| 1. |
- Forsberg, Annika Mandahl, et al.
(author)
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Open partial nephrectomy for renal cell cancer in a medium patient volume centre: Is high quality possible?
- 2010
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In: Scandinavian Journal of Urology and Nephrology. - : Informa UK Limited. - 1651-2065 .- 0036-5599. ; 44, s. 204-211
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Journal article (peer-reviewed)abstract
- Abstract Objective. To describe the surgical complication rate of open partial nephrectomy (OPN) in patients with renal tumours, and to report the oncological long-term outcome in unilateral renal cell cancer patients subjected to this procedure, from a medium patient volume urological centre. Material and methods. Data from all patients (n = 89) subjected to OPN for proven or suspected renal cell cancer during the period 1965-2007 were registered in a specifically designed database system. Tumour stage and size, surgical margin, histology, perioperative and postoperative complications were analysed in all patients. In addition, long-term follow-up outcomes in malignant unilateral tumours (n = 51) were analysed. Results. Seventy-four of the resected tumours were malignant. Six of these had a positive surgical margin; five from patients with multifocal or bilateral tumours and one from a patient with a solitary malignant cyst. Perioperative complications were registered in only one case (1%). Postoperative complications (within 30 days postoperatively) reached 18%. The long-term follow-up (mean 79 months, median 49 months, range 14 months to 26 years) in patients with unilateral malignant tumours, all staged T1-T2, revealed two systemic recurrences, both in patients with poor prognostic markers at the time of surgery, but no local recurrence. Conclusions. OPN has complication rates similar to open radical nephrectomy. Long-term tumour control in unilateral cases and with organ confined disease is excellent. The results demonstrate that carefully performed OPN at a medium-volume centre can achieve equal results to high-volume centres.
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| 2. |
- Ljungberg, Börje, et al.
(author)
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Nephron Sparing Surgery Associated With Better Survival Than Radical Nephrectomy in Patients Treated for Unforeseen Benign Renal Tumors
- 2016
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In: Urology. - : Elsevier BV. - 0090-4295 .- 1527-9995. ; 93, s. 117-121
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Journal article (peer-reviewed)abstract
- Objective: To evaluate the role of the surgical technique used for the treatment of benign renal tumors, with regard to renal function and overall survival (OS) in patients without cancer-related mortality.Patients and methods: The study included 506 patients, mean age of 63.3 years, with histologically proven benign renal lesions originating from 5 European centers. Retrospective data from each hospital were retrieved and merged into a common database for analyses. OS, American Society of Anesthesiology score, and renal functions were measured in relation to surgical technique. The Mann-Witney U-test, the paired t-test, and Cox's multivariate analysis were used.Results: Patients treated with radical nephrectomy had significantly reduced renal function postoperatively compared with nephron sparing surgery (NSS). OS was significantly reduced after radical nephrectomy compared with NSS (P = .012), a survival difference that remained significant [hazard ratio (HR) 0.042, 95% confidence interval (CI) 0.221-0.972, P = .042] in multivariate analysis, together with age at diagnosis (HR 1.065, 95% CI 1.026-1.106, P = .001) and American Society of Anesthesiology score (HR 2.361, 95% CI 1.261-4.419, P = .007). Also renal function assessed by estimated glomerular filtration rate significantly correlated to survival in univariate analysis, but did not remain independent after multivariate analysis. Oncocytoma was the most frequent benign lesion, followed by angiomyolipoma.Conclusion: The present study in patients with benign renal tumors shows that the remaining renal function and OS correspond to the choice of surgical procedure. Our results support the recommendation to perform NSS whenever possible when surgery is performed for patients with renal masses. The limitations of the study are the retrospective design and the selection bias for the surgical approach.
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| 3. |
- Ljungberg, Börje, et al.
(author)
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Untitled
- 2016
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In: Urology. - : Elsevier BV. - 0090-4295 .- 1527-9995. ; 93, s. 122-123
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Journal article (other academic/artistic)
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| 4. |
- Pålsson, Birger, et al.
(author)
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Partial splenic embolization: long-term outcome.
- 2003
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In: Langenbeck's Archives of Surgery. - : Springer Science and Business Media LLC. - 1435-2451 .- 1435-2443. ; 387:11-12, s. 421-426
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Journal article (peer-reviewed)
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