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Bekku K, Kawada T, Yanagisawa T, Karakiewicz PI, Shariat SF. Role of lymphadenectomy during primary surgery for kidney cancer. Curr Opin Urol 2023; 33:294-301. [PMID: 37014778 PMCID: PMC10256307 DOI: 10.1097/mou.0000000000001095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
PURPOSE OF REVIEW Lymph node dissection (LND) during radical nephrectomy (RN) for renal cell carcinoma (RCC) is not considered as a standard. The emergence of robot-assisted surgery and effective immune checkpoint inhibitors (ICI) in recent years may change this and lymph node (LN) staging has become easier and has a clinical impact. In this review, we aimed to reconsider the role of LND today. RECENT FINDINGS Although the extent of LND has still not been well established, removal of more LN seems to provide better oncologic outcomes for a select group of patients with high-risk factors such as clinical T3-4. Adjuvant therapy using pembrolizumab has been shown to improve disease free survival if complete resection of metastatic lesions as well as the primary site is obtained in combination. Robot assisted RN for localized RCC has been widespread and the studies regarding LND for RCC has been recently appeared. SUMMARY The staging and surgical benefits and its extent of LND during RN for RCC remains unclear, but it is becoming increasingly important. Technologies that allow an easier LND and adjuvant ICI that improve survival in LN-positive patients are engaging the role of LND, a procedure that was needed, but almost never done, is now indicated sometimes. Now, the goal is to identify the clinical and molecular imaging tools that can help identify with sufficient accuracy who needs a LND and which LNs to remove in a targeted personalized approach.
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Affiliation(s)
- Kensuke Bekku
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Tatsushi Kawada
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Takafumi Yanagisawa
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna
- Department of Urology, The Jikei University School of Medicine, Tokyo, Japan
| | - Pierre I. Karakiewicz
- Cancer Prognostic and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Canada
| | - Shahrokh F. Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
- Division of Urology, Department of Special Surgery, The University of Jordan, Amman, Jordan
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
- Department of Urology, Weill Cornell Medical College, New York, New York, USA
- Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria
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2
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Fallara G, Larcher A, Rosiello G, Raggi D, Marandino L, Martini A, Basile G, Colandrea G, Cignoli D, Belladelli F, Re C, Musso G, Cei F, Bertini R, Briganti A, Salonia A, Montorsi F, Necchi A, Capitanio U. How to optimize the use of adjuvant pembrolizumab in renal cell carcinoma: which patients benefit the most? World J Urol 2022; 40:2667-2673. [PMID: 36125505 DOI: 10.1007/s00345-022-04153-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 09/07/2022] [Indexed: 10/14/2022] Open
Abstract
PURPOSE The KEYNOTE-564 trial showed improved disease-free survival (DFS) for patients with high-risk renal cell carcinoma (RCC) receiving adjuvant pembrolizumab as compared to placebo. However, if systematically administered to all high-risk patients, it might lead to the overtreatment in a non-negligible proportion of patient. Therefore, we aimed to determine the optimal candidate for adjuvant pembrolizumab. METHODS Within a prospectively maintained database we selected patients who fulfilled the inclusion criteria of the KEYNOTE-564. We compared baseline characteristics and oncologic outcomes in this cohort with those of the placebo arm of the KEYNOTE-564. Regression tree analyses was used to generate a risk stratification tool to predict 1-year DFS after surgery. RESULTS In the off-trial setting, patients had worse tumor characteristics then in the KEYNOTE-564 placebo arm, i.e. there were more pT4 (5.4 vs. 2.7%, p = 0.046) and pN1 (15 vs. 6.3%, p < 0.001) cases. Median DFS was 29 (95% CI 21-35) months as compared to value not reached in KEYNOTE-564 and 1-year DFS was 64.2% (95% CI 59.6-69.2) as compared to 76.2% (95% CI 72.2-79.7), respectively. Patients with pN1 were at the highest risk of 1-year recurrence (1-year DFS 28.6% [95% CI 20.2-40.3]); patients without LNI, but necrosis were at intermediate risk (1-year DFS 62.5% [95% CI 56.9-68.8]); those without LNI and necrosis were at the lowest risk (1-year DFS 83.8% [95% CI 79.1-88.9]). LVI substratification furtherly improved the accuracy in the prediction of early recurrence. CONCLUSIONS Patients potentially eligible for adjuvant pembrolizumab have worse characteristics and DFS in the off-trial setting as compared to the placebo arm of the KEYNOTE-564. Patients with either LNI or necrosis were at the highest risk of early-recurrence, which make them the ideal candidate to adjuvant pembrolizumab.
