Paul Russo

..Widespread education and training in kidney preserving surgical strategies is essential going forward...

..Despite these important advances in understanding, which support the use of partial nephrectomy for the treatment of small renal masses, the technique remains underused...

..73m2, a level of significant CKD, is 95% after PN, but only 64% after RN. RN should be reserved for patients with massive renal tumors in whom PN is not an option. Increased training in PN and its wider application is essential...

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..Once effective systemic agents are developed, both metastasectomy and cytoreductive nephrectomy will play greater roles in consolidating clinical responses...

..Despite these advances, the prognosis for patients with metastatic RCC is poor. Studies that examine combinations of surgery and systemic therapy aim to improve survival in this high-risk group...

..The overzealous use of radical nephrectomy for small renal tumors must now be considered detrimental to the long-term health and safety of the patient with a small renal cortical tumor...

..This surgical experience provides a contemporary foundation as new targeted therapeutic agents are integrated into the neoadjuvant or adjuvant treatment of locally advanced and metastatic renal cancer...

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..To describe the rationale for expanding the role of partial nephrectomy in the treatment of renal cortical tumors...

..We report preliminary results of partial nephrectomy for renal tumors of > or =4 cm in 39 patients with the intent of extending the indications for kidney-sparing surgery...

..To provide the clinical evidence and benefits of performing partial nephrectomy for renal tumors greater than 4 cm...

..Whether these new approaches to localized renal tumors will supplement or replace current surgical techniques will depend on the findings of carefully designed and controlled clinical trials...

..We review a 10-year Memorial Sloan-Kettering Cancer Center experience with urinary diversion in this setting...

..In this article, the optimum approach to the surgical management of localized renal tumors and its impact on renal function are discussed...

..Perioperative complications are substantial, with urinary incontinence rates of 40% to 50% and rectal injury rates of 10% to 15%. Long-term disease-free survival rates of 30% to 40% can be expected...

..We present our experience with renal cell carcinoma. We evaluated the association between tumor size and the metastasis risk in a large patient cohort...

..Gemcitabine plus cisplatin (GC) has similar efficacy and less toxicity than MVAC in metastatic disease, but is untested as neoadjuvant treatment...

..We evaluated our experience with renal cortical tumors to determine whether tumor size is associated with malignant histology and/or nuclear grade...

..We analyzed characteristics in patients with recurrent renal cell carcinoma 5 years or later after nephrectomy and determined predictors of survival after recurrence...

..CONCLUSIONS: This study demonstrates that a history of BTCC (invasive or superficial) has an adverse effect on the prognosis of patients diagnosed with UTTCC independent of primary tumor stage...

..We reviewed our experience with young patients with renal cell carcinoma and compared them to their older counterparts...

..When complications were sustained, patients were less likely to receive systemic therapy in a timely fashion. These observations may influence the timing or patient selection for surgery or systemic therapy...

..CONCLUSION: At disease recurrence after nephrectomy for localized disease, a scoring system based on objective clinical and laboratory data provides meaningful risk stratification for both patient counseling and clinical trial entry...

..Sarcomatoid variant is a spindle cell phenotype of renal cell carcinoma (RCC), which is associated with a poor prognosis. We reviewed outcomes of systemic therapy for metastatic, sarcomatoid-variant RCC...

..CONCLUSIONS: In highly selected patients with invasive bladder cancer, partial cystectomy offers acceptable outcomes. Concomitant CIS and presence of metastases to regional lymph nodes predict advanced recurrence...

..Further understanding of the genetics and molecular biology and subtypes involved may provide the basis for more effective agents. Treatment with targeted therapies or other experimental agents is warranted...

..We evaluated the prognostic roles of metastasectomy and an established risk stratification system in patients with disease recurrence following nephrectomy for nonmetastatic renal cell carcinoma...

..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...

..Both extent and patterns must be considered for a definitive diagnosis...

..Knowledge of renal cortical tumor histological subtype is critical for projecting prognosis, tailoring follow-up strategies, and designing clinical trials...

..On the basis of this long follow-up on a large number of cases, chromophobes seem to have better clinical outcomes than those reported for clear cell and papillary RCCs...

