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  • 101.
    Ljungberg, Börje
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Kidney cancer: a new nomogram predicting survival in renal cell carcinoma2010Ingår i: Nature reviews. Urology, ISSN 1759-4820, Vol. 7, nr 8, s. 423-424Artikel i tidskrift (Refereegranskat)
  • 102.
    Ljungberg, Börje
    Umeå universitet, Medicinsk fakultet, Kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Nephron-sparing surgery--strategies for partial nephrectomy in renal cell carcinoma.2004Ingår i: Scand J Surg, ISSN 1457-4969, Vol. 93, nr 2, s. 126-31Artikel i tidskrift (Refereegranskat)
  • 103.
    Ljungberg, Börje
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Prognostic factors in renal cell carcinoma2004Ingår i: Der Urologe (Ausg. A), ISSN 0340-2592, E-ISSN 1433-0563, Vol. 43, nr Suppl 3, s. 119-120Artikel i tidskrift (Refereegranskat)
  • 104.
    Ljungberg, Börje
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Prognostic factors in renal cell carcinoma2004Ingår i: Scandinavian Journal of Surgery, ISSN 1457-4969, E-ISSN 1799-7267, Vol. 93, nr 2, s. 118-125Artikel i tidskrift (Refereegranskat)
  • 105.
    Ljungberg, Börje
    Umeå universitet, Medicinsk fakultet, Kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Prognostic markers in renal cell carcinoma.2007Ingår i: Curr Opin Urol, ISSN 0963-0643, Vol. 17, nr 5, s. 303-8Artikel, forskningsöversikt (Övrig (populärvetenskap, debatt, mm))
  • 106.
    Ljungberg, Börje
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Re: can partial nephrectomy preserve renal function and modify survival in comparison with radical nephrectomy?2011Ingår i: European Urology, ISSN 0302-2838, E-ISSN 1873-7560, Vol. 60, nr 3, s. 595-596Artikel i tidskrift (Refereegranskat)
  • 107.
    Ljungberg, Börje
    Umeå universitet, Medicinsk fakultet, Kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Should patients with pathologic stage pT3 and pT4 RCC be reclassified to improve prognostic accuracy?2006Ingår i: Nature Clinical Practice Urology, ISSN 1743-4270, Vol. 3, nr 3, s. 136-137Artikel, recension (Refereegranskat)
  • 108.
    Ljungberg, Börje
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    The role of metastasectomy in renal cell carcinoma in the era of targeted therapy2013Ingår i: Current Urology Reports, ISSN 1527-2737, Vol. 14, nr 1, s. 19-25Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Despite contemporary innovations in systemic therapy and surgical treatment, renal cell carcinoma (RCC) remains the most lethal urologic malignancy. Still, around 20 % of patients with RCC present with metastases at diagnosis, and 40-50 % of those with localized advanced disease will ultimately progress to metastatic disease. Although the new, targeted therapy paradigms have changed the treatment of patients with advanced RCC and offer prolonged survival, cure is extremely uncommon in the absence of surgical resections. In this paper, the current role of metastasectomy is reviewed. Searches were carried out in the PubMed database and the Cochrane Library of Controlled Clinical Trials. While there is no randomized study available, recent large observational studies have better defined the prognosis of patients with metastatic RCC with or without metastasectomy. In multivariate analysis, independent predictive factors included male gender, disease-free interval > 1 year, single metastatic site and complete metastasectomy. Other reports from selected patient materials show 29-31 % 5-year overall survival rates. In patients with recurrent disease after resection of a lung metastasis, 60 % were able to undergo a subsequent resection, compared with 25 % with recurrent bone metastasis. Also, metastasectomy after initial systemic therapy gave partial or complete response in a majority of patients. In these patients, the median survival was 4.7 years and 21 % remained free of disease at last follow-up. Patients with metastatic renal cell carcinoma should be considered for multimodal therapy, including surgery of metastatic lesions. A proportion of patients will achieve long-term survival with aggressive surgical resection.

  • 109.
    Ljungberg, Börje
    Umeå universitet, Medicinsk fakultet, Kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Words of wisdom. Re: Radical nephrectomy with and without lymph-node dissection2009Ingår i: European urology, ISSN 1873-7560, Vol. 55, nr 6, s. 1486-7Artikel i tidskrift (Refereegranskat)
  • 110.
    Ljungberg, Börje
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Albiges, Laurance
    Abu-Ghanem, Yasmin
    Bensalan, Karim
    Dabestani, Saeed
    Montes, Sergio Fernandez-Pello
    Giles, Rachel H.
    Hofmann, Fabian
    Hora, Milan
    Kuczyk, Markus A.
    Kuusk, Teele
    Lam, Thomas B.
    Marconi, Lorenzo
    Merseburger, Axel S.
    Powles, Thomas
    Staehler, Michael
    Tahbaz, Rana
    Volpe, Alessandro
    Bex, Axel
    European Association of Urology Guidelines on Renal Cell Carcinoma: The 2019 Update2019Ingår i: European Urology, ISSN 0302-2838, E-ISSN 1873-7560, Vol. 75, nr 5, s. 799-810Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Context: The European Association of Urology Renal Cell Carcinoma (RCC) Guideline Panel has prepared evidence-based guidelines and recommendations for the management of RCC.

    Objective: To provide an updated RCC guideline based on standardised methodology including systematic reviews, which is robust, transparent, reproducible, and reliable.

    Evidence acquisition: For the 2019 update, evidence synthesis was undertaken based on a comprehensive and structured literature assessment for new and relevant data. Where necessary, formal systematic reviews adhering to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were undertaken. Relevant databases (Medline, Cochrane Libraries, trial registries, conference proceedings) were searched until June 2018, including randomised controlled trials (RCTs) and retrospective or controlled studies with a comparator arm, systematic reviews, and meta-analyses. Where relevant, risk of bias (RoB) assessment, and qualitative and quantitative syntheses of the evidence were performed. The remaining sections of the document were updated following a structured literature assessment. Clinical practice recommendations were developed and issued based on the modified GRADE framework.

    Evidence synthesis: All chapters of the RCC guidelines were updated based on a structured literature assessment, for prioritised topics based on the availability of robust data. For RCTs, RoB was low across studies. For most non-RCTs, clinical and methodological heterogeneity prevented pooling of data. The majority of included studies were retrospective with matched or unmatched cohorts, based on single- or multi-institutional data or national registries. The exception was for the treatment of metastatic RCC, for which there were several large RCTs, resulting in recommendations based on higher levels of evidence.

    Conclusions: The 2019 RCC guidelines have been updated by the multidisciplinary panel using the highest methodological standards. These guidelines provide the most reliable contemporary evidence base for the management of RCC in 2019.

    Patient summary: The European Association of Urology Renal Cell Carcinoma Guideline Panel has thoroughly evaluated the available research data on kidney cancer to establish international standards for the care of kidney cancer patients.

  • 111.
    Ljungberg, Börje
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Bensalah, Karim
    Canfield, Steven
    Dabestani, Saeed
    Hofmann, Fabian
    Hora, Milan
    Kuczyk, Markus A.
    Lam, Thomas
    Marconi, Lorenzo
    Merseburger, Axel S.
    Mulders, Peter
    Powles, Thomas
    Staehler, Michael
    Volpe, Alessandro
    Bex, Axel
    EAU Guidelines on Renal Cell Carcinoma: 2014 Update2015Ingår i: European Urology, ISSN 0302-2838, E-ISSN 1873-7560, Vol. 67, nr 5, s. 913-924Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Context: The European Association of Urology Guideline Panel for Renal Cell Carcinoma (RCC) has prepared evidence-based guidelines and recommendations for RCC management. Objectives: To provide an update of the 2010 RCC guideline based on a standardised methodology that is robust, transparent, reproducible, and reliable. Evidence acquisition: For the 2014 update, the panel prioritised the following topics: percutaneous biopsy of renal masses, treatment of localised RCC (including surgical and nonsurgical management), lymph node dissection, management of venous thrombus, systemic therapy, and local treatment of metastases, for which evidence synthesis was undertaken based on systematic reviews adhering to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Relevant databases (Medline, Cochrane Library, trial registries, conference proceedings) were searched (January 2000 to November 2013) including randomised controlled trials (RCTs) and retrospective or controlled studies with a comparator arm. Risk of bias (RoB) assessment and qualitative and quantitative synthesis of the evidence were performed. The remaining sections of the document were updated following a structured literature assessment. Evidence synthesis: All chapters of the RCC guideline were updated. For the various systematic reviews, the search identified a total of 10 862 articles. A total of 151 studies reporting on 78 792 patients were eligible for inclusion; where applicable, data from RCTs were included and meta-analyses were performed. For RCTs, there was low RoB across studies; however, clinical and methodological heterogeneity prevented data pooling for most studies. The majority of studies included were retrospective with matched or unmatched cohorts based on single or multi-institutional data or national registries. The exception was for systemic treatment of metastatic RCC, in which several RCTs have been performed, resulting in recommendations based on higher levels of evidence. Conclusions: The 2014 guideline has been updated by a multidisciplinary panel using the highest methodological standards, and provides the best and most reliable contemporary evidence base for RCC management. Patient summary: The European Association of Urology Guideline Panel for Renal Cell Carcinoma has thoroughly evaluated available research data on kidney cancer to establish international standards for the care of kidney cancer patients. 

