Læknablaðið : fylgirit - 01.06.2009, Blaðsíða 26

2 7 T H CONGR SCAND ASSOC UROL
F Y L G I R I T 6 1
all of our patients who have been treated with Zoledronic acid
during a five-year period (2003 - 2007).
Results: 53 patients, median age 69 years (range 56-81 years)
were treated with Zoledronic acid during that period. 51
patients had hormone refractory hormone metastatic prostate
cancer and 2 women with metastatic renal cell carcinoma. In
this 5 years period, 686 treatments with Zoledronic acid were
administrated. There was an average treatment time of 14
months (1-40 months).
Two cases of osteonecrosis of the jaw were registered. In the
first case, the patient developed spontaneous osteonecrosis,
whereas the second patient developed symptoms after a dental
procedure. We have not registered any new cases of this serious
complication since our department adopted an obligatory
maxillofacial exam to all patients thought to be treated with
Zoledronic acid.
Conclusion: Osteonecrosis of the jaw is a rare but a very serious
complication to treatment with biphosphonates. Our review
shows that this complication could be preventable.
50 Renal cell carcinoma diagnosed at autopsy in
lceland 1971-2005
A Jonsson1'4, S Hardarson2, V Petursdottir2, HB Palsdottir1'4, E Jonsson1'4,
GV Einarsson1, T Gudbjartsson3-4
Departments ofl) Urology, 2) Pathology and 3) Surgery, Landspitali University
Hospital, 4) Faculty ofMcdicine, University of Iceland, Reykjavik, Iceland
arjl@hi.is
Introduction: The incidence of renal cell carcinoma (RCC) is
rising in Iceland. This has been attributed to increased diagnostic
activity, such as abdominal imaging of unrelated diseases, rather
than changes in the behavior of the disease. The aim of this
study was to compare RCCs diagnosed in living patients and
at autopsy, but also to investigate the relationship between the
incidence of RCC and autopsy findings.
Material and Methods: RCC found incidentally in individuals
at autopsy was compared to patients diagnosed alive in
Iceland 1971-2005. Stage at diagnosis and tumor histology was
reviewed.
Results: 110 tumors were diagnosed at autopsy with a rate of
7.1/1000 autopsies. When compared to patients diagnosed alive
(n=913), the mean age at diagnosis was higher in the autopsy
group (74.4 vs. 65 yrs.) while male to female ratio and laterality
was similar. Tumors found at autopsy were smaller (3.7 vs. 7.3
cm), at lower stage (88% at stage I+Il vs. 42%) and at lower tumor
grade (85% at grade I+II vs. 56%). Furthermore the autopsy
detected tumors were more frequently of papillary cell type
(21% vs. 8%). A difference, although smaller, was present when
the autopsy detected cases were compared to only incidentally
detected RCCs in living patients. After correcting for declining
autospy rate (>50%), a slight trend for a reduced rate of autopsy
dectected RCC cases was seen during the last 10 years of the
period but the difference was not significant.
Conclusion: RCCs diagnosed at autopsy are at a lower stage
and tumor grade than in patients diagnosed alive. The autopsy-
rate is declining in Iceland, but after correcting for this decline,
the rate of RCC detected at autopsy is relatively unchanged.
The increase in incidence of RCC is therefore not explained by
findings at autopsy.
51 Pulmonary metastasis due to renal cell carcinoma
- How many could benefit from surgery?
SJ Oddsson1,4' S Hardarson3' V Petursdottir3' E Jonsson3'4- GV Einarsson3- T
Gudbjartsson1-4
Departments of 'Cardiothoracic Surgery, 2Pathology and 3Urology,
Landspitali University Hospital, 4Faculty of Medicine, University of
Iceland, Reykjavik Iceland
sacmiodds@hotmail.com
Objective: The incidence of renal cell carcinoma (RCC) is
high in Iceland and about 45 new cases are diagnosed every
year. Symptoms are often absent which results in over 30% of
patients presenting with metastases (most often pulmonary)
when diagnosed. The prognosis in such cases is usually dismal.
However, recent findings show that pulmonary metastatectomy
in a selected group of patients can improve survival and up
to 49%5-year disease free survival has been reported. The aim
of the study was to analyze the patients diagnosed with RCC
and pulmonary metastasis in Iceland to try to evaluate the how
many could possibly benefit from surgery according to recent
studies.
Material and methods: This is a retrospective study which
includes all patients that were diagnosed alive with RCC in
1971-2000 (n=701). Information was obtained from clinical
records, The National Cancer Registry and pathology reports.
Tumors were classified with the TNM staging system.
Results: 130 patients had pulmonary metastases, or 18.5%
of all patients diagnosed with RCC. In 54 cases, metastases
were only detected in the lungs, 8 of them being incidentally
diagnosed (14%). 38 (79%) had multiple pulmonary metastasis,
27 (56%) of them with metastases in both lungs. Ten patients
were diagnosed with a solitary metastasis and one of them
underwent metastasectomy.
Conclusion: Approximately one in five patients has a lung
metastasis when diagnosed with RCC. In 44% of cases the
metastasis is only in the lungs and 22% are single. Recent findings
suggest that some of these could benefit from metastatectomy
which has been rare in Iceland. It has to be kept in mind that the
study is retrospective (35 years) and the potential of such surgery
has only recently been described and has to be evaluated with
regard to recent progress in chemotherapy.
52 Cryoablation of small renal tumors- complications
and oncological outcome
U Moldrup', J Solvig2, TEB Johansen', 0 0straat'
’Dept. ofUrology, 2Dept. ofRadiology, Árhus University Hospital, Skejby,
Denmark
Ullmoeld@rm.dk
Aim: To evaluate the feasibility, complication rate and short-
26 LÆKNAblaðið 2009/95