Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0149871 (deep vein thrombosis)
 12,364 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To provide information about long-term outcome after radical prostatectomy for clinically localized prostatic cancer (stage T2c or lower), we undertook a retrospective analysis of 3,170 consecutive patients (mean age 65.3 +/- 6.4 years, range 31 to 81) with a mean followup of 5 years. Complication rates for patients who underwent prostatectomy before 1988 were compared with those who underwent radical prostatectomy more recently. Of the patients 49 (1.5%), 178 (5.6%), 897 (28%) and 2,047 (65%) had clinical stages T1a, T1b, T2a and T2b,c disease, respectively. The Gleason score was 3 or less in 292 patients (9%) and 7 or greater in 782 (25%). Overall, 438 patients (14%) died, 159 (5%) of cancer. The crude 10 and 15-year survival rates for all patients were 75% and 60%, respectively, which is comparable to the expected survival of a control group (67% and 46%). The cause specific survival rates were 90% and 82%, respectively, metastasis-free survival rates 82% and 76%, local recurrence-free survival rates 83% and 75%, overall recurrence-free rates 72% and 61%, and overall recurrence plus prostate specific antigen progression-free (greater than 0.2 ng./ml.) rates 52% and 40%, respectively. Clinical stage did not significantly affect survival but tumor grade was associated: 10 and 15-year cause specific survival rates were 95% and 93%, respectively, for a Gleason score of 3 or less, 90% and 82%, respectively, for a score of 4 to 6, and 82% and 71%, respectively, for a score of 7 or more. Of all patients 26% received adjuvant treatment (hormonal and/or radiation) within 3 months postoperatively because of advanced local pathological stage (pT3 or higher) or margin positive disease. The 30-day mortality rate was 0.3% (0% for 1,728 patients who underwent surgery in 1988 or later). Only 1 patient in the 70 year or older age group died during hospitalization. Complications decreased with time. In a contemporary group the complications were rectal injury in 0.6% of the patients, colostomy in 0.06%, myocardial infarction in 0.4%, deep venous thrombosis in 1.1%, pulmonary embolism in 0.7% and total urinary incontinence (3 or more pads per day) in 0.8%. Recent intraoperative blood loss was a median of 600 ml., and the incidence of recent need for any transfusion was 31% and it is presently less than 5%. In this series patients undergoing radical prostatectomy for clinically localized prostate cancer were usually healthy and, thus, had low co-morbidity. Survival rates at 10 and 15 years compare favorably with those of an age-matched control group.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Long-term (15 years) results after radical prostatectomy for clinically localized (stage T2c or lower) prostate cancer. 793 40

Backgrounds: Surgical procedures in the elderly are associated with higher perioperative morbidity and mortality rates than in younger patients. This is especially significant because elderly individuals are more likely to be operated on now than in the past because they represent the fastest growing subset of the population in advanced countries. Our cases are three nonagenarian patients with renal malignancy in poor general condition and were effectively treated by laparoscopic surgery. Case Presentation: Case 1 was a 91-year-old male patient with a right renal cell carcinoma of pT1b N0 M0. Case 2 was a 92-year-old male patient with a right renal pelvic tumor of pT3 N0 M0. Case 3 was a 90-year-old female patient with a left renal pelvic tumor of pT2 N0 M0. Case 1 had an Eastern Cooperative Oncology Group performance status of 1. The status of cases 2 and 3 was both rated as 2. All three cases had grade 3A chronic kidney disease. Cases 2 and 3 also had deep vein thrombosis in the lower extremities and dementia. In addition, case 2 had coronary occlusive disease. All cases were treated by laparoscopic surgery and effectively discharged from hospital without major physical complications. Conclusion: This report is the first English-language article that describes treating nonagenarian patients by laparoscopic urologic surgery. An increasing number of nonagenarian patients present with urologic malignancies, and surgeons are frequently faced with the question, "Are they too old for surgery?" Our report suggests that laparoscopic surgery for renal malignancy in nonagenarian patients is feasible.
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PMID:Effective Treatment of Upper Urinary Tract Malignancies Using Laparoscopic Surgery in Three Nonagenarians in Poor General Condition: Are They Too Old for Surgery? 3026 66