To Örebro University

oru.seÖrebro University Publications
Change search
Link to record
Permanent link

Direct link
Publications (10 of 55) Show all publications
Almdalal, T., Karlsson Rosenblad, A., Hellström, M., Kjellman, A., Lindblad, P., Lundstam, S., . . . Ljungberg, B. (2023). Predictive characteristics for disease recurrence and overall survival in non-metastatic clinical T1 renal cell carcinoma: results from the National Swedish Kidney Cancer Register. Scandinavian journal of urology, 57(1-6), 67-74
Open this publication in new window or tab >>Predictive characteristics for disease recurrence and overall survival in non-metastatic clinical T1 renal cell carcinoma: results from the National Swedish Kidney Cancer Register
Show others...
2023 (English)In: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813, Vol. 57, no 1-6, p. 67-74Article in journal (Refereed) Published
Abstract [en]

Objective:  Patients with clinical T1 renal cell carcinoma (cT1RCC) have risks for recurrence and reduced overall survival despite being in the best prognostic group. This study aimed to evaluate the association of different treatments on disease recurrence and overall survival using clinical and pathological characteristics in a nation-wide cT1RCC cohort.

Materials and methods: A total of 4,965 patients, registered in the National Swedish Kidney Cancer Register (NSKCR) between 2005 and 2014, with ≥ 5-years follow-up were identified: 3,040 males and 1,925 females, mean age 65 years. Times to recurrence and overall survival were analyzed with Kaplan-Meier curves, log-rank test, and Cox regression models.

Results: Age, TNM-stage, tumor size, RCC-type, and performed treatment were all associated with disease recurrence. Patients selected for ablative treatments had increased risk for recurrent disease: hazard ratio (HR) = 3.79 [95% confidence interval (CI) = 2.69-5.32]. In multivariate analyses, age, gender, tumor size, RCC-type, N-stage, recurrence and performed treatment were all independently associated with overall survival. Patients with chRCC had a 41% better overall survival (HR = 0.59, 95% CI = 0.44-0.78; p < 0.001) than ccRCC. Patients treated with partial nephrectomy (PN) had an 18% better overall survival (HR = 0.83, 95% CI = 0.71-0.95, p < 0.001) than patients treated with radical nephrectomy.

Conclusions: Age, gender, T-stage, tumor size, RCC type and treatment modality are all associated with risk of recurrence. Furthermore, age, male gender, tumor size, N-stage and recurrence are associated with reduced overall survival. Patients with chRCC, compared with ccRCC and pRCC patients, and PN compared with RN treated patients, had an advantageous overall survival, indicating a possible survival advantage of nephron sparing treatment.

Place, publisher, year, edition, pages
Taylor & Francis, 2023
Keywords
RCC type, Radical nephrectomy, T-stage, TNM stage, cryoablation, overall survival, partial nephrectomy, radiofrequency ablation, renal cell carcinoma, tumor recurrence, tumor size.
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:oru:diva-102746 (URN)10.1080/21681805.2022.2154383 (DOI)000897992900001 ()36520023 (PubMedID)2-s2.0-85144116341 (Scopus ID)
Available from: 2022-12-15 Created: 2022-12-15 Last updated: 2023-05-19Bibliographically approved
Almdalal, T., Sundqvist, P., Harmenberg, U., Hellström, M., Lindskog, M., Lindblad, P., . . . Ljungberg, B. (2022). Clinical T1a Renal Cell Carcinoma, Not Always a Harmless Disease-A National Register Study. European Urology Open Science, 39, 22-28
Open this publication in new window or tab >>Clinical T1a Renal Cell Carcinoma, Not Always a Harmless Disease-A National Register Study
Show others...
2022 (English)In: European Urology Open Science, ISSN 2666-1691, E-ISSN 2666-1683, Vol. 39, p. 22-28Article in journal (Refereed) Published
Abstract [en]

Background: T1a renal cell carcinoma (RCC) is typically considered a curable disease, irrespective of the choice of local treatment modality.

Objective: To identify factors associated with the risk of local and distant recurrence, and overall survival (OS) in patients with primary nonmetastatic clinical T1a RCC.