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Affiliation(s)
- Giuseppe Fallara
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy. .,University Vita-Salute San Raffaele, Milan, Italy.
| | - Alessandro Larcher
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Giuseppe Rosiello
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Daniele Raggi
- University Vita-Salute San Raffaele, Milan, Italy.,Division of Experimental Oncology/Unit of Oncology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Laura Marandino
- University Vita-Salute San Raffaele, Milan, Italy.,Division of Experimental Oncology/Unit of Oncology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Alberto Martini
- Department of Urology, La Croix du Sud Hospital, Toulouse, France.,Department of Urology, Institut Universitaire du Cancer Toulouse-Oncopôle, Toulouse, France
| | - Giuseppe Basile
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Gianmarco Colandrea
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Daniele Cignoli
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Federico Belladelli
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Chiara Re
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Giacomo Musso
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Francesco Cei
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Roberto Bertini
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Alberto Briganti
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Francesco Montorsi
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Andrea Necchi
- University Vita-Salute San Raffaele, Milan, Italy.,Division of Experimental Oncology/Unit of Oncology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Umberto Capitanio
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
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Potential benefit of lymph node dissection during radical nephrectomy for kidney cancer: A review and critical analysis of current literature. Asian J Urol 2022; 9:215-226. [PMID: 36035351 PMCID: PMC9399553 DOI: 10.1016/j.ajur.2022.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 02/20/2022] [Accepted: 03/22/2022] [Indexed: 11/21/2022] Open
Abstract
Objective The role of lymph node dissection (LND) is still controversial in patients with renal cell carcinoma undergoing surgery. We aimed to provide a comprehensive review of the literature about the effect of LND on survival, prognosis, surgical outcomes, as well as patient selection and available LND templates. Methods Recent literature (from January 2011 to December 2021) was assessed through PubMed and MEDLINE databases. A narrative review of most relevant articles was provided. Results The frequencies in which LNDs are being carried out are decreasing due to an increase in minimally invasive and nephron sparing surgery. Moreover, randomized clinical trials and meta-analyses failed to show any survival advantage of LND versus no LND. However, retrospective studies suggest a survival benefit of LND in high-risk patients (bulky tumors, T3-4 stage, and cN1 patients). Moreover, extended LND might provide important staging information, which could be of interest for adjuvant treatment planning. Conclusion No level 1 evidence of any survival advantage deriving from LND is currently available in literature. Thus, the role of LND is limited to staging purposes. However, low grade evidence suggests a possible role of LND in high-risk patients. Randomized clinical trials are warranted to corroborate these findings.
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Yanagisawa T, Mori K, Katayama S, Mostafaei H, Quhal F, Laukhtina E, Rajwa P, Motlagh RS, Aydh A, König F, Grossmann NC, Pradere B, Miki J, Schmidinger M, Egawa S, Shariat SF. Hematological prognosticators in metastatic renal cell cancer treated with immune checkpoint inhibitors: a meta-analysis. Immunotherapy 2022; 14:709-725. [DOI: 10.2217/imt-2021-0207] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Aim: We aimed to assess the prognostic value of pretreatment hematological biomarkers in patients with metastatic renal cell carcinoma (mRCC) treated with immune checkpoint inhibitors (ICIs). Methods: PubMed, Web of Science and Scopus databases were searched for articles according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Results: Fifteen studies comprising 1530 patients were eligible for meta-analysis. High levels of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), C-reactive protein and lactate dehydrogenase were significantly associated with worse progression-free survival. High NLR and PLR were significantly associated with worse overall survival. Conclusion: High pretreatment NLR and PLR appear to be hematological prognostic factors of progression and overall mortality in mRCC patients treated with ICIs. These findings might help in the design of correlative biomarker studies to guide the clinical decision-making in the immune checkpoint inhibitor era.
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Affiliation(s)
- Takafumi Yanagisawa
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria
- Department of Urology, The Jikei University School of Medicine, Tokyo105-8461, Japan
| | - Keiichiro Mori
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria
- Department of Urology, The Jikei University School of Medicine, Tokyo105-8461, Japan
| | - Satoshi Katayama
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry & Pharmaceutical Sciences, Okayama, 700-8558, Japan
| | - Hadi Mostafaei
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria
- Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, 5166, Iran
| | - Fahad Quhal
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria
- Department of Urology, King Fahad Specialist Hospital, Dammam, 32253, Saudi Arabia
| | - Ekaterina Laukhtina
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria
- Institute for Urology & Reproductive Health, Sechenov University, Moscow, 119991, Russia
| | - Pawel Rajwa
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria
- Department of Urology, Medical University of Silesia, Zabrze, 41-808, Poland
| | - Reza S Motlagh
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria
- Men's Health & Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran , Iran
| | - Abdulmajeed Aydh
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria
- Department of Urology, King Faisal Medical City, Abha, 614312, Saudi Arabia
| | - Frederik König
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria
- Department of Urology, University Medical Centre Hamburg-Eppendorf, Hamburg, 20251, Germany
| | - Nico C Grossmann
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria
- Department of Urology, University Hospital Zurich, Zurich, 8091, Switzerland
- Department of Urology, Luzerner Kantonsspital, Lucerne, 6004, Switzerland
| | - Benjamin Pradere
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria
| | - Jun Miki
- Department of Urology, The Jikei University School of Medicine, Tokyo105-8461, Japan
| | - Manuela Schmidinger
- Department of Medicine I & Comprehensive Cancer Center, Clinical Division of Oncology, Medical University of Vienna, Vienna, 1090, Austria
