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Chun, Brian, Haleh Ramian, Cameron Jones, et al. "Changes in Urologic Cancer Surgical Volume and Length of Stay During the COVID-19 Pandemic in Pennsylvania." JAMA Network Open 6, no. 4 (2023): e239848. http://dx.doi.org/10.1001/jamanetworkopen.2023.9848.
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ImportanceDisruptions in cancer surgery during the COVID-19 pandemic led to widespread deferrals and cancellations, creating a surgical backlog that presents a challenge for health care institutions moving into the recovery phase of the pandemic.ObjectiveTo describe patterns in surgical volume and postoperative length of stay for major urologic cancer surgery during the COVID-19 pandemic.Design, Setting, and ParticipantsThis cohort study identified 24 001 patients 18 years or older from the Pennsylvania Health Care Cost Containment Council database with kidney cancer, prostate cancer, or bladder cancer who received a radical nephrectomy, partial nephrectomy, radical prostatectomy, or radical cystectomy between the first quarter (Q1) of 2016 and Q2 of 2021. Postoperative length of stay and adjusted surgical volumes were compared before and during the COVID-19 pandemic.Main Outcomes and MeasuresThe primary outcome was adjusted surgical volume for radical and partial nephrectomy, radical prostatectomy, and radical cystectomy during the COVID-19 pandemic. The secondary outcome was postoperative length of stay.ResultsA total of 24 001 patients (mean [SD] age, 63.1 [9.4] years; 3522 women [15%], 19 845 White patients [83%], 17 896 living in urban areas [75%]) received major urologic cancer surgery between Q1 of 2016 and Q2 of 2021. Of these, 4896 radical nephrectomy, 3508 partial nephrectomy, 13 327 radical prostatectomy, and 2270 radical cystectomy surgical procedures were performed. There were no statistically significant differences in patient age, sex, race, ethnicity, insurance status, urban or rural status, or Elixhauser Comorbidity Index scores between patients who received surgery before and patients who received surgery during the pandemic. For partial nephrectomy, a baseline of 168 surgeries per quarter decreased to 137 surgeries per quarter in Q2 and Q3 of 2020. For radical prostatectomy, a baseline of 644 surgeries per quarter decreased to 527 surgeries per quarter in Q2 and Q3 of 2020. However, the likelihood of receiving radical nephrectomy (odds ratio [OR], 1.00; 95% CI, 0.78-1.28), partial nephrectomy (OR, 0.99; 95% CI, 0.77-1.27), radical prostatectomy (OR, 0.85; 95% CI, 0.22-3.22), or radical cystectomy (OR, 0.69; 95% CI, 0.31-1.53) was unchanged. Length of stay for partial nephrectomy decreased from baseline by a mean of 0.7 days (95% CI, −1.2 to −0.2 days) during the pandemic.Conclusions and RelevanceThis cohort study suggests that partial nephrectomy and radical prostatectomy surgical volume decreased during the peak waves of COVID-19, as did postoperative length of stay for partial nephrectomy.
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Mensah, Elsie Ellimah, Luke Hounsome, Julia Verne, Roger Kockelbergh, and Erik Mayer. "Cardiovascular outcomes in kidney cancer patients." Journal of Clinical Urology 10, no. 1_suppl (2017): 24–28. http://dx.doi.org/10.1177/2051415816685245.
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Introduction: In the surgical management of small renal tumours, current guidelines recommend that partial nephrectomy should be the preferred option wherever possible. This is based on evidence suggesting improved quality of life outcomes, morbidity and mortality and equivalent oncological outcomes when compared with radical nephrectomy. Chronic kidney disease is a significant risk factor for cardiovascular disease and subsequent mortality. This study explored differences in cardiac-related events and co-morbidity, using linked registry data for patients undergoing radical or partial nephrectomy for T1 renal tumours. Methods: Data from the National Cancer Registration Service was searched to identify T1 renal cancer diagnoses between 1999 and 2012. This data was matched against hospital episode statistics to identify those patients who had undergone radical or partial nephrectomy between 1999 and 2013 using OPCS codes. Data was collected on cardiac-related admissions and deaths in nephrectomy patients. Equivalent data was also collected for the general population to allow age-standardized comparison. Charlson score was used as a proxy for pre-operative co-morbidity. Results: Radical/partial nephrectomy patients had a greater risk of cardiac-related admissions compared with the general population (relative risk (RR) 3.32, 95% confidence interval (CI) 3.24–3.40), but with no increase in cardiac-related deaths (RR 0.84, 95% CI 0.70–1.01). There was no difference in the admission risk, or death, comparing radical or partial nephrectomy for T1 renal tumours (RR 1.02, 95% CI 0.88–1.17) using ‘time to event’ analysis. There was no difference in the comorbidity index between radical nephrectomy and partial nephrectomy patients. Conclusion: The higher incidence of cardiac-related admissions seen for radical/partial nephrectomy patients may be explained by a higher proportion of patients with medical illnesses including cardiovascular risk factors (hypertension, diabetes) undergoing renal imaging. The absence of a difference between the radical nephrectomy and partial nephrectomy groups supports the phenomenon of surgically-induced chronic kidney disease, which may not have the same morbidity implications as medically-induced chronic kidney disease.
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A.K.M, Shamsuddin, Mamunur Rahman, Jahangir Md Sarwar, Mohammad Mahabub Alam, Nasrin Sultana, and Atiar Rahman. "Treatment and Outcome of Choledochal Cyst, our Experience in Sheikh Russel National Gastroliver Institute and Hospital, Mohakhali Dhaka, Bangladesh." Asian Journal of Pediatric Research 14, no. 4 (2024): 11–19. http://dx.doi.org/10.9734/ajpr/2024/v14i4336.
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Objectives: The aim of the study was to evaluate the demographic information, clinical features, surgical methods, postoperative complications, and outcomes at 6 months for patients with choledochal cysts who were treated at the Sheikh Russel National Gastroliver Institute and Hospital. The goal was to assess the outcomes of radical cystectomy versus partial hepatectomy in the treatment of choledochal cysts. Methods: This was a retrospective analysis of 36 patients who had choledochal cysts and were treated with either a total cystectomy (n=30) or partial hepatectomy (n=6). Results: The groups that underwent radical cystectomy and partial hepatectomy had similar age ranges, sex distributions, and types of cysts. The majority of the cysts were type I (83.3% of the total cystectomy group) and type V (100% of the partial hepatectomy group). Other associations included: gallstones (26.7% vs. 83.3%) and Abnormal pancreatic biliary duct junction (APBDJ) (36.7% vs. 16.7%). An increased frequency of post-operative pain, jaundice, upper abdominal swelling, and fever was noted in the group that had a radical cystectomy. Minimal post-operative complications were seen in both groups. At 6 months, the rates of complications were similar, with hypertrophic scars being the most common (30.7% for radical cystectomy and 25% for partial hepatectomy). Conclusion: The groups that had radical cystectomy and partial hepatectomy were of similar demographics, cyst types, abnormalities, clinical traits, and complication rates post surgery and at 6 months. Both procedures are still good ways to treat choledochal cysts, and this small group doesn't clearly show which is better. To get a better idea of differences in long-term results, bigger studies are needed.
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Popov, Sergey V., Murad M. Mirzabekov, Ruslan G. Guseinov, Evgenii V. Pomeshkin, Boris A. Neymark, and Adylbek R. Urazmetov. "Comparative assessment of perioperative and functional results of organ saving surgery for localized renal cell carcinoma in patients of different age groups." Urology reports (St. - Petersburg) 13, no. 2 (2023): 135–44. http://dx.doi.org/10.17816/uroved492304.
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BACKGROUND: The number of older patients with kidney tumors is steadily increasing. Surgical methods are the main ones in the treatment of patients with localized forms of renal cell carcinoma, including the elderly.
 AIM: to conduct a comparative analysis of perioperative data and functional results of surgical interventions for renal cell carcinoma in patients of different age groups.
 MATERIALS AND METHODS: The study included 256 patients with kidney tumors (mean age 65.2 8.6 years). 146 (57.0%) patients aged 56 to 64 years made up group I, and 110 (43.0%) patients aged 65 to 75 years group II. In 210 (82.0%) patients, the tumor diameter did not exceed 4 cm (T1a), in 46 (18.0%) patients it ranged from 4 to 6.2 cm (T1b). Radical nephrectomy and partial nephrectomy were performed respectively in 44 (30.1%) and 102 (69.9%) patients of group I and 58 (52.7%) and 52 (47.3%) patients of group II. All operations were performed laparoscopically.
 RESULTS: In patients of group I, the duration of radical nephrectomy was 115.0 18.0 min, and partial nephrectomy 135.5 25.0 min (p 0.0001), in patients of group II, 120.0 20.5 and 138.0 25.5 min (p 0.0001), respectively. Warm ischemia time during partial nephrectomy was 17.6 1.2 min in patients of group I and 18.2 1.5 min in patients of group II (p = 0.25). The volume of blood loss in patients of both groups I and II was significantly higher during partial nephrectomy. The average volume of blood loss in patients of group I was 130.0 20.0 ml when performing radical nephrectomy and 236.5 20.0 ml when performing partial nephrectomy (p 0.0001), and in group II 125.0 18.5 ml for radical nephrectomy and 246.0 22.0 ml for partial nephrectomy (p 0.0001). The frequency of significant complications did not differ in patients of groups I and II. Grade IIIa complications according to the ClavienDindo classification of surgical complications were observed in 5 (3.4%) patients of group I and 4 (3.9%) patients of group II (p 0.05), and grade IIIb in 3 (2.1%) and 2 (1.8%) patients (p 0.05). Intraoperative bleeding developed in 19 (7.4%) patients: in 13 (8.4%) of 154 patients with partial nephrectomy, and in 6 (5.9%) of 102 patients with radical nephrectomy. In the early postoperative period in patients of group I after radical nephrectomy and partial nephrectomy, normal glomerular filtration rates was observed in 34.0% and 54.0% of patients, respectively, and in group II in 31.0% and 52.0% of patients, respectively. Renal function significantly decreased in patients of both groups after radical nephrectomy compared with partial nephrectomy (p 0.05). The results of GFR 3 months after surgery improved in patients after partial nephrectomy, and did not change significantly in the radical nephrectomy group.
 CONCLUSIONS: The results of the study showed no differences in perioperative parameters (volume of intraoperative blood loss, warm ischemia time) during radical nephrectomy and partial nephrectomy in patients aged 5664 and 6575 years. The functional results of partial nephrectomy in patients of both groups were better compared to patients after radical nephrectomy. Thus, our data indicate the justification for performing organ-preserving operations, including in elderly patients.
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ANAST, JASON W., MARSHALL L. STOLLER, MAXWELL V. MENG, et al. "DIFFERENCES IN COMPLICATIONS AND OUTCOMES FOR OBESE PATIENTS UNDERGOING LAPAROSCOPIC RADICAL, PARTIAL OR SIMPLE NEPHRECTOMY." Journal of Urology 172, no. 6 Part 1 (2004): 2287–91. http://dx.doi.org/10.1097/01.ju.0000143820.56649.a4.