  • 112.
    Ljungberg, Börje
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Campbell, Steven C.
    Section of Urologic Oncology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.
    Cho, Han Yong
    Department of Urology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Korea.
    Jacqmin, Didier
    Service de Chirurgie Urologique, 1 Place de l’Hôpital, Strasbourg, France.
    Lee, Jung Eun
    Department of Food and Nutrition, Sookmyung Women's University, Seoul, Korea.
    Weikert, Steffen
    Department of Urology, Charité – University Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany.
    Kiemeney, Lambertus A.
    Department of Epidemiology, Biostatistics and Health Technology Assessment, Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
    The epidemiology of renal cell carcinoma2011Ingår i: European Urology, ISSN 0302-2838, E-ISSN 1873-7560, Vol. 60, nr 4, s. 615-621Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Context: Kidney cancer is among the 10 most frequently occurring cancers in Western communities. Globally, about 270 000 cases of kidney cancer are diagnosed yearly and 116 000 people die from the disease. Approximately 90% of all kidney cancers are renal cell carcinomas (RCC). Objective: The causes of RCC are not completely known. We have reviewed known aetiologic factors.

    Evidence acquisition: The data provided in the current review are based on a thorough review of available original and review articles on RCC epidemiology with a systemic literature search using Medline.

    Evidence synthesis: Smoking, overweight and obesity, and germline mutations in specific genes are established risk factors for RCC. Hypertension and advanced kidney disease, which makes dialysis necessary, also increase RCC risk. Specific dietary habits and occupational exposure to specific carcinogens are suspected risk factors, but results in the literature are inconclusive. Alcohol consumption seems to have a protective effect for reasons yet unknown. Hardly any information is available for some factors that may have a high a priori role in the causation of RCC, such as salt consumption.

    Conclusions: Large collaborative studies with uniform data collection seem to be necessary to elucidate a complete list of established risk factors of RCC. This is necessary to make successful prevention possible for a disease that is diagnosed frequently in a stage where curative treatment is not possible anymore.

  • 113.
    Ljungberg, Börje
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Campbell, Steven C.
    Choi, Han Yong
    Jacqmin, Didier
    Lee, Jung Eun
    Weikert, Steffen
    Kiemeney, Lambertus A.
    Corrigendum to "The Epidemiology of Renal Cell Carcinoma" (vol 60, pg 615, 2011)2011Ingår i: European Urology, ISSN 0302-2838, E-ISSN 1873-7560, Vol. 60, nr 6, s. 1317-1317Artikel i tidskrift (Refereegranskat)
  • 114.
    Ljungberg, Börje
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Cowan, Nigel C
    Hanbury, Damian C
    Hora, Milan
    Kuczyk, Markus A
    Merseburger, Axel S
    Patard, Jean-Jacques
    Mulders, Peter F A
    Sinescu, Ioanel C
    EAU guidelines on renal cell carcinoma: the 2010 update2010Ingår i: European Urology, ISSN 0302-2838, E-ISSN 1873-7560, Vol. 58, nr 3, s. 398-406Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Context and objectives

    The European Association of Urology Guideline Group for renal cell carcinoma (RCC) has prepared these guidelines to help clinicians assess the current evidence-based management of RCC and to incorporate the present recommendations into daily clinical practice.

    Evidence acquisition

    The recommendations provided in the current updated guidelines are based on a thorough review of available RCC guidelines and review articles combined with a systematic literature search using Medline and the Cochrane Central Register of Controlled Trials.

    Evidence synthesis

    A number of recent prospective randomised studies concerning RCC are now available with a high level of evidence, whereas earlier publications were based on retrospective analyses, including some larger multicentre validation studies, meta-analyses, and well-designed controlled studies.

    Conclusions

    These guidelines contain information for the treatment of an individual patient according to a current standardised general approach. Updated recommendations concerning diagnosis, treatment, and follow-up can improve the clinical handling of patients with RCC.

    Take Home Message

    This review of the 2010 European Association of Urology renal cell carcinoma guidelines is intended to help clinicians access knowledge of current evidence-based management according to a standardised general approach. Structured literature searches were carried out in different databases of systematic reviews and clinical trials. Grade of recommendation was assigned based on the underlying evidence.

  • 115.
    Ljungberg, Börje
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Gudmundsson, Eirikur
    Christensen, Stina
    Lundstam, Sven
    Practice patterns for the surgical treatment of T1 renal cell carcinoma: a nationwide population-based register study2014Ingår i: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813, Vol. 48, nr 5, s. 445-452Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective. Treatment of renal cell carcinoma (RCC) with radical nephrectomy (RN) induces chronic kidney disease more frequently compared with nephron-sparing surgery (NSS), which may have an impact on overall survival. Thus, NSS is recommended for RCCs up to 7 cm (T1). The aim of this study was to determine the extent to which these recommendations are implemented in clinical practice. Material and methods. Data were extracted from the Swedish National Kidney Cancer Register, a population-based register covering 98% of all RCCs in Sweden. In total, 3158 patients (1892 men, 1266 women) were primarily diagnosed with cT1N0M0 and treated surgically during 2005-2011. The administered treatments were evaluated between different hospitals as well as between the 21 independent healthcare counties. Results. In all, 742 patients were treated with NSS, 2339 with RN and 77 with minimally invasive ablative treatments. For cT1a RCC, patients treated with NSS increased from 22% in 2005 to 53% in 2011, and for cT1b from 2% to 10%. Nephron-sparing treatments for cT1a RCC were performed in 62% in university hospitals, 34% in intermediate- and 11% in low-volume hospitals. There was significant (p < 0.001) variation (31-67%) between the university hospitals and also for patient care in the 21 different counties (16-78%). There was an increased relative survival after NSS for T1a patients compared with RN. The register design by itself indicates limitations using data gathered from all Swedish hospitals. Conclusions. NSS was underutilized in many hospitals and a patient's chance of being offered NSS varied according to their place of residence. Patients with cT1a RCC treated with NSS had a significantly better relative survival than those treated with RN.