| | - Shin Egawa
- Department of Urology, The Jikei University School of Medicine, Tokyo105-8461, Japan
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria
- Institute for Urology & Reproductive Health, Sechenov University, Moscow, 119991, Russia
- Division of Urology, Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, 19328, Jordan
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
- Department of Urology, Second Faculty of Medicine, Charles University, Prague, 11638, Czech Republic
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5
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Fallara G, Bandini M, Larcher A, Pederzoli F, Karakiewicz P, Tian Z, Briganti A, Necchi A, Salonia A, Bertini R, Montorsi F, Bex A, Capitanio U. High-risk Surgically Resected Renal Cell Carcinoma: Is There a Role for Adjuvant VEGF-TKI Inhibitors? Curr Probl Cancer 2021; 45:100759. [PMID: 34130863 DOI: 10.1016/j.currproblcancer.2021.100759] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 05/02/2021] [Accepted: 05/07/2021] [Indexed: 12/30/2022]
Abstract
The indications for adjuvant vascular endothelial growth factor-tyrosine kinase inhibitor (VEGF-TKI) agents after curative intent nephrectomy for renal cell carcinoma are still a matter of debate. The ASSURE, PROTECT and ATLAS trials have failed to meet their primary end-points. Conversely, S-TRAC has shown a disease free survival (DFS) benefit. To date, meta-analyses have repeatedly proved the absence of a clinical benefit, in term of DFS and overall survival (OS). Nevertheless, the results of the SORCE trial have been recently released and might add valuable information. We pooled the results of all five reported trials testing for any potential DFS and OS benefits associated with VEGF-TKI use. Interestingly, for pooled DFS we found a marginal positive hazard ratio (HR) of 0.92 (95% confidence interval [CI] 0.85-1.00; P-value = 0.049) in favor of adjuvant VEGF-TKI agents. This benefit was more pronounced for DFS in the sub-groups of only high-risk patients (HR: 0.89, 95% CI 0.80-0.99; P-value = 0.026), but less pronounced in clear-cell only subgroup (HR 0.92, 95% CI: 0.85-1.00; P-value = 0.044). Overall survival benefit was instead not reached. However, pooled relative risk for high-grade (grade ≥3 according to CTCAE classification) adverse events was irremediably high, 2.56 (95% CI: 2.15-3.04; P-value < 0.001). Given the marginal benefit in terms of DFS and the drawback of high-grade adverse events, even after the SORCE trial publication, adjuvant VEGF-TKIs therapy cannot be considered in the whole group of patients with non-metastatic high-risk renal cell carcinoma after surgery.
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Affiliation(s)
- Giuseppe Fallara
- Urological Research Institute (URI), Unit of Urology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy.
| | - Marco Bandini
- Urological Research Institute (URI), Unit of Urology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Alessandro Larcher
- Urological Research Institute (URI), Unit of Urology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Filippo Pederzoli
- Urological Research Institute (URI), Unit of Urology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Pierre Karakiewicz
- Centre de recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM) and Institut du cancer de Montréal, Montréal, Québec, Canada
| | - Zhe Tian
- Centre de recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM) and Institut du cancer de Montréal, Montréal, Québec, Canada
| | - Alberto Briganti
- Urological Research Institute (URI), Unit of Urology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Andrea Necchi
- Department of Oncology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Andrea Salonia
- Urological Research Institute (URI), Unit of Urology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Roberto Bertini
- Urological Research Institute (URI), Unit of Urology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Francesco Montorsi
- Urological Research Institute (URI), Unit of Urology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Axel Bex
- Division of Surgery and Interventional Science ,The Royal Free London NHS Foundation Trust and UCL, London, UK; Department of Urology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Umberto Capitanio
- Urological Research Institute (URI), Unit of Urology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
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6
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Xia M, Yang H, Wang Y, Yin K, Bian X, Chen J, Shuang W. Development and Validation of a Nomogram Predicting the Prognosis of Renal Cell Carcinoma After Nephrectomy. Cancer Manag Res 2020; 12:4461-4473. [PMID: 32606940 PMCID: PMC7295215 DOI: 10.2147/cmar.s250371] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 05/26/2020] [Indexed: 12/22/2022] Open
Abstract
Objective To develop and validate a nomogram for predicting the overall survival (OS) of renal cell carcinoma (RCC) patients after nephrectomy. Materials and Methods In total, 488 patients with RCC who underwent nephrectomy at the Urology Department of the First Hospital of Shanxi Medical University between January 2013 and December 2018 were randomly divided into a development cohort (n = 344) and a validation cohort (n = 144). The development cohort was used to build a prediction model, and the validation cohort was used for validation. Single-factor and multifactor analyses were carried out with R software, and the nomogram, calibration chart, ROC curve and C index were constructed. Results The median follow-up time of the development and validation cohorts was 34 months. The total 3-year and 5-year survival rates of the development cohort were 93.3% and 91.6%, respectively; those of the validation cohort were 92.4% and 91.0%, respectively. Cox univariate analysis of the development cohort showed that age, type 2 diabetes mellitus (T2DM), smoking history, type of surgery, T stage, N stage, M stage and Fuhrman nuclear grade were prognostic factors for OS in RCC patients undergoing nephrectomy. Cox multivariate analysis showed that T2DM, smoking history and T stage were independent prognostic factors for OS in RCC patients undergoing nephrectomy (P < 0.05). According to the univariate and multivariate analyses, a nomogram was constructed. In the development cohort, the C index of predicted OS was 0.875 (95% CI, 0.820-0.930). The calibration curve of the 3-year and 5-year survival rates showed that the predicted value of the nomogram was consistent with the actual observed value. The area under the 3-year and 5-year survival ROC curves was 0.861 and 0.901, respectively. In the validation cohort, the C index was 0.880 (95% CI, 0.778-0.982). The calibration curve of the 3-year and 5-year survival rates showed that the predicted value of the nomogram was consistent with the actual observed value. The area under the 3-year and 5-year survival ROC curves was 0.813 and 0.799, respectively. Conclusion We developed and verified a new and accurate nomogram with available clinicopathological data that can effectively predict the OS of RCC patients after nephrectomy.