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Mulyati, Erna. "MULTIGROUP ANALYSIS IN SUPPLY CHAIN PERFORMANCE." Jurnal Bisnis dan Manajemen 21, no. 2 (2020): 100–113. http://dx.doi.org/10.24198/jbm.v21i2.466.
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This study aims to examine differences in private and government third-party logistics companies in Indonesia in terms of improving supply chain performance. In this research, supply chain performance testing is influenced by collaboration, radical innovation, and incremental innovation. The sample used is the third-party logistics industry in West Java and DKI Jakarta, totaling 100, which is divided into private third-party logistic companies and government-owned third-party logistics companies. The results showed that there are differences in the effects of collaboration. There is supply chain performance where there are differences in the influence of collaboration and radical innovation on supply chain performance between private companies and government. There is no difference in the influence of collaboration and incremental innovation on supply chain performance between private companies and the government. The findings of this study indicate that radical and incremental innovation acts as a partial mediation on the effect of collaboration on supply chain performance in private and government companies.
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Syed, Jamil, Alejandro Abello, Juan Javier-Desloges, Michael Leapman, and Patrick Aloysius Kenney. "Urologic malignancies: A comparison of outcomes after index surgery between academic and community hospitals." Journal of Clinical Oncology 37, no. 7_suppl (2019): 489. http://dx.doi.org/10.1200/jco.2019.37.7_suppl.489.
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489 Background: To compare the rate of hospital based outcomes in patients with urologic malignancies who underwent surgery as part of treatment in academic and community hospitals. Methods: We reviewed the Vizient Clinical Database from September 2014 to December 2017. Vizient is a member-driven health services organization that includes ~99% of academic hospitals (AH) and more than 40 community hospitals (CH). This is a comparative database comprised of administrative billing. Data include patient demographics, readmission rates, costs, LOS, case mix index (CMI) and mortality. Patients aged ≥ 18 were included and ICD-9 and ICD-10 codes were used to identify patients with urologic malignancies who underwent surgical treatment. Chi square and student t-tests were used to compare categorical and continuous variables, respectively. Results: We identified a total of 37,628 cases. There were 33,290 (88%) procedures performed in AH and 4,330 (12%) in CH. These included radical prostatectomy (RP) 18,540, radical nephrectomy (rNx) 8,059, partial nephrectomy (pNx) (5,287), radical cystectomy (4,421), radical nephroureterectomy (rNu) (1,006), and partial cystectomy (321). There were no significant differences in 30-day readmission rates or mortality for any procedure between AH and CH. LOS was significantly lower (P<0.01) for radical cystectomy (8.83 vs 11.43 days) and RP (1.63 days vs 1.77 days) in AH, and lower in CH for rNx (4.93 vs 4.51, P: 0.03). AH had a significantly lower amount of partial cystectomies performed when compared to community centers (6.2% vs 16.2% P<0.001), and a similar number of partial nephrectomies performed (39.8% vs 38.0%, P=0.2). The mean direct cost for index admission was significantly higher in AH for rNx, pNx, rNu, and RP. Case complexity using the CMI was similar between CH and AH. Conclusions: The Vizient clinical database provides a novel resource for observational data at US hospitals. Despite academic and community hospitals having similar case complexity, direct costs were lower in community hospitals without an associated increase in readmission rates or deaths. The only clinically significant difference in length of stay was shorter stays for cystectomy in academic centers.
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Odisho, Anobel Y., John L. Gore, and Ruth Douglas Etzioni. "Beyond classical risk adjustment: Socioeconomic status and hospital performance in urologic oncology." Journal of Clinical Oncology 35, no. 6_suppl (2017): 526. http://dx.doi.org/10.1200/jco.2017.35.6_suppl.526.
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526 Background: Safety-net hospitals care for more patients of lower socioeconomic status (SES) than non-safety-net hospitals and may be disproportionately punished under readmission risk adjustment models that do not incorporate (SES). We developed a readmission risk adjustment framework incorporating SES to assess impact of SES on safety-net hospital rankings for patients undergoing major surgery for urologic malignancies. Methods: Quasi-experimental design using California Office of Statewide Health Planning and Development data from 2007-2011. Subjects included all patients undergoing radical cystectomy for bladder cancer (n = 3,771), partial nephrectomy (n = 5,556), and radical nephrectomy (n = 13,136) for kidney cancer. Unadjusted hospital rankings and predicted rankings under a base model, which simulated the Medicare Hospital Readmissions Reduction Program model, were compared with predicted rankings under models incorporating socioeconomic status. Socioeconomic status was derived from a multifactorial neighborhood score at the ZIP code level calculated from US Census data. The main outcome measures were hospital rankings based on 30-day all-cause readmission rate and differences between model predicted rankings. Results: For all procedures, the addition of socioeconomic status, geographic, and hospital factors changed the overall hospital rankings significantly compared with the base model (p < 0.01), with the exception of socioeconomic status in radical cystectomy (p = 0.07) and socioeconomic status and rural factors in partial nephrectomy (p = 0.12). For radical nephrectomy and partial nephrectomy, the addition of socioeconomic status and hospital factors significantly improved the mean ranking of safety-net hospitals and improved the ratio of observed relative to expected rankings (p < 0.01). For radical cystectomy there was no significant change in rankings with the addition of socioeconomic status, rural status, or hospital factors. Conclusions: Adding socioeconomic status to existing Medicare readmission risk adjustment models leads to significant changes in hospital rankings, with a differential impact on safety-net hospitals.
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Cano Garcia, C., R. S. Flammia, M. Piccinelli, et al. "Differences in survival of clear cell metastatic renal cell carcinoma patients according to partial vs. radical nephrectomy." European Urology 83 (February 2023): S477—S478. http://dx.doi.org/10.1016/s0302-2838(23)00377-9.
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Chang, S. L., L. E. Cipriano, L. C. Harshman, and B. I. Chung. "The economic and clinical costs of chronic kidney disease following radical and partial nephrectomy in the management of small renal masses." Journal of Clinical Oncology 29, no. 7_suppl (2011): 353. http://dx.doi.org/10.1200/jco.2011.29.7_suppl.353.
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353 Background: Postoperative chronic kidney disease (PCKD), defined as a glomerular filtration rate of < 60mL/min/1.73m2, is a recognized adverse outcome after extirpative therapy for small renal masses (SRM, ≤ 4cm). We quantified the long-term economic and clinical costs of PCKD following radical and partial nephrectomy for the management of SRM. Methods: Using a Markov model, we evaluated open and laparoscopic approaches for radical and partial nephrectomy in the treatment of SRMs. The base case was a 65-year old healthy individual with a unilateral SRM and normal renal function. We used a 3-month cycle length, lifetime horizon, societal perspective, and 3% discount rate. The costs, quality of life adjustments, and transition probabilities were estimated from the literature, Medicare, and expert opinion. Health outcomes were measured in quality-adjusted life-years (QALY) gained and costs in 2008 U.S. dollars. The model was tested with sensitivity analyses. Results: The average discounted lifetime outcomes are listed in the Table. There were minimal differences between the open and laparoscopic approaches. PCKD led to a substantial increase costs and decrease in health outcomes. The impact of PCKD was indirectly associated with age. Conclusions: Partial nephrectomy provides cost-savings and improved health outcomes compared to radical nephrectomy in the management of patients with SRMs. Both procedures incur significant economic and clinical costs due to the development of PCKD. A discussion about the potential for PCKD should be incorporated into the informed consent for surgical treatment of SRMs. [Table: see text] No significant financial relationships to disclose.
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Song, Yangbo, Jie Wang, and Xiaojian Pu. "Analysis of Differences in Metabolite and Antioxidant Activity in Highland Red Raspberry Pulp Based on Widely Targeted Metabolomics." Molecules 30, no. 10 (2025): 2124. https://doi.org/10.3390/molecules30102124.
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In order to achieve differentiated utilization of red raspberry fruit pulp, a widely targeted metabolomics analysis of pulp from two regions was performed to explore the effect of plateau environment on the accumulation of secondary metabolites of red raspberry. Ultra-high performance liquid chromatography–mass spectrometry (UHPLC-MS/MS), combined with principal component analysis and Orthogonal Partial Least Squares Discriminant Analysis (OPLS-DA), was used to process the data and correlate them with the results of four antioxidant assays. Fourteen metabolites were characterized in the fruit pulp of Qinghai raspberries, and 618 up-regulated differential metabolites were found, which was 4.35 times higher than that of Yunnan. Flavonoids and phenolic acids were more abundant, with kaempferol-3-O-sambubioside being endemic to Qinghai, and saccharin-7-O-glucoside and rhamnocereus citrinus being endemic to Yunnan. Metabolic pathway enrichment analysis showed that the fruit pulp from the two regions differed significantly (p < 0.01) in ATP-binding cassette transporter (ABC transporter), purine metabolism, and so on. Antioxidant analysis showed that the Yunnan raspberries (Y-RP) were significantly superior to Qinghai raspberries (Q-RP) in terms of DPPH radical scavenging ability (DPPH) and ferric ion reducing/antioxidant power (FRAP), while Q-RP was significantly superior to Y-RP in terms of oxygen radical absorbance capacity (ORAC) and ABTS radical scavenging capacity (ABTS). This study showed that the plateau environment significantly promotes the accumulation of functional secondary metabolites of red raspberry, which provides a theoretical basis for the development of the functional components of plateau raspberry.
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Frascarelli, Mara, and Marco Casentini. "The Interpretation of Null Subjects in a Radical Pro-drop Language: Topic Chains and Discourse-semantic Requirements in Chinese." Studies in Chinese Linguistics 40, no. 1 (2019): 1–45. http://dx.doi.org/10.2478/scl-2019-0001.
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Abstract Based on original data collected through an online experiment, evidence is provided in this paper that the interpretation of null subjects in a radical pro-drop language like Chinese relies on the topic criterion proposed for consistent and partial pro-drop languages (Frascarelli 2007 and Frascarelli 2018), thereby supporting the theory that the null subject parameter implies an information-structural strategy for interpretation. Nevertheless, radical Chinese shows specificities that must be integrated in this theory for a comprehensive account. In particular, even though silent topic can start chains (consistent with the topic criterion), data show a significant preference for overt and local topics as antecedents. This locality requirement thus integrates phonological visibility in a general syntactic condition (minimal overt link condition), proposing an interesting parallel with the properties shown by partial pro-drop languages (Frascarelli and Jimenez-Fernandez in press). The present investigation also contributes to outline the structural differences existing between adverbial clauses in Chinese, supporting a distinction between central and peripheral adverbial clauses (Haegeman 2012). Specifically, while temporal and conditional clauses show the properties of nonrestrictive relative clauses, this is not the case for concessive clauses, which merged as subordinate clauses in either the C-domain or the high split-TP area. Differences between temporal and conditional clauses are attributed to the presence of an overt operator in the latter, and the pre-matrix position of adverbial clauses is explained in the light of their discourse role as frame-setters (Krifka 2007).
