The occurrence of @entity3969 in @entity8 : a report from the National XXXX Study Group (NWTSG).

@entity1 @entity8 @entity1901 @entity5 @entity1695 @entity532 @entity177 @entity3969
BACKGROUND/PURPOSE: An increased incidence of @entity3969 has been noted in @entity1 with a @entity8 . These represent a difficult diagnostic and therapeutic challenge. The charts of all National @entity3969 Study Group (NWTSG) @entity1 with @entity3969 occurring in a @entity8 were reviewed. METHODS: From 1969 to 1998, 8,617 @entity1 were enrolled in the NWTSG. Forty-one @entity1 were found to have a @entity3969 arising in a @entity8 for an incidence of 0.48%. Their records were reviewed retrospectively. RESULTS: Horseshoe kidney was not recognized preoperatively in 13 @entity1 , 10 of whom were evaluated with computed tomography (CT). Four of the 10 also had renal ultrasonography and one an intravenous pyelogram (IVP). Two of the 13 were evaluated with an IVP only, and the last had no preoperative imaging studies performed. Stage at presentation was stage I, 10 pts; stage II, 10; stage III, 12; stage IV, 6; stage V, 3. Primary surgical resection was performed in 26 @entity1 , including 23 nephrectomies and 3 partial nephrectomies. Fifteen @entity1 were treated with preoperative chemotherapy after initial biopsy of the @entity5 . The mean total remaining @entity8 after all operations (excluding treatment of relapses) was approximately 75%. @entity532 occurred in 14.6% of @entity1 , including 2 urine leaks, 2 @entity1695 , and 1 @entity1901 . Two @entity1 had transient @entity177 . CONCLUSIONS: The diagnosis of @entity8 often was missed on preoperative imaging. Accurate preoperative diagnosis is important in planning the operative approach and may help to decrease complications related to transection of the urinary collecting system. Although 37% of @entity1 with @entity3969 arising in a @entity8 were judged inoperable at initial exploration, all were amenable to resection after chemotherapy.