Design setting and participants: A population-based nationwide register study of all 1935 patients with cT1a RCC, diagnosed during 2005-2012, identified through The National Swedish Kidney Cancer Register, was conducted.

Outcome measurements and statistical analysis: Outcome variables were recurrence (local or distant) and OS. Possible explanatory variables included tumor size, RCC type, T stage, surgical technique, age, and gender. Associations with disease recurrence and OS were evaluated by multivariable regression and Cox multivariate analyses, respectively.

Results and limitations: Among 1935 patients, 938 were treated with radical nephrectomy, 738 with partial nephrectomy, and 169 with ablative treatments, while 90 patients had no surgery. Seventy-eight (4%) patients were upstaged to pT3. Local or metastatic recurrences occurred in 145 (7.5%) patients, significantly more often after ablation (17.8%). The risk of recurrence was associated with tumor size, upstaging, and ablation. Larger tumor size, disease recurrence, and older age adversely affected OS, whereas partial nephrectomy and chromophobe RCC (chRCC) were associated with improved survival. Limitations include register design and a lack of comorbidity or performance status data.

Conclusions: Upstaging and recurrence occurred, respectively, in 4.0% and 7.5% of patients with nonmetastatic RCCs ≤4 cm. Tumor size upstaging and ablation were associated with the risk for recurrence, while tumor size and recurrence were associated with decreased OS. Patients with chRCC and partial nephrectomy had prolonged OS in a real-world setting.

Patient summary: We studied factors that may influence the risk of disease recurrence and overall survival, in a large nationwide patient cohort having nonmetastatic renal cell carcinoma ≤4 cm. Tumor size, tumor type, and treatment were associated with the risk of recurrence and overall death. Partial nephrectomy prolonged overall survival.

Place, publisher, year, edition, pages
Elsevier, 2022
Keywords
Cryoablation, Overall survival, Partial nephrectomy, Radical nephrectomy, Radiofrequency ablation, Renal cell carcinoma, Renal cell carcinoma type, T stage, Tumor size
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:oru:diva-98918 (URN)10.1016/j.euros.2022.03.005 (DOI)000792905200003 ()35528783 (PubMedID)2-s2.0-85127324868 (Scopus ID)
Note

Funding agencies:

Swedish Association of Local Authorities and Regions (SALAR)

Clinical Research Center in the county of Sörmland, Sweden

Available from: 2022-05-10 Created: 2022-05-10 Last updated: 2022-07-05Bibliographically approved
Karlsson Rosenblad, A., Sundqvist, P., Harmenberg, U., Hellström, M., Hofmann, F., Kjellman, A., . . . Ljungberg, B. (2022). Surgical waiting times and all-cause mortality in patients with non-metastatic renal cell carcinoma. Scandinavian journal of urology, 56(5-6), 383-390
Open this publication in new window or tab >>Surgical waiting times and all-cause mortality in patients with non-metastatic renal cell carcinoma
Show others...
2022 (English)In: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813, Vol. 56, no 5-6, p. 383-390Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To examine the association between surgical waiting times (SWTs) and all-cause mortality (ACM) in non-metastatic patients with RCC, in relation to tumour stage.

PATIENTS AND METHODS: This nation-wide population-based cohort study included 9,918 M0 RCC patients registered in the National Swedish Kidney Cancer Register, between 2009 and 2021, followed-up for ACM until 9 December 2021, and having measured SWTs. The associations between primarily SWTs from date of radiological diagnosis to date of surgery (WRS) and secondarily SWTs from date of radiological diagnosis to date of treatment decision (WRT) and date of treatment decision to date of surgery (WTS), in relation to ACM, were analysed using Cox regression analysis, adjusted for clinical and demographic characteristics, stratified and unstratified according to T-stage.

RESULTS: During a mean follow-up time of 5 years (49,873 person-years), 23% (n = 2291) of the patients died. The adjusted hazard ratio (AHR) for WRS (months) for all patients was 1.03 (95% confidence interval [CI] = 1.02-1.04; p < 0.001). When subdividing WRS on T-stage, the AHRs were 1.03 (95% CI = 1.01-1.04; p < 0.001) and 1.05 (95% CI = 1.02-1.08; p = 0.003) for stages T1 and T3, respectively, while non-significant for T2 (p = 0.079) and T4 (p = 0.807). Similar results were obtained for WRT and WTS.