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Cruz, Alejandro, Faith Dickerson, Kathryn R. Pulling, et al. "Impacts of Neighborhood Characteristics and Surgical Treatment Disparities on Overall Mortality in Stage I Renal Cell Carcinoma Patients." International Journal of Environmental Research and Public Health 19, no. 4 (2022): 2050. http://dx.doi.org/10.3390/ijerph19042050.
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Racial/ethnic minority groups in the United States have high renal cell carcinoma (RCC) mortality rates. This study assessed surgical treatment disparities across racial/ethnic groups and impacts of neighborhood socioeconomic characteristics on surgical treatments and overall mortality. Stage I RCC patients diagnosed between 2004 and 2016 from National Cancer Database were included (n = 238,141). We assessed differences in associations between race/ethnicity and treatment patterns using logistic regression and between race/ethnicity and overall mortality using Cox regression with and without neighborhood characteristics in the regression models. When compared to non-Hispanic Whites (NHWs), American Indians/Alaska Natives and non-Hispanic Blacks (NHBs) were more likely not to receive surgical care and all racial/ethnic minority groups had significantly increased odds of undergoing radical rather than partial nephrectomy, even after adjusting for neighborhood characteristics. Including surgical treatment and neighborhood factors in the models slightly attenuated the association, but NHBs had a significantly increased risk of overall mortality. NHBs who underwent radical nephrectomy had an increased risk of mortality (HR 1.15, 95% CI: 1.08–1.23), but not for NHBs who underwent partial nephrectomy (HR 0.92, 95% CI: 0.84–1.02). Neighborhood factors were associated with surgical treatment patterns and overall mortality in both NHBs and NHWs. Neighborhood socioeconomic factors may only partly explain RCC disparities.
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Vourganti, S., W. Linehan, and G. Bratslavsky. "Comparison of partial nephrectomy for tumors greater than 7 cm to radical nephrectomy and effect on overall survival." Journal of Clinical Oncology 29, no. 7_suppl (2011): 323. http://dx.doi.org/10.1200/jco.2011.29.7_suppl.323.
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323 Background: As growing evidence indicates the importance of renal functional preservation, there is an increased utilization of partial nephrectomy (PN) performed for small renal masses (SRM). The optimal cutoff size for PN has been based on historical observation of low metastatic rates for SRM and increasing metastatic potential with increase in size of the primary tumor. We aim to evaluate the outcomes of patients treated by PN or radical nephrectomy (RN) for tumors greater than 7 cm. Methods: SEER 17 database was queried to identify patients treated for kidney tumors between 1983 and 2007. We excluded cases treated for non-RCC histology, not treated surgically, and those without specified size. Patients were included if treated by PN or RN with tumor size between 7 and 20 cm. Demographic information included age, gender, and race. The comparison of RCC-specific and overall survival was performed for the entire cohort and stratified by SEER stage (localized, regional, or distant). The survival was compared using Kaplan-Meier method with log rank test to identify significant differences. Results: We identified a total of 18,927 patients treated for RCC that included 18,575 cases of RN and 352 treated with PN. There were no differences in age, gender, or race (Caucasian vs. non-Caucasian) between patients treated by RN or PN (p>0.05). The mean size for tumors treated by PN was 9.7 cm vs. 10.2 cm for RN (p<0.01) and there was more localized disease in the PN group (p<0.01). The overall median survival for patients treated with PN was 108 months vs. 80 months for patients treated with RN (p<0.01). The cancer-specific survival for the entire cohort treated with PN was 195 months vs. 145 months for RN (p<0.01). When stratified by stage, there were no differences in the cancer specific survival between PN and RN groups (p>0.05). Conclusions: PN for tumors 7 to 20 cm is not associated with inferior oncologic outcomes but may provide survival advantage. While patient selection may have influenced overall survival outcomes, PN may provide survival advantage by maximizing renal reserve. These findings may be best answered in a randomized trial to establish if there should be a size cutoff for nephron sparing surgery. No significant financial relationships to disclose.
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Puri, Dhruv, Kit Yuen, Luke Wang, et al. "Single institutional experience of neoadjuvant therapy prior to planned surgical resection for complex or locoregional renal cell carcinoma." Journal of Clinical Oncology 42, no. 4_suppl (2024): 439. http://dx.doi.org/10.1200/jco.2024.42.4_suppl.439.
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439 Background: Cytoreduction via systemic neoadjuvant therapy is an emerging investigational strategy in localized renal cell carcinoma (RCC). We analyzed our single institutional experience with neoadjuvant therapy. Methods: ingle institutional retrospective analysis of patients with T2-T3N0M0 RCC. Patients received confirmatory biopsy for clear cell histology prior to receipt of systemic therapy and underwent radical (RN) or partial nephrectomy (RN). Neoadjuvant therapy consisted of tyrosine kinase inhibitor (TKI) or Immuno-oncology (IO) therapy and/or combination (TKI-IO). Neoadjuvant therapy was given prior to planned partial nephrectomy for complex renal mass with imperative indications for nephron preservation and prior to planned radical nephrectomy in setting of locoregional disease with possible adjacent organ or great vessel involvement where multiorgan system resection was risked. Primary outcome was percentage cytoreduction comparing pre-treatment and post treatment mass size. Secondary outcome included partial response (PR) rate as per RECIST criteria, negative surgical margins, and lack of major 30-day complications (Clavien ≥3). Comparative analysis was conducted for outcomes between groups for overall survival (OS), cancer specific survival (CSS), and progression free survival utilizing Kaplan Meier Analyses (KMA). Results: A total of 50 patients (33 TKI, 17 IO + TKI-IO) were analyzed (median follow up 31.1 months). Overall PR and cytoreduction rates were 18.0% and 4.2%. No differences in tumor size were noted (7.7 vs. 10.4 cm, p= 0.08). There were no differences in % cytoreduction (12.2 vs. 11.8, p=0.13) and % PR (17.8% vs. 30.7%, p=0.73) between the groups. Overall, 18 patients and 30 patients underwent PN and RN, respectively. 30-day major complication rate was 28.0% and 20.5% was PSM rate. KMA revealed 3-year OS, CSS and PFS of 74%, 75%, and 14%. No differences were noted between TKI and IO/IO-combination groups for PFS (16.7% vs. 10.0%, p=0.45), CSS (70.9% vs. 93.3%, p=0.20), and OS (68.3% vs. 93.3%, p=0.06). Conclusions: Neoadjuvant therapy prior to surgery for complex and locoregional disease resulted in cytoreduction and was associated with acceptable safety, surgical quality, and short term oncological outcomes. Further investigation is requisite to delineate role of neoadjuvant therapy in localized RCC.
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Eaton, Vincent, Connor Tupper, Kevin McMahon, and Peter T. Silberstein. "Surgical subtypes and survival in stage II osteosarcoma: A National Cancer Database (NCDB) analysis." Journal of Clinical Oncology 40, no. 16_suppl (2022): e23513-e23513. http://dx.doi.org/10.1200/jco.2022.40.16_suppl.e23513.
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e23513 Background: Osteosarcoma (OSC) is the most common primary malignancy of bone and is most commonly diagnosed in its earlier stages (I and II). Standard of care involves a combination of chemotherapy and surgical resection and, to date, there are few reports examining different surgical subtypes in these patients. This study aims to analyze different surgical subtypes in OSC patients to assess survival, particularly in stage II. Methods: Using the NCDB, patients diagnosed with stage II OSC between 2004-2018 were identified using ICD-O-3 histology codes 9180-9193. The cohort was analyzed to determine if they received any of the following surgical subtypes: local tumor destruction/excision, partial excision, radical excision with limb salvage, limb amputation, and major amputation. Univariate analysis was performed assessing patient survival length for each surgical subtype. Data was analyzed using SPSS and statistical significance was set at α = 0.05. Results: A total of 3827 patients were analyzed. Patients who received surgery survived significantly longer than those who did not (p < .00001). Patients who underwent major amputations had shorter median survival times ranging from 24-74 months. Patients who received radical tumor excision with limb salvage had the longest survival of any surgical subtype with a mean of 130.1 months and survived significantly longer than patients receiving local tumor resection, partial resection, partial and total limb amputations, or any major amputation (p < .001). Patients with local tumor destruction survived similarly to those with local tumor excision (p > .05). Patients with partial or total limb amputation had significantly better survival than patients with major limb amputation (p < .01). Conclusions: We found numerous significant differences between the different surgical subtypes used to treat patients with OSC. Radical excision with limb salvage proved to yield the best survival outcomes, with significantly higher survival when compared to almost all other surgical subtypes (excluding local tumor destruction). Future studies should investigate additional parameters within each surgical subtype to assess the impact that variables like patient demographics and socioeconomic status, tumor characteristics, and surgical center may have on access to care and survival outcomes.[Table: see text]
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Eaton, Vincent, Connor Tupper, Kevin McMahon, and Peter T. Silberstein. "Surgical subtypes and survival in stage II osteosarcoma: A National Cancer Database (NCDB) analysis." Journal of Clinical Oncology 40, no. 16_suppl (2022): e23513-e23513. http://dx.doi.org/10.1200/jco.2022.40.16_suppl.e23513.
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e23513 Background: Osteosarcoma (OSC) is the most common primary malignancy of bone and is most commonly diagnosed in its earlier stages (I and II). Standard of care involves a combination of chemotherapy and surgical resection and, to date, there are few reports examining different surgical subtypes in these patients. This study aims to analyze different surgical subtypes in OSC patients to assess survival, particularly in stage II. Methods: Using the NCDB, patients diagnosed with stage II OSC between 2004-2018 were identified using ICD-O-3 histology codes 9180-9193. The cohort was analyzed to determine if they received any of the following surgical subtypes: local tumor destruction/excision, partial excision, radical excision with limb salvage, limb amputation, and major amputation. Univariate analysis was performed assessing patient survival length for each surgical subtype. Data was analyzed using SPSS and statistical significance was set at α = 0.05. Results: A total of 3827 patients were analyzed. Patients who received surgery survived significantly longer than those who did not (p < .00001). Patients who underwent major amputations had shorter median survival times ranging from 24-74 months. Patients who received radical tumor excision with limb salvage had the longest survival of any surgical subtype with a mean of 130.1 months and survived significantly longer than patients receiving local tumor resection, partial resection, partial and total limb amputations, or any major amputation (p < .001). Patients with local tumor destruction survived similarly to those with local tumor excision (p > .05). Patients with partial or total limb amputation had significantly better survival than patients with major limb amputation (p < .01). Conclusions: We found numerous significant differences between the different surgical subtypes used to treat patients with OSC. Radical excision with limb salvage proved to yield the best survival outcomes, with significantly higher survival when compared to almost all other surgical subtypes (excluding local tumor destruction). Future studies should investigate additional parameters within each surgical subtype to assess the impact that variables like patient demographics and socioeconomic status, tumor characteristics, and surgical center may have on access to care and survival outcomes.[Table: see text]
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M. Taufiq Hidayat and Yusuf Rahman. "AL-QURAN DAN INTERPRETASI IDEOLOGIS." Al Burhan: Jurnal Kajian Ilmu dan Pengembangan Budaya Al-Qur'an 22, no. 01 (2022): 46–56. http://dx.doi.org/10.53828/alburhan.v22i01.743.
