Renal & Urology News January 2012 Issue

Page 1

JANUARY 2012

VOLUME 11, ISSUE NUMBER 1

www.renalandurologynews.com

Incidental RCC Offers Better Survival

© LIVING ART ENTERPRISES, LLC / PHOTO RESEARCHERS, INC.

An Icelandic study shows a substantial increase in incidentally detected tumors over a 35-year period

IN A STUDY, symptomatic tumors were larger than those detected incidentally.

High Salt Intake Cuts CKD Risk BY JODY A. CHARNOW PHILADELPHIA—High dietary salt intake may decrease the risk of chronic kidney disease (CKD), whereas low dietary potassium intake may increase the risk, investigators reported at Kidney Week 2011. The findings are from two analyses of 2001-2006 data from 13,917 individu-

CME FEATURE

als aged 18 years or older (mean age 45 years) who participated in the National Health and Nutrition Examination Survey. After adjusting for age, gender, race, diabetes and hypertension status, and diuretic usage, researchers found a significant association between higher quartiles of sodium intake and continued on page 12

Earn 1 CME credit in this issue

An Update on Robotic-Assisted Partial Nephrectomy PAGE 28

BY JODY A. CHARNOW INCIDENTAL DETECTION of renal cell carcinoma (RCC) is increasing and is associated with better survival from the malignancy, according to a populationbased study conducted in Iceland. Using centralized databases, Tomas Gudbjartsson, MD, PhD, of the Landspitali University Hospital in Reykjavik, and collaborators conducted a retrospective study of all living patients diagnosed with RCC in Iceland from 1971 to 2005. In 2005, Iceland had an estimated 300,000 people. The researchers compared survival of patients with incidentally diagnosed and symptomatic RCC. Of 910 patients diagnosed with RCC during the 35-year observation period, 254 (27.9%) were diagnosed incidentally,

Small Prostate Increases Risk of PCa Upgrade SMALLER PROSTATES in men with low risk prostate cancer (PCa) may indicate a greater likelihood of harboring tumors of higher grade than indicated by prostate biopsy, according to investigators. In a study of 1,251 patients undergoing radical prostatectomy for low risk PCa, researchers found that those with smaller prostates had a higher risk of Gleason score upgrades upon examination of the surgical specimen. The implications of identifying patients at high risk for Gleason score upgrading are “profound,” the researchers reported in The Journal of Urology (2011;186:2221-2227), noting that patients, urologists, and radiation oncologists base treatment plans on patient risk strata, of which biopsy Gleason scores are an important part. “The ability to distinguish patients at high risk for upgrading may help patients and clinicians determine patient eligibility for treatment options such as continued on page 13

Dr. Gudbjartsson’s team reported in The Journal of Urology (2012;187:48-53). The incidental detection rate rose significantly from 11.1% in 1971 through 1975 to 39.2% in 2001 through 2005. The rate increased significantly among male subjects during those same intervals, but only during the last five study years among female subjects. Mortality remained unchanged for males and females. Tumors diagnosed incidentally on average were 2.6 cm smaller than symptomatic tumors, and diagnosed at lower stage and lower grade than symptomatic tumors. TNM stage was by far the strongest independent predictor of survival, the researchers found. Compared with patients with stage I continued on page 12

IN THIS ISSUE 11

Prostate cancer linked to highdose vitamin E

20

Denosumab found to delay CRPC bone metastases

23

Black donors’ kidneys may worsen transplant outcomes

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Epinephrine can reduce blood loss during TURP

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FDA advisory committee backs peginesatide

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Electromagnetic treatment could ease BPH symptoms

Kidney paired donation boosts odds of transplantation PAGE 14


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