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Affiliation(s)
- Mancheng Xia
- First Clinical Medical College, Shanxi Medical University, Taiyuan, People's Republic of China
| | - Haosen Yang
- Kidney Transplantation Center, Shanxi Second People's Hospital, Taiyuan, People's Republic of China
| | - Yusheng Wang
- First Clinical Medical College, Shanxi Medical University, Taiyuan, People's Republic of China
| | - Keqiang Yin
- First Clinical Medical College, Shanxi Medical University, Taiyuan, People's Republic of China
| | - Xiaodong Bian
- First Clinical Medical College, Shanxi Medical University, Taiyuan, People's Republic of China
| | - Jiawei Chen
- First Clinical Medical College, Shanxi Medical University, Taiyuan, People's Republic of China
| | - Weibing Shuang
- Department of Urology, The First Hospital of Shanxi Medical University, Taiyuan, People's Republic of China
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7
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Marchioni M, Berardinelli F, Zhang C, Simone G, Uzzo RG, Capitanio U, Minervini A, Lau C, Kaouk J, Langenstroer P, Amparore D, de Luyk N, Porter J, Gallucci M, Kutikov A, Larcher A, Mari A, Kilday P, Rha KH, Quarto G, Perdonà S, White W, Eun DD, Derweesh I, Mottrie A, Anele UA, Jacobsohn K, Porpiglia F, Challacombe B, Sundaram CP, Autorino R, Yang B, Schips L. Effect of Obesity and Overweight Status on Complications and Survival After Minimally Invasive Kidney Surgery in Patients with Clinical T2-4 Renal Masses. J Endourol 2020; 34:289-297. [DOI: 10.1089/end.2019.0604] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- Michele Marchioni
- Department of Medical, Oral and Biotechnological Sciences, Urology Unit, SS Annunziata Hospital, “G.D'Annunzio” University of Chieti, Chieti, Italy
| | | | - Chao Zhang
- Department of Urology, Changhai Hospital, Shanghai, China
| | - Giuseppe Simone
- Department of Urology, Regina Elena National Cancer Institute, Rome, Italy
| | - Robert G. Uzzo
- Division of Urology, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Umberto Capitanio
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Andrea Minervini
- Department of Urology, University of Florence, Careggi Hospital, Florence, Italy
| | - Clayton Lau
- Division of Urology, City of Hope Medical Center, Duarte, California
| | - Jihad Kaouk
- Glickman Urology and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
| | - Peter Langenstroer
- Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Daniele Amparore
- Department of Urology, University of Turin-San Luigi Gonzaga Hospital, Turin, Italy
| | | | | | - Michele Gallucci
- Department of Urology, Regina Elena National Cancer Institute, Rome, Italy
| | - Alexander Kutikov
- Division of Urology, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Alessandro Larcher
- Unit of Urology, Division of Oncology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Andrea Mari
- Department of Urology, University of Florence, Careggi Hospital, Florence, Italy
| | - Patrick Kilday
- Division of Urology, City of Hope Medical Center, Duarte, California
| | - Koon Ho Rha
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Giuseppe Quarto
- Uro-Gynecological Department, Fondazione “G. Pascale” IRCCS, Naples, Italy
| | - Sisto Perdonà
- Uro-Gynecological Department, Fondazione “G. Pascale” IRCCS, Naples, Italy
| | - Wesley White
- Department of Urology, University of Tennessee Medical Center, Knoxville, Tennessee
| | - Daniel D. Eun
- Department of Urology, Temple University School of Medicine, Philadelphia, Pennsylvania
| | - Ithaar Derweesh
- Department of Urology, UC San Diego Health System, La Jolla, California
| | - Alexandre Mottrie
- ORSI Academy, Melle, Belgium
- Department of Urology, OLV Hospital, Aalst, Belgium
| | | | - Ken Jacobsohn
- Department of Urology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Francesco Porpiglia
- Department of Urology, University of Turin-San Luigi Gonzaga Hospital, Turin, Italy
| | | | - Chandru P. Sundaram
- Department of Urology, Indiana University School of Medicine, Indianapolis, Indiana
| | | | - Bo Yang
- Department of Urology, Changhai Hospital, Shanghai, China
| | - Luigi Schips
- Department of Medical, Oral and Biotechnological Sciences, Urology Unit, SS Annunziata Hospital, “G.D'Annunzio” University of Chieti, Chieti, Italy
- Department of Urology, ASL 02 Lanciano Vasto Chieti, Chieti, Italy
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8