  • 116.
    Ljungberg, Börje
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Guomundsson, Eirikur
    Hellborg, Henrik
    Erikson, Stina
    Lundstam, Sven
    Reply from Authors re: Eric C. Umbreit, R. Houston Thompson. Metastatic Potential of the Small Renal Mass: Why Can't We Agree? Eur Urol 2011;60:983-52011Ingår i: European Urology, ISSN 0302-2838, E-ISSN 1873-7560, Vol. 60, nr 5, s. 985-986Artikel i tidskrift (Refereegranskat)
  • 117.
    Ljungberg, Börje
    et al.
    Umeå universitet, Medicinsk fakultet, Kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Hanbury, D C
    Kuczyk, M A
    Merseburger, A S
    Mulders, P F A
    Patard, J-J
    Sinescu, I C
    Guidelines on Renal Cell Carcinoma2007Ingår i: European Association of Urology Guidelines, European Association of Urology , 2007, s. 1-28Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 118.
    Ljungberg, Börje
    et al.
    Umeå universitet, Medicinsk fakultet, Kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Hanbury, D C
    Kuczyk, M A
    Merseburger, A S
    Mulders, P F A
    Patard, J-J
    Sinescu, I C
    Guidelines on Renal Cell Carcinoma2006Ingår i: European Association of Urology Guidelines, European Association of Urology , 2006, s. 1-26Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 119.
    Ljungberg, Börje
    et al.
    Umeå universitet, Medicinsk fakultet, Kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Hanbury, D C
    Kuczyk, M A
    Mulders, P F A
    Sinescu, I C
    Reply to Guiseppe Di Lorenzo`s Letter to the Editor re: B Ljungberg, DC Hanbury, MA Kuczyk, AS Merseburg, PFA Mulders, J-J Patard, I Sinescu. Renal Cell Carcinoma Guideline. Eur Urol 2007;51:1502-102007Ingår i: European Urology, ISSN 0302-2838, Vol. 52, s. 928-Artikel, recension (Refereegranskat)
  • 120.
    Ljungberg, Börje
    et al.
    Umeå universitet, Medicinsk fakultet, Kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Hanbury, Damian C
    Kuczyk, Marcus A
    Merseburger, Axel S
    Mulders, Peter F A
    Patard, Jean-Jacques
    Sinescu, Ioanel C
    Renal cell carcinoma guideline.2007Ingår i: Eur Urol, ISSN 0302-2838, Vol. 51, nr 6, s. 1502-10Artikel i tidskrift (Refereegranskat)
  • 121.
    Ljungberg, Börje
    et al.
    Umeå universitet, Medicinsk fakultet, Kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Hanbury, Damian C
    Kuczyk, Marcus A
    Merseburger, Axel S
    Mulders, Peter FA
    Patard, Jean-Jacques
    Sinescu, Ioanel C
    Reply to Giuseppe Di Lorenzo's Letter to the Editor. re: Börje Ljungberg, Damian C Hanbury, Marcus A Kuczyk, Axel S Merseburger, Peter FA Mulders, Jean-Jaques Patard and Ioanel Sinescu. Renal cell Carcinoma Guideline2007Ingår i: European Urology, ISSN 0302-2838, E-ISSN 1873-7560, Vol. 52, s. 928-928Artikel i tidskrift (Refereegranskat)
  • 122.
    Ljungberg, Börje
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Hedin, Oskar
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Lundstam, Sven
    Warnolf, Asa
    Forsberg, Annika Mandahl
    Hjelle, Karin M.
    Stief, Christian G.
    Borlinghaus, Claudia
    Beisland, Christian
    Staehler, Michael
    Nephron Sparing Surgery Associated With Better Survival Than Radical Nephrectomy in Patients Treated for Unforeseen Benign Renal Tumors2016Ingår i: Urology, ISSN 0090-4295, E-ISSN 1527-9995, Vol. 93, s. 117-121Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To evaluate the role of the surgical technique used for the treatment of benign renal tumors, with regard to renal function and overall survival (OS) in patients without cancer-related mortality.

    Patients and methods: The study included 506 patients, mean age of 63.3 years, with histologically proven benign renal lesions originating from 5 European centers. Retrospective data from each hospital were retrieved and merged into a common database for analyses. OS, American Society of Anesthesiology score, and renal functions were measured in relation to surgical technique. The Mann-Witney U-test, the paired t-test, and Cox's multivariate analysis were used.

    Results: Patients treated with radical nephrectomy had significantly reduced renal function postoperatively compared with nephron sparing surgery (NSS). OS was significantly reduced after radical nephrectomy compared with NSS (P = .012), a survival difference that remained significant [hazard ratio (HR) 0.042, 95% confidence interval (CI) 0.221-0.972, P = .042] in multivariate analysis, together with age at diagnosis (HR 1.065, 95% CI 1.026-1.106, P = .001) and American Society of Anesthesiology score (HR 2.361, 95% CI 1.261-4.419, P = .007). Also renal function assessed by estimated glomerular filtration rate significantly correlated to survival in univariate analysis, but did not remain independent after multivariate analysis. Oncocytoma was the most frequent benign lesion, followed by angiomyolipoma.

    Conclusion: The present study in patients with benign renal tumors shows that the remaining renal function and OS correspond to the choice of surgical procedure. Our results support the recommendation to perform NSS whenever possible when surgery is performed for patients with renal masses. The limitations of the study are the retrospective design and the selection bias for the surgical approach.

  • 123.
    Ljungberg, Börje
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Hedin, Oskar
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Lundstam, Sven
    Warnolf, Asa
    Forsberg, Annika Mandahl
    Hjelle, Karin M.
    Stief, Christian G.
    Borlinghaus, Claudia
    Beisland, Christian
    Staehler, Michael
    Untitled2016Ingår i: Urology, ISSN 0090-4295, E-ISSN 1527-9995, Vol. 93, s. 122-123Artikel i tidskrift (Övrigt vetenskapligt)
  • 124.
    Ljungberg, Börje
    et al.
    Umeå universitet, Medicinsk fakultet, Kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Jacobsen, Jan
    Umeå universitet, Medicinsk fakultet, Kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Häggström Rudolfsson, Stina
    Umeå universitet, Medicinsk fakultet, Kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Lindh, Gudrun
    Umeå universitet, Medicinsk fakultet, Kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Grankvist, Kjell
    Umeå universitet, Medicinsk fakultet, Medicinsk biovetenskap, Klinisk kemi.
    Rasmuson, Torgny
    Umeå universitet, Medicinsk fakultet, Strålningsvetenskaper, Onkologi.
    Different vascular endothelial growth factor (VEGF), VEGF-receptor 1 and -2 mRNA expression profiles between clear cell and papillary renal cell carcinoma.2006Ingår i: BJU Int, ISSN 1464-4096, Vol. 98, nr 3, s. 661-667Artikel i tidskrift (Refereegranskat)
  • 125.
    Ljungberg, Börje
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Jacobsen, Jan
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Häggström-Rudolfssson, Stina
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Rasmuson, Torgny
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Onkologi.
    Lindh, Gudrun
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Grankvist, Kjell
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap.
    Tumour vascular endothelial growth factor (VEGF) mRNA in relation to serum VEGF protein levels and tumour progression in human renal cell carcinoma2003Ingår i: Urological research, ISSN 0300-5623, E-ISSN 1434-0879, Vol. 31, nr 5, s. 335-40Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Angiogenesis is gaining interest because of its importance in tumour growth and metastasis. Renal cell carcinoma (RCC) is known to be a well-vascularized tumour. The aim of this study was to evaluate the expression of VEGF mRNA and receptor flt-1 mRNA (VEGF R1) in a clinical material of RCCs compared with clinicopathological variables and serum VEGF levels. Total RNA was extracted from snap-frozen tumour tissue obtained from 61 patients. Expression of mRNA for VEGF121, VEGF165 and flt-1 were analysed using quantitative RT-PCR. Relative VEGF mRNA levels, corrected for corresponding cyclophilin value, were related to stage, grade, RCC type and survival time. Serum VEGF165 protein was analysed using a quantitative ELISA. Papillary RCC had significantly lower VEGF121 and flt-1 mRNA levels compared with conventional RCC (p=0.001). VEGF121 mRNA levels were significantly lower in locally advanced tumours in relation to tumours limited to the kidney and those with metastatic disease (p=0.047 and p=0.036). This statistical difference disappeared when only conventional RCCs were evaluated. No association was found between VEGF mRNA levels and nuclear grade. Patients with lower VEGF121 mRNA levels had significantly longer survival time compared with those with higher levels (when adjusted to stage, p=0.0097, log rank test). There was an inverse relation between VEGF165 mRNA and serum VEGF165 levels. The trend to lower VEGF121 mRNA levels in locally advanced RCC indicate that angiogenic activity and degradation might be up-regulated in tumours with a high ability to invade. The association with tumour progression shows that VEGF is a promising angiogenic factor especially important in conventional RCCs. VEGF expression might possibly be of help to identify RCCs susceptible for anti-angiogenic therapies.

