In the period, 1973-1985, a total of 305 renal autotransplantations (often with extracorporeal repair) were performed in 274 patients for fibromuscular (56) or atherosclerotic (98) renovascular disease, nephrolithiasis (97), renal tumor (15), or ureteral injury (8). One-third of the patients had reduced renal function, and approximately half of the patients with renovascular lesions presented with severe or malignant hypertension. The postoperative mortality rate of 4% was related to age over 60 years and reduced renal function. Postoperatively, 3.6% of the autografted kidneys were lost due to vascular thrombosis (7) or other causes (4). Twenty-five percent (69) of the patients had a solitary kidney. Two patients died postoperatively with functioning autografts. Long-term renal function remained stable in 60 patients, and deteriorated in 7. We conclude that autotransplantation and extracorporeal repair provide safe and efficient treatment for selected difficult renal lesions.

Adolescent↗

PubMedDate not supplied

Pre-operative radiotherapy prolongs survival in operable esophageal carcinoma: a randomized, multicenter study of pre-operative radiotherapy and chemotherapy. The second Scandinavian trial in esophageal cancer.

In a prospective multicenter study, 186 patients with squamous cell esophageal carcinoma, who after evaluation were considered suitable for surgery, were randomized to 4 treatment groups: Group 1, surgery alone; Group 2, pre-operative chemotherapy (cisplatin and bleomycin) and surgery; Group 3, pre-operative irradiation (35 Gy) and surgery; Group 4, pre-operative chemotherapy, radiotherapy, and surgery. Three-year survival was significantly higher in the pooled groups receiving radiotherapy as compared with the pooled groups not receiving radiotherapy. Comparison of the groups having pre-operative chemotherapy with those not having chemotherapy showed no significant difference in survival. Female patients had a significantly better survival than males. The results indicate that pre-operative irradiation had a beneficial effect on intermediate term survival, whereas the chemotherapy regime used did not influence survival.

Adult↗

PubMedDate not supplied

Prognostic significance of p53, Her-2, and EGFR overexpression in borderline and epithelial ovarian cancer.

The objective of the study was to evaluate the prognostic effect of p53, Her-2, and EGFR in borderline and epithelial ovarian cancer. Tumor tissue from 85 patients with borderline and 783 patients with epithelial ovarian cancer stage I-IV were analyzed immunohistochemically for p53 positivity and over-expression of Her-2 and EGFR. In the ovarian cancer (OC) group 415 patients (53%) had p53-positive tumors, 272 (35%) had tumors with Her-2 over-expression, and 483 (62%) had over-expression of EGFR. In the OC group the classical prognostic factors (older age, higher FIGO stage, and poorer differentiated stage) had significant prognostic value in both uni- and multivariate analyses. Multivariate analyses in the OC group proved p53 positivity to increase mortality significantly depending on the grade of the tumor. Her-2 likewise increased the risk of mortality significantly in this group depending on the grade of the tumor. EGFR on the other hand did not have any additional prognostic effect in the OC group after adjustment for the classical prognostic and molecular factors was made. In the borderline group Her-2 and EGFR over-expression in combination, adjusted for age and p53, significantly improved the prognosis.

Adenocarcinoma, Clear Cell↗

PubMedDate not supplied

Effect of prophylactic gastric resection on upper gastrointestinal (GI) complications in uremic and transplanted patients.

Among 125 consecutive transplant recipients 10 (8%) demonstrated previous or present peptic ulcer and 9 underwent prophylactic gastric resection before transplantation. Two of these patients experienced upper GI complications in the posttransplant period and 1 died. Another 7 patients without previous dyspepsia had similar problem after transplantation and 4 died. Prophylactic gastric resection is recommended in potential recipients with pretransplant ulcer disease.

Gastrectomy↗