Percutaneous radiofrequency ablation of renal cell carcinoma: preliminary results.

Purpose: To report early results in percutaneous radiofrequency ablation (RFA) of renal cell carcinoma with an expandable RF probe.

Material And Methods: In 14 patients (9 male, mean age 67.9 +/- 9.

Changes in bone structure after augmentation cystoplasty in chronic uraemic rats.

Objective: To investigate the effect of urinary diversion using several types of intestinal segments on cortical and cancellous bone structure of growing rats with renal insufficiency.

Material And Methods: In all, 110 female Sprague-Dawley rats (8 weeks old) had either a two-stage subtotal nephrectomy by removing five-sixths of the renal mass, or a sham operation. Except for a uraemic control group, all uraemic rats then had an enterocystoplasty using stomach, ileum or colon (20 animals per group).

All-trans retinoic acid and interferon-alpha for treatment of human renal cell carcinoma multicellular tumor spheroids.

Introduction: Conventional preclinical investigations have strongly recommended to combine interferon-alpha (IFN-alpha) with 13-cis retinoic acid (13-cRA, isotretinoin) for treatment of renal cell carcinoma (RCC). However, a recent randomized controlled trial on the drug combination ultimately failed to demonstrate an increased tumor-specific survival of patients with metastatic RCC (MRCC). All-trans retinoic acid (ATRA, tretinoin) was suggested to provide stronger antineoplastic properties than 13-cRA in different other tumors.

Effect of augmentation cystoplasty on bone metabolism in chronic uremic rats.

Purpose: We examined the impact of urinary diversion using several types of intestinal segments on the bone metabolism of growing rats with renal insufficiency.

Materials And Methods: A total of 110, 8-week-old Sprague-Dawley rats underwent 2-stage subtotal nephrectomy by removal of 5/6 of the renal mass or sham operation. Except for a uremic control group all uremic rats underwent enterocystoplasty using stomach, ileum or colon.

[Gemcitabine/cisplatin vs. MVAC. 5 year survival outcome of the phase III study of chemotherapy of advanced urothelial carcinoma in Germany].

Of 405 patients with stage IV transitional cell carcinoma from an international multicenter phase III trial, 70 were randomized in Germany to receive either gemcitabine/cisplatin or standard MVAC systemic chemotherapy for locally advanced or metastatic urothelial cancer. Overall survival as the primary endpoint of the study was similar in both arms (median survival GC 15.4 months vs MVAC 16.

[Therapy of ureteral tumor].

Nephroureterectomy is the standard treatment of tumors in the upper and middle third of the ureter. Whereas, resection of the distal ureter and uretercystoneostomy is the treatment of choice of tumors in the lower third, as long as there is enough renal function which is worthwhile to be preserved. Lymphadenectomy should be performed in all patients suspicious for invasion of the ureteral wall since already 10% of patients with pT1 and pT2 tumors will present with metastases to the lymphnodes.

Impaired bone metabolism following augmentation cystoplasties in growing rats.

Objective: The aim of this study was to evaluate the possible risk of impaired bone metabolism following augmentation cystoplasties with different gastrointestinal segments.

Method: 60 young rats underwent augmentation cystoplasties using gastric, ileal or sigma segments, or sham operations. An additional group undergoing sigma-cystoplasty received the bisphosphonate ibandronate to inhibit osteoclast-mediated bone resorption.

The role of radical surgery for renal cell carcinoma with extension into the vena cava.

Purpose: New operative technologies, such as the bypass procedures that have become established in the last decade, have led to improved prognosis in patients with renal cell carcinoma and vena caval thrombi. We report the outcome of stage dependent surgical strategies in patients with renal cell carcinoma extending into the vena cava.

Materials And Methods: From January 1987 to August 1998, 93 patients with renal cell carcinoma invading the inferior vena cava were seen at our institution.

[Spontaneous kidney rupture after delivery due to an urothelial carcinoma].

The case of a spontaneous kidney rupture due to an urothelial carcinoma one week after delivery is presented. Diagnosis was made during operation. In comparison to the carcinoma, which is diagnosed and treated in time, the prognosis is poor.

[The role of surgery in renal cell carcinoma].

Renal cell carcinoma accounts about three percent of all adult neoplasms. This review provides a current status about the surgical management of renal cell carcinoma. In localised carcinomas radical nephrectomy is still the standard treatment and provides 5 Year survival rates up to 98 %.

Role of color-coded Doppler sonography in the assessment of internal ureteral stent patency.

Objective: To evaluate the role of color-coded Doppler sonography (CCDS) in the assessment of internal ureteral stent patency.

Patients And Methods: We compared micturating cystography (MC) and CCDS in 48 patients with internal ureteral stents. Forty-five of these patients had pyelocaliectasis on renal sonography.

[Vena cava invasion in kidney carcinoma--a typical example of multidisciplinary surgery].

Between 1987 and 1998, a total of 79 patients with renal cell carcinoma and venal caval thrombus underwent radical nephrectomy with removal of the tumor thrombus. Of these patients, nine had atrial thrombus extension. Actuarial 5 year survival for patients without metastasis was 39%.

Effects of carbon dioxide pneumoperitoneum in pigs with impaired pulmonary function.

The objective of our study was to investigate the possible adverse hemodynamic effects of a CO2 pneumoperitoneum in an experimental model in pigs with impaired pulmonary function. Thirteen animals were anesthetized with azaperon/ketamine and ventilated with 67% nitrous oxide in oxygen. By intravenous injection of dextran microspheres, a capillary pulmonary embolism was induced.

[Magnetic resonance urography. First clinical results].