  • 126.
    Ljungberg, Börje
    et al.
    Umeå universitet.
    Sundqvist, Pernilla
    Fovaeus, Magnus
    Holmstrom, Benny
    Elfving, Peter
    Local recurrence after nephron-sparing therapy in Sweden, a register based study2019Ingår i: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813, Vol. 53, s. 27-28Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    Background: In the Swedish Kidney Cancer Registry 99% of all patients nationwide are reported. The aim of this study is to present results of occurrence of recurrences in the treated kidney after nephron sparing treatments in patients with T1aN0M0 renal cell carcinoma (RCC) and their overall survival.

    Material: Since 2005 around 14.000 patients have been included prospectively in the National Swedish Kidney Cancer Register. Among those patients there were 5013 out of 5311 patients (94%) without metastatic disease that had a follow-up checkup 5 years after diagnosis. Among the 5013 patients, 39 had unclear recurrence data and were excluded from the analysis. Statistical analysis was done by SPSS 24. SCANDINAVIAN JOURNAL OF UROLOGY 27

    Results: In total, 1015 (19.9%) had recurrent disease during 5 years follow-up. During the time of diagnosis (2005 -2012,) 1077 patients were treated with nephron sparing treatment: 947 with partial nephrectomy (PN), 114 with radiofrequency ablation (RF) and 16 with other treatments. Among pT1a patients 16 of 712 treated with PN (1.7%) had a local recurrence compared with 13 of 105, (12.3%) RF patients. PN Patients had significantly better overall survival than RF patients. However RF patients were significantly older than PN (67.7 vs 60.6 years, p< 0.0001). Also tumor size was larger in PN (27.3 VS 24.4 MM, P< 0.001) as well as longer follow-up-time 8.1 versus 7.1 years. All PNs had a verified histology while only 97 out of 114 tumors treated with RF had a verified histology (85%).

    Conclusion: Conclusions. In this population-based study, 19.9% with M0 disease recurred within 5 years. Patients with T1a tumors treated with RF had significantly more frequently local recurrence than PN patients. Furthermore, patients with RF treatment had a significantly shorter overall survival but were older. In contrast, patients treated with PN had larger tumors, had longer follow-up time and were all histology proven. The significance of these observations might be important.

  • 127.
    Ljungberg, Börje
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Thurm, Mascha
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Anestesiologi och intensivvård.
    Kröger Dahlin, Britt-Inger
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap.
    Winsö, Ola
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Anestesiologi och intensivvård.
    A randomized controlled study of spinal analgesia show improved surgical outcome after open nephrectomy for renal cell carcinoma as compared with epidural analgesia2017Ingår i: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813, Vol. 51, s. 47-47Artikel i tidskrift (Övrigt vetenskapligt)
  • 128. Lund, Lars
    et al.
    Nisen, Harry
    Jarvinen, Petrus
    Fovaeus, Magnus
    Gudmundson, Eirikur
    Kromann-Andersen, Bjarne
    Ljungberg, Börje
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Nilsen, Frode
    Sundqvist, Pernilla
    Clark, Peter
    Beisland, Christian
    Use of venous-thrombotic-embolic (vte) prophylaxis in patients undergoing surgery for renal tumors in Nordic countries (the Norenca-II study)2017Ingår i: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813, Vol. 51, s. 48-48Artikel i tidskrift (Övrigt vetenskapligt)
  • 129. Lund, Lars
    et al.
    Nisen, Harry
    Jarvinen, Petrus
    Fovaeus, Magnus
    Gudmundson, Eirikur
    Kromann-Andersen, Bjarne
    Ljungberg, Börje
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Nilsen, Frode
    Sundqvist, Pernilla
    Clark, Peter E.
    Beisland, Christian
    Use of venous-thrombotic-embolic prophylaxis in patients undergoing surgery for renal tumors: a questionnaire survey in the Nordic countries (The NORENCA-2 study)2018Ingår i: Open Access Journal of Urology, ISSN 2253-2447, E-ISSN 1179-1551, Vol. 10, s. 181-187Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To examine the variation in venous thromboembolism prophylactic treatment (VTEP) among renal cancer patients undergoing surgery.

    Materials and methods: An Internet-based questionnaire on renal tumor management before and after surgery was mailed to all Nordic departments of urology. The questions focused on the use of VTEP and were subdivided into different surgical modalities.

    Results: Questionnaires were mailed to 91 institutions (response rate 53%). None of the centers used VTEP before surgery, unless the patient had a vena caval tumor thrombus. Overall, the VTEP utilized during hospitalization for patients undergoing renal surgery included early mobilization (45%), compression stockings (52%) and low-molecular-weight heparin (89%). In patients undergoing open radical Nx, 80% of institutions used VTEP during their hospitalization (23% compression stockings and 94% low-molecular-weight heparin). After leaving the hospital, the proportion and type of VTEP received varied considerably across institutions. The most common interval, used in 60% of the institutions, was for a period of 4 weeks. The restriction to the Nordic countries was a limitation and, therefore, may not reflect the practice patterns elsewhere. It is a survey study and, therefore, cannot measure the behaviors of those institutions that did not participate.

    Conclusion: We found variation in the type and duration of VTEP use for each type of local intervention for renal cancer. These widely disparate variations in care strongly argue for the establishment of national and international guidelines regarding VTEP in renal surgery.

  • 130.
    Lundberg, Erik
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Hagberg, Oskar
    Jahnson, Staffan
    Ljungberg, Börje
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Association between occurrence of urinary bladder cancer and treatment with statin medication2019Ingår i: Turkish Journal of Urology, ISSN 2149-3235, Vol. 45, nr 2, s. 97-102Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The incidence of urinary bladder cancer (UBC) has increased in Sweden despite decreased smoking, indicating that other factors might be associated. The increased use of statin medication for elevated blood lipids might be one such influencing factor. The aim of the present study was to assess whether statins are afflicted with an increased incidence of UBC.

    Material and methods: Data from the Swedish National Register of Urinary Bladder Cancer, National Population Register, and Swedish Prescribed Drug Register were extracted. There were 22,936 patients with new diagnosed UBC between 2005 and 2014. Statin prescription was defined as any medication prescribed with the Anatomical Therapeutic Classification code C10A. For each patient, 10 control individuals were matched by age, gender, and living area, comprising 229,326 individuals. The Cochran-Mantel-Haenszel test was used to evaluate the hazards ratios.

    Results: Statins were more frequently used in patients with UBC (33.8%) than in controls (29.8%, p<0.0001). The use of statins was afflicted with a 23% increased odds ratio (OR) for UBC (OR 1.23 (1.19-1.27), p<0.001). Subgroup analyses showed that an increased OR was found in non-muscle invasive UBC only. There was a tendency that OR was stronger for men and for younger patients. Limitations include its retrospective register-based design and potential risk of bias of confounding factors, such as smoking and body mass index.

    Conclusion: This nationwide register study suggests an association between the occurrence of UBC and patients using statins. The association was found in patients with non-muscle invasive disease only. Confounding factors, such as smoking, cannot be overruled.

