Correlação entre os Parâmetros Clínicos, Patológicos e a Sobrevida Livre de Doença de Pacientes com Câncer Renal Tratados com Cirurgia em um Centro Oncológico do Sistema Público de Curitiba / Correlation Among Clinical and Pathological Parameters and Disease-Free Survival of Patients with Renal Cancer Treated with Surgery at a Public Cancer Clinic in Curitiba / Correlación entre Parámetros Clínicos, Patológicos y Supervivência Libre de Enfermedad de Pacientes con Cáncer Renal Tratados con Cirugía en un Centro Oncológico Público de Curitiba

Introdução: O câncer renal corresponde a 13ª neoplasia mais incidente no mundo, sendo o terceiro tipo de câncer geniturinário mais comum. A maioria dos pacientes é assintomática, ocorrendo o diagnóstico de maneira incidental durante a realização de exames de imagem. O tratamento padrão-ouro é o cirúrgico. Objetivo: Correlacionar os parâmetros clínicos e patológicos com a sobrevida livre de doença em pacientes com câncer renal submetidos à nefrectomia. Método: Estudo retrospectivo com 99 pacientes submetidos a tratamento cirúrgico do câncer renal no período de 2010 a 2020. Foram comparados os parâmetros clínicos e patológicos com o desfecho clínico oncológico após nefrectomia. Resultados: Os 99 pacientes tiveram seguimento pós-operatório médio de 26,9 meses, sendo a sobrevida livre de doença (média) de 61,9%. A análise univariada demonstrou que as variáveis tamanho de tumor >7 cm e graus de Fuhrman III e IV estiveram relacionadas à progressão de doença após a nefrectomia (p=0,046 e IC=1,017-7,083; p=0,005 e IC=1,725-23,004, respectivamente). Na análise multivariada, o tamanho do tumor >7 cm (p=0,014 e IC=1,290-9,326) e os graus de Fuhrman III e IV (p=0,028 e IC=1,174-16,616) foram identificados como fatores preditores à progressão. Conclusão: O tamanho tumoral >7 cm e/ou os graus III ou IV de Fuhrman são fatores de risco para recorrência tumoral após o tratamento cirúrgico do câncer renal

Introduction: Kidney cancer corresponds to the 13th most incident cancer in the world, and the third most common type of genitourinary cancer. Most patients are asymptomatic, and the diagnosis used to be incidental during routine imaging exams. Surgical treatment is the gold standard. Objective: To correlate clinical and pathological parameters with diseasefree survival in renal cancer patients submitted to nephrectomy. Method: Retrospective study with 99 patients who underwent surgical treatment of kidney cancer from 2010 to 2020. Clinical and pathological parameters were compared with the clinical oncologic outcome after surgery. Results: Ninety-nine patients were followed-up postoperatively for an average time of 26.9 months, and the mean disease-free survival was 61.9%. Univariate analysis showed that tumor size >7 cm and Fuhrman grades III and IV were risk factors related to disease progression after nephrectomy (p=0.046 and CI=1.017-7.083; p=0.005 and CI=1.725-23.004, respectively). In the multivariate analysis, tumor size > 7cm (p=0.014 and CI=1.290-9.326) and Fuhrman grades III and IV (p=0.028 and CI=1.174-16.616) were identified as predictors of progression. Conclusion: Tumor size >7 cm and/or Fuhrman grades III or IV are risk factors for tumor recurrence after surgical treatment of renal cancer

Introducción: El cáncer de riñón corresponde a la 13ª neoplasia más incidente en el mundo, siendo el tercer tipo de cáncer genitourinario más común. La mayoría de los pacientes son asintomáticos, realizándose el diagnóstico de forma incidental durante las pruebas de imagen. El tratamiento estándar de oro es el quirúrgico. Objetivo: Correlacionar parámetros clínicos y patológicos con la supervivencia libre de enfermedad en pacientes con cáncer renal sometidos a nefrectomía. Método: Estudio retrospectivo con 99 pacientes sometidos a tratamiento quirúrgico de cáncer renal desde 2010 hasta 2020. Se compararon los parámetros clínicos y patológicos con el resultado clínico oncológico tras la nefrectomía. Resultados: Los 99 pacientes tuvieron un seguimiento postoperatorio medio de 26,9 meses, siendo la supervivencia libre de enfermedad (mediana) de 61,9%. El análisis univariado demostró que las variables tamaño del tumor >7 cm y grados III y IV de Fuhrman fueron factores relacionados con la progresión de la enfermedad tras la nefrectomía (p=0,046 e IC=1,017-7,083; p=0,005 e IC=1,725-23,004, respectivamente). En el análisis multivariante, el tamaño del tumor >7 cm (p=0,014 e IC=1,290-9,326) y grados de Fuhrman III y IV (p=0,028 e IC=1,174-16,616) fueron identificados como predictores de progresión. Conclusión: El tamaño tumoral >7 cm y/o los grados III o IV de Fuhrman son factores de riesgo para la recidiva tumoral tras el tratamiento quirúrgico del cáncer renal

Tadalafil protector effect during ischemia-reperfusion in rats.

