Results: For all patients, mean age, mean serum neutrophil, lymphocyte counts and mean NLR were 33±8, 4800±2100, 1100±520 and 3,69±1.1,respectively.In histopathological examination, pure seminoma, pure non-seminom and mix histologic type were detected in 21(31.4%),23(34.3%)and 23(34.3%)patients, respectively.Stage 1 disease and stage ≥2 disease were revealed in 42(62%) and 25(38%)of the patients.During median 67 months follow-up period, DSS rate was 91%.According to previous studies, we determined NLR cutoff value as 4. Patients were divided into two groups as NLR≤4 and NLR>4.There was no statistically significant difference on DSS between two groups. Conclusion:According to our outcomes, we observed that NLR was not a prognostic factor to predict of DSS.However, high patient volume and prospective trials are needed to support our results.
Objective: In some selected Renal Cell Carcinoma (RCC) cases long-term oncologic outcomes of nephron sparing surgery and radical nephrectomy are similar.In renal tumor cases, one of the main factors affecting the prognosis is histological subtype.In this study, we aimed to determine the factors that predict cancer specific survival in pathologically non-clear cell RCC cases after nephron sparing surgery.Materials and Methods: Data of 50 patients undergoing nephron sparing surgery for non-clear cell renal cell carcinoma and pathological T1-3N0M0 stage (according to 2010 TNM classification) between January 1998 and February 2014 was investigated retrospectively.All patients were evaluated for pathological T stage, Fuhrmann grade, tumor size, local recurrence, positive surgical border, microvascular invasion and metastatic progression.Results: For all patients, overall survival and cancer specific survival rates were 90% and 92%, respectively.Five years of cancer specific survival rate for papillar and non-papillar RCC groups were 92% and 78%, respectively (p=0.158).When the patients were separated into two groups according to Fuhrmann grade, 5 years cancer specific survival rate for grade 1-2 and grade 3-4 groups were 100% and 54%, respectively (p=0.002).In univariate analysis for cancer specific survival predicting, Fuhrmann grade, microvascular invasion, positive surgical border and local recurrence were statistically significant.However, in multivariate analysis, only Fuhrmann grade was statistically significant (p=0.014,HR: 5.58, %95 CI: 1.425-21.845). Conclusion:In non-clear cell RCC cases whatever the subtype is successful results have been taken with nephron sparing surgery.To evaluate the results of nephron sparing surgery, there is a need for studies which are prospective and have larger patient population.
Objectives: To compare the short-term and 1-year follow-up functional outcomes of modified anatomical structure preserving and Retzius-repairing robot-assisted radical prostatectomy (APR-RARP) compared with Retzius-sparing (RS) RARP. Methods: Eighty consecutive patients 40–75 years of age with low-intermediate risk prostate cancer were prospectively randomized to APR-RARP or RS-RARP. Urinary continence (UC) recovery rates were evaluated from catheter removal up to 1 year follow-up. Postoperative UC was defined as 0 pads/one security pad per day. UC recovery rates from catheter removal to 1 year were calculated by Kaplan–Meier curve; log-rank test was used for the curve comparison. Postoperative potency was evaluated at 3 and 12 months after surgeries. Perioperative complications, positive surgical margin (PSM), and biochemical recurrence rates represent secondary outcomes reported in the study. Results: At the catheter removal, 1, 3, 6, and 12 months after operation, 52.5% (confidence interval [CI] 95%: 37.6–67), 82.5% (CI 95%: 70.8–94), 95% (CI 95%: 88.3–99.1), 97.5% (CI 95%: 92.5–99.9), and 97.5% (CI 95%: 92.5–99.9) of men undergoing the APR-RARP were continent (0 pads/one security pad per day), compared with 61.5% (CI 95%: 46.5–76.6), 89.7% (CI 95%: 80.3–98.1), 97.5% (CI 95%: 92.6–99.9), 97.5% (CI 95%: 92.6–99.9), and 97.5% (CI 95%: 92.6–99.9) undergoing the RS-RARP, respectively, and the Kaplan Meier curve showed no statistically significant difference for both technique at any time point (log-rank p = 0.556). The median (95% CI) time to UC recovery was 9.8 (5.2–14.4) days for the APR-RARP vs 6.7 (3.2–10.2) days for the RS-RARP group. Potency rates were similar in both groups at 3 and 12 months after surgeries. The two compared approaches; in terms of rate of complications, PSM was similar. Conclusions: Surgeons can achieve functional results comparable to the RS technique with the modified reconstructive anterior approach, without changing the surgical technique they are used to.