  • 131. Lundstam, S.
    et al.
    Gudmundsson, E.
    Hellberg, H.
    Erikson, S.
    Ljungberg, Börje
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap.
    Impact of tumour size on metastases and locally advanced growth in renal cell carcinoma up to 7 cm2012Ingår i: BJU International, ISSN 1464-4096, E-ISSN 1464-410X, Vol. 109, s. 7-7Artikel i tidskrift (Övrigt vetenskapligt)
  • 132. Machiela, Mitchell J.
    et al.
    Hofmann, Jonathan N.
    Carreras-Torres, Robert
    Brown, Kevin M.
    Johansson, Mattias
    Wang, Zhaoming
    Foll, Matthieu
    Li, Peng
    Rothman, Nathaniel
    Savage, Sharon A.
    Gaborieau, Valerie
    Mckay, James D.
    Ye, Yuanqing
    Henrion, Marc
    Bruinsma, Fiona
    Jordan, Susan
    Severi, Gianluca
    Hveem, Kristian
    Vatten, Lars J.
    Fletcher, Tony
    Koppova, Kvetoslava
    Larsson, Susanna C.
    Wolk, Alicja
    Banks, Rosamonde E.
    Selby, Peter J.
    Easton, Douglas F.
    Pharoah, Paul
    Andreotti, Gabriella
    Freeman, Laura E. Beane
    Koutros, Stella
    Albanes, Demetrius
    Mannisto, Satu
    Weinstein, Stephanie
    Clark, Peter E.
    Edwards, Todd E.
    Lipworth, Loren
    Gapstur, Susan M.
    Stevens, Victoria L.
    Carol, Hallie
    Freedman, Matthew L.
    Pomerantz, Mark M.
    Cho, Eunyoung
    Kraft, Peter
    Preston, Mark A.
    Wilson, Kathryn M.
    Michael Gaziano, J.
    Sesso, Howard S.
    Black, Amanda
    Freedman, Neal D.
    Huang, Wen-Yi
    Anema, John G.
    Kahnoski, Richard J.
    Lane, Brian R.
    Noyes, Sabrina L.
    Petillo, David
    Colli, Leandro M.
    Sampson, Joshua N.
    Besse, Celine
    Blanche, Helene
    Boland, Anne
    Burdette, Laurie
    Prokhortchouk, Egor
    Skryabin, Konstantin G.
    Yeager, Meredith
    Mijuskovic, Mirjana
    Ognjanovic, Miodrag
    Foretova, Lenka
    Holcatova, Ivana
    Janout, Vladimir
    Mates, Dana
    Mukeriya, Anush
    Rascu, Stefan
    Zaridze, David
    Bencko, Vladimir
    Cybulski, Cezary
    Fabianova, Eleonora
    Jinga, Viorel
    Lissowska, Jolanta
    Lubinski, Jan
    Navratilova, Marie
    Rudnai, Peter
    Szeszenia-Dabrowska, Neonila
    Benhamou, Simone
    Cancel-Tassin, Geraldine
    Cussenot, Olivier
    Bueno-de-Mesquita, H. Bas
    Canzian, Federico
    Duell, Eric J.
    Ljungberg, Börje
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Sitaram, Raviprakash T.
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Peters, Ulrike
    White, Emily
    Anderson, Garnet L.
    Johnson, Lisa
    Luo, Juhua
    Buring, Julie
    Lee, I-Min
    Chow, Wong-Ho
    Moore, Lee E.
    Wood, Christopher
    Eisen, Timothy
    Larkin, James
    Choueiri, Toni K.
    Lathrop, G. Mark
    Teh, Bin Tean
    Deleuze, Jean-Francois
    Wu, Xifeng
    Houlstonmmm, Richard S.
    Brennan, Paul
    Chanock, Stephen J.
    Scelo, Ghislaine
    Purdue, Mark P.
    Genetic Variants Related to Longer Telomere Length are Associated with Increased Risk of Renal Cell Carcinoma2017Ingår i: European Urology, ISSN 0302-2838, E-ISSN 1873-7560, Vol. 72, nr 5, s. 747-754Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Relative telomere length in peripheral blood leukocytes has been evaluated as a potential biomarker for renal cell carcinoma (RCC) risk in several studies, with conflicting findings.

    Objective: We performed an analysis of genetic variants associated with leukocyte telomere length to assess the relationship between telomere length and RCC risk using Mendelian randomization, an approach unaffected by biases from temporal variability and reverse causation that might have affected earlier investigations.

    Design, setting, and participants: Genotypes from nine telomere length-associated variants for 10 784 cases and 20 406 cancer-free controls from six genome-wide association studies (GWAS) of RCC were aggregated into a weighted genetic risk score (GRS) predictive of leukocyte telomere length.

    Outcome measurements and statistical analysis: Odds ratios (ORs) relating the GRS and RCC risk were computed in individual GWAS datasets and combined by meta-analysis.

    Results and limitations: Longer genetically inferred telomere length was associated with an increased risk of RCC (OR = 2.07 per predicted kilobase increase, 95% confidence interval [CI]: = 1.70-2.53, p < 0.0001). As a sensitivity analysis, we excluded two telomere length variants in linkage disequilibrium (R-2 > 0.5) with GWAS-identified RCC risk variants (rs10936599 and rs9420907) from the telomere length GRS; despite this exclusion, a statistically significant association between the GRS and RCC risk persisted (OR = 1.73, 95% CI = 1.36-2.21, p < 0.0001). Exploratory analyses for individual histologic subtypes suggested comparable associations with the telomere length GRS for clear cell (N = 5573, OR = 1.93, 95% CI = 1.50-2.49, p < 0.0001), papillary (N = 573, OR = 1.96, 95% CI = 1.01-3.81, p = 0.046), and chromophobe RCC (N = 203, OR = 2.37, 95% CI = 0.78-7.17, p = 0.13).

    Conclusions: Our investigation adds to the growing body of evidence indicating some aspect of longer telomere length is important for RCC risk.

    Patient summary: Telomeres are segments of DNA at chromosome ends that maintain chromosomal stability. Our study investigated the relationship between genetic variants associated with telomere length and renal cell carcinoma risk. We found evidence suggesting individuals with inherited predisposition to longer telomere length are at increased risk of developing renal cell carcinoma.

  • 133. MacLennan, Sara J
    et al.
    MacLennan, Steven
    Bex, Axel
    Catto, James W F
    De Santis, Maria
    Glaser, Adam W
    Ljungberg, Börje
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    N'Dow, James
    Plass, Karin
    Trapero-Bertran, Marta
    Van Poppel, Hendrik
    Wright, Penny
    Giles, Rachel H
    Changing Current Practice in Urology: Improving Guideline Development and Implementation Through Stakeholder Engagement2017Ingår i: European Urology, ISSN 0302-2838, E-ISSN 1873-7560, Vol. 72, nr 2, s. 161-163Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Effective stakeholder integration for guideline development should improve outcomes and adherence to clinical practice guidelines.

  • 134. MacLennan, Steven
    et al.
    Imamura, Mari
    Lapitan, Marie C
    Omar, Muhammad Imran
    Lam, Thomas BL
    Hilvano-Cabungcal, Ana M
    Royle, Pam
    Stewart, Fiona
    MacLennan, Graeme
    MacLennan, Sara J
    Dahm, Philipp
    Canfield, Steven E
    McClinton, Sam
    Griffiths, TR Leyshon
    Ljungberg, Börje
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    N'Dow, James
    Systematic review of perioperative and quality-of-life outcomes following surgical management of localised renal cancer2012Ingår i: European Urology, ISSN 0302-2838, E-ISSN 1873-7560, Vol. 62, nr 6, s. 1097-1117Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Context: For the treatment of localised renal cell carcinoma (RCC), uncertainties remain over the perioperative and quality-of-life (QoL) outcomes for the many different surgical techniques and approaches of nephrectomy. Controversy also remains on whether newer minimally invasive nephron-sparing interventions offer better QoL and perioperative outcomes, and whether adrenalectomy and lymphadenectomy should be performed simultaneously with nephrectomy. These non-oncological outcomes are important because they may have a considerable impact on localised RCC treatment decision making.

    Objective: To review systematically all the relevant published literature comparing perioperative and QoL outcomes of surgical management of localised RCC (T1-2N0M0).

    Evidence acquisition: Relevant databases including Medline, Embase, and the Cochrane Library were searched up to January 2012. Randomised controlled trials (RCTs) or quasi-randomised controlled trials, prospective observational studies with controls, retrospective matched-pair studies, and comparative studies from well-defined registries/databases were included. The outcome measures were QoL, analgesic requirement, length of hospital stay, time to normal activity level, surgical morbidity and complications, ischaemia time, renal function, blood loss, length of operation, need for blood transfusion, and perioperative mortality. The Cochrane risk of bias tool was used to assess RCTs, and an extended version was used to assess nonrandomised studies (NRSs). The quality of evidence was assessed using Grading of Recommendations, Assessment, Development, and Evaluation.

    Evidence synthesis: A total of 4580 abstracts and 380 full-text articles were assessed, and 29 studies met the inclusion criteria (7 RCTs and 22 NRSs). There were high risks of bias and low-quality evidence for studies meeting the inclusion criteria. There is good evidence indicating that partial nephrectomy results in better preservation of renal function and better QoL outcomes than radical nephrectomy regardless of technique or approach. Regarding radical nephrectomy, the laparoscopic approach has better perioperative outcomes than the open approach, and there is no evidence of a difference between the transperitoneal and retroperitoneal approaches. Alternatives to standard laparoscopic radical nephrectomy (LRN) such as hand-assisted, robot-assisted, or single-port techniques appear to have similar perioperative outcomes. There is no good evidence to suggest that minimally invasive procedures such as cryotherapy or radiofrequency ablation have superior perioperative or QoL outcomes to nephrectomy. Regarding concomitant lymphadenectomy during nephrectomy, there were low event rates for complications, and no definitive difference was observed. There was no evidence to base statements about concomitant ipsilateral adrenalectomy during nephrectomy.