CONCLUSIONS: Prolonged SWTs significantly increased the risk of early overall death among patients with RCC. The increased risk of early death from any cause show the importance of shortening SWTs in clinical work of patients with this malignant disease.

Place, publisher, year, edition, pages
Taylor & Francis, 2022
Keywords
T-stage, all-cause mortality, cryoablation, kidney cancer, nephrectomy, nephron sparing surgery, overall survival, radiofrequency ablation, renal cancer carcinoma, renal surgery, surgical waiting time, time-to-surgery
National Category
Cancer and Oncology Surgery
Identifiers
urn:nbn:se:oru:diva-100729 (URN)10.1080/21681805.2022.2107067 (DOI)000842796900001 ()35983600 (PubMedID)2-s2.0-85136527331 (Scopus ID)
Funder
Swedish Association of Local Authorities and Regions
Available from: 2022-08-22 Created: 2022-08-22 Last updated: 2023-01-19Bibliographically approved
Åkerlund, J., Holmberg, E., Lindblad, P., Stendahl, M., Ljungberg, B., Thorstenson, A. & Lundstam, S. (2021). Increased risk for renal cell carcinoma in end stage renal disease: a population-based case-control study. Scandinavian journal of urology, 55(3), 209-214
Open this publication in new window or tab >>Increased risk for renal cell carcinoma in end stage renal disease: a population-based case-control study
Show others...
2021 (English)In: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813, Vol. 55, no 3, p. 209-214Article in journal (Refereed) Published
Abstract [en]

PURPOSE: End-stage renal disease (ESRD) is a known risk factor for the development of renal cell carcinoma (RCC). This case-control study was performed to assess the risk in a nationwide cohort and evaluate tumor characteristics and survival in the ESRD-RCC population.

METHODS: In this study, 9,299 patients with RCC identified in the National Swedish Kidney Cancer Register from 2005 until 2014 and 93,895 matched controls were linked to the Swedish Renal Registry and the National Patient Register. ESRD was defined as chronic kidney disease stage 5, kidney transplantation or kidney dialysis 0-40 years before the diagnosis of RCC.

RESULTS: A total of 117 patients with ESRD and subsequent RCC were identified and compared with 9,087 patients with RCC. There was a 4.5-times increased risk for RCC among ESRD patients (95% CI = 3.6-5.6; p < 0.001) compared to matched controls. Longer time with ESRD increased the risk of RCC (ESRD > 9 years, OR = 10.2, 95% CI = 7.0-14.8). The ESRD-RCC patients were younger (p = 0.002), had smaller tumors (p < 0.001) and had lower tumor stage (p = 0.045). The incidence of papillary and chromophobe RCC was higher and clear cell RCC lower among the ESRD patients (p < 0.001). The 5-year overall survival was 50% in ESRD-RCC patients and 63% in RCC-only patients (p < 0.05).

CONCLUSION: More than 9 years with ESRD increased the risk of developing RCC 10-times compared to individuals without ESRD and the tumors showed a different histopathological pattern. Despite a less advanced tumor stage at diagnosis, the overall survival in ESRD-RCC patients was lower compared to patients with RCC-only.

Place, publisher, year, edition, pages
Taylor & Francis, 2021
Keywords
Renal cell carcinoma, end-stage renal disease, pathology, survival
National Category
Urology and Nephrology
Identifiers
urn:nbn:se:oru:diva-90772 (URN)10.1080/21681805.2021.1900387 (DOI)000633252700001 ()33769206 (PubMedID)2-s2.0-85103185222 (Scopus ID)
Note

Funding Agencies:

Martha and Gustaf Agren's research Foundation  

Foundation of Anna-Lisa and Bror Björnsson  

Research Foundation at the Urology Department of Sahlgrenska University Hospital  

Project ALF at Sahlgrenska University Hospital 75770

Available from: 2021-03-29 Created: 2021-03-29 Last updated: 2021-06-29Bibliographically approved
Landberg, A., Bruce, D., Lindblad, P., Ljungberg, B., Lundstam, S., Thorstenson, A. & Sundqvist, P. (2021). Validation of data quality in the National Swedish Kidney Cancer Register. Scandinavian journal of urology, 55(2), 142-148
Open this publication in new window or tab >>Validation of data quality in the National Swedish Kidney Cancer Register
Show others...
2021 (English)In: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813, Vol. 55, no 2, p. 142-148Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: The National Swedish Kidney Cancer Register (NSKCR) was launched in 2005. It is used for health care quality improvement and research. The aim of this study was to validate the register's data quality by assessing the timeliness, completeness, comparability and validity of the register.

MATERIAL AND METHODS: To assess timeliness we evaluated the number of days between date of diagnosis and date of reporting the patient to the NSKCR. For completeness, we used data on number of cancer cases reported to the NSKCR compared to cases reported to the Swedish Cancer Register. Comparability was evaluated by reviewing coding routines and comparing data collected in the NSKCR to national and international guidelines. Validity was assessed by reabstraction of data from medical charts from 431 randomly selected patients diagnosed in 2007, 2010, 2013 and 2016.

RESULTS: Timeliness has improved since the register started. In 2016, 76.9% and 96.5% of the patients were reported within 6 and 12 months respectively. Completeness was high, with a 99.5% coverage between 2008 and 2017. Registration forms and manuals were updated according to national and European guidelines. Improvements have been made continuously to decrease the risk of reporting mistakes and misunderstandings. Validity was high where a majority of the variables demonstrated an exact agreement >90% and few missing values.

CONCLUSION: Overall, the data quality of the NSKCR is high. Completeness, comparability and validity is high. Timeliness can be further improved, which will make it easier to follow changes and improve the care and research of RCC patients.

Place, publisher, year, edition, pages
Taylor & Francis, 2021
Keywords
Renal cell carcinoma, quality register, validation
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:oru:diva-89752 (URN)10.1080/21681805.2021.1885485 (DOI)000619326700001 ()33599561 (PubMedID)2-s2.0-85100979959 (Scopus ID)
Note

Funding Agencies:

Swedish government  c

Cunty councils (ALF-agreement)  

Available from: 2021-02-19 Created: 2021-02-19 Last updated: 2023-12-08Bibliographically approved
Ljungberg, B., Sundqvist, P., Lindblad, P., Kjellman, A., Thorstenson, A., Hellström, M., . . . Lundstam, S. (2020). Survival advantage of upfront cytoreductive nephrectomy in patients with primary metastatic renal cell carcinoma compared with systemic and palliative treatments in a real-world setting. Scandinavian journal of urology, 54(6), 487-492
Open this publication in new window or tab >>Survival advantage of upfront cytoreductive nephrectomy in patients with primary metastatic renal cell carcinoma compared with systemic and palliative treatments in a real-world setting
Show others...
2020 (English)In: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813, Vol. 54, no 6, p. 487-492Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Recently, the CARMENA and SURTIME studies, suggested that upfront cytoreductive nephrectomy (CN) should be abandoned for patients with intermediate and high-risk metastatic renal cell carcinoma (mRCC). However, CN remains an indication in low-risk and when immediate systemic treatment is not required. The aim was to evaluate the long-term overall survival (OS) in patients with primary mRCC, based on the first line treatment.

METHODS: There were 1483 patients with primary mRCC in the National Kidney Cancer Registry from 2005 to 2013. Data on primary treatment, TNM stage, RCC type, tumor size, patient age and sex were extracted. Survival time was calculated from time of diagnosis to time of death or until July 2019. Mann-Whitney U and Chi-square tests, the Kaplan-Meyer method and Cox regression analyses were used.

RESULTS: Patients primary treated with CN had a significantly longer OS (p < .001) than patients primary treated with systemic therapy or palliation. In a Cox regression multivariate analysis, the hazard ratio for CN compared with no CN was 1.600, 95%Ci (1.492 - 1.691), p < .001. Also occurrence of lymph node metastases, T-stage, patients age and year of diagnosis, remained as independent predictors of OS.