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This paper proves that the ideological construction of an interpretation will determine the tendency of a product of interpretation and has the potential to reduce the meaning of a text and even reject other interpretations. The product of such interpretation is only more concerned with the process of elaborating verses for certain interests by designing themes and sub-themes as well as tendentious conclusions and even blaming "infidel" Muslims who are not in line, intolerant of differences of opinion, partial and fanatical which are full of radical ideologies. The findings in this article prove that the construction of Rokhmat S. Labib's interpretation is more of a process of elaborating verses for certain interests by designing themes and sub-themes with tendentious conclusions and even blaming "infidels" Muslims who are impartial, intolerant of differences, partial and fanatical. . The interpretation is often separated from the context of the verse, which causes this work to be inconsistent in taking references even though it does not ignore the historical context of the verse. This article also proves that the author's background determines ideological tendencies and interests in an interpretation.
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Anceschi, Umberto, Aldo Brassetti, Gabriele Tuderti, et al. "Impact of Clinical Response to Neoadjuvant Chemotherapy in the Era of Robot Assisted Radical Cystectomy: Results of a Single-Center Experience." Journal of Clinical Medicine 9, no. 9 (2020): 2736. http://dx.doi.org/10.3390/jcm9092736.
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Background: Response to neoadjuvant chemotherapy (NACT) has been proven to be an established prognostic factor after open radical cystectomy (ORC). We evaluated the impact of NACT on survival outcomes of a single-institution robotic radical cystectomy (RARC) series. Methods: From January 2012 to June 2020, 79 patients were identified. Baseline, demographic, perioperative, and pathologic data were described. Kaplan–Meier with the log-rank test was used to compare overall survival (OS) differences between complete, partial, and no-NACT responders, respectively. Univariable and multivariable regression analyses were performed to identify predictors of OS. Results: Complete, partial, and absent response to NACT were recorded in 43 (54.4%), 21 (19%), and 15 (26.6%) patients, respectively. A complete response to NACT displayed a trend toward significant higher OS (p = 0.03). In univariable analysis, significant predictors of lower OS were hypertension (HR 3.37; CI 95% 1.31–8.62; p = 0.01); advanced nodal involvement (HR 2.41; CI 95% 0.53–10.9; p < 0.001); and incomplete response to NACT (HR 0.41; CI 95% 0.18–0.95; p = 0.039). In multivariable analysis, the only independent predictor of worse OS was advanced pathologic N stages (HR 10.1; CI: 95% CI 2.3–44.3; p = 0.002). Conclusions: Complete response to NACT is associated with increased OS probability, but significant nodal residual disease remains the only independent predictor of OS after RARC.
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Lee, Lui Shiong, John SP Yuen, and Hong Gee Sim. "Renal Cell Carcinoma in Young Patients is Associated with Poorer Prognosis." Annals of the Academy of Medicine, Singapore 40, no. 9 (2011): 401–6. http://dx.doi.org/10.47102/annals-acadmedsg.v40n9p401.
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Introduction: Renal cell carcinoma (RCC) in young patients is uncommon but thought to represent a distinctive clinical entity from older patients with different clinico-pathologic features and outcomes. We evaluated the association of age at the time of diagnosis with pathological staging, histological parameters, disease recurrence and overall survival (OS) following radical or partial nephrectomy for non-metastatic RCC in native kidneys. Materials and Methods: A retrospective review of 316 patients with RCC after nephrectomy at a single institution between January 2001 and June 2008 was performed. Eligible patients included all histologically proven primary non-metastatic RCC treated by radical or partial nephrectomy. They were categorised into group A (≤40 years at diagnosis) and B (>40 years). Differences in clinical parameters were analysed using the Mann Whitney U test. The prognostic potential of age at diagnosis was evaluated using Cox proportional hazards regression. Survival was estimated using the Kaplan Meier method. Results: There were 33 patients in group A and 283 patients in group B. There were more non-clear cell tumours in the younger group (30% vs 14%, P <0.05). No statistical differences were found in the stage and grade of both groups. At a median follow-up time of 41 months, the younger group had a higher metastatic rate (18% vs 10.5%, P <0.05), lower 5-year cancer-specific survival (82% vs 98%, P <0.05) and lower 5-year OS (82 % vs 95%, P<0.05). Conclusion: Younger patients were more likely to have non-clear cell RCC with higher disease recurrence and lower OS. They should not be assumed to have similar features and outcomes as screen-detected early RCC in older patients. Key words: Age, Cancer recurrence, Overall survival, Renal cell carcinoma, Nephrectomy
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Huang, Shuting, Weihao Lin, Mengheng Xu, Ruiming Wang, and Zhenguang G. Cai. "On the tip of the pen: Effects of character-level lexical variables and handwriter-level individual differences on orthographic retrieval difficulties in Chinese handwriting." Quarterly Journal of Experimental Psychology 74, no. 9 (2021): 1497–511. http://dx.doi.org/10.1177/17470218211004385.
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In the past few decades, Chinese speakers have suffered from difficulties in handwriting, which include tip-of-the-pen (TOP) states (knowing a character but failing to fully handwrite it) and character amnesia in general (a general inability to handwrite a character despite being able to recognise it). The current study presents a systematic empirical investigation of the effects of character-level lexical characteristics and handwriter-level individual differences on TOP, character amnesia, and partial orthographic access in TOP states. Using a spelling-to-dictation task, we had 64 participants to handwrite 200 simplified Chinese characters. We showed that, at the lexical level, participants experienced more TOP and character amnesia in handwriting if a character was less frequent, was acquired later in life, was embedded in a less familiar word, or had more strokes; TOP but not character amnesia was additionally affected by phonetic radical order and spelling regularity. At the handwriter level, people also experienced more TOP and character amnesia if they had more digital exposure, less pen exposure, or less print exposure. In a TOP state, partial orthographic access was more likely if a character was acquired later in life, had fewer strokes, or had a left-right or top-down composition or, if a handwriter had less digital exposure.
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Brunet-Rossinni, Anja K. "Reduced free-radical production and extreme longevity in the little brown bat (Myotis lucifugus) versus two non-flying mammals." Mechanisms of Ageing and Development 125, no. 1 (2004): 11–20. https://doi.org/10.5281/zenodo.13418622.
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(Uploaded by Plazi for the Bat Literature Project) The extended longevity of bats, despite their high metabolic rate, may provide insight to patterns and mechanisms of aging. Here I test predictions of the free radical or oxidative stress theory of aging as an explanation for differences in lifespan between the little brown bat, Myotis lucifugus (maximum lifespan potential MLSP = 34 years), the short-tailed shrew, Blarina brevicauda (MLSP = 2 years), and the white-footed mouse, Peromyscus leucopus (MLSP = 8 years) by comparing whole-organism oxygen consumption, hydrogen peroxide production, and superoxide dismutase activity in heart, kidney, and brain tissue. Mitochondria from M. lucifugus produced half to one-third the amount of hydrogen peroxide per unit of oxygen consumed compared to mitochondria from B. brevicauda and P. leucopus, respectively. Superoxide dismutase (SOD) activity did not differ among the three species. These results are similar to those found for birds, which like bats have high metabolic rates and extended longevities, and provide support for the free radical theory of aging as an at least partial explanation for the extreme longevity of bats.
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Brunet-Rossinni, Anja K. "Reduced free-radical production and extreme longevity in the little brown bat (Myotis lucifugus) versus two non-flying mammals." Mechanisms of Ageing and Development 125, no. 1 (2004): 11–20. https://doi.org/10.5281/zenodo.13418622.
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(Uploaded by Plazi for the Bat Literature Project) The extended longevity of bats, despite their high metabolic rate, may provide insight to patterns and mechanisms of aging. Here I test predictions of the free radical or oxidative stress theory of aging as an explanation for differences in lifespan between the little brown bat, Myotis lucifugus (maximum lifespan potential MLSP = 34 years), the short-tailed shrew, Blarina brevicauda (MLSP = 2 years), and the white-footed mouse, Peromyscus leucopus (MLSP = 8 years) by comparing whole-organism oxygen consumption, hydrogen peroxide production, and superoxide dismutase activity in heart, kidney, and brain tissue. Mitochondria from M. lucifugus produced half to one-third the amount of hydrogen peroxide per unit of oxygen consumed compared to mitochondria from B. brevicauda and P. leucopus, respectively. Superoxide dismutase (SOD) activity did not differ among the three species. These results are similar to those found for birds, which like bats have high metabolic rates and extended longevities, and provide support for the free radical theory of aging as an at least partial explanation for the extreme longevity of bats.
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Brunet-Rossinni, Anja K. "Reduced free-radical production and extreme longevity in the little brown bat (Myotis lucifugus) versus two non-flying mammals." Mechanisms of Ageing and Development 125, no. 1 (2004): 11–20. https://doi.org/10.5281/zenodo.13418622.
Full textAbstract:
(Uploaded by Plazi for the Bat Literature Project) The extended longevity of bats, despite their high metabolic rate, may provide insight to patterns and mechanisms of aging. Here I test predictions of the free radical or oxidative stress theory of aging as an explanation for differences in lifespan between the little brown bat, Myotis lucifugus (maximum lifespan potential MLSP = 34 years), the short-tailed shrew, Blarina brevicauda (MLSP = 2 years), and the white-footed mouse, Peromyscus leucopus (MLSP = 8 years) by comparing whole-organism oxygen consumption, hydrogen peroxide production, and superoxide dismutase activity in heart, kidney, and brain tissue. Mitochondria from M. lucifugus produced half to one-third the amount of hydrogen peroxide per unit of oxygen consumed compared to mitochondria from B. brevicauda and P. leucopus, respectively. Superoxide dismutase (SOD) activity did not differ among the three species. These results are similar to those found for birds, which like bats have high metabolic rates and extended longevities, and provide support for the free radical theory of aging as an at least partial explanation for the extreme longevity of bats.
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Yuce, Yucel, Kutlu Hakan Erkal, Cemal Goktas, Bilal Eryildirim, and Kemal Sarica. "The effect of surgical technique on hemodynamics, arterial oxygenation and pulmonary mechanics in radical prostatectomy operations." Archivio Italiano di Urologia e Andrologia 89, no. 1 (2017): 65. http://dx.doi.org/10.4081/aiua.2017.1.65.