    Conclusions: Partial nephrectomy results in significantly better preservation of renal function over radical nephrectomy. For tumours where partial nephrectomy is not technically feasible, there is no evidence that alternative procedures or techniques are better than LRN in terms of perioperative or QoL outcomes. In making treatment decisions, perioperative and QoL outcomes should be considered in conjunction with oncological outcomes. Overall, there was a paucity of data regarding QoL outcomes, and when reported, both QoL and perioperative outcomes were inconsistently defined, measured, or reported. The current evidence base has major limitations due to studies of low methodological quality marked by high risks of bias.

    (C) 2012 European Association of Urology. Published by Elsevier B. V. All rights reserved.

  • 135. MacLennan, Steven
    et al.
    Lam, Thomas
    Imamura, Mari
    Dahm, Philipp
    Canfield, Steven
    Ljungberg, Börje
    Urology Unit, University of Aberdeen, Aberdeen, United Kingdom.
    N'Dow, James
    Re: comparative effectiveness for survival and renal function of partial and radical nephrectomy for localized renal tumors: a systematic review and meta-analysis2013Ingår i: Journal of Urology, ISSN 0022-5347, E-ISSN 1527-3792, Vol. 189, nr 3, s. 1166-1167Artikel i tidskrift (Övrigt vetenskapligt)
  • 136.
    Mallikarjuna, Pramod
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    Aripaka, Karthik
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    Tumkur Sitaram, Raviprakash
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap.
    Ljungberg, Börje
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Landström, Maréne
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    Expression and association of HIF-3α with hypoxic and TGF-β signalling components in renal cell carcinomaManuskript (preprint) (Övrigt vetenskapligt)
  • 137.
    Mallikarjuna, Pramod
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    Tumkur Sitaram, Raviprakash
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    Aripaka, Karthik
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    Ljungberg, Börje
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Landström, Maréne
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    Interactions between TGF-β type I receptor and hypoxia-inducible factor-alpha mediates a synergistic crosstalk leading to poor prognosis for patients with clear cell renal cell carcinoma2019Ingår i: Cell Cycle, ISSN 1538-4101, E-ISSN 1551-4005, Vol. 18, nr 17, s. 2141-2156Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    To investigate the significance of expression of HIF-1 alpha, HIF-2 alpha, and SNAIL1 proteins; and TGF-beta signaling pathway proteins in ccRCC, their relation with clinicopathological parameters and patient's survival were examined. We also investigated potential crosstalk between HIF-alpha and TGF-beta signaling pathway, including the TGF-beta type 1 receptor (ALK5-FL) and the intracellular domain of ALK5 (ALK5-ICD). Tissue samples from 154 ccRCC patients and comparable adjacent kidney cortex samples from 38 patients were analyzed for HIF-1 alpha/2 alpha, TGF-beta signaling components, and SNAIL1 proteins by immunoblot. Protein expression of HIF-1 alpha and HIF-2 alpha were significantly higher, while SNAIL1 had similar expression levels in ccRCC compared with the kidney cortex. HIF-2 alpha associated with poor cancer-specific survival, while HIF-1 alpha and SNAIL1 did not associate with survival. Moreover, HIF-2 alpha positively correlated with ALK5-ICD, pSMAD2/3, and PAI-1; HIF-1 alpha positively correlated with pSMAD2/3; SNAIL1 positively correlated with ALK5-FL, ALK5-ICD, pSMAD2/3, PAI-1, and HIF-2 alpha. Intriguingly, in vitro experiments performed under normoxic conditions revealed that ALK5 interacts with HIF-1 alpha and HIF-2 alpha, and promotes their expression and the expression of their target genes GLUT1 and CA9, in a VHL dependent manner. We found that ALK5 induces expression of HIF-1 alpha and HIF-2 alpha, through its kinase activity. Under hypoxic conditions, HIF-alpha proteins correlated with the activated TGF-beta signaling pathway. In conclusion, we reveal that ALK5 plays a pivotal role in synergistic crosstalk between TGF-beta signaling and hypoxia pathway, and that the interaction between ALK5 and HIF-alpha contributes to tumor progression.

  • 138.
    Mallikarjuna, Pramod
    et al.
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    Tumkur Sitaram, Raviprakash
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi. Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Landström, Maréne
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    Ljungberg, Börje
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    VHL status regulates transforming growth factor-β signaling pathways in renal cell carcinoma2018Ingår i: OncoTarget, ISSN 1949-2553, E-ISSN 1949-2553, Vol. 9, nr 23, s. 16297-16310Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    To evaluate the role of pVHL in the regulation of TGF-β signaling pathways in clear cell renal cell carcinoma (ccRCC) as well as in non-ccRCC; the expression of pVHL, and the TGF-β pathway components and their association with clinicopathological parameters and patient’s survival were explored. Tissue samples from 143 ccRCC and 58 non-ccRCC patients were examined by immunoblot. ccRCC cell lines were utilized for mechanistic in-vitro studies. Expression levels of pVHL were significantly lower in ccRCC compared with non-ccRCC. Non-ccRCC and ccRCC pVHL-High expressed similar levels of pVHL. Expression of the TGF-β type I receptor (ALK5) and intra-cellular domain were significantly higher in ccRCC compared with non-ccRCC. In non-ccRCC, expressions of ALK5-FL, ALK5-ICD, pSMAD2/3, and PAI-1 had no association with clinicopathological parameters and survival. In ccRCC pVHL-Low, ALK5-FL, ALK5-ICD, pSMAD2/3, and PAI-1 were significantly related with tumor stage, size, and survival. In ccRCC pVHL-High, the expression of PAI-1 was associated with stage and survival. In-vitro studies revealed that pVHL interacted with ALK5 to downregulate its expression through K48-linked poly-ubiquitination and proteasomal degradation, thus negatively controlling TGF-β induced cancer cell invasiveness. The pVHL status controls the ALK5 and can thereby regulate the TGF-β pathway, aggressiveness of tumors, and survival of the ccRCC and non-ccRCC patients.

  • 139. Marconi, Lorenzo
    et al.
    Dabestani, Saeed
    Lam, Thomas B.
    Hofmann, Fabian
    Stewart, Fiona
    Norrie, John
    Bex, Axel
    Bensalah, Karim
    Canfield, Steven E.
    Hora, Milan
    Kuczyk, Markus A.
    Merseburger, Axel S.
    Mulders, Peter F. A.
    Powles, Thomas
    Staehler, Michael
    Ljungberg, Börje
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Volpe, Alessandro
    Systematic Review and Meta-analysis of Diagnostic Accuracy of Percutaneous Renal Tumour Biopsy2016Ingår i: European Urology, ISSN 0302-2838, E-ISSN 1873-7560, Vol. 69, nr 4, s. 660-673Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Context: The role of percutaneous renal tumour biopsy (RTB) remains controversial due to uncertainties regarding its diagnostic accuracy and safety.

    Objective: We performed a systematic review and meta-analysis to determine the safety and accuracy of percutaneous RTB for the diagnosis of malignancy, histologic tumour subtype, and grade.

    Evidence acquisition: Medline, Embase, and Cochrane Library were searched for studies providing data on diagnostic accuracy and complications of percutaneous core biopsy (CB) or fine-needle aspiration (FNA) of renal tumours. A meta-analysis was performed to obtain pooled estimates of sensitivity and specificity for diagnosis of malignancy. The Cohen kappa coefficient (κ) was estimated for the analysis of histotype/grade concordance between diagnosis on RTB and surgical specimen. Risk of bias assessment was performed (QUADAS-2).

    Evidence synthesis: A total of 57 studies recruiting 5228 patients were included. The overall median diagnostic rate of RTB was 92%. The sensitivity and specificity of diagnostic CBs and FNAs were 99.1% and 99.7%, and 93.2% and 89.8%, respectively. A good (κ = 0.683) and a fair (κ = 0.34) agreement were observed between histologic subtype and Fuhrman grade on RTB and surgical specimen, respectively. A very low rate of Clavien ≥2 complications was reported. Study limitations included selection and differential-verification bias.

