Dissertation > Excellent graduate degree dissertation topics show

Study on Safe Extension in Nephron Sparing Surgery for Renal Cell Carcinoma 4 cm or Less in Diameter

Author: MengPing
Tutor: WangHe
School: Fourth Military Medical University
Course: Surgery
Keywords: Kidney neoplasms Nephrectomy Nephron sparing surgery Excision extension
CLC: R737.11
Type: Master's thesis
Year: 2007
Downloads: 81
Quote: 0
Read: Download Dissertation


Renal cell carcinoma (RCC) is one of the malignant tumors which is secondary to carcinoma of urinary bladder in the urinary carcinoma.It’s estimated that the morbility of RCC is increased 2% annumly and about 100,000 patients died from this kind of carcinomas every year in the world. About half members of those patients are in their late stage when they were firstly diagnosed of this cancer,about 40% will be recurrenced after and metabasised before radical renal resection,the survival rate is lower than 3% within 3 years who had not received any treatment.RCC has more malignant and insensitivity to radiotherapy and chemotherapy,and immunotherapy is also has little effect on it.Radical nephrectomy has been proven to be an effective choice for cure of localized renal cell carcinoma (RCC).Renal cell carcinoma (RCC) of 4 cm or less is with a low incidence of multicentricity and metastasis and is usually considered suitable for nephron sparing surgery (NSS).Open partial nephrectomy,or nephron sparing surgery (NSS),is now considered the standard of care for the treatment of small renal tumors.The oncologic efficacy and safety of NSS for the treatment of stage - T1a renal tumors has been repeatedly demonstrated to be equivalent to radical nephrectomy.NSS initially was reserved for patients with solitary kidneys,impaired renal function,hereditary tumor syndromes,bilateral renal tumors, and those with significant comorbidities predisposing to future renal failure.The indications have expanded recently to allow elective partial nephrectomy in the setting of a normal contralateral kidney.Furthermore , recent data demonstrate that partial nephrectomy for larger tumors (T1b),which have been historically treated with radical nephrectomy,is a viable option when surgical margins can safely be achieved.Renal cell carcinoma (RCC) of 4 cm or less is with a low incidence of multicentricity and metastasis and is usually considered suitable for nephron sparing surgery (NSS).It is widely accepted that tumor excision with a surrounding margin of normal parenchyma is the safest approach to ensure no residual tumor in the renal remnant. However agreement on the optimal margin in nephron sparing surgery has never been reached.RCC of 4 cm or less was with a lower incidence of multicentricity and NSS in these tumors has showed an excellent long term results compared with those of larger than 4 cm.This pilot study was designed to investigate the distance between extra-pseudocapsule lesions and primary tumors,and to suggest the optimal margin in NSS for RCC 4 cm or less.Objective Renal cell carcinoma (RCC) of 4 cm or less is with a low incidence of multicentricity and metastasis and is usually considered suitable for nephron - sparing surgery (NSS).To explore the excision extension in nephron-sparing surgery (NSS) for renal cell carcinoma (RCC) 4 cm or less in diameter and study Ki-67 and PCNA expression.Methods Forty-one kidneys with RCC 4 cm or less in diameter resected by radical nephrectomy were prospectively studied. The kidney samples were sectioned and examined using immunohistochemistry to observe pathological changes and expressions of Ki - 67 and PCNA in primary tumor and paracarcinoma tissues.Results The diameter of 41 primary tumors was 3.3±0.8cm(range 0.8–4.0cm). Of these,17.0%(7/41) with positive cancer lesions beyond pseudocapsule. Along with the further distance from primary tumor , the proportions of positive expressions of Ki-67 and PCNA in paracarcinoma tissue were decreased gradually. The ratio of strong expression was 57.4% (4/7)in the group with extra-pseudocapsule cancer lesions.Conclusions These data suggest that when NSS is performed in RCC 4 cm or less in diameter,a margin of more than 1 cm of adjacent parenchyma should be excised with the tumor. It is necessary to choice individual treatment for RCC with strong expression of Ki-67 and PCNA.

Related Dissertations

  1. Comparative Study of Clinical Curative Effect between Retroperitoneal Laparoscopic Radical Nephrectomy and Open Surgery for cT1-T2 Renal Carcinoma,R699
  2. 1、The Biological Effect of Carbon Dioxide Laser on Ribbit Kidney and the Application of Carbon Dioxide Laser in the Partial Nephrectomy 2、The Exploration of Canine Model of Chronic Renal Failure Through the Renal Artery Injection of Iodized Oil,R737.11
  3. The Experimental Research of Expression of Activin A and Drug Prophylaxis in 5/6 Nephrectomized Rats,R692.9
  4. ⅠMolecular Mechanisms of Vascular Remodeling in Rat Model of Hyperaldosteronism ⅡTechnique of Retroperitoneoscopic Radical Nephrectomy Based on Anatomy of the Perirenal Area,R699.3
  5. Effect and Activation of HIF-α Isoforms in the Progression of Rat Remnant Kidney Model,R692.9
  6. The Study of Clinical Application of Nephron Sparing Surgery for Renal Cell Carcinoma,R737.11
  7. Effects of Cobalt Pretreatment on Renoprotection of 5/6 Nephrectomized Rats via Hypoxia-Inducible Factor,R692
  8. The Haikunshenxi 5/6 renal ablation rats glomerulosclerosis platelet-derived growth factor-BB regulation mechanism,R285.5
  9. Clinic Application of Laparoscopic Living Related Donor Nephrectomy,R699.2
  10. The Tongluo Baoshen Compound resection model renoprotective effect mechanism of rat kidney of 5/6,R285.5
  11. The Diagnosis and Treatment of the Renal Tuberculosis,R527.1
  12. Clinical Analysis of 65 Cases of Incidental Renal Carcinoma,R737.11
  13. Field Planting of Bacillus Bifidus and Bacillus Acidi-lactici Ongastrointestinal Various Sites in Rats with Chronic Renal Failure and Their Decomposition Effect on Micromolecule Urotoxins,R692.5
  14. Leflunomide Attenuates Renal Injury in 5/6 Renal Ablation in Rats,R965
  15. Effect of Cordycepssinensis on the ECM of Progressive Glomerularsclerosis in Rats,R285
  16. Clinical Research on the Effect of Liuweidihuang Decoction on Treating Chronic Glomerulonephritis,R277.51
  17. Surgical Treatment and Immunohistochemical Study of Renal Cell Carcinoma (Report of 116 Cases),R737.11
  18. Studies on Properties of the Calcium Ion Channels of 5/6 Subtotal Nephrectomy (SNx) Rat Ventricular Myocytes,R329
  19. Evaluation of Nephron Sparing Surgery for Renal Cell Carcinoma,R737.11
  20. The Experimental Study of Pai Du and Shuang Tiao Synthetic Therapy on the Level of AngⅡ and ALD in Model Rats of CRF,R277.5

CLC: > Medicine, health > Oncology > Genitourinary tumors > Urinary tumors > Kidney,renal pelvis tumor
© 2012 www.DissertationTopic.Net  Mobile