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- Lundstam, Sven, 1944, et al.
(författare)
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Expansiva processer i njurarna.
- 2012
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Ingår i: Urologi 2ed. eds: Damber JE, Peeker R.. - Lund, Sverige : Lund: Studentlitteratur. - 9789144075921 ; , s. 149-172
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 2. |
- Lyrdal, David, 1965, et al.
(författare)
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Kidney cancer in Sweden: A decrease in incidence and tumour stage, 1979 - 2001.
- 2013
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Ingår i: Scandinavian journal of urology. - : Informa UK Limited. - 2168-1813 .- 2168-1805. ; 47:4, s. 302-310
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Objective. In the Western world the incidence of renal cell carcinoma (RCC) has been increasing for several decades. In Sweden the incidence has decreased since 1980. This may reflect better health of the population. Another possible explanation could be a decrease in incidentally diagnosed RCC. Since these tumours are smaller, relatively more advanced tumours would then enter the cancer registry. The aim of this study was to compare methods of detection of RCC, tumour characteristics and survival from three periods over a timespan of more than 20 years. Material and methods. Adult patients (n = 515) with RCC were identified in a well-defined population-based area with the same incidence of RCC as the rest of Sweden. Patient data from three periods, 1979 - 1981 (A), 1989 - 1991 (B) and 1999 - 2001 (C), were collected for gender, age, tumour side, method of detection, tumour size, tumour type, metastasis, T stage and Fuhrman grade at the time of diagnosis. Using the Swedish Cause-of-Death Register, cause-specific survival was calculated. When available, tissue was reanalysed according to modern standards by an experienced pathologist. Results.The frequency of ultrasound and computed tomography increased and autopsy and intravenous pyelography decreased with time as the first detection method. There was a significant change towards smaller tumours and less severe stages and grades in more recent periods. Metastatic disease was most common in the first period. The distribution between the different histological tumour types did not change over time. Five-year cause-specific survival increased significantly from 41% to 63%. Subgroup analysis found significantly increased survival for patients with no metastases or with low-grade tumours. Conclusion. The data support a true decrease in the incidence of RCC over time in Sweden with a migration towards lower tumour stages but no change in distribution between the different histological subtypes over time.
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| 3. |
- Lyrdal, David, 1965, et al.
(författare)
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Ultrasound-guided percutaneous radiofrequency ablation of small renal tumors: Clinical results and radiological evolution during follow-up
- 2010
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Ingår i: Acta Radiologica. - : SAGE Publications. - 0284-1851 .- 1600-0455. ; 51:7, s. 808-818
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Tidskriftsartikel (refereegranskat)abstract
- Background: Treatment of small renal masses with percutaneous radiofrequency ablation (RFA) is under development. Data are limited regarding the oncologic efficacy and complication rates of ultrasound (US)-guided RFA. Purpose: To retrospectively analyze results and factors predictive of incomplete ablation and local recurrence in patients treated for small renal tumors with US-guided percutaneous RFA. Material and Methods: Forty-one consecutive patients (27 males), mean 70 (40–86) years, with 44 tumors were included. Core biopsies were obtained before treatment. Follow-up was performed with CT or MRI. Tumor diameter, tumor volume, volume of the ablation zone, necrosis index, tumor location, distance from tumor to skin, and BMI were analyzed. Results: Biopsies showed malignancy in 72%, 10% were benign, and 18% were inconclusive. Thirty-six tumors (82%) were completely ablated after first RFA and 40 tumors (91%) after a second treatment. Mean follow-up was 27 months. Nine completely ablated tumors (23%) showed local recurrence during follow-up, six of them were retreated. Tumor size was significantly larger and mean necrosis index lower in tumors with incomplete ablation compared with those completely ablated initially. In tumors <30 mm, the initial complete ablation rate was 93% and the local recurrence rate during follow-up was 16% (4/25). Conclusion: US guidance is feasible for RFA of small renal tumors. However, thorough long-term follow-up appears mandatory, as a substantial proportion of the patients will develop late local recurrence and will need more than one RFA treatment session. Large tumor diameter and volume and a low necrosis index were predictive indicators of incomplete ablation after the first treatment.
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