ABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinicopathological features and prognosis of chromophobe renal cell carcinoma (ChRCC).</p><p><b>METHODS</b>The clinical data of 68 ChRCC cases treated in our department between January 2003 and September 2010 were collected and retrospectively analyzed. The prognostic factors were evaluated by Log-rank test. Kaplan-Meier survival curve was used to estimate the survival rate.</p><p><b>RESULTS</b>Fifty cases were treated with radical nephrectomy and 18 with partial nephrectomy. The mean tumor size was 5.7 cm (1.5 - 16.0 cm). The TNM stages were as follows: pT1aN0M0 in 25, pT1bN0M0 in 22, pT2aN0M0 in 9, pT2bN0M0 in 5, and pT3aN0M0 in 7. According to the Fuhrman grading system, 8 patients were classified as grade I, 42 cases were grade II, 14 cases were grade III, and 4 cases were grade IV. The 3-year and 5-year survival rates were 93.0% and 90.0%, respectively. The log-rank test showed that tumor size (> 7 cm vs. ≤ 7 cm) (P = 0.004), TNM stage (T1-2 vs. T3-4) (P = 0.008) and urinary collecting system invasion (P = 0.024) were associated with survival time. The multivariable Cox regression model revealed that tumor size (> 7 cm vs. ≤ 7 cm) was an independent predictor of aggressive ChRCC (P = 0.038).</p><p><b>CONCLUSIONS</b>ChRCC is a distinct type of renal cell carcinoma exhibiting a low degree of malignancy. Most tumors are larger, but predominantly with a favorable prognosis. Fuhrman nuclear grading is not suitable for ChRCC. Tumor size (> 7 cm vs. ≤ 7 cm) is an independent predictor of prognosis of ChRCC.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Carcinoma, Renal Cell , Pathology , General Surgery , Follow-Up Studies , Kidney Neoplasms , Pathology , General Surgery , Neoplasm Staging , Nephrectomy , Methods , Proportional Hazards Models , Retrospective Studies , Survival Rate , Tumor BurdenABSTRACT
Objective To evaluate the effcacy and side effects of [~(90)Y-1,4,7,10-tetraazacyclododecane-N,N',N",N'"-tetraacetic acid (DOTA)~0,Tyr3]octreotate (~(90)Y-DOTATATE) combined with lysine as a renal protective agent.Methods Twenty-five patients with advanced neuroendocrine tumors were confirmed as somatostatin receptor subtype-2 (SSTR2)-positive by somatostatin receptor scintigraphy (SRS).Each patient received 1-5 cycles of treatment and the interval between two cycles of treatment was 6-9 weeks.~(90)Y-DOTATATE was administered intravenously within 30 min.Lysine was injected before and after the administration of ~(90)Y-DOTATATE.After each treatment cycle.the side effects were assessed according to National Cancer Institute Grading Criteria(NCIGC).The etticacy was evaluated by the WHO criteria 8 weeks after the last treatment.Results Pattial remission was found in 1 patient (4%).minor response in 3 patients(12%),stable disease in 16 patients (64%)and tumor progression in 5 patients (20%).Two patients suffered from renal functional injuries and 3 patients developed leukocytopenia.Three patients showed nausea while another 3 patients presented vomiting.Conclusions ~(90)Y-DOTATATE in association with lysine may be a promising treatment method for the patients with metastatic and inoperable neuroendocrine tumors.More research work may be directed to reduce renal injury.
ABSTRACT
<p><b>OBJECTIVE</b>To compare three different surgical approaches to varicocelectomy.</p><p><b>METHODS</b>Eighty-eight cases of varicocelectomy performed in our hospital between January 2006 and January 2008 were divided into an retroperitoneal high ligation group (n = 44), a laparoscopy group (n = 12) and a microsurgery group (n = 32), and retrospectively analyzed for postoperative semen quality, recurrence, early complications, hospital stay, and medical cost.</p><p><b>RESULTS</b>The rates of semen quality improvement were 56.52% (13/23), 66.67% (4/6) and 78.26% (18/23) , the rates of recurrence were 25% (8/32), 22.22% (2/9) and 7.41% (2/27), and the medical costs were RMB yen (1984 +/- 126), (8576 +/- 547) and (2159 +/- 298), respectively, in the retroperitoneal high ligation, laparoscopy and microsurgery groups (P < 0.05). None experienced serious early complications.</p><p><b>CONCLUSION</b>Microsurgery is obviously superior to retroperitoneal high ligation and laparoscopic approaches in improving semen quality and preventing postoperative recurrence, and, with its advantages of minor invasiveness and quick recovery, is preferred by most patients. Laparoscopy, however, ranks highest in medical cost.</p>