..This nomogram may be useful for patient counseling, clinical trial design and effective patient followup strategies...

..The aim of this phase II study was to determine the efficacy of gemcitabine administered as an intravesical agent in patients with bacille Calmette-Guérin (BCG) -refractory transitional cell carcinoma of the bladder...

..We determined if the association of age and perioperative outcomes differed between nephrectomy types...

..A unifying feature of these malignancies is their aggressive course and poor outcome with standard chemotherapeutic regimens. Given the rarity of these tumors, no prospective data are available to guide management...

..We combine data from 2 tertiary care intuitions, and report predictors of positive surgical margins and long-term oncological outcomes for patients with positive surgical margins...

..To evaluate intravenous mannitol during minimally invasive partial nephrectomy (PN) by comparing the renal function outcomes of the patients who received it versus those who did not...

..Indications for partial nephrectomy (PN) in the treatment of renal cell carcinoma are evolving, particularly for larger, more complex tumors...

..Therefore, similar to the clone M75, NB100-417 can be used as a diagnostic and potentially a prognostic marker in CRCC, with the advantage of its commercial availability...

..Although oncologic outcomes appear to be similar after laparoscopic partial nephrectomy (LPN) and open partial nephrectomy (OPN), data on renal function are lacking...

..To investigate whether the presence and degree of peritumoral vascularity may provide any diagnostic information regarding the histological subtypes of renal tumors...

..Toxicities included fatigue, hyperglycemia, dyspnea, and myelosuppression with decreased hemoglobin, lymphopenia, and neutropenia. Lenalidomide is tolerable, but no objective responses were observed in this clinical trial...

..It may be reasonable to target RCC patients displaying altered bcl-2 levels for molecular therapies, such as anti-bcl2, should metastatic disease develop...

..13). CONCLUSIONS: A significant number (16.4%) of benign lesions less than 7 cm in radiological diameter were operated on based on suspicious preoperative imaging. Women had almost twice the likelihood of having a benign lesion...

..To examine the effect of radical nephrectomy (RN) with adjacent organ and structure resection on survival, as invasion of adjacent organs in patients with renal cell carcinoma (RCC) is rare...

..To describe survival in previously treated patients with metastatic renal cell carcinoma (RCC) who are candidates for clinical trials of new agents as second-line therapy...

..To investigate the use of quantitative multiphasic contrast material-enhanced magnetic resonance (MR) imaging in differentiating between common benign and malignant histologic subtypes of renal cortical tumors...

..Thromboembolic events are rare but are more likely to occur in patients with coronary artery disease, cardiac arrhythmia, prior DVT, Stage 3 or 4 tumors, or a large estimated blood loss...

..The objective of this study was to evaluate the feasibility and survival impact of adjuvant, sequential chemotherapy in patients with high-risk UC...

..We describe our experience with renal oncocytosis, focusing on management and outcomes...

..To evaluate the effect of baseline renal function and comorbidity index on survival in patients with renal tumors...

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..We evaluated survival in patients with 4 to 7 cm renal tumors in a bi-institutional collaboration...

..Longer clamping time is particularly detrimental in patients with a solitary kidney but it does not appear to influence long-term renal function. Patients of advanced age may be less likely to recover from acute ischemic renal injury...

..To report on the contemporary Memorial Sloan-Kettering Cancer Center experience with radical nephrectomy and vena caval thrombectomy...

..We developed a predictive model that could be used in the preoperative setting...

..The use of partial nephrectomy for renal cortical tumors appears unacceptably low in the United States according to population based data. We examined the use of partial nephrectomy at our tertiary care facility in the contemporary era...

..At the dose and schedule used in this trial, the lack of antitumor activity associated with ZD1839 does not support further study in patients with metastatic RCC...

..In this study, the efficacy and toxicity of pegylated IFN was assessed in patients with metastatic renal cell carcinoma (mRCC)...

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..The presence of synchronous metastasis and nonoperative therapy are related to these low survival rates. However, if there is no metastatic disease, complete surgical resection of LRs is associated with improved survival...