    Conclusions: RTB is safe and has a high diagnostic yield in experienced centres. Both CB and FNA have good accuracy for the diagnosis of malignancy and histologic subtype, with better performance for CB. The accuracy for Fuhrman grade is fair. Overall, the quality of the evidence was moderate. Prospective cohort studies recruiting consecutive patients and using homogeneous reference standards are required.

    Patient summary: We systematically reviewed the literature to assess the safety and diagnostic performance of renal tumour biopsy (RTB). The results suggest that RTB has good accuracy in diagnosing renal cancer and its subtypes, and it appears to be safe. However, the quality of evidence was moderate, and better quality studies are required to provide a more definitive answer.

  • 140. Marconi, Lorenzo
    et al.
    de Bruijn, Roderick
    van Werkhoven, Erik
    Beisland, Christian
    Fife, Kate
    Heidenreich, Axel
    Kapoor, Anil
    Karam, Jose
    Kauffmann, Caroline
    Klatte, Tobias
    Ljungberg, Börje
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Matin, Surena
    Sjoberg, Daniel
    Staehler, Michael
    Stewart, Grant D.
    Tanguay, Simon
    Uzzo, Robert
    Welsh, Sarah
    Wood, Lori
    Wood, Chris
    Bex, Axel
    External validation of a predictive model of survival after cytoreductive nephrectomy for metastatic renal cell carcinoma2018Ingår i: World journal of urology, ISSN 0724-4983, E-ISSN 1433-8726, Vol. 36, nr 12, s. 1973-1980Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    IntroductionRecent trials have emphasized the importance of a precise patient selection for cytoreductive nephrectomy (CN). In 2013, a nomogram was developed for pre- and postoperative prediction of the probability of death (PoD) after CN in patients with metastatic renal cell carcinoma. To date, the single-institutional nomogram which included mostly patients from the cytokine era has not been externally validated. Our objective is to validate the predictive model in contemporary patients in the targeted therapy era.MethodsMulti-institutional European and North American data from patients who underwent CN between 2006 and 2013 were used for external validation. Variables evaluated included preoperative serum albumin and lactate dehydrogenase levels, intraoperative blood transfusions (yes/no) and postoperative pathologic stage (primary tumour and nodes). In addition, patient characteristics and MSKCC risk factors were collected. Using the original calibration indices and quantiles of the distribution of predictions, Kaplan-Meier estimates and calibration plots of observed versus predicted PoD were calculated. For the preoperative model a decision curve analysis (DCA) was performed.ResultsOf 1108 patients [median OS of 27months (95% CI 24.6-29.4)], 536 and 469 patients had full data for the validation of the pre- and postoperative models, respectively. The AUC for the pre- and postoperative model was 0.68 (95% CI 0.62-0.74) and 0.73 (95% CI 0.68-0.78), respectively. In the DCA the preoperative model performs well within threshold survival probabilities of 20-50%. Most important limitation was the retrospective collection of this external validation dataset.ConclusionsIn this external validation, the pre- and postoperative nomograms predicting PoD following CN were well calibrated. Although performance of the preoperative nomogram was lower than in the internal validation, it retains the ability to predict early death after CN.

  • 141. Marconi, Lorenzo
    et al.
    Lam, Thomas B.
    Bex, Axel
    Ljungberg, Börje
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Volpe, Alessandro
    Reply to E. Jason Abel Letter to the Editor re: Lorenzo Marconi, Saeed Dabestani, Thomas B. Lam, et al. Systematic Review and Meta-analysis of Diagnostic Accuracy of Percutaneous Renal Tumour Biopsy. Eur Urol 2016;69:660-732016Ingår i: European Urology, ISSN 0302-2838, E-ISSN 1873-7560, Vol. 69, nr 6, s. E119-E120Artikel i tidskrift (Refereegranskat)
  • 142. Marconi, Lorenzo
    et al.
    Lam, Thomas B.
    Bex, Axel
    Ljungberg, Börje
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Volpe, Alessandro
    Reply to Jae Heon Kim's Letter to the Editor re: Lorenzo Marconi, Saeed Dabestani, Thomas B. Lam, et al. Systematic Review and Meta-analysis of Diagnostic Accuracy of Percutaneous Renal Tumour Biopsy. Eur Urol 2016; 69: 660-732016Ingår i: European Urology, ISSN 0302-2838, E-ISSN 1873-7560, Vol. 70, nr 5, s. E141-E142Artikel i tidskrift (Refereegranskat)
  • 143. Martuszewska, Danuta
    et al.
    Ljungberg, Börje
    Umeå universitet, Medicinsk fakultet, Kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Johansson, Martin
    Landberg, Göran
    Oslakovic, Cecilia
    Dahlbäck, Björn
    Hafizi, Sassan
    Tensin3 is a negative regulator of cell migration and all four Tensin family members are downregulated in human kidney cancer.2009Ingår i: PloS one, ISSN 1932-6203, Vol. 4, nr 2, s. e4350-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: The Tensin family of intracellular proteins (Tensin1, -2, -3 and -4) are thought to act as links between the extracellular matrix and the cytoskeleton, and thereby mediate signaling for cell shape and motility. Dysregulation of Tensin expression has previously been implicated in human cancer. Here, we have for the first time evaluated the significance of all four Tensins in a study of human renal cell carcinoma (RCC), as well as probed the biological function of Tensin3. PRINCIPAL FINDINGS: Expression of Tensin2 and Tensin3 at mRNA and protein levels was largely absent in a panel of diverse human cancer cell lines. Quantitative RT-PCR analysis revealed mRNA expression of all four Tensin genes to be significantly downregulated in human kidney tumors (50-100% reduction versus normal kidney cortex; P<0.001). Furthermore, the mRNA expressions of Tensins mostly correlated positively with each other and negatively with tumor grade, but not tumor size. Immunohistochemical analysis revealed Tensin3 to be present in the cytoplasm of tubular epithelium in normal human kidney sections, whilst expression was weaker or absent in 41% of kidney tumors. A subset of tumor sections showed a preferential plasma membrane expression of Tensin3, which in clear cell RCC patients was correlated with longer survival. Stable expression of Tensin3 in HEK 293 cells markedly inhibited both cell migration and matrix invasion, a function independent of putative phosphatase activity in Tensin3. Conversely, siRNA knockdown of endogenous Tensin3 in human cancer cells significantly increased their migration. CONCLUSIONS: Our findings indicate that the Tensins may represent a novel group of metastasis suppressors in the kidney, the loss of which leads to greater tumor cell motility and consequent metastasis. Moreover, tumorigenesis in the human kidney may be facilitated by a general downregulation of Tensins. Therefore, anti-metastatic therapies may benefit from restoring or preserving Tensin expression in primary tumors.

