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Vamesu S, Ursica OA, Milea SE, Deacu M, Aschie M, Mitroi AF, Voinea F, Pundiche MB, Orasanu CI, Voda RI. Same Organ, Two Cancers: Complete Analysis of Renal Cell Carcinomas and Upper Tract Urothelial Carcinomas. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1126. [PMID: 39064555 PMCID: PMC11279004 DOI: 10.3390/medicina60071126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Revised: 07/06/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024]
Abstract
Background and Objectives: Renal cell carcinomas and upper tract urothelial carcinomas are types of malignancies that originate in the kidneys. Each of these examples shows an increasing trend in the frequency and the mortality rate. This study aims to comprehensively define carcinomas by analyzing clinical, paraclinical, and histological aspects to predict aggressiveness and mortality. Materials and Methods: We conducted a retrospective investigation on a group of patients suspected of kidney cancers. Results: We identified 188 cases. We observed a higher mortality rate and older age in individuals with urothelial carcinomas. Anemia, acute kidney injury, hematuria, and perineural invasion were the main risk factors that predicted their mortality. Tumor size in renal cell carcinomas correlates with the presence of necrosis and sarcomatoid areas. Factors that indicate a higher rate of death are older age, exceeding the renal capsule, a lesion that includes the entire kidney, lymphovascular invasion, acute kidney injury, and anemia. Conclusions: Even if they originate at the renal level, and the clinical-paraclinical picture is similar, the histopathological characteristics make the difference. In addition, to these are added the previously mentioned common parameters that can represent important prognostic factors. In conclusion, the characteristics commonly identified in one type of cancer may act as risk factors for the other tumor. The detected data include threshold values and risk factors, making a significant contribution to the existing literature.
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Affiliation(s)
- Sorin Vamesu
- Clinical Service of Pathology, Departments of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania
| | - Oana Andreea Ursica
- Clinical Service of Pathology, Departments of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania
| | - Serban Eduard Milea
- Clinical Service of Pathology, Departments of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania
| | - Mariana Deacu
- Clinical Service of Pathology, Departments of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania
| | - Mariana Aschie
- Clinical Service of Pathology, Departments of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania
- Department of Anatomy, Academy of Medical Sciences of Romania, 030171 Bucharest, Romania
- Department of Medical Sciences, The Romanian Academy of Scientists, 030167 Bucharest, Romania
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology (CEDMOG), “Ovidius” University of Constanta, 900591 Constanta, Romania
| | - Anca Florentina Mitroi
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology (CEDMOG), “Ovidius” University of Constanta, 900591 Constanta, Romania
- Clinical Service of Pathology, Departments of Genetics, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania
| | - Felix Voinea
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania
- Urology Clinical Department, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania
| | - Mihaela Butcaru Pundiche
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania
- Clinical Department of General Surgery, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania
| | - Cristian Ionut Orasanu
- Clinical Service of Pathology, Departments of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology (CEDMOG), “Ovidius” University of Constanta, 900591 Constanta, Romania
| | - Raluca Ioana Voda
- Clinical Service of Pathology, Departments of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology (CEDMOG), “Ovidius” University of Constanta, 900591 Constanta, Romania
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Li S, Chen X, Zheng J, Liu X. Reduced Preoperative Glomerular Filtration Rate Is Associated With Adverse Postoperative Oncological Prognosis in Patients Undergoing Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma: A Retrospective Cohort Study. Front Surg 2022; 9:872273. [PMID: 35548184 PMCID: PMC9082599 DOI: 10.3389/fsurg.2022.872273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 03/30/2022] [Indexed: 11/13/2022] Open
Abstract