..We evaluated our experience with tumor histology in patients with localized renal cell carcinoma...

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..To evaluate the difference between radiographic size on computed tomography (CT) and the pathological size of renal tumours, in contemporary patients...

..Efforts to identify the molecular profile associated with clinical response or combination therapy with interferon alfa or other novel agents, may be considered...

..Conventional clear cell histology was the most common histologic subtype; concordance among tumors was found to be 76%. DFS rates comparable to those of unilateral tumors can be obtained by using combinations of PN and RN...

..We determined the prognostic significance of renal vein or inferior vena caval (IVC) extension in patients with nonmetastatic renal cell carcinoma (RCC) or oncocytoma undergoing surgery...

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..To study the effect of central tumor location on the glomerular filtration rate (GFR) after partial nephrectomy for renal cortical tumor...

..We aimed to assess whether iodine-124-labelled antibody chimeric G250 ((124)I-cG250) PET predicts clear-cell renal carcinoma, the most common and aggressive renal tumour...

..The nomogram may be useful for patient counseling, clinical trial design and patient followup planning...

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..To retrospectively determine if solid renal cortical tumors can be differentiated on computed tomographic (CT) images on the basis of their morphologic features and enhancement patterns...

..The purpose of this review is to familiarize the reader with the known heritable forms of kidney cancer, the recent advances in the field and their impact on patient management...

..Previous small series have suggested a prognostic benefit for incidental presentation. This study utilizes a large contemporary patient cohort to examine patterns of RCC presentation and their clinical implications...

..The aim of this phase I study was to determine the safety and toxicity profile of gemcitabine administered as an intravesical agent in patients with transitional-cell carcinoma (TCC) of the bladder...

..008). CONCLUSIONS: When controlled for preoperative risk factors for renal insufficiency, patients undergoing RN are at a greater risk of chronic renal insufficiency than a similar cohort of patients undergoing PN...

..To define outcome data for patients with metastatic renal cell carcinoma (RCC) with histology other than clear-cell type, including collecting duct (or medullary carcinoma), papillary, chromophobe, and unclassified histologies...

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..The data can be applied to design and interpretation of clinical trials of new agents and treatment programs against this refractory malignancy...

..This prospective study was performed to determine whether preoperative IV microbubble contrast-enhanced ultrasound can be used to differentiate indolent and benign renal tumors from more aggressive clear cell carcinoma...

..To validate this presumed equivalence we compared patients with isolated muscular venous branch invasion to those with renal vein invasion and those with no confirmed vascular invasion...

..In a cohort of patients who underwent exploratory laparotomy for unsuspected metastatic GCT we determined the impact of this surgery on morbidity, therapeutic delay and cancer therapy...

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..These PET probes are handheld, allowing for real-time evaluation of cancer using a tool that provides surgeons with better intraoperative assessment of tumor sites...

..We evaluated the impact of BMI and other clinical/pathological characteristics on survival in patients with RCC treated with radical or partial nephrectomy...

..To compare the outcomes of patients who had a elective partial nephrectomy (PN) or radical nephrectomy (RN) for clear cell renal cell carcinoma (RCC) of 4-7 cm...

..We investigated the hypoxia inducible pathway marker immunohistochemical expression profile, and any potential therapeutic implications that such expression may have, in these tumors...

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..5 cm right renal mass, pathologically confirmed as type 2 papillary renal cell carcinoma (RCC). Two years later he was referred to a specialist oncology center after routine follow-up raised suspicion for metastatic disease...

..This case report illustrates the long-term response to sunitinib for patients with metastatic renal cell carcinoma...

..3% frequency of multifocal renal cortical tumors and a 3.5% frequency of clinically unsuspected multifocal tumors. Multifocality had no apparent effect on recurrence or survival in patients who underwent radical nephrectomy...

..No difference was found in the complication rate for these procedures (p > .05). CONCLUSION: Hospital-based charges for radical and partial nephrectomy are similar at when performed at a tertiary care referral center...

..An understanding of the prevention, recognition, and treatment of urologic complications is important for every surgeon performing major pelvic surgery...