CONCLUSION: Patients primary treated with CN survived significantly longer than patients primary treated with systemic therapy or palliation, in all age groups. CN was an important first-line treatment option in mRCC patients.

Place, publisher, year, edition, pages
Taylor & Francis, 2020
Keywords
Cytoreductive nephrectomy, metastatic renal cell carcinoma, renal cell carcinoma, systemic therapy, targeted therapy
National Category
Cancer and Oncology Urology and Nephrology
Identifiers
urn:nbn:se:oru:diva-85509 (URN)10.1080/21681805.2020.1815833 (DOI)000567593800001 ()32897123 (PubMedID)2-s2.0-85090466668 (Scopus ID)
Available from: 2020-09-09 Created: 2020-09-09 Last updated: 2020-12-18Bibliographically approved
Landberg, A., Lindblad, P., Harmenberg, U., Lundstam, S., Ljungberg, B., Thorstenson, A. & Sundqvist, P. (2020). The renal cell cancer database Sweden (RCCBaSe): a new register-based resource for renal cell carcinoma research. Scandinavian journal of urology, 54(3), 235-240
Open this publication in new window or tab >>The renal cell cancer database Sweden (RCCBaSe): a new register-based resource for renal cell carcinoma research
Show others...
2020 (English)In: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813, Vol. 54, no 3, p. 235-240Article in journal (Refereed) Published
Abstract [en]

Introduction: In 2005, the National Swedish Kidney Cancer Register (NSKCR) was set up to collect data on newly diagnosed patients with renal cell carcinoma (RCC). In 2015, the NSKCR was linked to a number of national healthcare and demographic registers to construct the Renal Cell Cancer Database Sweden (RCCBaSe). The aim was to facilitate research on trends in incidence, effects of treatment and survival, with detailed data on tumour characteristics, treatment, pharmaceutical prescriptions, socioeconomic factors and comorbidity.

Material and methods: All patients registered in the NSKCR between 2005 and 2014 were included. For each case, ten controls and first-degree relatives for cases and controls were identified. The RCCBaSe was created linking all cases, controls and first-degree relatives to a number of national registers with information on co-morbidity, socioeconomic factors and pharmaceutical prescriptions.

Results: Between 2005 and 2014, a total of 9,416 patients with RCC were reported to the NSKCR. 94,159 controls and a total cohort of 575,007 individuals including cases, controls and first-degree relatives were identified. Linkage to the Swedish cancer register resulted in 106,772 matches. When linked to the National patient register, 432,677 out-patient and 471,359 in-patient matches were generated. When linked to the Swedish renal registry 1,778 matches were generated. Linkage to the Prescribed drug register resulted in 448,084 matches and linkage to the The Longitudinal integration database for health insurance and labour market studies database resulted in 450,017 matches.

Conclusion: By linking the NSKCR to several Swedish national databases, a unique database for RCC research has been created.

Place, publisher, year, edition, pages
Taylor & Francis, 2020
Keywords
Renal cell carcinoma, quality register, record linkage
National Category
Cancer and Oncology
Identifiers
urn:nbn:se:oru:diva-81983 (URN)10.1080/21681805.2020.1766561 (DOI)000537939700001 ()32436435 (PubMedID)2-s2.0-85085500730 (Scopus ID)
Note

Funding Agencies:

Swedish government and the county councils (ALF-agreement) 

Available from: 2020-05-22 Created: 2020-05-22 Last updated: 2020-12-01Bibliographically approved
Grabowska, B., Ulvskog, E., Carlsson, J., Fiorentino, M., Giunchi, F., Lindblad, P. & Sundqvist, P. (2018). Clinical outcome and time trends of surgically treated renal cell carcinoma between 1986 and 2010: results from a single centre in Sweden. Scandinavian journal of urology, 52(3), 206-212
Open this publication in new window or tab >>Clinical outcome and time trends of surgically treated renal cell carcinoma between 1986 and 2010: results from a single centre in Sweden
Show others...
2018 (English)In: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813, Vol. 52, no 3, p. 206-212Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: The aims of this study were to create a cohort of retrospectively collected renal cell carcinoma (RCC) specimens to be used a basis for prognostic molecular studies, and to investigate the outcome and time trends in patients surgically treated for RCC in a single-centre cohort.