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Objective: The effects of surgical technique on respiratory mechanics, arterial oxygenation and hemodynamics in radical prostatectomy operation were investigated. Methods: The study was planned on ASA II-III, 40-65 years old, fourty patients scheduled for radical prostatectomy under general anesthesia. They were divided into two groups: perineal and suprapubic (Group P, n = 20; Group S, n = 20). Heart rate, mean arterial blood pressure, arterial oxygen saturation (SpO<sub>2</sub>), partial pressure of end-tidal carbon dioxide (PEtCO<sub>2</sub>), Peak inspiratory pressure (PIP), plato pressure (Pplato), partial pressure of oxygen in arterial blood (PaO2), partial pressure of carbon dioxide in arterial blood (PaCO<sub>2</sub>) values were evaluated at 10 minutes after induction. After the position applied for surgery in the 30.60 and 90<sup>th</sup> minutes, the Alveolar-arterial oxygen pressure gradient (P(A-a) O<sub>2</sub>), the ratio of physiologic dead space over tidal volume (VD/VT), arterial to end tidal CO2 gradient (P(a-et) CO<sub>2</sub>), static compliance (CS), dynamic compliance (CD) were assessed. Results: In the assessment of groups, there were not statistical differences about mean blood pressure, heart rate, SpO<sub>2</sub>, PetCO<sub>2</sub>, PaO<sub>2</sub>, plateau pressure, and P (A-a) values (p &gt; 0.05). Peak inspiratory pressure was higher in Group P. Peak inspiratory pressure and plateau pressure increased with CO<sub>2</sub> insufflation in Group P. PaCO<sub>2</sub> and P(a-et) CO<sub>2</sub> were higher statistically significantly in Group 0. There was no difference in terms of the PetCO<sub>2</sub> values. VD/VT ratios were statistically significantly lower in the Group P. Conclusions: Suprapubic surgery was shown to improve oxygenation and respiratory mechanics without causing any hemodynamic side effect in radical prostatectomy operation.
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Soper, J. T., A. A. Secord, L. J. Havrilesky, A. Berchuck, and D. L. Clarke-Pearson. "Comparison of gracilis and rectus abdominis myocutaneous flap neovaginal reconstruction performed during radical pelvic surgery: flap-specific morbidity." International Journal of Gynecologic Cancer 17, no. 1 (2007): 298–303. http://dx.doi.org/10.1111/j.1525-1438.2007.00784.x.
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To compare flap-specific complications of gracilis myocutaneous (GM) and rectus abdominis myocutaneous (RAM) flap neovaginal reconstructions after radical pelvic surgery. The study was a single-institution retrospective review of patients undergoing concurrent radical pelvic surgery with GM or RAM neovaginal reconstructions performed on a gynecological oncology service, 1978–2003. Flap-specific complications were compared between the techniques. Forty-four GM and 32 RAM neovaginal reconstructions were analyzed: plastic surgeons developed 12 (27%) GM and 4 (13%) RAM flaps, with all other flaps performed by gynecological oncologists. Primary procedures included 54 (71%) total pelvic exenterations, with partial exenterations or radical vulvovaginectomies in 16 (21%) and 6 (8%) patients, respectively. Forty (53%) patients had received radiation and 28 (36%) received chemoradiation before radical surgery. There were no significant differences in patient characteristics, other than more frequent use of continent urinary conduits (P < 0.001) and a trend for more frequent sidewall radiation (P < 0.1) in the RAM group, reflecting use in more recent patients (P < 0.001). Median follow-up is 28 months (range: 2 weeks to 216 months), with 5% acute operative mortality. Flap-specific complications were significantly increased in GM patients (P < 0.03). Overall flap loss was significantly increased in GM patients (P < 0.02). Thirty (59%) of 51 patients surviving for more than 12 months reported coitus, with no significant difference between the groups. Because of lower overall incidence of flap-specific complications and significantly lower incidence of flap loss compared with GM flap, RAM flap has become our technique of choice for neovaginal reconstruction concurrent with radical pelvic surgery.
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Thomas, Raymond H., Floyd M. Woods*, William A. Dozier, et al. "Physicochemical and Antioxidant Changes in Six Alabama-grown Blackberry Cultivars." HortScience 39, no. 4 (2004): 807C—807. http://dx.doi.org/10.21273/hortsci.39.4.807c.
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Blackberries are an excellent source of natural antioxidants. Fully ripened fruit of `Apache', `Arapaho', `Chester', `Loch Ness', `Navaho', and `Triple Crown' thornless blackberries were evaluated for their physicochemical and antioxidative activity. Differences in initial pH, titratable acidity (TA), total soluble solids (TSS), TSS/TA ratio and soluble sugars (reducing sugar, sucrose, and total sugars) differed among cultivars. Differences among cultivars with respect to reduced ascorbic acid (AA) were established, but there were no differences in either oxidized ascorbic acid (DHA) or total ascorbic acid (TAA) content. Antioxidant activity was determined by ABTS radical cation procedure for fractionated crude fruit extracts and the cultivars varied in the parameters evaluated. Hydrophilic antioxidant activity (HAA) was not different among cultivars evaluated. In contrast, lipophilic antioxidant activity (LAA) and total antioxidant activity (TAA) differed. The results obtained in this study indicate that Alabama-grown blackberries vary in their quality indices and are an excellent source of natural antioxidants. Information compiled will assist in marketing, handling, postharvest storage of these fruit and serve as a guide to partial fulfillment of recommended daily dietary requirements.
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Hakimi, A. Ari, Ling Chen, Philip H. Kim, et al. "The impact of metformin use on recurrence and cancer-specific survival in clinically localized high-risk renal cell carcinoma." Canadian Urological Association Journal 7, no. 11-12 (2013): 687. http://dx.doi.org/10.5489/cuaj.1447.
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Background: Recent data suggest that metformin may have antineoplastic properties. We sought to determine what effect metformin had on recurrence and cancer-specific survival (CSS) rates of patients with clinically localized pT2 and pT3 renal cell carcinoma (RCC) following radical or partial nephrectomy.Methods: We obtained data on 784 patients who underwent partial or radical nephrectomy for pT2 or pT3 tumours at our centre between 1996 and 2011. Patients with benign masses, nodal positivity, or metastasis at the time of surgery were excluded. Using a competing-risks regression model, we compared differences in probability of recurrence between patients who used metformin versus those who did not.Results: The patients on metformin at the time of surgery had worse disease recurrence than patients not on metformin. However, this was not statistically significant on multivariate analysis when controlling for age, race, body mass index, glomerular filtration rate, and tumour stage and grade (hazard ratio [HR], 1.22; 95% confidence interval [CI], 0.66-2.27 [p = 0.5]). Metformin use was associated with a lower risk of cancer-specific mortality, but this was not statistically significant when adjusted for clinical and tumour characteristics (HR, 0.76; 95% CI 0.21-2.7 [p = 0.7]). Limitations include the retrospective nature of the study and the lack on information on duration of metformin use.Conclusions: Metformin use at the time of surgery for high-risk clinically localized RCC is not protective in terms of recurrence or CSS. Further studies should be done to confirm these findings and determine what effect concurrent metformin use might have on improved response to targeted therapies in the metastatic setting.
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Siech, Carolin, Reha-Baris Incesu, Simone Morra, et al. "Differences in other-cause mortality in metastatic renal cell carcinoma according to partial vs. radical nephrectomy and age: A propensity score matched study." Surgical Oncology 53 (April 2024): 102047. http://dx.doi.org/10.1016/j.suronc.2024.102047.
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Roohi Mumtaz. "Does Gender Differences Matter! Investigating the Prejudiced Practices and Gender-Role Conflict Among Female Professionals Working in Male-Dominated Professions." International Journal of Business and Society 23, no. 2 (2022): 1297–315. http://dx.doi.org/10.33736/ijbs.4872.2022.
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This study investigates the perceptions of gender role conflict, prejudice practices, office stress, and their impact on female professionals working in male-dominated professions. The paper's concepts and contexts are grounded on the role of congruity theory and transactional theories of stress. A survey was conducted in different institutions of Pakistan and Malaysia. A conceptual model was then developed on five crucial hypotheses on broad-ranging literature analyses using statistical analyses and structural equation modeling with Smart-Partial Least Square (PLS). The findings reveal that females find it difficult to seek the top executive positions as assertive and decisive behaviors in them are seen as obligatory traits. Moreover, the personal experiences of females working in different male-dominant professions in both countries related to discriminatory practices, office stress, role, work-family conflicts are somewhat similar. However, the ways, approaches, and intensity of those experiences are different. Therefore, it is recommended that radical changes be required in terms of stereotypical behavior, psychological and social belief systems for genders to mitigate and replace the old thumb rule concepts.
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Alasker, Ahmed, Turki Rashed Alnafisah, Mohammad Alghafees, et al. "Preserving Renal Function without Compromising Oncological Outcomes: A Comparative Study of Partial and Total Nephrectomies in T3 Stage Renal Cell Carcinoma." Journal of Kidney Cancer and VHL 10, no. 4 (2023): 28–32. http://dx.doi.org/10.15586/jkcvhl.v10i4.290.
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The utility of partial nephrectomy (PN) in locally advanced, stage T3 renal cell carcinoma (RCC) is controversial. This retrospective study aimed to review the oncological and functional outcomes of patients with T3a RCC who underwent PN. We included all patients with pT3a stage RCC undergoing either open, laparoscopic, or robotic PN at our center between January 2015 and 2023. A Wilcoxon rank sum test was utilized to compare nephrectomy types (radical nephrectomy [RN] vs PN). Survival analysis was conducted using Kaplan–Meier plots and a log-rank test. P-value < 0.05 indicated statistical significance. There were no significant differences in demographic characteristics between the RN and PN groups, except age (53.0 vs 6.5, respectively; P = 0.012) and body mass index (28.7 vs 34.3, respectively; P = 0.020). Furthermore, there were also no significant differences in the rates of local recurrence (P = 0.597), metastatic progression (P = 0.129), and chemotherapy use (P = 0.367) between nephrectomy types. Patient survival did not differ significantly based on the type of nephrectomy (log-rank P-value = 0.852). Together, our findings indicated that PN and RN yield near-equivalent oncological outcomes in terms of local recurrence, metastasis, and overall survival rates among pT3a RCC patients during a nearly 3-year follow-up period.
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McKay, Katlyn G., Muhammad O. Abdul Ghani, Gabriella L. Crane, et al. "Oncologic Fidelity of Minimally Invasive Surgery to Resect Neoadjuvant-Treated Wilms Tumors." American Surgeon 88, no. 5 (2022): 943–52. http://dx.doi.org/10.1177/00031348211070796.