We report our preliminary results using a new magnetic resonance imaging technique for visualization of the urinary tract. Using the paramagnetic contrast medium gadolinium diethylene triamine penta-acetic acid (DTPA), we were able to obtain images of the urinary tract comparable to those obtained by conventional excretory urography. The major advantage of our technique is that besides good morphologic visualization, the excretion of gadolinium-DTPA can be studied simultaneously.

[Brain metastases in renal cell carcinoma. Results of treatment and prognosis].

Brain metastases develop as a late manifestation of renal cell cancer (RCC) and pose an increasing challenge to urologists as a result of the more frequent prolonged survival of patients with advanced RCC. Therapeutic options, including surgical resection and radiotherapy, were analyzed retrospectively to assess survival and to identify factors influencing prognosis in a group of 90 patients treated either by brain metastasectomy (n = 64) or radiotherapy (n = 26). The analysis confirmed that the overall median survival was a disappointing 461 days and the 1-year survival rate was 31% for patients treated by surgical resection and 310 days and 15% respectively for patients treated by radiotherapy.

[Renal cell carcinoma with vena cava involvement. Surgical strategies and results].

The elaboration of new operative procedures established in the last decade has led to an improved prognosis in patients with renal cell carcinoma with vena caval extension. We report on our personal operative experience in over 100 patients and present the current analysis of 76 patients with renal carcinoma with vena caval extension seen in our institution between 1985 and 1996. Sixty-six patients underwent nephrectomy and removal of vena caval tumor thrombi.

[Status of organ preserving surgery in renal cell carcinoma].

Nephron-sparing surgery in renal cell carcinoma is an accepted approach in patients with bilateral carcinomas, solitary kidneys and in patients with chronic renal failure in whom radical nephrectomy would necessitate immediate renal replacement therapy (mandatory indications). Because of the improvement of operative techniques-like renal perfusion in hypothermia or work-bench surgery-over 95% of patients can spared dialysis even if multiple tumors or locally advanced renal cancer is present. Based on the excellent outcome of nephron-sparing surgery in mandatory indications (5-year survival rates over 80%), several centers advocate extending the use of partial nephrectomy to selected patients with a normal opposite kidney (elective indications).

Surgical treatment of invasive penile cancer--the Heidelberg experience from 1968 to 1994.

Objectives: This study was performed to establish oncological guidelines for the surgical treatment of invasive penile cancer.

Materials And Methods: The medical records of 51 patients with invasive penile cancer seen between 1968 and 1994 were reviewed in respect to treatment and long-term outcome.

Results: For stage T1 tumors treated with organ-preserving procedures the local recurrence rats was 56%, whereas no patient experienced a local recurrence after partial amputation.

[Repetitive immuno-embolization of inoperative liver metastases of renal cell carcinoma. Method characterization and preliminary results].

Interleukin 2 (IL2)-based immunotherapy is effective in a subgroup of patients with metastatic renal cancer, but cure from liver metastases is very rare and even the selection of patients to be treated is very much limited by the toxicity of IL2. To reduce this toxicity and to augment the efficacy of intrahepatic IL2 application, a protocol of combined rIL2 (3 mg/day) and Lipiodol (2-5 ml/day according to tumour size), via a catheter inserted percutaneously into the hepatic artery, was implemented. As an adverse reaction, moderate fever (WHO) grade I and II was noted.

Aetiology, diagnosis and management of spontaneous perirenal haematomas.

This study focuses on the diagnostic and therapeutic challenge posed by spontaneous perirenal haematomas (SPHs). The medical records of 18 patients with SPHs seen in the past 8 years were reviewed with respect to aetiology, diagnosis and therapeutic management. SPH was secondary to angiomyolipoma (n = 4), polycystic kidneys (n =4), panarteritis nodosa (n = 3), renal cell carcinomas (RCCs, n = 2), glomerulonephritis, pyelonephritis, Morbus Wegener and cortical adenoma (one each).

[Spontaneous kidney ruptures--a complication of panarteritis nodosa].

Besides renal cell carcinomas and angiomyolipomas panarteritis nodosa (PAN) is a common underlying disorder for spontaneous perirenal hematomas (SPH). Herein we report on 3 cases with PAN associated kidney ruptures where diagnosis of PAN was not known before in 2 instances. The hematoma was identified by computerized tomography (CT) in all patients, nevertheless CT failed to reveal the underlying disorder in any case.

Tumor response and 4 year survival-data of patients with advanced renal-cell carcinoma treated with autologous tumor vaccine and subcutaneous R-IL-2 and IFN-alpha(2b).

Several forms of immunotherapy are apparently effective in inducing clinical remissions in metastatic renal cancer, but their benefit on survival times have not been demonstrated so far. The present analysis was designed to assess the effects of concomitant application of renal cancer vaccine and cytokines on DTH skin responses to tumor cell challenge, clinical remissions and patients survival. 40 patients with advanced RCC, all with distant metastases in at least one organ, were entered after nephrectomy into a protocol involving multiple vaccinations with Newcastle disease virus (NDV)-infected autologous irradiated tumor cells, with subsequent repetitive 3 bi-weekly cycles of low dose interleukin-2 (r-IL-2) and interferon-alpha(2b)/rIFN-alpha(2) s.

[Local recurrence after organ saving kidney tumor surgery].

Although excellent survival rates for nephron-sparing surgery in mandatory indications (solitary kidney, bilateral renal neoplasms) have been documented, parenchymasparing surgery in elective indications (normal contralateral kidney) is a point of controversy. Local tumor recurrence is the most important argument against this approach. From January 1971 to December 1989, 107 patients suffering from renal cell carcinoma in solitary kidneys or bilateral renal carcinoma underwent nephron-sparing surgery.