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A Plea for Optimizing Selection in Current Adjuvant Immunotherapy Trials for High-risk Nonmetastatic Renal Cell Carcinoma According to Expected Cancer-specific Mortality. Clin Genitourin Cancer 2019; 18:314-321.e1. [PMID: 32482565 DOI: 10.1016/j.clgc.2019.11.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 11/17/2019] [Accepted: 11/27/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND Tyrosine kinase inhibitor-based adjuvant therapy showed no survival benefits for patients with high-risk nonmetastatic renal cell carcinoma (nmRCC). Five randomized immune-oncology checkpoint inhibitor trials are ongoing. We assessed the effect of stage, grade, and histologic type on cancer-specific mortality (CSM) in candidates for 1 of the 4 North American ongoing immune-oncology checkpoint inhibitor trials of high-risk nmRCC. PATIENTS AND METHODS From the Surveillance, Epidemiology, and End Results database (2001-2015), we identified patients who had undergone surgery for nmRCC and had met the inclusion criteria for the PROSPER RCC (nivolumab in treating patients with localized kidney cancer undergoing nephrectomy), CheckMate 914 (a study comparing the combination of nivolumab and ipilimumab versus placebo in participants with localized renal cell carcinoma), KEYNOTE-564 [safety and efficacy study of pembrolizumab (MK-3475) as monotherapy in the adjuvant treatment of renal cell carcinoma post nephrectomy], or IMmotion010 [a study of atezolizumab as adjuvant therapy in participants with renal cell carcinoma (RCC) at high risk of developing metastasis following nephrectomy] trials. Kaplan-Meier and multivariable Cox regression models were used to assess the 10-year CSM rates in the overall cohort according to stage, grade, and histologic characteristics, and in 4 generated random samples according to the eligible patients for each of the 4 trials. RESULTS Of 116,750 patients who had undergone surgery for nmRCC, 18,559 (15.9%) had fulfilled the inclusion criteria for 1 of the 4 trials. The greatest proportion of higher stage and grade combinations and sarcomatoid histologic features would have qualified for IMmotion010, followed by KEYNOTE-564, CheckMate 914, and PROSPER RCC. Multivariable Cox regression models demonstrated the most unfavorable prognosis for stage N1 grade 3/4 (hazard ratio [HR], 11.5; P < .001), stage T4N0 grade 3/4 (HR, 9.8; P < .001), and sarcomatoid histologic features (HR, 5.5; P < .001). Among the 4 random samples, the difference in the qualifying criteria resulted in the greatest versus progressively lower CSM rates in the IMmotion010, KEYNOTE-564, CheckMate 914, and PROSPER RCC trials, respectively (P < .001). CONCLUSIONS Our findings indicate that participation in adjuvant immunotherapy trials should be predominantly encouraged for patients with high-grade stage T3, T4, and N1 and patients with any stage with sarcomatoid pathologic features.
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Buti S, Karakiewicz PI, Bersanelli M, Capitanio U, Tian Z, Cortellini A, Taguchi S, Briganti A, Montorsi F, Leonardi F, Bandini M. Validation of the GRade, Age, Nodes and Tumor (GRANT) score within the Surveillance Epidemiology and End Results (SEER) database: A new tool to predict survival in surgically treated renal cell carcinoma patients. Sci Rep 2019; 9:13218. [PMID: 31519981 PMCID: PMC6744465 DOI: 10.1038/s41598-019-49250-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 08/20/2019] [Indexed: 01/31/2023] Open
Abstract
The purpose of the present study was to validate the new GRade, Age, Nodes and Tumor (GRANT) score for renal cell carcinoma (RCC) prognostication within a large population of patients. Within the Surveillance, Epidemiology, and End Results database, we identified patients with either clear-cell or papillary RCC, who underwent nephrectomy between 2001 and 2015. Harrell’s C-Index, calibration plot and decision curve analysis were used to validate the GRANT model using a five-risk group stratification (0 vs. 1 vs. 2 vs. 3 vs. 4 risk factors). The primary endpoint was overall survival (OS) at 60 months. The analyses were repeated according to the histologic subgroup. The overall population included 73217 cases; 60900 with clear-cell RCC and 12317 with papillary histology, respectively. According to a five-risk group stratification, 23985 patients (32.8%) had no risk factor (0), 35019 (47.8%) had only one risk factor (1), 13275 (18.1%) had risk score 2854 (1.2%) had 3 risk factors and 84 (0.1%) of cases had a GRANT score of 4, respectively. At 60 months, OS rates as determined by the GRANT score were respectively 94% (score 0) vs. 86% (score 1) vs. 76% (score 2) vs. 46% (score 3) vs. 16% (score 4). In both histologic subtypes, the GRANT score yielded good calibration and high net benefit. OS C-Index values were 0.677 and 0.650 for clear-cell and papillary RCC at 60 months after surgery, respectively. In conclusion, the GRANT score was validated with a five-risk group stratification in a huge population from the SEER database, offering a further demonstration of its reliability for prognostication in RCC.