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Background The Children's Oncology Group recommends upfront resection of Wilms tumor (WT), however, unique scenarios warrant neoadjuvant chemotherapy and delayed resection. We hypothesized that in the context of neoadjuvant chemotherapy, minimally invasive surgery (MIS) to resect WT achieves equivalent oncologic fidelity and better maintains therapy schedules. Methods A retrospective analysis of WT treated between 2010-2021 at a free-standing children's hospital was performed. Patient and disease specific characteristics were collected, and pre-resection tumor volumes (TV) were calculated. Impact of MIS or open resection on oncologic fidelity and time to resume chemotherapy was analyzed. Results For the study period, 62 patients were treated for 65 WT, and 14 patients (22.6%) received neoadjuvant chemotherapy to treat 17 WT (26.2%): 7 Stage I (all predisposition syndromes), 2 stage III, 7 stage IV, and 1 stage V (bilateral). MIS was utilized to resect 6 WT from 5 patients. For partial nephrectomy, pre-resection TV was 0.38 ml if MIS and 10.38 ml if open ( P = .025). For radical nephrectomy, pre-resection TV was 31.58 ml if MIS and 175.00 ml if open ( P = .101). No significant differences between surgical approach were detected regarding pathologic variables or survival. Epidural use was significantly greater with open procedures ( P = .001). Length of stay was 2.00 days after MIS compared to 6.00 for open resection ( P = .004). Time to resume chemotherapy was 7.00 days after MIS versus 27.00 for open ( P = .004). Conclusion After neoadjuvant chemotherapy for WT, MIS partial and radical nephrectomies achieved equivalent oncologic fidelity, reduced epidural use and post-operative stays, and better maintained adjuvant therapy timelines when compared to open resections.
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Boll, Meinrad, W. D. Lutz, Eberhard Becker, and Andreas Stampfl. "Mechanism of Carbon Tetrachloride-Induced Hepatotoxicity. Hepatocellular Damage by Reactive Carbon Tetrachloride Metabolites." Zeitschrift für Naturforschung C 56, no. 7-8 (2001): 649–59. http://dx.doi.org/10.1515/znc-2001-7-826.
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CCl4-induced liver damage was modeled in monolayer cultures of rat primary hepatocytes with a focus on involvement of covalent binding of CCl4 metabolites to cell components and/or peroxidative damage as the cause of injury.(1) Covalent binding of 14C-labeled metabolites was detected in hepatocytes immediately after exposure to CCl4. (2) Low oxygen partial pressure increased the reductive metabolism of CCl4 and thus covalent binding. (3) [14C]-CCl4 was bound to lipids and to proteins throughout subcellular fractions. Binding occurred preferentially to triacylglycerols and phospholipids, with phosphatidylcholine containing the highest amount of label. (4) The lipid peroxidation potency of CCl4 revealed subtle differences compared to other peroxidative substances, viz., ADP-Fe3+ and cumol hydroperoxide, respectively. (5) CCl4, but not the other peroxidative substances, decreased the rate of triacylglycerol secretion as very low density lipoproteins. (6) The anti-oxidant vitamin E (α-tocopherol) blocked lipid peroxidation, but not covalent binding, and secretion of lipoproteins remained inhibited. (7) The radical scavenger piperonyl butoxide prevented CCl4-induced lipid peroxidation as well as covalent binding of CCI4 metabolites to cell components, and also restored lipoprotein metabolism.The results confirm that covalent binding of the CCl3* radical to cell components initiates the inhibition of lipoprotein secretion and thus steatosis, whereas reaction with oxygen, to form CCI3*-OO*, initiates lipid peroxidation. The two processes are independent of each other, and the extent to which either process occurs depends on partial oxygen pressure. The former process may result in adduct formation and, ultimately, cancer initiation, whereas the latter results in loss of calcium homeostasis and, ultimately, apoptosis and cell death
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Frederick, Wayne A. I., Sarah Ames, Stephanie R. Downing, Tolulope A. Oyetunji, David C. Chang, and Lasalle D. Leffall. "Surgical Treatment for Women with Breast Cancer: Do Randomized Clinical Trials Represent Current Medical Practices?" American Surgeon 76, no. 6 (2010): 630–36. http://dx.doi.org/10.1177/000313481007600629.
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Randomized clinical trials have not shown survival differences between breast cancer patients who undergo breast-conserving surgery and those who undergo modified radical mastectomy (MRM). Recent studies however, have suggested that these randomized clinical trials findings may not be representative of the entire population or the nature of current patient care. A retrospective analysis of female invasive breast cancer patients who underwent surgery in the Surveillance, Epidemiology, and End Results database (1990-2003) was performed. Survival was compared amongst women who underwent partial mastectomy, partial mastectomy plus radiation (PMR), or MRM. Cox proportional hazards regressions were used to investigate the impact of method of treatment upon survival, after adjusting for patient and tumor characteristics. A total of 218,043 patients, mean age 62 years, were identified. MRM accounted for 51.5 per cent of the study population whereas PMR accounted for 34.9 per cent. On multivariate analyses, significant improvement was observed in patient survival associated with PMR when compared with MRM patients (hazard ratio = 0.71, 95% confidence interval = 0.67-0.74, P < 0.001). This population-based study suggests that there is a survival benefit for women undergoing PMR in the treatment of breast cancer.
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Sosnowski, Roman, Jan Karol Wolski, Urszula Ziętalewicz, Michał Szymański, Robert Bakuła, and Tomasz Demkow. "Assessment of selected quality of life domains in patients who have undergone conservative or radical surgical treatment for penile cancer: an observational study." Sexual Health 16, no. 1 (2019): 32. http://dx.doi.org/10.1071/sh17119.
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Background Surgery is the standard treatment for organ-restricted penile cancer, but it is also a disfiguring procedure that can profoundly affect quality of life. Using a survey, in this study we assessed the effect of different surgical invasiveness on satisfaction in selected life domains of patients who underwent penile-sparing surgery and partial penectomy. Methods: Forty patients who underwent penile-sparing surgery (n=13) or partial penectomy (n=27) were enrolled in the study. The response rate was 71%. Information was obtained after surgery on sexuality, self-esteem, masculinity and partner relationships using the International Index of Erectile Function, the Self-Esteem Scale and the Conformity to Masculinity Norms Inventory questionnaires. We evaluated the effect of primary surgery type on selected domains of quality of life and correlations between study variables after surgery. Results: High self-esteem, satisfactory erectile function and masculinity results in both groups were comparable to those in the published literature. Men who underwent less disfiguring treatment had a significantly higher sense of masculinity than those who underwent partial penectomy (P=0.05). No significant differences were observed in erectile dysfunction and self-esteem. The level of aggressiveness of a surgical procedure was a predictor of sense of masculinity (P=0.01), but was not associated with self-esteem and sexual dysfunction (P=0.28 and P=0.55 respectively); 83% of patients were able to satisfactorily maintain partner relationships. Conclusions: Disfiguring treatments for penile cancer significantly interfere with the sense of masculinity, but sexual functioning and self-esteem do not differ according to the type of surgical procedure. Most men maintained stable partner relationships after surgery, regardless of surgery type.
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Kim, Dongsu, Bumjin Lim, Jungyo Suh, et al. "Efficacy of Partial Nephrectomy in the Management of Unpredicted pT3a Renal Cell Carcinoma." Journal of Urologic Oncology 21, no. 2 (2023): 148–53. http://dx.doi.org/10.22465/juo.224400400020.
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Purpose: To compare the oncological outcomes between patients with pathologic T3a (pT3a) renal cell carcinoma (RCC) who underwent partial nephrectomy (PN) and radical nephrectomy (RN).Materials and Methods: We retrospectively reviewed 149 patients with pT3a N0 M0 RCC who underwent PN and RN between 2001 and 2012. Recurrence-free survival (RFS) and cancer-specific survival (CSS) were analyzed using the Kaplan-Meier method and prognostic factors were identified using Cox proportional hazard regression models.Results: A total of 41 recurrences (27.5%) and 24 cancer related death (16.1%) were observed during a median follow-up of 136 months (interquartile range, 77–163 months). We observed no significant differences in the RFS and CSS between the PN and RN (RFS: 85.4±64.0 months vs. 75.9±52.8 months, p=0.061; CSS: 153.2±52.5 months vs. 124.9±59.8 months, p=0.292). The surgical method did not affect the tumor recurrence and patients’ survival. On multivariable Cox regression analysis, only tumor size remained associated with worse RFS (hazard ratio [HR], 1.237; 95% confidence interval [CI], 1.132–1.350; p<0.001) and CSS (HR, 1.156; 95% CI, 1.027–1.302; p=0.017).Conclusions: Due to the large tumor size, there may be hesitation in performing PN concerning pT3a in postoperative biopsy. Our study findings suggest that since tumor size is the only prognostic factor, PN can be performed in pT3a as long as there is no thrombus in the renal vein.
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VAN DUONG, DOAN, MASUMI HASEGAWA, MANH TUONG VU, and VAN hUNG HOANG. "RADIAL AND AMONGCLONAL VARIATIONS OF TRANSVERSE SHRINKAGE AND BASIC DENSITY IN 5-YEAR-OLDACACIA AURICULIFORMIS CLONES PLANTED IN VIETNAM." Wood Research 69, no. 4 (2024): 573–84. http://dx.doi.org/10.37763/wr.1336-4561/69.4.573584.
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This study investigated transverse shrinkages and wood density for Acacia auriculiformis trees from six clones planted in north-central Vietnam. Radial and among-clonal variations of partial and total shrinkages in tangential (respective to Tn and T) and radial (respective to Rn and R) directions, partial and total coefficient of anisotropy (respective to Tn/Rn and T/R), and basic density (BD) were examined. There were significant differences among clones for Rn and R, but no significant differences were found among clones for Tn and T. The lowest average Rn and R were detected in clones Clt18 and Clt26, suggesting that these clones might be more appropriate for breeding programs focused on improving shrinkage traits for sawn timber production. BD is not a good indicator for predicting transverse shrinkages. In contrasts, stress wave velocity measured in standing trees has the potential to be used as a non-destructive method for predicting the transverse shrinkage of A. auriculiformis planted in Vietnam.
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Chung, Younsoo, Seok-Soo Byun, Sung Kyu Hong, et al. "Comparison of Outcomes Between Radical Nephrectomy and Partial Nephrectomy in Clinical T2 Renal Cell Carcinoma: A Retrospective Korean Renal Cell Carcinoma Cohort Study." Journal of Urologic Oncology 22, no. 2 (2024): 136–43. http://dx.doi.org/10.22465/juo.244800360018.
