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Eila Skinner

Publications and source records attributed to Eila Skinner.

4 recordsLinked to original sources
PubMed2006

A prospective randomized EORTC intergroup phase 3 study comparing the complications of elective nephron-sparing surgery and radical nephrectomy for low-stage renal cell carcinoma.

OBJECTIVES: This study compared the complications and the cancer control of elective nephron-sparing surgery (NSS) and radical nephrectomy (RN) in patients with a small (<or=5 cm), solitary, low-stage N0 M0 tumour suspicious for renal cell carcinoma (RCC) and a normal contralateral kidney. METHODS: 541 patients were randomised in a prospective, multicentre, phase 3 trial to undergo NSS (n=268) or RN (n=273) together with a limited lymph node dissection. RESULTS: This publication reports only on the complications reported for both surgical methods. The rate of perioperative blood loss<0.5l was slightly higher after RN (96.0% vs. 87.2%) and the rate of severe haemorrhage was slightly higher after NSS (3.1% vs. 1.2%). Ten patients (4.4%), all of whom were treated with NSS, developed urinary fistulas. Pleural damage (11.5% for NSS vs. 9.3% for RN) and spleen damage (0.4% for NSS and 0.4% for RN) were observed with similar rates in both groups. Postoperative computed tomography scanning abnormalities were seen in 5.8% of NSS and 2.0% of RN patients. Reoperation for complications was necessary in 4.4% of NSS and 2.4% of RN patients. CONCLUSIONS: NSS for small, easily resectable, incidentally discovered RCC in the presence of a normal contralateral kidney can be performed safely with slightly higher complication rates than after RN. The oncologic results are eagerly awaited to confirm that NSS is an acceptable approach for small asymptomatic RCC.

Aged↗
PubMed2005

Quality of life after radical treatment for invasive bladder cancer.

Considerable effort has been put into improving the quality of life after radical therapy for bladder cancer, though it has proved difficult to demonstrate conclusively that these aims have been achieved. There can be little doubt that the impact of a cystectomy is substantial but that it can be lessened by the use of continent and orthotopic diversion. Quality-of-life studies have, however, shown the remarkable ability of patients to adapt well to the more commonly used incontinent ileal conduit. Chemoradiation appears to have little impact on bladder function for about three-quarters of all patients and this effect will likely be lessened in the future by the use of partial bladder irradiation or better targeting using fiducial markers. Both radical surgery and chemoradiation can perturb bowel function but this may be reduced by choosing less functionally critical portions of bowel for diversion or by better targeted pelvic nodal radiation. Male sexual function is profoundly affected by both treatment approaches although conformal radiation or nerve-sparing cystectomy may help in the future. Female sexual function has never been fully examined but the impact of both approaches is likely very high.

Chemotherapy, Adjuvant↗
PubMed2004

Genitourinary cancer in the elderly.

Genitourinary malignancy comprises nearly half of the cancers diagnosed in men, and the incidence of this group of cancers increases with age. The key to successful management is to define appropriate goals (cure v palliation) based on the natural history and extent of disease, physiology and life expectancy of the patients, and cost-benefit ratio of treatment options. Of particular importance, the chance for cure should not be sacrificed because of age-based considerations in early-stage cancers of the prostate or kidney nor in the early stage of locally advanced urothelial malignancy.

Aged↗