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Affiliation(s)
- Sebastiano Buti
- Medical Oncology Unit, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Pierre I Karakiewicz
- Centre de recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM) and Institut du cancer de Montréal, Montréal, Québec, Canada
| | - Melissa Bersanelli
- Medical Oncology Unit, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy. .,Medicine and Surgery Department, University of Parma, Via Gramsci 14, 43126, Parma, Italy.
| | - Umberto Capitanio
- Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Zhe Tian
- Centre de recherche du Centre Hospitalier de l'Université de Montréal (CR-CHUM) and Institut du cancer de Montréal, Montréal, Québec, Canada
| | - Alessio Cortellini
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Satoru Taguchi
- Department of Urology, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Alberto Briganti
- Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Francesco Montorsi
- Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Francesco Leonardi
- Medical Oncology Unit, University Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Marco Bandini
- Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
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Capitanio U, Necchi A, Larcher A, De Cobelli F, Montorsi F. Adjuvant Therapy in Nonmetastatic High-risk Kidney Cancer: Importance of the Timing of Postnephrectomy Imaging and Treatment Delivery. Eur Urol Oncol 2019; 1:538-539. [PMID: 31158101 DOI: 10.1016/j.euo.2018.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 06/08/2018] [Indexed: 11/25/2022]
Affiliation(s)
- Umberto Capitanio
- Department of Urology, San Raffaele Scientific Institute, Milan, Italy; Division of Experimental Oncology, Unit of Urology; Urological Research Institute, IRCCS San Raffaele Hospital, Milan, Italy.
| | - Andrea Necchi
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Alessandro Larcher
- Department of Urology, San Raffaele Scientific Institute, Milan, Italy; Division of Experimental Oncology, Unit of Urology; Urological Research Institute, IRCCS San Raffaele Hospital, Milan, Italy
| | | | - Francesco Montorsi
- Department of Urology, San Raffaele Scientific Institute, Milan, Italy; Division of Experimental Oncology, Unit of Urology; Urological Research Institute, IRCCS San Raffaele Hospital, Milan, Italy
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Eupatilin Inhibits Renal Cancer Growth by Downregulating MicroRNA-21 through the Activation of YAP1. BIOMED RESEARCH INTERNATIONAL 2019; 2019:5016483. [PMID: 31179326 PMCID: PMC6507163 DOI: 10.1155/2019/5016483] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 04/02/2019] [Indexed: 02/07/2023]
Abstract
Renal cell carcinoma (RCC) is the second most common human urinary tumor. Eupatilin is the main active ingredient of the traditional Chinese medicine Artemisia asiatica. The effect of Eupatilin on RCC and the underlying mechanism remain unknown. Here, we investigated the anticancer effects and mechanisms of Eupatilin in RCC in vivo and in vitro, laying an experimental foundation for the clinical application of Eupatilin in the treatment of RCC. The results showed that Eupatilin significantly inhibited 786-O cell viability and migration and promoted apoptosis. Eupatilin inhibited the expression of miR-21 in 786-O cells, and overexpression of miR-21 suppressed the effect of Eupatilin on viability, apoptosis, and migration in 786-O cells. Eupatilin inhibited the growth of renal tumors in nude mice by downregulating miR-21. YAP1, which was identified as a target of miR-21, showed significantly lower expression in RCC tissues than in healthy tissues. miR-21 significantly inhibited YAP1 protein expression in 786-O cells and tumor tissues isolated from nude mice, and YAP1 attenuated the effect of miR-21 on the viability, apoptosis, and migration of 786-O cells. In conclusion, Eupatilin inhibited the expression of miR-21, which mediated the proapoptotic and antimigratory effects of Eupatilin by suppressing YAP1 in renal cancer cells. These results suggested that Eupatilin could be a potent agent for the treatment of RCC.