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Purpose: We compared the surgical outcomes of radical nephrectomy (RN) and partial nephrectomy (PN) in adult patients with clinical T2 stage (cT2) renal cell carcinoma (RCC) by utilizing data from the Korean Renal Cell Carcinoma (KORCC) database.Materials and Methods: We retrospectively analyzed adult patients with cT2 RCC from 8 tertiary hospitals who were registered in the KORCC between 2003 and 2023. Patients with a solitary kidney or bilateral tumors were excluded. The patient cohort was divided into RN and PN arms, and propensity score matching (PSM) was conducted with a 1:3 ratio. Perioperative and survival outcomes were compared between arms.Results: After PSM, the PN and RN arms included 44 and 132 patients, respectively. No significant differences were observed in baseline characteristics, apart from laterality, following PSM. Regarding perioperative outcomes, complications of Clavien-Dindo classification grade III or higher (11.4%, p<0.001) and urological complications (9.1%, p=0.045) were more common in the PN arm than in the RN arm. Postoperative renal function was superior in the PN arm, whereas the incidence of de novo chronic kidney disease (CKD) at 6 months was higher among the recipients of RN (37.6%, p<0.001). Pathological examination indicated a higher pathological T stage in the RN arm. Overall, cancer-specific, and recurrence-free survival rates did not differ significantly between arms. Based on Cox regression analysis, the use of PN was not a significant predictor of recurrence-free survival (hazard ratio, 0.675; p=0.474).Conclusions: In cT2 RCC, PN was associated with a lower incidence of de novo CKD than RN. No significant differences in survival outcomes were noted. PN may represent a viable alternative to RN for certain patients with cT2 RCC. Further research is warranted to explore the management of advanced RCC.
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SHANG, Ji-wen, Xin MA, Xu ZHANG, Hong-zhao LI, and Tao-ping SHI. "Comparison of two different renorrhaphy techniques in retroperitoneal laparoscopic partial nephrectomy for complex tumor." Chinese Medical Journal 126, no. 24 (2013): 4629–32. http://dx.doi.org/10.3760/cma.j.issn.0366-6999.20131761.
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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.
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Liang, Chao, Jundong Zhu, Chenkui Miao, et al. "Protective Effects of the Segmental Renal Artery Clamping Technique on Ischemia-Reperfusion Injury in db/db Diabetic Mice." BioMed Research International 2017 (2017): 1–13. http://dx.doi.org/10.1155/2017/4763828.
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Renal ischemia-reperfusion (I/R) injury is inevitable in partial nephrectomy and other kidney surgeries, with a higher incidence in patients with renal insufficiency. This study aimed to investigate the protective effects of precise segmental renal artery clamping (SRAC) against renal I/R injury in db/db diabetic mice, compared with conventional renal artery clamping (RAC). Grape seed extract, a powerful free radical scavenger, was administered to diabetic mice for 4 weeks before operation in subgroups (30 mg/kg/d). The unilateral renal pedicle was ligatured, and I/R injury to the contralateral kidney was induced (ischemia for 30 min followed by reperfusion for 24 h). Blood glucose value, creatinine, blood urea nitrogen, and urine microalbumin/urine creatinine ratio increased gradually and showed no preoperative statistical differences among six subgroups. These parameters were significantly lower in the SRAC than in the RAC group 24 h postoperatively. Moreover, the nonischemic area in the SRAC group expressed less KIM-1 and TNF-αmRNA and also revealed minor histopathological damage induced by I/R. These findings suggest that SRAC effectively reduces early renal injury induced by I/R and accelerates the recovery of renal function in diabetic mice. Thus, SRAC may be an ideal technique in partial nephrectomy, especially for patients with diabetic nephropathy and other renal insufficiencies.
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Chu, Yamin, Pei Jin, Nuan Xu, and Xiaoyan Mu. "Oncologic Outcomes and Safety Assessment of Retroperitoneal Laparoscopic Partial Nephrectomy versus Open Partial Nephrectomy in Treating Patients with Localized Renal Cell Carcinoma: A Propensity Score Matching Study." Annali Italiani di Chirurgia 95, no. 5 (2024): 926–33. http://dx.doi.org/10.62713/aic.3520.
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AIM: Surgical intervention is crucial in radical resection of renal cell carcinoma (RCC). Different surgical procedures have different oncologic outcomes and safety in patients with RCC. Therefore, we aimed to investigate the oncologic outcomes and safety of retroperitoneal laparoscopic partial nephrectomy (RLPN) versus open partial nephrectomy (OPN) in treating patients with localized RCC. METHODS: This retrospective cohort study included 160 patients with localized RCC who underwent either OPN or RLPN from January 2016 to June 2020. Out of these patients, 75 patients were treated with OPN and 85 patients were treated with RLPN. After propensity score matching, 130 patients (65 cases in each group) were finally included in the analysis. Additionally, surgical outcomes, three-year survival rates, and renal function parameters were assessed between the two groups, and the data were statistically analyzed using SPSS. RESULTS: Compared to the OPN group, RLPN demonstrated significantly shorter surgical time, lower estimated blood loss (p < 0.05), and lower incidence of complications (p = 0.024). In contrast, the RLPN group had significantly longer warm ischemia time (p = 0.011) than the OPN group. Furthermore, there were no significant differences in three-year overall survival, disease-free survival, cancer specific survival rates, positive surgical margins, hospitalization time between the RLPN and OPN groups (p > 0.05). The incidence of complications in the RLPN group was significantly lower than that in the OPN group (p = 0.024). Postoperatively, creatinine level was significantly lower following RLPN at one year compared to OPN (p = 0.029). CONCLUSIONS: RLPN offers advantages in surgical time, estimated blood loss, and postoperative complications, and it positively affects postoperative renal function, while OPN shows a shorter warm ischemia time. These two approaches result in comparable three-year survival rates. This study provides valuable insights into the oncologic outcomes and safety of RLPN compared to OPN in treating localized RCC.
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Yang, Hee Seok, Jeong Woo Kim, Sung Hyun Lee, and Byung Min Yoo. "Comminuted Radial Head Fracture in All-arthroscopic Repair of Elbow Fracture-dislocation: Is Partial Excision of the Radial Head an Acceptable Treatment Option?" Clinics in Shoulder and Elbow 21, no. 4 (2018): 234–39. http://dx.doi.org/10.5397/cise.2018.21.4.234.
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BACKGROUND: In elbow fracture-dislocation, partial excision of the comminuted radial head fracture that is not amenable to fixation remains controversial considering the accompanying symptoms. This study was undertaken to evaluate the results of radial head partial excision when the comminuted radial head fracture involved < 50% of the articular surface in all-arthroscopic repair of elbow fracture-dislocation.METHODS: Patients were divided into two groups based on the condition of the radial head fracture. In Group A, the patients had a radial head comminuted fracture involving < 50% of the articular surface, and underwent arthroscopic partial excision. Group B was the non-excision group comprising patients with stable and non-displacement fractures. Follow-up consultations were conducted at 6 weeks and at 3, 6, 12, and 24 months after surgery.RESULTS: In all, 19 patients (Group A: 11; Group B: 8) met the inclusion criteria and were enrolled in the study. At the final follow-up, all 19 patients showed complete resolution of elbow instability. No significant differences were observed in the range of motion, visual analogue scale score, and Mayo elbow performance score between groups. Radiological findings did not show any complications of the radiocapitellar joint. However, nonunion of the coracoid fracture was observed in 3 patients (Group A: 1; Group B: 2), without any accompanying instability and clinical symptoms.CONCLUSIONS: Considering that the final outcome is coronoid fracture fixation and lateral collateral ligament complex repair for restoring elbow stability, arthroscopic partial excision for radial head comminuted fractures involving < 50% of articular surface is an effective and acceptable treatment for elbow fracture-dislocation.
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Ramirez, Maria Jose Ferrer, Enrique Estelles Ferriol, Fernando Guallart Domenech, Marina Carrasco Llatas, Maria Morales Suarez-Varela, and Ramon Lopez Martinez. "Psychosocial adjustment in patients surgically treated for laryngeal cancer." Otolaryngology–Head and Neck Surgery 129, no. 1 (2003): 92–97. http://dx.doi.org/10.1016/s0194-59980300478-9.
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OBJECTIVE: To assess the psychosocial adjustment in 62 patients surgically treated for cancer of the head and neck. STUDY DESIGN AND SETTING: Forty-one patients were grouped as having had radical surgery (total laryngectomy) and 21 as having had functional surgery (horizontal supraglottic laryngectomy or partial vertical surgery). The Psychosocial Adjustment to Illness Scale-Self Report (PAIS-SR) was used for the evaluation. RESULTS: No significant differences were found between groups when global adjustment or domain adjustment was compared. Patients did not consider the permanent stoma and voice loss to be the most important determinant of quality of life. Work and family relationship were the domains with poorest adjustment. CONCLUSION: Social and medical support are important factors in improving patients' self-confidence and satisfaction, playing an important role in recovering useful phonation, psychological adjustment, and global quality of life. SIGNIFICANCE: Information collected in this way may facilitate improved rehabilitation and thus better quality of life.
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Nosov, A. K., E. M. Mamizhev, N. A. Shchekuteev, et al. "Techniques of surgical hemostasis and sealing after laparoscopic partial nephrectomy." Cancer Urology 18, no. 3 (2022): 27–34. http://dx.doi.org/10.17650/1726-9776-2022-18-3-27-34.
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Background. The kidney cancer treatment remains cornerstone problem in our country for healthcare. Survival results of partial nephrectomy as a radical nephrectomy are similar in groups of patients with the same morphological features and was confirmed by previously results: “indications for nephron-sparing treatment of kidney cancer is determined with the degree of resectability, assessed subjectively by surgeon and his experience, ambitions and technical capabilities. It does not depend on oncological prognostic factors”. This thesis is actual due to oncological preoperative factors and limited only by tumor size. Therefore, development of technical capabilities, techniques and skills expand our capabilities in organ-preserving treatment.Aim. To evaluate the effectiveness and safety of bipolar coagulation with fibrin glue in comparison with the standard technique of surgical suture to the area of non-ischemic partial nephrectomy.Materials and methods. This is prospective trial which had included the results of treatment of 121 patients who received partial-nephrectomy for localized kidney cancer from 2015 to 2017 at the N.N. Petrov National Medical Research Center of Oncology. Two variants of hemostasis were used in the work: standard surgical (surgical suture) and electrohemostasis with an additional hemostatic component (fibrin glue). Among the selected patients, there were no patients with a single kidney and a pronounced violation of the excretory function of the organ.Results. The groups were comparable in terms of tumor size (р = 0.09), morphometric characteristics according to the R.E.N.A.L. scale (p = 0.07), no differences were found in clinical and morphological staging. The use of electrohemostasis with a hemostatic glue component did not significantly affect at the excretory function of the kidney, assessed on the 3rd and 10th days after laparoscopic non-ischemic resection, which indirectly confirms the functional safety of the tested technique (р >0.05). The groups did not differ significantly in terms of the blood loss, hemotransfusions (р = 0.067), and none of delayed bleeding was found which indicates the reliability of electrohemostasis using an adhesive composition.Conclusion. We proposed a patent “Method of surgical hemostasis in laparoscopic partial nephrectomy” RU2654402C1 by combining bipolar coagulation in the 90 W-effect 7–8 mode and hemostatic fibrin glue (SURGIFLO, PERCLOT). Used adhesive compositions complement the achieved electrohemostasis, and also provide sealing of the area of the resected kidney tissue.
