Biomedical subjects

Per Christian Medby

Publications and source records attributed to Per Christian Medby.

4 recordsLinked to original sources

PubMed2004

Presumed radically treated renal cell carcinoma--recurrence of the disease and prognostic factors for subsequent survival.

OBJECTIVE: To gain knowledge about when, where and how metastases after presumed radical treatment for renal cell carcinoma (RCC) are detected, and to use this information to establish a follow-up programme for radically treated RCC. Further aims were to establish survival rates, together with identifying prognostic factors influencing survival for different groups of patients after recurrence of the disease. MATERIAL AND METHODS: A retrospective study of 305 pT1-4N0M0/pT1-4NxM0 (clinically N0) tumours treated with nephrectomy was performed. RESULTS: A total of 89 patients (29.2%) developed metastases, with a median time to recurrence of 25.1 months. Within 5 years, 80% of the metastases had been detected. The lungs were the commonest metastatic site. A total of 34.8% of the recurrences were diagnosed as a result of routine follow-up. Median cancer-specific survival (CSS) after recurrence was 9.8 months. For patients with a disease-free interval (DFI) > or =24 months the median CSS was 35 months. In a univariate analysis, performance status, DFI > or =24 months, metastases in a single organ, primary tumour size < or =70 mm, primary tumour stage pT1-2 and age <65 years were all associated with better survival. In a multivariate analysis, performance status, DFI and number of organs affected were independent predictors of survival. CONCLUSION: The information from this material is used to suggest a simple, but adequate, follow-up protocol. Easily accessible information can be used to identify groups with different prognoses regarding survival after recurrence of the disease.

Adolescent↗

PubMed2002

[Renal cancer--a retrospective study of 368 patients].

BACKGROUND: We wanted to evaluate our treatment results for renal cell carcinoma (RCC). MATERIAL AND METHODS: A retrospective study of 368 patients operated with nephrectomy between 1978 and 2000 was carried out. RESULTS: 29% of the renal cell carcinomas were diagnosed incidentally and we observed a significant increase in this respect between the first and second half of the study. 18% had postoperative complications and 3% had major complications needing reoperation. 2% of the nephrectomies on the left side were complicated with splenectomy. 11 patients (3%) died within 30 days, most of the deaths occurring in the early part of the study period. Five-year cancer-specific survival rates were: 92% for stage 1; 83% for stage 2; 67% for stage 3; and 16% for stage 4. No differences were encountered between transabdominal and retroperitoneal surgical approaches in terms of cancer-specific survival. INTERPRETATION: Increasing numbers of incidentally detected tumours have been observed. Our survival, complication and mortality rates are comparable to those in other reports.

Adolescent↗

PubMed2002

[Postoperative urinary retention].

BACKGROUND: Retention of urine is a common postoperative problem. MATERIALS AND METHODS: We present two patients with postoperative urinary retention. Current opinions on monitoring and treatment are reviewed. RESULTS: One male postoperative patient was transferred from the postanaesthesia care unit after orthopaedic surgery under spinal anaesthesia. Shortly thereafter he collapsed. Hypotension and bradycardia were treated with intravenous ephedrine and atropine. Urinary retention was suspected and the bladder catheterised for 1,000 ml urine. A follow-up examination revealed no sequelae. A female patient was operated for haemorrhoids under epidural anaesthesia. The second postoperative day she was catheterised for 1,500 ml of urine. Two years later she had an ovarian cyst removed under general anaesthesia. Postoperative urinary retention developed with bladder overdistension (volume > 1,000 ml). A follow-up examination showed rest urine of 25 to 75 ml, and a chronic bladder dysfunction. The incidence of postoperative urinary retention varies depending upon type of surgery, gender, age, and preoperative history of urinary tract dysfunction. Method of anaesthesia or postoperative pain treatment is not correlated to incidence of urinary retention, but excessive intravenous volume load during the operation is. INTERPRETATION: Postoperative urinary retention should be monitored in all patients after surgery. All patients with history of difficulties with micturition need close supervision to avoid urinary bladder overdistention.

Adult↗

PubMed2002

Renal cell carcinoma: gender difference in incidental detection and cancer-specific survival.

OBJECTIVE: To look for an increase in the incidental detection of renal cell carcinoma (RCC) over the last two decades and to see if different patterns of healthcare use for men and women have implications for tumour detection and survival. MATERIAL AND METHODS: We present an historical series of 368 consecutive patients treated with nephrectomy for RCC during the period 1978-2000. The patients were classified according to detection mode (incidental or symptomatic disease), TNM stage and cancer-related death. RESULTS: The frequency of incidentally detected RCC (IRCC) increased from 21.1% to 34.7% between the first and second decades of the study. The IRCC group had significantly more low-stage (I-II) tumours (p = 0.002), a smaller tumour size (p < 0.0001) at operation and significantly better cancer-specific survival (p = 0.0048) than the symptomatic renal cell carcinoma (SRCC) group. The frequency of women was significantly higher in the IRCC group than in the SRCC group (p = 0.02). Females had significantly more low-stage (I-II) tumours (p = 0.02) and better cancer-specific survival (p = 0.05) than males. CONCLUSIONS: The number of incidentally discovered renal tumours is increasing. IRCC have lower TNM-stage and are smaller than SRCC. IRCC have better long term cancer specific survival than SRCC. The better survival rate found in females may be due to more extensive use of the healthcare system by females than males.

Carcinoma, Renal Cell↗