS group was less than non-SRS group （18.0 vs. 24.8 minutes, P=-0.021）. Renorrhaphy suture cost in SRS group was lower than non-SRS group （$269.6 vs. $335.8, P=0,001）. There were no significant differences between the two groups for postoperative changes in creatinine and estimated glomerular filtration rate and the rate of peri-operative complications. Conclusion SRS was safe for complex renal tumor with two layers, continuous and unknot suture, during LPN and would reduce the WIT and renorrhaphy suture cost significantly.

关键词： kidney neoplasm laparoscopic partial nephrectomy self-retaining barbed suture warm ischemia time,peri-operative complications

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