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Kuusk T, De Bruijn R, Brouwer OR, De Jong J, Donswijk M, Hendricksen K, Horenblas S, Jóźwiak K, Prevoo W, Valdés Olmos RA, Van Der Poel HG, Van Rhijn BW, Wit EM, Bex A. Outcome of sentinel lymph node biopsy in patients with clinically non-metastatic renal cell carcinoma. Scand J Urol 2018; 52:411-418. [PMID: 30526184 DOI: 10.1080/21681805.2018.1531057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To investigate the rate of occult SN metastases, oncological outcome, and association of recurrence with the pattern of lymphatic tumour drainage in RCC. MATERIALS AND METHODS A pooled RCC sub-group analysis was conducted of secondary endpoints from a published feasibility and a phase II prospective single-arm SN study to investigate oncological outcome. Patients with cT1-3 (<10 cm) cN0M0 RCC of any sub-type were enrolled. After intratumoural injection of Tc99m nanocolloid, pre-operative imaging of SNs with SPECT/CT was followed by (partial) nephrectomy with SN and regional lymph node dissection using a γ-probe. The patients were followed with a risk-adapted surveillance programme. Endpoints of the studies were analysed using Cox proportional hazard models. RESULTS Sixty-six RCC patients were included. Two patients (3%, 95% CI =0.5-11%) had occult SN metastases and remained free of disease at 57 and 72 months. Ten patients (15%, 95% CI =7-26%) developed recurrences, and four (6%, 95% CI =2.3-14.5%) had died of disease at a median follow-up of 57 months (IQR =18-72 months). Occurrence of distant metachronous metastases were associated with tumour size (HR =1.39, p = 0.02), pT stage (HR =6.83, p < 0.01 for comparison T1 vs T3/4), Grade 3/4 (HR =8.38, p = 0.05 for comparison 1/2 vs 3/4) and interaortocaval sentinel lymph node location (HR =10.52, p = 0.03 for comparison yes vs no). CONCLUSIONS The rate of occult metastatic SN is low, but long disease-free survival (DFS) was observed in two patients with occult SN metastases. We hypothesize an interaortocaval lymphatic route in thoracic recurrences. Evaluation of the prognostic and therapeutic role of sentinel lymph node biopsy (SLNB) requires a clinical trial in high-risk RCC.
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Affiliation(s)
- Teele Kuusk
- a Department of Urology, The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Roderick De Bruijn
- a Department of Urology, The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Oscar R Brouwer
- b Department of Radiology, Interventional Molecular Imaging Laboratory and Nuclear Medicine Section , Leiden University Medical Center , Leiden , The Netherlands
| | - Jeroen De Jong
- c Department of Pathology, The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Maarten Donswijk
- d Department of Nuclear Medicine, The Netherlands Cancer Institute , A msterdam , The Netherlands
| | - Kees Hendricksen
- a Department of Urology, The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Simon Horenblas
- a Department of Urology, The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Katarzyna Jóźwiak
- e Department of Epidemiology and Biostatistics, The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Warner Prevoo
- f Department of Radiology, The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Renato A Valdés Olmos
- b Department of Radiology, Interventional Molecular Imaging Laboratory and Nuclear Medicine Section , Leiden University Medical Center , Leiden , The Netherlands
| | - Henk G Van Der Poel
- a Department of Urology, The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Bas Wg Van Rhijn
- a Department of Urology, The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Esther M Wit
- a Department of Urology, The Netherlands Cancer Institute , Amsterdam , The Netherlands
| | - Axel Bex
- a Department of Urology, The Netherlands Cancer Institute , Amsterdam , The Netherlands
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Borchert A, Rogers CG. Urologic Pathology: Key Parameters from a Urologist's Perspective. Surg Pathol Clin 2018; 11:893-901. [PMID: 30447847 DOI: 10.1016/j.path.2018.07.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Prostate cancer, bladder cancer, and kidney cancer represent the 3 most common urologic malignancies, and form a heterogenous group of disease processes, with a wide range of pathologic features. As a urologist, a strong understanding of the pathologic features of urologic malignancies is essential to prognosticate and counsel patients and to determine the most effective course of treatment. This review discusses the pathologic features of prostate, bladder, and kidney cancer, and examines how detailed pathologic reporting is critical to today's practicing urologist.
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Affiliation(s)
- Alex Borchert
- Vattikuti Urology Institute, Henry Ford Health System, 2799 W Grand Boulevard, Detroit, MI 48202, USA
| | - Craig G Rogers
- Vattikuti Urology Institute, Henry Ford Health System, 2799 W Grand Boulevard, Detroit, MI 48202, USA.
