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Nephrectomy
About: Nephrectomy is a research topic. Over the lifetime, 24266 publications have been published within this topic receiving 443004 citations.
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TL;DR: Nephrectomy followed by interferon therapy results in longer survival among patients with metastatic renal-cell cancer than does interferons therapy alone.
Abstract: Background The value of nephrectomy in metastatic renal-cell cancer has long been debated. Several nonrandomized studies suggest a higher rate of response to systemic therapy and longer survival in patients who have undergone nephrectomy. Methods We randomly assigned patients with metastatic renal-cell cancer who were acceptable candidates for nephrectomy to undergo radical nephrectomy followed by therapy with interferon alfa-2b or to receive interferon alfa-2b therapy alone. The primary end point was survival, and the secondary end point was a response of the tumor to treatment. Results The median survival of 120 eligible patients assigned to surgery followed by interferon was 11.1 months, and among the 121 eligible patients assigned to interferon alone it was 8.1 months (P=0.05). The difference in median survival between the two groups was independent of performance status, metastatic site, and the presence or absence of a measurable metastatic lesion. Conclusions Nephrectomy followed by interferon ther...
1,547 citations
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TL;DR: The effectiveness of immunotherapy, although previously widely used for treatment of metastatic renal cell carcinoma, is still controversial, and is mainly reserved for patients with good prognostic factors as discussed by the authors.
1,442 citations
TL;DR: Radical nephrectomy is a significant risk factor for the development of chronic kidney disease and might no longer be regarded as the gold standard treatment for small, renal cortical tumours.
Abstract: Summary Background Chronic kidney disease is a graded and independent risk factor for substantial comorbidity and death. We aimed to examine new onset of chronic kidney disease in patients with small, renal cortical tumours undergoing radical or partial nephrectomy. Methods We did a retrospective cohort study of 662 patients with a normal concentration of serum creatinine and two healthy kidneys undergoing elective partial or radical nephrectomy for a solitary, renal cortical tumour (≤4 cm) between 1989 and 2005 at a referral cancer centre. Glomerular filtration rate (GFR) was estimated with the abbreviated Modification in Diet and Renal Disease Study equation. Separate analysis was undertaken, with chronic kidney disease defined as GFR lower than 60 mL/min per 1·73 m 2 and GFR lower than 45 mL/min per 1·73 m 2 . Findings 171 (26%) patients had pre-existing chronic kidney disease before surgery. After surgery, the 3-year probability of freedom from new onset of GFR lower than 60 mL/min per 1·73 m 2 was 80% (95% CI 73–85) after partial nephrectomy and 35% (28–43; p 2 were 95% (91–98) and 64% (56–70; p 2 (hazard ratio 3·82 [95% CI 2·75–5·32]) and 45 mL/min per 1·73 m 2 (11·8 [6·24–22·4]; both p Interpretation Because the baseline kidney function of patients with renal cortical tumours is lower than previously thought, accurate assessment of kidney function is essential before surgery. Radical nephrectomy is a significant risk factor for the development of chronic kidney disease and might no longer be regarded as the gold standard treatment for small, renal cortical tumours.
1,422 citations
TL;DR: A tumor-bearing right kidney was completely excised from an 85-year-old woman using a Laparoscopic approach using a newly devised method for intra-abdominal organ entrapment and a recently developed laparoscopic tissue morcellator.
1,344 citations
TL;DR: Radical nephrectomy done before interferon-alfa-based immunotherapy might substantially delay time to progression and improve survival of patients with metastatic renal cell carcinoma who present with good performance status.
1,277 citations