PURPOSE: To evaluate histological parameters in rat renal tissue after tadalafil use during hot ischemia for 45 minutes and reperfusion for 24 hours. METHODS: Twenty rats were divided into 2 groups. In the experimental group 10 mg/kg of tadalafil was used per gavage before the procedure. All cases underwent left partial nephrectomy, followed by 45 minutes of warm ischemia. Left nephrectomy of the remaining kidney was performed after 24 hours from the initial procedure. The histological parameters analyzed were: detachment of tubular cells, accumulation of desquamated cells in the proximal tubule, loss of brush border, tubular cylinders, interstitial edema, leukocyte infiltration, capillary congestion, vacuolization, tubular dilatation, necrosis and collapse of the capillary tuft. RESULTS: Two rats from each group died and were excluded from the study. Tadalafil significantly reduced leukocyte infiltration (p = 0.036). The remaining histological parameters did not show statistical difference between the groups. CONCLUSION: The use of tadalafil during warm ischemia and reperfusion demonstrates statistically significant reduction of leukocyte infiltration in the renal interstitium.

Tadalafil protector effect during ischemia-reperfusion in rats

Abstract Purpose: To evaluate histological parameters in rat renal tissue after tadalafil use during hot ischemia for 45 minutes and reperfusion for 24 hours. Methods: Twenty rats were divided into 2 groups. In the experimental group 10 mg/kg of tadalafil was used per gavage before the procedure. All cases underwent left partial nephrectomy, followed by 45 minutes of warm ischemia. Left nephrectomy of the remaining kidney was performed after 24 hours from the initial procedure. The histological parameters analyzed were: detachment of tubular cells, accumulation of desquamated cells in the proximal tubule, loss of brush border, tubular cylinders, interstitial edema, leukocyte infiltration, capillary congestion, vacuolization, tubular dilatation, necrosis and collapse of the capillary tuft. Results: Two rats from each group died and were excluded from the study. Tadalafil significantly reduced leukocyte infiltration (p = 0.036). The remaining histological parameters did not show statistical difference between the groups. Conclusion: The use of tadalafil during warm ischemia and reperfusion demonstrates statistically significant reduction of leukocyte infiltration in the renal interstitium.

Influence of chlorpromazine on renal histology of rats submitted to ischemia and reperfusion injury.

PURPOSE:: To analyze the influence of chlorpromazine on renal histology of rats submitted to ischemia and reperfusion injury. METHODS:: Sixteen Wistar rats - split in two groups - have been used: control group, receiving 3 mg/kg isotonic saline solution through caudal vein, and, the chlorpromazine group, receiving 3 mg/kg-IV of such medication. The nephrectomy of the left kidney lower third was carried out; immediately, the test-drug was administrated. After 15 minutes of test-drug administration, the renal pedicle was clamped; in 60 minutes of ischemia it was released. After 24 hours of the renal reperfusion, the rats were, once more, anesthetized and submitted to total left nephrectomy, and, afterwards, to euthanasia. Histological findings regarding ischemia have been evaluated and compared between the groups. RESULTS:: There was no statistical difference related to inferior renal pole histological analysis. Regarding 60-minute renal ischemia, chlorpromazine has statistically reduced the accrual of leucocytes within the vasa recta renis (p=0.036) and the congestion of peritubular capillaries (p=0.041). When conducting joint analysis of histological patterns, the control group showed a median score of 11 and chlorpromazine group of 5.5 (p=0.036). CONCLUSION:: Chlorpromazine significantly reduced the occurrence of secondary damage to ischemia and reperfusion process in the overall histological analysis.

Influence of chlorpromazine on renal histology of rats submitted to ischemia and reperfusion injury

ABSTRACT PURPOSE: To analyze the influence of chlorpromazine on renal histology of rats submitted to ischemia and reperfusion injury. METHODS: Sixteen Wistar rats - split in two groups - have been used: control group, receiving 3 mg/kg isotonic saline solution through caudal vein, and, the chlorpromazine group, receiving 3 mg/kg-IV of such medication. The nephrectomy of the left kidney lower third was carried out; immediately, the test-drug was administrated. After 15 minutes of test-drug administration, the renal pedicle was clamped; in 60 minutes of ischemia it was released. After 24 hours of the renal reperfusion, the rats were, once more, anesthetized and submitted to total left nephrectomy, and, afterwards, to euthanasia. Histological findings regarding ischemia have been evaluated and compared between the groups. RESULTS: There was no statistical difference related to inferior renal pole histological analysis. Regarding 60-minute renal ischemia, chlorpromazine has statistically reduced the accrual of leucocytes within the vasa recta renis (p=0.036) and the congestion of peritubular capillaries (p=0.041). When conducting joint analysis of histological patterns, the control group showed a median score of 11 and chlorpromazine group of 5.5 (p=0.036). CONCLUSION: Chlorpromazine significantly reduced the occurrence of secondary damage to ischemia and reperfusion process in the overall histological analysis.

Prevalência de pólipos com displasia de alto grau em pacientes com idade inferior a 50 anos / Prevalence of polyps with high degree dysplasia in patients with less than 50 years of age

O câncer colorretal é uma doença freqüente e passível de diagnóstico precoce. Objetiva-se avaliar uma idade ideal para o início do rastreio dessa doença. Avaliaram-se 2.068 colonoscopias em estudo transversal; 411 mostravam pólipos e em 270 obteve-se resultado histopatológico. Verificou-se idade média de 61 anos, sendo 52 (141) do sexo feminino; 61 (161) eram pólipos neoplásicos; desses, 15 (25) continham displasia de alto grau; 28 (7) das displasias de alto grau concentravam-se na população com idade inferior a 50 anos.