Recurrence rates and survival in a Danish cohort with renal cell carcinoma.

INTRODUCTION: Patients with localised and locally advanced renal cancer experience about 20% recurrence during a five-year follow-up period. The aim of the present study was to report recurrence rates and survival in a Danish population with renal cancer. METHODS: Data on patients diagnosed with renal cell carcinoma (RCC) at our institute from January 2005 to December 2013 were collected retrospectively. RESULTS: Overall, 367 patients were diagnosed with RCC during the period, and 78 patients (21%) presented with metastasis. The mean follow-up period for all patients was 41 months (standard deviation = 29, 95% confidence interval: 38-44). The total recurrence rates (RRs) at one, three and five years were 4.5%, 13.5% and 22.3%, respectively. Overall survival rates in the patients who underwent surgery with localised and locally advanced disease were 96.1%, 88.2% and 78.3% for one, three and five years, respectively. The mean time to first recurrence was 26.6 months. The one-year RR was 1.2%, 5.5% and 13.8% for low, intermediate and high-risk Leibovich scores, respectively. The three-year RR was 8.3%, 14.1% and 29.6% for low, intermediate and high-risk Leibovich scores, respectively; and the five-year RR was 12.0%, 26.6% and 52.9% for low, intermediate and high-risk Leibovich scores, respectively. CONCLUSIONS: RRs after localised and locally advanced RCC was 22%. According to the risk of recurrence, we recommend a follow-up programme after nephrectomy with computed tomography every second year for low-risk patients, annually for intermediate-risk patients and every six months for high-risk patients. FUNDING: none. TRIAL REGISTRATION: none.

Do the different types of renal surgery impact the quality of life in the postoperative period?

PURPOSE: Because more than 70 % of patients with localized tumors experience 10 years of cancer-specific survival, their quality of life (QoL) after surgery is important. The aim of this study was to explore the impact of the type of surgery (partial vs. total nephrectomy) and the postoperative outcome on the QoL of patients with renal cancer. METHODS: A total of 205 patients underwent partial or total nephrectomy at the Department of Urology, Roskilde Hospital, between February 2008 and June 2013 and survived until the time of the survey. The European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire 30 (EORTC QLQ-C30) was sent to this cohort in January 2014. RESULTS: The response rate was 74.1 % for complete answers. The overall global health status (QoL) was low (69.12 %) for all patient groups, regardless of the operation technique and the underlying medical status. Total nephrectomy was a negative predictor of QoL, physical functioning, role functioning, and fatigue. Patients who experienced recurrence reported significant deterioration in 11 of the 15 EORTC QLQ-C30 domains. Additionally, thinking about cancer only during the follow-up visit was associated with a significant decrease in emotional functioning and role functioning compared with never thinking about one's cancer. CONCLUSION: Total nephrectomy was a negative predictor of overall global health status. There is a demand for a reasonable follow-up program with an individual control interval according to the risk of recurrence and the possibility of treatment as well as the patient's discretion.

[Primary omental actinomycosis]. / Primær aktinomykose i omentum majus.

We report a case of omental actinomycosis in a female patient with an intrauterine device. A computed tomography had shown an inflammatory tumour in the abdomen. The patient was treated with laparoscopic resection of the tumour and prolonged antibiotic therapy. Abdominal actinomycosis should be considered as a differential diagnosis in patients with abdominal symptoms and unspecific clinical, radiological and laboratory findings. Definitive diagnosis of actinomycosis requires histological examination of affected tissue. Laparoscopic resection seems feasible as an alternative to open surgery.