Results of Cytoreductive Nephrectomy in Synchronous Metastatic Kidney Cancer and a Review of the Literature
Smith Giscard Olagui,
Mariette Nsa Bidzo,
Jean Placide Owono Bouengou,
Ernest Belembaogo
Issue:
Volume 3, Issue 3, September 2022
Pages:
38-42
Received:
15 May 2022
Accepted:
30 May 2022
Published:
20 July 2022
DOI:
10.11648/j.wjmcr.20220303.11
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Abstract: The management of synchronous metastatic renal cell carcinoma (mRCC) continues to be a therapeutic challenge. Surgery is a conceivable therapeutic option in the management of metastatic kidney cancer. The aim of our study is to clarify the interest and place of cytoreductive nephrectomy (NCR) in the treatment of mRCC, in the face of certain African realities where systemic treatment is rare and expensive. It was observational, retrospective, bi-centric study on a series of patients who underwent metastatic nephrectomy regardless of their prognostic group, between 2018 and 2020; monitored and treated jointly at the HIA OBO and at the ICL. Postoperative progression was defined by the appearance of new lesions or by the aggravation of pre-existing metastatic lesions. The primary endpoint of the study was survival without locoregional recurrence (LR), progression-free survival (PFS), the secondary endpoint was overall survival (OS). We collected 14 oligo metastatic patients, ECOG 0-1, the mean age was 50.64 years, with a sex ratio of 1.75. 57% of patients were T3-T4. There was a single metastatic site in 71.5%, 22%, 7.5%, pulmonary, hepatic, adrenal respectively. The patients were distributed according to Heng's prognosis group as follows: 64% patients with good, 22% patients with intermediate, 14% patients with poor prognosis. At 3 years, there was no LR, PFS was 78.57% and OS was 85.71%. 3 patients had received adjuvant treatment with sunitinib. And 5 patients, or 36%, had complete remission (CR). CRN remains a treatment option for metastatic kidney cancer, alone or associated with systemic treatment, in patients in good general condition. This CRN sometimes remains the only therapeutic option available in the absence of adjuvant treatment in our settings, even in the event of a poor prognosis in operable patients.
Abstract: The management of synchronous metastatic renal cell carcinoma (mRCC) continues to be a therapeutic challenge. Surgery is a conceivable therapeutic option in the management of metastatic kidney cancer. The aim of our study is to clarify the interest and place of cytoreductive nephrectomy (NCR) in the treatment of mRCC, in the face of certain African...
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Isolated Ischimic Gangrene of the Glans Penis Post Cathiterization in a Diabetic Patient: A Case Report
Tfeil Yahya,
Mohamed Mahmoud Beya,
Mohamed Elbchir Essalem
Issue:
Volume 3, Issue 3, September 2022
Pages:
43-45
Received:
2 July 2022
Accepted:
23 July 2022
Published:
29 July 2022
DOI:
10.11648/j.wjmcr.20220303.12
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Abstract: Gangrene of the glans penis is a rare but serious condition because of rich collateral circulation and blood flow in the perineum and lower abdomen. The etiologies are diverse, with mainly predisposing factors of diabetes mellitus, artritis and chronic renal failure. We report the case of a 64-year-old diabetic patient with chronic smoking who presented to the emergency room of the nearest hospital for acute urinary retention which required the placement of an indwelling catheter, the patient developed severe penile pain after the placement of an indwelling catheter which was neglected by the care giver, four days later the patient presented again to the emergency room, but this time with severe supra pubic pain and necrosis of the glans, the patient was hospitalized and brad spectrum antibiotic was administered and he prepared for surgical treatment and had undergone a partial amputation of the penis after suprapubic urinary diversion. The evolution was marked by the installation of a stenosis of the urethral orifice which required repeated dilation, and the Histological examination of the specimen revealed no pathology other than severe necrosis, Indwelling catheter is frequently used to manage male urinary retention, but it should not be used carelessly or overlooked as it can cause severe complications such as penile gangrene.
Abstract: Gangrene of the glans penis is a rare but serious condition because of rich collateral circulation and blood flow in the perineum and lower abdomen. The etiologies are diverse, with mainly predisposing factors of diabetes mellitus, artritis and chronic renal failure. We report the case of a 64-year-old diabetic patient with chronic smoking who pres...
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