Published data from individual studies present conflicting evidence about the relationship between clinicopathological risk factors and oncological outcomes in renal cell cancer (RCC) following nephron-sparing surgery (NSS). This study was conducted to explore the potential risk factors for RCC progress after NSS. Studies published in PubMed, Web of Science, and EMBASE were systematically reviewed from inception to March 2019 to determine risk factors for RCC following NSS. The predictive ability of identified predictors was assessed by hazard ratios (HRs) with 95% confidence intervals (CIs). A fixed-effect or random-effect was used to pool the estimates. Subgroup analyses were performed to explore the source of heterogeneity. Seventeen studies including 38,522 patients with RCC were analyzed. The meta-analysis indicated that positive surgical margin (pooled HR = 1.47; 95% CI:1.24-1.73; < 0.001), higher Fuhrman grade (pooled HR = 1.58; 95% CI:1.10-2.28; = 0.013), higher pathological stage (pooled HR = 1.72; 95% CI:1.40-2.12; < 0.001) and large tumor size (pooled HR = 1.09; 95% CI:1.03-1.16; = 0.003) were significantly associated with recurrence risk. However, age (pooled HR = 1.00; 95% CI: 1.00-1.01; = 0.257), sex (male vs. female) (pooled HR = 1.04; 95% CI: 0.89-1.21; = 0.605) and surgical approach (laparoscope vs. open) (pooled HR = 0.80; 95% CI: 0.59-1.07; = 0.129) had no effect on recurrence after NSS. In addition, we found that positive surgical margin was significantly associated with recurrence-free survival (pooled HR = 1.87; 95% CI: 1.32-2.66; < 0.001) and overall mortality (pooled HR = 1.15; 95% CI: 1.07-1.23; < 0.001), as well as large tumor size for recurrence-free survival (pooled HR = 1.18; 95% CI: 1.06-1.30; = 0.002)and overall mortality (pooled HR = 1.01; 95% CI: 1.00-1.02; = 0.004). Unfavorable pathological characteristics were distinctly related to worse oncological outcomes in RCC patients following NSS. These results may contribute to proposed prediction models for RCC patients to aid in counseling and risk stratification.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7067827 | PMC |
| http://dx.doi.org/10.3389/fonc.2020.00286 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
[Elements of high-grade iatrogenic risk in care of patients with somatic symptom disorder].
Psychiatr Hung
January 2025
Rosszullétek speciális elme- és ideggyógyászati szakrendelô, Budapest, Hungary, E-mail:
Author analyses the process of care of somatic symptom disorder in the general medical practice with special concern to iatrogenic harms. In his opinion the latency of the patients' first appointment with a psychiatrist or clinical psychologist is caused by multiple factors. Patients do not have knowledge on the basic activities of central nervous system necessary to recognize the pathomechanism.
View Article and Find Full Text PDFFunctional dyspepsia (FD) is a gut-brain axis disorder characterized by postprandial fullness, early satiety, bloating and/or epigastric pain, which are presumed to originate in the gastroduodenal tract. While the international recommendations in the Rome IV consensus require endoscopy to rule out an organic condition before establishing a diagnosis of FD, international guidelines recommend that, in the absence of risk factors, patient management be initiated at the primary care level by establishing Helicobacter pylori infection status, with eradication when positive, followed by empiric therapy with proton pump inhibitors and/or prokinetics, and that endoscopy be reserved for patients refractory to said measures. Second-line therapy includes neuromodulating agents, among which tricyclic antidepressants and atypical antipsychotics such as levosulpiride stand out.
View Article and Find Full Text PDFEnhancing accessibility to the dementia risk profile (DRP) and knowledge of dementia risk reduction (KoDeRR) measuring tools to diverse communities through translation and adaptation in the Nepali language.
Dementia (London)
January 2025
Wicking Dementia Research and Education Centre, College of Health and Medicine, University of Tasmania, Australia.
Dementia is one of the fastest emerging global public health concerns today, as the World Health Organisation has predicted that the number of cases will triple from 55 million in 2023 to 152 million by 2050. Current evidence indicates that approximately 45% of dementia cases can be prevented or delayed by acting on potentially modifiable risk factors. However, public knowledge regarding this remains unknown in numerous poorly resourced countries, including Nepal, where the prevalence of dementia continues to increase.
View Article and Find Full Text PDFNavigating Children's Risky Play: A Comparative Analysis of Saudi Mothers and Fathers.
OTJR (Thorofare N J)
January 2025
Colorado State University, Fort Collins, USA.
Despite documented benefits for development, children are engaging in considerably fewer risky play activities. Research on parent gender and children's risky play is inconsistent. Gender and cultural context shape how individuals perceive and tolerate children's risky play.
View Article and Find Full Text PDFThe use of assisted reproductive technology (ART) is growing, both to assist individuals with infertility and for fertility preservation. Individuals with cardiovascular disease (CVD), or risk factors for CVD, are increasingly using ART. Thus, knowing how to care for patients undergoing ART is important for the cardiovascular clinician.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!