Objective To evaluate the association between perioperative estimated glomerular filtration rate (eGFR) and postoperative oncological outcomes in patients with upper tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy (RNU),and to evaluate the effect of sex on this association. Methods The medical records of patients with UTUC who underwent RNU between January 2012 and December 2017 at our hospital were retrospectively reviewed. Patients were divided into three groups based on preoperative eGFRs: normal eGFR (>60 mL/min/1.73 m2; n = 179), moderately reduced eGFR (45-60 mL/min/1.73 m2; n = 45), and severely reduced eGFR (≤ 45 mL/min/1.73 m2; n = 36). Statistical analyses were performed to evaluate the prognostic impact of preoperative eGFR on prognosis. Results Patient mean age was 66.7 ± 9.6 years, and 47.9% were female. Multivariate regression analysis based on Cox proportional risk models and Kaplan-Meier survival rates showed that lower preoperative eGFR was associated with decreased OS, PFS, and CSS. In the adjusted Cox regression model, patients with normal and moderately reduced eGFRs had a decreased hazard for mortality, with adjusted hazard ratios of 0.13 [95% confidence interval (CI): 0.07-0.26] and 0.36 (95% CI: 0.18-0.73), respectively (P < 0.001). The smooth fitting curve suggested a linear relationship between eGFR and prognostic survival. Additionally, sensitivity subgroup analyses verified an inverse relationship between the reduced eGFR and OS. Women had a lower eGFR and worse oncological outcomes than men. A nomogram for OS was developed based on multivariate analysis with a C-index of 0.754 (95% CI: 0.728-0.779). Conclusion Preoperative renal insufficiency is strongly associated with a higher risk of cancer progression and a lower survival probability. It is important to identify preoperative renal insufficiency in patients with UTUC, particularly female patients.
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Affiliation(s)
| | | | | | - Xuefeng Liu
- Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China
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Tan C, Jiang Y, Song S, Li X, Zhou C. Therapeutic effects of flexible ureteroscopy alone and in combination with external physical vibration on upper urinary tract calculi: a randomized controlled trial. Wideochir Inne Tech Maloinwazyjne 2021; 16:536-542. [PMID: 34691303 PMCID: PMC8512516 DOI: 10.5114/wiitm.2021.106425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 04/25/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Upper urinary tract calculus is a common disease of the urinary system. AIM To compare the therapeutic effects of flexible ureteroscopy alone and in combination with external physical vibration on upper urinary tract calculi. MATERIAL AND METHODS A total of 146 patients were randomly divided into control and experimental groups (n = 73). The control group received flexible ureteroscopy lithotripsy, and the experimental group underwent the same but combined with external physical vibration. The rate of finding stones in the urine on the day after treatment, clearance rate, components of stones, levels of renal function indices blood urea nitrogen (BUN) and serum creatinine (Scr), and incidence of complications were compared. The stone-free rate during 1-year follow-up was analysed by Kaplan-Meier method. RESULTS The rate of finding stones in the urine on the day after treatment was higher in the experimental group (100%) than that in the control group (29.73%) (p < 0.05). The clearance rates on the day, at 1 week, and at 2 weeks after treatment in the experimental group were 71.23%, 87.67%, and 95.89%, respectively, which surpassed those of the control group at corresponding time points (p < 0.05). BUN and Scr levels decreased after treatment in both groups, especially in the experimental group (p < 0.05). The stone-free rate during 1-year follow-up in the experimental group (n = 71 (97.26%)) exceeded that of the control group (n = 61 (83.56%)) (p < 0.05). CONCLUSIONS External physical vibration combined with flexible ureteroscopy lithotripsy significantly increased the rate of finding stones in the urine the day after treatment, the clearance rate of upper urinary tract calculi, and the ameliorated renal function and reduced the stone re-formation rate.
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Affiliation(s)
- Cheng Tan
- Medical Examination Centre, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, Zhejiang Province, China
| | - Yongbao Jiang
- Medical Examination Centre, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, Zhejiang Province, China
| | - Shanshan Song
- Department of Urology, Ningbo Urology and Nephrology Hospital, Ningbo University, Ningbo, Zhejiang Province, China
| | - Xiaoge Li
- Department of Urology, Ningbo Urology and Nephrology Hospital, Ningbo University, Ningbo, Zhejiang Province, China
| | - Chunliang Zhou
- Ningbo University of Finance and Economics, Ningbo, Zhejiang Province, China
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