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Karakiewicz PI, Zaffuto E, Kapoor A, Basappa NS, Bjarnason GA, Blais N, Breau RH, Canil C, Drachenberg D, Hotte SJ, Jeldres C, Jewett MA, Kassouf W, Kollmannsberger C, Lavallée LT, Maloni R, Patenaude F, Pouliot F, Reaume MN, Sabbagh R, Shayegan B, So A, Soulières D, Tanguay S, Wood L, Bandini M. Kidney Cancer Research Network of Canada consensus statement on the role of adjuvant therapy after nephrectomy for high-risk, non-metastatic renal cell carcinoma: A comprehensive analysis of the literature and meta-analysis of randomized controlled trials. Can Urol Assoc J 2018; 12:173-180. [PMID: 29877179 PMCID: PMC5994982 DOI: 10.5489/cuaj.5187] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
INTRODUCTION The Kidney Cancer Research Network of Canada (KCRNC) collaborated to prepare this consensus statement about the use of target agents as adjuvant therapy in patients with non-metastatic renal cell carcinoma (nmRCC) after nephrectomy. We reviewed the published data and performed a meta-analysis of studies that focused on vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors (TKIs). METHODS A systematic literature search identified seven trials on adjuvant target therapy in nmRCC. Three trials, the ASSURE, S-TRAC, and PROTECT, focused on VEGFR TKIs and represented the focus of the study, including a meta-analysis combining their data on disease-free survival (DFS) and overall survival (OS). RESULTS The ASSURE trial showed no DFS or OS benefit of TKIs over placebo after one year of adjuvant sorafenib or sunitinib. In contrast, the S-TRAC trial showed improved DFS after one year of adjuvant sunitinib using central review process, but not using investigator review process. No OS benefit was recorded in either study. Recently, the PROTECT trial also showed no DFS or OS benefit when one year of adjuvant pazopanib was compared to placebo. Meta-analyses of the pooled DFS and OS estimates from all three trials resulted in DFS and OS hazard ratios of 0.87 (95% confidence interval [CI] 0.73-1.04) and 1.04 (95% CI 0.89-1.22), respectively. CONCLUSIONS Data from three available clinical trials of adjuvant VEGFR TKIs vs. placebo do not currently support the use of adjuvant TKI therapy as standard of care after nephrectomy for nmRCC. At this time, adjuvant TKI-based adjuvant therapy is not recommended for routine use after nephrectomy for high-risk nmRCC, but highly motivated patients may benefit from a discussion with their oncologist regarding the risks and benefits of adjuvant TKI.
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Affiliation(s)
- Pierre I. Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, QC, Canada
| | - Emanuele Zaffuto
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, QC, Canada
- Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, and Vita-Salute San Raffaele University, Milan, Italy
| | - Anil Kapoor
- Division of Urology, McMaster University, Hamilton, ON, Canada
| | - Naveen S. Basappa
- Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, AB, Canada
| | - Georg A. Bjarnason
- Division of Medical Oncology/Hematology, Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Normand Blais
- Division of Medical Oncology/Hematology, Centre Hospitalier de l’Université de Montréal, Montreal, QC, Canada
| | - Rodney H. Breau
- Clinical Epidemiology Program and Division of Urology, The Ottawa Hospital Research Institute and University of Ottawa Ottawa, ON, Canada
| | - Christina Canil
- Division of Medical Oncology, The Ottawa Hospital Cancer Centre and the University of Ottawa, Ottawa, ON, Canada
| | | | | | - Claudio Jeldres
- Centre hospitalier de l’Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Michael A.S. Jewett
- Departments of Surgery (Urology) and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Wassim Kassouf
- Division of Urology, McGill University, Montreal, QC, Canada
| | - Christian Kollmannsberger
- Division of Medical Oncology, British Columbia Cancer Agency-Vancouver Cancer Centre, and the University of British Columbia, Vancouver, BC, Canada
| | - Luke T. Lavallée
- Clinical Epidemiology Program and Division of Urology, The Ottawa Hospital Research Institute and University of Ottawa Ottawa, ON, Canada
| | - Ranjena Maloni
- Departments of Surgery (Urology) and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Francois Patenaude
- Department of Medicine, Hematology Service and Department of Oncology, Sir Mortimer B. Davis Jewish General Hospital and McGill University, Montreal, QC, Canada
| | - Frédéric Pouliot
- Division of Urology, Department of Surgery, Université Laval, Quebec, QC, Canada
| | - M. Neil Reaume
- Division of Medical Oncology, The Ottawa Hospital Cancer Centre and the University of Ottawa, Ottawa, ON, Canada
| | - Robert Sabbagh
- Centre hospitalier de l’Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Bobby Shayegan
- Division of Urology, McMaster University, Hamilton, ON, Canada
| | - Alan So
- Department of Urologic Sciences, The University of British Columbia, Vancouver, BC, Canada
| | - Denis Soulières
- Division of Medical Oncology/Hematology Centre Hospitalier de l’Université de Montréal, Montreal, QC, Canada
| | - Simon Tanguay
- Division of Urology, McGill University, Montreal, QC, Canada
| | - Lori Wood
- Department of Medicine and Urology, Dalhousie University, Halifax, NS, Canada
| | - Marco Bandini
- Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, QC, Canada
- Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, and Vita-Salute San Raffaele University, Milan, Italy
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Adjuvant Therapies in Nonmetastatic Renal-Cell Carcinoma: A Review of the Literature. Clin Genitourin Cancer 2018; 16:176-183. [DOI: 10.1016/j.clgc.2018.01.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Revised: 01/11/2018] [Accepted: 01/16/2018] [Indexed: 02/07/2023]
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