MATERIALS AND METHODS: Patients undergoing surgery for RCC between 1986 and 2010 were included in the study. Medical records were reviewed, and the diagnostic tissue was re-evaluated according to a modern classification. The change in patient and tumour characteristics over time was analysed.

RESULTS: The study included 345 patients. Smaller tumours, as indicated by primary tumour diameter, tumour (T) stage and American Joint Committee on Cancer (AJCC) stage, were found more frequently in later years compared to the early 1990s. No changes in the clinical outcome for the patients were seen among the time periods investigated. Increasing T stage, AJCC stage, primary tumour diameter and decreasing haemoglobin levels were associated with cancer-specific mortality in univariate analysis. A high calcium level was significantly associated with increased cancer-specific mortality (hazard ratio = 4.25, 95% confidence interval 1.36-13.28) in multivariate analysis.

CONCLUSIONS: This study on patients who underwent surgery for RCC from 1986 to 2010 at a single institution in Sweden indicates that there has been a change in tumour characteristics of patients diagnosed with RCC over time. It was also shown that calcium levels were an independent prognostic factor for cancer-specific mortality in this cohort. This cohort could provide a valuable basis for further molecular studies.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2018
Keywords
OKCC, RCC, histopathology, kidney cancer, molecular biomarkers, renal cancer, survival
National Category
Urology and Nephrology Cancer and Oncology
Identifiers
urn:nbn:se:oru:diva-68371 (URN)10.1080/21681805.2018.1430706 (DOI)000452052700008 ()29972347 (PubMedID)2-s2.0-85049554390 (Scopus ID)
Available from: 2018-08-07 Created: 2018-08-07 Last updated: 2023-06-29Bibliographically approved
Åström, M., Tajeddinn, W., Karlsson, M. G., Linder, O., Palmblad, J. & Lindblad, P. (2018). Cytokine Measurements for Diagnosing and Characterizing Leukemoid Reactions and Immunohistochemical Validation of a Granulocyte Colony-Stimulating Factor and CXCL8-Producing Renal Cell Carcinoma. Biomarker Insights, 13, Article ID UNSP 1177271918792246.
Open this publication in new window or tab >>Cytokine Measurements for Diagnosing and Characterizing Leukemoid Reactions and Immunohistochemical Validation of a Granulocyte Colony-Stimulating Factor and CXCL8-Producing Renal Cell Carcinoma
Show others...
2018 (English)In: Biomarker Insights, E-ISSN 1177-2719, Vol. 13, article id UNSP 1177271918792246Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Various paraneoplastic syndromes are encountered in renal cell carcinomas. This case report illustrates that a paraneoplastic leukemoid reaction may precede the diagnosis of renal cell carcinoma and be explained by cytokine production from the cancer cells.

CASE PRESENTATIONS: A 64-year-old man was referred for hematology workup due to pronounced leukocytosis. While being evaluated for a possible hematologic malignancy as the cause, he was found to have a metastasized renal cell carcinoma, and hyperleukocytosis was classified as a leukemoid reaction. A multiplex panel for measurement of 25 serum cytokines/chemokines showed highly elevated levels of granulocyte colony-stimulating factor (G-CSF) and CXCL8 (C-X-C-motif chemokine ligand 8, previously known as interleukin [IL]-8). By immunohistochemistry it was shown that the renal carcinoma cells expressed both these cytokines. Two additional, consecutive patients with renal cell carcinoma with paraneoplastic leukocytosis also showed elevated serum levels of CXCL8, but not of G-CSF. Nonparametric statistical evaluation showed significantly higher serum concentrations of CXCL8, IL-6, IL-10, monocyte chemoattractant protein 1 (MCP-1), and tumor necrosis factor, but lower interferon gamma (IFN-gamma) and IL-1 alpha, for the 3 renal cell carcinoma cases compared with healthy blood donors.