  • 144. Merseburger, Axel S.
    et al.
    Ljungberg, Börje
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Bex, Axel
    Renal cell carcinoma2016Ingår i: World journal of urology, ISSN 0724-4983, E-ISSN 1433-8726, Vol. 34, nr 8, s. 1051-1052Artikel i tidskrift (Övrigt vetenskapligt)
  • 145. Merseburger, Axel S
    et al.
    Ljungberg, Börje
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Doehn, Christian
    Hot topics in kidney cancer 20102010Ingår i: World journal of urology, ISSN 0724-4983, E-ISSN 1433-8726, Vol. 28, nr 3, s. 245-246Artikel i tidskrift (Refereegranskat)
  • 146. Muller, David C.
    et al.
    Fanidi, Anouar
    Midttun, Oivind
    Steffen, Annika
    Dossus, Laure
    Boutron-Ruault, Marie-Christine
    Severi, Gianluca
    Kuehn, Tilman
    Katzke, Verena
    Alonso de la Torreon, Ramon
    Gonzalez, Carlos A.
    Sanchez, Maria-Jose
    Dorronsoro, Miren
    Santiuste, Carmen
    Barricarte, Aurelio
    Khaw, Kay-Tee
    Wareham, Nick
    Travis, Ruth C.
    Trichopoulou, Antonia
    Giotaki, Maria
    Trichopoulos, Dimitrios
    Palli, Domenico
    Krogh, Vittorio
    Tumino, Rosario
    Vineis, Paolo
    Panico, Salvatore
    Tjonneland, Anne
    Olsen, Anja
    Bueno-de-Mesquita, H. Bas
    Peeters, Petra H.
    Ljungberg, Börje
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Wennberg, Maria
    Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Näringsforskning.
    Weiderpass, Elisabete
    Murphy, Neil
    Riboli, Elio
    Ueland, Per Magne
    Boeing, Heiner
    Brennan, Paul
    Johansson, Mattias
    International Agency for Research on Cancer (IARC-WHO), Lyon, France.
    Circulating 25-Hydroxyvitamin D-3 in Relation to Renal Cell Carcinoma Incidence and Survival in the EPIC Cohort2014Ingår i: American Journal of Epidemiology, ISSN 0002-9262, E-ISSN 1476-6256, Vol. 180, nr 8, s. 810-820Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Normal renal function is essential for vitamin D metabolism, but it is unclear whether circulating vitamin D is associated with risk of renal cell carcinoma (RCC). We assessed whether 25-hydroxyvitamin D-3 (25(OH)D-3) was associated with risk of RCC and death after RCC diagnosis in the European Prospective Investigation into Cancer and Nutrition (EPIC). EPIC recruited 385,747 participants with blood samples between 1992 and 2000. The current study included 560 RCC cases, 557 individually matched controls, and 553 additional controls. Circulating 25(OH)D-3 was assessed by mass spectrometry. Conditional and unconditional logistic regression models were used to calculate odds ratios and 95% confidence intervals. Death after RCC diagnosis was assessed using Cox proportional hazards models and flexible parametric survival models. A doubling of 25(OH)D-3 was associated with 28% lower odds of RCC after adjustment for season of and age at blood collection, sex, and country of recruitment (odds ratio = 0.72, 95% confidence interval: 0.60, 0.86; P = 0.0004). This estimatewas attenuated somewhat after additional adjustment for smoking status at baseline, circulating cotinine, body mass index (weight (kg)/height (m)(2)), and alcohol intake (odds ratio = 0.82, 95% confidence interval: 0.68, 0.99; P = 0.038). There was also some indication that both low and high 25(OH)D-3 levels were associated with higher risk of death from any cause among RCC cases.

  • 147. Nisen, Harry
    et al.
    Järvinen, Petrus
    Fovaeus, Magnus
    Guðmundsson, Eirikur
    Kromann-Andersen, Bjarne
    Ljungberg, Börje
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Lund, Lars
    Nilsen, Frode
    Sundqvist, Pernilla
    Beisland, Christian
    Contemporary treatment of renal tumors: a questionnaire survey in the Nordic countries (the NORENCA-I study)2017Ingår i: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813, Vol. 51, nr 5, s. 360-366Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The five Nordic countries comprise 25 million people, and have similar treatment traditions and healthcare systems. To take advantage of these similarities, a collaborative group (Nordic Renal Cancer Group, NORENCA) was founded in 2015. Materials and methods: A questionnaire of 17 questions on renal tumor management and surgical education was designed and sent to 91 institutions performing renal tumor surgery in 2015. The response rate was 68% (62 hospitals), including 28 academic, 25 central and nine district hospitals. Hospital volume was defined as low (LVH: <20 operations), intermediate (IVH: 20-49 operations), high (HVH: 50-99) and very high (VHVH: 100). Descriptive statistics were performed. Results: Fifteen centers were LVH, 16 IVH, 21 HVH and 10 VHVH. Of all 3828 kidney tumor treatments, 55% were radical nephrectomies (RNs), 37% partial nephrectomies (PNs) and 8% thermoablations. For RN and PN, the percentages of open, laparoscopic and robotic approaches were 47%, 40%, 13% and 47%, 20%, 33%, respectively. The mean complication rate (Clavien-Dindo 3-5) was 4.9%, and 30day mortality (TDM) was 0.5%. The median length of hospital stay was 4days. Training with a simulator, black box or animal laboratory was possible in 48%, 74% and 21% of institutions, respectively. Conclusions: Despite some differences between countries, the data suggest an overall general common Nordic treatment attitude for renal tumors. Furthermore, the data demonstrate high adherence to international standards, with a high proportion of PN and acceptable rates for major complications and TDM.

  • 148.
    Norén, Niklas
    et al.
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för tillämpad fysik och elektronik. Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Centrum för medicinsk teknik och fysik (CMTF).
    Andersson, Britt
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för tillämpad fysik och elektronik. Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Centrum för medicinsk teknik och fysik (CMTF).
    Bergh, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap.
    Ljungberg, Börje
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap.
    Lindahl, Olof
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för tillämpad fysik och elektronik. Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Centrum för medicinsk teknik och fysik (CMTF).
    Spring-damper model for prostate tissue2005Ingår i: 13th Nordic-Baltic conference on biomedical engineering and medical physics, IFMBE , 2005, s. 281-282Konferensbidrag (Refereegranskat)
  • 149.
    Nyberg, Morgan
    et al.
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Centrum för medicinsk teknik och fysik (CMTF). Dept. of Engineering Sciences and Mathematics, Luleå University of Technology, Luleå, Sweden.
    Jalkanen, Ville
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för tillämpad fysik och elektronik. Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Centrum för medicinsk teknik och fysik (CMTF).
    Ramser, Kerstin
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Centrum för medicinsk teknik och fysik (CMTF). Dept. of Engineering Sciences and Mathematics, Luleå University of Technology, Luleå, Sweden.
    Ljungberg, Börje
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Bergh, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    Lindahl, Olof A.
    Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper, Radiofysik. Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Centrum för medicinsk teknik och fysik (CMTF). Dept. of Engineering Sciences and Mathematics, Luleå University of Technology, Luleå, Sweden.
    Dual-modality probe intended for prostate cancer detection combining Raman spectroscopy and tactile resonance technology—discrimination of normal human prostate tissues ex vivo2015Ingår i: Journal of Medical Engineering & Technology, ISSN 0309-1902, E-ISSN 1464-522X, Vol. 39, nr 3, s. 198-207Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Prostate cancer is the most common cancer for men in the western world. For the first time, a dual-modality probe, combining Raman spectroscopy and tactile resonance technology, has been used for assessment of fresh human prostate tissue. The study investigates the potential of the dual-modality probe by testing its ability to differentiate prostate tissue types ex vivo. Measurements on four prostates show that the tactile resonance modality was able to discriminate soft epithelial tissue and stiff stroma (p<0.05). The Raman spectra exhibited a strong fluorescent background at the current experimental settings. However, stroma could be discerned from epithelia by integrating the value of the spectral background. Combining both parameters by a stepwise analysis resulted in 100% sensitivity and 91% specificity. Although no cancer tissue was analysed, the results are promising for further development of the instrument and method for discriminating prostate tissues and cancer.

  • 150.
    Nyberg, Morgan
    et al.
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Centrum för medicinsk teknik och fysik (CMTF). Institutionen för teknikvetenskap och matematik, Luleå tekniksa universitet.
    Jalkanen, Ville
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Centrum för medicinsk teknik och fysik (CMTF). Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Institutionen för tillämpad fysik och elektronik.
    Ramser, Kerstin
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Centrum för medicinsk teknik och fysik (CMTF). Institutionen för teknikvetenskap och matematik, Luleå tekniska universitet.
    Ljungberg, Börje
    Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Urologi och andrologi.
    Bergh, Anders
    Umeå universitet, Medicinska fakulteten, Institutionen för medicinsk biovetenskap, Patologi.
    Lindahl, Olof A.
    Umeå universitet, Teknisk-naturvetenskapliga fakulteten, Centrum för medicinsk teknik och fysik (CMTF). Umeå universitet, Medicinska fakulteten, Institutionen för strålningsvetenskaper. Institutionen för teknikvetenskap och matematik, Luleå tekniksa universitet.
    First study on freshly operated prostate tissue using a combination of Raman spectroscopy and tactile resonance sensor technology2014Ingår i: Medicinteknikdagarna 2014: Göteborg, 14-16 oktober, 2014, 2014, s. 26-26Konferensbidrag (Refereegranskat)
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