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Huang, William C., Elena B. Elkin, Andrew S. Levey, Thomas L. Jang, and Paul Russo. "Partial Nephrectomy Versus Radical Nephrectomy in Patients With Small Renal Tumors—Is There a Difference in Mortality and Cardiovascular Outcomes?" Journal of Urology 181, no. 1 (2009): 55–62. http://dx.doi.org/10.1016/j.juro.2008.09.017.
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Mehrazin, Reza, Robert G. Uzzo, Alexander Kutikov, et al. "Lymphopenia as an independent predictor of worse survival in papillary renal cell carcinoma." Journal of Clinical Oncology 32, no. 4_suppl (2014): 397. http://dx.doi.org/10.1200/jco.2014.32.4_suppl.397.
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397 Background: Lymphopenia signifies inflammatory response and is an index of poor systemic immunity which can be associated with poor survival outcomes. The aim of this study was to evaluate the prognostic relevance of preoperative absolute lymphocyte count (ALC) in patients with papillary renal cell carcinoma (RCC). Methods: We retrospectively analyzed our institutional, prospectively maintained, renal cancer database and identified patients with pathologic diagnosis of papillary RCC after partial or radical nephrectomy. Patients with preoperative ALC value within 3 months prior to surgery were eligible for the study. ALC of 1,300 cells/µl was used as the cutoff value (our lowest laboratory reference value). We evaluated the correlation between ALC and age, gender, Charlson comorbidity index (CCI), pathologic T stage, nuclear grade, and overall TNM stage. Differences in overall survival (OS) by ALC status were assessed using the log−rank test. Cox proportional hazards modeling was used for multivariable analyses. Results: We identified 314 out of 2,732 patients with a pathologic diagnosis of papillary RCC after partial or radical nephrectomy from 1997 to 2013. Those undergoing multiple surgical procedures (multifocal or bilateral disease) or missing preoperative ALC were excluded from the study. A total 205 patients met inclusion criteria with a median follow up of 37.3 months. As a continuous variable, low absolute lymphocyte count was associated with higher pT stage (p=0.038), TNM stage (p=0.029) and older age (p=0.022). Lymphopenia below 1,300 cells/µl was also associated with pT stage (p=0.008) and TNM stage (p=0.018). On multivariable analysis, independent of stage, older age,and CCI, lymphopenia was associated with inferior overall survival (HR 2.1 [CI 1.1−4.03], p=0.037). Conclusions: In our series of patients with papillary renal cell carcinoma, lymphopenia was associated with lower overall survival independent of stage, age,and charlson comorbidity index. ALC significantly increases the accuracy of already established prognostic factors and can be helpful for patient counseling and design of clinical trials.
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Soper, J. T., L. J. Havrilesky, A. A. Secord, A. Berchuck, and D. L. Clarke-Pearson. "Rectus abdominis myocutaneous flaps for neovaginal reconstruction after radical pelvic surgery." International Journal of Gynecologic Cancer 15, no. 3 (2005): 542–48. http://dx.doi.org/10.1136/ijgc-00009577-200505000-00021.
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The objective of this article is to compare the flap-specific complications associated with vertical (VRAM) and transverse (TRAM) rectus abdominis myocutaneous flap vaginal reconstructions performed during radical pelvic procedures. A retrospective chart review was performed to identify all patients who underwent VRAM and TRAM neovaginal reconstructions performed on the Gynecologic Oncology Service at Duke University Medical Center. Flap-specific complications were compared between the two techniques. From 1988 to 2003, 14 VRAM and 18 TRAM flap neovaginal reconstructions were performed on 32 women during the course of 22 (68%) total pelvic exenterations, 8 (25%) partial exenterations, and 2 (6%) radical vulvovaginectomies. Twenty-eight (88%) patients had been previously treated with radiation therapy or concurrent chemoradiation. Associated procedures included continent urinary conduit in 21 (66%), rectosigmoid reanastomosis in 8 (25%), and intraoperative or postoperative sidewall radiation therapy in 7 (22%) of patients. Overall median survival was 14 months (range: 2-week postoperative death to 65 months), with two (6%) acute postoperative mortalities. Fifteen flap-specific complications occurred in 12 (38%) patients, with no significant differences in flap type. Abdominal wound complications included four (12%) superficial wound separations, while one (3%) patient had a fascial dehiscence associated with complex fistulas that contributed to her death, but no patient developed incisional hernia. One patient each developed >50% flap loss after TRAM and <50% flap loss after VRAM flap, respectively. Four (12%) patients developed vaginal stricture or stenosis, two (6%) required percutaneous drainage of pelvic abscess or hematoma, and two (6%) developed rectovaginal fistula. Univariate analysis revealed a trend for increasing flap loss with body mass index >35 (P = 0.056, Fisher exact two-tailed test), but there were no significant associations with other patient characteristics or flap-specific complications. Thirteen (62%) of 21 patients who survived >12 months reported coitus. Both VRAM and TRAM are reliable techniques for neovaginal reconstructions after radical pelvic surgery and have a similar distribution of flap-specific complications involving the donor and recipient sites.
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Yang, Baoyu, Chunmei Shi, Xiaoyan Lin, Xinli Wang, and Qiang Chen. "Retrospective study on efficacy of a paclitaxel combined with a leucovorin and fluorouracil regimen for advanced gastric cancer." Tumori Journal 105, no. 6 (2018): 509–15. http://dx.doi.org/10.1177/0300891618792481.
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Purpose: To investigate the efficacy of paclitaxel combined with a leucovorin and 5-fluorouracil regimen (PLF regimen; q2w) as neoadjuvant chemotherapy (NCT) for advanced gastric cancer. Methods: A total of 183 patients with advanced gastric cancer who underwent 3 cycles of PLF regimen chemotherapy before surgery and received surgery 2 weeks after chemotherapy were enrolled as a treatment group. A total of 184 patients with advanced gastric cancer and no NCT during the same period were enrolled as the controls and treated with surgery. Both groups underwent a D2 radical gastrectomy and the standard postoperative adjuvant chemotherapy. Results: In the NCT group, there were 19 cases of complete remission, 86 cases of partial remission, 72 cases of stable disease, and 6 cases of progressive disease, with an overall response rate of 57.4%. The R0 resection rate was higher than in the control group (85.2% vs 61.4%, p < .05). In the NCT group, 12 cases of esophagogastric cancer (20.7%) showed complete remission and 32 cases (55.2%) showed partial remission, while 7 cases of distal gastric cancer (5.6%) showed complete remission and 54 cases (43.2%) showed partial remission. Pathologic complete remission was higher for esophagogastric cancer than for distal gastric cancer (20.7% vs 3.2%, p < .05). Differences were found between the NCT and control groups in terms of 1-year, 3-year, and 5-year overall and disease-free survival. Conclusion: The PLF regimen showed good tolerability and a high response rate, especially for esophagogastric cancer. This regimen reduced the tumor size, lowered the tumor stage, and improved the R0 resection rate and survival rate.
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Pikul, Maksym, Axel Heidenreich, Eduard Stakhovsky, et al. "Key parameters that influence surgical strategy in localised kidney cancer." Journal of Clinical Oncology 42, no. 4_suppl (2024): 423. http://dx.doi.org/10.1200/jco.2024.42.4_suppl.423.
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423 Background: The goal of this studywas to select the key factors affecting choice between radical nephrectomy (RN) and partial nephrectomy (PN) for patients with localized RCC based on clinical and nephrometry data. Methods: A special retrospective cohort study was conducted in National Cancer Institute of Ukraine, which results were further validated on patient dataset in urological department of University Clinic of Cologne. The Institutional Review Boards and the local ethics committees of both high-volume centres approved the study. The main nephrometry parameters of tumor location in the kidney were analysed according to the R.E.N.A.L nephrometry score. The remaining functional parenchymal volume (RFPV) was calculated using the special formula. To determine the relationship between the risk of RN or PN, the multivariate predictive modelling method containing 12 parameters was used (Artificial Neural Networks [ANN]). Data validation based on referential centre experience using ROC-curve analysis to detect clinical applicability of the null hypothesis was performed. Results: Based on the analysis, for polary and laterally located tumors, the risk of RN was conditioned only by RFPV. The average critical value of RFPV for polar lesions was X6crit = 58% (in X6 < X6crit, RN was predicted); for lateral tumors - X6crit = 67% (in X6 < X6crit, RN was predicted). For medial location, the risk of RN only depended on the tumor size. Average critical value of the tumor size in the medial location was X7crit = 38 mm (in X7 > X7crit, RN was predicted). Based on the ROC curve comparison, there were no statistically significant differences between the AUCLin_12 and AUCMLP_3 (p = 0.12); thus, the reduced amount of the factor indicators from 12 to 3 did not worsen the model predictive qualities. Designed during primary analysis hypothesis was successfully validated in a referent centre on the cohort of 300 patients. Out of the cohort - 14 (4.6%) patients experienced false positive/negative outcome, which resulted in a radical/partial nephrectomy out of the hypothesis margins. Predictive model is characterized by high sensitivity (95.2%) and specificity (95.4%) in selecting patients for partial nephrectomy. Conclusions: For the polar and lateral tumor locations, the functioning parenchymal volumes of over 58 and 67% respectively serve as PN indications. However, for the medial lesions, the primary PN indication is a tumor size less than 38 mm.
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Mangano, Mario S., Alberto De Gobbi, Francesco Beniamin, Claudio Lamon, Matteo Ciaccia, and Luigino Maccatrozzo. "Robot-assisted nerve-sparing radical prostatectomy using near-infrared fluorescence technology and indocyanine green: initial experience." Urologia Journal 85, no. 1 (2018): 29–31. http://dx.doi.org/10.5301/uj.5000244.
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Introduction: Indocyanine green (ICG) is a fluorescent molecule that provokes detectable photon emission. The use of ICG with near-infrared (NIR) imaging system (Akorn, Lake Forest, IL) has been described during robotic partial nephrectomy (RAPN) as an adjunctive means of identifying renal artery and parenchymal perfusion. We propose the use of the ICG with NIR fluorescence during laparoscopic robot-assisted radical prostatectomy (RARP), to identify the benchmark artery improving the preservation of neurovascular bundle and to improve the visualization of the vascularization and then the hemostasis. Methods: From April 2015 to February 2016, 62 patients underwent to RARP in our Urology Unit. In 26 consecutive patients, in the attempt to have a better visualization of neurovascular bundles, we used to inject ICG during the procedure. We evaluated the percentage of identification of neurovascular bundles using NIR fluorescence. Then, we evaluated complications related to injection of ICG and operative time differences between RARP with and without ICG injection performed by the same surgeons. Results: We identified prostatic arteries and neurovascular bundles using NIR fluorescence technology in all patients (100%). There was not any increase in the operative time compared with RARP without ICG injection performed by the same surgeons. Complications related to injection of ICG did not occurred. Conclusions: In our experience, even if on a limited number of patients, the application of ICG with NIR fluorescence during RARP is helpful to identify the benchmark artery of neurovascular bundle.