CONCLUSIONS: In suspected paraneoplastic leukocytosis, multiplex serum cytokine analyses may facilitate diagnosis and provide an understanding of the mechanisms for the reaction. In the index patient, combined G-CSF and CXCL8 protein expression by renal carcinoma cells was uniquely documented. A rapidly fatal course was detected in all 3 cases, congruent with the concept that autocrine/paracrine growth signaling in renal carcinoma cells may induce an aggressive tumor phenotype. Immune profiling studies could improve our understanding for possible targets when choosing therapies for patients with metastatic renal cell carcinoma.

Place, publisher, year, edition, pages
Sage Publications, 2018
Keywords
chemokine, IL-6, IL-10, monocytosis, paraneoplastic leukocytosis, autocrine signaling, multiplex, inflammatory response, precision medicine, biomarker
National Category
Immunology in the medical area Medical Biotechnology (with a focus on Cell Biology (including Stem Cell Biology), Molecular Biology, Microbiology, Biochemistry or Biopharmacy)
Identifiers
urn:nbn:se:oru:diva-68648 (URN)10.1177/1177271918792246 (DOI)000441829800001 ()30147294 (PubMedID)2-s2.0-85060719764 (Scopus ID)
Available from: 2018-08-31 Created: 2018-08-31 Last updated: 2023-12-08Bibliographically approved
Thorstenson, A., Harmenberg, U., Lindblad, P., Ljungberg, B. & Lundstam, S. (2016). Impact of quality indicators on adherence to National and European guidelines for renal cell carcinoma. Scandinavian journal of urology, 50(1), 2-8
Open this publication in new window or tab >>Impact of quality indicators on adherence to National and European guidelines for renal cell carcinoma
Show others...
2016 (English)In: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813, Vol. 50, no 1, p. 2-8Article in journal (Refereed) Published
Abstract [en]

Objective: The aim of this population-based study was to evaluate the impact of quality indicators on the adherence to guidelines for renal cell carcinoma (RCC).

Material and methods: Since 2005, virtually all patients with newly diagnosed RCC in Sweden have been registered in the National Swedish Kidney Cancer Register (NSKCR). The register contains information on histopathology, nuclear grade, clinical stage, preoperative work-up, treatment, recurrence and survival. In addition, a number of quality indicators have been measured in the register aiming to increase the quality of care. The quality indicators are: the coverage of the register, histology reports, preoperative chest computed tomography (CT), partial nephrectomy, laparoscopic surgery, centralization to high-volume hospitals and waiting times.

Results: A total of 8556 patients with diagnosed RCC were registered from 2005 to 2013 (99% coverage). In 2013, 99% of the histopathology reports were standardized. The number of patients with preoperatively chest CT increased from 59% in 2005 to 89% in 2013. The proportion of patients with RCC T1aN0M0 who underwent partial nephrectomy increased from 22% in 2005 to 56% in 2013. Similarly, laparoscopic radical nephrectomies increased from 6% in 2005 to 24% in 2013. The median tumour size at detection decreased from 60 mm in 2005 to 55 mm in 2013. The proportion of patients who were incidentally detected increased from 43% in 2005 to 55% in 2013.

Conclusions: The data show an improved adherence to the guidelines for RCC as measured by quality indicators and a steady process of earlier detection of patients with RCC.

Place, publisher, year, edition, pages
Taylor & Francis, 2016
Keywords
Population-based, quality indicators, renal cell carcinoma, surgery, Sweden, tumour size, tumour type
National Category
Cancer and Oncology Urology and Nephrology
Research subject
Surgery esp. Urology Specific; Oncology
Identifiers
urn:nbn:se:oru:diva-45369 (URN)10.3109/21681805.2015.1059882 (DOI)000367832000002 ()26202573 (PubMedID)2-s2.0-84954092344 (Scopus ID)
Note

Funding Agencies:

Umeå University

Lions Cancer Research Foundation, Umeå

Research Foundation at the Urology Department of Sahlgrenska University Hospital

Foundation of Anna-Lisa and Bror Björnsson

Stockholm Cancer Society

Capio St Görans Hospital

Available from: 2015-07-29 Created: 2015-07-29 Last updated: 2023-11-30Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-1217-4289

Search in DiVA

Show all publications